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diagnosis differential causes nephrology hepatology management microscopy urine ascites chronic clinical syndrome acute albumin gradient granular hematuria injury liver peds
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG) SAAG ≥ 1.1: - Ascitic protein
albumin gradient (SAAG ... ) SAAG ≥ 1.1: ... Cirrhosis, Late Budd-Chiari ... pericarditis, Early Budd-Chiari ... differential #diagnosis #algorithm
Ascites Differential Diagnosis Table - Serum Ascites Albumin Gradient (SAAG) SAAG ≥ 1.1: • Cirrhosis • Portal
Albumin Gradient (SAAG ... ) SAAG ≥ 1.1: ... thrombosis • Late budd-chiari ... obstruction • Early budd-chiari ... SAAG < 1.1:
Granular & “Muddy Brown” Casts on Urine Microscopy A. Finely granular cast B. slightly coarser granular cast
Granular & “Muddy ... Brown” Casts on ... Finely granular cast ... coarser granular cast ... coarse (c) and muddy
Urine Microscopy - Casts Acellular Casts • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy - Casts ... Acellular Casts ... • Hyaline Casts ... • "Muddy Brown ... " Casts - Strongly
Muddy Brown Granular Casts three ways - Brightfield, Darkfield, Phase Contrast. Dr. Vipin Varghese @vipvargh #Muddy #Brown #Granular
Muddy Brown Granular ... Casts three ways ... Varghese @vipvargh #Muddy ... Brown #Granular #Casts
Examples of varying granular and granular/waxy mixed casts: A: coarse granular/broad-waxy (and surrounding white blood cells);
granular/waxy mixed casts ... light granular/muddy ... granular, C and D: muddy ... Granular #MuddyBrown #Casts
Causes of Ascites Normal Peritoneum Portal hypertension (SAAG > 1.1 g/dL) 1. Hepatic congestionl
hypertension (SAAG ... insufficiency - Budd-Chiari ... Hypoalbuminemia (SAAG ... - Myxedema (SAAG ... Diseased Peritoneum (SAAG
Atlas of Urine Microscopy Findings • Epithelial cells - Normal • Renal tubular cells - Acute
microscopy • Red cell casts ... • White cell casts ... disease • Granular casts ... renal disease • “Muddy ... brown cast” - Necrotic
Ascites - Differential Diagnosis and Workup Algorithm • Perform paracentesis: • Cell count and diff • Total
Diagnosis and Workup Algorithm ... • Calculate SAAG ... Differential #Diagnosis #Algorithm
Hepatomegaly - Differential Diagnosis Algorithm Malignant • Primary Carcinoma • Metastases • Lymphoma • Leukemia • Polycythemia
Differential Diagnosis Algorithm ... Fatty Liver • Cysts ... Heart Failure • Budd-Chiari ... Differential #Diagnosis #Algorithm
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