LABORATORY 5: The Complete Urinalysis
Notes
1. This lab combines the objectives and activities of the macroscopic and microscopic lab activities. Students
are expected to review those labs for reference.
2. Students are expected to review the corresponding information in the course textbook(s) as well as the
classroom notes in preparation for this lab and to aid in answering the study questions.
Points Points are awarded for prelab assessments, skills, as well as successful and timely completion of
study questions.
Objectives
According to the standards set by the instructor, the student will be able to:
1. perform complete routine urinalysis on five specimens within the level of accuracy determined in the
macroscopic and microscopic labs.
2. recognize abnormal dipstick and microscopic results as have been outlined in previous lab exercises.
3. record results accurately.
4. analyze quality control results to determine quality control acceptability.
Purposes of testing
Routine complete urinalysis is done for a number of reasons:
1. Screen for asymptomatic, congenital, and inherited diseases such as diabetes mellitus, galactosemia, renal
and liver disease.
2. To aid in diagnosis of diseases such as urinary tract infections, diabetes, and types of jaundice.
3. To determine the progress of a disease and the effectiveness of treatment.
Equipment and Supplies
1. Appropriate urine dipstix (Multistix)
2. Urine specimens (5 or more)
3. Centrifuge, Centrifuge tubes & racks
4. Microscope
5. Sharpie marker, Kim-wipes, microscope slides and cover glasses.
6. Color reference pictures of urinary sediment-textbook.
Trouble-shooting correlation discrepancies
There are many possible reasons that a specimen’s physical/chemical characteristics do not correlate with the
microscopic results. Among the first thing to be considered is a mix-up in samples where the microscopic was
not performed on the same sample as the physical and/or chemical analysis. Another possibility to consider is
deterioration in the sample. This is most commonly seen when there is a significant lag period between the
different phases of testing or if the sample is very alkaline. Regardless of the reason, the best course of action
is to recollect the sample and repeat the testing ASAP.
Procedures
Refer to UA Macroscopic and Microscopic labs for specific procedures.
Follow the “Urinalysis Reporting Standardization Guide” to appropriately report results using blue or
black ink. Result forms not using appropriate format will have a 50% penalty assessment.
RECORDING RESULTS
Record all results in appropriate place. Use appropriate format for recording patient and performance control
results on the report form provided. Result forms not using appropriate format will have a penalty and may be
completely rejected! See example report form in Lab Exercises 2 & 3.
 Recording of any laboratory result MUST be in black or blue ink.
 Acceptable recording for positive results: Positive OR Pos
 Acceptable recording for negative results: Negative OR Neg
 Other results are to be as indicated on the manufacturer’s chart or by the instructor’s direction.
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MLAB 1311 UA/BF Laboratory Exercise 5
Revised 9/3/2015
URINALYSIS REPORT SHEET
XYZ Medical Clinic
2243 Round Rock Road
Austin, Texas 78701
Name ____________________________________ Date ________________
Control 1 Lot # ____________
Control
1
Control 1 Exp Date__________
Control 1
expected
results
Control
2
____/10 points
Control 2
expected results
Control 2 Lot # ___________
Control 2 Exp Date_________
Multistix:
Glucose
Negative
100-1000 mg/dL
Trace – 3+
Bilirubin
Negative
Small – Large
Ketones
Negative
5 – 160 mg/dL
Trace – Large
Within Range?
Yes or No
(If No, must bring to
instructor’s attention and
add a comment - as to
course of action.)
Whether yes or no, you
must include your
initials!
Lot#:
Exp Date:
Sp. Gravity
1.010-1.025
1.005 – 1.020
Negative
10 – 200 cells/uL
Trace – Large
5.0-6.5
7.0 – 9.0
Negative
Trace ->= 300 mg/dL
Trace – 3+
0.2 mg/dL
2 – 8 mg/dL
Nitrite
Negative
Positive
Leukocyte
Esterase
Negative
Trace - Large
Blood
pH
Protein
Urobilinogen
Controls performed by:
Date:
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MLAB 1311 UA/BF Laboratory Exercise 5
Revised 9/3/2015
XYZ Medical Clinic, Austin, Texas 78701
Specimen
Student Name __________________________ Date _________________
1
2
3
4
____ / 25 points
5
Patient Name
Patient ID #
Physical
Properties
Color
Transparency
Specific Gravity
Refractometer
Multistix 10SG:
Lot#:________
Exp Date: _____
(Results read at
differing intervals.
Leukocytes read
positive at 60
seconds, make
final determination
at 120 seconds.)
Glucose (mg/dL)
Bilirubin (negative)
Ketone (mg/dL)
Specific Gravity
Blood (negative)
pH (5.0 – 6.5)
Protein (mg/dL)
Urobilinogen (mg/dL)
Nitrate (negative)
Leukocyte (negative)
Microscopic
(With the
exceptions of Casts
and Mucous, all
microscopic
elements are
quantified under
hpf.
Elements listed in
‘Other’ must be
identified as well
as quantified.)
WBC (hpf)
RBC (hpf)
Squamous epi (hpf)
Other epi (hpf)
Bacteria (hpf)
Crystals (hpf)
Mucus (lpf)
Casts (lpf)
Other
Back-up / Confirmatory Tests
(Identify which, if any, confirmatory tests to
be performed on this sample.)
Testing performed by:
Date:
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MLAB 1311 UA/BF Laboratory Exercise 5
Revised 9/3/2015
Exercise #5: Study Questions
Student Name ______________________ Date _____________________ ____ / 30 points
Instructions: Answer the following questions using related lecture notes and textbook reading assignments.
Each question is worth one point unless otherwise stated.
1. A yellow-brown urine which produces yellow foam when shaken can be suspected of containing what
substance?
2. The technician refrigerates a yellow, clear freshly voided urine specimen. Several hours later she retrieves
the sample for testing, but sees white turbid sediment in the bottom of the cup. Upon testing, the sample
is noted to have a pH of 7.5. Which of the following is the most likely reason for the turbid sediment?
A.
Uroerythrin
B.
Many WBCs
C.
Few triple phosphate crystals
D.
3+ amorphous phosphate crystals
E.
4+ amorphous urate crystals
3. A urine sample has a specific gravity of 1.035. What normal color would you expect it to be?
4. What is the name of the gelatinous - like substance makes up the matrix of casts?
5. What is the most frequently found cast?
(2 points)
6. RBC casts often have serious diagnostic implications. What two (2) minimum criteria should be met
before calling a structure an RBC cast?
7. Finding WBC casts is primarily associated with what condition?
8. What type of epithelial cell is found in an epithelial cell cast?
9. List two (2) structures that usually accompany a fatty cast?
10. What two (2) types of casts are most often associated with ‘chronic renal failure’?
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MLAB 1311 UA/BF Laboratory Exercise 5
Revised 8/3/15
11. The following terms are common or trivial names sometimes given to common urine crystals. For each
one, indicate the correct or reportable name and indicate whether it is most commonly associated with an
acid or alkaline environment. In the third column, indicate whether or not this crystal is considered
pathological – keeping in mind that nearly all crystals have been associated with the formation of kidney
stones. (12 total pts)
You must correctly complete all parts of the row for credit.
Trivial name
Reportable name
(1 pt each)
Normally found in
ACID / ALKALINE?
(1/2 point each)
Considered pathological?
YES / NO?
(1/2 point each)
Brick dust
Thorn apples
Envelopes
Coffin lids
Dumbbells
Notched plates (with 90
degree corners)
12. List three (3) crystals that are NEVER found in normal urine in any amount. (3 points)
13. Which
A.
B.
C.
D.
of the following abnormal crystals is NOT associated with severe liver disease?
Leucine
Tyrosine
Cystine
Bilirubin
14. I am a substance that can form a huge amount of precipitate in the urine of a patient who has recently
undergone kidney x-ray. I will cause of the specific gravity reading to be incredibly high if it is measured
with a refractometer. I am not pathological, but my structural appearance is sometimes confused with a
pathological crystal.
1. Who am I? ___________________________
2. What pathological crystal do I look like? ___________________________________
15. What are oval fat bodies?
16. What is the significance of finding oval fat bodies?
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MLAB 1311 UA/BF Laboratory Exercise 5
Revised 8/3/15