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diagnosis differential hepatology nephrology management clinical hematology urine dermatology microscopy ascites hyponatremia injury syndrome treatment chronic endocrinology gastroenterology hematuria peds
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG) SAAG ≥ 1.1: - Ascitic protein
) SAAG ≥ 1.1: ... Cirrhosis, Late Budd-Chiari ... syndrome, Massive liver ... pericarditis, Early Budd-Chiari ... differential #diagnosis #algorithm
Granular & “Muddy Brown” Casts on Urine Microscopy A. Finely granular cast B. slightly coarser granular cast
Granular & “Muddy ... Brown” Casts on ... coarse (c) and muddy ... of mb granular casts ... Granular #MuddyBrown #Casts
Causes of Ascites Normal Peritoneum Portal hypertension (SAAG > 1.1 g/dL) 1. Hepatic congestionl
Causes of Ascites ... insufficiency - Budd-Chiari ... Liver disease ... - Acute fatty liver ... peritonitis #Ascites #Causes
Hepatomegaly - Differential Diagnosis Algorithm Malignant • Primary Carcinoma • Metastases • Lymphoma • Leukemia • Polycythemia
Differential Diagnosis Algorithm ... Non-Malignant • Fatty Liver ... • Cysts • Hemochromatosis ... Heart Failure • Budd-Chiari ... #Causes #Hepatology
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
Portal Hypertension - Differential Diagnosis Portal Pressure = the pressure difference between the pressure in the portal
HTN: ascites (SAAG ... Post-Hepatic: • Cardiac causes ... pericarditis • Budd ... sarcoidosis) • Liver ... metastasis • Fatty liver
Atlas of Urine Microscopy Findings • Epithelial cells - Normal • Renal tubular cells - Acute
microscopy • Red cell casts ... • White cell casts ... infection • Hyaline casts ... disease • Granular casts ... diagnosis #nephrology #casts
Causes of Acute Liver Injury - Differential Diagnosis Hepatocellular - Liver Parenchyma • Infectious: Hepatitis C, A,
Causes of Acute ... Hepatocellular - Liver ... Hepatic Vein: Budd-Chiari ... Differential #Diagnosis #Causes ... #Acute #algorithm
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