Urine 5 Flashcards
what does a cast do?
gives a picture of the nephron
what is the kidney specific protein?
Tamm-Horsfall
produced in the tubules
describe how casts work?
Tamm-Horsfall proteins start to gel in the distal convluted tubuel and sloughs into the system
proteins indicate what?
upper urinary tract problem
what can incorporate into a cast?
proteins, acidic pH, urinary stasis, increased solutes
what kind of casts are normally found?
granular and hyaline (0-2/LPF)
when are the normal casts in urine a significant finding?
when they are associated with other findings
where do casts come from?
nephron, no where else
red cast indicates?
upper UT bleeding
WBC cast indicates?
upper UT infection
where specifically does bleeding occur with a red cast?
nephron
what can you assume someone has if they have a red cast?
glomerulonephritis
what are the findings of glomerulonephritis
RBC casts, dominantly RBCs, WBCs, oliguria, red (smoky), cloudy urine
low specific gravity
if someone has a sore throat right before they started having kidney problems, what is the kidney problem likely due to?
strep
what can glomerulonephritis also be due to?
systemic lupus
signs and symptoms assoicated with RBC casts
+protein
flank pain
fever
usually secondary to untreated strep infection
if you find RBC casts, what do you do next?
get an immediate concurrent consultation
who usually gets post streptococcal glomerulonephritis? What are their symptoms?
6-10 year olds
suddenly has malaise, fever, nausea, oliguria, proteinuria, hematuria and the urine contains RBC casts
what might a patient have with post streptococcal glomerulonephritis?
HTN
elevated antistreptolysin O titer
chronic glomerulonephritis progresses to?
death, unless patient undergoes dialysis or transplant intervention
what do patients with post streptococcal glomerulonephritis need to do?
maintain electrolyte and water balance
what do WBC casts indicate?
infection/inflammation
pyelonephritis
what is pyelonephritis?
an infection of the kidney interstitium
what are the symptoms of WBC casts?
flank pain positive positive punch test low grade fever malaise dysuria burning sensation urgency and frequency
WBC casts implicate what?
renal involvement, only formed in the tubules
what are the findings associated with WBC casts?
yellow-cloudy urine
+ protein
bacteria casts indicate
upper UTI
clusters of WBCs indicate
UTI
glitter cells indicate
WBCs undergoing phagocytosis
indicates UTI
what casts indicate renal failure?
waxy, broad, fatty casts
yeast cells in casts indicate?
candida
cholesterol plates in casts are associated with?
hyperlipidemia
granular casts are associated with?
renal disease
it is a byproduct of metabolism
could be fine or course
upper UTI urinary findings?
casts protein cloudy hazy urine maybe has blood flank pain WBCs
lower UTI urinary findings?
increase WBCs mucous blood no casts no proteins lower back/pubic pain
what are some other things you can find in urine samples?
bacteria yeast cells sperm cells mucous threads parasites (enterobius vermicularis (pinworms) transferred from GI fibers
