RBC casts are seen in all except
Correct Answer: Diabetic nephropathy
Description: Ans: a (Diabetic nephropathy)Ref: Harrison, 17 edpg. 1785Diabetic nephropathy is an example of nephrotic syndrome whereas other three options represent acute nephritic syndrome.Acute nephritic syndrome is characterized by l-2g/24 hr proteinuria, hematuria with RBC casts, pyuria, hypertension, fliud retention and a rise in creatinine associated with a fall in GFR .If the rise in creatinine occurs quickly over days them acute nephritis is called RPGN (rapidly progressive glomerulo nephritis)Examples of acute nephritic syndromePost streptococcal glomerulonephritis Subacute bacterial endocarditis Lupus nephritis Good pasture syndrome ANCA small vessel vasculitis- Wegner, microscopic polyangitis, PAN Henoch schonlein purpuraCryoglobulinaemia Membranoproliferative glomerulonephritis Mesangioproliferative glomerulonephritisClinical significance of different castsHyaline casts - Normal constituent formed of Tom horsfall protein from epithelial cells of loop of Henle.RBC casts - glomerular injury WBC casts - interstitial injury; seen in interstitial nephritisBroad granular casts - Chronic renal failure Muddy brown granular casts - ischaemic/nephrotoxic injury -ATN
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