AUBF Transes Table - Midterms Lesson 7

BS Medical Technology (Universidad de Sta. Isabel)

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ANALYSIS OF URINE AND BODY FLUIDS
TRANSES:
Lesson 7 – Renal Diseases
Glomerular Disorders

Glomerulonephritis
May progress from one form to another:
Urinalysis findings:
Refers to: - From: rapidly progressive glomerular nephritis
- Blood
- Sterile - To: chronic glomerulonephritis
- Protein
- Inflammatory process which affects that glomerulus - To: nephrotic syndrome
- Casts
And eventually: chronic glomerulonephritis
Name Description Etiology Clinical Course Initial Urinalysis Findings Other Significant Test
Cause: onset of symptoms consistent
with damage to the glomerular
 Macroscopic
membrane Deposition of immune
hematuria
Acute complexes, formed in Rapid onset of hematuria and  Anti-group A
 Proteinuria
Poststreptococcal Vulnerable population: children and conjunction with group A edema, permanent renal damage streptococcal enzyme
 RBC casts
Glomerulonephritis young adults following respiratory Streptococcus infection, on the seldom occurs test
 Hyaline and granular
infections (group A Streptococcus glomerular membranes
casts
that contain M
protein in the cell wall)
Symptoms are initiated by:
Deposition of immune Rapid onset with glomerular  Macroscopic
Rapidly Progressive - Another form of  BUN
complexes from systemic damage and possible hematuria
(Crescentic) glomerulonephritis  Creatinine
immune disorders on the progression to end-stage renal  Proteinuria
Glumerulonephritis - Systemic lupus  eGFR
glomerular membrane failure  RBC casts
erythematosus (SLE)
Autoimmune disorder in conjunction Attachment of a cytotoxic
 Macroscopic
with morphologic changes to the antibody formed during viral  Antiglomerular
Goodpasture Hemoptysis and dyspnea hematuria
glomeruli resembling those in rapidly respiratory infections to basement membrane
Syndrome followed by hematuria  Proteinuria
progressive glomerular nephritis glomerular and alveolar antibody
 RBC casts
basement membranes
Antineutrophilic cytoplasmic Pulmonary symptoms including  Macroscopic
 Antineutrophilic
Wegener autoantibody binds to hemoptysis develop first hematuria
ANCA peripheral or
Granulomatosis neutrophils in vascular walls followed by renal  Proteinuria
 RBC casts cytoplasmic antibody
producing damage to small involvement and possible

Clinical Instructor: Melissa B. Seriñ a, RMT

Prepared by: Francis Hermie A. Caballero, RMT
2024

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ANALYSIS OF URINE AND BODY FLUIDS
TRANSES:
Lesson 7 – Renal Diseases
vessels in the lungs and progression to end-stage renal
glomerulus failure
Initial appearance of purpura
followed by blood in sputum and
Occurs primarily in children
Upper respiratory infection in children stools and eventual renal  Macroscopic
following viral respiratory
Henoch-Schönlein involvement hematuria
infections; a decrease in  Stool occult blood
Purpura Raised red patches on the skin  Proteinuria
platelets disrupts vascular
Complete recovery is common,  RBC casts
integrity
but may progress to
renal failure
 Antinuclear antibody
 Hepatitis B surface
Thickening of the glomerular
antigen
membrane following IgG Slow progression to the  Macroscopic
Membranous Associated with Sjörgen  Fluorescent treponemal
immune complex deposition nephrotic syndrome or possible hematuria
Glomerulonephritis syndrome antibody- absorption
associated with systemic remission  Proteinuria
test (FTA- ABS)
disorders

Type 1: increased cellularity in the

subendothelial cells of the mesangium
Membranoproliferative
Type 2: displays extremely dense
Glomerulonephritis
deposits in the glomerular basement
membrane
Cellular proliferation affecting
the capillary walls or the Slow progression to chronic
 Hematuria  Serum complement
glomerular basement membrane, glomerulonephritis or nephrotic
 Proteinuria levels
possibly immune- mediated syndrome

Gradually worsening symptoms  Hematuria

include: Marked decrease in renal  Proteinuria
 BUN
- Fatigue function resulting from Noticeable decrease in renal  Glucosuria
Chronic  Serum creatinine
- Anemia glomerular damage precipitated function progressing to renal  Cellular and
Glomerulonephritis  eGFR
- Hypertension by other renal disorders failure granular cast
 Electrolytes
- Edema  Waxy and broad
- Oliguria casts

Clinical Instructor: Melissa B. Seriñ a, RMT

Prepared by: Francis Hermie A. Caballero, RMT
2024

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ANALYSIS OF URINE AND BODY FLUIDS
TRANSES:
Lesson 7 – Renal Diseases
Early stages:
 Macroscopic and
Deposition of IgA on the Recurrent macroscopic hematuria microscopic
Immunoglobulin A glomerular membrane resulting following exercise with slow hematuria Early stages:
Also known as <Berger Disease=
Nephropathy from increased levels of serum progression to chronic  Serum IgA
IgA glomerulonephritis Late stages:
 See Chronic
Glomerulonephritis

Nephrotic Syndrome

Massive proteinuria: greater than 3.5g/day Low levels of serum albumin High levels of serum lipids and Pronounced edema

Name Description Etiology Clinical Course Initial Urinalysis Findings Other Significant Test
Disruption of the podocytes
Frequent complete remission  Heavy proteinuria  Serum albumin
Minimal Change Associated with human leukocyte occurring primarily in children
following corticosteroid treatment  Transient hematuria  Cholesterol
Disease antigen-B12 (HLA-B12) following allergic reactions
 Fat droplets  Triglycerides
and immunizations
Associated with:  Proteinuria
Disruption of podocytes In certain
- Abuse of heroin and May resemble nephrotic  Microscopic
Focal Segmental areas of glomeruli associated wit  Drugs of abuse
analgesics syndrome or minimal change hematuria
Glomerulosclerosis heroin and analgesic abuse and  HIV tests
- AIDS disease  Macroscopic or
AIDS
microscopic

Clinical Instructor: Melissa B. Seriñ a, RMT

Prepared by: Francis Hermie A. Caballero, RMT
2024

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ANALYSIS OF URINE AND BODY FLUIDS
TRANSES:
Lesson 7 – Renal Diseases
Tubular Disorders

Name Description Etiology Clinical Course Initial Urinalysis Findings Other Significant Test
 Microscopic
hematuria
 Proteinuria
Acute onset of renal dysfunction
Damage to renal tubular cells  Renal tubular
Acute Tubular Primary disorder associated with usually resolved when underlying  Hematocrit
caused by ischemia or toxic epithelial cells
Necrosis damage to renal tubules cause is corrected  Hemoglobin
agents  Renal tubular
epithelial cell casts
 Hyaline, granular,
waxy broad cassts

Hereditary and Metabolic Tubular Disorders

Caused by systemic conditions

Name Description Etiology Clinical Course Initial Urinalysis Findings Other Significant Test
Inherited in association with  Serum and urine
Generalized failure of tubular Generalized defect in renal  Glucosuria
cystinosis and Hartnup disease electrolytes
Fanconi Syndrome reabsorption in the proximal tubular reabsorption requiring  Possible cysteine
or acquired through  Amino acid
convoluted tubule exposure to toxic agents
supportive therapy crystals
chromatography
 Proteinuria
Males inheriting the X-linked gene are Genetic disorder showing  Urinary fat droplats
Slow progression to nephrotic
more severely affected than females lamellated and thinning  OFB
Alport Syndrome syndrome and end-stage renal  Genetic testing
inheriting the autosomal gene glomerular basement membrane  RTE cells
disease
 Epithelial, fatty, and
waxy casts
 Hematuria
Most common cause of end-stage renal
Diabetic Nephropathy  Proteinuria  Blood glucose
disease  Glucosuria

Clinical Instructor: Melissa B. Seriñ a, RMT

Prepared by: Francis Hermie A. Caballero, RMT
2024

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ANALYSIS OF URINE AND BODY FLUIDS
TRANSES:
Lesson 7 – Renal Diseases
 Cellular and granular
casts
 Waxy and broad casts
Inherited as a sex-linked recessive gene
Nephrogenic Diabetes Inherited defect of tubular Requires supportive therapy to
or acquired from medications  Low SG, polyuria  ADH testing
Insipidus response to ADH prevent dehydration
(lithium and amphotericin B)
Affects only the reabsorption of Inherited autosomal recessive trait
Renal Glycosuria Benign disorder  Glucosuria  Blood glucose
glucose

Interstitial Disorders

Name Description Etiology Clinical Course Initial Urinalysis Findings Other Significant Test
 Leukocyturia
 Bacteriuria
Acute onset of urinary
Ascending bacterial infection of  Microscopic
Cystitis Bladder infection frequency and burning resolved  Urine culture
the bladder hematuria
with antibiotics
 Mild proteinuria
 Increased pH
 Leukocyturia
 Bacteriuria
Infection of the renal tubules and Acute onset of urinary frequency,
 WBC casts
intersititum related to burning, and lower back pain
Acute Pyelonephritis  Bacterial casts  Urine culture
interference of urine flow to the resolved with antibiotics
 Microscopic
Pyelonephritis is infection of the: bladder, reflux to
hematuria
- upper urinary tract  Proteinuria
- tubules
 Leukocyturia  Urine Culture for
- interstitium Recurrent infection of the
 Bacteriuria Leukocyturia N for
renal tubules and interstitium Frequently diagnosed in
Chronic  WBC casts Bacteriuria
caused by structural children; requires correction of
pyelonephritis  Bacterial casts  Creatinine for GWB
abnormalities affecting the flow underlying defect
 Granular, casts
of urine
waxy, broad  eGFR for Proteinuria
casts

Clinical Instructor: Melissa B. Seriñ a, RMT

Prepared by: Francis Hermie A. Caballero, RMT 2024

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ANALYSIS OF URINE AND BODY FLUIDS
TRANSES:
Lesson 7 – Renal Diseases
 Hematuria
 Proteinuria
 Hematuria  Urine eosinophils
Acute Interstitial  Proteinuria  BUN
Nephritis  Leukocyturia  Creatinine
 WBC casts  eGFR

Clinical Instructor: Melissa B. Seriñ a, RMT

Prepared by: Francis Hermie A. Caballero, RMT 2024

Downloaded by Aroha Astro (chaeunwooastro412@gmail.com)