1 urinalysis 2 ua casts 3 cast formation urinary casts are formed only in the distal convoluted...
TRANSCRIPT
![Page 1: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/1.jpg)
1URINALYSIS
![Page 2: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/2.jpg)
2
UA Casts
![Page 3: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/3.jpg)
3
Cast Formation
Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron). The proximal convoluted tubule (PCT) and loop of Henle are not locations for cast formation. Hyaline casts are composed primarily of a mucoprotein (Tamm-Horsfall protein) secreted by tubule cells. The Tamm-Horsfall protein secretion (green dots) is illustrated in the diagram below, forming a hyaline cast in the collecting duct:
![Page 4: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/4.jpg)
4
Cast Formation
• Cast are molded in the lumen of the renal tubules
• Formed in Distal and Collection tubules
• Composed of plasma proteins of Glomerular Filtrate
• Tamm-Horsfall Protein makes up matrix
![Page 5: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/5.jpg)
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Cast Names
• Named by how they appear
• Convoluted
• Broad
• Granular (Finely or Coarsely granular)
• Waxy
![Page 6: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/6.jpg)
6
Cast Names
• Named by what is in casts
• Cells WBC, RBC, Renal Epithelial or Mixed
• Substances Fat Hemoglobin
![Page 7: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/7.jpg)
7Casts
![Page 8: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/8.jpg)
8Fiber
Don’t mistake fibers for casts!!!!
![Page 9: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/9.jpg)
9Hyaline Casts
Low refractive Index
Difficult to see
Use low light
![Page 10: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/10.jpg)
10Hyaline Casts
Cylindroid
Hyaline cast with tail
![Page 11: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/11.jpg)
11Hyaline Cast
Mucous Threads
Phase Contrast
![Page 12: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/12.jpg)
12Hyaline Cast
Spermatozoa
Tortuouse
Cigar Shaped
Phase Contrast
![Page 13: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/13.jpg)
13Hyaline Cast
Tortuous
Interference Contrast
![Page 14: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/14.jpg)
14Hyaline Cast
• Hyaline Cast• Triple Phosphate• Note how
Hyaline Casts are barely visible
![Page 15: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/15.jpg)
15Hyaline Cast
• Convoluted• Note cells on
matrix
![Page 16: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/16.jpg)
16
Granular Casts
• Formed by the breakdown of cellular casts
• In patients with renal disease the granules become more fine as they progress through the nephron and eventually become Waxy
![Page 17: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/17.jpg)
17
Cast Degeneration
![Page 18: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/18.jpg)
18Finely Granular Cast
• C
![Page 19: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/19.jpg)
19Finely Granular Cast
• Higher refractive index than Hyaline cast
• May be present in urine of healthy person after severe physical exercise
• Found in all forms of renal disease
![Page 20: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/20.jpg)
20Coarse Granular Cast
• Granules may be disintegrated RBC’s due to reddish color
![Page 21: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/21.jpg)
21Coarse Granular Cast
• Sternheimer-Malbin Stain
![Page 22: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/22.jpg)
22Coarse Granular Cast
![Page 23: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/23.jpg)
23Coarse Granular Cast
Note mucous threads in background
![Page 24: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/24.jpg)
24Broad Finely Granular Cast
In early stage of evolving into waxy cast
Notched margins
![Page 25: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/25.jpg)
25Waxy Cast
• High Refractive Index
• Notched parallel margins
• “Broken Off” ends
• Chronic renal disease
![Page 26: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/26.jpg)
26Waxy Cast
• High Refractive Index
• Notched parallel margins
• “Broken Off” ends
• Chronic renal disease
![Page 27: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/27.jpg)
27Waxy Cast
• High Refractive Index
• Notched parallel margins
• “Broken Off” ends
• Chronic renal disease
![Page 28: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/28.jpg)
28Waxy Cast
SM Stain• High Refractive
Index• Notched parallel
margins• “Broken Off”
ends• Chronic renal
disease
![Page 29: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/29.jpg)
29Waxy Cast
• Note Spheric lipid globules on surface
• Notched parallel margins
• “Broken Off” ends
• Chronic renal disease
![Page 30: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/30.jpg)
30
Fatty Casts
• Casts that contain free fat or oval fat bodies
• Fat appears as globular lipids of varying size
• Often have a yellow tan color
• Lipid has high refractive index
• Lipid is birefringent
• Maltese Cross in polarized light
![Page 31: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/31.jpg)
31Fatty Cast
• Lipid globules on surface
• RBC in background
• Nephrotic Syndrome
![Page 32: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/32.jpg)
32Fatty Cast
• Lipid globules on surface
• RBC in background
• Nephrotic Syndrome
• Polarized Maltese Cross
![Page 33: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/33.jpg)
33Fatty Cast
• Lipid globules on surface
• RBC in background
• Nephrotic Syndrome
• Polarized Maltese Cross
![Page 34: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/34.jpg)
34Fatty Cast
• Lipid globules on surface
• RBC in background
• Nephrotic Syndrome
• Polarized Maltese Cross
![Page 35: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/35.jpg)
35Fatty Cast
• Lipid globules on surface
• RBC in background
• Nephrotic Syndrome
![Page 36: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/36.jpg)
36Fatty Cast Polarized
![Page 37: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/37.jpg)
37Broad Red Cell Casts
![Page 38: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/38.jpg)
38Cast Formation in Nephron
Cellular Cast are named for the types of cells they contain
![Page 39: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/39.jpg)
39
Cellular Cast formation
![Page 40: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/40.jpg)
40Hemoglobin Cast ??
• Reddish color
![Page 41: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/41.jpg)
41RBC Cast
• RBC in hyaline cast matrix
• RBC more concentrated at one end
![Page 42: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/42.jpg)
42RBC Cast
• RBC in hyaline cast matrix
• Surrounding urine filled with PMN’s and RBC
![Page 43: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/43.jpg)
43RBC Cast
• RBC in hyaline cast matrix
![Page 44: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/44.jpg)
44RBC Cast
• RBC in hyaline cast matrix
• Very difficult in this cast to see intact RBC’s
• Hb granules
![Page 45: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/45.jpg)
45Cellular Cast Mixed
• Epi’s• WBC• Note yeast
![Page 46: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/46.jpg)
46Cellular Cast
• Renal Tubular Cells
![Page 47: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/47.jpg)
47
Cast Review
![Page 48: 1 URINALYSIS 2 UA Casts 3 Cast Formation Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron)](https://reader033.vdocuments.us/reader033/viewer/2022051018/56649eb45503460f94bbbedd/html5/thumbnails/48.jpg)
48
Casts Overhead