A 56 year old African American woman sees her doctor with complaints
of edema, decreased urine volume, fever, general malaise and abdominal
pain. Her records show that she has previously received treatment
for dermatomyositis but only recently did she feel her current symptoms.
Results of a urinalysis are:
| COLOR Amber | PROTEIN 300 mg/dl | BLOOD Moderate |
| APPEARANCE 3+ | GLUCOSE Negative | UROBILINOGEN Negative |
| SPECIFIC GRAVITY 1.020 | KETONES Negative | NITRITE Negative |
| pH 5.5 | BILIRUBIN Negative | LEUKOCYTE Small |
MICROSCOPIC
WBC: 5-10/hpf
RBC: 10-20/hpf
CELLULAR CASTS: 0-2/lpf
__________________________________________________________________________________________________________________________________
1) Find and explain the discrepancies.
A 56 year old African American woman sees her doctor with complaints
of edema, decreased urine volume, fever, general malaise and abdominal
pain. Her records show that she has previously received treatment
for dermatomyositis but only recently did she feel her current symptoms.
Results of a urinalysis are:
| COLOR Amber | PROTEIN 300 mg/dl | BLOOD Moderate |
| APPEARANCE 3+ | GLUCOSE Negative | UROBILINOGEN Negative |
| SPECIFIC GRAVITY 1.020 | KETONES Negative | NITRITE Negative |
| pH 5.5 | BILIRUBIN Negative | LEUKOCYTE Small |
MICROSCOPIC
WBC: 5-10/hpf
RBC: 10-20/hpf
CELLULAR CASTS: 0-2/lpf
__________________________________________________________________________________________________________________________________
2) Find and explain the correlations.
A 56 year old African American woman sees her doctor with complaints
of edema, decreased urine volume, fever, general malaise and abdominal
pain. Her records show that she has previously received treatment
for dermatomyositis but only recently did she feel her current symptoms.
Results of a urinalysis are:
| COLOR Amber | PROTEIN 300 mg/dl | BLOOD Moderate |
| APPEARANCE 3+ | GLUCOSE Negative | UROBILINOGEN Negative |
| SPECIFIC GRAVITY 1.020 | KETONES Negative | NITRITE Negative |
| pH 5.5 | BILIRUBIN Negative | LEUKOCYTE Small |
MICROSCOPIC
WBC: 5-10/hpf
RBC: 10-20/hpf
CELLULAR CASTS: 0-2/lpf
__________________________________________________________________________________________________________________________________
3) What type of cast is seen in the image below?
A 56 year old African American woman sees her doctor with complaints
of edema, decreased urine volume, fever, general malaise and abdominal
pain. Her records show that she has previously received treatment
for dermatomyositis but only recently did she feel her current symptoms.
Results of a urinalysis are:
| COLOR Amber | PROTEIN 300 mg/dl | BLOOD Moderate |
| APPEARANCE 3+ | GLUCOSE Negative | UROBILINOGEN Negative |
| SPECIFIC GRAVITY 1.020 | KETONES Negative | NITRITE Negative |
| pH 5.5 | BILIRUBIN Negative | LEUKOCYTE Small |
MICROSCOPIC
WBC: 5-10/hpf
RBC: 10-20/hpf
CELLULAR CASTS: 0-2/lpf
__________________________________________________________________________________________________________________________________
4) Label the formed elements in the image below.
A 56 year old African American woman sees her doctor with complaints
of edema, decreased urine volume, fever, general malaise and abdominal
pain. Her records show that she has previously received treatment
for dermatomyositis but only recently did she feel her current symptoms.
Results of a urinalysis are:
| COLOR Amber | PROTEIN 300 mg/dl | BLOOD Moderate |
| APPEARANCE 3+ | GLUCOSE Negative | UROBILINOGEN Negative |
| SPECIFIC GRAVITY 1.020 | KETONES Negative | NITRITE Negative |
| pH 5.5 | BILIRUBIN Negative | LEUKOCYTE Small |
MICROSCOPIC
WBC: 5-10/hpf
RBC: 10-20/hpf
CELLULAR CASTS: 0-2/lpf
__________________________________________________________________________________________________________________________________
5) What is the suspected disease? (hint: there are two possible names for the same disease)
A 56 year old African American woman sees her doctor with complaints
of edema, decreased urine volume, fever, general malaise and abdominal
pain. Her records show that she has previously received treatment
for dermatomyositis but only recently did she feel her current symptoms.
Results of a urinalysis are:
| COLOR Amber | PROTEIN 300 mg/dl | BLOOD Moderate |
| APPEARANCE 3+ | GLUCOSE Negative | UROBILINOGEN Negative |
| SPECIFIC GRAVITY 1.020 | KETONES Negative | NITRITE Negative |
| pH 5.5 | BILIRUBIN Negative | LEUKOCYTE Small |
MICROSCOPIC
WBC: 5-10/hpf
RBC: 10-20/hpf
CELLULAR CASTS: 0-2/lpf
__________________________________________________________________________________________________________________________________
6) Is there a relationship between dermatomyositis and her current diagnosis? What are possible precursors that increase risk of this disease.
A 56 year old African American woman sees her doctor with complaints
of edema, decreased urine volume, fever, general malaise and abdominal
pain. Her records show that she has previously received treatment
for dermatomyositis but only recently did she feel her current symptoms.
Results of a urinalysis are:
| COLOR Amber | PROTEIN 300 mg/dl | BLOOD Moderate |
| APPEARANCE 3+ | GLUCOSE Negative | UROBILINOGEN Negative |
| SPECIFIC GRAVITY 1.020 | KETONES Negative | NITRITE Negative |
| pH 5.5 | BILIRUBIN Negative | LEUKOCYTE Small |
MICROSCOPIC
WBC: 5-10/hpf
RBC: 10-20/hpf
CELLULAR CASTS: 0-2/lpf
__________________________________________________________________________________________________________________________________
7) What confirmatory test(s) would you run and what would you expect as the result(s)?
A 56 year old African American woman sees her doctor with complaints
of edema, decreased urine volume, fever, general malaise and abdominal
pain. Her records show that she has previously received treatment
for dermatomyositis but only recently did she feel her current symptoms.
Results of a urinalysis are:
| COLOR Amber | PROTEIN 300 mg/dl | BLOOD Moderate |
| APPEARANCE 3+ | GLUCOSE Negative | UROBILINOGEN Negative |
| SPECIFIC GRAVITY 1.020 | KETONES Negative | NITRITE Negative |
| pH 5.5 | BILIRUBIN Negative | LEUKOCYTE Small |
MICROSCOPIC
WBC: 5-10/hpf
RBC: 10-20/hpf
CELLULAR CASTS: 0-2/lpf
__________________________________________________________________________________________________________________________________
8) Why is this considered a secondary glomerular disease?