BookVictoria J.A. Sharp, Lisa M. Antes, M. Lee Sanders, Gina M. Lockwood, editors.
Summary: Urine tests are used by a variety of primary care providers and specialists in order to diagnose, monitor and treat patients with various medical conditions. This first-of-its-kind text is a comprehensive clinical guide to the evaluation and application of urine tests. Clinical cases are used to highlight important aspects of urine testing. Further evaluation and management are then discussed based on the results of the urine tests. Topics covered include financial considerations, regulations, proper collection, testing methods, dipstick analysis, microscopy as well as cancer and drug screening tests, among others. Each chapter contains specific objectives for focus of study. Pertinent images, algorithms and board style review questions for important topics are also included. Written by nephrologists, urologists, other specialists and primary care physicians, Urine Tests uses a comprehensive approach to the clinical use of both common and uncommon urine testing. Primarily appealing to practicing primary care physicians, this book is also a useful resource for specialists, nurse practitioners, physician assistants, physician fellows, residents and medical students alike.
Contents:
Intro
Preface
Abbreviations
Contents
Editor Bios
Contributors
Chapter 1: Urine: The Golden Elixir of Life
Overview
Urine Production
Urine Refinement
Urine Elimination
Summary
References
Chapter 2: Follow the Money: Costs, Reimbursement and Regulations of Urine Based Testing
Overview
Costs
Reimbursement
Regulations
Additional Considerations
Future Directions
Summary
References
Chapter 3: Going with the Flow: Proper Urine Testing Methods for Clinical Practice
Overview
Case 1: Urine Specimen Collection Methods of Urine Collection
Random (Routine) Specimen
First Morning Specimen
Timed Collection
Midstream "Clean-Catch" Specimen
Catheterized Specimen
Suprapubic Aspirate
Ordering of Urine Tests
Case 2: Urine Dipstick Versus Urine Microscopy
Methods of Urine Testing
Methods for Chemical Screening
Methods for Examination of Urine Sediment (Microscopy)
Automated Urinalysis
Case 3: Special Urine Testing
Pregnancy and Ovulation Testing
Urinary Calculi
Cytopathologic Examination
Summary
References Chapter 4: Urine Dipstick: Blood
The Spectrum of Red
Overview
The Urine Dipstick Test for Blood
Sensitivity/Specificity
When Is it Appropriate to Check Urine for Blood?
Case 1: Positive Dipstick for Blood, Negative Microscopy for Red Blood Cells
Case 2: Positive Dipstick for Blood, Positive Microscopy for Normal Shaped Red Blood Cells
Case 3: Positive Dipstick for Blood, Positive Microscopy for Dysmorphic RBCs
Summary
References
Chapter 5: Urine Dipstick: Proteinuria - Causes, Consequences and Diagnostic Approach
Overview The Pathophysiology and Significance of Proteinuria
Case 1: Dipstick Positive Proteinuria in a Healthy/Low Risk Patient
The Dipstick Analysis
Urine Protein Quantification
Urine Albumin to Creatinine Ratio
Transient Causes of Proteinuria
Proteinuria Indicative of Intrinsic Kidney Disease: Nephrotic versus Nephritic Proteinuria
Case 2: Nephrotic Proteinuria
Nephrotic Syndrome
Case 3: Nephritic Proteinuria
Nephritic Syndrome
When Is a Kidney Biopsy Indicated?
Case 4: Proteinuria Screening Indications
Patients Requiring Routine Screening for Proteinuria Treatment of Proteinuria
Summary
References
Chapter 6: Urine Dipstick: Urinary Nitrites and Leukocyte Esterase - Dipping into Murky Waters
Overview
Interpretation: Clinical Context
Case 1: Asymptomatic Bacteriuria
Case 2: Use of Urine Nitrites in Clinical Diagnosis
Case 3: Use of Urine Leukocyte Esterase in Clinical Diagnosis
Additional Approaches to Interpreting Urine Dipsticks
Summary
References
Chapter 7: Urine Dipstick: An Approach to Glucosuria, Ketonuria, pH, Specific Gravity, Bilirubin and Urobilinogen - Undeniable Chemistry
Overview