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diagnosis differential nephrology causes management treatment microscopy algorithm nephrotic proteinuria renal classification disease glomerular hematuria nephritic pulmonary rhabdomyolysis signs syndromes
Atlas of Urine Microscopy Findings • Epithelial cells - Normal • Renal tubular cells - Acute
Atlas of Urine Microscopy ... also be seen if urine ... glomerular disease • Leukocytes ... • “Muddy brown cast ... contamination #Urine
Glomerular Diseases - Nephritic and Nephrotic Syndromes Nephritic syndrome—due to GBM disruption. Hypertension. t BUN and creatinine.
and Nephrotic Syndromes ... Nephritic syndrome—due ... RBC casts in urine ... but in severe cases ... Nephritic #Nephrotic #Syndromes
Urinalysis & Urine Sodium Theophilus Protospatharius, a seventh-century physician who wrote the first manuscript focused exclusively
Urinalysis & Urine ... • Ketones • Leukocyte ... • Urinary casts ... dipstick #nitrite #leucocyte-esterase ... #urine #UNa #casts
Nephritic vs Nephrotic Syndrome Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes. Step
Nephritic vs Nephrotic Syndrome ... nephrotic/nephritic syndromes ... hematuria (RBC casts ... dysmorphic RBCs in urine ... Nephritic #Nephrotic #Syndrome
Urine Microscopy - Casts Acellular Casts • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... - Casts Acellular ... Casts • Hyaline ... suggestive of nephrotic sydnrome ... #Urine #Microscopy
Urinary Casts and Disease Associations Hyaline - May be nonspecific; seen in normal individuals or during severe
Urinary Casts and ... and concentrated urine ... breakdown of cellular casts ... heme-granular casts ... Fatty - Nephrotic syndrome
Causes of Proteinuria - Differential Diagnosis Algorithm Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
Proteinuria (Negative urine ... • Fanconi's syndrome ... Proteinuria (Positive urine ... albuminuria) - Active urine ... sediment - WBC/RBC casts
Hematuria - Differential Diagnosis Framework Gross Hematuria: Red/Dark urine • 1ml blood/liter urine can induce color change
1ml blood/liter urine ... disease - Alport syndrome ... pain hematuria syndrome ... hematuria: - RBC casts ... • Nutcracker syndrome
Urine Microscopy - Urinary Sediment Examination Instructions Preparation of the urine for microscopic examination: • Clean catch
Urine Microscopy ... protein, blood or leukocyte ... up by cells or casts ... and condenser focus ... protein matrix of casts
Takotsubo Cardiomyopathy - Right Ventricular Involvement In up to 1/4 of cases of stress cardiomyopathy (takotsubo),
In up to 1/4 of cases ... #BrokenHeart #Syndrome ... A4C #Clinical #POCUS
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