Urine 5

Question 1

what does a cast do?

Answer 1

gives a picture of the nephron

Question 2

what is the kidney specific protein?

Answer 2

Tamm-Horsfall

produced in the tubules

Question 3

describe how casts work?

Answer 3

Tamm-Horsfall proteins start to gel in the distal convluted tubuel and sloughs into the system

Question 4

proteins indicate what?

Answer 4

upper urinary tract problem

Question 5

what can incorporate into a cast?

Answer 5

proteins, acidic pH, urinary stasis, increased solutes

Question 6

what kind of casts are normally found?

Answer 6

granular and hyaline (0-2/LPF)

Question 7

when are the normal casts in urine a significant finding?

Answer 7

when they are associated with other findings

Question 8

where do casts come from?

Answer 8

nephron, no where else

Question 9

red cast indicates?

Answer 9

upper UT bleeding

Question 10

WBC cast indicates?

Answer 10

upper UT infection

Question 11

where specifically does bleeding occur with a red cast?

Answer 11

nephron

Question 12

what can you assume someone has if they have a red cast?

Answer 12

glomerulonephritis

Question 13

what are the findings of glomerulonephritis

Answer 13

RBC casts, dominantly RBCs, WBCs, oliguria, red (smoky), cloudy urine
low specific gravity

Question 14

if someone has a sore throat right before they started having kidney problems, what is the kidney problem likely due to?

Answer 14

strep

Question 15

what can glomerulonephritis also be due to?

Answer 15

systemic lupus

Question 16

signs and symptoms assoicated with RBC casts

Answer 16

+protein
flank pain
fever
usually secondary to untreated strep infection

Question 17

if you find RBC casts, what do you do next?

Answer 17

get an immediate concurrent consultation

Question 18

who usually gets post streptococcal glomerulonephritis? What are their symptoms?

Answer 18

6-10 year olds

suddenly has malaise, fever, nausea, oliguria, proteinuria, hematuria and the urine contains RBC casts

Question 19

what might a patient have with post streptococcal glomerulonephritis?

Answer 19

HTN

elevated antistreptolysin O titer

Question 20

chronic glomerulonephritis progresses to?

Answer 20

death, unless patient undergoes dialysis or transplant intervention

Question 21

what do patients with post streptococcal glomerulonephritis need to do?

Answer 21

maintain electrolyte and water balance

Question 22

what do WBC casts indicate?

Answer 22

infection/inflammation

pyelonephritis

Question 23

what is pyelonephritis?

Answer 23

an infection of the kidney interstitium

Question 24

what are the symptoms of WBC casts?

Answer 24

flank pain
positive
positive punch test
low grade fever
malaise
dysuria
burning sensation
urgency and frequency

Question 25

WBC casts implicate what?

Answer 25

renal involvement, only formed in the tubules

Question 26

what are the findings associated with WBC casts?

Answer 26

yellow-cloudy urine | + protein

Question 27

bacteria casts indicate

Answer 27

upper UTI

Question 28

clusters of WBCs indicate

Answer 28

UTI

Question 29

glitter cells indicate

Answer 29

WBCs undergoing phagocytosis | indicates UTI

Question 30

what casts indicate renal failure?

Answer 30

waxy, broad, fatty casts

Question 31

yeast cells in casts indicate?

Answer 31

candida

Question 32

cholesterol plates in casts are associated with?

Answer 32

hyperlipidemia

Question 33

granular casts are associated with?

Answer 33

renal disease it is a byproduct of metabolism could be fine or course

Question 34

upper UTI urinary findings?

Answer 34

``` casts protein cloudy hazy urine maybe has blood flank pain WBCs ```

Question 35

lower UTI urinary findings?

Answer 35

``` increase WBCs mucous blood no casts no proteins lower back/pubic pain ```

Question 36

what are some other things you can find in urine samples?

Answer 36

``` bacteria yeast cells sperm cells mucous threads parasites (enterobius vermicularis (pinworms) transferred from GI fibers ```