A 28 year old man visits his physician complaining of an intense, sharp pain in his back and side.  In a conversation with his physician, the patient confesses to eating a diet high in animal proteins such as meat, cheese, and fish.  Results of a complete urinalysis are shown below.

Chemical/Physical Analysis

Color	Yellow	Glucose	Negative	Urobilinogen	Normal
Appearance	Clear	Protein	Trace	Blood	Large
Specific Gravity	1.025	Ketones	150mg/dL	Nitrite	Negative
pH	5.0	Bilirubin	Negative	Leukocyte	Negative

Microscopic Analysis
>100 RBC/hpf
0-3 WBC/hpf
20-30 Bacteria/hpf
0-5 Squamous Epithelial Cells/hpf
Unidentified Crystals
 

Question 1

Question 2

Question 3

Question 4

Question 5

Questions

1.    Is there a discrepancy between the leukocyte and nitrite counts on the reagent stix

2.    Is the presence of WBCs with bacteria clinically significant?  View Case History and Analysis

3.    Suggest an explanation for blood in the urine.  View Case History and Analysis

4.    Below is a photomicrograph from the patient's urine sample:

                What is the cause of the patient's condition?  Click on the appropriate answer.

                    a)  Uric acid crystals

                    b)  Cystine crystals

                    c)  Triple phosphate crystals

5.    What is the diagnosis and treatment for this patient?  Click on the appropriate

                    a)  Cystinuria

                    b)  Urinary tract infection

                    c)  Renal calculi caused by the formation of uric acid crystals

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