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A 24-year-old female presents to a walk-in clinic with fever, flank pain, frequency and dysuria. The urinalysis (urine microscopy) shows 1+ proteinuria, 25 white blood cells per high power field and a few granular casts. Which one of the following is the next best step in the management of this patient?

1. Midstream urine culture.

2. Intravenous pyelography.

3. Intravenous antibiotics.

4. Creatinine clearance.

5. Oral analgesia.

3.

next step after that? Ultrasound right?
Granular casts mean?

I dont have correct answer but My answer is also 3

i agreew with 3

granular OR broad n waxy casts r found in CRF
RBC cast............GN
Fatty cast.............NS
WBC cast.............Interstitila nephritis,pyelonephritis

thx purine, even wiki didnt have that about granular and CRF

really!
i have made my notes from UW.this is from those notes.