A 29-year old woman who is pregnant with her first child consults her physician about problems she has been having.  She has been experiencing frequent urination, nausea, and tiredness, all of which she originally attributed to the pregnancy.  It was not until she felt severe flank pain and ran a high fever that she went to the physician.  He ordered a complete urinalysis which came back with the following results:

Color:  Yellow	Protein: 100mg/dL   (2+)	Blood:  Trace
Appearance:  Cloudy	Glucose:  Negative	Urobilinogen:  Normal
Specific Gravity:  1.010	Ketones:  Negative	Nitrite:  Positive
pH:  6.0	Bilirubin:  Negative	Leukocyte:  2+

Microscopic:
Many bacteria
5-10 RBC/hpf
50-60 WBC/hpf
White Blood Casts:  2/lpf


Questions:

1.  What is the most probable diagnosis for this woman?
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2. List all the abnormal results.
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3. What formed element is in the following photomicrograph?  Does it correlate with the patient's diagnosis?


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4. Would you expect to see this photomicrograph in the sample of a patient with a similar diagnosis?


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5. What does the patient's pregnancy have to do with her diagnosis?  What can the physician do to help her?
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