phuluong2k
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Photomicrograph presents a finding in urinary segment, from a 10 y.o boy with an upper respiratory infection and low grade fever, his urinalysis is otherwise unremarkable
Which of the following best describes your evaluation on this patient ?
A. Minimal change disease
B. Urinary tract infection
C. Nephritic syndrome
D. Nephrotic syndrome
E. No follow-up necessary
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| ssrpk
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well it is A- Minimal change disease
plz explain this phtotmicrograph....
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| Kazem
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I can see a protein cast, so agree with ssprk. minimal change disease which is causing a nephrotic syndrome in the child.
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| phuluong2k
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urinanalysis is unremarkable :arrow: not minimal disease with proteinuria
This is a hyaline cast :arrow: choice E
The hyaline matrix is by far the most frequently observed.
Some of these conditions are the results of a pathological process, but many are results of a normal physiological activity.
Hyaline casts can be seen after a strenuous exercise. Hyaline casts are considered as physiological casts. A count of 1000 or less hyaline casts in a 24-hour specimen is a normal value.
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| ssrpk
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thnx....i did'nt know about this hyaline cast apearing physiologically
exactly wht is this hyaline casts compose of?
Tamm-horsfall glycoprotein from DCT????????
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| phuluong2k
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precipitated protein
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| phuluong2k
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Yes, you are right, protein Tamm Horsfall is located at the thick ascending loop of henle & beginning of DTC
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| ssrpk
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thx
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| mjl1717
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Just to clarify Tamm Horsfall protein is considered normal in Many cases
just as phuloung is saying. Good!
{For example a bus driver always driving a bumpy bus could have trace proteinuria}
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| ssrpk
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yeah thnx..well i was just chkin thru the notes ; it says whenever flow gets slower(eg. excercise) in the tip of LH and DCT,proteins can be precipitated in the form of hyaline casts and this whole process is re-inforced by inc. in salt conc..........any explanation?
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