1. 1 Case History - 1 24-year-old female patient. Asymptomatic UA during a physical exam. Rapid Chemistry SG = 1.016 pH = 6.0 Blood, Protein, Glucose, & Leukocyte Esterase = Negative

2. 2 Common Acidic Crystals Amorphous Urates Calcium Oxalate Uric Acid

3. 3 Abnormal Acidic Crystals Leucine Tyrosine Cystine Cholesterol Bilirubin

4. 4 Uncommon Acid Crystals Calcium Sulfates Hippuric Acid Sodium Urate Sulfonamide X-Ray Dye (Renografin) X-Ray Dye (Hypaque)

5. 5 Case History - 2 48-year old male found incoherent and hospitalized. Rapid Chemistries Cloudy urine Blood 2+ Protein 4+ Nitrite & Leukocyte Esterase = Positive

6. 6 Cast Comparison Opaque Cylindrical Blunt Ends Hyaline CastWaxy CastFiber Transparent Cylindrical Rounded Ends Refractile Flat Dark Edges

7. 7 Case History - 3 63-year old male with lower back pain. Rapid Chemistries pH 5.0 Nitrite = Positive Protein, Blood, Leukocyte Esterase, Glucose, Ketones = Negative

8. 8 Case History - 4 45-year old male with chronic hepatitis. Rapid Chemistries Specific Gravity = 1.015 pH 5.5 Bilirubin = Positive Protein = 3+ Leukocyte Est. = Positive Nitrite, Blood, Glucose, Ketones = Negative

9. 9 Common Acidic Crystals Amorphous Urates Calcium Oxalate Uric Acid

10. 10 Abnormal Acidic Crystals Leucine Tyrosine Cystine Cholesterol Bilirubin

11. 11 Uncommon Acid Crystals Calcium Sulfates Hippuric Acid Sodium Urate Sulfonamide X-Ray Dye (Renografin) X-Ray Dye (Hypaque)

12. 12 Case History - 5 19-year old female. Asymptomatic with UA during a physical exam. Rapid Chemistries pH 6.5 Blood = 1+ Protein = Trace Leukocyte Est., Nitrite, Glucose, Ketones = Negative

13. 13 Cast Comparison Opaque Cylindrical Blunt Ends Hyaline CastWaxy CastFiber Transparent Cylindrical Rounded Ends Refractile Flat Dark Edges

14. 14 Case History - 6 25-year old female admitted for multiple substance abuse. Rapid Chemistries Cloudy pH 6.5 Protein = Trace Leukocyte Est., Nitrite, Blood, Glucose & Ketones = Negative

15. 15 Common Acidic Crystals Amorphous Urates Calcium Oxalate Uric Acid

16. 16 Abnormal Acidic Crystals Leucine Tyrosine Cystine Cholesterol Bilirubin

17. 17 Uncommon Acid Crystals Calcium Sulfates Hippuric Acid Sodium Urate Sulfonamide X-Ray Dye (Renografin) X-Ray Dye (Hypaque)

18. 18 Case History - 7 52-year old female admitted for renal disease. Rapid Chemistries pH 5.0 Protein = 3+ Specific Gravity = 1.030 Leukocyte Est., Nitrite, Blood, Glucose, Ketones = Negative

19. 19 Cast Comparison Opaque Cylindrical Blunt Ends Hyaline CastWaxy CastFiber Transparent Cylindrical Rounded Ends Refractile Flat Dark Edges

20. 20 Case History - 8 71-year old male with alcoholic cirrhosis and esophageal bleeding. Rapid Chemistries pH 5.0 Specific Gravity = 1.030 Protein = 2+ Blood = 2+ Bilirubin = 3+ Leukocyte Est. = Negative Nitrite & Glucose = Negative

21. 21 Cast Comparison Cellularity Indeterminate Cylindrical Rounded Ends Cellular Cylindrical Rounded Ends Cellular Cast (Renal) Granular Cast

22. 22 Case History - 9 20-year old female with acute pyelonephritis (renal Infection). Rapid Chemistries pH 5.0 Nitrite = Positive Protein = 2+ Leukocyte Esterase = Positive Blood, Bilirubin, Ketones & Glucose = Negative

23. 23 Cast Comparison Cellularity Indeterminate Cylindrical Rounded Ends Cellular Cylindrical Rounded Ends Cellular Cast (Renal) Granular Cast

24. 24 Case History - 10 20-year old male. Asymptomatic with UA performed during a physical exam. Rapid Chemistries pH 7.5 Protein = Trace Leukocyte Esterase, Nitrite, Blood, Bilirubin, Ketones & Glucose = Negative

25. 25 Alkaline Crystals Amorphous Phosphates Calcium Oxalate Triple Phosphate Calcium Carbonate Calcium Phosphate Ammonium Biurate

26. 26 Urine Sediment Training Questions?? Any one need to look at a slide again??  Let’s review our case studies.