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Urine Microscopy

Urine Microscopy. + Dr. Mohammed Iqbal Musani, MD. Urine Microscopy :. Cells Casts Crystals . Casts are formed within nephron. Casts Suggest Kidney pathology. Casts can be made up of Protein, lipid, cells or mixed. Crystals suggest high concentration or altered solubility. .

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Urine Microscopy

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  1. Urine Microscopy +Dr. Mohammed Iqbal Musani, MD

  2. Urine Microscopy : • Cells Casts Crystals. • Casts are formed within nephron. • Casts Suggest Kidney pathology. • Casts can be made up of Protein, lipid, cells or mixed. • Crystals suggest high concentration or altered solubility.

  3. WBC in Urine :

  4. White blood cell cast • Seen in interstitial disease most commonly • Also seen in glomerulonephritis

  5. WBC Cast Urine:

  6. Mixed Cast Urine:

  7. Waxy cast • Thought to result from the degeneration of cellular casts

  8. Non-renal epithelial cells • Uro-epithelium is columnar • If there are a lot of these it means there is sloughing of the system • Skin is squamous • If there are a lot of squamous it is a contaminated specimen

  9. Urine Oxalate Crystals:

  10. White blood cells/red blood cells in urine

  11. Red blood cells in urine

  12. White blood cells and bacteria

  13. Squamous epithelial cells

  14. Squamous epithelial cell in urine

  15. Renal Epithelial Cells

  16. Bacteria and white blood cells

  17. Mucus

  18. Budding yeast cells

  19. Hyaline cast

  20. Red blood cell cast

  21. White blood cell cast

  22. Coarsely granular cast

  23. Waxy cast

  24. Waxy cast

  25. Amorphous urates in urine

  26. Uric acid crystals in urine

  27. Calcium oxalate crystals in urine

  28. Amorphous phosphates in urine

  29. Triple phosphate crystals in urine

  30. Ammonium biurate crystals in urine

  31. Calcium phosphate crystals in urine

  32. Calcium carbonate crystals in urine

  33. Cystine crystals in urine

  34. Tyrosine crystals in urine

  35. Leucine crystals in urine

  36. Cholesterol crystals in urine

  37. Sulfa crystals in urine

  38. Fecal material in urine

  39. Talc in urine

  40. Starch in urine

  41. Cotton fiber in urine

  42. Fiber in urine

  43. So…what is a cast??? • Protein based cylindrical molds of the renal tubule • Form in distal tubules and collecting ducts • Result of damage to the renal tubule • Can contain cells and other material • Dehydration and acidic urine especially predisposes to cast formation

  44. Formation of Casts:

  45. Red cell cast • Almost always associated with glomerulonephritis or vasculitis • Virtually exclude extra-renal causes of bleeding

  46. Red cell Casts in Urine:

  47. Epithelial Casts in Urine:

  48. Granular Casts in Urine:

  49. Granular cast • Non-specific but usually pathologic • Usually the ‘granules’ are from the degeneration of cellular casts

  50. White blood cell cast • Seen in interstitial disease most commonly • Also seen in glomerulonephritis

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