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1 Case History - 1 24-year-old female patient. Asymptomatic UA during a physical exam. Rapid Chemistry SG = 1.016 pH = 6.0 Blood, Protein, Glucose, & Leukocyte Esterase = Negative

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2 Common Acidic Crystals Amorphous Urates Calcium Oxalate Uric Acid

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3 Abnormal Acidic Crystals Leucine Tyrosine Cystine Cholesterol Bilirubin

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4 Uncommon Acid Crystals Calcium Sulfates Hippuric Acid Sodium Urate Sulfonamide X-Ray Dye (Renografin) X-Ray Dye (Hypaque)

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5 Case History - 2 48-year old male found incoherent and hospitalized. Rapid Chemistries Cloudy urine Blood 2+ Protein 4+ Nitrite & Leukocyte Esterase = Positive

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6 Cast Comparison Opaque Cylindrical Blunt Ends Hyaline CastWaxy CastFiber Transparent Cylindrical Rounded Ends Refractile Flat Dark Edges

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7 Case History - 3 63-year old male with lower back pain. Rapid Chemistries pH 5.0 Nitrite = Positive Protein, Blood, Leukocyte Esterase, Glucose, Ketones = Negative

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8 Case History - 4 45-year old male with chronic hepatitis. Rapid Chemistries Specific Gravity = 1.015 pH 5.5 Bilirubin = Positive Protein = 3+ Leukocyte Est. = Positive Nitrite, Blood, Glucose, Ketones = Negative

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9 Common Acidic Crystals Amorphous Urates Calcium Oxalate Uric Acid

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10 Abnormal Acidic Crystals Leucine Tyrosine Cystine Cholesterol Bilirubin

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11 Uncommon Acid Crystals Calcium Sulfates Hippuric Acid Sodium Urate Sulfonamide X-Ray Dye (Renografin) X-Ray Dye (Hypaque)

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12 Case History - 5 19-year old female. Asymptomatic with UA during a physical exam. Rapid Chemistries pH 6.5 Blood = 1+ Protein = Trace Leukocyte Est., Nitrite, Glucose, Ketones = Negative

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13 Cast Comparison Opaque Cylindrical Blunt Ends Hyaline CastWaxy CastFiber Transparent Cylindrical Rounded Ends Refractile Flat Dark Edges

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14 Case History - 6 25-year old female admitted for multiple substance abuse. Rapid Chemistries Cloudy pH 6.5 Protein = Trace Leukocyte Est., Nitrite, Blood, Glucose & Ketones = Negative

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15 Common Acidic Crystals Amorphous Urates Calcium Oxalate Uric Acid

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16 Abnormal Acidic Crystals Leucine Tyrosine Cystine Cholesterol Bilirubin

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17 Uncommon Acid Crystals Calcium Sulfates Hippuric Acid Sodium Urate Sulfonamide X-Ray Dye (Renografin) X-Ray Dye (Hypaque)

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18 Case History - 7 52-year old female admitted for renal disease. Rapid Chemistries pH 5.0 Protein = 3+ Specific Gravity = 1.030 Leukocyte Est., Nitrite, Blood, Glucose, Ketones = Negative

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19 Cast Comparison Opaque Cylindrical Blunt Ends Hyaline CastWaxy CastFiber Transparent Cylindrical Rounded Ends Refractile Flat Dark Edges

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20 Case History - 8 71-year old male with alcoholic cirrhosis and esophageal bleeding. Rapid Chemistries pH 5.0 Specific Gravity = 1.030 Protein = 2+ Blood = 2+ Bilirubin = 3+ Leukocyte Est. = Negative Nitrite & Glucose = Negative

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21 Cast Comparison Cellularity Indeterminate Cylindrical Rounded Ends Cellular Cylindrical Rounded Ends Cellular Cast (Renal) Granular Cast

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22 Case History - 9 20-year old female with acute pyelonephritis (renal Infection). Rapid Chemistries pH 5.0 Nitrite = Positive Protein = 2+ Leukocyte Esterase = Positive Blood, Bilirubin, Ketones & Glucose = Negative

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23 Cast Comparison Cellularity Indeterminate Cylindrical Rounded Ends Cellular Cylindrical Rounded Ends Cellular Cast (Renal) Granular Cast

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24 Case History - 10 20-year old male. Asymptomatic with UA performed during a physical exam. Rapid Chemistries pH 7.5 Protein = Trace Leukocyte Esterase, Nitrite, Blood, Bilirubin, Ketones & Glucose = Negative

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25 Alkaline Crystals Amorphous Phosphates Calcium Oxalate Triple Phosphate Calcium Carbonate Calcium Phosphate Ammonium Biurate

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26 Urine Sediment Training Questions?? Any one need to look at a slide again?? Lets review our case studies.