HEMATOLOGY WORKSHEETS

MLSC-382A INSTRUCTOR: Beth Rawson

1 UA Case Studies Updated 8/2020

URINALYSIS CASE STUDIES Worksheet STUDENT NAME: ________________

PART 1: Review the reported results for each case and answer the associated questions.

Case 1: 47-year old male

MACROSCOPIC EXAMINATION OBSERVED RESULT Color Light yellow Clarity Cloudy

CHEMICAL ANALYSIS OBSERVED RESULT Specific Gravity (refractometer) 1.015 Bilirubin Neg Ketone Moderate Glucose Neg Blood Large pH 5.0 Protein 30 Urobilinogen 0.2 Nitrite Neg Leukocytes Moderate CONFIRMATORY TESTS OBSERVED RESULT Protein (SSA) Trace Ketones (Acetest) Pos Bilirubin (Ictotest) ---

1. What would explain the apparent disagreement between the nitrite and leukocyte reaction?

2. What is the most likely explanation for the observed clarity of the sample?

3. What would you expect to see on microscopic evaluation of this specimen?

MLSC-382A INSTRUCTOR: Beth Rawson

2 UA Case Studies Updated 8/2020

Case 2: 68-year old female

1. What could explain the negative leukocyte value? Why is this a concerning discrepancy?

2. What could account for the discrepancy in the SSA and dipstick protein results?

3. What is the most likely explanation for the urine color?

4. What would you expect to see on microscopic evaluation of this specimen?

MACROSCOPIC EXAMINATION OBSERVED RESULT Color Yellow-Brown Clarity Clear

CHEMICAL ANALYSIS OBSERVED RESULT Specific Gravity (refractometer) 1.030 Bilirubin Moderate Ketone Neg Glucose 2+ Blood Moderate pH 8.5 Protein 2000 Urobilinogen 0.2 Nitrite Positive Leukocytes Neg CONFIRMATORY TESTS OBSERVED RESULT Protein (SSA) 1+ Ketones (Acetest) --- Bilirubin (Ictotest) Moderate

MLSC-382A INSTRUCTOR: Beth Rawson

3 UA Case Studies Updated 8/2020

Case 3: 24-year old female

1. What are some possible explanations for the markedly increased specific gravity result seen here? What is the most likely explanation for this specimen, given the other values seen here?

2. What would you expect to see on microscopic evaluation of this specimen?

MACROSCOPIC EXAMINATION OBSERVED RESULT Color Light yellow Clarity Cloudy

CHEMICAL ANALYSIS OBSERVED RESULT Specific Gravity (refractometer) >1.035 Bilirubin Neg Ketone Neg Glucose Neg Blood Neg pH 6.5 Protein Trace Urobilinogen 0.2 Nitrite Neg Leukocytes Neg CONFIRMATORY TESTS OBSERVED RESULT Protein (SSA) --- Ketones (Acetest) --- Bilirubin (Ictotest) ---

MLSC-382A INSTRUCTOR: Beth Rawson

4 UA Case Studies Updated 8/2020

Case 4: 23-year old female

1. What disease is suggested by these findings?

2. Will all sugars be detected by the reagent test strip for glucose? Why?

3. What is the clinical significance of the positive ketone result? What would you suspect if the ketones were positive and everything else was normal?

MACROSCOPIC EXAMINATION OBSERVED RESULT Color Yellow Clarity Clear

CHEMICAL ANALYSIS OBSERVED RESULT Specific Gravity (refractometer) 1.025 Bilirubin Neg Ketone 4+ Glucose 4+ Blood Neg pH 5.5 Protein Neg Urobilinogen 0.2 Nitrite Neg Leukocytes Neg CONFIRMATORY TESTS OBSERVED RESULT Protein (SSA) --- Ketones (Acetest) 3+ Bilirubin (Ictotest) ---