Casts

Question 1

urinary casts are produced in kidney, specifically _______ ; ____ shape reflects where they are formed

Answer 1

distal convoluted tubules and collecting ducts

cylindrical

Question 2

casts are formed via precipitation of _________ MUCOprotein, secreted by renal tubules

Answer 2

Tamm-Horsfall

Question 3

characteristics of casts

Answer 3

• may or may not be present with protein
• parallel sides with rounded/blunt edges
• convoluted, straight or curved shape
• could be cylindrical with NO dark edges

Question 4

broad casts are formed in ______ and signify _______

Answer 4

pathologically diluted or atrophied tubules or collecting ducts
renal failure

Question 5

(4) things that casts always signify

Answer 5

glomerular damage
tubular damage
renal inflammation
renal infxn

Question 6

count casts on _____ power magnification; MC seen on _____ part of slide

Answer 6

low power (10x)
edges of cover slip

Question 7

colorless, homogenous, transparent casts

Answer 7

hyaline casts

Question 8

a few hyaline casts may be present in healthy urine; may be present in (2); may also be seen in ____ disease

Answer 8

excessive physical exercise
physiological dehydration
renal disease

Question 9

RBC casts are always _____; indicates _____ is present

Answer 9

pathologic

hematuria

Question 10

RBC casts may indicate

Answer 10

glomerular disease
renal trauma
renal inflammation
severe pyelonephritis
renal vein thrombosis

Question 11

white cell and WBC casts are usually ______ in _____ matrix

Answer 11

neutrophils

protein

Question 12

WBC casts present in INFECTIOUS and NON-INFECTIOUS ______ inflammation; (4)

Answer 12

renal
acute pyelonephritis
interstitial nephritis
lupus nephritis
some glomerular diseases

Question 13

epithelial cell casts consists of only ______ cells;

Answer 13

renal tubule epithelial cells

Question 14

epithelial cell casts may be present in (4)

Answer 14

• acute tubular necrosis after exposure to nephrontoxic agent (mercury, salycilates)
• viral infections
• due to damage from glomerular injury (nephritic syndrome)
• rejection of kidney allograft

Question 15

granular casts may result from breakdown of ______, _____ or ____ ; divided in 2 categories — __ & ___

Answer 15

cellular casts
inclusion of aggregates of plasma proteins
immunoglobulin light chains
coarse and fine

Question 16

granular casts usually signify _____, but also may be present after ____

Answer 16

CHRONIC renal diseases

strenuous exercise

Question 17

____ casts represent end stage of cast evolution, suggest low urine flow associated with ________ or _____

Answer 17

waxy
long-standing kidney disease
renal failure

Question 18

waxy casts usually have ____ edges, _____ and _____ ends

Answer 18

blunt edges
fractures
broken-off ends

Question 19

waxy casts fall under umbrella of ____ casts

Answer 19

broad

Question 20

conditions that waxy casts are found in (5)

Answer 20

nephritic syndrome
renal amyloidosis
diabetic neuropathy
tubular inflammation and degeneration
malignant HTN

Question 21

____ casts are hyaline casts formed by lipid-rich renal epithelial cells; yellow-tan in color

Answer 21

fatty casts

Question 22

fatty casts are present during fatty degeneration of renal epithelial cells in degenerative tubular diseases (4)

Answer 22

• nepHROTIC syndrome with heavy proteinuria
• diabetic nephropathy (Kimmelsteil-Wilson lesions)
• lupus nePHRITIS
• toxic renal poisoning

Question 23

formation of casts at distal convoluted tubule may produce structures with tapering end called ______ ; usually classified as ____ casts

Answer 23

cylindroids

hyaline

Question 24

confusing artifact that appears as thin, ribbon-like structure, fiber-like bands of line across field that have no particular form or shape

Answer 24

mucus

Question 25

mucus is not ______ and has a low _____

Answer 25

birefringent

low refractive index

Question 26

mucus may be present in normal urine in small amounts, large amounts may indicate:

Answer 26

inflammation or irritation of urinary tract

Question 27

characteristics of fibers (confusing artifacts) -2

Answer 27

have DARK edges

flat

Question 28

confusing artifact- hair has _____

Answer 28

very thick outer wall