Body Fluids Exam 3 Disorders

Glomerulonephritis

Inflammation of the glomerulus causing RBCs, protein, and RBC casts in urine. Often immune-complex mediated.

Acute Glomerulonephritis

Post-streptococcal immune reaction → hematuria, RBC casts, and mild proteinuria.

Chronic Glomerulonephritis

Long-term glomerular damage → progressive renal failure, broad casts, and isosthenuria.

Nephrotic Syndrome

Loss of large proteins through damaged glomerular membrane → heavy proteinuria, lipiduria, oval fat bodies, and edema.

Acute Tubular Necrosis (ATN)

Destruction of renal tubular cells by ischemia or toxins → RTE cells, RTE casts, granular (“muddy brown”) casts.

Acute Interstitial Nephritis (AIN)

Allergic inflammation of renal interstitium (often due to drugs) → WBCs, WBC casts, eosinophiluria.

Cystitis

Bladder infection → positive nitrite, LE, bacteria, and WBCs without casts.

Pyelonephritis

Upper UTI involving kidney → WBC casts, bacteria, positive nitrite and LE.

Diabetic Nephropathy

Glomerular damage due to chronic hyperglycemia → persistent proteinuria and progressive renal failure.

Renal Failure (Chronic)

Loss of renal concentrating ability → isosthenuria (SG ~1.010), proteinuria, all types of casts.

Renal Glycosuria

Glucose in urine despite normal blood glucose → tubular reabsorption defect.

Fanconi Syndrome

Proximal tubule defect → loss of glucose, amino acids, phosphate, bicarbonate in urine.

Hematuria

Presence of intact RBCs in urine → glomerular or post-renal bleeding source.

Hemoglobinuria

Free hemoglobin in urine → intravascular hemolysis or transfusion reaction.

Myoglobinuria

Myoglobin from muscle breakdown → dark brown urine, positive blood pad, no RBCs microscopically.

Melaninuria

Melanogen oxidized to melanin in acidic urine → darkens on standing; false ketone reaction.

Alkaptonuria

Homogentisic acid buildup → black urine in alkaline pH; ferric chloride test positive (blue).

Phenylketonuria (PKU)

Deficiency of phenylalanine hydroxylase → phenylpyruvic acid in urine, mousy odor, Guthrie test positive.

Tyrosinemia

Defect in tyrosine metabolism → tyrosine crystals, rancid odor, positive nitrosonaphthol test.

Maple Syrup Urine Disease (MSUD)

Defective metabolism of branched-chain amino acids → sweet “maple syrup” odor, DNPH positive.

Isovaleric Acidemia

Leucine metabolism defect → isovaleric acid buildup, “sweaty feet” odor, CN-nitroprusside positive.

Homocystinuria

Cystathionine β-synthase deficiency → elevated homocysteine, cyanide-nitroprusside test positive.

Porphyria

Disorder of heme synthesis → porphobilinogen in urine, Ehrlich’s reaction positive, port-wine color.

Cystinosis

Cystine accumulation in tissues → cystine crystals in urine, Fanconi-type tubular dysfunction.

QHurler’s Syndrome

Bacterial Meningitis

Neutrophil-predominant CSF, ↑ protein, ↓ glucose, ↑ lactate.

Viral (Aseptic) Meningitis

Lymphocyte-predominant CSF, mild ↑ protein, normal glucose.

Fungal or Tubercular Meningitis

Monocyte-predominant CSF, ↑ protein, ↓ glucose, ↑ lactate.

Multiple Sclerosis (MS)

Autoimmune demyelinating CNS disease → oligoclonal bands in CSF, ↑ IgG index, ↑ myelin basic protein.

Subarachnoid Hemorrhage (SAH)

Blood evenly in all CSF tubes, xanthochromic supernatant, ↑ protein, normal glucose.

Traumatic Tap

RBCs decrease from tube 1→3, clear supernatant (no xanthochromia).

CSF Leak

CSF drainage through nose or ear → β₂-transferrin positive.

Acute Glomerulonephritis (Post-Strep)

Occurs after Group A strep infection → RBC casts, hematuria, mild proteinuria, edema.

Nephritic vs Nephrotic Syndrome

Nephritic = hematuria, RBC casts, mild protein.
Nephrotic = massive proteinuria, fatty casts, oval fat bodies, edema.

Diabetes Mellitus

↑ glucose and ketones in urine; high SG; may progress to diabetic nephropathy.

Diabetes Insipidus

↓ SG, very dilute urine, no glucose; due to ADH deficiency or renal resistance.

Renal Calculi (Kidney Stones)

Crystals (calcium oxalate, uric acid, cystine) → hematuria, pain, and crystal detection on microscopy.

Acute Interstitial Nephritis (Drug-Induced)

Allergic reaction to drugs → WBCs, WBC casts, eosinophiluria, mild proteinuria.

Acute Tubular Necrosis (Ischemic/Toxic)

Tubular cell death → RTE casts, granular “muddy brown” casts, moderate protein.

Neurogenic Proteinuria (Functional)

Temporary protein increase due to stress, fever, or exercise.

Overflow Proteinuria

Excess small proteins (e.g., Bence Jones, hemoglobin, myoglobin) exceed reabsorption capacit