Transcript Urine Sediment Identification

Case History - 1

24-year-old female
patient. Asymptomatic
UA during a physical
exam.
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Rapid Chemistry
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SG = 1.016
pH = 6.0
Blood, Protein, Glucose, &
Leukocyte Esterase =
Negative
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Common Acidic Crystals
Amorphous Urates
Uric Acid
Calcium Oxalate
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Abnormal
Acidic Crystals
Bilirubin
Tyrosine
Cystine
Cholesterol
Leucine
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Uncommon
Acid Crystals
Calcium Sulfates
Sodium Urate
Hippuric Acid
X-Ray Dye (Hypaque)
X-Ray Dye (Renografin)
Sulfonamide
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Case History - 2
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48-year old male found
incoherent and
hospitalized.
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Rapid Chemistries
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Cloudy urine
Blood 2+
Protein 4+
Nitrite & Leukocyte
Esterase = Positive
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Cast Comparison
Hyaline Cast
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Transparent
Cylindrical
Rounded Ends
Waxy Cast
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Opaque
Cylindrical
Blunt Ends
Fiber
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Refractile
Flat
Dark Edges 6
Case History - 3
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63-year old male with
lower back pain.
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Rapid Chemistries
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pH 5.0
Nitrite = Positive
Protein, Blood,
Leukocyte Esterase,
Glucose, Ketones =
Negative
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Case History - 4
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45-year old male with
chronic hepatitis.
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Rapid Chemistries
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Specific Gravity = 1.015
pH 5.5
Bilirubin = Positive
Protein = 3+
Leukocyte Est. = Positive
Nitrite, Blood, Glucose,
Ketones = Negative
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Common Acidic Crystals
Amorphous Urates
Uric Acid
Calcium Oxalate
9
Abnormal
Acidic Crystals
Bilirubin
Tyrosine
Cystine
Cholesterol
Leucine
10
Uncommon
Acid Crystals
Calcium Sulfates
Sodium Urate
Hippuric Acid
X-Ray Dye (Hypaque)
X-Ray Dye (Renografin)
Sulfonamide
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Case History - 5

19-year old female.
Asymptomatic with UA
during a physical exam.
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Rapid Chemistries
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pH 6.5
Blood = 1+
Protein = Trace
Leukocyte Est., Nitrite,
Glucose, Ketones = Negative
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Cast Comparison
Hyaline Cast



Transparent
Cylindrical
Rounded Ends
Waxy Cast



Opaque
Cylindrical
Blunt Ends
Fiber



Refractile
Flat
Dark Edges13
Case History - 6
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25-year old female admitted
for multiple substance
abuse.
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Rapid Chemistries
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Cloudy
pH 6.5
Protein = Trace
Leukocyte Est., Nitrite, Blood,
Glucose & Ketones =
Negative
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Common Acidic Crystals
Amorphous Urates
Uric Acid
Calcium Oxalate
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Abnormal
Acidic Crystals
Bilirubin
Tyrosine
Cystine
Cholesterol
Leucine
16
Uncommon
Acid Crystals
Calcium Sulfates
Sodium Urate
Hippuric Acid
X-Ray Dye (Hypaque)
X-Ray Dye (Renografin)
Sulfonamide
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Case History - 7
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52-year old female
admitted for renal
disease.
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Rapid Chemistries
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pH 5.0
Protein = 3+
Specific Gravity = 1.030
Leukocyte Est., Nitrite,
Blood, Glucose, Ketones =
Negative
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Cast Comparison
Hyaline Cast



Transparent
Cylindrical
Rounded Ends
Waxy Cast



Opaque
Cylindrical
Blunt Ends
Fiber



Refractile
Flat
Dark Edges19
Case History - 8
71-year old male with
alcoholic cirrhosis and
esophageal bleeding.
Rapid Chemistries
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pH 5.0
Specific Gravity = 1.030
Protein = 2+
Blood = 2+
Bilirubin = 3+
Leukocyte Est. = Negative
Nitrite & Glucose = Negative
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Cast Comparison
Granular
Cast
Cellular Cast (Renal)
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Cellular
Cylindrical
Rounded Ends
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Cellularity Indeterminate
Cylindrical
Rounded Ends
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Case History - 9
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20-year old female with
acute pyelonephritis (renal
Infection).
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Rapid Chemistries
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pH 5.0
Nitrite = Positive
Protein = 2+
Leukocyte Esterase = Positive
Blood, Bilirubin, Ketones &
Glucose = Negative
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Cast Comparison
Granular
Cast
Cellular Cast (Renal)
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
Cellular
Cylindrical
Rounded Ends
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Cellularity Indeterminate
Cylindrical
Rounded Ends
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Case History - 10
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20-year old male.
Asymptomatic with UA
performed during a physical
exam.
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Rapid Chemistries
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pH 7.5
Protein = Trace
Leukocyte Esterase, Nitrite,
Blood, Bilirubin, Ketones &
Glucose = Negative
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Alkaline Crystals
Calcium Oxalate
Calcium
Carbonate
Ammonium
Biurate
Amorphous
Phosphates
Triple Phosphate
Calcium
Phosphate
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Urine Sediment Training
Questions??
 Any one need to look at a slide again??
 Let’s review our case studies.
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