CAP Pro Course - Urinalysis - Microscopic Urinalysis Part 1 (2025 & 2026)

Author: Marjorie Schaub Di Lorenzo, BS, MLS(ASCP)SH
Reviewers: Joshua J. Cannon, MS, MLS(ASCP)CMSHCM and 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
      • A 20-year-old female patient with symptoms of a urinary tract infection visited her OB/GYN doctor. The doctor ordered a routine urinalysis with a urin...
      • A new employee is being trained on an automated urinalysis system that performs both the chemical and microscopic portions of the urinalysis. The qual...
      • A laboratory procedure for the preparation of urine samples for microscopic analysis states that following centrifugation, the sample should be decant...
      • A 20-year-old female patient with symptoms of a urinary tract infection visited her OB/GYN doctor. The doctor ordered a routine urinalysis with a urin...
      • A routine urinalysis was a mandatory component of a new employee’s physical requirement. The laboratory performed a manual chemical and microsco...
  • 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
      • The following cell was seen in the urine sediment of a 91-year-old man with stage 4 kidney disease. To confirm the identification of the cell, the med...
      • A urine sample from a patient with known nephrotic syndrome is received in the laboratory for chemical and microscopic examination. The technologist o...
      • Which of the following can be used to differentiate among red blood cells, yeast, and oil droplets?
      • What can cause a medical laboratory scientist to report a falsely decreased number of urine sediment constituents?
      • A 40-year-old man with inflammation of the renal interstitium is seen by his physician. The physician orders a routine urinalysis with microscopic exa...
  • 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
      • A 20-year-old woman had symptoms of dysuria, vaginal itching, and a white, curd-like discharge. She had recently completed two regimens of broad-spect...
      • The urine sediment of a patient following catheterization contained many of the cells in the image. What is the identification of the cells in this cl...
      • When performing a microscopic analysis, what type of white blood cell (WBC) might be confused with red blood cells (RBCs) in the urine sediment?
      • What is the predecessor of the oval fat body?
      • What condition would be indicated by the observance of the red blood cells in the image?
  • Correlate sediment constituents with physical and chemical results.
      • Correlation of Microscopic Findings with Reagent Strip Results
      • A 25-year-old female patient with symptoms of a urinary tract infection (UTI) was seen at her physician’s office. The physician ordered a routin...
      • A 68-year-old man with symptoms of a urinary tract infection visited the urologist. The doctor ordered a routine urinalysis with reflex to culture and...
      • A urinalysis is ordered on a 33-year-old woman with symptoms of urinary tract infection. The reagent strip test results are as follows:TestResultRefer...
      • What else should the medical laboratory scientist look for in a urine sediment when 25-30 WBCs/hpf are already counted in the microscopic examination?
      • A 62-year-old woman presents with symptoms of a urinary tract infection. A routine urinalysis with reflex to urine culture was ordered by the physicia...
  • 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
      • The core lab service leader was asked to review an unusual constituent from a urine sample received from the physician’s clinic. The results of ...
      • A specimen forwarded to the laboratory for routine testing has negative results on all the chemical strip tests, with the exception of a 1+ protein. M...
      • The medical laboratory scientist trainee received a sample from the walk-in clinic. What can they conclude based on the representative image to the ri...
      • A new employee was having difficulty keeping all of the urine sediment constituents in focus at the same time while using the microscope during a micr...
      • A few structures are noted in urine sediment that resemble white blood cells (WBCs). However, characteristics of the structures do not exactly identif...
  • References
      • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: This program is designed as an educational and training tool for MLS and MLT personnel, medical laboratory science students and interns, pathology residents, and practicing pathologists.
Author Information: Marjorie Schaub Di Lorenzo, BS, MLS(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:
Joshua J. Cannon, MS, MLS(ASCP)CMSHCM received his Bachelor of Science and Master of Science in Medical Laboratory Science from Thomas Jefferson University in Philadelphia, PA. He holds Medical Laboratory Scientist and Specialist in Hematology certifications through the ASCP Board of Certification. He was a professor at Thomas Jefferson University for seven years before transitioning into his current role as an Education Developer. His areas of expertise and professional passions include clinical hematology and interprofessional education.
Laurie Bjerklie, M.A., MLS(ASCP)CM, is currently an Education Developer. 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.

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