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Book Details
Abstract
Renowned for its clear writing style, logical organization, level and depth of content, and excellent color illustrations, Fundamentals of Urine & Body Fluid Analysis, 3rd Edition covers the collection and analysis of urine, fecal specimens, vaginal secretions, and other body fluids such as cerebrospinal, synovial, seminal, amniotic, pleural, pericardial, and peritoneal fluids. Expert author Nancy Brunzel shares her extensive knowledge and expertise in the field, presenting key information and essential techniques and procedures, as well as easy-to-grasp explanations of how to correlate data with basic anatomy and physiology to understand pathological processes.
- Vaginal Fluid Analysis chapter covers vaginal wet preps, a topic not found in many other references.
- Case studies help you understand how key concepts apply to real-world practice.
- Full-color images and photomicrographs show you what you should see under the microscope.
- An image glossary presents 94 additional images to help you identify rare and common cells.
- Multiple-choice questions at the end of every chapter allow you to test your understanding of the material.
- A glossary at the end of the book offers quick access to key terms and definitions.
- NEW! Automation of Urine and Body Fluid Analysis chapter helps you understand the automated procedures being used in more and more labs.
- NEW! Body Fluid Analysis: Manual Hemacytometer Counts and Differential Slide Preparation chapter ensures you know how to perform manual analysis methods.
- UPDATED! Coverage of the latest instrumentation keeps you up to date with the technology used in today's laboratories.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Half title page | i | ||
| Evolve page | ii | ||
| Fundamentals of Urine and Body Fluid Analysis, 3/e | iii | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Contributors and Reviewers | vii | ||
| Preface | ix | ||
| Organization | ix | ||
| New to this Edition | x | ||
| Learning Aids | x | ||
| Evolve Instructor Resources | x | ||
| Acknowledgments | xi | ||
| Table Of Contents | xiii | ||
| 1 Microscopy | 1 | ||
| Chapter Outline | 1 | ||
| Learning Objectives | 1 | ||
| Key Terms | 1 | ||
| Brightfield Microscope | 3 | ||
| Eyepiece | 4 | ||
| Mechanical Stage | 5 | ||
| Condenser | 5 | ||
| Illumination System | 6 | ||
| Objectives | 6 | ||
| Ocular Field Number | 8 | ||
| Microscope Adjustment Procedure | 9 | ||
| Care and Preventive Maintenance | 9 | ||
| Types of Microscopy | 10 | ||
| Brightfield Microscopy | 10 | ||
| Phase-Contrast Microscopy | 10 | ||
| Polarizing Microscopy | 12 | ||
| Interference Contrast Microscopy | 14 | ||
| Modulation Contrast Microscopy (Hoffman). | 14 | ||
| Differential Interference Contrast Microscopy (Nomarski). | 15 | ||
| Darkfield Microscopy | 16 | ||
| Fluorescence Microscopy | 17 | ||
| Study Questions | 19 | ||
| References | 20 | ||
| Bibliography | 20 | ||
| 2 Quality Assurance and Safety | 21 | ||
| Chapter Outline | 21 | ||
| Learning Objectives | 21 | ||
| Key Terms | 21 | ||
| Quality Assurance | 22 | ||
| Quality Assurance: What Is It? | 22 | ||
| Preanalytical Components of Quality Assurance | 23 | ||
| Analytical Components of Quality Assurance | 24 | ||
| Equipment. | 24 | ||
| Reagents. | 25 | ||
| Procedure Manuals. | 26 | ||
| Monitoring. | 26 | ||
| Monitoring Analytical Components of Quality Assurance | 27 | ||
| Postanalytical Components of Quality Assurance | 28 | ||
| Safety in the Urinalysis Laboratory | 28 | ||
| Biological Hazards | 29 | ||
| Personal Protective Equipment. | 30 | ||
| Specimen Processing. | 31 | ||
| Disposal of Waste. | 31 | ||
| Decontamination. | 31 | ||
| Chemical Hazards | 32 | ||
| Handling Chemical Spills. | 33 | ||
| Disposal of Chemical Waste. | 33 | ||
| Other Hazards | 33 | ||
| Study Questions | 33 | ||
| References | 35 | ||
| Bibliography | 36 | ||
| 3 Urine Specimen Types, Collection, and Preservation | 37 | ||
| Chapter Outline | 37 | ||
| Learning Objectives | 37 | ||
| Key Terms | 37 | ||
| Why Study Urine? | 38 | ||
| Specimen Types | 38 | ||
| First Morning Specimen | 38 | ||
| Random Urine Specimen | 38 | ||
| Timed Collection | 39 | ||
| Collection Techniques | 40 | ||
| Routine Void | 40 | ||
| Midstream “Clean Catch” | 40 | ||
| Catheterized Specimen | 40 | ||
| Suprapubic Aspiration | 41 | ||
| Pediatric Collections | 41 | ||
| Reasons for Urine Specimen Rejection | 42 | ||
| Urine Volume Needed for Testing | 42 | ||
| Urine Specimen Storage and Handling | 42 | ||
| Containers | 42 | ||
| Labeling | 42 | ||
| Handling and Preservation | 43 | ||
| Changes in Unpreserved Urine. | 43 | ||
| Preservatives. | 43 | ||
| Timed Collections. | 43 | ||
| Is this Fluid Urine? | 45 | ||
| Study Questions | 45 | ||
| References | 46 | ||
| Bibliography | 46 | ||
| 4 The Kidney | 47 | ||
| Chapter Outline | 47 | ||
| Learning Objectives | 47 | ||
| Key Terms | 47 | ||
| Renal Anatomy | 49 | ||
| Renal Circulation | 51 | ||
| Renal Physiology | 54 | ||
| Urine Formation | 54 | ||
| Glomerulus | 54 | ||
| Tubules | 57 | ||
| Tubular Function | 58 | ||
| Transport. | 58 | ||
| Reabsorption. | 59 | ||
| Secretion. | 59 | ||
| Regulation of Acid-Base Equilibrium. | 60 | ||
| Tubular Transport Capacity. | 62 | ||
| Proximal Tubular Reabsorption. | 63 | ||
| Water Reabsorption. | 64 | ||
| Renal Concentrating Mechanism. | 64 | ||
| Study Questions | 68 | ||
| References | 70 | ||
| Bibliography | 70 | ||
| 5 Renal Function | 71 | ||
| Chapter Outline | 71 | ||
| Learning Objectives | 71 | ||
| Key Terms | 71 | ||
| Urine Composition | 72 | ||
| Solute Elimination | 72 | ||
| Measurements of Solute Concentration | 73 | ||
| Osmolality | 73 | ||
| Specific Gravity | 73 | ||
| Urine Volume | 76 | ||
| Assessment of Renal Concentrating Ability/Tubular Reabsorptive Function | 77 | ||
| Osmolality Versus Specific Gravity | 77 | ||
| Fluid Deprivation Tests | 78 | ||
| Osmolar and Free-Water Clearance | 78 | ||
| Assessment of Glomerular Filtration | 79 | ||
| Renal Clearance | 79 | ||
| Clearance Tests | 79 | ||
| Inulin Clearance. | 80 | ||
| Creatinine Clearance. | 80 | ||
| Advantages and Disadvantages. | 81 | ||
| Importance of Time Interval. | 81 | ||
| Alternate Approaches to Assessing Glomerular Filtration Rate | 82 | ||
| Estimated GFR (eGFR). | 82 | ||
| β2-Microglobulin and Cystatin C. | 83 | ||
| Screening for Albuminuria | 83 | ||
| Assessment of Renal Blood Flow and Tubular Secretory Function | 84 | ||
| Determination of Renal Plasma Flow and Renal Blood Flow | 84 | ||
| Assessment of Tubular Secretory Function for Acid Removal | 85 | ||
| Measurement of Titratable Acid Versus Urinary Ammonia. | 85 | ||
| Oral Ammonium Chloride Test. | 85 | ||
| Study Questions | 86 | ||
| References | 89 | ||
| Bibliography | 90 | ||
| 6 Physical Examination of Urine | 91 | ||
| Chapter Outline | 91 | ||
| Learning Objectives | 91 | ||
| Key Terms | 91 | ||
| Color | 92 | ||
| Foam | 95 | ||
| Clarity | 95 | ||
| Odor | 97 | ||
| Taste | 97 | ||
| Concentration | 97 | ||
| Specific Gravity | 98 | ||
| Urinometry. | 98 | ||
| Harmonic Oscillation Densitometry. | 99 | ||
| Refractometry. | 99 | ||
| Reagent Strip Method. | 100 | ||
| SG Result Discrepancies Between Reagent Strip and Refractometry. | 102 | ||
| Osmolality | 102 | ||
| Freezing Point Osmometry. | 103 | ||
| Vapor Pressure Osmometry. | 104 | ||
| Volume | 104 | ||
| Study Questions | 105 | ||
| References | 108 | ||
| Bibliography | 108 | ||
| 7 Chemical Examination of Urine | 109 | ||
| Chapter Outline | 110 | ||
| Learning Objectives | 109 | ||
| Key Terms | 110 | ||
| Reagent Strips | 111 | ||
| 8 Microscopic Examination of Urine Sediment | 157 | ||
| Chapter Outline | 157 | ||
| Learning Objectives | 157 | ||
| Key Terms | 157 | ||
| Standardization of Sediment Preparation | 158 | ||
| Commercial Systems | 159 | ||
| Specimen Volume | 160 | ||
| Centrifugation | 160 | ||
| Sediment Concentration | 161 | ||
| Volume of Sediment Viewed | 161 | ||
| Reporting Formats | 161 | ||
| Enhancing Urine Sediment Visualization | 163 | ||
| Staining Techniques | 163 | ||
| Supravital Stains. | 163 | ||
| Acetic Acid. | 164 | ||
| Fat or Lipid Stains. | 164 | ||
| Gram Stain. | 164 | ||
| Prussian Blue Reaction. | 165 | ||
| Hansel Stain. | 165 | ||
| Microscopy Techniques | 165 | ||
| Phase-Contrast Microscopy. | 165 | ||
| Polarizing Microscopy. | 165 | ||
| Interference Contrast Microscopy. | 166 | ||
| Cytocentrifugation and Cytodiagnostic Urinalysis | 166 | ||
| Cytocentrifugation | 166 | ||
| Cytodiagnostic Urinalysis | 167 | ||
| Formed Elements in Urine Sediment | 167 | ||
| Blood Cells | 167 | ||
| Red Blood Cells (Erythrocytes). | 167 | ||
| Microscopic Appearance. | 167 | ||
| Correlation With Physical and Chemical Examinations. | 168 | ||
| Look-Alikes. | 169 | ||
| Clinical Significance. | 169 | ||
| White Blood Cells (Leukocytes). | 169 | ||
| Neutrophils | 169 | ||
| Microscopic Appearance. | 169 | ||
| Correlation With Physical and Microscopic Examinations. | 171 | ||
| Look-Alikes. | 171 | ||
| Clinical Significance. | 171 | ||
| Eosinophils. | 171 | ||
| Lymphocytes. | 172 | ||
| Monocytes and Macrophages (Histiocytes). | 172 | ||
| Epithelial Cells | 173 | ||
| Squamous Epithelial Cells. | 175 | ||
| Transitional (Urothelial) Epithelial Cells. | 175 | ||
| Renal Tubular Epithelial Cells. | 176 | ||
| Convoluted Renal Tubular Cells. | 176 | ||
| Proximal Convoluted Tubular Cells. | 176 | ||
| Distal Convoluted Tubular Cells. | 176 | ||
| Collecting Duct Cells. | 177 | ||
| Renal Tubular Cells With Absorbed Fat. | 178 | ||
| Casts | 178 | ||
| Formation and General Characteristics. | 178 | ||
| Clinical Significance. | 180 | ||
| Classification of Casts. | 180 | ||
| Homogeneous Matrix Composition. | 181 | ||
| Hyaline Casts. | 181 | ||
| Waxy Casts. | 181 | ||
| Cellular Inclusion Casts | 183 | ||
| Red Blood Cell Casts. | 183 | ||
| White Blood Cell Casts. | 184 | ||
| Renal Tubular Cell Casts. | 185 | ||
| Mixed Cell Casts. | 185 | ||
| Bacterial Casts. | 185 | ||
| Casts With Inclusions | 185 | ||
| Granular Casts. | 185 | ||
| Fatty Casts. | 186 | ||
| Other Inclusion Casts. | 187 | ||
| Pigmented Casts. | 187 | ||
| Size. | 187 | ||
| Correlation With Physical and Chemical Examinations. | 187 | ||
| Look-Alikes. | 188 | ||
| Crystals | 189 | ||
| Contributing Factors. | 189 | ||
| Acidic Urine | 189 | ||
| Amorphous Urates. | 189 | ||
| Acid Urates. | 192 | ||
| Monosodium Urate. | 192 | ||
| Uric Acid. | 192 | ||
| Calcium Oxalate. | 193 | ||
| Alkaline Urine | 194 | ||
| Amorphous Phosphate. | 194 | ||
| Triple Phosphate. | 195 | ||
| Calcium Phosphate. | 195 | ||
| Magnesium Phosphate. | 196 | ||
| Ammonium Biurate. | 196 | ||
| Calcium Carbonate. | 197 | ||
| Crystals of Metabolic Origin | 197 | ||
| Bilirubin. | 197 | ||
| Cystine. | 197 | ||
| Tyrosine and Leucine. | 198 | ||
| Cholesterol. | 198 | ||
| Crystals of Iatrogenic Origin | 199 | ||
| Medications. | 199 | ||
| Ampicillin. | 199 | ||
| Indinavir. | 199 | ||
| Sulfonamides. | 199 | ||
| Radiographic Contrast Media. | 200 | ||
| Microorganisms in Urine Sediment | 201 | ||
| Bacteria. | 201 | ||
| Yeast. | 201 | ||
| Trichomonas Vaginalis. | 203 | ||
| Clue Cells and Gardnerella Vaginalis. | 204 | ||
| Parasites. | 204 | ||
| Miscellaneous Formed Elements | 205 | ||
| Mucus. | 205 | ||
| Fat. | 205 | ||
| Hemosiderin. | 207 | ||
| Sperm. | 207 | ||
| Contaminants | 208 | ||
| Fibers. | 208 | ||
| Starch. | 208 | ||
| Fecal Matter. | 209 | ||
| Correlation of Urine Sediment Findings With Disease | 210 | ||
| Study Questions | 211 | ||
| References | 217 | ||
| Bibliography | 218 | ||
| Urine Sediment Image Gallery | 219 | ||
| OUTLINE | 219 | ||
| Artifacts/Contaminants | 219 | ||
| Blood Cells | 220 | ||
| Red Blood Cells | 220 | ||
| White Blood Cells | 220 | ||
| Casts | 221 | ||
| Cellular Casts | 221 | ||
| Granular Casts | 223 | ||
| Hyaline Casts | 224 | ||
| Waxy Casts | 225 | ||
| Crystals | 226 | ||
| Ammonium Biurate Crystals | 226 | ||
| Bilirubin Crystals | 226 | ||
| Calcium Carbonate Crystals | 227 | ||
| Calcium Oxalate Crystals | 227 | ||
| Cholesterol Crystal | 228 | ||
| Cystine Crystal | 228 | ||
| Drug Crystals | 228 | ||
| Phosphate Crystals | 229 | ||
| Urate Crystals | 230 | ||
| Uric Acid Crystals | 230 | ||
| X-Ray Contrast Media Crystals | 231 | ||
| Epithelial Cells | 231 | ||
| Fat GLOBULES AND OVAL FAT BODIES | 233 | ||
| Microorganisms | 234 | ||
| Bacteria | 234 | ||
| Trichomonads | 235 | ||
| Yeast | 235 | ||
| Miscellaneous Formed Elements | 236 | ||
| Hemosiderin | 236 | ||
| Mucus | 237 | ||
| Sperm | 237 | ||
| 9 Renal and Metabolic Disease | 239 | ||
| Chapter Outline | 239 | ||
| Learning Objectives | 239 | ||
| Key Terms | 240 | ||
| Renal Diseases | 242 | ||
| Glomerular Disease | 242 | ||
| Morphologic Changes in the Glomerulus. | 242 | ||
| Pathogenesis of Glomerular Damage. | 242 | ||
| Clinical Features of Glomerular Diseases. | 243 | ||
| Nephrotic Syndrome. | 243 | ||
| Types of Glomerulonephritis. | 244 | ||
| Acute Glomerulonephritis. | 244 | ||
| Rapidly Progressive Glomerulonephritis. | 245 | ||
| Membranous Glomerulonephritis. | 245 | ||
| Minimal Change Disease. | 245 | ||
| Focal Segmental Glomerulosclerosis. | 246 | ||
| Membranoproliferative Glomerulonephritis. | 246 | ||
| IgA Nephropathy. | 246 | ||
| Chronic Glomerulonephritis. | 246 | ||
| Systemic Diseases and Glomerular Damage. | 247 | ||
| Tubular Disease | 248 | ||
| Acute Tubular Necrosis. | 248 | ||
| Tubular Dysfunction. | 248 | ||
| Fanconi Syndrome. | 249 | ||
| Cystinosis and Cystinuria. | 249 | ||
| Renal Glucosuria. | 250 | ||
| Renal Phosphaturia. | 250 | ||
| Renal Tubular Acidosis. | 250 | ||
| Tubulointerstitial Disease and Urinary Tract Infections | 251 | ||
| Urinary Tract Infections. | 251 | ||
| Acute Pyelonephritis. | 252 | ||
| Chronic Pyelonephritis. | 252 | ||
| Acute Interstitial Nephritis. | 253 | ||
| Yeast Infections. | 253 | ||
| Vascular Disease | 253 | ||
| Acute and Chronic Renal Failure | 253 | ||
| Acute Renal Failure. | 253 | ||
| Chronic Renal Failure. | 254 | ||
| Calculi | 254 | ||
| Pathogenesis. | 254 | ||
| Factors Influencing Calculi Formation. | 255 | ||
| Prevention and Treatment. | 256 | ||
| Metabolic Diseases | 256 | ||
| Amino Acid Disorders | 256 | ||
| Cystinosis. | 257 | ||
| Cystinuria. | 257 | ||
| Maple Syrup Urine Disease. | 257 | ||
| Phenylketonuria. | 258 | ||
| Alkaptonuria. | 258 | ||
| Tyrosinuria. | 259 | ||
| Melanuria. | 260 | ||
| Carbohydrate Disorders | 260 | ||
| Glucose and Diabetes Mellitus. | 260 | ||
| Galactosemia. | 261 | ||
| Diabetes Insipidus | 261 | ||
| Porphyrias | 262 | ||
| Study Questions | 264 | ||
| References | 270 | ||
| 10 Fecal Analysis | 271 | ||
| Chapter Outline | 271 | ||
| Learning Objectives | 271 | ||
| Key Terms | 271 | ||
| Fecal Formation | 272 | ||
| Diarrhea | 272 | ||
| Steatorrhea | 273 | ||
| Specimen Collection | 274 | ||
| Patient Education | 274 | ||
| Specimen Containers | 274 | ||
| Type and Amount Collected | 275 | ||
| Contaminants to Avoid | 275 | ||
| Gas Formation | 275 | ||
| Macroscopic Examination | 275 | ||
| Color | 275 | ||
| Consistency and Form | 276 | ||
| Mucus | 277 | ||
| Odor | 277 | ||
| Microscopic Examination | 277 | ||
| Fecal Leukocytes | 277 | ||
| Fecal Fat, Qualitative | 277 | ||
| Meat Fibers | 278 | ||
| Chemical Examination | 278 | ||
| Fecal Blood | 278 | ||
| Guaiac-Based Fecal Occult Blood Tests. | 279 | ||
| Immunochemical Fecal Occult Blood Tests. | 280 | ||
| Porphyrin-Based Fecal Occult Blood Test. | 280 | ||
| Fetal Hemoglobin in Feces (Apt Test) | 281 | ||
| Quantitative Fecal Fat | 281 | ||
| Fecal Carbohydrates | 281 | ||
| Study Questions | 282 | ||
| References | 285 | ||
| 11 Seminal Fluid Analysis | 287 | ||
| Chapter Outline | 287 | ||
| Learning Objectives | 287 | ||
| Key Terms | 287 | ||
| Physiology | 288 | ||
| Specimen Collection | 290 | ||
| Physical Examination | 291 | ||
| Appearance | 291 | ||
| Volume | 291 | ||
| Viscosity | 291 | ||
| Microscopic Examination | 292 | ||
| Motility | 292 | ||
| Concentration and Sperm Count | 292 | ||
| Postvasectomy Sperm Counts | 293 | ||
| Morphology | 293 | ||
| Vitality | 295 | ||
| Cells Other Than Spermatozoa | 295 | ||
| Agglutination | 295 | ||
| Chemical Examination | 296 | ||
| pH | 296 | ||
| Fructose | 296 | ||
| Other Biochemical Markers | 296 | ||
| Study Questions | 297 | ||
| References | 298 | ||
| Bibliography | 299 | ||
| 12 Amniotic Fluid Analysis | 301 | ||
| Chapter Outline | 301 | ||
| Learning Objectives | 301 | ||
| Key Terms | 301 | ||
| Physiology and Composition | 302 | ||
| Function | 302 | ||
| Formation | 302 | ||
| Volume | 303 | ||
| Specimen Collection | 303 | ||
| Timing of and Indications for Amniocentesis | 303 | ||
| Collection and Specimen Containers | 303 | ||
| Specimen Transport, Storage, and Handling | 303 | ||
| Differentiation From Urine | 304 | ||
| Physical Examination | 304 | ||
| Color | 304 | ||
| Turbidity | 304 | ||
| Chemical Examination | 304 | ||
| Fetal Lung Maturity Tests | 304 | ||
| Lecithin/Sphingomyelin Ratio. | 305 | ||
| Phosphatidylglycerol. | 306 | ||
| Foam Stability Index. | 306 | ||
| Fluorescence Polarization Assay. | 306 | ||
| Lamellar Body Counts. | 307 | ||
| Amniotic Fluid Bilirubin (or ΔA450 Determination) | 307 | ||
| Study Questions | 308 | ||
| References | 311 | ||
| 13 Cerebrospinal Fluid Analysis | 313 | ||
| Chapter Outline | 313 | ||
| Learning Objectives | 313 | ||
| Key Terms | 313 | ||
| Physiology and Composition | 314 | ||
| Specimen Collection | 315 | ||
| Physical Examination | 317 | ||
| Microscopic Examination | 318 | ||
| Total Cell Count | 318 | ||
| Red Blood Cell (Erythrocyte) Count | 319 | ||
| White Blood Cell (Leukocyte) Count | 319 | ||
| Differential Cell Count | 319 | ||
| Techniques. | 319 | ||
| Pleocytosis | 319 | ||
| Neutrophils. | 319 | ||
| Lymphocytes. | 319 | ||
| Plasma Cells. | 320 | ||
| Monocytes. | 322 | ||
| Eosinophils. | 322 | ||
| Macrophages. | 322 | ||
| Other Cells. | 323 | ||
| Malignant Cells. | 323 | ||
| Chemical Examination | 324 | ||
| Protein | 324 | ||
| Total Protein. | 324 | ||
| Albumin and Immunoglobulin G. | 325 | ||
| Protein Electrophoresis. | 325 | ||
| Myelin Basic Protein. | 326 | ||
| Glucose | 327 | ||
| Lactate | 327 | ||
| Microbiological Examination | 327 | ||
| Microscopic Examination of CSF Smears | 327 | ||
| Culture | 328 | ||
| Immunologic Methods | 328 | ||
| Study Questions | 328 | ||
| References | 331 | ||
| 14 Synovial Fluid Analysis | 333 | ||
| Chapter Outline | 333 | ||
| Learning Objectives | 333 | ||
| Key Terms | 333 | ||
| Physiology and Composition | 333 | ||
| Classification of Joint Disorders | 334 | ||
| Specimen Collection | 335 | ||
| Physical Examination | 336 | ||
| Color | 336 | ||
| Clarity | 336 | ||
| Viscosity | 337 | ||
| Clot Formation | 337 | ||
| Microscopic Examination | 337 | ||
| Total Cell Count | 337 | ||
| Differential Cell Count | 337 | ||
| Crystal Identification | 338 | ||
| Microscope Slide Preparations. | 338 | ||
| Monosodium Urate Crystals. | 338 | ||
| Calcium Pyrophosphate Dihydrate Crystals. | 339 | ||
| Cholesterol Crystals. | 340 | ||
| Hydroxyapatite Crystals. | 340 | ||
| Corticosteroid Crystals. | 340 | ||
| Artifacts. | 340 | ||
| Chemical Examination | 341 | ||
| Glucose | 341 | ||
| Total Protein | 342 | ||
| Uric Acid | 342 | ||
| Lactate | 342 | ||
| Microbiological Examination | 342 | ||
| Gram Stain | 342 | ||
| Culture and Molecular Methods | 342 | ||
| Study Questions | 342 | ||
| References | 345 | ||
| Bibliography | 345 | ||
| 15 Pleural, Pericardial, and Peritoneal Fluid Analysis | 347 | ||
| Chapter Outline | 347 | ||
| Learning Objectives | 347 | ||
| Key Terms | 347 | ||
| Physiology and Composition | 348 | ||
| Specimen Collection | 349 | ||
| Transudates and Exudates | 350 | ||
| Physical Examination | 351 | ||
| Microscopic Examination | 352 | ||
| Total Cell Counts | 352 | ||
| Differential Cell Count | 352 | ||
| Microscope Slide Preparation. | 352 | ||
| Cell Differential. | 352 | ||
| Cytologic Examination | 355 | ||
| Chemical Examination | 355 | ||
| Total Protein and Lactate Dehydrogenase Ratios | 355 | ||
| Glucose | 355 | ||
| Amylase | 356 | ||
| Lipids (Triglyceride and Cholesterol) | 356 | ||
| pH | 356 | ||
| Carcinoembryonic Antigen | 356 | ||
| Microbiological Examination | 356 | ||
| Staining Techniques | 356 | ||
| Culture | 357 | ||
| Study Questions | 357 | ||
| References | 359 | ||
| Bibliography | 359 | ||
| 16 Analysis of Vaginal Secretions | 361 | ||
| Chapter Outline | 361 | ||
| Learning Objectives | 361 | ||
| Key Terms | 361 | ||
| Specimen Collection and Handling | 362 | ||
| pH | 363 | ||
| Microscopic Examinations | 363 | ||
| Wet Mount Examination | 363 | ||
| Blood Cells. | 364 | ||
| Bacterial Flora. | 364 | ||
| Yeast. | 364 | ||
| Epithelial Cells. | 364 | ||
| Trichomonads. | 365 | ||
| KOH Preparation and Amine Test | 366 | ||
| Clinical Correlations | 367 | ||
| Bacterial Vaginosis | 367 | ||
| Candidiasis | 367 | ||
| Trichomoniasis | 368 | ||
| Atrophic Vaginitis | 369 | ||
| Study Questions | 369 | ||
| References | 370 | ||
| Bibliography | 371 | ||
| 17 Automation of Urine and Body Fluid Analysis | 373 | ||
| Chapter Outline | 373 | ||
| Learning Objectives | 373 | ||
| Key Terms | 373 | ||
| Automation of Urinalysis | 373 | ||
| Urine Chemistry Analyzers | 374 | ||
| Principle of Reflectance Photometry. | 374 | ||
| Semi-Automated Chemistry Analyzers. | 374 | ||
| Fully Automated Chemistry Analyzers. | 375 | ||
| Automated Microscopy Analyzers | 376 | ||
| iQ200 Urine Microscopy Analyzer. | 377 | ||
| Sysmex UF-1000I and UF-100 Flow Cytometers. | 379 | ||
| Fully Automated Urinalysis Systems | 380 | ||
| iRICELL Urinalysis Systems. | 380 | ||
| CLINITEK AUWi System. | 380 | ||
| Automation of Body Fluid Analysis | 381 | ||
| Body Fluid Cell Counts Using Hematology Analyzers | 381 | ||
| Body Fluid Cell Counts Using iQ200 | 382 | ||
| Study Questions | 382 | ||
| References | 383 | ||
| 18 Body Fluid Analysis: | 385 | ||
| Chapter Outline | 385 | ||
| Learning Objectives | 385 | ||
| Using A Hemacytometer | 385 | ||
| Diluents and Dilutions | 385 | ||
| Pretreatment and Dilution of Synovial Fluid Specimens. | 386 | ||
| Semen Dilution and Pretreatment of Viscous Specimens. | 387 | ||
| Hemacytometer Cell Counts | 387 | ||
| Calculations | 388 | ||
| Hemacytometer Calculation Examples | 388 | ||
| Example A: Using Undiluted Body Fluid. | 388 | ||
| Example B: Using Diluted Body Fluid. | 389 | ||
| Example C: Sperm Count Using Diluted Semen. | 389 | ||
| Preparation of Slides for Differential | 389 | ||
| Cytocentrifugation | 390 | ||
| Slide Preparations | 391 | ||
| Study questions | 391 | ||
| References | 392 | ||
| Glossary | 393 | ||
| A | 393 | ||
| B | 393 | ||
| C | 394 | ||
| D | 395 | ||
| E | 396 | ||
| F | 396 | ||
| G | 397 | ||
| H | 397 | ||
| I | 398 | ||
| J | 398 | ||
| K | 398 | ||
| L | 398 | ||
| M | 398 | ||
| N | 399 | ||
| O | 400 | ||
| P | 400 | ||
| Q | 401 | ||
| R | 401 | ||
| S | 402 | ||
| T | 403 | ||
| U | 403 | ||
| V | 404 | ||
| X | 404 | ||
| Y | 404 | ||
| Answer Key | 405 | ||
| Chapter 1 | 405 | ||
| Chapter 2 | 405 | ||
| Case 2-1 | 405 | ||
| Chapter 3 | 405 | ||
| Chapter 4 | 405 | ||
| Chapter 5 | 406 | ||
| Case 5-1 | 406 | ||
| Case 5-2 | 406 | ||
| Chapter 6 | 406 | ||
| Case 6-1 | 407 | ||
| Case 6-2 | 407 | ||
| Chapter 7 | 407 | ||
| Case 7-1 | 407 | ||
| Case 7-2 | 408 | ||
| Case 7-3 | 408 | ||
| Case 7-4 | 408 | ||
| Case 7-5 | 408 | ||
| Case 7-6 | 408 | ||
| Chapter 8 | 409 | ||
| Case 8-1 | 409 | ||
| Case 8-2 | 409 | ||
| Case 8-3 | 410 | ||
| Case 8-4 | 410 | ||
| Case 8-5 | 410 | ||
| Case 8-6 | 410 | ||
| Case 8-7 | 411 | ||
| Chapter 9 | 411 | ||
| Case 9-1 | 411 | ||
| Case 9-2 | 411 | ||
| Case 9-3 | 411 | ||
| Case 9-4 | 412 | ||
| Case 9-5 | 412 | ||
| Case 9-6 | 412 | ||
| Chapter 10 | 412 | ||
| Case 10-1 | 413 | ||
| Case 10-2 | 413 | ||
| Case 10-3 | 413 | ||
| Chapter 11 | 413 | ||
| Case 11-1 | 413 | ||
| Case 11-2 | 413 | ||
| Chapter 12 | 413 | ||
| Case 12-1 | 413 | ||
| Chapter 13 | 414 | ||
| Case 13-1 | 414 | ||
| Case 13-2 | 414 | ||
| Chapter 14 | 414 | ||
| Case 14-1 | 414 | ||
| Case 14-2 | 414 | ||
| Case 14-3 | 414 | ||
| Chapter 15 | 415 | ||
| Case 15-1 | 415 | ||
| Case 15-2 | 415 | ||
| Chapter 16 | 415 | ||
| Case 16-1 | 415 | ||
| Chapter 17 | 415 | ||
| Chapter 18 | 415 | ||
| Appendices | 416 | ||
| Appendix A Reagent Strip Color Charts | 416 | ||
| Appendix B Reference Intervals | 418 | ||
| Appendix C Body Fluid Diluent and Pretreatment Solutions | 421 | ||
| Outline | 421 | ||
| Saline, Isotonic (0.85%) or “Normal Saline” | 421 | ||
| Saline, Hypotonic (0.30%) | 421 | ||
| Dilute Acetic Acid (3.0%) | 421 | ||
| Turk’s Solution | 421 | ||
| 0.5% Methylene Blue Solution (Used to Prepare Turk’s Solution) | 421 | ||
| Synovial Fluid Solutions | 422 | ||
| Hyaluronidase Pretreatment for Synovial Fluid | 422 | ||
| 0.05% Buffered Hyaluronidase | 422 | ||
| Hyaluronidase (0.1 g/L) Diluent for Cell Counts in Synovial Fluid | 422 | ||
| Semen Solutions | 423 | ||
| Semen Pretreatment Solutions | 423 | ||
| A. Dilution With Physiologic Solution. | 423 | ||
| Dulbecco’s Phosphate-Buffered Saline (pH 7.4) | 423 | ||
| B. Digestion With Bromelain. | 423 | ||
| Bromelain Solution (10 IU/mL) | 423 | ||
| Semen Diluent for Sperm Counts | 423 | ||
| References | 423 | ||
| Index | 424 | ||
| A | 424 | ||
| B | 425 | ||
| C | 425 | ||
| D | 427 | ||
| E | 427 | ||
| F | 428 | ||
| G | 428 | ||
| H | 429 | ||
| I | 429 | ||
| J | 430 | ||
| K | 430 | ||
| L | 430 | ||
| M | 431 | ||
| N | 432 | ||
| O | 433 | ||
| P | 433 | ||
| Q | 435 | ||
| R | 435 | ||
| S | 436 | ||
| T | 438 | ||
| U | 438 | ||
| V | 440 | ||
| W | 440 | ||
| X | 441 |