The Urine Microscopic: Microscopic Analysis of Urine Sediment

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Authors: Betty Smith, MT(ASCP); Kathleen Ann Foster, MS, MT(ASCP) SM
Reviewer: Laurie Bjerklie, MA, MLS(ASCP)CM

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 MLS / MLT students.

Continuing Education Credits

Objectives

  • Explain the importance of the microscopic examination.
  • Describe the correct preparation of the urine sediment.
  • Recognize cells, casts, bacteria, yeast, crystals, and other structures that may be present in urine sediment.
  • Recognize artifacts in urine sediment and distinguish from significant findings.
  • Correlate microscopic findings with urine reagent strip findings.

Course Outline

  • Introduction to the Urine Microscopic
      • Course Introduction
  • Specimen Collection and Preparation
      • Urine Specimen Collection
      • Specimen Collection and Storage
      • Steps in Preparing a Concentrated Urine Sediment
      • Microscopic Examination of Urine Sediment
      • The volume of urine that is centrifuged and the amount of sediment that is used for microscopic examination should be the same for all persons perform...
  • Casts
      • Formation and Significance of Casts
      • Factors Promoting Cast Formation
      • Hyaline Casts
      • Hyaline Casts: High Power
      • Hyaline Casts: Phase-Contrast Microscopy
      • Cellular Casts
      • White Cell Casts
      • Red Cell Casts
      • Renal Tubular Epithelial (RTE) Cell Casts
      • Granular Casts
      • Waxy Casts
      • Fatty Casts
      • Broad Casts
      • Table: Clinical Significance of Casts
      • Which of the following are characteristics of casts? (Choose all that apply.)
      • All of the following factors promote cast formation except:
      • Match the following descriptions with the casts they describe.
  • Cellular Elements
      • Cell Types Observed in Urine Sediment
      • Squamous Epithelial Cells
      • Squamous Epithelial Cells: Phase-Contrast Microscopy
      • Transitional Epithelial Cells
      • Renal Tubular Epithelial (RTE) Cells
      • White Blood Cells (WBCs)
      • WBC Clumps
      • Red Blood Cells (RBCs)
      • Crenated Red Cells
      • Ghost Cells
      • Distinguishing Between Red and White Cells
      • Characteristics of Cellular Elements
      • Which of the following are characteristic of normal RBCs when viewed microscopically?
      • All of the following are characteristic of WBCs under high power (400X magnification) brightfield microscopy except that they:
  • Bacteria, Yeast, and Parasites
      • Yeast
      • Bacteria
      • Parasites
      • Trichomonas: Phase-Contrast Microscopy
      • Enterobius vermicularis: Phase-Contrast Microscopy
      • Match the following:
      • Which of the following helps to distinguish yeast from red blood cells (RBCs) when performing a microscopic examination of urine sediment?
  • Common Crystals
      • Crystals
      • Identification of Crystals
      • Table: Normal Crystals
      • Which of the following may be found in normal acidic urine? (Choose all that apply.)
      • Which of the following may be found in normal alkaline urine? (Choose all that apply.)
      • Match each of the crystals shown below that may be seen in normal urine with its identification from the drop-down box.
  • 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 abnormal crystals may indicate liver disease?
      • Match the following:
      • True or False: This slide shows 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.
  • Artifacts in Urine Sediment
      • Introduction to Artifacts in Urine Sediment
      • Oil or Fat Droplets
      • Air Bubbles
      • Starch Granules
      • Fibers
      • True or False: The structure indicated by the arrow is a fiber and would not be reported.
  • Miscellaneous Elements
      • Sperm
      • Mucous Threads
      • Mucous Threads: Phase-Contrast Microscopy
      • True or False: Hyaline casts are present in this urine sediment microscopic field.
  • Distinguishing Structures That May Be Confused With Each Other
      • Introduction to Distinguishing Similar Elements
      • Distinguishing Yeast from Red Blood Cells
      • Distinguishing Renal Tubular Epithelial (RTE) Cells from White Blood Cells (WBCs)
      • Bacteria and Amorphous Material
      • Fat Droplets and RBCs
      • Starch Granules and Urinary Crystals
      • Distinguishing Eosinophils from Neutrophils
      • Iodine will confirm the presence of:
      • A urine specimen was delayed in transport to a medical laboratory. Upon examination of the urine sediment, the medical laboratory scientist cannot dis...
      • A medical laboratory scientist is trying to enumerate red blood cells in sediment containing numerous fat droplets. Which of the following reagents wo...
  • Correlation of Microscopic and Macroscopic Results
      • Correlation of Results
  • References
      • References

Additional Information

Level of Instruction: Basic
Intended Audience: Medical laboratory and other healthcare personnel who perform microscopic analysis of urine sediment. This course is also appropriate for medical laboratory science and medical laboratory technician students. 
Author Information: Betty Smith MT (ASCP), Kathleen Ann Foster, MS, MT(ASCP) SM
Reviewer Information: Laurie Bjerklie, M.A., MLS(ASCP)CM is currently a Content Developer for MediaLab and LabCE. She has been in higher education for over 14 years, has been a professor in both MLT and MLS programs, and has served as a Program Director.
Course Description: This course was adapted by MediaLab, under license from Education Materials for Health Professionals, Inc. Dayton, OH, 45420. Copyright EMHP. This course covers the basics of urine 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 dipstick 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 medical laboratory scientist.
 

This course is part of:
Compliance & CE
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