Urinalysis Austin Community College尿液分析奥斯汀社区学院.pptVIP

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * A 27-year old woman presents with severe abdominal pain. Physical characteristics: clear-yellow. Microscopic: Not performed. Questions: - What is the most likely diagnosis? - What do you make of the ketone result? - What do you expect to happen to the ketone measurement when treatment begins? ++ Negative Trace 1.015 Negative 6.0 Negative 1.0 mg/dL Negative Negative Glucose Bilirubin Ketones S.G. Blood pH Protein Nitrite L.E. Urobilinogen DiabetesMay be decompensated and with ketoacidosisKetones should become negative after treatment Case 4 Negative Negative Negative 1.015 +++ 6.5 + 1.0 mg/dL Negative Negative 8-year old boy presents with discolored urine Physical characteristics: Red, turbid. Microscopic: erythrocytes = 100 per HPF (almost all dysmorphic) Red cell casts present. Questions: - What is the most likely diagnosis in this case? - Does the presence of red cell casts help you in any way? - If the erythrocytes were not dysmorphic would that change your diagnosis? Glucose Bilirubin Ketones S.G. Blood pH Protein Nitrite L.E. Urobilinogen Case 5 GlomerulonephritisRBC casts reveals renal cortex involvementRBC cast are not always present in GN Negative Negative Negative 1.010 Negative 5.0 + 0.2 mg/dL Negative Negative 22-year old man presenting for a routine physical required for admission to medical school Physical characteristics: Yellow Microscopic: Not performed Questions: - What is your differential diagnosis? - Would you order a microscopic analysis on this sample? - What would you do next to confirm the diagnosis? Glucose Bilirubin Ketones S.G. Blood pH Protein Nitrite L.E. Urobilinogen Case 6 “Functional” proteinuria?Microscopic may reveal a few leukocytesRequest protein concentration in 24 h urine Common Findings in:Acute Tubular Necrosis Decreased + / - + / - Microscopic: Renal tubular epithelial