Question

Case Study #5 A 9 year-old boy has a history of a recent viral infection. He now feels faint and is feverish, an he is generally not well. He has to urinate f He is seen in an urgent care clinic, where blood is drawn and urine collected for routine urinalysis. The following urinalysis results were obtained frequently and is very thirsty. His breath smells fruity Physical Appearance Color: Pale Transparency: Clear 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/hpf White blood cells: 0-2/hpf

Answer 1

1.The common cause of presence of ketones in large quantities in urine is Juvenile diabetes or Type I Diabetes. Usually our body burns glucose for energy but in Diabetes due to the production of less Insulin body can't burn Glucose instead it burns fats.it results in the production of ketone bodies, an end product of fat metabolism. Presence of ketones in blood or urine may lead to fruity smell breathing and serious complication such as Diabetic ketoacidosis, which inturn may affect brain.

2. Presence of ketones may demonstrate in the conditions such as chronic vomiting or diarrhoea, a very low carbohydrate diet,strenuous exercise, eating disorder and pregnancy. The child in this case have a high level of Glucose in urine ,it indicates the presence of Juvenile Diabetes .also the child suffers with increased urination and thirsty ,it strongly suggest the presence of Diabetes.