Case Histories 5. A 9-year-old boy has a history of a recent viral infection. Anorexia nervosa. Diabetes insipidus. Diabetes mellitus. Galactosemia …
Case Histories 5
A 9-year-old boy has a history of a recent viral infection He now feels
faint and is feverish, and is generally not well He has to urinate
frequently and is very thirsty His breath smells fruity He is seen in an
urgent care clinic, where blood is drawn and urine collected for routine
urinalysis The following urinalysis results were obtained
Physical appearance:
Color pale
Transparency clear
Chemical screening:
pH 50
Specific gravity 1029 refractometer
1005 reagent strip
Protein reagent strip negative
Blood negative
Nitrite negative
Leukocyte esterase negative
Glucose 2000 mg/dL
Ketones large
Bilirubin negative
Urobilinogen negative
Microscopic examination:
RBC 0-2 per hpf
WBC 0-2 per hpf, clumps of white cells seen
1 List the abnormal findings
2 The difference in the specific gravity values in this specimen is
probably due to which of the following?
a Ability of the refractometer to measure only
nonionizing
substances
b Difference in the principles of the methods
c Failure to use proper quality control
d Instrument error
e Poor technique by the person performing the urinalysis
3 Calculate the concentration of glucose in this urine specimen, given
the difference in specific gravity values
4 The unusual fruity smell of the breath of this patient is due to the
presence of:
a acetone
b beta-hydroxybutyric acid
c diacetic acid
d glucose
5 This patient is at risk of losing consciousness as a result of:
a Diabetic coma
b Diabetic shock
c infection
d kidney failure
6 Which of the following conditions is exhibited by this patient?
a Anorexia nervosa
b Diabetes insipidus
c Diabetes mellitus
d Galactosemia
e Nephritic syndrome
Source:deanza.edu
