Urine Sediment Microscopy

Question 1

Answer 1

Dysmorphic RBC’s

Question 2

Answer 2

Isomorphic RBC

Question 3

Answer 3

RBC cast

seen in acute glomerulonephritis or vasculitis

Question 4

Answer 4

Sterile Pyuria

WBC’s without any bacteria; see with TB

Question 5

Answer 5

WBC cast (cells are larger than RBC’s)

Seen in pyelonephritis or tubulointerstitial dz

Question 6

Answer 6

Renal tubular epithelial cells; seen in acute tubulonecrosis (ATN) or tubulointerstitial nephritis

Question 7

Answer 7

Hyaline cast

transparent looking; made of Tamm-Horsfall protein; not indicative of renal dz

Question 8

Answer 8

Granular cast

Degeneration of cellular elements within a cast or precipitation of non-Tamm Horsfall protein in cast matrix

= Muddy Brown Casts = ATN

Question 9

Answer 9

Waxy cast (on the Right, much larger); are degenerative granular casts and associated with severe renal failure

Granular cast (on the Left, smaller)

Question 10

Answer 10

Hyaline cast

Seen in pre-renal states

Question 11

Answer 11

Granular cast

seen in ATN

Question 12

Answer 12

Rental Tubular Epithelial Cell

(Top arrow)

Seen in ATN

Question 13

Answer 13

WBC

Seen in AIN (interstitial nephritis)

Question 14

Answer 14

WBC cast

Seen in AIN

Question 15

Answer 15

Non-dysmorphic RBC, seen in Glomerulonephritis/ RPGN

Question 16

Answer 16

dysmorphic RBC

Seen in glomerulonephritis/ RPGN

Question 17

Answer 17

RBC cast, seen in glomerulonephritis/RPGN

Question 18

Describe the UA pattern for pre-renal, intrinsic (glomerulonephritis, ATN, and interstitial nephritis), and post-renal states

Answer 18