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Analysis of Urine and Body Fluids > MIDTERM LEC: CHEMICAL EXAMINATION > Flashcards

MIDTERM LEC: CHEMICAL EXAMINATION Flashcards

1
Q
  • composed of several chemical-impregnated
  • absorbent pads attached to a plastic
  • color producing chemical reaction takes place when absorbent pad comes in contact with urine
  • reactions are interpreted by comparing the color produced on the pad with a chart supplied by the manufacturer
A

REAGENT STRIP

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2
Q

TYPES OF REAGENT STRIP

A
  1. MULTISTIX
  2. CHEMSTRIP
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3
Q

(Siemens Healthcare Diagnostics, Deerfield, IN)

A

MULTISTIX

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4
Q

(Roche Diagnostics, Indianapolis, IN)

A

CHEMSTRIP

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5
Q

PROCEDURE:

A
  1. Dip the reagent strip completely in the urine
  2. Remove excess urine from the strip by running the edge of the strip on the container when withdrawing it from the specimen
  3. Blot the strip horizontally on an absorbent medium pad
  4. Wait for the specified length of time for reactions to take place
  5. Compare the colored reactions against the
    manufacturer’s chart using a good light source
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6
Q

ERRORS CAUSED BY IMPROPER TECHNIQUE

A

✓ Formed elements such as RBC & WBC sink to the bottom of the specimen therefore it will be undetected in an unmixed specimen
✓ Allowing the strip to remain in the urine for an extended period may cause leaching of reagents from the pads
✓ Excess urine remaining on the strip after its removal from the specimen can produce over-run between chemicals on adjacent pads, producing distortion of the colors
✓ The timing of reactions should be followed; when precise timing can’t be achieved, the reactions
✓ should be read between 60 & 120 second
✓ A good light source is essential for accurate
interpretation of color reactions
✓ The strip must be held close to the color chart without actually being placed on the chart
✓ Reagent strips & color charts from different
manufacturers are not interchangeable
✓ Specimens that have been refrigerated must allow to return to room temperature prior to reagent strip testing

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7
Q

HANDLING & STORAGE OF REAGENT STRIP

A

✓ Reagent strips must be protected from deterioration caused by moisture, heat, light, & volatile chemicals
✓ Reagents are packed in opaque containers with a desiccant to protect them from light & moisture
✓ Strips are removed just prior to testing, & the bottle is tightly resealed immediately
✓ Bottle should not be open in the presence of volatile fumes
✓ Reagents should be stored at room temperature but never refrigerated
✓ All bottles are stamped with an expiration date that represents the functional life expectancy of the reagent strips therefore it must not be used past the expiration date
✓ Care must be taken not to touch the chemical pads when removing the strips
✓ A visual inspection should be done each time a strip is used to detect deterioration even though the strips may still be within the expiration date

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8
Q

QUALITY CONTROL OF REAGENTS STRIPS

A

✓ Reagent strips must be checked with both positive & negative controls a minimum of once every 24hrs, usually every start of the shift
✓ Testing is also performed when a new bottle is opened, questionable results are obtained, or when there is concern about the integrity of the reagent strip

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9
Q

AUTOMATED REAGENT STRIP READERS

A

PRINCIPLE: REFLECTANCE PHOTOMETRY

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10
Q

light reflection from the test pads decreases in
proportion to the intensity of color produced by the concentration of the test substance

A

PRINCIPLE: REFLECTANCE PHOTOMETRY

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11
Q

The most common sugar in the urine

A

GLUCOSE

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12
Q

should not be detected in normal urine

A

GLUCOSE

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13
Q

Small amounts when present are detected by any sensitive test

A

GLUCOSE

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14
Q

GLUCOSE RENAL THRESHOLD:

A

160-180 mg/dl

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15
Q

commonly used as a screening test for possible DM or to monitor control of blood glucose in diabetes

A

GLUCOSE

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16
Q

Other Sugars in Urine
* Identified by TLC:

A
  1. FRUCTOSE (Levulose)
  2. GALACTOSE
  3. LACTOSE (Glu+Gal)
  4. PENTOSE
  5. SUCROSE (NON-REDUCING SUGAR)
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17
Q

increase fruits, honey, syrup,
fructose intolerance

A

FRUCTOSE(Levulose)

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18
Q

increase in infants with galactosemia

A

GALACTOSE

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19
Q

increase during pregnancy, lactation, strict milk diet, lactose intolerance

A

LACTOSE (Glu+Gal)

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20
Q

– increase in benign essential pentosuria (Xylulose, Arabinose)

A

PENTOSE

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21
Q

increase in intestinal disorders, sucrose intolerance

A

SUCROSE (non-reducing sugar)

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22
Q

HYPERGLYCEMIA-ASSOCIATED

blood glucose:
urine glucose:

A

INCREASE; INCREASE

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23
Q

RENAL-ASSOCIATED

blood glucose:
urine glucose:

A

NORMAL; INCREASE

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24
Q

HYPERGLYCEMIA-ASSOCIATED CAUSES:

A
  • DM
  • PANCREATITIS
  • ACROMEGALY
  • CUSHING’S SYNDROME
  • HYPERTHYROIDISM
  • PHEOCHROMOCYTOMA
  • STRESS
  • GESTATIONAL DIABETES
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25
Q

RENAL-ASSOCIATED CAUSES:

A
  • FANCONI SYNDROME
  • ADVANCED RENAL DISEASE
  • OSTEOMALACIA
  • PREGNANCY
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26
Q

GLUCOSE REACTION TIME:

A

30 SECONDS

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27
Q

GLUCOSE PRINCIPLE:

A

DOUBLE SEQUENTIAL ENZYME
REACTION

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28
Q

REAGENTS FOR GLUCOSE
MULTISTIX:

A

Glucose oxidase and Peroxidase

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29
Q

REAGENTS FOR GLUCOSE
MULTISTIX
CHROMOGEN:

A

Potassium Iodide →
(𝑏𝑙𝑢𝑒 𝑡𝑜 𝑔𝑟𝑒𝑒𝑛 𝑡𝑜 𝑏𝑟𝑜𝑤𝑛)

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30
Q

REAGENTS FOR GLUCOSE
CHEMSTRIP:

A

Glucose oxidase and Peroxidase

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31
Q

REAGENTS FOR GLUCOSE
CHEMSTRIP
CHROMOGEN:

A

Tetramethylbenzidine →
(𝑦𝑒𝑙𝑙𝑜𝑤 𝑡𝑜 𝑔𝑟𝑒𝑒𝑛)

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32
Q

REAGENTSTRIP FOR GLUCOSE
FALSE-POSITIVE:

A

Contamination by oxidizing

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33
Q

REAGENTSTRIP FOR GLUCOSE
FALSE – NEGATIVE:

A

✓ high levels of ascorbic acid
✓ high levels of ketones
✓ high specific gravity
✓ low temperatures
✓ improperly preserved specimens

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34
Q

COPPERREDUCTION TEST (CLINITEST (TABLET)/BENEDICT’S TEST) PRINCIPLE:

A

Copper Reduction

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35
Q

ability of the glucose and other substances to
reduce copper sulfate to cuprous oxide in the presence of alkali and heat.

A

COPPERREDUCTION TEST (CLINITEST (TABLET)/BENEDICT’S TEST)

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36
Q

color change progressing from negative blue
through green, yellow, and orange/red occurs when reaction takes place

A

COPPERREDUCTION TEST (CLINITEST (TABLET)/BENEDICT’S TEST)

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37
Q
  • NOTE: Observe the reaction closely , because at high glucose level “ pass through” phenomenon may occur.
A

COPPERREDUCTION TEST (CLINITEST (TABLET)/BENEDICT’S TEST)

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38
Q

COPPERREDUCTION TEST (CLINITEST (TABLET)/BENEDICT’S TEST)
PREVENT PASS THROUGH :

A

use 2 gtts urine

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39
Q

FALSE-POSITIVE : Reducing agents

A
  • Clinitest tablet test follow the same principle with Benedict’s Test
  • The classic Benedict’s solution was developed in 1908 and contained copper sulfate, sodium carbonate, and sodium citrate buffer
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40
Q

GLUCOCE OXIDASE: 1+ POSITIVE
CLINETEST: ______
INTERPRETATION: ________

A

CLINETEST: negative
INTERPRETATION: small amount of glucose

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41
Q

GLUCOCE OXIDASE: NEGATIVE
CLINETEST: ______
INTERPRETATION: __

A

CLINETEST: positive
INTERPRETATION: non-glucose reducing substance possible interfering substances for reagent strip

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41
Q

GLUCOCE OXIDASE: 4+ POSITIVE
CLINETEST: ______
INTERPRETATION: __

A

CLINETEST: negative
INTERPRETATION: oxidizing agent interfere on reagent strip

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42
Q

DETECT: Conjugated Bilirubin(water soluble)

A

BILIRUBIN

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43
Q

provide an early indication of liver disease

A

BILIRUBIN

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44
Q

pigmented yellow compound from the breakdown of hemoglobin

A

BILIRUBIN

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45
Q

Amber urine (Tea Color)with yellow foam

A

BILIRUBIN

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46
Q

CLINICAL SIGNIFICANCE OF BILIRUBIN IN URINE:

A
  • Hepatitis
  • Cirrhosis
  • Other liver disease
  • Biliary obstruction(gallstones, carcinoma)
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47
Q

REAGENTSTRIPFORBILIRUBIN(30 SECONDS)
PRINCIPLE:

A

Based on the “Diazo Reaction” of Bilirubin

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48
Q

BILIRUBIN
MULTISTIX:

A

2,4- dichloroaniline diazonium salt

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49
Q

BILIRUBIN
CHEMSTRIP:

A

2,6- dichlorobenzene diazonium

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50
Q

BILIRUBIN
FALSE- POSITIVE:

A

✓ Highly pigmented urines
✓ Phenazopyridine
✓ Indican
✓ Metabolites of iodine

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51
Q

BILIRUBIN
FALSE-NEGATIVE:

A

✓ Specimen exposure to light
✓ High conc. of nitrite
✓ Ascorbic acid

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52
Q
  • More sensitive than reagent strip with less interference
  • (+) blue to purple color
    Contains:
    ✓ P- nitrobenzene-diazonium Ptoluenesulfonate
    ✓ SSA
    ✓ Sodium Carbonate
    ✓ Boric Acid
A

ICTOTEST (TABLET)

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52
Q

Result from increased fat metabolism due to inability to metabolize carbohydrates

A

KETONES

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53
Q

end product of rapid or excessive fatty acid breakdown when glucose is not used as source of energy

A

KETONE BODIES

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54
Q

KETONE BODIES:

A
  • Beta-hydroxybutyric acid(78%)
  • Acetoacetic acid(AAA)/Diacetic
    acid (20%)
    Acetone(2%)
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55
Q

major ketone but not detected in
reagent strip

A

Beta-hydroxybutyric acid(78%)

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56
Q

parent ketone

A

Acetoacetic acid(AAA)/Diacetic
acid (20%)

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57
Q

detected only when glycine is present

A

Acetone(2%)

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58
Q

CLINICAL SIGNIFICANCE OF KETONES IN URINE:

A
  • Type 1 DM
  • Insulin Dosage Monitoring
  • Starvation
  • Strenuous Exercise
  • Malabsorption
  • Vomiting
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59
Q

REAGENTSTRIP FOR KETONES(40 SECONDS)
PRINCIPLE:

A

Based on “NITROPRUSSIDE” reaction for ketones

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60
Q

KETONES REAGENT
CHEMSTRIP:

A

Sodium Nitroprusside(Sodium
Nitroferricyanide), Glycine

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61
Q

The ketone pad on the multi-reagent dip stick
detects mainly acetoacetic acid and acetone;
_________ is not detected.

A

ß-hydroxybutyrate

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62
Q

KETONES
FALSE-POSITIVE:

A

✓ Pthalein dyes
✓ Highly pigmented red urine
✓ Levodopa
✓ Medications containing free sulfhydryl groups

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63
Q

KETONES
FALSE- NEGATIVE:

A

✓ Improperly preserved specimens

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64
Q

CONTAINS:
✓ Sodium Nitroprusside
✓ Disodium Phosphate
✓ Lactose

A

ACETEST (TABLET)

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65
Q
  • Density of the solution compared with density of similar volume of distilled water at a similar temperature
  • Influenced by number and size of particles in a solution
A

SPECIFIC GRAVITY

66
Q

REAGENTSTRIP FOR SPECIFIC GRAVITY(45 SECONDS)
* PRINCIPLE:

A

Change in pKa (dissociation constant) of polyelectrolyte

66
Q

SPECIFIC GRAVITY CLINICAL SIGNIFICANCE:

A
  • Monitoring Patient hydration and dehydration
  • Loss of renal tubular concentrating ability
  • Diabetes Insipidus
  • Determination of unsatisfactory specimens
    due to low concentration
67
Q
  • the polyelectrolyte ionizes, releasing hydrogen ions in proportion to the number of ions in the solution.
  • reagent is sensitive to the no. ions in urine, indicator changes color in relation to ionic concentration
A

REAGENTSTRIP FOR SPECIFIC GRAVITY(45
SECONDS)
* PRINCIPLE: Change in pKa (dissociation constant) of polyelectrolyte

68
Q

SPECIFIC GRAVITY REAGENT
CHEMSTRIP:

A

Ethyleneglycoldiaminoethylethertetraacetic bromthymol blue

68
Q

SPECIFIC GRAVITY REAGENT
MULTISTIX:

A

Poly (methyl vinyl ether/ maleic
anhydride) bromthymol blue

69
Q

SPECIFIC GRAVITY
FALSE-POSITIVE:

A

High concentration of protein

70
Q

SPECIFIC GRAVITY
FALSE-NEGATIVE:

A

Highly alkaline urines (greater than 6.5)

71
Q

the most indicative of renal diseases

A

PROTEIN DETERMINATION

72
Q

associated with renal disorder

A

PROTEINURIA

73
Q

Urine contains very little protein:

A

100 mg/24 hrs or 10 mg/dl of urine

74
Q

These protein –are of low molecular weight:

A

50,000- 60,000 traversing the glomerulus

75
Q

major protein found in the urine

A

ALBUMIN

76
Q

normal urinary albumin content is ___

A

low

77
Q

Albumin presented to glomerulus is ___ filtered

A

not

78
Q

Filtered albumin is reabsorbed by the____

A

tubules

79
Q

ALBUMIN NORMAL VALUES:

A

< 10 mg/dL or 100
mg/24 hrs (Strasinger)
< 150 mg.24 hrs (Henry)

80
Q
  • produced by the renal tubular cells and protein from prostatic, seminal and vaginal secretions
  • mucoprotein found in the matrix of renal tubular casts.
A

TAMM-HORSFALL (UROMODULIN)

81
Q

Caused by conditions that affect the plasma prior to its reaching the kidney

A

PRE-RENAL PROTEINURIA(“before”)

82
Q

PRE-RENAL PROTEINURIA(“before”)
* Intravascular hemolysis =

A

hemoglobin

83
Q

PRE-RENAL PROTEINURIA(“before”)
* Muscle Injury =

A

myoglobin

84
Q

PRE-RENAL PROTEINURIA(“before”)
Severe infection and inflammation =

A

HIGH APRs

85
Q

proliferation of immunoglobulin-producing plasma cells (Bence-Jones Protein)

A

Multiple myeloma

86
Q

immunoglobulin light chains

A

Bence-Jones Protein

87
Q

Bence-Jones Protein
URINE:

A

precipitates at 40-60℃ (cloudy)
and dissolves at 100℃

88
Q

Bence-Jones Protein
TESTS:

A

Serum electrophoresis, immunofixation electrophoresis

89
Q

RENAL PROTEINURIA(“true renal disease”)
A. GLOMERULAR PROTEINURIA:

A
  1. DIABETIC NEPHROPHATHY
  2. ORTHOSTATIC/CADET/ POSTURAL PROTEINURIA
90
Q
  • Decreased glomerular filtration
  • May lead to renal failure
  • INDICATOR: MICROALBUMINURIA = proteinuria undetectable by routine
    reagent strip
A

DIABETIC NEPHROPHATHY

91
Q

Proteinuria when standing
due to increases pressure to renal
veins

A

ORTHOSTATIC/CADET/ POSTURAL
PROTEINURIA

92
Q
  • Test for microalbuminuria
  • A strip employing antibody-enzyme
    conjugate that binds the albumin
  • PRINCIPLE: enzyme immunoassay
  • REAGENTS:
  • Gold-labeled antibody
  • ß-galactosidase
  • Chlorophenol red galactoside
A

MICRAL TEST

92
Q

MICRAL TEST PRINCIPLE:

A

enzyme immunoassay

93
Q

MICRAL TEST SENSITIVITY:

A

0-10 mg/dL

94
Q
  • Normally filtered albumin can no longer be
    reabsorbed
    1. Fanconi syndrome
    2. Toxic agents/heavy metals
    3. Several viral infections
A

TUBULAR PROTEINURIA

94
Q

MICRAL TEST INTERFERENCE:

A

Dilute urine = False negative

95
Q
  • Increased protein in the urine caused by
    inflammation/infections that add protein in
    the urine after its formation
    1. Lower UTI/inflammation
    2. Injury / trauma
    3. Menstrual Contamination
    4. Prostatic fluid / spermatozoa
    5. Vaginal Secretion
A

POST-RENAL PROTEINURIA(“after”)

96
Q

REAGENT STRIP FOR PROTEIN(60 SECONDS)
PRINCIPLE:

A

Based on the protein error-of-indicator principle.

97
Q
  • At a constant pH, the development of any green color is due to the presence of protein.
  • The reaction is extremely sensitive to albumin (as it contains the most amino groups), but is much less sensitive to globulins.
A

REAGENT STRIP FOR PROTEIN(60 SECONDS)
PRINCIPLE: Based on the protein error-of-indicator principle.

98
Q

PROTEIN REAGENTS
MULTISTIX:

A

Tetrabromphenol blue

99
Q

PROTEIN REAGENTS
CHEMSTRIP:

A

Tetrachlorophenol
Tetrabromosulfonphthalein -(indicator used)

100
Q

PROTEIN FALSE-POSITIVE:

A

✓ Highly buffered alkaline urine
✓ Pigmented specimen
✓ Phenazopyridine
✓ Quarternary ammonium compound
(detergents)
✓ Antiseptics
✓ Chlorhexidine
✓ Loss of buffer from prolonged exposure
of the reagent strip to the specimen
✓ High specific gravity

101
Q

PROTEIN FALSE-NEGATIVE:

A

Proteins other than albumin,
microalbumin

102
Q

A cold precipitation test that reacts equally with all forms of proteins

A

SULFOSALICYLIC ACID (SSA) PRECIPITATION

103
Q

SULFOSALICYLIC ACID (SSA) PRECIPITATION
False positives:

A
  • Contrast media
  • Antibiotics in high concentration (penicillin, cephalosporin )
    -Uncentrifuged turbid urines can look positive.
  • SSA should always be performed on urine supernatant
104
Q

SULFOSALICYLIC ACID (SSA) PRECIPITATION
False negatives:

A
  • buffered alkaline urine
  • Dilute urine
  • Turbid urine - may mask a positive reaction.
105
Q
  • reabsorption of sodium and the tubular secretion of hydrogen and ammonium ions
  • excrete non-volatile acids produced by normal body metabolism
A

KIDNEYS

105
Q

regulate the acid-base balance
of the body

A

KIDNEYS & LUNGS

106
Q

Important in the identification of crystals and
determination of unsatisfactory specimens

A

pH

106
Q

NORMAL pH
random:

A

4.8-8.0

107
Q

NORMAL pH
1st morning:

A

5.0-6.0

108
Q

pH of 9.0

A

UNPRESERVED URINE

109
Q

CAUSES OF ACIDIC URINE:

A
  • diabetic mellitus
  • starvation
  • high protein diet
  • cranberry juice
  • emphysema, dehydrtion, diarrhea, presence of acid producing bacteria (E. coli), medications
110
Q

CAUSES OF ALKALINE URINE:

A
  • renal tubular acidosis
  • vegetarian diet
  • after meal
  • vomiting
  • old specime, hyperventilation, presence of urease-producing bacteria
111
Q

pH CLINICAL SIGNIFICANCE:

A
  • Respiratory or metabolic alkalosis
  • Defects in renal tubular secretion and reabsorption of
    acids and bases – renal tubular acidosis
  • Renal calculi formation and prevention
  • Treatment of urinary tract infections
  • Precipitation/ identification of crystals
  • Determination of unsatisfactory specimen
112
Q

If kept for any length of time fo pH , it should be _____

A

refrigerated

113
Q

An accurate measurement of pH is done on a_____

A

freshly voided specimen

113
Q

pH During sleep:

A

decreased pulmonary ventilation causes Respiratory acidosis-thus, a first waking urine is highly acidic.

114
Q

Urine pH is an important screening test for the diagnosis of_____

A

renal disease, respiratory disease,
and certain metabolic disorders

115
Q

If urine pH is to be useful, it is necessary to use pH information in comparison with other
diagnostic information.

A

TRUE

116
Q

REAGENT STRIP FOR Ph (60 SECONDS)
PRINCIPLE:

A

Based on the “DOUBLE INDICATOR SYSTEM”

117
Q

REAGENT STRIP FOR Ph (60 SECONDS)
REAGENTS:

A

Methyl red and Bromthymol Blue

118
Q

REAGENT STRIP FOR Ph (60 SECONDS)
INTERFERENCES:

A

Run-over from adjacent pads
Old specimens

119
Q

clear red urine

A

HEMOGLOBINURIA

120
Q

cloudy red urine

A

HEMATURIA

121
Q

clear red (reddish-brown) urine

A

MYOGLUBINURIA

122
Q

HEMATURIA SEEN IN:

A
  • glomerulonephritis
  • renal calculi, tumors
  • strenous exercise, trauma
  • MICROSCOPIC: intact RBC
123
Q

HEMOGLOBINURIA SEEN IN:

A
  • intravascular hemolysis
  • transfusion reactions
  • hemolytic anemia
  • severe burns
  • HEMOGLOBIN - product of RBC destruction, releasing hemoglobin
124
Q

MYOGLOBINURIA SEEN IN:

A
  • rhabdomyolysis
  • muscular injury, crush syndrome
  • extensive exertion
  • Heme portion of the myoglobin is toxic to the renal tubules
125
Q

REAGENTSTRIPFOR BLOOD(60 SECONDS)
PRINCIPLE:

A

“ Pseudoperoxidase activity of
Hemoglobin

126
Q

Based on the liberation of oxygen from peroxidelike activity of heme from free hemoglobin.

A

REAGENTSTRIPFOR BLOOD(60 SECONDS)
PRINCIPLE: “ Pseudoperoxidase activity of
Hemoglobin”

126
Q

REAGENTSTRIPFOR BLOOD(60 SECONDS)
PRINCIPLE: “ Pseudoperoxidase activity of
Hemoglobin” REAGENTS
CHEMSTRIP:

A

dimethyldihydroperoxyhexane and tetramethylbenzidine

127
Q

REAGENTSTRIPFOR BLOOD(60 SECONDS)
PRINCIPLE: “ Pseudoperoxidase activity of
Hemoglobin” REAGENTS
MULTISTIX:

A

Diisopropylbenzene dihydroperoxide and 3,3’,5,5’ – tetramethylbenzidine

128
Q

BLOOD
FALSE-POSITIVE:

A

✓ Strong oxidizing agents
✓ Bacterial peroxidases
✓ Menstrual contamination

129
Q

BLOOD
FALSE-NEGATIVE:

A

✓ High specific gravity/ crenated cells
✓ Formalin
✓ Captopril
✓ High concentration of nitrite
✓ Ascorbic acid greater than 25 mg/dL
✓ Unmixed specimens

130
Q
  • A bile pigment produced from bilirubin when
    bacteria act on it in the intestine.
  • It is a colorless substance.
  • It is oxidized to urobilin(stercobilin) responsible for the brown color of stool
A

UROBILINOGEN

131
Q

UROBILINOGEN NORMAL VALUE =

A

< 1 mg/dL or Ehrlich unit

132
Q

UROBILINOGEN SPECIMEN:

A

Afternoon urine (2-4pm)

133
Q

REAGENT STRIP FOR UROBILINOGEN (60SECONDS)
PRINCIPLE:

A

“Ehrlichs Reaction”

134
Q

REAGENT STRIP FOR UROBILINOGEN (60
SECONDS)
PRINCIPLE: “Ehrlichs Reaction” REAGENT
MULTISTIX:

A

p-diethylaminobenzaldehyde (PDAB or Ehrlich Reage

135
Q

REAGENT STRIP FOR UROBILINOGEN (60
SECONDS)
PRINCIPLE: “Ehrlichs Reaction” REAGENT
CHEMSTRIP:

A

4- methoxybenzene diazoniumtetrafluoroborate (specific for urobilinogen)

136
Q

UROBILINOGEN
FALSE-POSITIVE:

A

✓ porphobilinogen
✓ Indican
✓ p-aminosalicylic acid
✓ sulfonamides
✓ Methyldopa

137
Q

UROBILINOGEN
FALSE-NEGATIVE:

A

✓ Old specimens
✓ Preservation in formalin
✓ High conc. of nitrite

138
Q

✓ Differentiate urobilinogen, porphobilinogen and other Ehrlich-reactive compounds
✓ Uses extraction with organic solvents: Chloroform and Butanol

A

WATSON-SCHWARTS

139
Q

Rapid screening test for porphobilinogen (>2mg/dL)

A

HOESCH TEST(INVERSE EHRLICH REACTION)

140
Q

Rapid screening tests for UTI/Bacteria

A

NITRITE

141
Q

NITRITE SPECIMEN:

A

1st morning or 4-hour urine

142
Q

Most species of bacteria in the urine cause
nitrates, which are derived from dietary
metabolites, to be converted to nitrites

A

NITRITE

143
Q

A negative nitrite test does not necessarily mean that the urine is free of all bacteria, particularly if there are clinical symptoms, because some bacteria do not produce nitrites.

A

TRUE

144
Q

NITRITE CLINICAL SIGNIFICANCE:

A
  • CYSTITIS
  • PYELONEPHRITIS
  • Evaluation of antibiotic therapy
  • Monitoring of patients at high risk for UTI
  • Screening of urine culture specimens
145
Q

REAGENT STRIP FOR NITRITE(60 SECONDS)
PRINCIPLE:

A

Based on “ Greiss Reaction”

146
Q

REAGENT STRIP FOR NITRITE(60 SECONDS)
PRINCIPLE: Based on “ Greiss Reaction” REAGENT
MULTISTIX:

A

p-arsalinic acid, tetrahydrobenzo (h)- quinoline-3-ol

147
Q

REAGENT STRIP FOR NITRITE(60 SECONDS)
PRINCIPLE: Based on “ Greiss Reaction”
CHEMSTRIP:

A

Sulfanilamide, hydroxytetrahydro
benzoquinoline
* NITRITE

148
Q

NITRITE FALSE-POSITIVE:

A

✓ Improperly preserved
specimens
✓ Highly pigmented urine

149
Q

NITRITE FALSE-NEGATIVE:

A

✓ Nonreductase-containing bacteria
✓ Insufficient contact time of
bacteria and urinary nitrate
✓ Lack of urinary nitrate
✓ Large quantities of bacteria
converting nitrite to nitrogen
✓ Presence of antibiotics
✓ High concentration of ascorbic acid

150
Q
  • White cells in the urine usually indicate a urinary tract infection.
  • The leukocyte esterase (LE) test detects esterase, an enzyme released by white blood cells. Positive test results are clinically significant
  • The combination of the LE test with the urinary nitrite test -an excellent screen for predicting a urinary tract infection.
  • A urine sample that tests positive for both nitrate and leukocyte esterase should be cultured for pathogenic microorganisms
  • The urinary nitrite and LE tests- to screen patients at high-risk for urinary tract infections: pregnant women, school-age females, elderly patients, and persons with
    a history of urinary tract infections
A

LEUKOCYTE ESTERASE

151
Q

```

REAGENT STRIP FOR LEUKOCYTES (120 SECONDS)
PRINCIPLE:

A

Based on “Leukocyte Esterase”

152
Q

REAGENT STRIP FOR LEUKOCYTES (120
SECONDS)
PRINCIPLE: Based on “Leukocyte Esterase”
MULTISTIX:

A

Derivatized pyrrole amino acid ester, diazonium salt

153
Q

REAGENT STRIP FOR LEUKOCYTES (120
SECONDS)
PRINCIPLE: Based on “Leukocyte Esterase”
CHEMSTRIP:

A

Indoxylcarbonic acid ester, diazonium salt

154
Q

LEUKOCYTE ESTERASE
FALSE-POSITIVE:

A

✓ Strong oxidizing agents
✓ Formalin
✓ Highly pigmented urine
✓ Nitrofurantoin

155
Q

LEUKOCYTE ESTERASE
FALSE-NEGATIVE:

A

✓ High concentrations of protein
✓ Glucose
✓ Oxalic acid
✓ ascorbic acid
✓ gentamicin,
✓ Cephalosporins
✓ Tetracycline
✓ Inaccurate timing

Analysis of Urine and Body Fluids (5 decks)

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