Urine Examination With Urine Strips

PRACTICUM II URINE CHEMICAL EXAMINATION (DIPSTIK) Practice : Urine examination with urine strips Objective : To diagnose Urinary Tract Infections (UTI), kidney stones evaluation various kidney diseases,follow up therapy, and screening of general health status. A dipstick is a reagent strip in the form of a thin plastic strip attached to celluloid paper containing certain chemicals according to the type of parameter to be checked. Urine Dipstick is a rapid chemical analysis to diagnose various diseases. Chemical tests available on reagent strips are generally glucose, protein, bilirubin, urobilinogen, pH, specific gravity, blood, ketones, nitrites and leukocyte esterase. Method : Dip strip Work principle : The presence of a number of chemical elements in urine will change the paper strip urine containing indicators (reagents) over a certain period of time. The reaction results are read visually. Principles On each strip: 1. Ph : Combination of methyl red and bromthymol blue indicators contained in the strip allows a clear change in the color of the strip, from orange, green, to blue at pH 5 - 9. 2. Proteins : 3,3;5,5 Tetrachorophenol – 3,4,5,6 tetrabromosulfo-phthalein in a buffer system that maintains a constant pH, reacts with proteins to form light green to dark green compounds. 3. Glucose : D-glucose is converted by the glucose oxidase enzyme into Dgluconolactone and H2O2. The H2O2 formed will oxidize the chromogen to form a green compound. 4. Ketones : Na - Nitroprusside as a strong oxidizing agent with acetoacetic acid and acetone which is alkaline forms a violet colored compound 5. Bilirubin : Bilirubin with diazonium salt in acidic conditions forms azobilirubin which is violet red in color. 6. Urobilinogen: Urobilinogen with para-aminobenzaldehyde in acidic conditions A red azo compound will be formed. 7. Nitrite : Sulfanilamide tetrahydrobenzoquinoline and tartaric acid, when they react with nitrite to produce an azo color, the intensity of the azo/red color is a measure of the nitrite concentration in the urine. aromatic 3 – hydroxy – 1,2,3,4 8. Occult blood: H2O2 by peroxidase in Hb forms H2O2 and On. The oxygen formed will oxidize benzidine (chromogen) to form a green-blue compound. 9. Leukocyte esterase: The colorless ester carbonic acid idroxyl is described by The esterase found in granulocytes will form free indoxyl reacting with diazonium salts to form a violet colored compound. 10. BJ : Bromthymol blue with methyl vinyl ether maleic acid sodium salt will give urine color with BJ ≥ 6.5. Tools and materials: 1.Test Tube + Rack 2.Dipstick 3.Urine sample Ways of working 1. Mix the urine so that it is homogeneous, then put approximately 7-8 ml into the tube. 2. Take one strip from the container and immediately close the container. 3. Dip the reagent strip completely into the urine for 2 seconds. 4. Remove excess urine by touching the strip to the edge of the specimen container or by placing the strip on a piece of tissue paper. 5. Color changes are interpreted by comparing them with a reference scale, which is usually attached to the reagent strip container/bottle. Observation result 1. Bj Urine 2. pH 3. Leukocytes 4. Occult blood 5. Nitrite 6. Ketones 7. Bilirubin 8. Urobilinogen: 9. Proteins 10. Glucose Normal Value: 1. Bj Urine : 1,003 -1,030 2. pH : 4.5 – 8.5 3. Leukocytes : 3-5/LPB 4. Occult Blood: Negative 5. Nitrite : Negative 6. Ketones : Negative 7. Bilirubin : Negative 8. Urobilinogen: Normal 9. Proteins : Negative 10. Glucose : Negative