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Case Study 1: The Soccer Player with Fatigue

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Case Study 1: The Soccer Player with Fatigue

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Background:

A 20-year-old male college athlete presents with fatigue, dark-colored urine after practice, and mild muscle soreness.

Urinalysis Results:

• Color: Dark brown

• Specific Gravity: 1.030

• pH: 6.0

• Protein: +1

• Blood: +3

• Microscopy: No RBCs seen

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Case Study 1 Response: Paige, Liv, Caroline

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Case Study 1 Response: Paige, Liv, Caroline

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1. Dark brown coloring, +3 blood on the dip stick but no RBCs in the microscopy, and protein all stand out in the UA.

2. Intense exercise, along with severe dehydration can cause muscle cells to burst and leak into the bloodstream, so that can be seen as the underlying cause, which can cause muscle pain. This happens because the cells are shrinking due to dehydration. He is experiencing muscle pain and fatigue, and this can lead to dark urine, proving this to be true. Additionally, he could be dehydrated after soccer practice, so his renal system is trying to reserve extra water in his kidneys. This means that he will have dark urine.

3. Rhabdomyolysis is his final diagnosis.

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Case Study 2: The Pregnant Woman with Swelling

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Case Study 2: The Pregnant Woman with Swelling

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Background:

A 26-year-old pregnant woman in her third trimester comes in with complaints of swollen ankles and elevated blood pressure.

Urinalysis Results:

• Color: Pale yellow

• Specific Gravity: 1.010

• pH: 6.5

• Protein: +3

• Glucose: Negative

• Ketones: Negative

• Microscopy: Few casts, no bacteria

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Case Study 3: The Child with Bedwetting and Sweet-Smelling Urine

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Case Study 3: The Child with Bedwetting and Sweet-Smelling Urine

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Background:

A 10-year-old child presents with frequent urination, bedwetting, weight loss, and fruity-smelling urine.

Urinalysis Results:

• Color: Light yellow

• Specific Gravity: 1.020

• pH: 5.0

• Glucose: +4

• Ketones: +3

• Protein: Negative

• Microscopy: Normal

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Case Study 4: The Elderly Man with Fever and Back Pain

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Case Study 4: The Elderly Man with Fever and Back Pain

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Background:

A 72-year-old male complains of fever, chills, lower back pain, and frequent, painful urination.

Urinalysis Results:

• Color: Cloudy yellow

• Specific Gravity: 1.015

• pH: 7.5

• Leukocyte esterase: Positive

• Nitrites: Positive

• Protein: +1

• Microscopy: Numerous WBCs and bacteria

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Case Study 5: The Student with Starvation Diet

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Case Study 5: The Student with Starvation Diet

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Background:

A 19-year-old female college student on a strict low-carb, high-protein diet presents with lightheadedness and fatigue.

Urinalysis Results:

• Color: Yellow

• Specific Gravity: 1.025

• pH: 5.0

• Ketones: +2

• Glucose: Negative

• Protein: Trace

• Microscopy: Normal

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Case Study 6: The Teen with Abdominal Pain

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Case Study 6: The Teen with Abdominal Pain

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Background:

17-year-old female with lower abdominal pain and fever.

Urinalysis:

• Color: Cloudy

• Leukocyte esterase: Positive

• Nitrites: Positive

• WBCs: Many

• RBCs: Moderate

• Bacteria: Present

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Case Study 7: The Construction Worker with Headache and Cola-Colored Urine

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Case Study 7: The Construction Worker with Headache and Cola-Colored Urine

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Background:

45-year-old male working in heat; reports headache, nausea, dark urine.

Urinalysis:

• Color: Cola-brown

• SG: 1.035

• Blood: +3

• Microscopy: No RBCs

• Protein: +1

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Case Study 8: The Girl with Swollen Face

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Case Study 8: The Girl with Swollen Face

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Background:

8-year-old girl with puffy eyes, tea-colored urine, recent sore throat.

Urinalysis:

• Protein: +2

• Blood: +2

• RBCs: Many

• RBC casts: Present

• SG: 1.020

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Case Study 9: The Diabetic with Sudden Confusion

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Case Study 9: The Diabetic with Sudden Confusion

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Background:

65-year-old diabetic male with confusion, fruity breath, and rapid breathing.

Urinalysis:

• Glucose: +4

• Ketones: +4

• SG: 1.030

• pH: 5.0

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For each case study- examine the UA results and consider the follow:

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For each case study- examine the UA results and consider the follow:

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1. What characteristics stand out in the UA

2. What is the underlying cause of the abnormal findings- how can you tie it back to renal physiology

3. What is your final diagnosis

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1. The color is most concerning since it is so dark. The specific gravity, blood and proteins are in the normal ranges

2. The body is likely producing ADH (Anti-diuretic Hormone) to prevent losing much water, so that he is only losing the minimal amount in the filtration process creating a urine sample that is very dark and concentrated.

3. Dehydration

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Yellow color and specific gravity of 1.025, which is normal but slightly concentrated, possibly from not drinking enough fluids.

pH of 5.0 shows her urine is acidic, which is common with high-protein diets.

Ketones +2 means her body is burning fat for energy because she isn’t getting enough carbohydrates. This causes ketonuria and can lead to tiredness and dizziness.

Glucose is negative, so she is not diabetic.

Trace protein could be from her body breaking down muscle due to the low energy intake.

Microscopy is normal, so there’s no sign of infection or other problems.

her symptoms are likely caused by her restrictive diet. The body is in a starvation-like state and using fat for energy. She should consider eating a more balanced diet with enough carbs and staying hydrated to avoid further health issues.

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1. Glucose- +4 ( might indicate Diabetes), Ketones +3 (lack of glucose)

Ph- 5 (acidic)

SG- 1.021 (normal but on the higher end, dehydration)

2. Renal Threshold for glucose- kidneys might not be absorbing glucose properly

Osmotic diuresis- glucose takes water either it- could cause dehydration

Ketone production- no insulin, glucose isn't entering cells - causes body to breakdown fat - sign of diabetes

No protein in pee- metabolic and not renal

3. Type 1 diabetes

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1. Cloudy yellow urination stands out because it’s cloudy and not transparent. He has white blood cells( leukocytes) in his urine which is concerning. He is also positive for nitrites in the urine. He has high amount of protein in his urine(+1) supposed to be none. Has lots of bacteria count in urine.

2. His underlying condition is old age and weakened immune system.

3. His diagnosis is that he has a UTI because there is high white blood cells fighting the bacteria in the urinary tract. This is common in the elderly population because immune system is decreased.

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3.

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1. Swollen ankles, high blood pressure, few cast but no bacteria

2. Pregnancy

3. Glomerulonephritis