Cases Discussion: Interpretation of the Urinalysis

Department of Clinical Pathology

Case 1
A construction worker is pinned under collapsed scaffolding for several hours prior to being taken to the emergency room. His abdomen and upper legs are severely bruised, but no fractures are detected. A specimen for urinalysis obtained by catheterization has the following results:

Urinalysis
Macroscopic: Color Clarity Chemistry: pH SG Protein Leuko Blood Bilirubin Urobilinogen Sediment: Erythrocytes Leuko
Red-brown

Clear 6.5 1.017 trace 3+ 0.4 EU

2 5 /HPF 3 4 /HPF

Questions: 1. List the clinical & lab abnormalities in this patient! 2. What is the most probable cause of the positive blood reaction? 3. What is the source of the substance causing the positive blood reaction and the name of the condition?

Case 5

Case 2
Mr. Z/44 yo Fever since 2 days ago, low back pain, cloudy urine. Physic diagnostic: toAx: 38.5oC pain on flank area +

Macroscopic: Color Clarity

Chemistry: pH SG Protein Leuko Blood Nitrite Sediment: Erythrocytes Leuko Bacteria Cast

Yellow Cloudy 6.8 1.020 2+ 3+ 1+ + 2 5/HPF +++ (unaccountable)/HPF ++ Granular + (1-2) /LPF Leuko : + (1-2) /LPF

Questions: List: 1. Clinical & lab abnormality in this patient! 2. Diagnosis & differential diagnosis of patient! 3. Other examination that support no 2 (clinical, lab, and/or other)

Case 3
Mrs. S/47 yo Chief complaint: swelling Anamnesis: Swelling since 1 wk before admission (swell in feet, arms and face), shortness of breath, nausea vomit 3 days before admission. Physisc diagnostic: General swelling

Lab findings: Ureum 24.2 mg/dl (N: 20-40) Creatinine 1.20 mg/dl (N: < 1.2) Total cholesterol 595 mg/dl (N: 130 200) Albumin 1,7 g/dl (N: 3.5-5.5)

Urinalysis
Macroscopic: Color Clarity Chemistry: pH SG Protein Leuko Blood Bilirubin Others Sediment: Erythrocytes Leuko Cast
Yellow

Clear 6.7 1.017 4+ trace 1+ 2 3 /HPF 5 10 /HPF hyaline 0-2/LPF granular 5-10/LPF

Questions: List: 1. Clinical & lab abnormality in this patient! 2. Diagnosis & differential diagnosis of patient! 3. Other examination that support no 2 (clinical, lab, and/or other)

Case 4
Mrs. T/30 yo Dysuria in the end of urination, frequent urination, pain on suprapubic area. toAx: 37.2oC

Urinalysis
Macroscopic: Color Clarity
Chemistry: pH SG Protein Blood Leuko Nitrite Others Sediment: Erythrocytes Leuko Bacteria
Yellow

Cloud

7.0 1.019 1+ 3+ + 3 5 /HPF 50 60 /HPF ++

Questions: List: 1. Clinical & lab abnormality in this patient! 2. Diagnosis & differential diagnosis of patient! 3. Other examination that support no 2 (clinical, lab, and/or other)