The Urine Microscopic: Microscopic Analysis of Urine Sediment
Betty Smith, MT(ASCP); Kathleen Ann Foster, MS, MT(ASCP) SM
This richly illustrated course discusses entities that could be observed in urine sediment, including casts, cellular elements, and crystals. The student will learn to distinguish significant findings from normal findings or artifacts and review the biochemical results that correlate with specific sediment constituents. This course is an excellent review of urine microscopic procedures for clinical laboratory scientists and CLS students.
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Continuing Education Credits
Objectives
- Explain the importance of the microscopic examination.
- Describe the correct preparation of the urine sediment.
- Describe an appropriate system for examining urine microscopics using brightfield and phase microscopy.
- Explain the system for quantitating and reporting urine microscopics according to the information in this unit.
- Correlate microscopic findings with macroscopic findings to determine if results can be reported or should be rechecked or referred.
- Describe or perform biochemical tests for the following:
- Red blood cells
- Yeast
- White blood cells
- Cuboidal epithelial cells
- Amorphous crystals
- Bacteria
- Fat
- Talc
Course Outline
Click on a link in the outline to view a sample page from this course.
- Introduction to the Urine Microscopic
- Specimen Collection and Preparation
- Casts
- Formation and Significance of Casts
- Factors Promoting Cast Formation
- Hyaline Casts
- Hyaline Casts Under High Power
- Hyaline Casts
- Cellular Casts
- White Cell Casts
- Red Cell Casts
- Red Cell Cast Under High Power
- Renal Tubular Epithelial Cell Casts
- Renal Tubular Epithelial Cast Under High Power
- Granular Casts
- Coarse Granular Casts
- Fine Granular Casts
- Waxy Casts
- Fatty Cast
- Broad Cast
- Cylindroids
- Squamous Epithelial Cell
- Recognition and Identification
- Which of the following are characteristics of casts?
- All of the following factors favor cast formation except:
- Match the following:
- Match the following:
- Cellular Elements
- Cells Types Observed in Urine Sediment
- Squamous Epithelial Cells
- Squamous Cells Under High Power
- Squamous Cells Under Phase Contrast
- Renal Tubular Epithelial Cell
- Renal Epithelial Cells of Collecting Duct Origin
- Cuboidal Cells
- Renal Epithelial Fragments
- Transitional Epithelial Cells
- Epithelial Cell Groups
- Urine Sediment
- White Blood Cells Under Phase Contrast and High Power Magnification
- Large Clumps of White Cells
- Red Blood Cells
- Red Cells Under Brightfield Microscopy and High Power Magnification
- Red and White Cells
- Crenated Red Cells
- Swollen RBCs
- Ghost Cells
- Ghost Cells under Phase Contrast
- Yeast
- Bacteria
- Bacteria Under Phase Contrast
- Characteristics of Cellular Elements
- The different types of epithelial cells include:
- Which of the following are characteristic of normal RBCs under high power (40x) brightfield microscopy?
- In concentrated urine RBCs may appear:
- All of the following are characteristic of WBCs under high power (40x) brightfield microscopy except that they:
- Common Crystals
- Crystals
- Identification of Crystals
- Normal Crystals
- Crystals in Normal Acid Urine
- Uric Acid Crystal Morphology
- Calcium Oxalate Crystals
- Amorphous Urates
- Crystals in Normal Alkaline Urine
- Calcium Carbonate Crystals
- Ammonium Biurate Crystals
- Review of Common Crystals
- Which of the following may be found in normal acid urine?
- Which of the following may be found in normal alkaline urine?
- Please identify these crystals.
- Please identify these crystals.
- Please identify these crystals occurring in acid urine.
- Please identify these crystals.
- Please identify these crystals.
- Please identify these crystals.
- Abnormal Crystals
- Abnormal Crystals
- Crystals of Clinical Significance
- Leucine Crystals
- Tyrosine Crystals
- Cystine Crystals
- Cholesterol Crystals
- Bilirubin Crystals
- Summary of Abnormal Crystals
- Which of the following pairs of abnormal crystals may appear together?
- Match the following:
- True or false? This slide show tyrosine crystals.
- True or false? This slide shows leucine crystals.
- True or false? This slide shows cholesterol crystals.
- True or false? This slide shows leucine crystals.
- True or false? This slide shows cholesterol crystals
- Miscellaneous Structures
- Introduction
- Parasites
- Trichomonas under Phase-Contrast
- Trichomonas versus White Cells
- Enterobius Vermicularis Pinworm Ova
- High Power of Enterobius vermicularis Ova
- Phase-Contrast of Enterobius vermicularis
- Schistosoma Haematobium Ova
- Sperm
- Sperm Under Phase-Contrast
- Oval Fat Bodies
- Oil or Fat Droplets
- Mucous Threads
- Mucous Threads Under Phase Contrast
- Contaminants and Artifacts
- Air Bubbles
- Coverslip Defects
- Coverslip Scratches
- Starch Granules
- Match the following:
- Which of the following are artifacts often confused with urinary elements? (Choose ALL of the correct answers.)
- True or false? This slide shows Enterobius vermicularis (pinworm).
- True or false? This slide shows coverslip defects.
- True or false? This slide shows oval fat bodies.
- True or false? This slide shows fat droplets.
- True or false? This slide shows mucous.
- True or false? This slide shows sperm.
- True or false? This slide shows Schistosoma haematobium ovum.
- True or false? This slide shows only fiber.
- True or false? This slide only shows fiber.
- True or false? This slide shows coverslip defects.
- True or false? This slide shows coverslip scratches.
- True or false? This slide shows fat droplets.
- Identifying Elements with Biochemical Tests
- Introduction
- Red Blood Cells versus Yeast
- Lysis of Red Blood Cells with Acetic Acid
- White Blood Cells versus Cuboidal Epithelium
- White Blood Cells versus Cuboidal Epithelium
- Bacteria and Amorphous Material
- Amorphous Urates
- Fat Droplets
- Starch Materials
- Supravital Stains
- Sternheimer-Malbin Stain
- Staining Eosinophils
- Iodine will confirm the presence of:
- A urine specimen was delayed in transport to a medical laboratory. Upon examination of the urine sediment, the technologist cannot distinguish between...
- A technologist is trying to enumerate the number of fat droplets in a urine sediment which also contains numerous red blood cells. Which of the follow...
- A 10% solution of acetic acid can be used to differentiate what from red blood cells?
- Quantitating the Urine Microscopic
- An Introduction to Quantitating the Urine Microscopic
- Looking for Casts
- Counting Elements
- Estimating Elements
- True or false? You scan for casts by examining the edges of the coverslip under high-power phase contrast.
- Match the following.
Note: Answers may be used more than once.
- An element fills, on average, about 1/4 of a high power field. This is estimated as:
- Correlation of Microscopic and Macroscopic Results
- Correlation of Results
- Urinalysis Reports
- Specimen #1 - Adult Female
- Specimen #2 - Adult Male
- Specimen #3 - Adult Female
- Specimen #4 - Adult Male
- Specimen #5 - Female Child
Additional Information
Level of instruction: Basic
Intended Audience: Clinical Laboratory Science Students, and medical technologists and technicians seeking review or continuing education opportunities. It is also appropriate medical students, pathology residents, and pathologists.
Course Description: This course covers the basics of urinalysis microscopic examination, including numerous brightfield and phase contrast images of urinary sediment elements. It is assumed that students have a basic knowledge of urinalysis macroscopic and dip stick examination. The course covers specimen collections and processing, casts, cellular elements, normal and abnormal crystals, parasites, artifacts, and basic biochemical tests to help identify certain elements. It describes a method of quantitation of urine specimens, and emphasizes the intelligent correlation of macroscopic and microscopic results, by the reported technologist.
About the Course: This course is part of a series of courses adapted for the web by MediaLab, under license from Education Materials for Health Professionals, Inc. Dayton OH, 45420. Copyright EMHP.
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