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CLINICAL MICROSCOPY > Microscopic Examination of Urine - Urinary Casts > Flashcards

Microscopic Examination of Urine - Urinary Casts Flashcards

1
Q

Presence of urinary cast

A

Cylindruria

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2
Q

The only elements found in the urinary sediment that are unique to the kidney

A

Casts

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3
Q

It is where casts are formed

A

DCT and CD

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4
Q

Magnification used to examine urinary casts

A

Low power magnification

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5
Q

How to examine specimen for urinary casts?

A

Low-power scanning should be performed along the edges of the cover slip

Observe with reduced lighting, because the cast matrix has a low refractive index

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6
Q

Cast matrix dissolves quickly in dilute, acidic urine. True or False?

A

False; alkaline

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7
Q

The major constituent matrix of cast

A

Uromodulin

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8
Q

Uromodulin protein is found in both normal and abnormal urine and is a major constituent of mucus. True or False?

A

True

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9
Q

Casts can be detected by reagent strip protein methods. True or False?

A

False; not detected

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10
Q

List the casts from least to most significant

A

Hyaline Cast→ Cellular cast→ Coarse granular cast → Fine granular cast → Waxy cast → Broad Cast

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11
Q

Product of incomplete cast formation, or cast disintegration

A

Cylindroids

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12
Q

It is where cylindroids are formed

A

ALH and DCT

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13
Q

Shape of Cylindroids

A

Tapered at the end

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14
Q

Factors promoting disintegration of casts in the urine sediment

A

Hypotonic and alkaline urine

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15
Q

Factors enhancing cast formation

A

Acid pH, increased solute concentration, urine stasis, and increased plasma proteins (particularly albumin)

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16
Q

Most frequently seen cast which consists almost entirely of uromodulin

A

Hyaline casts

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17
Q

Hyaline casts is also known as

A

Pro-casts

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18
Q

Appearance of hyaline casts in unstained sediments

A

Colorless

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19
Q

Appearance of hyaline casts in stained sediments (Sternheimer-Malbin stain)

A

Pink color

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20
Q

Microscopy technique for visualization of hyaline casts

A

Phase microscopy

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21
Q

Normal value of hyaline casts

A

0-2 /lpf

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22
Q

Cast seen during bleeding in the nephron

A

RBC casts

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23
Q

RBC cast is associated with

A

Glomerulonephritis

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24
Q

Color of RBC casts

A

Orange-red color

25
Q

Manner of reporting for RBC casts

A

Number of RBC casts per lpf

26
Q

Casts that represents hemoglobin degradation products

A

Granular dirty brown casts

27
Q

Disease associated with granular dirty brown casts

A

Acute tubular necrosis

28
Q

The appearance of WBC casts in the urine signifies

A

Infection or inflammation within the nephron

29
Q

Casts frequently associated with pyelonephritis

A

WBC casts

30
Q

Primary marker for distinguishing pyelonephritis (upper UTI) from Cystitis (lower UTI)

A

WBC casts

31
Q

WBC casts are composed of

A

Neutrophils

32
Q

Helpful to enhance the nuclear detail needed for differentiating WBC cast from Epithelial cast

A

Staining and phase microscopy

33
Q

Bacterial casts containing bacilli both within and bound to the protein matrix are seen in

A

Pyelonephritis

34
Q

Confirmation of bacterial casts is best made by performing

A

Gram stain

35
Q

Casts containing RTE cells represent the presence of

A

Advanced tubular destruction

36
Q

Bilirubin-stained RTE cells are seen in cases of

A

Hepatitis

37
Q

Casts seen in conjunction with oval fat bodies and free fat droplets in disorders causing lipiduria

A

Fatty casts

38
Q

Fatty casts are most frequently associated with

A

Nephrotic syndrome

39
Q

Confirmation of fatty casts is performed using

A

Polarized microscopy
Sudan III/Oil Red O fat stains

40
Q

Demonstrates characteristic Maltese cross formations under polarized light

A

Cholesterol

41
Q

Color of triglycerides and neutral fats after staining

A

Orange

42
Q

Fats do stain perfectly with Sternheimer-Malbin stains. True or False?

A

False; fats do not stain with Sternheimer-Malbin stains

43
Q

Predominant casts in cases of glomerulonephritis

A

RBC casts

44
Q

Predominant casts in cases of pyelonephritis

A

WBC casts

45
Q

Observing casts containing multiple cell types is not uncommon. True or False?

A

True

46
Q

Coarsely and finely granular casts are frequently seen in the urinary sediment and may be of pathologic or nonpathologic significance. True or False?

A

True

47
Q

Granular casts indicates

A

Disintegration of cellular casts and tubule cells

48
Q

Cast that represents extreme urine stasis

A

Waxy casts

49
Q

Cast that indicates chronic renal failure

A

Waxy casts

50
Q

Appearance of waxy casts

A

Brittle, highly refractive cast matrix, cast matrix appear fragmented with jagged ends and have notches in their sides

51
Q

Cast with ground glass appearance

A

Waxy casts

52
Q

Waxy casts are more easily visualized than hyaline casts. True or False?

A

True

53
Q

Why is it that waxy casts are more easily visualized than hyaline casts?

A

Waxy casts have higher refractive index

54
Q

Appearance of waxy casts with supravital stain

A

Homogenous, dark pink

55
Q

Often referred to as renal failure casts

A

Broad casts

56
Q

Broad casts may result from

A

Tubular distension
Extreme urine stasis

57
Q

The presence of broad casts indicates

A

Destruction (widening) of the tubular walls

58
Q

Bile-stained broad, waxy casts are seen as the result of

A

Tubular necrosis caused by viral hepatitis

59
Q

Two most commonly seen broad cast

A

Granular cast
Waxy cast

CLINICAL MICROSCOPY (20 decks)

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