Match each clinical presentation describing a patient with renal dysfunction to the most characteristic urinalysis sediment finding associated with their underlying pathology.
- A 65-year-old man who develops an acute increase in serum creatinine three days after a prolonged episode of septic shock.Muddy brown granular casts
- A 35-year-old woman with a history of systemic lupus erythematosus presenting with hypertension, edema, and new-onset hematuria.Red blood cell casts and dysmorphic red blood cells
- A 28-year-old man presenting with acute kidney injury, fever, maculopapular rash, and arthralgias two weeks after starting omeprazole.White blood cell casts and eosinophiluria
- A 55-year-old man with long-standing diabetes mellitus presenting with generalized edema and a urine protein excretion of g/day.Oval fat bodies and fatty casts
Answer
Septic shock matches with muddy brown granular casts (ATN). Lupus nephritis matches with red blood cell casts (nephritic syndrome). Omeprazole-induced AKI matches with white blood cell casts (AIN). Diabetic nephropathy matches with oval fat bodies (nephrotic syndrome).
Urinalysis sediment provides critical clues to the etiology of renal dysfunction. Muddy brown casts represent sloughed epithelial cells in ATN. Red blood cell casts represent bleeding through an inflamed glomerulus in nephritic syndromes. White blood cell casts represent interstitial inflammation in AIN. Oval fat bodies represent lipiduria secondary to the hyperlipidemia of nephrotic syndrome.
Step-by-Step Solution
Key Concept
Correlation of distinct acute kidney injury and chronic kidney disease syndromes with their pathognomonic urinalysis findings.
Estimated Time:1m 30s