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Book Details
Abstract
Learn to accurately analyze urine and body fluids with Fundamentals of Urine & Body Fluid Analysis, 4th Edition. Known for its clear writing style, logical organization, and vivid full-color illustrations, this renowned text covers the fundamental principles of urine and body fluids that are frequently encountered in the clinical laboratory. This includes 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. In addition, author Nancy Brunzel also shares her own extensive knowledge and expertise in the field as she highlights key information and walks you through essential techniques and procedures — showing you how to correlate data with your knowledge of basic anatomy and physiology in order to understand pathologic processes. In all, this is the perfect book to help you master all aspects of urine and body fluid analysis.
- UNIQUE! Analysis of Vaginal Secretions chapter covers vaginal wet preps — a fluid collected and evaluated frequently in physician offices.
- UNIQUE! Image gallery on urine sediment houses 100 urine sediment micrographs to help you accurately identify urine sediment elements.
- UNIQUE! Chapter on microscopy provides valuable information as you complete clinical work with microscopes.
- Full color, high quality images aid in accurately identifying urine and body fluids at a microscopic level.
- Glossary at the end of the book provides accurate definitions at your fingertips.
- Excellent pedagogy includes key terms, learning objectives, case studies, and study questions to help provide a framework and learning pathway.
- NEW! Fully updated content provides the latest information and procedures in fluid analysis.
- NEW! Updated illustrations and micrographs paint a vivid picture of text concepts to ensure you can properly identify fluid elements.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Inside Front Cover | ES2 | ||
| Fundamentals of Urine & Body Fluid Analysis | iii | ||
| Copyright | iv | ||
| Dedication | v | ||
| Reviewers | vii | ||
| Preface | ix | ||
| Organization | ix | ||
| New to This Edition | x | ||
| Learning Aids | x | ||
| Evolve Instructor Resources | x | ||
| Acknowledgments | xi | ||
| Contents | xiii | ||
| Chapter 1: Quality Assessment and Safety | 1 | ||
| Quality assessment | 2 | ||
| Quality Assessment: What Is It? | 2 | ||
| Preanalytical Components of Quality Assessment | 2 | ||
| Analytical Components of Quality Assessment | 4 | ||
| Equipment | 4 | ||
| Reagents | 5 | ||
| Procedures | 5 | ||
| Standardization of Technique | 5 | ||
| Qualified Personnel | 5 | ||
| Monitoring Analytical Components of Quality Assessment | 6 | ||
| Postanalytical Components of Quality Assessment | 7 | ||
| Safety in the urinalysis laboratory | 7 | ||
| Biological Hazards | 8 | ||
| Personal Protective Equipment | 9 | ||
| Specimen Processing | 10 | ||
| Disposal of Waste | 10 | ||
| Decontamination | 10 | ||
| Chemical Hazards | 11 | ||
| Handling Chemical Spills | 11 | ||
| Disposal of Chemical Waste | 13 | ||
| Other Hazards | 13 | ||
| References | 14 | ||
| Bibliography | 15 | ||
| Study questions | 15 | ||
| Chapter 2: Urine Specimen Types, Collection, and Preservation | 18 | ||
| Why study urine? | 19 | ||
| Specimen types | 19 | ||
| First Morning Specimen | 19 | ||
| Random Urine Specimen | 20 | ||
| Timed Collection | 20 | ||
| Collection techniques | 21 | ||
| Routine Void | 21 | ||
| Midstream ``Clean Catch´´ | 21 | ||
| Catheterized Specimen | 21 | ||
| Suprapubic Aspiration | 22 | ||
| Pediatric Collections | 22 | ||
| Reasons for Urine Specimen Rejection | 22 | ||
| Urine Volume Needed for Testing | 22 | ||
| Urine specimen storage and handling | 22 | ||
| Containers | 22 | ||
| Labeling | 23 | ||
| Handling and Preservation | 23 | ||
| Changes in Unpreserved Urine | 23 | ||
| Preservatives | 23 | ||
| Timed Collections | 24 | ||
| Is this fluid urine? | 25 | ||
| References | 25 | ||
| Bibliography | 25 | ||
| Study questions | 25 | ||
| Chapter 3: The Kidney | 27 | ||
| Renal anatomy | 28 | ||
| Renal circulation | 30 | ||
| Renal physiology | 32 | ||
| Urine Formation | 32 | ||
| Glomerulus | 32 | ||
| Tubules | 35 | ||
| Tubular Function | 37 | ||
| Transport | 37 | ||
| Reabsorption | 38 | ||
| Secretion | 38 | ||
| Regulation of Acid-Base Equilibrium | 39 | ||
| Tubular Transport Capacity | 41 | ||
| Proximal Tubular Reabsorption | 42 | ||
| Water Reabsorption | 42 | ||
| Renal Concentrating Mechanism | 42 | ||
| References | 46 | ||
| Bibliography | 46 | ||
| Study questions | 47 | ||
| Chapter 4: Renal Function | 50 | ||
| Urine composition | 51 | ||
| Solute elimination | 51 | ||
| Measurements of solute concentration | 51 | ||
| Osmolality | 51 | ||
| Specific Gravity | 53 | ||
| Urine volume | 54 | ||
| Assessment of renal concentrating ability/tubular reabsorptive function | 55 | ||
| Osmolality Versus Specific Gravity | 55 | ||
| Fluid Deprivation Tests | 56 | ||
| Osmolar and Free-Water Clearance | 56 | ||
| Assessment of glomerular filtration | 57 | ||
| Renal Clearance | 57 | ||
| Clearance Tests | 57 | ||
| Inulin Clearance | 58 | ||
| Creatinine Clearance | 58 | ||
| Advantages and Disadvantages | 58 | ||
| Importance of Time Interval | 59 | ||
| Alternate Approaches to Assessing Glomerular Filtration Rate | 60 | ||
| Estimated GFR (eGFR) | 60 | ||
| Cystatin C and β2-Microglobulin | 61 | ||
| Screening for Albuminuria | 62 | ||
| Assessment of renal blood flow and tubular secretory function | 62 | ||
| Determination of Renal Plasma Flow and Renal Blood Flow | 62 | ||
| Assessment of Tubular Secretory Function for Acid Removal | 63 | ||
| Measurement of Titratable Acid Versus Urinary Ammonia | 63 | ||
| Oral Ammonium Chloride Test | 63 | ||
| References | 63 | ||
| Bibliography | 64 | ||
| Study questions | 64 | ||
| Chapter 5: Physical Examination of Urine | 68 | ||
| Color | 69 | ||
| Foam | 71 | ||
| Clarity | 72 | ||
| Odor | 73 | ||
| Taste | 74 | ||
| Concentration | 74 | ||
| Specific Gravity | 74 | ||
| Urinometry (Historical) | 75 | ||
| Harmonic Oscillation Densitometry (Historical) | 75 | ||
| Refractometry | 76 | ||
| Reagent Strip Method | 77 | ||
| Specific Gravity Result Discrepancies Between Reagent Strip and Refractometry | 78 | ||
| Osmolality | 79 | ||
| Freezing Point Osmometry | 79 | ||
| Vapor Pressure Osmometry | 80 | ||
| Volume | 80 | ||
| References | 81 | ||
| Bibliography | 81 | ||
| Study questions | 81 | ||
| Chapter 6: Chemical Examination of Urine | 85 | ||
| Reagent strips | 86 | ||
| Care and Storage | 87 | ||
| Quality Control Testing | 87 | ||
| Tablet and chemical tests | 88 | ||
| Care and Storage | 88 | ||
| Quality Control Testing | 88 | ||
| Chemical testing technique | 88 | ||
| Reagent Strips | 88 | ||
| Tablet and Chemical Tests | 89 | ||
| Chemical tests | 89 | ||
| Specific Gravity | 89 | ||
| Clinical Significance | 89 | ||
| Principle | 89 | ||
| pH | 90 | ||
| Clinical Significance | 90 | ||
| Methods | 91 | ||
| Reagent Strip Tests | 91 | ||
| pH Meter | 91 | ||
| pH Test Papers | 91 | ||
| Protein | 91 | ||
| Clinical Significance | 91 | ||
| Methods | 94 | ||
| Sulfosalicylic Acid Precipitation Test | 95 | ||
| Reagent Strip Tests | 95 | ||
| Sensitive Albumin Tests | 95 | ||
| Blood | 98 | ||
| Clinical Significance | 98 | ||
| Hematuria and Hemoglobinuria | 98 | ||
| Myoglobinuria | 99 | ||
| Differentiation of Hemoglobinuria and Myoglobinuria | 99 | ||
| Method | 100 | ||
| Leukocyte Esterase | 101 | ||
| Clinical Significance | 101 | ||
| Methods | 101 | ||
| Nitrite | 102 | ||
| Clinical Significance | 102 | ||
| Methods | 103 | ||
| Glucose | 104 | ||
| Clinical Significance | 104 | ||
| Methods | 106 | ||
| Reagent Strip Tests | 106 | ||
| Copper Reduction Tests | 106 | ||
| Comparison of the Clinitest Method and Glucose Reagent Strip Tests | 108 | ||
| Ketones | 108 | ||
| Formation | 108 | ||
| Clinical Significance | 109 | ||
| Methods | 109 | ||
| Reagent Strip Tests | 109 | ||
| Nitroprusside Tablet Test for Ketones (Acetest) | 110 | ||
| Bilirubin and Urobilinogen | 110 | ||
| Formation | 110 | ||
| Clinical Significance | 111 | ||
| Bilirubin Methods | 112 | ||
| Physical Examination | 112 | ||
| Reagent Strip Tests for Bilirubin | 112 | ||
| Diazo Tablet Test for Bilirubin (Ictotest Method) | 114 | ||
| Urobilinogen Methods | 114 | ||
| Classic Ehrlichs Reaction (Historical) | 114 | ||
| Reagent Strip Tests for Urobilinogen | 115 | ||
| Multistix Reagent Strips | 115 | ||
| Chemstrip and vChem Reagent Strips | 115 | ||
| Ascorbic Acid | 116 | ||
| Clinical Significance | 116 | ||
| Mechanisms of Interference | 116 | ||
| Method | 117 | ||
| Reflex testing and result correlation | 117 | ||
| References | 118 | ||
| Study questions | 119 | ||
| Chapter 7: Microscopic Examination of Urine Sediment | 126 | ||
| Standardization of sediment preparation | 127 | ||
| Commercial Systems | 127 | ||
| Specimen Volume | 128 | ||
| Centrifugation | 128 | ||
| Sediment Concentration | 129 | ||
| Volume of Sediment Viewed | 129 | ||
| Reporting Formats | 130 | ||
| Enhancing urine sediment visualization | 131 | ||
| Staining Techniques | 131 | ||
| Supravital Stains | 131 | ||
| Acetic Acid | 131 | ||
| Fat or Lipid Stains | 131 | ||
| Gram Stain | 133 | ||
| Prussian Blue Reaction | 133 | ||
| Hansel Stain | 133 | ||
| Microscopy Techniques | 134 | ||
| Phase-Contrast Microscopy | 134 | ||
| Polarizing Microscopy | 134 | ||
| Interference Contrast Microscopy | 134 | ||
| Cytocentrifugation and cytodiagnostic urinalysis | 135 | ||
| Cytocentrifugation | 135 | ||
| Cytodiagnostic Urinalysis | 135 | ||
| Formed elements in urine sediment | 135 | ||
| Blood Cells | 136 | ||
| Red Blood Cells (Erythrocytes) | 136 | ||
| Microscopic Appearance | 136 | ||
| Correlation With Physical and Chemical Examinations | 138 | ||
| Look-Alikes | 139 | ||
| Clinical Significance | 139 | ||
| White Blood Cells (Leukocytes) | 139 | ||
| Neutrophils | 139 | ||
| Microscopic Appearance | 139 | ||
| Correlation With Physical and Microscopic Examinations | 140 | ||
| Look-Alikes | 141 | ||
| Clinical Significance | 141 | ||
| Eosinophils | 141 | ||
| Lymphocytes | 142 | ||
| Monocytes and Macrophages (Histiocytes) | 142 | ||
| Epithelial Cells | 143 | ||
| Squamous Epithelial Cells | 143 | ||
| Transitional (Urothelial) Epithelial Cells | 143 | ||
| Decoy Cells | 146 | ||
| Renal Tubular Epithelial Cells | 146 | ||
| Convoluted Renal Tubular Cells | 146 | ||
| Proximal Convoluted Tubular Cells | 146 | ||
| Distal Convoluted Tubular Cells | 148 | ||
| Collecting Duct Cells | 148 | ||
| Renal Tubular Cells With Absorbed Fat | 149 | ||
| Other Epithelial Cells | 149 | ||
| Bladder Diversion | 149 | ||
| Casts | 149 | ||
| Formation and General Characteristics | 149 | ||
| Clinical Significance | 151 | ||
| Classification of Casts | 151 | ||
| Homogeneous Matrix Composition | 151 | ||
| Hyaline Casts | 151 | ||
| Waxy Casts | 153 | ||
| Cellular Inclusion Casts | 154 | ||
| Red Blood Cell Casts | 154 | ||
| White Blood Cell Casts | 155 | ||
| Renal Tubular Cell Casts | 155 | ||
| Mixed Cell Casts | 155 | ||
| Bacterial Casts | 155 | ||
| Casts With Inclusions | 156 | ||
| Granular Casts | 156 | ||
| Fatty Casts | 156 | ||
| Other Inclusion Casts | 157 | ||
| Pigmented Casts | 157 | ||
| Size | 158 | ||
| Correlation With Physical and Chemical Examinations | 158 | ||
| Look-Alikes | 158 | ||
| Crystals | 159 | ||
| Contributing Factors | 159 | ||
| Acidic Urine | 160 | ||
| Amorphous Urates | 160 | ||
| Acid Urates | 160 | ||
| Monosodium Urate | 160 | ||
| Uric Acid | 160 | ||
| Calcium Oxalate | 160 | ||
| Alkaline Urine | 164 | ||
| Amorphous Phosphate | 164 | ||
| Triple Phosphate | 165 | ||
| Calcium Phosphate | 166 | ||
| Magnesium Phosphate | 166 | ||
| Ammonium Biurate | 167 | ||
| Calcium Carbonate | 167 | ||
| Crystals of Metabolic Origin | 167 | ||
| Bilirubin | 167 | ||
| Cystine | 168 | ||
| Tyrosine and Leucine | 168 | ||
| Cholesterol | 169 | ||
| Crystals of Iatrogenic Origin | 170 | ||
| Medications | 170 | ||
| Ampicillin | 171 | ||
| Indinavir | 171 | ||
| Sulfonamides | 171 | ||
| Radiographic Contrast Media | 172 | ||
| Microorganisms in Urine Sediment | 172 | ||
| Bacteria | 173 | ||
| Yeast | 173 | ||
| Trichomonas vaginalis | 174 | ||
| Clue Cells and Gardnerella vaginalis | 175 | ||
| Parasites | 176 | ||
| Miscellaneous Formed Elements | 176 | ||
| Mucus | 176 | ||
| Fat | 177 | ||
| Hemosiderin | 179 | ||
| Sperm | 180 | ||
| Contaminants | 180 | ||
| Fibers | 180 | ||
| Starch | 180 | ||
| Fecal Matter | 181 | ||
| Correlation of urine sediment findings with disease | 181 | ||
| References | 183 | ||
| Study questions | 184 | ||
| Urine Sediment Image Gallery | 192 | ||
| Artifacts/contaminants | 192 | ||
| Blood cells | 193 | ||
| Red Blood Cells | 193 | ||
| White Blood Cells | 194 | ||
| Casts | 194 | ||
| Cellular Casts | 194 | ||
| Granular Casts | 197 | ||
| Hyaline Casts | 198 | ||
| Waxy Casts | 198 | ||
| Crystals | 199 | ||
| Ammonium Biurate Crystals | 199 | ||
| Bilirubin Crystals | 200 | ||
| Calcium Carbonate Crystals | 200 | ||
| Calcium Oxalate Crystals | 200 | ||
| Cholesterol Crystals | 201 | ||
| Cystine Crystals | 201 | ||
| Drug Crystals | 202 | ||
| Phosphate Crystals | 202 | ||
| Urate Crystals | 204 | ||
| Uric Acid Crystals | 204 | ||
| X-ray Contrast Media Crystals | 205 | ||
| Epithelial cells | 205 | ||
| Fat droplets and oval fat bodies | 207 | ||
| Microorganisms | 208 | ||
| Bacteria | 208 | ||
| Trichomonads | 208 | ||
| Yeast | 209 | ||
| Miscellaneous formed elements | 210 | ||
| Hemosiderin | 210 | ||
| Mucus | 210 | ||
| Sperm | 210 | ||
| Chapter 8: Renal and Metabolic Disease | 211 | ||
| Renal Diseases | 212 | ||
| Glomerular Disease | 212 | ||
| Morphologic Changes in the Glomerulus | 213 | ||
| Pathogenesis of Glomerular Damage | 213 | ||
| Clinical Features of Glomerular Diseases | 213 | ||
| Nephrotic Syndrome | 214 | ||
| Types of Glomerulonephritides | 215 | ||
| Acute Glomerulonephritis | 215 | ||
| Rapidly Progressive Glomerulonephritis | 216 | ||
| Membranous Glomerulonephritis | 216 | ||
| Minimal Change Disease | 216 | ||
| Focal Segmental Glomerulosclerosis | 216 | ||
| Membranoproliferative Glomerulonephritis | 217 | ||
| IgA Nephropathy | 217 | ||
| Chronic Glomerulonephritis | 217 | ||
| Systemic Diseases and Glomerular Damage | 217 | ||
| Tubular Disease | 218 | ||
| Acute Tubular Necrosis | 218 | ||
| Tubular Dysfunction | 219 | ||
| Fanconis Syndrome | 219 | ||
| Cystinosis and Cystinuria | 220 | ||
| Renal Glucosuria | 220 | ||
| Renal Phosphaturia | 220 | ||
| Renal Tubular Acidosis | 220 | ||
| Tubulointerstitial Disease and Urinary Tract Infections | 221 | ||
| Urinary Tract Infections | 221 | ||
| Acute Pyelonephritis | 222 | ||
| Chronic Pyelonephritis | 223 | ||
| Acute Interstitial Nephritis | 223 | ||
| Yeast Infections | 223 | ||
| Vascular Disease | 223 | ||
| Acute and Chronic Renal Failure | 224 | ||
| Acute Renal Failure | 224 | ||
| Chronic Renal Failure | 224 | ||
| Calculi | 224 | ||
| Pathogenesis | 224 | ||
| Factors Influencing Calculus Formation | 225 | ||
| Prevention and Treatment | 226 | ||
| Screening for metabolic diseases | 226 | ||
| Amino Acid Disorders | 226 | ||
| Cystinosis | 227 | ||
| Cystinuria | 228 | ||
| Maple Syrup Urine Disease | 228 | ||
| Phenylketonuria | 228 | ||
| Alkaptonuria | 230 | ||
| Tyrosinuria | 230 | ||
| Melanuria | 230 | ||
| Carbohydrate Disorders | 231 | ||
| Glucose and Diabetes Mellitus | 231 | ||
| Galactosemia | 231 | ||
| Diabetes Insipidus | 232 | ||
| Porphyrias | 232 | ||
| References | 234 | ||
| Study Questions | 235 | ||
| Chapter 9: Cerebrospinal Fluid Analysis | 243 | ||
| Physiology and composition | 243 | ||
| Specimen collection | 246 | ||
| Physical examination | 247 | ||
| Microscopic examination | 248 | ||
| Total Cell Count | 248 | ||
| Red Blood Cell (Erythrocyte) Count | 248 | ||
| White Blood Cell (Leukocyte) Count | 249 | ||
| Differential Cell Count | 250 | ||
| Techniques | 250 | ||
| Pleocytosis | 250 | ||
| Neutrophils | 250 | ||
| Lymphocytes | 250 | ||
| Plasma Cells | 251 | ||
| Monocytes | 251 | ||
| Eosinophils | 251 | ||
| Macrophages | 252 | ||
| Other Cells | 253 | ||
| Malignant Cells | 253 | ||
| Chemical examination | 254 | ||
| Protein | 254 | ||
| Total Protein | 254 | ||
| Albumin and Immunoglobulin G | 254 | ||
| Protein Electrophoresis | 255 | ||
| Myelin Basic Protein | 256 | ||
| Glucose | 256 | ||
| Lactate | 256 | ||
| Microbiological examination | 256 | ||
| Microscopic Examination of CSF Smears | 256 | ||
| Culture | 257 | ||
| Immunologic methods | 257 | ||
| References | 257 | ||
| Study questions | 258 | ||
| Chapter 10: Pleural, Pericardial, and Peritoneal Fluid Analysis | 261 | ||
| Physiology and composition | 261 | ||
| Specimen collection | 263 | ||
| Transudates and exudates | 264 | ||
| Physical examination | 265 | ||
| Microscopic examination | 266 | ||
| Total Cell Counts | 266 | ||
| Differential Cell Count | 266 | ||
| Microscope Slide Preparation | 266 | ||
| Cell Differential | 266 | ||
| Cytologic Examination | 269 | ||
| Chemical examination | 269 | ||
| Total Protein and Lactate Dehydrogenase Ratios | 269 | ||
| Glucose | 269 | ||
| Amylase | 269 | ||
| Lipids (Triglyceride and Cholesterol) | 270 | ||
| pH | 270 | ||
| Carcinoembryonic Antigen | 270 | ||
| Microbiological examination | 270 | ||
| Staining Techniques | 270 | ||
| Culture | 270 | ||
| References | 270 | ||
| Bibliography | 271 | ||
| Study questions | 271 | ||
| Chapter 11: Synovial Fluid Analysis | 274 | ||
| Physiology and composition | 274 | ||
| Classification of joint disorders | 275 | ||
| Specimen collection | 275 | ||
| Physical examination | 277 | ||
| Color | 277 | ||
| Clarity | 277 | ||
| Viscosity | 277 | ||
| Clot Formation | 278 | ||
| Microscopic examination | 278 | ||
| Total Cell Count | 278 | ||
| Differential Cell Count | 278 | ||
| Crystal Identification | 278 | ||
| Microscope Slide Preparations | 278 | ||
| Monosodium Urate Crystals | 279 | ||
| Calcium Pyrophosphate Dihydrate Crystals | 279 | ||
| Cholesterol Crystals | 279 | ||
| Hydroxyapatite Crystals | 281 | ||
| Corticosteroid Crystals | 282 | ||
| Artifacts | 282 | ||
| Chemical examination | 282 | ||
| Glucose | 282 | ||
| Total Protein | 283 | ||
| Uric Acid | 283 | ||
| Lactate | 283 | ||
| Microbiological examination | 283 | ||
| Gram Stain | 283 | ||
| Culture and Molecular Methods | 283 | ||
| References | 283 | ||
| Bibliography | 284 | ||
| Study questions | 284 | ||
| Chapter 12: Seminal Fluid Analysis | 288 | ||
| Physiology | 289 | ||
| Specimen collection | 291 | ||
| Physical examination | 291 | ||
| Appearance | 291 | ||
| Volume | 291 | ||
| Viscosity | 292 | ||
| Microscopic examination | 292 | ||
| Motility | 292 | ||
| Concentration and Sperm Count | 293 | ||
| Postvasectomy Sperm Counts | 293 | ||
| Morphology | 294 | ||
| Automated Semen Analysis Systems | 295 | ||
| Vitality | 295 | ||
| Cells Other Than Spermatozoa | 296 | ||
| Agglutination | 296 | ||
| Chemical examination | 296 | ||
| pH | 296 | ||
| Fructose | 297 | ||
| Other Biochemical Markers | 297 | ||
| References | 297 | ||
| Bibliography | 298 | ||
| Study questions | 298 | ||
| Chapter 13: Analysis of Vaginal Secretions | 300 | ||
| Specimen collection and handling | 301 | ||
| pH | 302 | ||
| Microscopic examinations | 302 | ||
| Wet Mount Examinations | 302 | ||
| Blood Cells | 302 | ||
| Bacterial Flora | 302 | ||
| Yeast | 303 | ||
| Epithelial Cells | 303 | ||
| Trichomonads | 304 | ||
| KOH Preparation and Amine Test | 304 | ||
| Clinical correlations | 305 | ||
| Bacterial Vaginosis | 305 | ||
| Candidiasis | 306 | ||
| Trichomoniasis | 306 | ||
| Atrophic Vaginitis | 307 | ||
| Pregnancy-associated tests | 307 | ||
| Fetal Fibronectin | 307 | ||
| Specimen Collection | 308 | ||
| fFN Test | 308 | ||
| Placental Alpha Microglobulin-1 | 308 | ||
| Specimen Collection | 309 | ||
| PAMG-1 Test | 309 | ||
| References | 309 | ||
| Study questions | 310 | ||
| Chapter 14: Amniotic Fluid Analysis | 312 | ||
| Physiology and composition | 312 | ||
| Function | 312 | ||
| Formation | 313 | ||
| Volume | 313 | ||
| Specimen collection | 313 | ||
| Timing of and Indications for Amniocentesis | 313 | ||
| Collection and Specimen Containers | 314 | ||
| Specimen Transport, Storage, and Handling | 314 | ||
| Differentiation From Urine | 314 | ||
| Physical examination | 314 | ||
| Color | 314 | ||
| Turbidity | 314 | ||
| Chemical examination | 315 | ||
| Tests to Determine Fetal Lung Maturity | 315 | ||
| Lecithin/Sphingomyelin Ratio | 315 | ||
| Phosphatidylglycerol | 316 | ||
| Lamellar Body Counts | 317 | ||
| Foam Stability Index | 317 | ||
| Test to Detect Blood Type Incompatibility | 317 | ||
| Amniotic Fluid Bilirubin (or ΔA450 Determination) | 317 | ||
| References | 319 | ||
| Study questions | 320 | ||
| Chapter 15: Fecal Analysis | 322 | ||
| Fecal formation | 323 | ||
| Diarrhea | 323 | ||
| Acute Diarrhea | 324 | ||
| Chronic Diarrhea | 324 | ||
| Steatorrhea | 326 | ||
| Specimen collection | 327 | ||
| Patient Education | 327 | ||
| Specimen Containers | 328 | ||
| Type and Amount Collected | 328 | ||
| Contaminants to Avoid | 328 | ||
| Gas Formation | 328 | ||
| Macroscopic examination | 328 | ||
| Color | 328 | ||
| Consistency and Form | 328 | ||
| Mucus | 328 | ||
| Odor | 328 | ||
| Microscopic examination | 329 | ||
| Fecal White Blood Cells | 329 | ||
| Qualitative Fecal Fat | 330 | ||
| Meat Fibers | 331 | ||
| Chemical examination | 331 | ||
| Fecal Blood | 331 | ||
| Guaiac-Based Fecal Occult Blood Tests | 331 | ||
| Immunochemical Fecal Occult Blood Tests | 333 | ||
| Porphyrin-Based Fecal Occult Blood Test | 333 | ||
| Fetal Hemoglobin in Feces (Apt Test) | 333 | ||
| Quantitative Fecal Fat | 334 | ||
| Fecal Carbohydrates | 334 | ||
| References | 335 | ||
| Study questions | 335 | ||
| Chapter 16: Automation of Urine and Body Fluid Analysis | 339 | ||
| Automation of urinalysis | 339 | ||
| Urine Chemistry Analyzers | 339 | ||
| Principle of Reflectance Photometry | 340 | ||
| Semiautomated Chemistry Analyzers | 340 | ||
| Fully Automated Chemistry Analyzers | 341 | ||
| Automated Microscopy Analyzers | 342 | ||
| iQ200 Urine Microscopy Analyzer | 342 | ||
| Sysmex UF-1000i and AUTION HYBRID Flow Cytometers | 343 | ||
| 77 Elektronika UriSed Analyzer | 345 | ||
| Fully Automated Urinalysis Systems | 346 | ||
| iRICELL Urinalysis Systems | 346 | ||
| CLINITEK AUWi System | 348 | ||
| AUTION HYBRID System | 348 | ||
| LabUMat 2 with UriSed 2 System | 348 | ||
| Automation of body fluid analysis | 348 | ||
| Body Fluid Cell Counts Using Hematology Analyzers | 349 | ||
| Body Fluid Cell Counts Using iQ200 | 349 | ||
| References | 349 | ||
| Study questions | 350 | ||
| Chapter 17: Body Fluid Analysis | 351 | ||
| Using a hemacytometer | 351 | ||
| Diluents and Dilutions | 351 | ||
| Pretreatment and Dilution of Synovial Fluid Specimens | 353 | ||
| Semen Dilution and Pretreatment of Specimens | 353 | ||
| Hemacytometer Cell Counts | 353 | ||
| Calculations | 353 | ||
| Hemacytometer Calculation Examples | 354 | ||
| Example A: Using Undiluted Body Fluid | 354 | ||
| Example B: Using Diluted Body Fluid | 355 | ||
| Example C: Sperm Count Using Diluted Semen | 356 | ||
| Preparation of slides for differential | 356 | ||
| Cytocentrifugation | 356 | ||
| Slide Preparations | 358 | ||
| References | 358 | ||
| Study questions | 358 | ||
| Chapter 18: Microscopy | 359 | ||
| Brightfield Microscope | 360 | ||
| Eyepiece | 361 | ||
| Mechanical Stage | 362 | ||
| Condenser | 362 | ||
| Illumination System | 363 | ||
| Objectives | 363 | ||
| Ocular Field Number | 365 | ||
| Microscope Adjustment Procedure | 365 | ||
| Care and Preventive Maintenance | 366 | ||
| Types of Microscopy | 366 | ||
| Brightfield Microscopy | 367 | ||
| Phase-Contrast Microscopy | 367 | ||
| Polarizing Microscopy | 368 | ||
| Interference Contrast Microscopy | 372 | ||
| Modulation Contrast Microscopy (Hoffman) | 373 | ||
| Differential Interference Contrast Microscopy (Nomarski) | 374 | ||
| Darkfield Microscopy | 374 | ||
| Fluorescence Microscopy | 375 | ||
| References | 377 | ||
| Bibliography | 377 | ||
| Study Questions | 377 | ||
| Chapter A: Reagent Strip Color Charts | 379 | ||
| Chapter B: Comparison of Reagent Strip Principles, Sensitivity, and Specificity | 381 | ||
| Chapter C: Reference Intervals | 385 | ||
| Chapter D: Body Fluid Diluents and Pretreatment Solutions | 389 | ||
| Commercial isotonic diluents | 389 | ||
| References | 391 | ||
| Chapter E: Manual and Historic Methods of Interest | 392 | ||
| References | 397 | ||
| Answer Key | 398 | ||
| Chapter 1 | 398 | ||
| Case 1.1 | 398 | ||
| Chapter 2 | 398 | ||
| Chapter 3 | 398 | ||
| Chapter 4 | 398 | ||
| Case 4.1 | 399 | ||
| Case 4.2 | 399 | ||
| Chapter 5 | 399 | ||
| Case 5.1 | 400 | ||
| Case 5.2 | 400 | ||
| Chapter 6 | 400 | ||
| Case 6.1 | 400 | ||
| Case 6.2 | 400 | ||
| Case 6.3 | 400 | ||
| Case 6.4 | 401 | ||
| Case 6.5 | 401 | ||
| Chapter 7 | 401 | ||
| Case 7.1 | 402 | ||
| Case 7.2 | 402 | ||
| Case 7.3 | 402 | ||
| Case 7.4 | 402 | ||
| Case 7.5 | 402 | ||
| Case 7.6 | 403 | ||
| Case 7.7 | 403 | ||
| Chapter 8 | 403 | ||
| Case 8.1 | 403 | ||
| Case 8.2 | 404 | ||
| Case 8.3 | 404 | ||
| Case 8.4 | 404 | ||
| Case 8.5 | 404 | ||
| Case 8.6 | 404 | ||
| Case 8.7 | 405 | ||
| Chapter 9 | 405 | ||
| Case 9.1 | 405 | ||
| Case 9.2 | 405 | ||
| Chapter 10 | 405 | ||
| Case 10.1 | 405 | ||
| Case 10.2 | 406 | ||
| Chapter 11 | 406 | ||
| Case 11.1 | 406 | ||
| Case 11.2 | 406 | ||
| Case 11.3 | 406 | ||
| Chapter 12 | 406 | ||
| Case 12.1 | 406 | ||
| Case 12.2 | 406 | ||
| Chapter 13 | 406 | ||
| Case 13.1 | 407 | ||
| Chapter 14 | 407 | ||
| Case 14.1 | 407 | ||
| Chapter 15 | 407 | ||
| Case 15.1 | 407 | ||
| Case 15.2 | 407 | ||
| Case 15.3 | 407 | ||
| Chapter 16 | 408 | ||
| Chapter 17 | 408 | ||
| Chapter 18 | 408 | ||
| Glossary | 409 | ||
| Index | 417 |