CAP Pro Course - Urinalysis - Microscopic Urinalysis Part 1

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Author: Marjorie Schaub Di Lorenzo, BS, MT(ASCP)SH
Reviewers: Rory Huschka, M.Ed., MT(ASCP) & Laurie Bjerklie, M.A., MLS(ASCP)CM

Continuing Education Credits

Objectives

  • Identify variables that can impact urine microscopic test results.
  • Describe microscopic techniques used in the examination of urine sediment.
  • Identify urine sediment constituents.
  • Correlate sediment constituents with physical and chemical results.
  • Identify potential sources of error in the identification of cellular elements in microscopic urine sediment analysis.

Course Outline

  • Identify variables that can impact urine microscopic test results.
      • Variables That Affect Microscopic Urinalysis Results
      • Variables That Affect Microscopic Urinalysis Results, continued
      • Microscopic Analysis: Microscope Slides
      • Which of the following results would occur in an unpreserved urine specimen that has not been tested for eight hours?
      • A new medical laboratory scientist's (MLS) semi-annual competency assessment included performing a manual microscopic examination of a urine specimen ...
      • A 65-year-old female patient was instructed to collect a clean-catch midstream urine specimen as part of a wellness physical and deliver it to the lab...
      • Which of the following can cause false-negative microscopic results?
      • Which of these procedures may decrease the reliability of a microscopic urine sediment report?
  • Describe microscopic techniques used in the examination of urine sediment.
      • Microscopic Examination of Urine Sediment: Staining Techniques
      • Microscopic Examination of Urine Sediment: Types of Microscopy
      • Which type of microscopy refracts light in two directions to stain birefringent substances?
      • The urinalysis supervisor was concerned with the variation in reporting urine constituents among the various technologists when analyzing the quality ...
      • A 93-year-old man with acute renal failure was seen in the emergency department. A battery of tests was ordered to include a routine urinalysis. Exami...
      • A recent MLS graduate was having difficulty focusing the microscope while performing a microscopic urinalysis. The results of the urinalysis are as fo...
  • Accurately identify urine sediment constituents.
      • Epithelial Cells
      • Table 4: Squamous and Transitional Epithelial Cells
      • Renal Tubular Epithelial Cells
      • Red Blood Cells (RBCs)
      • White Blood Cells (WBCs)
      • Bacteria, Yeast, and Parasites
      • Table 6: Bacteria, Yeast, and Parasites
      • What is the name of the cellular element seen in the two urine sediment images?
      • A newly hired medical laboratory scientist was viewing a urine specimen under the microscope that had already been reported earlier. They were to corr...
      • An 89-year-old man presented to the emergency department with symptoms of pneumonia. He was transferred to the ICU because of his stage 4 kidney disea...
      • A 16-year-old girl with symptoms of a lower urinary tract infection drank large amounts of water and cranberry juice. The symptoms worsened, causing h...
      • A 50-year-old woman presented with hematuria following the completion of running the New York marathon. No other symptoms were present. The microscopi...
      • An 89-year-old man presented to the emergency department with symptoms of pneumonia. He was transferred to the ICU because of his stage 4 kidney disea...
      • A 23-year-old female patient is seen in the urgent care center. She complains of vaginal itching and soreness. On pelvic examination, a white discharg...
  • Correlate sediment constituents with physical and chemical results.
      • Correlation of Microscopic Findings with Reagent Strip Results
      • A female patient presents with symptoms of vaginitis. Which of the following cells could you see in her urine sediment?
      • A 73-year-old man complained of fatigue, weight loss, lack of appetite, and lower abdominal pain. The patient stated that he has frequent urges to uri...
      • The results of a routine urinalysis on a urine specimen from an outpatient diagnosed with diabetes mellitus was as follows:Reagent strip results:TestR...
      • A 77-year-old woman was a resident of a long-term care facility. She seemed confused and complained of lower abdominal pain, dysuria, increased urinar...
      • A 77-year-old woman was a resident of a long-term care facility. She seemed confused and complained of lower abdominal pain, dysuria, increased urinar...
  • Identify potential sources of error in the identification of cellular elements in microscopic urine sediment analysis.
      • Potentially Confusing Cellular Elements in Urine Sediment
      • Potentially Confusing Artifacts in Urine Sediment
      • Round renal tubular cells can be very confusing to students and medical laboratory scientists. What cell are they most often confused with?
      • Observe the artifact in the image provided. What cellular constituent in the urine sediment could this be confused with?
      • An MLS is not sure if the constituents they are observing in this urine sediment are red blood cells or artifacts. The results of the routine urinalys...
      • The results of a routine urinalysis from a patient diagnosed with glomerular bleeding is as follows:Reagent strip results:TestResultReference ValueCol...
  • References
      • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: This program is designed as an educational and training tool for MLS, MT, and MLT personnel, medical laboratory science students and interns, pathology residents, and practicing pathologists.
Author: Marjorie Schaub Di Lorenzo, BS, MT(ASCP)SH is the Phlebotomy Technician Program Director in the Health Professions Department at Nebraska Methodist College and an Adjunct Instructor in the Division of Laboratory Sciences at the University of Nebraska Medical Center, Omaha, Nebraska. She has also co-authored several books on the topics of urinalysis and body fluids.
Reviewer Information: Rory Huschka, M. Ed., MT(ASCP), has over 20 years of experience as a medical technologist, technical supervisor, professor, and manager. He is the former Director of Medical Laboratory Science and Medical Laboratory Technician Programs at Brookline College. He is currently a Program Director at MediaLab, Inc. Rory holds a BS degree in Medical Technology from North Dakota State University and a Masters in Educational Leadership from Argosy University.
Reviewer Information: Laurie Bjerklie, M.A., MLS(ASCP)CM is currently a Content Developer for MediaLab and LabCE. She earned a B.S. in Medical Laboratory Science from the University of North Dakota and an M.A. in Curriculum and Instruction from Saint Xavier University. She has over 14 years of experience in higher education and has held faculty positions in both MLT and MLS programs. She most recently served as the Program Manager of Medical Laboratory Science at Saint Louis University.

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