Dr. Gerald Diaz @GeraldMD
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Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief πŸ‡΅πŸ‡­ πŸ‡ΊπŸ‡Έ - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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Urine Microscopy - Casts
Acellular Casts
 β€’ Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... suggestive of acute ... in a variety of acute ... #Urine #Microscopy ... #nephrology #interpretation
Atlas of Urine Microscopy Findings
 β€’ Epithelial cells - Normal
 β€’ Renal tubular cells - Acute
β€’ Red cell casts ... β€’ White cell casts ... disease β€’ Granular casts ... key #diagnosis #nephrology ... #casts
Simplified Approach to Acute Kidney Injury (AKI)
1) IS THIS AN EMERGENCY? 
Is there a dialysis indication
Simplified Approach to Acute ... require urgent nephrology ... PROBLEM ~80% of AKI cases ... Assess UA w/ microscopy ... for WBCs, RBCs, casts
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 ... are seen in acute ... 34t5DgJ #Urinary #Casts
Borrelia recurrentis on Peripheral Blood Smear
23M Somali refugee recently arrived w/severe abd pain, confusion and fever
Northeast Africa with cases ... Several cases have ... of blood smear, acute ... often experience acute ... recurrentis #BloodSmear #microscopy
Hematuria Workup and Diagnosis Algorithm
 β€’ Confirm hematuria β†’ Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
and Diagnosis Algorithm ... repeat testing β€’ Acute ... proteinuria, RBC casts ... β†’ Refer to Nephrology ... if cause not identified
Acute Kidney Injury - AKI Workup Algorithm and Differential Diagnosis
Baseline Investigations: full blood count with differential,
Acute Kidney Injury ... - AKI Workup Algorithm ... dipstick, urine microscopy ... Differential #Diagnosis #nephrology ... #causes