Question

Urinalysis Case 6-1 Karen F., a 40-year-old woman, presented with the following symptoms: flank pain, fever of 102°F, chills, and diaphoresis (sweating), dysuria, nocturia, and increased frequency and urgency of urination. A routine urinalysis was performed (See Table 6-1). Table 6-1 Urinalysis Karen F. Reference Range Macroscopic Color Appearance Specific gravity Colorless to amber Clear 1.001-1.035 pH 5-7 Neg Yellow Cloudy 1.019 6.0 1+ (30mg/dL) (SSA:4+) Neg Neg Neg 1+ Normal Protein Glucose Ketones Bilirubin Blood Urobilinogen Nitrite Leukocyte esterase Neg Neg Neg Neg Normal Neg Neg Pos 2+ Microscopic WBCS 0-5/HPF RBCS Epithelial cells 0-2/HPF Few to moderate 40-60/HPF 2-4 clumps/HPF 0-3/HPF Few squamous/HPF Rare renal epithelial/HPF 3-6 WBC/LPF 0-2 granular/LPF 0-1 bacterial casts/LPF Moderate/HPF Few-hyaline Casts None Bacteria Questions: 1. Are these findings consistent with an upper or lower urinary tract infection (UTI)? Why? 2. a. Which of these urinalysis results suggest renal disease/condition? b. How would you differentiate acute from chronic? 3. What type of leukocytes are usually associated with pyuria?

Answer 1

1.The finding on the patient suggests for upper urinary tract infections (flank pain ,fever ,chills,dysuria ,increased urgency and frequency ,urinalysis)

2.The presence of protein, leukocyte esterace,wbc,rbc,epithelial cells,casts and bacteria is suggestive of renal disease

b.A simple way to differentiate acute and chronic condition is acute conditions occurs suddenly and can be treated effectively if diagnosed at the earliest.In chronic condition it may develop or occur over a period of time from days to months and is often diff6to treatment where most of the time only symptomatic treatment is possible.

3.The presencevof leukocyte esterace is a typical indicator or associated with pyuria

5.The urinanalysis which is characteristics of the disease are

• Appearance: cloudy
• Protein:1+
• Blood:1+
• Nitrate
• Leukocyte esterace
• WBC,RBC,Casta ,Epithelial cells
• Bacteria