Question

Urinalysis Case 6-2 Kate R., a high school basketball player, had been hospitalized with a throat infection, fever, and a question of pneumonia. She had been taking some antibiotics. Her physician noted edema and elevated blood pressure. See Table 6-2 for UA results. Table 6-2 Urinalysis Kate R. Reference Range Macroscopic Color Appearance Specific gravity Red Cloudy 1.028 Colorless to amber Clear 1.001-1.035 5-7 pH 6,0 Neg 2+ (100mg/dL) (SSA:2+) Neg Neg Neg Protein Glucose Ketones Bilirubin Blood Urobilinogen Nitrite Leukocyte esterase Neg Neg Neg Neg Normal 2+(-50 RBC/UL Normal Neg Neg Neg Neg Microscopic WBCS RBCs 0-5/HPF 0-2/HPF Epithelial cells Few to moderate 0-3/HPF 30-607HPF (dysmorphic forms present) Few squamous/HPF Rare transitional/HPF 1-3 hyaline/LPF 0-3 RBC/LPF (1-3 granular/LPF Neg Casts T Few-hyaline Bacteria None Additional Urinalysis Tests Kate R. Reference Range 400 ml 1200-1500 mL/24 h 20g/24 h 50-80 mg/24 h 24-h urine volume 24-h total protein Chemistry BUN Creatinine Kate R. 128 mg/dL 11.6 mg/dL Reference Range 7-24 mg/dL 0.5-1.2 mg/dL

Answer 1

2. Acute Glomerulonephritis is the possible diagnosis. Since the patient presents with other symptoms such as throat

infections, fever, edema and increased BP leads to the dignosis of post streptococcal infection which led to injury to kidneys so that the function of kidney gets reduced.

3. RBCS, blood, red color, cloudy urine suggests the diagnosis. Increased protein in urine, blood in urine, reduced urine output, increased peotein in urine, presence of hyaline, RBC, Granular casts indicates the injury to glomerulus.

4. Dysmorphic red cells in urine indicates that RBCs are damaged and it occurs due to the injury to the kidney particularly glomerulus suggesting of the diagnosis.

5. Reagent strip protein test indicates any protein presence in urine. But if the urine is bloody it will give a false positive result.

SSA protein test is the secondary confirmation after reagent strip test. whatever substance present in the sample which can react with the acid can give false positive reaction such as radiographic dyes, penicillin, cephalosporin, sulphonyl urea etc.

6. 24 hour urine collection resulted in very less volume 400 ml of urine collected indicative of acute glomerulonephritis.

Also 1 gm of protein collected also substantiate diagnosis.