The cells in your sediment of
urine include the following:
bacteria, sign of
urinary tract infection
what kind do we talk about
over and over again?
What are we going to find?
And sensitivity- quite low.
specificity - quite high
RBCs, examples: renal stone,
cancer- bladder or renal
Stop here for one second..
If there was a RBC of a particular
shape known as a dysmorphic RBC
Well that RBC would be probably more
specific for what kind of damage?
What if there was a renal stone?
Maybe there was transitional cell
cancer, squamous cell cancer
adenocarcinoma of the
could you result in RBCs
being found in the urine?
Of course, you could.
Renal hematuria, RCC - renal
cell carcinoma, yes you could.
glomerulonephritis, more so with what
type of glomerulonephritis,
nephritic, or nephrotic?
And I told you earlier, with nephritic you
probably want to focus upon the letter "H"
give yourself one little clue in which
you start the cascade of symptoms.
hypertension, hematuria, RBC
cast - that's nephritic.
and nephrotic? Oh you pay
attention to letter "O", why?
"O", representing vast or large
amount of protein being lost.
We talked about dysmorphic,
we already did.
If you have an RBC that's passing through
the glomerulus, it might get disfigured,
well mal-shape and then morphic
would be your actual morphology
So misshapen RBC - glomerular.
Neutrophils - urinary tract
infection, sterile pyuria, both.
make sure that you
differentiate between the two.
Do not just read through this.
Urinary tract infection, you'd
find there to be pyuria
and you'd also find there to be esterase and
you'd find there to be positive culture
Sterile pyuria, give me two big examples:
chlamydia and what's the other one?
something like drug-induced nephritis.
Pyuria refers to what?
greater than or equal to 10 WBCs
by high field type of microscopy
in a centrifuged specimen
or greater than or equal to
(5) WBCs in an uncentrifuged specimen
So centrifugation becomes important to you
in terms of laboratory settings with neutrophils
Oval fat bodies.
Here, right off the bat you should
be thinking about nephrotic syndrome
Now let me give you a concept
here okay, as I love to do.
It's a fact that if you
have for whatever reason,
If you don't have enough
protein in your body,
you have an inverse relationship
with lipid accumulating in the body
Once again, for whatever reason, if you are
not having enough protein in your body,
you'll have an increase
in lipid in your patient.
For example, nephrotic syndrome.
You're losing greater than
2.5 grams of protein per day
thus your patient has hyperlipidemia,
because this is occuring in the kidney,
you'd expect to find oval fat body
another name perhaps you've known
nephrotic at times is lipoid nephrosis
Let me give you another one.
Say that your patient has
cirrhosis, you can't make protein.
Oftentimes, your patient will have
hyperlipidemia, that you already know.
And then of course say that you damaged
your rough endoplasmic reticulum
Rough endoplasmic reticulum,
dying organelle in your cell.
We can't produce what?
may result in?
Do you see the parallel
that I have just given you?
When dealing with
nanoprotein, increase lipid.
This is specifically in the kidney and I
will show you a picture of oval fat body
Let's continue, important
section of cells vs cast.