Urinalysis Case Study.

A 20-year-old female patient comes in with complaints of flank pain, with nocturia and urgency,
occasional burning sensation on urination and also mild headache with fever.  She says that the symptoms were
mild in the beginning but have been persisting for 3-4 days.

Multistix:

Color:  yellow	Glucose:  negative	Protein:  100 mg/dL
Appearance:  cloudy	Bilirubin:  negative	Urobilinogen:  0.2 mg/dL
Specific gravity:  1.015	Ketone:  negative	Nitrite:  Positive
pH:  7.5	Blood:  negative	Leukocyte:  Small

Confirmatory test:
SSA:  2+

Microscopic:

0-2 hyaline casts/lpf	2-5 RBC/hpf
5-10 squamous epithelial cells/hpf	Packed bacteria (rods)
artifacts?	10-20 wbc/hpf

Question 1:
What would be the most probable diagnosis for this patient?  How can you be sure?
Answer

Question 2:

What are the highly refractile formed element shown in this picture?
Answer

Ouestion 3:
What specialized microscopy can help you confirm the identity of these artifacts?  Are they pathological?
Phase contrast
Polarized

Question 4:
What are the major correlations present in the urinalysis results?
Answer

Question 5:
What is the most probably reason for the patient to contract this disease?
Answer