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MLS 415 Urinalysis & B.F. > Microscopic Examination of Urine - Casts > Flashcards

Microscopic Examination of Urine - Casts Flashcards

1
Q

Casts can be found in?

A

Only the kidneys.

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2
Q

Casts are formed in:

A

The distal convoluted tubule and collecting ducts.

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3
Q

What protein is responsible for the formation of hyaline casts?

A

Tamm-Horsfall (uromodulin).

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4
Q

What makes us a cast?

A

A matrix of Tamm-Horsfall protein (uromodulin) and cells, proteins, or fats incorporated in the matrix.

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5
Q

What factors promote casts?

A
  • Urinary stasis.
  • Acid pH.
  • High solute concentration.
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6
Q

What is the primary criteria for cast morphology?

A
  • Parallel sides.
  • Rounded or straight edge.
  • Uniform diameter.
  • Definite outline.
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7
Q

How are casts identified?

A
  • Reduce light.
  • Search with 10X.
  • Identify type with 40X.
  • Phase or interference microscopy.
  • Staining.
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8
Q

What are the clinical significance of casts?

A
  • Reflect status of tubules.
  • “Biopsy” of renal tubule.
  • Types and numbers indicate specific diseases.
  • Can be increased with after exercise.
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9
Q

What is the morphology of a hyline cast?

A
  • Semitransparent, nonrefractile, homogenous.
  • Hard to see.
  • Sometimes cylindroid or convoluted.
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10
Q

What color are hyaline casts stained?

A

Pink

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11
Q

What color are hyaline casts?

A

Colorless

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12
Q

How many are normally seen lpf?

A

0-2

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13
Q

Presence of hyaline casts could mean:

A
  • Renal disease.
  • Dehydration, fever, heat exposure, emotional distress.
  • congestive heart failure.
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14
Q

What do hyaline casts get mistaken for?

A

Mucous threads.

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15
Q

What do hyaline casts get mistaken for?

A

Mucous threads.

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16
Q

Is it normal to find cellular casts?

A

No

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17
Q

What color are RBC casts?

A
  • Yellow to red-brown.
  • Orange red homogenous.
  • Dirty brown and granular.
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18
Q

What color are RBC casts stained?

A

Lavender

19
Q

What is the clinical correlation of RBC casts?

A
  • Glomerular bleeding.
  • Upper UTI.
  • Diagnostic of renal disease.
20
Q

If RBC casts are present, what correlation will be on the chem strip?

A

Positive for protein and blood.

21
Q

What is the clinical significance of WBC casts?

A
  • Indicate interstitial inflammation or infection.

- Upper UTI, not lower.

22
Q

WBC casts can be mistaken for:

A

Pseudocast

23
Q

The presence of WBC casts will need to be correlated with:

A
  • Bacteria.
  • Protein.
  • Hematuria.
  • Red cell casts also if glomerular.
24
Q

What is the clinical significance of Renal tubular epithelial casts?

A
  • It’s not normal.
  • Indicates advanced destruction.
  • Associated with toxic chemicals or viral infections.
  • Also find proteinuria and granular casts.
25
Q

What is the composition of granular casts?

A
  • Degenerated cells.
  • Products excreted by RTE cells.
  • Aggregates of plasma proteins.
26
Q

What is the clinical significance of non-pathological granular casts?

A

These are lysosomes from RTE and are no cause of concern.

27
Q

What is the clinical significance of pathologic granular casts.

A
  • Degenerated cell casts.
  • Aggregated proteins filtered by the glomerulus.
  • Indicate stasis.
28
Q

What is the composition of fatty casts?

A
  • Oval fat bodies and/or free fat globules.
  • Hyaline or granular matrix.
  • May be other cells.
29
Q

What is the morphology of fatty casts?

A

Globules vary, and refractive.

30
Q

What color are fatty casts?

A

Light yellow or brown.

31
Q

Triglycerides and neutral fatty casts will test _______ on a fat stain and ______ on maltese cross.

A

Positive on fat stain and negative on maltese cross.

32
Q

Cholesterol and esters will test ______ on a fat stain and ______ on maltese cross.

A

Negative on fat stain and positive on maltese cross.

33
Q

What is the clinical significance of a fatty cast?

A
  • Severe renal disease.

- Proteinuria.

34
Q

What color are waxy casts?

A

Colorless, gray, yellow.

35
Q

What color does a waxy cast stain?

A

Darker pink.

36
Q

What is used to stain a waxy cast?

A

Sternheimer

37
Q

What is the clinical significance of waxy casts?

A
  • Serious trouble.
  • Imply tubular obstruction and prolonged stasis.
  • Chronic renal disease.
  • Renal graft rejection.
  • Malignant hypertension.
  • Some acute renal diseases.
38
Q

Broad casts mean:

A

Severe renal stasis.

39
Q

What cast has the nickname of “Renal failure” cast?

A

Broad cast.

40
Q

Bacterial casts is diagnostic of:

A

Pyelonephritis.

41
Q

Bacterial casts are mistaken for:

A

Granular casts.

42
Q

Bacterial casts can be correlated with?

A

Bacteria and WBC.

43
Q

Hemosiderin casts can be stained with?

A

Prussian blue.

MLS 415 Urinalysis & B.F. (37 decks)

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