Mrs. Armstrong is a 34-year-old female who presents to a health clinic with a chief complaint of blood in her urine. She is 24 weeks pregnant. She also reports symptoms of feeling tired and the development of a predilection for eating ice. Readers are encouraged to develop their own differential diagnosis for Mrs. Armstrong’s condition. Laboratory values are provided, and the reader is encouraged to further hone their hypotheses. Once the diagnosis is revealed, the reader is provided with answers to learning objectives that will solidify their understanding of the case and its associated clinical diagnosis. Exam questions will test the readers’ understanding of the topic.