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Urinalysis Case Study - #1

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by

Jason Molina

on 16 April 2013

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Transcript of Urinalysis Case Study - #1

By Jason Molina Case Study #1 What's wrong with her? Physical Examination The Patient
Color: Yellow


Clarity: Cloudy


Odor: Fowl Protein
Confirmatory Test Sulfosalicylic Acid Precipitation Test (SSA) Nitrite -The reagent strip test for nitrite provides a rapid screening test for the presence of urinary tract infection (UTI).

-A positive nitrite reagent test can indicate bacteriuria.

-Many labs use the nitrite test in combination with the leukocyte esterase test to further confirm UTI's. Microscopic Examination RBC's: 0-5/hpf
WBC's: 25-50/hpf
Casts: 2-5 WBC/lpf
Bacteria: moderate
Epithelial Cells: Squamous, Rare
Crystals: Negative White Blood Cells -An increase in urinary WBC's is called pyuria and indicates the presence of an infection or inflammation in the genitourinary system.

-Bacterial infections, such as cystitis and pyelonephritis, are frequent causes of pyuria. Bacteria -The presence of bacteria can be indicative of either lower or upper UTI.

-The Bacteria most frequently associated with UTI are the Enterobacteriaceae

-To be considered significant for UTI, bacgeria should accomponied by WBC's. -Fever of 101°
-nausea, headache, & flank pain
-painful urination
-frequent urination Chemical Examination Glucose: Neg
Bilirubin: Neg
Ketone: Neg
Specific Gravity: 1.010
Blood: Trace
pH: 6.5
Protein: 30 mg/dL
Urobilinogen: Neg
Nitrite: Pos
Leuk. Esterase: Pos The SSA test is a cold precipitation test that reacts equally with all forms of protein. SSA Precipitation Test Procedure -Add 3 ml of 3% SSA reagent to 3 mL of centrifuged urine.
-Mix by inversion and observe cloudiness.
-Grade the degree of turbidity. SSA Report Grade: 1+
Turbidity: Noticeable
Protein Range: 30-100 Proteinuria Confirmed! Leukocyte Esterase -The LE test detects the presence of esterase in the granulocytic WBC's
-Increased urinary leukocytes are indicators of UTI.
-A positive LE test result is accomponied by the presence of bacteria, which may also produce a positive nitrite test WBC Casts -The appearance of WBC casts in urine signifies infections within the nephron.

-WBC casts are the primary marker for distinguishing pyelonephritis (upper UTI) from lower UTI's. Here's what we know: In Conclusion Acute Pyelonephritis -Pyelum meaning "Renal Pelvis"
-Nephros meaning "Kidney"
-Itis meaning "Inflammation"
Upper Urinary Tract Infection Definition Treatment Antibiotic therapy needed to prevent progression of the infection.
Surgery may be needed
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