CAST Flashcards
Excretion of cast is termed as
Cylinduria
cast is primarily formed in
DCT & CD
Colorless and Translucent; SUBDUED LIGHT is required when using BF microscope
HYALINE CAST
Most fragile; Orange-red color, seen in Glomerulonephritis, Strenuous excercise
RBC cast
Muddy or Brown cast, contains hgb from lysed RBCs
Blood cast or Hemoglobin cast
how to differentiate RTE cast from WBC cast
Phase Microscopy and Supravital stain
seen in lOWER UTI clumped of leukocyte, should not be reported as cast
Pseudoleukocyte cast
Significant in Advanced tubular destruction and Tubular damage; use supravital stain
Epithelial (RTE) cast
granules derived from LYSOSOME of RTE cells, disintegrate when cast is retained in the tubule, SANDPAPER APPEARANCE
Granular (Course and Fine) cast
Significance of granular cast: ‘‘Py G S S’’
Pyelonephritis, Glomerulonephritis, Stress, Strenuous excercise
Brittle highly refractile w/ jagged ends, tend to look like paraffin shavings sitting o top of urine
Waxy cast
Indicates destruction widening of the tubular walls, 2-6x wider than ordinary cast
Broad cast
Crystals are reported as
Rare, few, Moderate or Many/ HPF
Abnormal crystals are reported as
Average No./ LPF
Factors that contribute to crystal formation: ‘’ P S T’’
pH
Solute conc.
Temperature
Normal Acid Crystals ‘‘C A U C H A M’’
Calcium oxalate
Amorphous Urates
Uric Acid
Calcium Sulfate
Hippuric Acid
Acid Urates
Monosodium Urates
Normal Alkaline Crystals: ‘‘M A T A C C’’
Magnesium Phosphate
Amorphous Phosphate
Triple Phosphate
Ammonium Biurate
Calcium Phosphate (Apatite)
Calcium Carbonate
Yellow Brown granules, Fluffy orange, Pink sediment
Turns into Ammnium biurate after adding Ammnonium hydroxide
Amorphous Urates
Amorphous Urates is soluble in
Heat (60C) and Alkali
Turn into URIC ACID after adding ACETIC ACID
Amorphous Urates
Acid Urates
Rhombic (diamond) 4 sided FLAT PLATE (whetstone) LEMON SHAPED; Hexagonal forms mistaken as CYSTINE crys.
Uric Acid
Uric acid is Increased in
Lesch-Nyhan syndrome
Chemotherapy
Gout
The most frequently observed urinary crystals
CaOx
Bipyramidal, Enveloped, Octahedron, Emerald cut ‘’ B E C O’’
Dihydrate (Weddellite)
Oval, Dumbell
Monohydrate (Whewellite)
Cigarette-butt, Soluble in Acetic acid
Calcium Sulfate
Yellow brown, Colorless, elogated prism
Soluble in water and ether
Hippuric Acid
brown spheres or clusters, resembles ammonium biurate, leucine & sulfamethoxazole crys.
Acid urates
tiny slender, colorless needles, SPHERULITE or BEACHBALL, ‘‘PICK-UP STICKS’’ when cluster
Monosodium Urates
Fine lacy white precipitate
Amorphous Phosphates
Alkaline counterpart of uric acid and Amorphous urates, OLD SPX
Ammonium Biurate
^ presence of UREA-SPLITTING bacteria
Ammnium biurate
Triple Phosphate
FEATHERY appearance when they disintegrate
Triple Phosphate
(Magnesium Ammonium Phosphate, STRUVITE)
End or corner may be NOTCHED, edges may be IRREGULAR or ERODED
Magnesium phosphate
Colorless FLAT PLATES, THIN PRISM in rosette form, may resemble sulfonamide crystals
Dibasic Calcium Phosphate (stellar phosphate)
small colorless, dumbell tetrads or spherical-shaped
Calcium Carbonate
Colorless, refractile hexaginal plates often laminated, SIX SIDED STOP SIGN
Mistaken as hexaginal Uric acid crystlas
Cystine
Uric acid is insoluble in
Dilute HCI
Absence or weak Birefringence
Cystine
Clumped granules or needles w/ bright yellow color; reddish brown needle
Bilirubin
FAN-shaped needles, SHEAVES of WHEAT,arrowheads, PETALS, WHETSTONE; mistaken as calcium phosphate crystals
Sulfonamide
Colorless needles that tend to form bundles following refrigeration
Ampicillin
Mistaken for parasite Ova
Starch granules
