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 ... #Urine #Microscopy ... #nephrology #interpretation ... #diagnosis
Atlas of Urine Microscopy Findings
 β€’ Epithelial cells - Normal
 β€’ Renal tubular cells - Acute
Atlas of Urine Microscopy ... β€’ Red cell casts ... β€’ White cell casts ... disease β€’ Granular casts ... #nephrology #casts
Simplified Approach to Acute Kidney Injury (AKI)
1) IS THIS AN EMERGENCY? 
Is there a dialysis indication
PROBLEM ~80% of AKI cases ... IMPROVEMENT If the urine ... Assess UA w/ microscopy ... for WBCs, RBCs, casts ... #diagnosis #nephrology
Hematuria Workup and Diagnosis Algorithm
 β€’ Confirm hematuria β†’ Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
Hematuria Workup ... and Diagnosis Algorithm ... repeat testing β€’ Acute ... proteinuria, RBC casts ... β†’ Refer to Nephrology
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 ... 34t5DgJ #Urinary #Casts ... #Diagnosis #Nephrology
Acute Kidney Injury - AKI Workup Algorithm and Differential Diagnosis
Baseline Investigations: full blood count with differential,
Acute Kidney Injury ... - AKI Workup Algorithm ... and Differential Diagnosis ... microscopy / urinary ... #nephrology #causes
Nephritic vs Nephrotic Syndrome

Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes.
Step
Nephritic vs Nephrotic Syndrome ... hematuria (RBC casts ... dysmorphic RBCs in urine ... Comparison #Algorithm #Nephrology ... #Diagnosis
Urine Microscopy Instructions
1) Spin fresh urine sample (10-15mL) in a centrifuge for 3-5 minutes - Don't
Urine Microscopy ... 1) Spin fresh urine ... under lower power (casts ... iMedEducation #Urine ... #nephrology #diagnosis
Workup for Hypophosphatemia - Differential Diagnosis Framework
Rule out spurious hypophosphatemia: paraproteinemia, acute leukemia
Measure Urine Fractional Excretion
Workup for Hypophosphatemia ... - Differential Diagnosis ... paraproteinemia, acute ... leukemia Measure Urine ... #phosphate #nephrology
Pulmonary Renal Syndromes - OnePager Summary
Autoimmune ANCA vasculitis (AAV): GPA (granulomatous with polyangiitis), EGPA (eosinophilic granulomatosis
polyangiitis), MPA (microscopic ... mononeuritis multiplex WORKUP ... : UA, Urine protein ... Goodpasture's cause ... hematuria, RBC casts