Urinary Casts Flashcards
cast that is normally seen in urine
Hyaline Casts
Normal value of hyaline casts in urine
0-2/LPF
Hyaline Casts Normally increased in:
strenuous exercise, dehydration, heat exposure, emotional stress
Hyaline Casts Pathologically increased in:
Acute glomerulonephritis, Pyelonephritis, Chronic renal disease, CHF
color of Unstained Hyaline Casts
colorless
color of Sternheimer-Malbin stain in hyaline cast
pink
Greater stasis of urine
Blood Cast
under LPO, Blood cast can seen as ___ ____ color
orange red color
Blood casts that orange red color is indication of __________
bleeding within in the nephron
RBC Casts seen in healthy body with strenuous exercise is __
Physiologic/normal
associated with proteinuria and dysmorphic erythrocytes
Glomerular damage (glomerulonephritis)
Usually neutrophil may appear as granular
WBC Casts
Non-Bacterial Inflammation
Acute interstitial Nephritis *RBC casts
Bacterial inflammation
Pyelonephritis *with bacteria
Signifies infection or inflammation within the nephron
WBC Casts
(upper UTI)
pyelonephritis
(lower UTI)
cystitis
Associated with pyelonephritis and are primary marker for distinguishing pyelonephritis (upper UTI) from cystitis (lower UTI)
WBC Casts
Bacterial casts containing bacilli both within and bound to the protein matrix
Pyelonephritis
Pure bacterial cast or mixed with WBCs
Pyelonephritis
May resemble granular cast
Bacterial Casts
Confirmation stain used to diff. bacterial casts to granular casts
Gram stain
Significant Epithelial Casts
Cast containing RTE cells
Indication of Significant Epithelial Casts
Advance tubular obstruction
Fatty casts + Oval fat bodies + Free fat Droplets =
Lipiduria
Fatty Casts Frequently associated with:
Nephrotic syndrome
Fatty Casts can also be seen in:
toxic tubular necrosis, DM and crush injuries
Casts containing multiple cell types
Mixed Cellular Casts
Mixed Cellular Casts in glomerulonephritis
RBC and WBC casts
Mixed Cellular Casts in pyelonephritis
WBC and RTE cell casts or WBC and bacterial casts
Result of cellular disintegration
Granular Casts
If left for a longer time in the tubules it will resemble as waxy cast
Granular Casts
Increase cellular metabolism occurring during periods of strenuous exercise accounts for the transient increase of granular casts that accompany the increased hyaline cast
Granular Casts
Fragmented with jagged ends and have notches on sides
Waxy Casts
Waxy Casts Indication of Extreme urine stasis
Extreme urine stasis (Chronic renal failure)
Supravital stain in Waxy Casts will appear___
Homogenous dark pink
“Renal failure casts”
Broad Casts
Presence of Broad Casts will indicate as ____
Destruction “widening” of the tubular walls
