The Urine Microscopic: Microscopic Analysis of Urine Sediment
Continuing Education Credits
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.
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
- True or False: The volume of centrifuged urine and the amount of sediment used for microscopic examination should be the same for all persons performing urine microscopic examinations within a given laboratory.
- Casts
- Formation and Significance of Casts
- Factors Promoting Cast Formation
- Hyaline Casts
- Hyaline Casts: High Power
- Hyaline Casts: Phase-Contrast Microscopy
- Cellular Casts
- White Blood Cell Casts
- Red Blood Cell Casts
- Renal Tubular Epithelial Cell Casts
- Granular Casts
- Waxy Casts
- Fatty Casts
- Broad Casts
- Clinical Significance of Casts
- Which of the following are characteristics of casts?
- 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 Cells
- White Blood Cells
- WBC Clumps
- Red Blood Cells
- Crenated Red Cells
- Ghost Cells
- Distinguishing Between Red and White Blood 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 (400× 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 characteristics with the corresponding parasite:
- 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
- Normal Crystals
- Which of the following may be found in normal acidic urine?
- Which of the following may be found in normal alkaline urine?
- Match each of the crystals shown below that may be seen in normal urine with its characteristic identification.
- 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 description with the corresponding crystal:
- 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 Cells from White Blood Cells
- 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 distinguish between bacteria and amorphous urates. Which of the following reagents would dissolve the crystals?
- A medical laboratory technician is trying to enumerate red blood cells in sediment containing numerous fat droplets. Which of the following reagents would stain the fat droplets red-orange but not stain the RBCs?
- 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 laboratory technician students.
Author Information: Betty Smith, MLS(ASCP) and Kathleen Ann Foster, MS, MLS(ASCP)SM
Reviewer Information: Laurie Bjerklie, MA, MLS(ASCP)CM, is an Education 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 15 years
of experience in higher education and has held program director and faculty
positions in both MLT and MLS programs.
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. Students are assumed to have 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 specific 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.