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1
Q

Principle:Double indicator system

A

Parameter: pH

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2
Q

Correlations of pH

A

✓ Nitrite
✓ Leukocytes
✓ Microscopic

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3
Q

1.Increase ph 7
2. Decrease ph 7

A

1.AMORPHOUS phosphate
2.AMORPHOUS URATES

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4
Q

Causes Acid urine

A

✓ Emphysema
✓ Diabetes mellitus
✓ Starvation
✓ Dehydration
✓ Diarrhea
✓ Presence of acid-producing
bacteria (Escherichia coli)
✓ High-protein diet
✓ Cranberry juice
✓ Medications (methenamine
mandelate [Mandelamine],
fosfomycin tromethamine
[Monurol])

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5
Q

IT CAUSES
✓ Hyperventilation
✓ Vomiting
✓ Renal tubular acidosis
✓ Presence of urease producing
bacteria
✓ Vegetarian diet
✓ Old specimen

“HPORVV”

A

Alkaline urine

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6
Q

PROTEIN principle

A

Principle: protein error of indicator

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7
Q

PROTEIN reagent
Multistix:
Chemstrip:

A

Multistix: Tetrabromophenol blue

✓ Chemstrip: 3’,3’’,5’,5’’-tetrachlorophenol 3,4,5,6-
tetrabromosulfophthalein

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8
Q

Sensitivity of protein

Multistix: ________________________________
✓ Chemstrip: ____________________

A

Multistix: 15-30 g/dL albumin
✓ Chemstrip: 6mg/dL albumin more sensitive

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9
Q

• Highly buffered interference alkaline urine
• Pigmented specimens, phenazopyridine
• Quaternary ammonium compounds
(detergents)
• Antiseptics, chlorhexidine
• Loss of buffer from prolonged exposure of the
strip to the specimen reagent
• High specific gravity

A

False positive result in protein

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10
Q

False neg in protein

A

• Proteins other than albumin
• Microalbuminuria

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11
Q

Correlation in protein

A

BLOOD
nitrite
LEUKOCYTES
microscopic

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12
Q

Glucose principle

A

Double sequential enzymatic reaction

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13
Q

Multistix and chemstrip of glucose

A

Multistix: potassium iodide (green to
brown)
▪ Chemstrip: tetramethylbenzidine (yellow
to green

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14
Q

Glucose + O2 air______ _> Gluconic acid + H202 hydorgen peroxide. What is the first catalyst in glucose parameter

A

Glucose oxidase

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15
Q

Protein negative result

A

Yellow

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16
Q

Protein positive result?

A

Blue green

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17
Q

Protein concentration increase result to?

A

GREEN BLUE

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18
Q

H2O2 + chromogen________ -> oxidized colored chromogen +H2O
What is the 2nd catalyst in glucose

A

Peroxidase

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19
Q

Is used if the px is allergic to iodine

A

Chlorhexidine aseptics

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20
Q

Regents in glucose
Multistix
Chemstrip

A

Multistix: Glucose oxidase, Peroxidase,
Potassium iodide
✓ Chemstrip: Glucose oxidase, Peroxidase,
Tetramethylbenzidine

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21
Q

Sensitivity of glycose
Multistix:
Chemstrip: _______

A

Multistix: 75-125mg/dl
✓ Chemstrip: 40 mg

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22
Q

Contamination by oxidizing agents and detergents

A

False positive in glucose

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23
Q

False negative in glucose is due to?

A

🙁High levels of ascorbic acid
• High levels of ketones
• High specific gravity
• Low temperatures
• Improperly preserved specimens

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24
Q

Correlations of glucose

A

Ketones
Protein

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25
Reagent strip reaction of glucose
Copper reduction test
26
The only non reducing sugar
Sucrose
27
method by impregnating the testing area with a mixture of glucose oxidase, peroxidase, chromogen, and buffer to produce a double sequential enzyme reaction
Glucose oxidase
28
• Relies on the ability of glucose and other substances to reduce copper sulfate to cuprous oxide in the presence of alkali and heat
Copper reduction test [clinitest]
29
Glucose blue to green reaction is called?
“PASS-THROUGH” phenomenon B-g-red-blue
30
Will oxidize the reducing substance due to heat and alkali
CuSO4 (Cupric Sulfide)
31
Present in urine
Reducing substance
32
Cu2O (Cuprous Oxide) + Oxidized Substance →
Color (Blue/Green → Orange/Red)
33
Principle of ketones
Niropusside reaction
34
Produce a purple color
Sodium nitroprusside nitroferricyanide
35
Use ACETEST TABLETS
Ketones
36
Acetoacetate (& acetone) + Sodium Nitroprusside + Glycine in alkaline will produce a color of? In ketones
Purple
37
Reagents in ketones
Sodium nitroprusside Glycine (Chemstrip)
38
Ketones sensitivity Multistix Chemstrip
Multistix: 5-10 acetoacetic acid Chemstrip: 9mg/dl acetoacetic acid;70 mg/dl acetone
39
✓ False Positive in ketones
✓ False Positive • Phthalein dyes • Highly pigmented red urine • Levodopa • Medications containing free sulfhydryl groups
40
False neg in ketones
Improperly preserved specimens
41
Ketones correlations
Glucose
42
Principle of blood
Pseudoperoxidase activity of hemoglobin
43
Reagent of blood Mutistix Chemstrip
Multistix: Diisopropylbenzene dihydroperoxide and 3,3’,5,5’- tetramethylbenzidine Chemstrip: dimethyldihydroperoxyhexane and tetramethylbenzidine
44
Chromogen of blood
tetramethylbenzidine
45
Blood reagent Multistix Chemstrip
Multistix: Diisopropylbenzene dihydroperoxide and 3,3’,5,5’- tetramethylbenzidine ✓ Chemstrip: dimethyldihydroperoxyhexane and tetramethylbenzidi
46
False-positive result in blood
• Strong oxidizing agents • Bacterial peroxidases • Menstrual contamination
47
False neg in blood
High specific gravity/crenated cells • Formalin • Captopril • High concentrations of nitrite • Ascorbic acid greater than 25 mg/dL • Unmixed specimens
48
Corellations in blood
Protein Microscopic
49
Principle of BILIRUBIN
diazo
50
uses ICTOTEST TABLETS
Bilirubin
51
Reagents of bilirubin multistiz Chemstrip
✓ Multistix: 2,4-dichloroaniline diazonium salt ✓ Chemstrip: 2,6-dichlorobenzenediazonium salt
51
Reagents of bilirubin multistiz Chemstrip
✓ Multistix: 2,4-dichloroaniline diazonium salt ✓ Chemstrip: 2,6-dichlorobenzenediazonium salt
52
FALSE positive result in bilirubin is caused by?
* Highly pigmented urines, * phenazopyridine * Indican (intestinal disorders) * Metabolites of Lodine
53
False-negative in bilirubin
* Specimen exposure to light * Ascorbic acid greater than 25 mg/dL *High concentrations of nitrite
54
Correlation of bilirubin
✓ Urobilinogen
55
UROBILINOGEN principle
Erlich/ diazo reaction
56
p-dimethylaminobenzaldehyde will produce what color?
light to dark pink
57
4-methoxybenzenediazoniumtetrafluoroborate will produce what color in urobilinogen
white to pink
58
UROBILINOGEN negative result will produce what color?
white
59
Reagent in urobilinogen Multistix: Chemstrip:
Multistix: p-dimethylaminobenzaldehyde ✓ Chemstrip: 4-methoxybenzenediazonium- ✓ tetrafluoroborate
60
False positive in urobilinogen (MULTISTIX)
Porphobilinogen * Indican * p-aminosalicylic acid * Sulfonamides * Methyldopa * Procaine * Chlorpromazine * Highly pigmented urine
61
False negative result in urobilinogen (MULTISTIX)
Old specimens * Preservation in formalin
62
Chemstrip: ✓ False-positive in urobilinogen
* Highly pigmented urine
63
Chemstrip: ✓ False-positive in urobilinogen
* Highly pigmented urine
64
✓ False-negative chemstrip in urobilinogen
* Old specimens * Preservation in formalin * High concentrations of nitrite
65
nitrite principle
greiss reaction
66
First reaction in nitrite
p-arsanilic acid (or sulfanilamide) NO2->Diazonium Salt (Nitrite
67
Diazonium Salt + tetrahydrobenzoquinolin->Pink Azodye
second reaaction in nitrite
68
Reagents in nitrite
Multistix: p-arsanilic acid, Tetrahydrobenzo(h)- quinolin-3-ol Chemstrip: Sulfanilamide, hydroxytetrahydrobenzoquinoline

CHEM STRIP REAGENT (7 decks)

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