CLS1113 Introduction to Clinical Laboratory Practices

1
CLS1113 Introduction to Clinical Laboratory
Practices

• Reagent Test Strip
• Blood, Protein, Leukocytes and Nitrites

2
Hematuria (Red Blood Cells)

• Intact RBCs present in the urine
• severe exercise
• football, running, soccer, aerobics
• UTIs
• glomerulonephritis
• pyelonephritis
• kidney stones
• tumors
• menstruation

3
Hemoglobinuria

• Hemoglobin present
• hemolytic anemia
• transfusion reaction
• burns
• malaria
• Correlate with microscopic findings and clarity

4
Myoglobinuria

• Myoglobin
• heme-containing protein involved in the transport
  of oxygen in muscles.
• muscle trauma
• seizures
• muscle diseases
• electric shock
• alcoholism (toxic effects of alcohol)
• Exercise ?? levels of Myoglobin

5
Blood on the RTS

• A positive test for blood can either be RBCs,
  hemoglobin or myoglobin. Table 7-7.
• False Negatives protein, high S. G., increased
  nitrite

6
Proteinuria

• Usually one of three causes(Table 7-8)
• excess production of proteins
• damaged glomerulus
• damaged renal tubules
• There is a normal amount of urine protein.
• Albumin, Globulins
• Increased Proteins is often the FIRST indicator
  of renal disesase.

7
Protein on the RTS

• Protein Error of Indicators
• Tetrabromphenol blue (Indicator dye) Protein ?
  Chromogen releases H ions (produces a color
  change)
• Most sensitive to albumin

8
Protein on the RTS
9

• False positives
• high pH
• cells
• medications
• Confirm with SSA
• SSA will pick up other types of proteins also.
• Microalbumin Test
• used for diabetes monitoring

10
Leukocyte Esterase (enzyme)

• Enzyme produced by Polymorphonuclear Leukocytes
  (WBC)
• WBCs usually indicate a UTI
• Correlate with microscopic exam and nitrite

11
Leukocyte Esterase (RTS)

• An Ester in the presence of an esterase will
  produce a color change.
• False negatives
• increased glucose
• protein
• S.G.

12
Nitrite

• Many urinary tract pathogens convert nitrate to
  nitrite
• Indicates presence of bacteria
• The bacteria must remain in the bladder long
  enough for this to occur
• Correlate with microscopic exam (3-4)
• Will not pick up all types of bacteria

13
Nitrite Test Strip

• Nitrite para-arsanilic acid produces a pink
  color change
• Greiss Reaction