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Clinitest Information and Courses from MediaLab, Inc.

These are the MediaLab courses that cover Clinitest and links to relevant pages within the course.

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Chemical Screening of Urine by Reagent Strip (retired March 2012)
When the glucose result on a urine specimen from an infant is negative on the reagent strip, it can be assumed that the specimen is negative for other reducing substances such as galactose.View Page
A copper reduction method (e.g. Clinitest® or Benedict's) is performed on pediatric specimens in order to check for the presence of:View Page

Confirmatory and Secondary Urinalysis Screening Tests
The Clinitest® Method

The Clinitest® method can detect reducing substances in the urine up to 2 g/dL. When the amount of sugar is over 2 g/dL (often expressed as 2%), a “pass through” phenomenon occurs. Pass through appears as rapid color changes through green, tan, and orange, and then a reversion in color back to the brownish color. This reversion in color indicates levels of reducing substances greater than 2 g/dL. Even a fleeting orange color should be recorded as “greater than or equal to 2 g/dL.” It is vital that you watch the boiling and color changes throughout the entire reaction so that a "pass through" is not missed.

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Testing for Reducing Substances Other Than Glucose

Some laboratories perform testing for other reducing substances on urine specimens from children below a certain age (eg, age 2) whenever a urinalysis is ordered. The purpose is to detect serious inborn errors of metabolism. The reducing substance assay uses the classic Benedict’s copper reduction reaction to detect glucose and other carbohydrate metabolites. If the reducing substance test (ie, Clinitest®) is positive and the reagent dipstick assay for urinary glucose is negative, it is possible that other reducing substances are present. Further testing would be required to diagnose the exact inborn error of metabolism. With the current practice in most U.S. states of screening all newborns for metabolic disorders, the urine test for reducing substances may be performed only when the clinician orders it, rather than the test being part of a routine urinalysis procedure. Clinitest® is not the recommended monitoring test for diabetics; glucose reagent strip testing is a better choice.

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What is the test principle of the Clinitest® reaction?View Page
The 2-Drop Clinitest® Procedure

Add 10 drops of water to the test tube and mix gently.

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The 2-drop Clinitest® Procedure

Add the Clinitest® reagent tablet to the test tube. Do not shake while boiling or for 15 seconds after boiling. Do not touch the bottom of the tube while the reaction is taking place; it gets very hot. Do not handle the tablets with your bare hands. It can contaminate the tablet and also any moisture on your hands can start a reaction which may result in a burn.

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The 2-drop Clinitest® Procedure

After the 15-second waiting period, shake the test tube gently to mix. Immediately compare the color of the liquid to the color chart for the 2-drop method.

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The 2-Drop Clinitest® Procedure

Record the test result that is associated with the color block that most closely matches the color of the test in the tube. Remember that the final color may not be the test result if the "pass through" phenomenon occurred. Test results should be recorded according to your laboratory's procedure. Laboratories may choose to record results as 1%, 2%, 3%, etc; 1+, 2+, 3+, etc; or 100mg/dL, 200mg/dL, 300mg/dL, etc. The result of the test in the top image is negative, and the result of the test in the bottom image, reported as a percentage, is 2%. (Note: Colors in the photograph may vary slightly from actual test colors.)

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Testing Methods for Urine Glucose and Other Reducing Substances

Enzyme-based methods are most often used to detect/monitor urine glucose and copper reduction methods are used to detect all reducing substances. Most enzyme tests use the enzyme glucose oxidase. which is impregnated on a dipstick along with a chromagen. These enzyme-based dipstick tests are specific for glucose.

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What is indicated if a sugar result on a reagent dipstick is negative and a Clinitest® result on the same specimen is positive?View Page
The 2-Drop Clinitest® Procedure

Place 2 drops of urine in a test tube.

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The Urine Microscopic: Microscopic Analysis of Urine Sediment
Use the following urinalysis report to answer:The patient is a female and the urinalysis is completed within two hours of collection.Color - light yellow Appearance - slightly turbid Sp. Gravity - 1.009 pH - 8.0 Glucose - negative Protein - 1+ Blood - negative WBC - 5/HPF RBC - 1/HPF Epithelial - 0/HPF Casts - 2 hyaline/LPF Crystals - amorphous urates Bacteria - 2+True or false? The results are abnormal but all results correlate.View Page
Specimen #5 - Female Child

The results of the Clinitest are abnormal, but can be reported. Because this specimen was from a child, the Clinitest was performed routinely even though not indicated by the results of the Multistix. Due to the fact that the Multistix is specific for glucose and was negative, therefore a non-glucose reducing substance is present. Further confirmatory testing such as thin-layered chromatography is needed for identification of the non-glucose reducing sugar.

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