Question

apter 6 ALYSIS CASE 6-6 Tammy S., a 20-year-old long-distance runner, went to the University Health Center for her physical following the first practice of the season. The results of her urinalysis are shown in Table 6-6. Table 6-6 URINALYSIS Reference Range Tammy S. Macroscopic Colorless to amber Amber Color Clear Appearance Specific gravity Clear 1.001-1.035 1.028 5-7 7,0 pH Neg Neg Neg Neg Trace 5-20 mg/dL (SSA: trace) Protein Neg Neg Neg Glucose Ketones Bilirubin Neg 1+ Blood 4 mg/dL Neg Normal Urobilinogen Neg Nitrite Trace Neg Leukocyte esterase Microscopic 10-20/HPF 0-5/HPF WBCs RBCS 30-40/HPF 0-2/HPF Few squamous/HPF 10-20 hyaline/LPF 10-15 granular/LPF Neg Neg Epithelial cells Few to moderate Casts Few hyaline Bacteria None Crystals QUESTIONS What ara th 1

Answer 1

QUESTIONS 1. What are the abnormal or discrepant urinalysis results? The abnormal urinalysis findings are given below Presence of protein Presence of blood Presence of urobilinogen Presence of leukocyte esterase High WBC number High RBC mumber Presence of granular casts Q5) Granular casts - They resemble hyaline casts, and from when the granular material released upon the renal tubule damage becomes incorporated in the matrix of hyaline cast or when the cellular casts degenerate. The presence of granular casts indicates kidney damage. 2. List five possible explanations for these abnormal results. 1. Chronic kidney disease 2. Diabetes mellitus 3. Chronic urinary tract infection 4. Kidney stones (calcuhus) 5. Immune system disorders 3. Should Tammy be concerned about these results? Yes, because proteinuria, hematuria, and high WBC mumber in the urine signifies the presence of an infection 4. What is the most likely explanation for the abnormal results? The most likely explanation for the abnormal results is, bacterial infection of the upper urinary tract.