检验-尿常规报告解读剖析.ppt

颗粒管型 蜡样管型 Questions 1.What factors can influence the results of urinalysis? 2. Please tell us the applications of urine OB test and uses the tests you have studied to differ OB positive situations from each other. 13-year-old boy,?with bloody urine of one days duration. He had been well until 1 week before admission when he developed a sore throat with fever that lasted for 2 or 3 days. The fever and the throat symptoms disappeared without treatment. However, he continued to feel generally fatigued. The day before admission, his urine became smoky brown; the morning of admission his mother noticed facial puffiness, pallor and noisy breathing. PE T 37.8, P 90/min, R 20/min, BP 150/95 mm Hg. HEENT: Slight swelling of the eyelids and periorbital edema were present. Fundi were normal. Throat and eardrums were normal. Chest: Rales were heard at both lung bases.Cardiac: The jugular veins were not distended. The point of maximal impulse was displaced slightly laterally. An S3 was heard. There were no murmurs. Abdomen: There were no masses or abdominal tenderness. The kidneys could not be felt. Neurologic, rectal: Normal. Lab findings Blood routine: hematocrit 35%, WBC normal. Urinalysis protein 2+, RBC100 /hpf, WBC20/hpf, BUN 25 mg/dl. Creatinine 1.6mg/dl. Electrolytes normal. Questions 1.What’s the diagnosis and what’s your evidences? 2.Which other diseases will you consider to differentiate? 3.In order to confirm your diagnosis, which tests will you do and why? Glomerular diseases may be primary or secondary to systemic disease. The major pathogenic categories are inflammatory (nephritic syndrome) and hemodynamic (nephrotic syndrome). and laboratory findings due to increased glomerular capillary wall permeability. The classic nephritic syndrome includes hematuria, hypertension, renal insufficiency, and edema. Frequently, individual components of the syndrome are absent. Nephritic syndrome may be acute and transient (eg, postinfectious GN), fulminant with rapi