6- Micro-examination: Casts

Question 1

Def: are cylindrical structures produced by the kidney and present in the urine in certain disease states.

Answer 1

Urinary casts

Question 2

Urinary Cast are formed Formed in lumen of the kidney, more specifically in

Answer 2

distal convoluted tubules and collecting ducts

(after the loop)

Question 3

Urinary Cast are form via precipitation of

Answer 3

Tamm-Horsfall mucoprotein

Question 4

Tamm-Horsfall mucoprotein is secreted by

Answer 4

renal tubule cells

Question 5

Casts can be cylindrical in shape with _____ edges

Answer 5

no dark

Question 6

To look for hyaline casts, it’s recommended to use

Answer 6

phase contrast microscopy

Question 7

RBCs cast

(picture)

Answer 7

Question 8

WBCs cast

(picture)

Answer 8

Question 9

Epithelial Cell Casts Consist only of

Answer 9

renal tubule epithelial cells

Question 10

Granular casts can result either from

Answer 10

breakdown of cellular cast

or

inclusion of aggregates of plasma proteins

or

immunoglobulin light chains

Question 11

Granular casts usually indicate

Answer 11

chronic renal diseases

Question 12

Granular Casts can be present for a short time after

Answer 12

strenuous exercise

Question 13

Granular Casts are divided to

Answer 13

coarse and fine granular casts

Question 14

Granular Casts

(picture)

Answer 14

Question 15

Waxy Casts with very low urine flow are associated with

Answer 15

longstanding kidney disease such as renal failure.

Question 16

Waxy casts also fall under the umbrella of

(what type of casts)

Answer 16

“broad” casts

Question 17

Fatty Casts is formed by the breakdown of

Answer 17

lipid-rich renal epithelial cells

Question 18

Fatty Casts are pesent in

Answer 18

degenerative tubular disease

Question 19

degenerative tubular disease includes

Answer 19

– nephrotic syndrome with heavy proteinuria

– diabetic nephropathy _{(diffuse glomerulosclerosis, Kimmelstiel–Wilson lesions)}

– lupus-nephritis

– toxic renal poisoning

Question 20

Mixed casts are

Answer 20

coarsely and finely granular stages in one granular cast can contains bacteria

Question 21

Mixed cell cast contains

Answer 21

more than one type of cell

Question 22

formation of casts at the distal convoluted tubule may produce structures with a tapering end, called

Answer 22

Cylindroids

Question 23

cylindroids have the same significance as _____

Answer 23

casts

Question 24

cylindroids have the same frequently as ____

Answer 24

hyaline

Question 25

how to differentiate mucus threads

Answer 25

Mucus is not birefringent , and has a low refractive index

present in normal urine in small numbers

Question 26

Unlike casts, fibers have ____ edges

Answer 26

Dark

Question 27

most of the fibers are

(shape)

Answer 27

flat

Question 28

Coarsely granular cast has a _______ outer boarder

Answer 28

very thin

Question 29

Hair has a ______ outer wall

Answer 29

very thick

Question 30

Type of yeast that may look like a cast

Answer 30

Candida albicans (Yeast infection)