11 results
Muddy Brown Granular Casts three ways - Brightfield, Darkfield, Phase Contrast.

Dr. Vipin Varghese @vipvargh

#Muddy #Brown #Granular
Muddy Brown Granular ... Casts three ways ... vipvargh #Muddy #Brown ... #Granular #Casts ... urine #microscopy #MBGC
Granular & “Muddy Brown” Casts on Urine Microscopy
A. Finely granular cast B. slightly coarser granular cast
Granular & “Muddy ... BrownCasts on ... Finely granular ... (c) and muddy brown ... (mb) granular cast
Examples of varying granular and granular/waxy mixed casts: 
A: coarse granular/broad-waxy (and surrounding white blood cells);
and granular/waxy ... mixed casts: ... /muddy brown granular ... C and D: muddy brown ... #Casts #Urine #
Urine Microscopy - Casts
Acellular Casts
 • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy - Casts ... Acellular Casts ... • Hyaline Casts ... • "Muddy Brown ... ) • Granular Casts
Urinary Casts and Disease Associations
Hyaline - May be nonspecific; seen in normal individuals or during severe
Urinary Casts and ... concentrated urine Granular ... breakdown of cellular casts ... "Muddy-brown" heme-granular ... casts are seen
Atlas of Urine Microscopy Findings
 • Epithelial cells - Normal
 • Renal tubular cells - Acute
• White cell casts ... renal disease • Granular ... casts - More significant ... disease • “Muddy brown ... cast” - Necrotic
Algorithmic Approach to Acute Interstitial Nephritis
When to suspect AIN? (not sensitive)
 • AKI, AKD, rapidly progressive
Algorithmic Approach ... sterile pyuria, WBC casts ... tubular proteinuria, granular ... casts/RTE; blend ... Nephritis #AIN #Algorithm
Core IM: Pearls on Contrast-Induced Nephropathy

Definition: 
 • no slam dunk criteria 
 • definition in
Core IM: Pearls ... of ATN (muddy brown ... casts) • FENa
Algorithm and Differential Diagnosis of Macroscopic Hematuria
Important Historical Elements:
- Painless: suggests malignancy
- Painful: suggests calculi/infection
- Urinalysis:
Algorithm and Differential ... RBC’s, RBC/WBC casts ... Diagnosis #EM #IM ... #Differential #Algorithm
Hematuria Workup and Diagnosis Algorithm
 • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
and Diagnosis Algorithm ... proteinuria, RBC casts ... identified by UW IM ... Hematuria #Diagnosis #Algorithm