Urine cotinine urine 24hour interpretation, protein electrophoresis and reflex to ife, 24hour test includes 24hour urine protein electrophoresis with interpretation and automatic reflex to urine immunofixation at an additional charge if mspike is present. In turbid urines the interpretation of results is difficult. The interpretation of urine buprenorphine testing can be complex. Interpretation of urinalysis results point of care diagnostics. This is more likely to occur if the urine ph is very alkaline 8 or the urine is very dilute usg urine. The entire test strip is dipped in the urine sample and color changes in each square are noted. Interpreting urinalysis and urine culture results philip sloane, md, mph professor of family medicine and geriatrics. During a urinalysis, a clean urine sample is collected into a. A pregnancy test is used to confirm that woman is pregnant or not. Uroflowmetry is a quick, noninvasive test that provides valuable feedback about the health of the lower urinary tract. To give a basic knowledge of the kidney structure and urine formation as an important aid in understanding urinalysis and test interpretation. Urine testing or urinalysis is a valuable tool to screen an patient and. Urine is normally acidic but its normal ph ranges from 4.
Quantitative urine buprenorphine testing is used to. Basic laboratory tests basic urine tests urinalysis. Interpretation of opiate urine drug screens summary urine drug testing is highly reliable, but false positives can rarely occur for some drugs. Albumin is a protein that can pass into the urine when the filters in the kidneys are damaged. Causes of false positive and false negative results in urine dipstick testing.
Patterns of urine buprenorphine and norbuprenorphine levels are described. The gold standard method of testing is to remove a small volume of urine from the sterile container with a fresh sterile syringe, and then apply the removed urine to the dipstick. Urine left at room temperature for 2 hours tends to develop an. Definitions electrophoresis is a method of separating proteins based on their physical properties. Urine creatinine interpretation and thccreatinine ratios information sheet urine creatinine interpretation and thccreatinine ratios confidence in testing. Those dipsticks make a pretty good catapult for drops of eyeballseeking urine. Many organic acids result from the metabolic pathways, or chemical reactions, your body uses to transform food into energy, growth, maintenance, and repair of body tissue.
Firstline definitive testing qualitative or quantitative is recommended for detecting the use of relevant overthe counter medications, prescribed and nonprescribed drugs, and illicit substances in pain management patients. A urinalysis, or urine test, is a common medical test in which the urine is examined to diagnose and monitor various illnesses. With the recent increase in deaths caused by opioid overdoses, several federal and state regulations have been enacted. Each small square represents a component of the test used to interpret urinalysis. A physician, trained to objectively look for specific abnormalities symptoms, is generally the first step in. This article discusses methods of collecting and testing urine using reagent strips and provides a guide for interpreting the results. Urine drug testing is an important part of managing longterm opioid therapy.
Occasionally, it can be difficult to interpret a result as normal or abnormal based on the metabolites found in the urine. In this way, the remainder of the collected sample contents remains untouched by a potentially unsterile dipstick and so can be sent for laboratory analysis if required. Microbiology fact sheet urine mc interpretation of results. Hematuria is the most common cause of a positive test, although in some cases of hematuria intact rbcs will not be observed in the urine sediment because of hemolysis. To be effective, the test must be performed properly and the results. Sep 12, 2014 urinalysis is the most commonly performed biochemical test in infancy and early childhood. Take time to discuss unexpected results with the patient and refer to preudt information the patient. Measures the hydrogen ion concentration of the urine. The immunofixation urine test is a common test used when a doctor suspects an individual may have certain health conditions, including multiple myeloma and waldenstroms macroglobulinemia. Clear urine with a dipstick strongly positive for blood usually means myoglobinuria. The length of time a drug can be detected in the urine varies due to several factors. It is important that a fresh sample be used as urine becomes more alkaline over time as bacteria convert urea to ammonia which is very alkaline.
Urine dipstick testing ceconnection for allied health. List and describe at least 6 different associated urine tests. However, it is critical to remember that urine sediment examination remains a timehonored test that provides a wealth of information about the patients underlying kidney disease. Improper collection the problem of urine testing can often be the sample and its method of collection, storage and time interval before testing. Immerse the dipstick completely in the specimen of fresh urine. Broad spectrum urine toxicology screen january 2016 the broad spectrum urine toxicology screen provided by dynacare incorporates liquid chromatography and tandem mass spectrometry lcmsms for the targeted identification of sixty. Urine test urinalysis, types, procedure, and disease. Dip test strip into urine for not more than 1 second. Creatinine interpretation introduction in an effort to further enhance the reliability of analyzing urine specimens for drugs of abuse, redwood toxicology laboratory. Serum is placed on a specific medium, and a charge is applied.
The net charge positive or negative and the size and shape of the protein commonly are used in differentiating various serum proteins. Jul 04, 2018 various urine test types that are performed for various reasons in the quest to determine what is wrong with a patient. Gfr a blood test measures how much blood your kidneys filter each minute, which is known as your glomerular filtration rate gfr. Jan 01, 2019 urine drug testing is an important part of managing longterm opioid therapy. Urinalysis is a simple test that can provide important clinical information, has a quick turnaround.
Diabetic ketoacidosis can cause urine to have a fruity or sweet odor, and alkaline fermentation can cause an ammoniacal odor after prolonged bladder retention. Screening test for bacteriuria reflects presence of 105cfu of enterobacteriaceae per ml of urine relies on ability of gramnegative bacteria to convert nitrate nitrite false negative can occur 1. When withdrawing the strip wipe side edge of the test strip along the rim of vessel to remove excess urine. Explain the progressive nature of ckd and the basics. Use caution if a negative dipstick test results in a patient with symptoms of a uti dipstick is specific, but not very sensitive sensitivity related to bacterial load perform a urine culture tests specific gravity, ph, leukocyte esterase, nitrites, hemoglobin, protein, glucose, ketones, urobilinogen, bilirubin. Urine concentrations of nicotine and metabolites in these ranges indicate the subject is using tobacco or is receiving highdose nicotine patch therapy. Both parent drug and metabolites may be detected in urine specimens and are usually in higher concentrations than in blood or serum samples.
Benign prostatic hyperplasia bph a benign enlargement. Significant myoglobinuria can produce acute renal failure. Understand the role of urine drug screens in the monitoring of patients on opioids understand the role of urine drug screens for patient on opioid agonist treatment correctly interpret a variety of urine drug screen results. Urine toxicology use and interpretation kara lynch readonly. Interpretation of urinalysis results urinalysis is used as a screening andor diagnostic tool to detect substances or cellular material in the urine associated with metabolic disorders, renal dysfunction or urinary tract infections uti. Metabolite levels to detect potentially adulterated urine specimens are suggested. Prior studies indicate that family physicians sometimes misinterpret urine drug test results, and interpretation may be more complex when results include prescription medications. Combur10 test parameters how to do it collect urine sample in clean, sterile specimen container preferably a disposable cup. Interpretation of the results the results are obtained by direct comparison with the color.
The urine sample should be correctly obtained, agespecific aspects should be considered, and agedependent reference values should be used. Urinalysis urine test, ua simply means analysis of urine. It is commonly performed to determine if there is obstruction to normal urine outflow. He notifies you that he ate a poppy seed muffin for breakfast.
While hcg is a dependable marker of pregnancy, it cannot be identified till after implantation. How to correctly interpret a urine drug screen result. The final part of a short series on urinalysis interpretation, including microscopy of casts and crystals. In such cases, the microscopic analysis would be negative for rbcs. Causes of falsepositive and falsenegative urinalysis results dipstick test false. It is important that a fresh sample be used as urine becomes more alkaline over. Many false positive protein tests occur, especially with alkaline urine. Basic laboratory tests basic urine tests urinalysis test alternative names occurunits usual normal range examples of conditions in which abnormal values ph, urine ph ph units 4. Scroll down to read the article or download a printfriendly pdf here. First and foremost, you should ask yourself if the observed change is due to non. Markers used in this test are found in urine and blood which highlights pregnancy, and pregnancy tests need one of these substances.
Sep 30, 2015 the final part of a short series on urinalysis interpretation, including microscopy of casts and crystals. Urine drug screens can confirm whether patients on chronic opioids are using prescribed drugs and abstaining from illicit substances. Often, substances such as protein or glucose will begin to appear. Urine toxicology use and interpretation kara lynch read. Urine test definition, disease detection, and results. If you know what you are looking for order a test that looks for it specifically definitive testing. This test performs very favorably as a urinary biomarker for a number of acute kidney diseases.
As always, clinical judgment is necessary when interpreting test results. Urine may be assessed both at the bedside dipstick and in the laboratory microscopy, culture, sensitivity and urinary electrolytes. May be a significant colony count if patient has uti symptoms. Urinalysis is often done as part of a general health evaluation, but ua can also assist in the diagnosis or monitoring of a number of disorders or conditions. Definitive urine drug testing specifically identifies or. A small amount of protein normally is present in urine and may be detected in concentrated urine. When autoplay is enabled, a suggested video will automatically play next. Urine test strip is a narrow plastic strip which has several squares of different colors attached to it. With the recent increase in deaths caused by opioid overdoses, several federal and state regulations have been enacted that recommend or require urine drug testing in patients receiving longterm opioid therapy. Urine samples from patients with opioid use disorder are analyzed. Urine albumin a urine test checks for albumin in your urine.
A patient taking oxycontin is given a urine drug test. Urine drug testing is frequently used in clinical, employment, educational, and legal settings and misinterpretation of test results can result in significant adverse consequences for the. Results of clinical pathologic tests should always be interpreted with respect to what is known about the patient signalment, history, clinical signs, results of other diagnostic testing and should not be interpreted in isolation. Urine test results and interpretation when the results are abnormal, the doctor determines the next step based on various factors. As a screening test, the initial immunoassay is less sensitive and therefore must be interpreted in the. Mar 28, 2019 the gold standard method of testing is to remove a small volume of urine from the sterile container with a fresh sterile syringe, and then apply the removed urine to the dipstick.
Urine drug toxicology and pain management testing kara lynch, phd, dabcc university of california san francisco. Always wear gloves whilst messing about with another persons pee. Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is. This is a very commonly ordered test which is performed in many clinical settings such as physicians offices, hospitals, clinics, emergency departments, and outpatient laboratories. In this lecture material the routine urine test, physical. Values outside the reference range should be interpreted in context with the. The need for trained human resources in the field is, therefore, very essential not only for patient care but also for preventive measures. This video is meant to describe the different tests that are performed from a urine dipstick test. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Retention of urine in bladder test that provides valuable information.
Urinalysis is often done as part of a general health evaluation, but ua can also. Some of the medical conditions that can alter the normal flow of urine are. Previous diagnosis with urinary tract problems, kidney issues or any other related condition may result in further tests. Urine test types, procedure, preparation, results interpretation. The container must be clean, dry and free from contaminants eg, jam in jam jars, and the specimen must be collected correctly. Urine sediment examination in the diagnosis and management of. It seems to be a straightforward test, and most physicians think they are well versed in the interpretation of the results. Urine tests detect the protein, ketones, bilirubin, fungi, bacteria, white and red blood cells, urinary tract problems, sexually transmitted diseases as well determine the general health. Discuss unexpected results with the local laboratory or toxicologist if assistance is needed with interpretation. Urine strip test strips are for in vitro diagnostic use and c.