Case Study: Answers


1. The abnormal results are as follows:


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2. The microscopic results, factoring in the dilution, are as follows:
 

50-100 WBC/ hpf
10-20 RBC/ hpf
Moderate bacteria
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3.  The results indicate the disease:
 

b. acute pyelonephritis


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4.  Acute pyelonephritis (b) differs from acute interstitial nephritis (a)because of the positive nitrite result, the presence of bacteria, and the triple phosphate crystals being the only crystals present.  It differs from acute glomerulonephritis (c) because of the positive nitrite result, the presence of bacteria, and the presence of WBC casts.  Also, acute glomerulonephritis would have higher amount of RBC's and a lower amount of WBC's present, and a higher result for the blood test and a lower result for a leukocyte esterase.  Acute pyelonephritis differs from cystitis because of the presence of WBC casts, granular casts, and renal epithelial cells.
 

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