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nephrology differential clinical video algorithm acute urine aki gunn jaw marcus ophthalmology phenomenon wink winking hematuria kidneyinjury management renal rheumatology
Urine Microscopy - Casts Acellular Casts • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... suggestive of nephrotic sydnrome ... #Urine #Microscopy ... #nephrology #interpretation ... #diagnosis
Hematuria - Differential Diagnosis Framework Gross Hematuria: Red/Dark urine • 1ml blood/liter urine can induce color change
- Differential Diagnosis ... urine sediment Microscopic ... hematuria: - RBC casts ... → Diagnostic of ... #causes #urology
Atlas of Urine Microscopy Findings • Epithelial cells - Normal • Renal tubular cells - Acute
• Red cell casts ... • White cell casts ... infection • Hyaline casts ... disease • Granular casts ... #nephrology #casts
Urine Microscopy Instructions 1) Spin fresh urine sample (10-15mL) in a centrifuge for 3-5 minutes - Don't
Urine Microscopy ... one drop on a microscope ... under lower power (casts ... #Instructions #nephrology ... #diagnosis
Urinary Casts and Disease Associations Hyaline - May be nonspecific; seen in normal individuals or during severe
Urinary Casts and ... breakdown of cellular casts ... heme-granular casts ... #Differential #Microscopy ... #Diagnosis #Nephrology
Marcus Gunn Phenomenon - Jaw Winking Syndrome Jaw-winking syndrome is thought to be caused by abnormal innervation
- Jaw Winking Syndrome ... thought to be caused ... Most cases are congenital ... #clinical #video ... #neurology #physicalexam
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 Simplified Approach to Acute Kidney Injury (AKI) 1) IS THIS AN EMERGENCY? Is there a dialysis indication
PROBLEM ~80% of AKI cases ... you confirmed diagnosis ... CONSIDER INTRINSIC CAUSES ... Assess UA w/ microscopy ... for WBCs, RBCs, casts
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm Acute Kidney Injury (AKI) - Acute increase
- Differential Diagnosis ... • Hepatorenal syndromes ... Epithelial cell casts ... Obstruction • Cast ... polyangiitis /microscopic
Causes of Proteinuria - Differential Diagnosis Algorithm Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
- Differential Diagnosis ... • Fanconi's syndrome ... sediment - WBC/RBC casts ... polyangiitis (GPA) / microscopic ... #Proteinuria #Nephrology
Algorithmic Approach to Acute Interstitial Nephritis When to suspect AIN? (not sensitive) • AKI, AKD, rapidly progressive
sterile pyuria, WBC casts ... eosinophiluria, microscopic ... proteinuria, granular casts ... AIN #Algorithm #nephrology ... #diagnosis
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