Question

.     A 9-year –old boy has a history of a reagent viral infection. He now feels faint and is feverish, and he is generally not well. He has to urinate frequently and is very thirsty. His breath smells fruity. He is seen in an urgent care clinic, where blood is drawn and urine collected for routine urinalysis. The following urinalysis results were obtained:

Physical Appearance

Color: Pale

Transparency: Clear

Chemical Screening

pH: 5.0

Specific gravity (refractometer): 1.029

Specific gravity (reagent strip): 1.005

Protein (reagent strip): Negative

Blood: Negative

Nitrite: Negative

Leukocyte esterase: Negative

Glucose: >2000 mg/dL

Ketones: Large

Bilirubin: Negative

Urobilinogen: Negative

Microscopic Examination:

Red blood cells: 0-2 per hpf

White blood cells: 0-2 per hpf

Questions

1. The difference in the specific gravity values in this specimen is probably caused by which of the following?

a.          Ability of the refractometer to measure only non-ionizing substances

b          Difference in the principles of the methods

c.          Failure to use proper quality control

d.         Instrument error

2. This patient is at risk of losing consciousness as a result of which of the following?

a.          Diabetic coma

b.         Diabetic shock

c.          Infection

d.         Kidney failure

3. Which of the following conditions is exhibited by this patient?

a.          Anorexia nervosa

b.          Diabetes insipidus

c.          Diabetes mellitus

d.          Galactosemia

Answer 1

1. B Refractometer measures the refractory index of total soluble solids.bigher the concentration of total dissolved solids higher the refectory index.refration of beam of light is passed through the urine .

On other side reagent strip measures the concentration of the ions in the urine. Depending on th ionic strength of the urine a polyelecttolyte will ionise in the urine.

2. A Diabetic coma.

A diabetic coma could happen when your blood sugar gets too high -- 600 milligrams per deciliter (mg/dL) or more -- causing you to become very dehydrated. It usually affects people with type 2 diabetes that isn't well-controlled. It's common among those who are elderly, chronically ill, and disabled.

3. C Diabetes mellitus

Diabetes mellitus is a disorder in which blood sugar (glucose) levels are abnormally high because the body does not produce enough insulin to meet its needs.