Asparaginase Erwinia Chrysanthemi (Recombinant) - rywn) Injection (Rylaze)- FDA

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Dysmorphic red blood cells from a patient with Wegener granulomatosis. Note irregular urination problems of dense cytoplasmic Asparaginase Erwinia Chrysanthemi (Recombinant) - rywn) Injection (Rylaze)- FDA around the cell membrane. Budding forms surrounded by leukocytes. Transitional epithelial cells from bladder lavage.

Epithelial cells are commonly tears in the urinary sediment. Squamous cells are frequently detected in female urine specimens and are derived from the lower portion of the urethra, the trigone of postpubertal females, and the vagina. Squamous epithelial cells are large, have a central small nucleus about the size of an erythrocyte, and have an irregular cytoplasm with fine granularity. Transitional epithelial cells may arise from the remainder of the urinary tract (Fig.

Transitional cells are smaller than squamous cells, have a larger nucleus, and demonstrate prominent cytoplasmic granules near the nucleus. Malignant transitional cells have altered nuclear size and morphology and can be identified with either routine Papanicolaou staining or automated flow cytometry. Renal tubular cells are the least commonly observed epithelial cells in the urine but are most significant because their presence in the urine is always indicative of renal pathology.

Renal tubular Chapter 1 Evaluation of the Urologic Patient: History, Physical Examination, and Urinalysis A 23 B Figure 1-20. Red blood cell cast. A, Low-power view demonstrates distinct border of hyaline matrix. B, High-power view demonstrates the sharply defined red blood cell membranes (arrow). Casts A cast is a protein coagulum that is formed in the renal tubule and traps any tubular luminal contents within the matrix.

TammHorsfall video colonoscopy is the basic matrix Asparaginase Erwinia Chrysanthemi (Recombinant) - rywn) Injection (Rylaze)- FDA all renal casts; it originates from tubular epithelial cells and is always present in the urine.

When Asparaginase Erwinia Chrysanthemi (Recombinant) - rywn) Injection (Rylaze)- FDA casts contain only mucoproteins, they are called hyaline casts and may not have any pathologic significance. Hyaline casts may be seen in the urine after exercise or heat exposure but may also be observed in pyelonephritis or chronic renal disease. RBC casts contain entrapped erythrocytes and are diagnostic of glomerular bleeding, most likely secondary to glomerulonephritis (Figs.

White blood cell casts are observed in acute glomerulonephritis, acute pyelonephritis, and acute tubulointerstitial nephritis. Casts with other cellular elements, usually sloughed renal tubular epithelial cells, are indicative of nonspecific renal damage (Fig.

Granular and waxy casts result from further degeneration of cellular elements. Fatty casts are seen in nephrotic syndrome, lipiduria, and hypothyroidism. Crystals Identification of crystals in the urine is particularly important in patients with stone disease because it may help determine the etiology (Fig. Although other types of crystals may be 75 mg clopidogrel in normal patients, the identification of cystine crystals establishes the diagnosis of cystinuria.

Crystals precipitated in acidic urine include calcium oxalate, uric acid, and cystine. Crystals precipitated in an alkaline urine include calcium phosphate and triple-phosphate (struvite) crystals. Cholesterol crystals are rarely seen in the urine and are not related to urinary pH.

They occur in lipiduria and remain in droplet form. Bacteria Normal urine should not contain bacteria; in a fresh Asparaginase Erwinia Chrysanthemi (Recombinant) - rywn) Injection (Rylaze)- FDA specimen, the finding of bacteria is indicative of a UTI.

This is the standard concentration used to establish the diagnosis of a UTI in a clean-catch specimen. This level should apply only to women, however, in whom a clean-catch specimen is frequently contaminated.

The finding of any bacteria in a bioorganic chemistry impact factor collected midstream specimen from a male should be further evaluated with a urine culture. Cells entrapped in a hyaline matrix. Under high power, it is possible to distinguish various bacteria. Gram-negative rods have a characteristic bacillary shape (Fig.

Yeast The most common yeast cells found in urine are Candida albicans. The biconcave oval shape of yeast can be confused with 24 PART I Clinical Decision Making A B Cystine C Calcium oxalate D Uric acid Triple phosphate (struvite) Figure 1-26.

Streptococcal urinary tract infection (Gram stain). D, Triple phosphate (struvite). Phase microscopy of Figure 1-25. Streptococcal urinary tract infection with typical chain formation (arrow).

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