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AUBF > Sediment Constituents (Casts) > Flashcards

Sediment Constituents (Casts) Flashcards

1
Q

What is the term for molds of the renal tubule?

A

Cylindruria

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2
Q

What does cylindruria represent?

A

Biopsy of individual tubule

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3
Q

What is the uniform diameter of the renal tubule mold in relation to RBCs?

A

7-8 times the diameter of RBCs

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4
Q

What is the most difficult and most important urinary sediment constituent?

A

Casts

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5
Q

Where are casts primarily formed in the kidney?

A

DCT and Collecting Duct

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6
Q

What is the major constituent of casts?

A

Uromodulin (Tamm Horsfall Protein)

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7
Q

What has the same significance as casts?

A

Cylindroids

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8
Q

How are casts examined?

A

Along the coverslip edges with subdued light

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9
Q

Under what magnification are casts counted?

A

LPF (Low Power Field)

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10
Q

Under what magnification are casts identified?

A

HPF (High Power Field)

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11
Q

What is the first step in the formation of casts?

A

Aggregation of uromodulin into individual protein fibrils attached to RTE cells

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12
Q

What is the last step in the formation of casts?

A

Excretion of casts

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13
Q

What is the order of cast degeneration?

A

Hyaline, Cellular, Degenerating cellular, Coarsely Granular, Finely granular, Waxy

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14
Q

What is the prototype cast and most frequently encountered?

A

Hyaline cast

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15
Q

What is the appearance of a hyaline cast?

A

Colorless and translucent, requires subdued light

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16
Q

What is the normal value of hyaline cast in urine?

A

0-2/LPF

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17
Q

What pathologies cause hyaline casts?

A

Glomerulonephritis, pyelonephritis, CHF, CKD

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18
Q

What is the most fragile cast that indicates bleeding within the nephron?

A

RBC Cast

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19
Q

What is the color of an RBC cast?

A

Orange-red

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20
Q

In what conditions is RBC cast significant?

A

Glomerulonephritis, strenuous exercise (physiologic cause in hyaline cast)

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21
Q

What is a muddy brown cast composed of?

A

Hemoglobin from lysed RBCs

22
Q

What is the color and appearance of a blood (hemoglobin) cast?

A

Orange-red, homogeneous appearance

23
Q

What cast indicates inflammation or infection within the nephron?

A

WBC/Leukocyte/Pus cast

24
Q

What is required to distinguish WBC casts?

A

Phase microscope and supravital stain

25
Q

In what conditions are WBC casts significant?

A

Pyelonephritis, acute interstitial nephritis

26
Q

What is not a true cast but a clump of leukocytes?

A

Pseudoleukocyte casts

27
Q

Where are pseudoleukocyte casts seen?

A

Lower UTI (without matrix)

28
Q

What type of cells are visible on the cast matrix in Epithelial (RTE) casts?

A

Smaller, round and oval cells

29
Q

What is the significance of Epithelial (RTE) casts?

A

Advanced tubular destruction, tubular damage

30
Q

How is a bacterial cast confirmed?

A

Gram stain

31
Q

What is the significance of bacterial casts?

A

Pyelonephritis

32
Q

Where are the granules of granular casts derived from?

A

Lysosomes of RTE cells during normal metabolism (nonpathologic)

33
Q

What is the appearance of a fine granular cast?

A

Sandpaper

34
Q

What possible casts are seen in pyelonephritis?

A

Bacterial, WBC casts, Granular Cast (Coarse and Fine)

35
Q

What is the significance of granular casts?

A

Glomerulonephritis, pyelonephritis, stress, strenuous exercise

36
Q

What does the Sternheimer-Malbin stain?

A

Cast matrix (not fat globules)

37
Q

How is cholesterol seen in casts?

A

Polarizing microscope

38
Q

What is the significance of fatty casts?

A

Nephrotic syndrome, toxic tubular necrosis, diabetes mellitus, crush injuries

39
Q

What is the final degenerative form of all types of casts?

A

Waxy casts

40
Q

What is the appearance of waxy casts?

A

Ground glass

41
Q

What is the significance of waxy casts?

A

Urinary stasis, chronic renal failure, ESRD

42
Q

What is often referred to as a Renal Failure Cast?

A

Broad cast

43
Q

What does a broad cast indicate?

A

Destruction (widening) of the tubular walls

44
Q

What is the appearance of broad casts compared to ordinary casts?

A

2-6x wider than ordinary casts

45
Q

What is the significance of broad casts?

A

Extreme urine stasis, renal failure

46
Q

What is the appearance of a miscellaneous cast that incorporates bilirubin color?

A

Golden-brown

47
Q

What is the appearance of a miscellaneous cast that incorporates hemoglobin or myoglobin color?

A

Yellow to red-brown

48
Q

What is a cast containing multiple cell types called?

A

Mixed cellular casts

49
Q

What is the composition of a mixed cellular cast in glomerulonephritis?

A

RBC and WBC casts

50
Q

What is the composition of a mixed cellular cast in pyelonephritis?

A

WBC and RTE casts or WBC and bacterial casts

51
Q

What types of casts contain urates, calcium oxalate, and sulfonamides?

A

Crystal casts

52
Q

Where are crystal casts formed?

A

Tubule or collecting duct

AUBF (26 decks)

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