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This reference for laboratory personnel presents instructions for the handling and analysis of nonblood body fluids. Strasinger (U. of West Florida) and Di Lorenzo (medical technology, U. of Nebraska Medical Center) discuss such topics as sharp, radioactive, and chemical hazards; renal function; urine specimen handling; physical, chemical, and microscopic examination of urine; renal diseases; cerebrospinal fluid; and fecal analysis. The fourth edition includes new chapters on seminal, synovial, serous, and amniotic fluids. Each chapter contains color illustrations and study questions. c. Book News Inc.

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• Chapter 1 Safety in the Clinical Laboratory
• Learning Objectives(p. 1)
• Key Terms(p. 1)
• Biological Hazards(p. 2)
• Personal Protective Equipment(p. 3)
• Handwashing(p. 5)
• Biological Waste(p. 5)
• Sharp Hazards(p. 5)
• Chemical Hazards(p. 5)
• Chemical Spills(p. 5)
• Chemical Handling(p. 5)
• Chemical Hygiene Plan(p. 5)
• Chemical Labeling(p. 6)
• Material Data Safety Sheets(p. 6)
• Radioactive Hazards(p. 6)
• Electrical Hazards(p. 7)
• Fire/Explosive Hazards(p. 7)
• Physical Hazards(p. 8)
• References(p. 8)
• Study Questions(p. 8)
• Chapter 2 Renal Function
• Learning Objectives(p. 9)
• Key Terms(p. 9)
• Renal Physiology(p. 10)
• Renal Blood Flow(p. 10)
• Glomerular Filtration(p. 11)
• Tubular Reabsorption(p. 12)
• Tubular Secretion(p. 14)
• Renal Function Tests(p. 15)
• Glomerular Filtration Tests(p. 15)
• Clearance Tests(p. 15)
• Calculations(p. 16)
• Clinical Significance(p. 17)
• Tubular Reabsorption Tests(p. 17)
• Osmolarity(p. 18)
• Freezing Point Osmometers(p. 18)
• Vapor Pressure Osmometers(p. 19)
• Technical Factors(p. 19)
• Clinical Significance(p. 19)
• Free Water Clearance(p. 19)
• Tubular Secretion And Renal Blood Flow Tests(p. 20)
• Pah Test(p. 20)
• Titratable Acidity and Urinary Ammonia(p. 20)
• References(p. 20)
• Study Questions(p. 21)
• Case Studies/Clinical Situations(p. 22)
• Chapter 3 Introduction to Urinalysis
• Learning Objectives(p. 23)
• Key Terms(p. 23)
• History And Importance(p. 24)
• Urine Formation(p. 25)
• Urine Composition(p. 25)
• Urine Volume(p. 25)
• Specimen Collection(p. 27)
• Specimen Handling(p. 27)
• Specimen Integrity(p. 27)
• Specimen Preservation(p. 28)
• Types of Specimens(p. 28)
• Random Specimen(p. 28)
• First Morning Specimen(p. 29)
• Fasting Specimen (Second Morning)(p. 29)
• 2-Hour Postrandial Specimen(p. 29)
• Glucose Tolerance Specimen(p. 29)
• 24-Hour (or Timed) Specimen(p. 29)
• Catheterized Specimen(p. 30)
• Midstream Clean-Catch Specimen(p. 30)
• Suprapubic Aspiration(p. 30)
• Three Glass Collection(p. 30)
• Pediatric Specimen(p. 30)
• Drug Specimen Collection(p. 30)
• References(p. 31)
• Study Questions(p. 31)
• Case Studies/Clinical Situations(p. 32)
• Chapter 4 Physical Examination of Urine
• Learning Objectives(p. 33)
• Key Terms(p. 33)
• Color(p. 34)
• Normal Urine Color(p. 34)
• Abnormal Urine Color(p. 34)
• Dark Yellow/Ambero/Orange(p. 34)
• Red/Pink/Brown(p. 34)
• Brown/Black(p. 36)
• Blue/Green(p. 36)
• Clarity(p. 36)
• Normal Clarity(p. 36)
• Nonpathologic Turbidity(p. 37)
• Pathologic Turbidity(p. 37)
• Specific Gravity(p. 37)
• Urinometer(p. 38)
• Refractometer(p. 38)
• Harmonic Oscillation Densitometry(p. 40)
• Clinical Correlations(p. 40)
• Odor(p. 41)
• References(p. 41)
• Study Questions(p. 41)
• Case Studies/Clinical Situations(p. 42)
• Chapter 5 Chemical Examination Of Urine
• Learning Objectives(p. 43)
• Key Terms(p. 44)
• Reagent Strips(p. 44)
• Reagent Strip Technique(p. 44)
• Handling and Storage of Reagent Strips(p. 45)
• Quality Control of Reagent Strips(p. 45)
• pH(p. 46)
• Clinical Significance(p. 46)
• Reagent Strip Reactions(p. 47)
• Protein(p. 47)
• Clinical Significance(p. 47)
• Prerenal Proteinuria(p. 47)
• Bence Jones Protein(p. 47)
• Renal Proteinuria(p. 48)
• Orthostatic (Postural) Proteinuria(p. 48)
• Microalbuminuria(p. 48)
• Postrenal Proteinuria(p. 49)
• Reagent Strip Reactions(p. 49)
• Reaction Interference(p. 49)
• Sulfosalicylic Acid Precipitation Test(p. 49)
• Glucose(p. 50)
• Clinical Significance(p. 50)
• Reagent Strip (Glucose Oxidase) Reactions(p. 51)
• Reaction Interference(p. 51)
• Copper Reduction Test(p. 51)
• Comparison of Glucose Oxidase and Clinitest(p. 52)
• Ketones(p. 52)
• Clinical Significance(p. 53)
• Reagent Strip Reactions(p. 53)
• Reaction Interference(p. 53)
• Blood(p. 54)
• Clinical Significance(p. 54)
• Hematuria(p. 54)
• Hemoglobinuria(p. 54)
• Myoblobinuria(p. 55)
• Hemoglobinuria Versus Myoglobinuria(p. 55)
• Reagent Strip Reactions(p. 55)
• Reaction Interference(p. 55)
• Bilirubin(p. 56)
• Production of Bilirubin(p. 56)
• Clinical Significance(p. 56)
• Reagent Strip (Diazo) Reactions(p. 57)
• Reaction Interference(p. 57)
• Urobilinogen(p. 58)
• Clinical Significance(p. 58)
• Reagent Strip Reactions and Interference(p. 58)
• Reaction Interference(p. 58)
• Ehrlich's Tube(p. 59)
• Watson-Schwartz Differentiation Test(p. 60)
• Hoesch Screening Test for Porphobilinogen(p. 60)
• Nitrite(p. 60)
• Clinical Significance(p. 60)
• Reagent Strip Reactions(p. 61)
• Reaction Interference(p. 61)
• Leukocyte Esterase(p. 62)
• Clinical Significance(p. 62)
• Reagent Strip Reaction(p. 62)
• Reaction Interference(p. 62)
• Specific Gravity(p. 62)
• Reagent Strip Reaction(p. 63)
• Reaction Interference(p. 63)
• References(p. 63)
• Study Questions(p. 64)
• Case Studies/Clinical Situations(p. 65)
• Chapter 6 Microscopic Examination of the Urine
• Learning Objectives(p. 67)
• Key Terms(p. 68)
• Macroscopic Screening(p. 68)
• Preparation And Examination Of the Urine Sediment(p. 68)
• Commercial Systems(p. 68)
• Specimen Preparation(p. 69)
• Specimen Volume(p. 69)
• Centrifugation(p. 69)
• Sediment Preparation(p. 69)
• Volume of Sediment Examined(p. 69)
• Examination of the Sediment(p. 69)
• Reporting the Microscopic Examination(p. 70)
• Correlation of Results(p. 70)
• Sediment Examination Techniques(p. 70)
• Sediment Stains(p. 70)
• Lipid Stains(p. 71)
• Gram Stain(p. 71)
• Hansel Stain(p. 72)
• Prussian Blue Stain(p. 72)
• Cytodiagnostic Urine Testing(p. 73)
• Microscopy(p. 73)
• The Microscope(p. 73)
• Bright-Field Microscopy(p. 75)
• Phase-Contrast Microscopy(p. 75)
• Polarizing Microscopy(p. 76)
• Interference-Contrast Microscopy(p. 76)
• Sediment Constituents(p. 77)
• Red Blood Cells(p. 77)
• White Blood Cells(p. 78)
• Eosinophils(p. 79)
• Mononuclear Cells(p. 79)
• Epithelial Cells(p. 80)
• Squamous Epithelial Cells(p. 80)
• Transitional Epithelial (Urothelial) Cells(p. 81)
• Renal Tubular Epithelial Cells(p. 82)
• Oval Fat Bodies(p. 83)
• Bacteria(p. 84)
• Yeast(p. 85)
• Parasites(p. 85)
• Spermatozoa(p. 85)
• Mucus(p. 86)
• Casts(p. 86)
• Cast Composition and Formation(p. 86)
• Hyaline Casts(p. 87)
• Red Blood Cell Casts(p. 88)
• White Blood Cell Casts(p. 89)
• Bacterial Casts(p. 89)
• Epithelial Cell Casts(p. 90)
• Fatty Casts(p. 90)
• Mixed Cellular Casts(p. 90)
• Granular Casts(p. 91)
• Waxy Casts(p. 92)
• Broad Casts(p. 93)
• Urinary Crystals(p. 93)
• Crystal Formation(p. 94)
• General Identification Techniques(p. 94)
• Normal Crystals Seen In Acidic Urine(p. 95)
• Normal Crystals Seen In Alkaline Urine(p. 97)
• Abnormal Urine Crystals(p. 98)
• Cystine Crystals(p. 98)
• Cholesterol Crystals(p. 99)
• Radiographic Dye Crystals(p. 99)
• Crystals Associated With Liver Disorders(p. 100)
• Sulfonamide Crystals(p. 101)
• Ampicillin Crystals(p. 101)
• Urinary Sediment Artifacts(p. 101)
• References(p. 103)
• Study Questions(p. 104)
• Case Studies/Clinical Situations(p. 105)
• Chapter 7 Quality Assurance and Management in the Urinalysis Laboratory
• Learning Objectives(p. 109)
• Key Terms(p. 109)
• Urinalysis Procedure Manual(p. 110)
• Preanalytical Factors(p. 110)
• Specimen Collection and Handling(p. 110)
• Analytical Factors(p. 111)
• Reagents(p. 111)
• Instrumentation and Equipment(p. 111)
• Testing Procedure(p. 111)
• Quality Control(p. 115)
• Personnel and Facilities(p. 116)
• Postanalytical Factors(p. 116)
• Reporting of Results(p. 116)
• Interpretation of Results(p. 117)
• Regulatory Issues(p. 117)
• Continuous Quality Improvement(p. 118)
• References(p. 121)
• Study Questions(p. 121)
• Case Studies/Clinical Situations(p. 122)
• Chapter 8 Renal Diseases
• Learning Objectives(p. 123)
• Key Terms(p. 123)
• Glomerular Disorders(p. 124)
• Glomerulonephritis(p. 124)
• Acute Poststreptococcal Glomerulonephritis(p. 124)
• Rapidly Progressive (Crescentic) Glomerulonephritis(p. 124)
• Goodpasture's Syndrome(p. 124)
• Vasculitis(p. 125)
• Immunoglobin a Nephropathy(p. 125)
• Membranous Glomerulonephritis(p. 125)
• Membranoproliferative Glomerulonephritis(p. 125)
• Chronic Glomerulonephritis(p. 125)
• Nephrotic Syndrome(p. 125)
• Minimal Change Disease(p. 126)
• Focal Segmental Glomerulosclerosis(p. 126)
• Tubular Disorders(p. 126)
• Acute Tubular Necrosis(p. 126)
• Hereditary and Metablic Tubular Disorders(p. 126)
• Interstitial Disorders(p. 127)
• Acute Pyelonephritis(p. 128)
• Chronic Pyelonephritis(p. 129)
• Acute Interstitial Nephritis(p. 129)
• Vascular Disorders(p. 130)
• Renal Failure(p. 130)
• Renal Lithiasis(p. 130)
• References(p. 131)
• Case Studies/Clinical Situations(p. 131)
• Chapter 9 Urine Screening for Metabolic Disorders
• Learning Objectives(p. 135)
• Key Terms(p. 136)
• Overflow Versus Renal Disorders(p. 136)
• Amino Acid Disorders(p. 137)
• Phenylalanine-Tyrosine Disorders(p. 137)
• Phenylketonuria(p. 137)
• Tyrosyluria(p. 138)
• Alkaptonuria(p. 138)
• Melanuria(p. 139)
• Branched Chain Amino Acid Disorders(p. 139)
• Maple Syrup Urine Disease(p. 139)
• Organic Acidemias(p. 140)
• Tryptophan Disorders(p. 140)
• Indicanuria(p. 140)
• 5-Hydroxyindoleacetic Acid(p. 141)
• Cystine Disorders(p. 141)
• Cystinuria(p. 141)
• Cystinosis(p. 142)
• Homocystinuria(p. 142)
• Porphyrin Disorders(p. 142)
• Mucopolysaccharide Disorders(p. 143)
• Purine Disorders(p. 144)
• Carbohydrate Disorders(p. 144)
• References(p. 145)
• Study Questions(p. 146)
• Case Studies/Clinical Situations(p. 147)
• Chapter 10 Cerebrospinal Fluid
• Learning Objectives(p. 149)
• Key Terms(p. 150)
• Formation and Physiology(p. 150)
• Specimen Collection and Handling(p. 150)
• Appearance(p. 150)
• Traumatic Collection(p. 152)
• Uneven Distribution of Blood(p. 152)
• Clot Formation(p. 152)
• Xanthrochromic Supernatant(p. 152)
• Cell Count(p. 152)
• Methodology(p. 152)
• Total Cell Count(p. 153)
• White Blood Cell Count(p. 153)
• Corrections for Contamination(p. 153)
• Quality Control of Cerebrospinal Fluid and Other Body Fluid Cell Counts(p. 153)
• Differential Count on a Cerebrospinal Fluid Specimen(p. 154)
• Cytocentrifugation(p. 154)
• Cerebrospinal Fluid Cellular Constituents(p. 154)
• Chemistry Tests(p. 159)
• Cerebrospinal Protein(p. 160)
• Clinical Significance of Elevated Protein Values(p. 160)
• Methodology(p. 161)
• Protein Factors(p. 161)
• Electrophoresis(p. 161)
• Myelin Basic Protein(p. 162)
• Cerebrospinal Fluid Glucose(p. 162)
• Cerebrospinal Fluid Lactate(p. 162)
• Cerebrospinal Fluid Glutamine(p. 162)
• Cerebrospinal Fluid Enzymes(p. 162)
• Microbiology Tests(p. 163)
• Serologic Testing(p. 164)
• Teaching Cerebrospinal Fluid Analysis(p. 165)
• References(p. 166)
• Study Questions(p. 166)
• Case Studies/Clinical Situations(p. 167)
• Chapter 11 Semen
• Learning Objectives(p. 169)
• Key Terms(p. 169)
• Physiology(p. 170)
• Specimen Collection(p. 170)
• Special handling(p. 170)
• Semen Analysis(p. 170)
• Appearance(p. 171)
• Volume(p. 171)
• Viscosity(p. 171)
• pH(p. 171)
• Sperm Concentration/Count(p. 171)
• Sperm Motility(p. 172)
• Sperm Morphology(p. 173)
• Additional Testing(p. 174)
• Sperm Viability(p. 174)
• Seminal Fluid Fructose(p. 174)
• Antisperm Antibodies(p. 174)
• Microbial and Chemical Testing(p. 175)
• Postvasectomy Semen Analysis(p. 176)
• Sperm Function Tests(p. 176)
• Semen Analysis Quality Control(p. 176)
• References(p. 176)
• Study Questions(p. 177)
• Case Studies/Clinical Situations(p. 177)
• Chapter 12 Synovial Fluid
• Learning Objectives(p. 179)
• Key Terms(p. 179)
• Physiology(p. 180)
• Specimen Collection and Handling(p. 180)
• Appearance and Viscosity(p. 181)
• Cell Counts(p. 181)
• Differential Count(p. 182)
• Crystal Identification(p. 182)
• Chemistry Tests(p. 185)
• Microbiologic Tests(p. 186)
• Serologic Tests(p. 186)
• References(p. 186)
• Study Questions(p. 186)
• Case Studies/Clinical Situations(p. 186)
• Chapter 13 Serous Fluid
• Learning Objectives(p. 189)
• Key Terms(p. 189)
• Formation(p. 190)
• Specimen Collection and Handling(p. 190)
• Transudates and Exudates(p. 190)
• General Laboratory Procedures(p. 191)
• Pleural Fluid(p. 191)
• Appearance(p. 191)
• Hematology Tests(p. 192)
• Chemistry Tests(p. 193)
• Microbiologic and Serologic Tests(p. 195)
• Pericardial Fluid(p. 195)
• Appearance(p. 195)
• Laboratory Tests(p. 195)
• Peritoneal Fluid(p. 196)
• Transudates Versus Exudates(p. 196)
• Appearance(p. 196)
• Laboratory Tests(p. 196)
• References(p. 198)
• Study Questions(p. 198)
• Case Studies/Clinical Situations(p. 198)
• Chapter 14 Amniotic Fluid
• Learning Objectives(p. 201)
• Key Terms(p. 201)
• Physiology(p. 202)
• Specimen Collection(p. 203)
• Specimen Handling and Processing(p. 203)
• Color and Appearance(p. 203)
• Tests for Fetal Distress(p. 203)
• Hemolytic Disease of the Newborn(p. 203)
• Neural Tube Defects(p. 204)
• Tests for Fetal Maturity(p. 205)
• Fetal Lung Maturity(p. 205)
• Lecithin-Sphingomyelin Ratio(p. 205)
• Amniostat-Flm(p. 205)
• Foam Stability(p. 205)
• Microviscosity(p. 206)
• Lamellar Bodies and Optical Density(p. 206)
• References(p. 206)
• Study Questions(p. 207)
• Case Studies/Clinical Situations(p. 207)
• Chapter 15 Fecal Analysis
• Learning Objectives(p. 209)
• Key Terms(p. 209)
• Physiology(p. 210)
• Specimen Collection(p. 210)
• Macroscopic Screening(p. 211)
• Color(p. 211)
• Appearance(p. 211)
• Microscopic Examination of Feces(p. 212)
• Fecal Leukocytes(p. 212)
• Muscle Fibers(p. 212)
• Qualitative Fecal Fats(p. 212)
• Chemical Testing Of Feces(p. 213)
• Occult Blood(p. 213)
• Quantitative Fecal Fat Testing(p. 214)
• Apt Test (Fecal Hemoglobin)(p. 214)
• Fecal Enzymes(p. 214)
• Carbohydrates(p. 215)
• References(p. 215)
• Study Questions(p. 216)
• Case Studies/Clinical Situations(p. 216)
• Appendix A Urinalysis Automation(p. 219)
• Automated Microscopy(p. 222)
• Additional Information Sources(p. 226)
• Answer Keys
• Answers to Study Questions(p. 227)
• Answers to Case Studies/Clinical Situations(p. 236)
• Abbreviations(p. 243)
• Glossary(p. 245)
• Index(p. 251)