CAP Pro Course - Urinalysis - Microscopic Urinalysis Part 2 - Crystals and Casts

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Author: Marjorie Di Lorenzo, MT(ASCP)SH Reviewer: Rory Huschka, M.Ed., MT(ASCP) and Laurie Bjerklie, M.A., MLS(ASCP)CM

Continuing Education Credits

Objectives

  • Identify normal and abnormal urinary crystals and correlate abnormal crystals with clinical conditions.
  • Identify urinary casts and correlate with clinical diseases and conditions.
  • Discuss methods to reduce cast identification errors.

Course Outline

  • Identify normal and abnormal urinary crystals and correlate abnormal crystals with clinical conditions.
      • Crystal Formation and Identification
      • Normal Urine Crystals
      • Abnormal Urine Crystals
      • Additional Test Methods for Crystal Identification
      • What is the identity of the crystals in the image on the right? The pH of the urine specimen was 5.5.
      • Which of the following is not true about what contributes to urinary crystals formation?
      • Which of the following can be used to distinguish uric acid crystals from cystine crystals?
      • An 18-year-old cystic fibrosis patient arrives at the emergency room complaining of a fever. She has a history of recurring urinary tract infections w...
      • During his required athletic physical, a routine urinalysis was ordered on a 16-year-old male patient. The patient collected a random urine specimen. ...
      • A 65-year-old woman develops back and abdominal pain after eating dinner. The pain continued throughout the night, and she noticed blood in her urine....
      • A 65-year-old woman develops back and abdominal pain after eating dinner. The pain continued throughout the night, and she noticed blood in her urine....
      • A 7-year-old boy with a fever, sore throat, and abdominal pain was seen at the urgent care center. The doctor ordered a CBC and routine urinalysis. Th...
      • A routine urinalysis was ordered on a 16-year-old male patient during his required athletic physical. The patient collected a random urine specimen. T...
  • Identify urinary casts and correlate with clinical diseases and conditions.
      • Identification of Casts
      • Casts and Clinical Significance
      • Table 4. Characteristics and Clinical Significance of Casts
      • What cast is significant for differentiating between cystitis and pyelonephritis?
      • What type of cast is shown in the image on the right?
      • A 93-year-old man was taken to the emergency department with loss of appetite, headaches, itching, muscle cramps, and making little urine. Significant...
      • A 93-year-old man was taken to the emergency department with loss of appetite, headaches, itching, muscle cramps, and making little urine. Significant...
      • A 15-year-old girl is seen by her physician for back pain, fever of 102°F, fatigue, and frequent painful urination. She has a history of recurren...
      • A 23-year-old woman, a new hire at the hospital laboratory, had a routine urinalysis test ordered as part of her pre-employment physical. The results ...
      • A 15-year-old girl is seen by her physician for back pain, fever of 102°F, fatigue, and frequent painful urination. She has a history of recurren...
      • A 23-year-old woman, a new hire at the hospital laboratory, had a routine urinalysis test ordered as part of her pre-employment physical. The results ...
  • Discuss methods to reduce cast identification errors.
      • Correlation of Casts with Other Urinalysis Results
      • Microscopic Errors in Identification of Casts
      • The cast in the image on the right was observed during the microscopic examination of the urine sediment of a person after running a marathon. A few h...
      • What is the identity of the large structure indicated by the arrow in the image on the right?
      • Which of the following is used to differentiate between casts and fibers in a urine specimen?
      • A random urine specimen from a long-term care facility was received in the laboratory and refrigerated. The specimen was removed from the refrigerator...
      • An 8-year-old boy had recently been sick with a respiratory illness that included a sore throat and fever. The patient was not seen or treated for thi...
      • A 28-year-old woman was having her first prenatal checkup. In addition to a pregnancy test, the physician ordered a routine urinalysis. The results of...
      • A 50-year-old male patient with marked jaundice was seen in the emergency department. Blood tests and a routine urinalysis were ordered. The blood tes...
      • An 8-year-old boy had recently been sick with a respiratory illness that included a sore throat and fever. The patient was not seen or treated for thi...
      • An 8-year-old boy had recently been sick with a respiratory illness that included a sore throat and fever. The patient was not seen or treated for thi...
      • A 40-year-old woman was having pre-op laboratory work for an elective surgery. The results of the urinalysis were:TestResultReference ValueColorYellow...
  • 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 Di Lorenzo, MT(ASCP)SH is a medical technologist with 40 years of laboratory experience. She has assumed many roles in her career, first as a staff technologist and moving into roles of laboratory management and education in CLS and MLT programs. She is the co-author for several textbooks and articles on the topics of urinalysis and body fluids. Marjorie is currently the Phlebotomy Technician Program Coordinator at Nebraska Methodist College and an Adjunct Instructor in the Division of Laboratory Sciences at the University of Nebraska Medical Center, Omaha, Nebraska.
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 Clinical 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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