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Operations Directorate, Health Branch

Immigration Medical Examination Instructions

Subject
Urinalysis Instructions for evaluating and reporting urine results in the context of the
Canadian immigration medical examination (IME).

Goal/Objective
These instructions are provided to ensure that panel physicians (PPs) follow a
consistent and appropriate process for the following:
• reporting of the urinalysis and
• c ompletion and grading of an IME for a client with abnormal urinalysis
findings.

Instructions
Although a urinalysis has always been included in the IME, with the
implementation of eMedical, the IME form (IMM5419 Laboratory Requisition
and Report) has led to some changes in the way the urinalysis is conducted and
reported.
A urinalysis is mandatory for all clients above the age of 5 years. For children
under the age of 5, a urinalysis is required if they present with history of diabetes,
hypertension, kidney disease or symptoms of urinary tract infection. The urinalysis
can be performed either by dipstick or microscopy.

Additional Investigation
Dipstick:  If any of the fields (blood, protein or glucose) = +2 or +3 then a
mandatory repeat microscopy urinalysis (where available) is required.
If microscopy is not available, a repeat dipstick will be accepted.
Microscopy: I f any of the fields (blood, protein or glucose) are abnormal then
a repeat microscopy is required. Microscopy should be reported as
abnormal in the following cases:
-- protein is greater than 0.30 mg/L
-- RBC above 10 RBC/HPF
-- glucose is present
If repeat urinalysis (dipstick or microscopy) is abnormal, then serum creatinine is
mandatory.

Reporting
• Abnormal results of initial testing must be attached to the IME.
• All reports of repeat testing (including serum creatinine if available) must

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Operations Directorate, Health Branch
Immigration Medical Examination Instructions

be attached to the IME.


Urinalysis Grading
All IMEs must be B graded if the repeat urinalysis results are abnormal.

Urinalysis IMEI
ALGORITHM Algorithm

Urinalysis
(all clients ≥ 5 years and ≤ 5 years with history of diabetes, hypertension,
kidney disease or symptoms of urinary tract infection)

Normal Abnormal dipstick


(2+ or 3+ blood, protein or glucose)
or
Abnormal microscopy

Repeat urinalysis
non

oui
Nouvelle analyse
Result should be no d’urine
reported on IME. Abnormal?
Actual laboratory
report not required. Résultats
yes
anormaux?

oui
Serum creatinine
Analyse de la
créatinine sérique

Mandatory
attachments:
all laboratory
reports

Continue IME

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Operations Directorate, Health Branch
Immigration Medical Examination Instructions

References
Urinalysis http://www.lifelabs.com/lifelabs_bc/patients/medicalconditions/urinalysis.asp

HB Approval and Authority


Director General, NHQ, Health Branch, CIC

Implementation Date
2012/11/01

Revision Date(s)
2013/11/01