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Case History - 1

Case History - 1. 24-year-old female patient. Asymptomatic UA during a physical exam. Rapid Chemistry SG = 1.016 pH = 6.0 Blood, Protein, Glucose, & Leukocyte Esterase = Negative. Common Acidic Crystals. Amorphous Urates. Uric Acid. Calcium Oxalate. Abnormal Acidic Crystals. Bilirubin.

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Case History - 1

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  1. Case History - 1 • 24-year-old female patient. Asymptomatic UA during a physical exam. • Rapid Chemistry • SG = 1.016 • pH = 6.0 • Blood, Protein, Glucose, & Leukocyte Esterase = Negative

  2. Common Acidic Crystals Amorphous Urates Uric Acid Calcium Oxalate

  3. AbnormalAcidic Crystals Bilirubin Tyrosine Cystine Cholesterol Leucine

  4. Uncommon Acid Crystals Calcium Sulfates Sodium Urate Hippuric Acid Sulfonamide X-Ray Dye (Renografin) X-Ray Dye (Hypaque)

  5. Case History - 2 • 48-year old male found incoherent and hospitalized. • Rapid Chemistries • Cloudy urine • Blood 2+ • Protein 4+ • Nitrite & Leukocyte Esterase = Positive

  6. Cast Comparison • Opaque • Cylindrical • Blunt Ends Hyaline Cast Waxy Cast Fiber • Transparent • Cylindrical • Rounded Ends • Refractile • Flat • Dark Edges

  7. Case History - 3 • 63-year old male with lower back pain. • Rapid Chemistries • pH 5.0 • Nitrite = Positive • Protein, Blood, Leukocyte Esterase, Glucose, Ketones = Negative

  8. Case History - 4 • 45-year old male with chronic hepatitis. • Rapid Chemistries • Specific Gravity = 1.015 • pH 5.5 • Bilirubin = Positive • Protein = 3+ • Leukocyte Est. = Positive • Nitrite, Blood, Glucose, Ketones = Negative

  9. Common Acidic Crystals Amorphous Urates Uric Acid Calcium Oxalate

  10. AbnormalAcidic Crystals Bilirubin Tyrosine Cystine Cholesterol Leucine

  11. Uncommon Acid Crystals Calcium Sulfates Sodium Urate Hippuric Acid Sulfonamide X-Ray Dye (Renografin) X-Ray Dye (Hypaque)

  12. Case History - 5 • 19-year old female. Asymptomatic with UA during a physical exam. • Rapid Chemistries • pH 6.5 • Blood = 1+ • Protein = Trace • Leukocyte Est., Nitrite, Glucose, Ketones = Negative

  13. Cast Comparison • Opaque • Cylindrical • Blunt Ends Hyaline Cast Waxy Cast Fiber • Transparent • Cylindrical • Rounded Ends • Refractile • Flat • Dark Edges

  14. Case History - 6 • 25-year old female admitted for multiple substance abuse. • Rapid Chemistries • Cloudy • pH 6.5 • Protein = Trace • Leukocyte Est., Nitrite, Blood, Glucose & Ketones = Negative

  15. Common Acidic Crystals Amorphous Urates Uric Acid Calcium Oxalate

  16. AbnormalAcidic Crystals Bilirubin Tyrosine Cystine Cholesterol Leucine

  17. Uncommon Acid Crystals Calcium Sulfates Sodium Urate Hippuric Acid Sulfonamide X-Ray Dye (Renografin) X-Ray Dye (Hypaque)

  18. Case History - 7 • 52-year old female admitted for renal disease. • Rapid Chemistries • pH 5.0 • Protein = 3+ • Specific Gravity = 1.030 • Leukocyte Est., Nitrite, Blood, Glucose, Ketones = Negative

  19. Cast Comparison • Opaque • Cylindrical • Blunt Ends Hyaline Cast Waxy Cast Fiber • Transparent • Cylindrical • Rounded Ends • Refractile • Flat • Dark Edges

  20. Case History - 8 • 71-year old male with alcoholic cirrhosis and esophageal bleeding. Rapid Chemistries • pH 5.0 • Specific Gravity = 1.030 • Protein = 2+ • Blood = 2+ • Bilirubin = 3+ • Leukocyte Est. = Negative • Nitrite & Glucose = Negative

  21. Cast Comparison • Cellularity Indeterminate • Cylindrical • Rounded Ends Granular Cast Cellular Cast (Renal) • Cellular • Cylindrical • Rounded Ends

  22. Case History - 9 • 20-year old female with acute pyelonephritis (renal Infection). • Rapid Chemistries • pH 5.0 • Nitrite = Positive • Protein = 2+ • Leukocyte Esterase = Positive • Blood, Bilirubin, Ketones & Glucose = Negative

  23. Cast Comparison • Cellularity Indeterminate • Cylindrical • Rounded Ends Granular Cast Cellular Cast (Renal) • Cellular • Cylindrical • Rounded Ends

  24. Case History - 10 • 20-year old male. Asymptomatic with UA performed during a physical exam. • Rapid Chemistries • pH 7.5 • Protein = Trace • Leukocyte Esterase, Nitrite, Blood, Bilirubin, Ketones & Glucose = Negative

  25. Alkaline Crystals Calcium Oxalate Calcium Carbonate Ammonium Biurate Amorphous Phosphates Triple Phosphate Calcium Phosphate

  26. Urine Sediment Training • Questions?? • Any one need to look at a slide again?? • Let’s review our case studies.

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