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AUBF > Reagent Strip Reaction > Flashcards

Reagent Strip Reaction Flashcards

1
Q

What is the Multistix reagent for specific gravity?

A

Poly (methyl vinyl ether/ maleic anhydride) bromthymol blue

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2
Q

What is the Chemstrip reagent for specific gravity?

A

Ethylene glycol diaminoethyl ether tetraacetic acid bromthymol blue

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3
Q

What causes false positive interference in specific gravity?

A

High concentration of protein

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4
Q

What causes false negative interference in specific gravity?

A

Highly alkaline urine; pH >6.5

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5
Q

What should be added to correct specific gravity if pH >6.5?

A

Add 0.005

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6
Q

What are the reagents for strip reaction for pH?

A

Methyl red and bromthymol blue

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7
Q

What interferes with reagent strips for pH?

A

Runover from adjacent pads, old specimens

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8
Q

What correlates with pH on reagent strips?

A

Nitrite, Leukocytes, Microscopic examination

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9
Q

What is the test for microalbuminuria?

A

Micral test

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10
Q

What is the principle of the micral test for albuminuria?

A

Enzyme-immunoassay

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11
Q

What are the reagents for the micral test?

A

Gold-labeled antibody, B-galactosidase, chlorophenol red galactoside

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12
Q

What is the sensitivity of the micral test?

A

0-10 mg/dL

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13
Q

What causes false negative interference in micral and immunodip tests?

A

Dilute urine

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14
Q

What is the principle of the Immunodip test for microalbuminuria?

A

Immunochromographics

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15
Q

What is the sensitivity of the Immunodip test?

A

1.2-8.0 mg/dL

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16
Q

What are the reagents for the Immunodip test?

A

Antibody-coated blue latex particle

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17
Q

What is the principle of the albumin:creatinine ratio in Clintest/multistix pro?

A

Sensitive albumin tests related to creatinine concentration to correct for patient hydration

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18
Q

What are the reagents for albumin in albumin:creatinine ratio (Clintest/Multistix Pro)?

A

Diiodo-dihydroxydinitrophenyl tetrabromosulfonphthalein

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19
Q

What are the reagents for creatinine in albumin:creatinine ratio (Clintest/Multistix Pro)?

A

Copper sulfate, tetramethylbenzidine, diisopropylbenzene dihydroperoxidase

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20
Q

What is the sensitivity for albumin in albumin:creatinine ratio?

A

10-150 mg/L

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21
Q

What is the sensitivity for creatinine in albumin:creatinine ratio?

A

10-300 mg/dL (0.9-26.5 mmol/L)

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22
Q

What interferes with albumin:creatinine ratio tests?

A

Visibly bloody or abnormally colored urine; creatinine: cimetidine false positive

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23
Q

How does the protein reagent strip work?

A

By accepting hydrogen ions from the indicator

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24
Q

What is the reagent for protein in Multistix?

A

Tetrabromophenol blue (citrate buffer at pH 3.0)

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25
Q

What is the reagent for protein in Chemstrip?

A

Tetrachlorophenol tetrabromosulfonphthalein (citrate buffer at pH 3.0)

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26
Q

What causes false positive protein interference?

A

Highly buffered alkaline urine, pigmented specimens, phenazopyridine, detergents, antiseptics, prolonged strip exposure, high specific gravity

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27
Q

What causes false negative protein interference?

A

Proteins other than albumin, microalbuminuria

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28
Q

To what is the protein indicator most sensitive?

A

Albumin

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29
Q

What correlates with protein on reagent strips?

A

Blood, nitrite, leukocytes, microscopic examination

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30
Q

What is the cold precipitation test for all forms of protein?

A

Sulfosalicylic acid precipitation test (Exton’s test)

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31
Q

What is the reagent for SSA precipitation test?

A

Exton’s reagent (3% SSA + Sodium sulfate)

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32
Q

What is the procedure for the SSA precipitation test?

A

3 mL of 3% SSA + 3 mL centrifuged urine or 3 mL 7% SSA + 11 mL centrifuged urine (10 mins incubation)

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33
Q

What indicates a positive result in the SSA test?

A

Cloudiness

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34
Q

What is the SSA turbidity grading for trace levels?

A

Noticeable turbidity; cannot see circle at tube bottom (6-30 mg/dL - Strasinger)

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35
Q

What is the SSA turbidity grading for 1+?

A

Distinct turbidity, no granulation (30-100 mg/dL - Strasinger)

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36
Q

What is the SSA turbidity grading for 2+?

A

No granulation or flocculation (100-200 mg/dL - Strasinger)

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37
Q

What is the SSA turbidity grading for 3+?

A

Turbidity with granulation and flocculation (200-400 mg/dL - Strasinger)

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38
Q

What is the SSA turbidity grading for 4+?

A

Clumps of protein (>400 mg/dL - Strasinger)

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39
Q

What is the SSA turbidity range for Henry’s trace grading?

A

20 mg/dL

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40
Q

What is the SSA turbidity range for Henry’s 1+ grading?

A

50 mg/dL

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41
Q

What is the SSA turbidity range for Henry’s 2+ grading?

A

200 mg/dL

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42
Q

What is the SSA turbidity range for Henry’s 3+ grading?

A

500 mg/dL

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43
Q

What is the SSA turbidity range for Henry’s 4+ grading?

A

1.0 g/dL

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44
Q

What causes a strip positive but SSA negative result?

A

Highly buffered alkaline urine with no albumin present (false positive strip) or albumin present (false negative SSA)

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45
Q

What is the correction for strip positive and SSA negative results?

A

Acidify urine to pH 5.0 and retest

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46
Q

What causes a strip negative but SSA positive result?

A

Radiographic contrast media, drugs (tolbutamide, penicillins, cephalosporins, sulfonamides)

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47
Q

How to differentiate strip negative and SSA positive results?

A

Examine precipitate microscopically; drugs/dyes form crystals, protein forms amorphous precipitates

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48
Q

What can cause negative protein results despite significant proteinuria?

A

Excessively diluted urine

49
Q

What should be considered when evaluating urine protein?

A

Specific gravity, as trace protein in dilute specimens is more significant

50
Q

What enzymes are involved in the glucose reagent strip?

A

Glucose oxidase, Peroxidase

51
Q

What are the reagents for glucose in Multistix?

A

Glucose oxidase, peroxidase, potassium iodide

52
Q

What is the color range for glucose in Multistix?

A

Blue to green to brown

53
Q

What is the reagent for glucose in Chemstrip?

A

Glucose oxidase, peroxidase, tetramethylbenzidine

54
Q

What is the color range for glucose in Chemstrip?

A

Yellow to green

55
Q

What causes false positive glucose strip results?

A

Oxidizing agents, detergents

56
Q

What causes false negative glucose strip results?

A

High levels of ascorbic acid, ketones, high specific gravity, low temperature, improperly preserved specimen

57
Q

What was the first dip-and-read reagent strip developed in 1950?

A

Glucose strip by Miles Inc.

58
Q

What is the sensitivity of the glucose reagent strip?

A

100 mg/dL

59
Q

What are other chromogens used for glucose determination?

A

Aminopropylcarbazole (yellow to orange brown), o-toluidine (pink to purple)

60
Q

What is the correlation of glucose with other reagent strips?

A

Ketones, Proteins

61
Q

What is the principle of the ketones reagent strip?

A

Sodium nitroprusside reaction (Legal’s test)

62
Q

What are the reagents for ketones in the reagent strip?

A

Sodium nitroprusside/nitroferricyanide, Glycine (Chemstrip)

63
Q

What causes false positive results for ketones in reagent strips?

A

Phthalein dyes, pigmented red urine, levodopa, drugs with sulfhydryl groups

64
Q

What causes false negative results for ketones in reagent strips?

A

Improperly preserved specimens

65
Q

When is acetone detected in reagent strips?

A

When glycine is present

66
Q

What is the correlation of ketones with other tests?

A

Glucose

67
Q

What percentage of ketones is beta-hydroxybutyric acid?

A

0.78

68
Q

What percentage of ketones is acetoacetic acid?

A

0.2

69
Q

What percentage of ketones is acetone?

A

0.02

70
Q

What is the first ketone formed (parent ketone)?

A

Acetoacetic acid/diacetic acid

71
Q

What is the composition of the Acetest tablet?

A

Sodium nitroprusside, disodium phosphate, glycine, lactose

72
Q

What is the reagent for blood in Multistix?

A

Diisopropylbenzene dihydroperoxidase tetramethylbenzidine

73
Q

What is the reagent for blood in Chemstrip?

A

Dimethyldihydroperoxyhexane tetramethylbenzidine

74
Q

What causes false positive results for blood in reagent strips?

A

Strong oxidizing agents, bactericidal peroxidases, menstrual contamination

75
Q

What causes false negative results for blood in reagent strips?

A

High specific gravity, crenated cells, formalin, captopril, nitrite, ascorbic acid >25 mg/dL, unmixed specimen

76
Q

What does a uniform green color for blood in reagent strips indicate?

A

Hemoglobin/Myoglobin

77
Q

What does a speckled or spotted pattern in blood reagent strips indicate?

A

Hematuria (presence of RBCs)

78
Q

What does Chemstrip contain to eliminate ascorbic acid interference?

A

Iodate overlay

79
Q

What hemoglobin level produces a positive protein reagent strip reaction?

A

> 10 mg/dL

80
Q

What is the correlation of blood with other tests?

A

Protein, Microscopic

81
Q

What is the bilirubin reagent in Multistix?

A

2,4-Dichloroaniline diazonium salt

82
Q

What is the bilirubin reagent in Chemstrip?

A

2,6-Dichlorobenzene diazonium salt (tetrafluoroborate)

83
Q

What causes false positive results for bilirubin in reagent strips?

A

Highly pigmented urines, phenazopyridine, indican metabolism of iodine

84
Q

What causes false negative results for bilirubin in reagent strips?

A

Specimen exposure to light, high nitrite, ascorbic acid >25 mg/dL

85
Q

What is the correlation of bilirubin with other tests?

A

Urobilinogen

86
Q

What is the composition of the Ictotest tablet for bilirubin?

A

p-Nitrobenzene-diazonium p-toluenesulfonate, SSA, Na2CO3, Boric acid

87
Q

What is the confirmatory test for bilirubin in urine?

A

Ictotest

88
Q

What is the sensitivity of the Ictotest?

A

Detects 0.05 to 0.1 mg/dL bilirubin

89
Q

What is the urobilinogen reagent in Multistix?

A

p-Dimethylaminobenzaldehyde (PDAB or Ehrlich reagent)

90
Q

What is the urobilinogen reagent in Chemstrip?

A

4-Methoxybenzene-diazonium tetrafluoroborate (specific for UBG)

91
Q

What causes false positive results for urobilinogen in reagent strips?

A

Ehrlich-reactive compounds (porphobilinogen, indican, methyldopa, procaine, sulfonamides, p-aminosalicylic acid, chlorpromazine), pigmented urine

92
Q

What causes false negative results for urobilinogen in reagent strips?

A

Old specimen, formalin preservative, high concentration of nitrite

93
Q

What is the correlation of urobilinogen with other tests?

A

Bilirubin

94
Q

What is the leukocyte reagent in Multistix?

A

Derivative of pyrrole amino acid ester, diazonium salt

95
Q

What is the leukocyte reagent in Chemstrip?

A

Indoxycarbonic acid ester, diazonium salt

96
Q

What causes false positive results for leukocytes in reagent strips?

A

Strong oxidizing agents, formalin, highly pigmented urine, nitrofurantoin

97
Q

What causes false negative results for leukocytes in reagent strips?

A

High concentration of protein, glucose, oxalic acid, ascorbic acid, gentamicin, cephalosporins, tetracyclines, inaccurate timing, crenated leukocytes

98
Q

What is the correlation of leukocytes with other tests?

A

Protein, nitrite, microscopic

99
Q

Which cells contain esterase?

A

Neutrophils, eosinophils, basophils, monocytes, histiocytes, trichomonas

100
Q

Which cells do not contain esterase?

A

Lymphocytes

101
Q

What can produce pyuria without bacteriuria?

A

Trichomonas, chlamydia, yeast, and interstitial nephritis

102
Q

What is p-arsanilic acid used for?

A

Nitrite detection

103
Q

What is the nitrite reagent in Multistix?

A

p-Arsanilic acid, tetrahydrobenzo(h)-quinolin-3-ol

104
Q

What is the nitrite reagent in Chemstrip?

A

Sulfanilamide, hydroxytetrahydrobenzoquinoline

105
Q

What causes false positive results for nitrite in reagent strips?

A

Improperly preserved specimen, highly pigmented urine

106
Q

What causes false negative results for nitrite in reagent strips?

A

Nonreductase-containing bacteria, insufficient contact time, lack of urinary nitrate, bacteria converting nitrite to nitrogen, antibiotics, high ascorbic acid, high specific gravity

107
Q

What do pink spots or edges in nitrite indicate?

A

Negative

108
Q

What does positive nitrite correspond to?

A

100,000 organisms/mL

109
Q

If the nitrite test is negative- can UTI be ruled out?

A

No

110
Q

What organisms can cause UTIs with negative nitrite tests?

A

Gram-positive cocci and yeast

111
Q

Where can dietary nitrate be found?

A

Green vegetables

112
Q

What is the correlation of nitrite with other tests?

A

Protein, leukocyte, microscopic

113
Q

What is the 11th reagent pad in a dipstick test?

A

Ascorbic acid

114
Q

What is the principal metabolite of ascorbic acid?

A

Oxalate

115
Q

How does ascorbic acid interfere in reagent strip tests?

A

It interferes with hydrogen peroxide or diazonium salt

116
Q

What tests show false negatives due to ascorbic acid?

A

Blood, Bilirubin, Leukocyte, Nitrite, Glucose (BBLNG)

117
Q

When should ascorbic acid be read on Chemstrip?

A

10 seconds

118
Q

When should ascorbic acid be read on Multistix?

A

60 seconds

119
Q

What is a more accurate and quantitative method for ascorbic acid?

A

GC-MS (Gas Chromatography-Mass Spectrometry)

AUBF (26 decks)

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