NBME 1- renal casts - pashna23

[ArchivalUser]

A 5-year-old boy is brought to the emergency department 30 minutes after he fainted at home after standing up from a sitting position. His symptoms began 3 days ago with diarrhea and vomiting. He has had no urine output for 18 hours. He is alert but quiet. His temperature is 37.5 C (99.5 F), blood pressure is 75/45 mm Hg, pulse is 120/min, and respirations are 28/min. Examination shows dry lips and tenting of the skin. There is no abdominal tenderness. Bowel sounds are hyperactive. The remainder of the examination shows no abnormalities. His capillary refill time is 5 seconds. Intravenous bolus doses of 0.9% saline are administered. Bladder catheterization yields 5 mL of urine. Urinalysis is most likely to show which of the following?

A
) Blood

B
) Erythrocyte casts

C
) Hyaline casts

D
) Leukocyte casts

E
) Oxalate crystals

[ArchivalUser]

CCCCCCCCCCC

[ArchivalUser]

c

[ArchivalUser]

what the difference btw Hylaine and Muddy brown casts in ATN

UW mentions Hylaine in conjunction w/ Fatty casts for nephrotic synd?

[ArchivalUser]

yeah ben thats why i posted this q... i was looking for muddy brown casts cause of ATN...
dont know why hyaline ...

[ArchivalUser]

This Statement is sraight from UW

Hyaline Casts are composed almost of entirely of Protein that Pass Unchanged along the Urinary Tract, these may be seen in ASx Pts and Pts w/ Pre-Renal Azotemia

Muddy Brown Casts are --Epithelial Cells

[ArchivalUser]

Muddy Brown Casts -- ATN from prolonged Hypotension
-- Consists of Renal Tubular Epithelial Cells  Sensitive for ATN but Non-Specific Finding




2. Broad Casts “ Seen in Pts w/ CRF.
-- These arise in Dilated Tubules of Enlarged Nephrons that have undergone Compensatory Hypertrophy in Response to Reduced Renal Mass


Wax Casts “ CRF
-- Casts are Shiny & Translucent




3. RBC Casts “ Glomerulonephritis or Vasculitis




4. WBC Casts “ Are Definite Evidence that Urinary WBC™s originate in the Kidney
They are seen in  Interstitial Nephritis
 Pyelonephritis




5. Fatty Casts “ Seen in Conditions that causes Nephrotic Syndromes
-- Hyaline Casts are composed almost of entirely of Protein that Pass Unchanged along the Urinary Tract, these may be seen in ASx Pts and Pts w/ Pre-Renal Azotemia

What the Dx here?

[ArchivalUser]

hyaline casts....there is nothing to specifically suggest hemolytic uremic syndrome...in which case it would have been RBC casts...CCCCC

[ArchivalUser]

ben it s just volume depletion