Granular Cast Present in Urine
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Usmle Rx Qbank 2017 Step 1 Renal
Item: 1 of 24 ~ 1 • M k -<:J 1>- Jil ~· !:';-~ QIO: 4749 ..L a r Previous Next Labfli!llues Not es Calculat o r • 1 & & A 67-year-old man admitted for postoperative recovery is found to be oliguric. Laboratory studies show a blood urea nitrogen level of 200 • 2 mg/dl and a serum creatinine level of 6 mg/dl. Urinalysis shows: • 3 Specific gravity: 1.050 · 4 Urine osmolality: 670 mOsm/kg • 5 Sodium: 14 mEq/L BUN/Creatinine ratio: 56 • 6 Fractional excretion of Na: 0.54% • 7 Protein: negative Casts: negative · 8 . 9 • 10 Which of the following is the most likely cause of this patient's oliguria? • 11 : • 12 A. Acute interstitial nephritis • 13 B. Acute tubular necrosis • 14 C. Bladder calculus • 15 • 16 D. Heart failure • 17 E. Nephrotic syndrome • 18 • 19 • 20 • 21 • a s 8 Lock Suspend End Block Item: 1of24 ~ . , . M k <:] t> al ~· ~ QIO: 4749 .l. ar Previous Next Lab'lifllues Notes Calculator 1 • The correct a nswer is 0. 4 80/o c hose t his. • 2 This patient's laboratory tests confirm the classic criteria for d iagnosing prerenal azotemia. Prerenal azotemia is caused by a reduction of the • 3 g lomerular filtration rate (GFR} provoked by an insult to the vascular supply to the kidney. Causes of prerenal azotemia include heart failure, sepsis, and renal artery stenosis. The reduction in GFR increases the accumulation of both blood urea nitrogen (BUN} and creatinine (Cr} in the • 4 blood, but because the BUN concentration in blood is determined by both g lomerular filtration and reabsorption (in contrast to Cr, which is • 5 limited to filtration and not reabsorbed}, the BUN level rises out of proportion to the Cr leveL This therefore elevates the BUN :Cr ratio. -
Name: Akinbile Grace Oluwaseun Matric Number
NAME: AKINBILE GRACE OLUWASEUN MATRIC NUMBER: 18/MHS02/029 DEPARTMENT: NURSING, MHS COURSE CODE: PHS 212 (PHYSIOLOGY) ANSWER URINALYSIS Urinalysis is the process of analysing urine for target parameters of health and disease. A urinalysis (UA), also known as routine and microscopy (R&M), is an array of tests performed on urine, and one of the most common methods of medical diagnosis. Urinalysis means the analysis of urine, and it is used to diagnose several diseases. The target parameters that are measured or quantified in urinalysis include many substances and cells, as well as other properties, such as specific gravity. A part of a urinalysis can be performed by using urine test strips, in which the test results can be read as the strip’s colour changes. Another method is light microscopy of urine samples. Test Strip Urinalysis Test strip urinalysis exposes urine to strips that react if the urine contains certain cells or molecules. Test strip urinalysis is the most common technique used in routine urinalysis. A urine test strip can identify: Leukocytes—their presence in urine is known as leukocyturia. Nitrites—their presence in urine is known as nitrituria. Proteins —their presence in urine is known as proteinuria, albuminuria, or micro albuminuria. Blood—its presence in urine is known as haematuria. pH—the acidity of urine is easily quantified by test strips, which can identify cases of metabolic acidosis or alkalosis. Urine Microscopy The numbers and types of cells and/or material, such as urinary casts, can yield a great detail of information and may suggest a specific diagnosis. -
Cardiovascular II 10:30 AM Saturday, February 23, 2019
Abstracts J Investig Med: first published as 10.1136/jim-2018-000974.619 on 28 January 2019. Downloaded from 669 NITRIC OXIDE SYNTHASE INHIBITION STIMULATES diagnostic information otherwise not identified in a single RENIN SYNTHESIS INDEPENDENT OF CGMP IN inspection. COLLECTING DUCT CELLS Methods used Microscopic examination of the urinary sedi- 1 1 1 1 1 2 ment (MicrExUrSed)±Sternheimer Malbin stain was under- A Curnow*, SR Gonsalez, B Visniauskas, SL Crabtree, VR Gogulamudi, EE Simon, 3Lara Morcillo Ld, 1,4MC Prieto. 1Tulane University-SOM, New Orleans, LA; 2Tulane taken in all patients with AKI stage 2 who were seen on University HSC, New Orleans, LA; 3Instituto de Biofisica Chagas Filho, Universidade Federal consultation in an inpatient nephrology service during a do Rio de Janeiro, Rio de Janeiro, Brazil; 4Tulane Hypertension and Renal Center of 6 month period. MicrExUrSed were done on the day of con- Excellence, Tulane University, New Orleans, LA sult (day 1), 48 hours later (day 3) and 96 hours later (day 5). Urinary cast scores (based on Chawla et al and Perazella 10.1136/jim-2018-000974.675 et al) were assigned to each specimen. Chawla scores (CS) 3– 4 and Perazella scores (PS) 2–3 were categorized as consistent Purpose of study Nitric oxide (NO) synthase (NOS) inhibitors with acute tubular injury (ATI), whereas CS 1–2 and PS 0–1 attenuate any stimulation of juxtaglomerular renin gene were categorized as non-diagnostic for ATI (non-ATI). Worsen- expression, regardless of the underlying challenge of the ing AKI was defined as a rise in serum creatinine renin-angiotensin system. -
Urinalysis: Sediment Examination, Currently, a Liquid Kidney Biopsy?
Nephrology and Renal Diseases Review Article ISSN: 2399-908X Urinalysis: Sediment examination, currently, a liquid kidney biopsy? Glísia Mendes Tavares Gomes* Laboratório de Diagnóstico, Ensino e Pesquisa-Centro de Saúde Escola Germano Sinval Faria/Escola Nacional de Saúde Pública Sergio Arouca (ENSP/Fiocruz), Rio de Janeiro, Brazil. Abstract The current article aims to assist in understanding the importance of urinalysis, more specifically, urinary sediment examination, in the diagnosis and monitoring of kidney injuries, its particularities and, especially, its most relevant characteristics: sample which is easy to obtain, low execution cost and diagnostic utility. In view of the panorama of the increase in kidney diseases in recent decades, the application of this analytical tool has been of paramount importance, which, when performed well, both in laboratory and clinic, can bring great benefits to patients who use it, being these people in a risk group for chronic kidney diseases or not. The databases used for search were- PubMed, Scielo and Web of Science. Introduction Urine testing is emphasized as an excellent biomarker of kidney disease. We highlight the important contribution of the centrifuged Among the diseases that represent a major public health problem urine test, evaluated by an experienced nephrologist, as a tool in the are the different types of kidney disorders that affect about 850 million diagnosis and management of many conditions that affect the kidneys people around the world [1,2]. It is believed that until 2040, chronic [18-28]. However, studies indicate low sensitivity and high specificity kidney disease (CKD) will be the fifth disease in numbers of death [2,3]. -
Accuracy of Urine Flow Cytometry and Urine Test Strip in Predicting Relevant
Gehringer et al. BMC Infectious Diseases (2021) 21:209 https://doi.org/10.1186/s12879-021-05893-3 RESEARCH ARTICLE Open Access Accuracy of urine flow cytometry and urine test strip in predicting relevant bacteriuria in different patient populations Christian Gehringer1,2,3, Axel Regeniter4, Katharina Rentsch5, Sarah Tschudin-Sutter6, Stefano Bassetti1,3† and Adrian Egli2,3,7*† Abstract Background: Urinary tract infection (UTI) is diagnosed combining urinary symptoms with demonstration of urine culture growth above a given threshold. Our aim was to compare the diagnostic accuracy of Urine Flow Cytometry (UFC) with urine test strip in predicting bacterial growth and in identifying contaminated urine samples, and to derive an algorithm to identify relevant bacterial growth for clinical use. Methods: Species identification and colony-forming unit (CFU/ml) quantification from bacterial cultures were matched to corresponding cellular (leucocytes/epithelial cells) and bacteria counts per μl. Results comprise samples analysed between 2013 and 2015 for which urine culture (reference standard) and UFC and urine test strip data (index tests, Sysmex UX-2000) were available. Results: 47,572 urine samples of 26,256 patients were analysed. Bacteria counts used to predict bacterial growth of ≥105 CFU/ml showed an accuracy with an area under the receiver operating characteristic curve of > 93% compared to 82% using leukocyte counts. The relevant bacteriuria rule-out cut-off of 50 bacteria/μl reached a negative predictive value of 98, 91 and 89% and the rule-in cut-off of 250 bacteria/μl identified relevant bacteriuria with an overall positive predictive value of 67, 72 and 73% for microbiologically defined bacteriuria thresholds of 105,104 or 103 CFU/ml, respectively. -
A Glossary for Basic Sciences Subjects
Department of Basic Sciences Faculty of Allied Health Sciences University of Peradeniya Sri Lanka June 2020 Dr TN Haththotuwa Terms of Use All rights reserved. No part of this glossary may print, copy, reproduce and redistribute by any means (electronic, photocopying) without obtaining the written permission from the copyright holder (Dr T N Haththotuwa). Any modifications, edition or revision to the original text should carry out only under author’s consent. Failure to comply with the terms of the copyright warning may expose you to legal action for copyright infringement. Published by: Dr TN Haththotuwa Lecturer Department of Basic Sciences Faculty of Allied Health Sciences University of Peradeniya Sri Lanka Published date: 13th June 2020 © Dr TN Haththotuwa Department of Basic Sciences/FAHS/UOP June 2020 2 Preface This document prepared as supportive learning material for first-year Allied health undergraduates of university of Peradeniya, Sri Lanka. This glossary summarizes the list of common scientific terms student should aware of under Human Physiology, Basic Human Anatomy and General Pathology and Basic Biochemistry subjects. The terms are categorize under different topics and course modules for convenience in preparing upcoming lecture topics. These terms will also use in a scientific terms game or Moodle activity in future. Therefore, terms listed without definitions on purpose. At the end of the activity, students will have a complete glossary with definitions. Please note that I have used British English in this document. Therefore, you may notice some spelling differences when you read reference books (E.g. Anaemia, Haemoglobin etc). This glossary may not cover all the scientific terms use under-listed course modules. -
USMLE and COMLEX II
USMLE and COMLEX Review Nephrology Supplement Glomerulonephritis, Acute Tubular Necrosis and Acute Interstitial Nephritis Northwestern Medical Review www.northwesternmedicalreview.com Lansing, Michigan 2014-2015 1. What is Tamm-Horsfall glycoprotein (THP)? Matching (4 – 15): Match the following urinary casts with the descriptions, conditions, or questions _______________________________________ presented hereafter: _______________________________________ A. Bacterial casts _______________________________________ B. Crystal casts _______________________________________ C. Epithelial casts D. Fatty casts _______________________________________ E. Granular casts _______________________________________ F. Hyaline casts G. Pigment casts H. Red blood cell casts 2. What is a urinary cast? I. Waxy casts J. White blood cell casts _______________________________________ _______________________________________ 4. These types of casts are by far the most common _______________________________________ urinary casts. They are composed of solidified Tamm-Horsfall mucoprotein and secreted from _______________________________________ tubular cells under conditions of oliguria, _______________________________________ concentrated urine, and acidic urine. _______________________________________ _______________________________________ _______________________________________ 5. These types of casts are pathognomonic of acute tubular necrosis (ATN) and at times are 3. What are the major types of urinary casts? described as “muddy brown casts”. _______________________________________ -
Urisys 1100® Urine Analyzer Policies and Procedures
Urisys 1100® Urine Analyzer Policies and Procedures for use with Urisys 1100® Urine Analyzer This is a CLIA-Waived System Roche Diagnostics is not responsible for any changes made to this diskette by the customer. Introduction Roche Diagnostics is pleased to assist you in developing policies and procedures and implementing regulations of the Clinical Laboratory Improvement Amendment of 1988 (CLIA ‘88) in your facility. This guide contains sample policies and procedures for use with the Urisys 1100® Urine Analyzer. These sample policies and procedures are intended only as a guide, and it is important that you make whatever adjustments may be required as a result of a change in policy or a change in law or regulations or their interpretation. A total quality management program should include written policies and testing procedures that are customized for your particular facility. Any policies and procedures that involve using Chemstrip urine test strips should be written prior to the start of any urine testing. This guide provides sample policies and procedures that meet the Section 493.1211 requirements. Blank spaces let you customize the policies and procedures with information specific to your facility. You are encouraged to highlight impor- tant areas and procedures currently in use. We suggest you store a Urisys 1100® Urine Analyzer Operator’s Manual, Chemstrip urine test strip package insert and control package insert in the Product Information section for quick reference. You may also want to include the following clinical guidelines and regulations in the Regulatory Requirements section. • JCAHO Guidelines • CAP Guidelines • CLIA ‘88 Guidelines • State Guidelines • Bloodborne Pathogen Standard If you have any questions, please call Roche Diagnostics Technical Service Center at 1-800-428-4674, available 7 days per week, 24 hours a day, and 365 days per year. -
PDF-Document
Supplementary Information for Design of Appropriate-technology-assisted Urine Tester Enabling Remote and Long-term Monitoring of Health Conditions Hyun-Kyung Lee1* and Jeong-Hyeon Bae2 1Division of Culture & Design Management, Underwood International College, Yonsei University 2School of Urban and Environmental Engineering, Ulsan National Institute of Science and Technology (UNIST) *Correspondence: Hyun-Kyung Lee Associate Professor Culture & Design Management, Techno Art Division The Humanities, Arts, and Social Sciences Underwood International College Yonsei University Email: [email protected] 1 Table S1. Ten most common compounds that can be analyzed from urine samples. Reference color scales and abnormal ranges are provided by the manufacturers to determine urine tests, which are dependent on the reagent test strips. Suspected diseases can be estimated by comparing the urine test results with the reference. Parameter Reference Range Abnormal Range Suspected Disease Blood 0–5 Ery/µl >10 Ery/µl Inflammation or tumors in the kidneys Gallstone disease, aCute hepatitis, ChroniC Bilirubin <0.2 mg/dl >1 mg/dl liver disease Liver disorder, hemolytiC jaundice, Urobilinogen <1 mg/dl >2 mg/dl pulmonary jaundice Ketones <5 mg/dl- >10 mg/dl Severe diabetes Protein <2 mg/dl >6 mg/dl Kidney infeCtion, diabetes, Wilson’s disease Nitrite 0 >0.05 mg/dl Cystitis, urethritis Diabetes, panCreas disease, liver disease, GluCose <30 mg/dl >40 mg/dl brain tumor Diabetes, gout, hunger, dehydration, urinary pH Value 4.8–7.4 <4 or >9 traCt infeCtions SpeCifiC Gravity 1.016–1.022 <1 or >1.040 Cystitis, urethritis Kidney and urinary traCt abnormalities, LeukoCytes <10 Leu/µl >30 Leu/µl tumors 2 Table S2. -
SEED Urinalysis Sysmex Educational Enhancement and Development February 2012
SEED Urinalysis Sysmex Educational Enhancement and Development February 2012 Laboratory investigation of haematuria Apart from diagnosing possible urinary tract infections, If no erythrocytes are found on microscopy, haemoglobi- haematuria is one of the most frequent findings on urinalysis. nuria and myoglobinuria can be confirmed by further The presence of erythrocytes in urine can be entirely laboratory tests physiological. According to literature, the number of n Haemoglobinuria is present when increased haemolysis excreted erythrocytes can amount up to 3,000 or 20,000 takes place in the blood. Some of the free haemoglobin erythrocytes/mL of normal urine or up to 3 x 106 erythro- has been excreted in the urine and was detected by the cytes/24h collected urine. Approx. 10% of healthy people test strip. In the blood, on the other hand, the increased have even higher levels, thus markedly exceeding the tendency to haemolysis can be underpinned diagnostically defined normal laboratory ranges. The normal ranges given by the finding of a raised serum LDH or reduced serum in the literature for erythrocytes in sediment microscopy haptoglobin level. also differ and the reported figures range between 2–3 n Myoglobinuria occurs together with myoglobinaemia erythrocytes/high power field and up to 10 erythrocytes/ when muscle tissue is destroyed. In the serum there are high power field, which can be explained by the different then higher levels of creatine kinase, which is released methods of obtaining and counting samples. from muscle cells when muscle is damaged. If a haematuria is pathological, there are many possible If no erythrocytes are found on microscopy, the possibility reasons for this. -
Preanalytical Requirements of Urinalysis Joris Delanghe*1, Marijn Speeckaert2
Review Preanalytical requirements of urinalysis Joris Delanghe*1, Marijn Speeckaert2 1Department of Clinical Chemistry, Ghent University Hospital, Gent, Belgium 2Department of Nephrology, Ghent University Hospital, Gent, Belgium *Corresponding author: [email protected] Abstract Urine may be a waste product, but it contains an enormous amount of information. Well-standardized procedures for collection, transport, sample preparation and analysis should become the basis of an effective diagnostic strategy for urinalysis. As reproducibility of urinalysis has been greatly improved due to recent technological progress, preanalytical requirements of urinalysis have gained importance and have become stricter. Since the patients themselves often sample urine specimens, urinalysis is very susceptible to preanalytical issues. Various sampling methods and inappro- priate specimen transport can cause important preanalytical errors. The use of preservatives may be helpful for particular analytes. Unfortunately, a universal preservative that allows a complete urinalysis does not (yet) exist. The preanalytical aspects are also of major importance for newer applications (e.g. metabolomics). The present review deals with the current preanalytical problems and requirements for the most common urinary analytes. Key words: flow cytometry; preservatives; sample preparation; urinalysis Received: September 30, 2013 Accepted: November 20, 2013 Introduction Urinalysis is the third major diagnostic screening 10-fold reduction in the analytical error rate over test in the clinical laboratory, only preceded by se- the last 30 years. Furthermore, also progress in in- rum/plasma chemistry profiles and complete formation technology and quality assurance meth- blood count analysis (1,2). For decades, microscop- ods have contributed to a further reduction of di- ic urine sediment analysis has been the gold stand- agnostic errors. -
View and in Accordance with the and RTEC Casts (Rteccs) (2,3)
Original Investigation Diagnostic Utility of Serial Microscopic Examination of the Urinary Sediment in Acute Kidney Injury Vipin Varghese,1,2 Maria Soledad Rivera,1 Ali A. Alalwan,2 Ayman M. Alghamdi,2 Manuel E. Gonzalez,3 and Juan Carlos Q. Velez1,2 Abstract Background Microscopic examination of the urinary sediment (MicrExUrSed) is an established diagnostic tool for AKI. However, single inspection of a urine specimen during AKI is a mere snapshot affected by timing. We hypothesized that longitudinal MicrExUrSed provides information otherwise not identified in a single inspection. Methods MicrExUrSed was undertaken in patients with AKI stage $2 and suspected intrinsic cause of AKI seen for nephrology consultation over a 2-year period. MicrExUrSed was performed on the day of consultation and repeated at a second (2–3 days later) and/or third (4–10 days later) interval. Cast scores were assigned to each specimen. Chawla scores (CS) 3–4 and Perazella scores (PS) 2–4 were categorized as consistent with acute tubular injury (ATI), whereas CS 1–2 and PS 0–1 were categorized as nondiagnostic for ATI (non-ATI). Nonrecovering AKI was defined as a rise in serum creatinine (sCr) $0.1 mg/dl between microscopy intervals. Results At least two consecutive MicrExUrSed were performed in 121 patients (46% women, mean age 61614, mean sCr at consult of 3.361.9 mg/dl). On day 1, a CS and PS consistent with non-ATI was assigned to 64 (53%) and 70 (58%) patients, respectively. After a subsequent MicrExUrSed, CS and PS changed to ATI in 14 (22%) and 16 (23%) patients.