Question

Coming through the ER complaining of severe abdominal pain (acute abdomen), this 20‐year‐old woman was admitted to R/O appendicitis, pancreatitis, pyelonephritis, abdominal abscess, or ruptured viscus. Because she was 36 weeks’ (estimate) IUP, a low C‐section was performed and the child was delivered. Her appendix was found to be ruptured, and it was removed at the same time. Blood cultures were positive for E. coli, sensitive to Cefotan (cefotetan disodium) and to gentamicin, which she was given. The urinalysis, obtained two days postsurgery, was as follows:

glucose negative

bilirubin small

ketones 40 mg/dL

specific gravity 1.025

blood negative

pH 6.5

protein 30 mg/dL

urobilinogen 1.0 EU/dL

nitrite negative

leukocyte esterase trace

color orange

WBCs 5‐10/HPF

RBCs rare/HPF

epithelial cells 1+/HPF

bacteria 1+/HPF

bactera 1+

casts 1‐5 granular

Icotest negative

C&S was not requested on this urine.

Case Question:

What aspects of the urinalysis do you find significant? Explain.

What would one expect see in her urine microscopic exam?