Urine casts
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This document defines urine casts and describes their types. Urine casts are cylindrical structures formed by condensation of proteins in the renal tubules. There are cellular casts containing cells and acellular casts without cells. The most common acellular cast is the hyaline cast, seen in conditions like fever and dehydration. Granular casts indicate conditions like kidney disease. Waxy casts signify advanced kidney disease. Cellular casts contain red blood cells, white blood cells, or epithelial cells, indicating various pathological conditions.
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Urine casts &crystals
Urinary casts form in the distal nephron and indicate kidney disease. They are cylindrical aggregations of particles that precipitate from Tamm-Horsfall mucoprotein secreted by renal tubule cells. Different types of casts provide information about underlying kidney conditions - hyaline casts are common, granular casts suggest chronic kidney disease, and red blood cell casts indicate glomerular damage. Urinary crystals also form in the urine and can provide some clinical information, though many patients with crystalluria do not develop kidney stones. The type of crystal present depends on urine pH and composition.
Microscopic examination of urinary sediments
This document provides a detailed summary of microscopic elements that may be observed during examination of urinary sediments. It describes both organized elements like epithelial cells, red blood cells, white blood cells and casts, as well as unorganized elements like crystals that can be seen. Common normal and abnormal crystals are outlined, along with their appearances and clinical associations. The document also discusses artifacts that may be present during microscopic urinalysis.
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Urine casts
This document discusses urinary casts seen on urinalysis and their significance in diagnosis. It describes the formation and composition of various types of casts including hyaline, RBC, WBC, epithelial, fatty, granular, waxy and broad casts. Hyaline casts are most common but increased numbers can indicate kidney issues. RBC casts signify bleeding in the nephron, often from glomerular damage. WBC casts indicate infection or inflammation in the kidney, especially seen in pyelonephritis. Other casts like fatty, epithelial and granular casts are associated with specific kidney conditions. Observation of casts is important for diagnosis of glomerulonephritis, pyelonephritis, nephrotic syndrome
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2. ESR works by fibrinogen proteins adhering to red blood cells, neutralizing their negative charge and allowing them to stick together and fall faster as rouleaux. Conditions with elevated fibrinogen like infection, inflammation, and malignancy increase ESR.
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Microcytic hypochromic anemia
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Urine casts &crystals
Urinary casts form in the distal nephron and indicate kidney disease. They are cylindrical aggregations of particles that precipitate from Tamm-Horsfall mucoprotein secreted by renal tubule cells. Different types of casts provide information about underlying kidney conditions - hyaline casts are common, granular casts suggest chronic kidney disease, and red blood cell casts indicate glomerular damage. Urinary crystals also form in the urine and can provide some clinical information, though many patients with crystalluria do not develop kidney stones. The type of crystal present depends on urine pH and composition.
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This document discusses urinary casts seen on urinalysis and their significance in diagnosis. It describes the formation and composition of various types of casts including hyaline, RBC, WBC, epithelial, fatty, granular, waxy and broad casts. Hyaline casts are most common but increased numbers can indicate kidney issues. RBC casts signify bleeding in the nephron, often from glomerular damage. WBC casts indicate infection or inflammation in the kidney, especially seen in pyelonephritis. Other casts like fatty, epithelial and granular casts are associated with specific kidney conditions. Observation of casts is important for diagnosis of glomerulonephritis, pyelonephritis, nephrotic syndrome
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3. ESR is measured using the Westergreen, Wintrobe, or automated methods. The Westergreen method is the reference standard. ESR values are interpreted based on age, sex and clinical context.
Microcytic hypochromic anemia
1) Microcytic hypochromic anemia is characterized by small, pale red blood cells and can be caused by iron deficiency, thalassemia, sideroblastic anemia, or other conditions.
2) Iron deficiency anemia is the most common cause and results from inadequate iron intake or absorption. It disrupts hemoglobin synthesis and cellular proliferation.
3) Thalassemia is an inherited disorder of hemoglobin production that can range from mild to severe. Thalassemia major requires regular blood transfusions and causes severe anemia from ineffective erythropoiesis and hemolysis.
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casoni test is an immediate hypersensitivity skin test previously used in the diagnosis of hydatid disease.
Intradermal injection of 0.2ml of hydatid fluid collected from animal/human cyst which is sterilized by seitz filtration OR membrane filtration.
equal volume of saline(control) injected on the other forearm and observation made for next 30 min and after 1 to 2 days.
As a precaution anaphylactic tray must be kept ready before carrying out the test.(Type 1 hypersensitivity reaction)
Interpretation: Sensitive patients develop large wheal measuring 5 cm or more with formation of pseudopodia like projection within 30 minutes occuring at injection site, considered positive result.(immediate hypersensitivity) .
No reaction in the control arm.
Disadvantage: It has low sensitivity (60-80%)
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Less reliable than imaging technique.
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- Jaundice occurs when there is excessive bilirubin production, impaired uptake or conjugation in the liver, or obstruction of bile flow, leading to accumulation of bilirubin in blood.
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- Factors like medications and transfusions can affect the test results. Proper technique and avoiding inclusions
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casoni test is an immediate hypersensitivity skin test previously used in the diagnosis of hydatid disease.
Intradermal injection of 0.2ml of hydatid fluid collected from animal/human cyst which is sterilized by seitz filtration OR membrane filtration.
equal volume of saline(control) injected on the other forearm and observation made for next 30 min and after 1 to 2 days.
As a precaution anaphylactic tray must be kept ready before carrying out the test.(Type 1 hypersensitivity reaction)
Interpretation: Sensitive patients develop large wheal measuring 5 cm or more with formation of pseudopodia like projection within 30 minutes occuring at injection site, considered positive result.(immediate hypersensitivity) .
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Disadvantage: It has low sensitivity (60-80%)
and gives false positive results in cross reactive cestode infections.
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Cerebrospinal fluid (CSF) is formed in the brain ventricles and circulates through the brain and spinal cord. A lumbar puncture, or spinal tap, is performed to collect a CSF sample for analysis. Routine CSF analysis includes examination of appearance, cell count and differential, glucose, and protein levels. Abnormal results can indicate infections, inflammatory conditions, tumors, or other neurological disorders. Precise evaluation of CSF findings is important for diagnosis.
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3) Intestinal metaplasia where squamous cells are replaced by columnar cells.
4) Three slides showing blood vessels filled with red blood cells, fibroblasts, and inflammatory cells, diagnosed as granulation tissue.
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MORPHOLOGY OF REVERSIBLE CELL INJURY
Common examples of morphologic forms of reversible cell injury are as under:
Hydropic change
2. Hyaline change
3. Mucoid change
4. Fatty change (discussed under intracellular accumulations)
1. HYDROPIC CHANGE
Hydropic change means accumulation of water within the cytoplasm of the cell.
Other synonyms used are cloudy swelling (for gross appearance of the affected organ) and vacuolar degeneration (due to cytoplasmic vacuolation).
Hydropic swelling is an entirely reversible change upon removal of the injurious agent.
ETIOLOGY
This is the commonest and earliest form of cell
injury from almost all causes.
The common causes include acute and subacute cell injury from various etiologic agents such as bacterial toxins, chemicals, poisons, burns, high fever, intravenous administration of hypertonic glucose or saline etc.
PATHOGENESIS
Cloudy swelling results from impaired
regulation of sodium and potassium at the level of cell membrane.
This results in intracellular accumulation of sodium and escape of potassium.
This, in turn, is accompanied with rapid flow of water into the cell to maintain iso-osmotic
2. HYALINE CHANGE
The word ‘hyaline’ or ‘hyalin’ means glassy (hyalos = glass).
Hyalinisation is a common descriptive histologic term for glassy, homo geneous, eosinophilic appearance of proteinaceous material in haematoxylin and eosin-stained sections and does not refer to any specific substance.
Though fibrin and amyloid have hyaline appearance, they have distinctive features and
staining reactions and can be distinguished from non-specific hyaline material.
Hyaline change is seen in heterogeneous pathologic conditions and may be intracellular or extracellular.
INTRACELLULAR HYALINE
Intracellular hyaline is mainly seen in epithelial cells.
1. Hyaline droplets in the proximal tubular epithelial cells due to excessive reabsorption of plasma proteins in proteinuria.
2. Hyaline degeneration of rectus abdominalis muscle called Zenker’s degeneration, occurring in typhoid fever. The muscle loses its fi brillar staining and becomes glassy and hyaline.
3. Mallory’s hyaline represents aggregates of intermediate filaments in the hepatocytes in alcoholic liver cell injury.
4. Nuclear or cytoplasmic hyaline inclusions seen in some viral infections.
5. Russell’s bodies representing excessive immuno glo bulins in the rough endoplasmic reticulum of the plasma cell
EXTRACELLULAR HYALINE
Extracellular hyaline commonly termed hyalinisation is seen in connective tissues.
1. Hyaline degeneration in leiomyomas of the uterus.
2. Hyalinised old scar of fi brocollagenous tissues.
3. Hyaline arteriolosclerosis in renal vessels in hyper tension and diabetes mellitus.
4. Hyalinised glomeruli in chronic glomerulonephritis.
5. Corpora amylacea seen as rounded masses of concentric hyaline laminae in the enlarged prostate in the elderly, in the brain and in the spinal cord in old age, and in old infarcts of the
lung.
Discovering a "new organ": Tales of the Interstitium
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6 anatomy circulatory system
The document discusses the circulatory system and its components. It describes how nutrients, oxygen, carbon dioxide, hormones and other substances are transported throughout the body via blood and lymph. The three main fluids in the body - blood, tissue fluid and lymph - are defined. Blood circulates through vessels and contains plasma, red blood cells, white blood cells and platelets. The properties and functions of these blood components are summarized.
Lecture 2 Degenerative changes and cellular injury
This document discusses different types of degenerative cellular changes and injury, including cloudy swelling, hydropic degeneration, fatty change, hyaline degeneration, glycogen infiltration, and mucinous degeneration. For each type, the document describes the gross and microscopic appearance, potential causes, and examples where each type of degeneration may be seen. The document is a lecture on degenerative changes and cellular injury presented by Prof. Dr. Khalil Hassan Zenad Aljeboori from Al-Iraqia University Faculty of Dentistry, Department of Pathology.
Salivary gland by Dr Deepak Kumar
The document discusses the anatomy and histology of salivary glands. It notes that salivary glands are compound exocrine glands that secrete saliva. They contain serous and mucous cells that make up acini, as well as a duct system of intercalated, striated, and excretory ducts. The glands also contain myoepithelial cells and receive nerve and blood supply to enable their exocrine secretion. Major and minor salivary glands are classified based on their location in the oral cavity or other sites.
Lecture 2 blood
The document summarizes key aspects of blood and blood cells. It discusses that blood is composed of plasma and formed elements including red blood cells, white blood cells, and platelets. Red blood cells contain hemoglobin and transport oxygen, while white blood cells help defend the body against infection. Platelets assist in clotting to stop bleeding from damaged blood vessels. The document provides details on the formation, components, and functions of these blood cells.
Circulation
The document discusses the circulatory system, including its components and functions. It describes the closed circulatory system in humans, which involves the heart pumping blood through arteries, arterioles, capillaries, venules and veins. The circulatory system transports nutrients, gases, wastes and more throughout the body. Blood consists of plasma and formed elements like red blood cells, white blood cells and platelets. Red blood cells contain hemoglobin and transport oxygen, while white blood cells help fight infection. Platelets help the blood clot to stop bleeding.
Microscopic examination of urine
1. Microscopic examination of urine sediment involves centrifuging urine to concentrate any cells, casts, crystals, or other structures present.
2. Common findings include red and white blood cells, epithelial cells, hyaline casts, calcium oxalate crystals, and triple phosphate crystals.
3. The presence and amounts of these components provide diagnostic information, such as renal infection from white blood cell casts or glomerular disease from red blood cell casts.
White blood
This document summarizes white blood cells (WBCs), also known as leukocytes. It discusses their formation in bone marrow, types including granulocytes (basophils, eosinophils, neutrophils) and agranulocytes (lymphocytes, monocytes). It describes their characteristics and functions in inflammatory response and fighting infection. The document also lists some diseases related to abnormalities in WBC counts, such as leukopenia, leukemia, and leukocytosis.
Calcification.pptx
Deposition of calcium salts in tissues other than osteoid or enamel is called pathologic or heterotopic calcification
Two distinct types of pathologic
calcification are recognised:
Dystrophic calcifi cation is characterised by deposition of calcium salts in dead or degenerated tissues with normal calcium metabolism and normal serum calcium level.
Metastatic calcifi cation, on the other hand, occurs in apparently normal tissues and is associated with deranged
calcium metabolism and hypercalcaemia.
Etiopathogenesis
The two types of pathologic calcifi cation result from distinctly different etiologies and mechanisms.
DYSTROPHIC CALCIFICATION
As apparent from definition, dystrophic
calcification may occur due to 2 types of causes:
Calcification in dead tissue.
Calcification of degenerated tissue.
Calcification in dead tissue
Caseous necrosis in tuberculosis is the most common site for dystrophic calcification. Living bacilli may be present even in calcified tuberculous lesions, lymph nodes, lungs, etc
2. Liquefaction necrosis in chronic abscesses may get calcified.
3. Fat necrosis following acute pancreatitis or traumatic fat necrosis in the breast results in deposition of calcium soaps.
4. Gamna-Gandy bodies in chronic venous congestion (CVC) of the spleen is characterised by calcific deposits admixed with haemosiderin on fi brous tissue.
5. Infarcts may sometimes undergo dystrophic calcifi cation.
6. Th rombi, especially in the veins, may produce phleboliths.
7. Haematomas in the vicinity of bones may undergo dystrophic calcification.
8. Dead parasites like in hydatid cyst, Schistosoma eggs, and cysticercosis are some of the examples showing dystrophic calcifi cation.
9. Microcalcifi cation in breast cancer detected by mammography.
10. Congenital toxoplasmosis involving the central nervous system visualised by calcifi cation in the infant brain.
Calcification in degenerated tissues
1. Dense old scars may undergo hyaline degeneration and subsequent calcifi cation.
2. Atheromas in the aorta and coronaries frequently undergo calcifi cation.
3. Mönckeberg’s sclerosis shows calcifi cation in the degenerated tunica media of muscular arteries in elderly people .
4. Stroma of tumours such as uterine fi broids, breast cancer, thyroid adenoma, goitre etc show calcification.
5. Goitre of the thyroid may show presence of calcifi cation in areas of degeneration.
6. Some tumours show characteristic spherules of calcification called psammoma bodies or calco spherites such as in meningioma, papillary serous cystadeno carcinoma of the ovary and papillary carci noma of the thyroid.
7. Cysts which have been present for a long time may show calcification of their walls e.g. epidermal and pilar cysts.
8. Calcinosiscutis is a condition of unknown cause in which there are irregular nodular deposits of calcium salts in the skin and subcutaneous tissue.
9. Senile degenerative changes may be accompanied by dystrophic calcification such as in costal cartilages
Histology of the Kidney part 1
The document provides an overview of the urinary system and kidney anatomy and histology. It describes the key functions and components of the kidneys, including the cortex and medulla. It explains the nephron is the functional unit of the kidney, consisting of the renal corpuscle and uriniferous tubule. The renal corpuscle contains the glomerulus and Bowman's capsule. Filtration occurs across the glomerular capillary endothelium, glomerular basement membrane, and podocytes within Bowman's capsule.
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1. What are the main phases of karyokinesis?
2. What structures help separate the chromosomes during mitosis?
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4. What ensures the daughter cells have the same genetic makeup as the parent cell after mitosis?
5. How can chemicals called mitotic poisons interfere with the cell division process?
Please let me know if answering any of these questions would help provide more context or understanding of the key topics covered in the mitosis document. I'm happy to elaborate on any part of the summary.
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GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
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Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort. 2nd-generation Antihistaminic Part I.pptx
CLASSIFICATION OF H1 ANTIHISTAMINICS-
FIRST GENERATION ANTIHISTAMINICS-
1)HIGHLY SEDATIVE-DIPHENHYDRAMINE,DIMENHYDRINATE,PROMETHAZINE,HYDROXYZINE 2)MODERATELY SEDATIVE- PHENARIMINE,CYPROHEPTADINE, MECLIZINE,CINNARIZINE
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Breast cancer: Post menopausal endocrine therapy
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
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Treatment Options
Endocrine Therapy
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Combination Therapies
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Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
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Urine casts
- 1. URINE CASTS
- 2. DEFINITION: Cylindrical, cigar-shaped bodies formed by condensation of Tamm- Horsfall mucoproteins formed in the renal tubules along with different structures related to different pathologies, and dislodged in the urine, detected by microscopy.
- 3. TYPES: b) Cellular: 1. RBC casts 2. WBC casts 3. Epithelial cells casts a) Acellular: 1. Hyaline casts 2. Granular casts 3. Waxy casts 4. Fatty casts
- 4. ACELLULAR CASTS: 1ST HYALINE CASTS:The most common type of cast, hyaline casts are solidified Tamm- Horsfallmucoprotein, their refractive index is very similar to surrounding fluid. Seen in fever, dehydration and after strenuous exercise.
- 5. ACELLULAR CASTS: 2ND GRANULAR CASTS:Formed by degeneration of cellular casts or aggregation of immunoglobulin light chains. They have higher refractive index and are more cigar-shaped than rest of casts. Seen in ATN, CKD, could be seen in strenuous exercise, thus clinical correlation is crucial to judgment.
- 6. ACELLULAR CASTS: 3RD: WAXY CASTSWaxy casts are the final stage of cast degeneration (usually originating from cellular and granular casts) Smooth and large, have higher refractive index than hyaline casts. Seen in advanced CKD, amyloidosis, and graft rejection.
- 7. ACELLULAR CASTS: 4TH FATTY CASTS Refractive fatty droplets within hyaline casts Seen tubular injury when lipid-rich tubular cells rupture.
- 8. CELLULAR CASTS: 1ST RBC CASTS presence of red blood cells casts is always pathologic, and is strongly indicative of glomerular damage. They are usually associated with nephritic syndromes.
- 9. CELLULAR CASTS: WBC CASTS Indicative of inflammation or infection, pyelonephritis, acute allergic interstitial nephritis, nephrotic syndrome, post-streptococcal acute glomerulonephritis
- 10. CELLULAR CASTS: 3RD EPITHELIAL CASTS formed by desquamated epithelial cells of the tubule lining, seen in acute tubular necrosis and toxins ingestion, such as mercury, diethylene glycol, or salicylate
- 11. QUIZ: IDENTIFY THE FOLLOWING TYPES OF CASTS