Snapshot A 22-year-old woman presents with dysuria, pyuria, and increased urinary frequency. She reports her symptoms began approximately 2 days prior to presentation. She has had similar symptoms 5 months ago. She is sexually active and uses condoms inconsistently. Physical examination is unremarkable. Urinalysis is positive for pyuria and bacteruria. Urine culture demonstrates ≥ 100,000 colony forming units (CFU) /mL. Introduction Process a fresh urine specimen is obtained and subsequently centrifuged the supernatant is placed in a separate tube login to view 27 more bullets the sediment should be resuspended and then transferred to a slide for analysis login to view 14 more bullets Urine Casts Casts Associated Conditions RBC casts Glomerulonephritis Vasculitis Malignant hypertension WBC casts Tubulointerstitial inflammation Acute pyelonephritis Transplant rejection Fatty casts Nephrotic syndrome "Maltese cross" sign Granular casts Acute tubular necrosis Waxy casts End-stage renal disease Chronic renal failure Hyaline casts Non-specific