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 nephrotic sydnrome ... #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
Hematuria Workup and Diagnosis Algorithm
 β€’ Confirm hematuria β†’ Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
Hematuria Workup ... and Diagnosis Algorithm ... proteinuria, RBC casts ... β†’ Refer to Nephrology ... if cause not identified
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
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
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,
Kidney Injury - AKI Workup ... and Differential Diagnosis ... microscopy / urinary ... osmolarity If cause ... #nephrology #causes
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
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
Algorithm - Approach to the differential diagnosis of the patient presenting with overt glomerular proteinuria. CMV
hemolytic-uremic syndrome ... arbitrarily defined as urine ... cell/white cell casts ... Nephrocalcinosis causes ... #nephrology