6- Micro-examination: Casts Flashcards
Def: are cylindrical structures produced by the kidney and present in the urine in certain disease states.
Urinary casts
Urinary Cast are formed Formed in lumen of the kidney, more specifically in
distal convoluted tubules and collecting ducts
(after the loop)
Urinary Cast are form via precipitation of
Tamm-Horsfall mucoprotein
Tamm-Horsfall mucoprotein is secreted by
renal tubule cells
Casts can be cylindrical in shape with _____ edges
no dark
To look for hyaline casts, it’s recommended to use
phase contrast microscopy
RBCs cast
(picture)
WBCs cast
(picture)
Epithelial Cell Casts Consist only of
renal tubule epithelial cells
Granular casts can result either from
breakdown of cellular cast
or
inclusion of aggregates of plasma proteins
or
immunoglobulin light chains
Granular casts usually indicate
chronic renal diseases
Granular Casts can be present for a short time after
strenuous exercise
Granular Casts are divided to
coarse and fine granular casts
Granular Casts
(picture)
Waxy Casts with very low urine flow are associated with
longstanding kidney disease such as renal failure.
Waxy casts also fall under the umbrella of
(what type of casts)
“broad” casts
Fatty Casts is formed by the breakdown of
lipid-rich renal epithelial cells
Fatty Casts are pesent in
degenerative tubular disease
degenerative tubular disease includes
– nephrotic syndrome with heavy proteinuria
– diabetic nephropathy (diffuse glomerulosclerosis, Kimmelstiel–Wilson lesions)
– lupus-nephritis
– toxic renal poisoning
Mixed casts are
coarsely and finely granular stages in one granular cast can contains bacteria
Mixed cell cast contains
more than one type of cell
formation of casts at the distal convoluted tubule may produce structures with a tapering end, called
Cylindroids
cylindroids have the same significance as _____
casts
cylindroids have the same frequently as ____
hyaline
how to differentiate mucus threads
Mucus is not birefringent , and has a low refractive index
present in normal urine in small numbers
Unlike casts, fibers have ____ edges
Dark
most of the fibers are
(shape)
flat
Coarsely granular cast has a _______ outer boarder
very thin
Hair has a ______ outer wall
very thick
Type of yeast that may look like a cast
Candida albicans (Yeast infection)
