UNIVERSITY OF MICHIGAN HEALTH
SYSTEM
DEPARTMENT OF PATHOLOGY
POINT OF CARE SERVICES
MICROSCOPIC URINALYSIS:
PROVIDER PERFORMED
PRINCIPLE:
Microscopic urinalysis is a microscopic review of urine sediment. Identification
of elements present include casts, cells, crystals, microorganisms,
mucus, spermatozoa and artifacts.
Identification of urinary elements assist in the diagnosis of disease
states manifested in the kidneys, bladder, and genitourinary tract.
COMPUTER CODE: PPM UA
SPECIMEN AND STORAGE:
• Collect a random urine sample from the patient for testing.
• Test within one hour, or store refrigerated (2-8°C) until
testing can be performed Bring to room temperature before testing. Testing
must be done within 6 hours of collection.
MATERIALS:
• Patient specimen
• Centrifuge
• Microscope with 10X and 40X objectives
• Gloves, 12 mL conical tube, slide and coverslip, pipette
PROCEDURE:
1. Fill a centrifuge tube with 12 mL urine. A minimum of 2 ml. may be
used if only a small amount is received.
2. Centrifuge urine for 3 minutes at 3000 - 3500 RPM.
3. Decant the liquid part of the specimen leaving the sediment intact
in the bottom of the tube.
4. Tap the tube to mix sediment.
5. Place a small drop of urine sediment on a clean glass microscope
slide and cover with a clean coverslip.
6. Examine the specimen on low power, (10X) for casts, epithelial cells,
mucous and crystals. Scan 8-10 fields with reduced light.
7. Examine the specimen on high power, (40X) for RBC's, WBC's and microorganisms.
Scan 8-10 fields with bright light.
8. Report elements as normal, occ, few, moderate or many. Refer to Urinalysis
Reporting Chart below.
URINALYSIS REPORTING CHART:
| |
ELEMENT |
REPORT |
| LOW POWER |
Epithelial cells |
Occ, Few, Mod, Many |
| |
Mucous |
Occ, Slt, Mod, Much |
| |
Casts |
Occ, (0-3), (3-5), (5-10), (10-25), (25-50) |
| |
Large crystals |
Few, Mod, Many |
| HIGH POWER |
RBC, WBC |
Occ, (0-3), (3-5), (5-10), (10-25), (25-50),
(50-75), (75-100), (>100) |
| |
Small crystals |
Few, Mod, Many |
| |
Clue cells, Bacteria, Sperm,
Trichomonas, Yeast |
Few, Mod, Many |
| |
|
|
| |
|
|
| |
|
|
| NORMAL RANGE: |
| Few(0-3)/LPF: |
Epithelial Cells
Mucous
Casts
Crystals: amorphous urates, uric acid, ammonium biurate, calcium
oxalate,
triple phosphate, amorphous phosphates |
RBC – (0-3)/HPF
WBC –(0-3)/HPF |
|
LIMITATIONS:
The volume and concentration of the urine obtained will cause results
to vary. For best results, collect at least 12 mL from a first morning
urine.
REFERENCES:
Urinalysis Today. Boehringer Mannheim Diagnostics.;
Chemstrip 10 with SG Package Insert. Roche Diagnostics Corporation,
Indianapolis, IN, 1999. www.roche.com
| Supervisor Review/Revisions: |
Date: |
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