Macroscopic and microscopic urinalyses
Analyzing information from both macroscopic and microscopic urinalyses from four fictional patients to make a medical diagnosis based on the information provided. Use the background information in this course to help you
make the proper diagnosis for each patient and help you to answer the questions.
Patient #1
Danny S. is a 27-year-old male who complains of being tired and frequently hungry. In
spite of an increasing appetite, he is losing weight. He has also noticed that the few
minor paper cuts on his hands are taking a long time to heal.
Macroscopic Urinalysis:
Color: yellow
Clarity: clear
Odor: slightly sweet
Leukocytes: negative
Nitrite: negative
Urobilinogen: negative
Protein:100+
pH: 6.0
Blood: negative
Specific Gravity: 1.010
Ketone: moderate
Bilirubin: negative
Glucose: 250mg/dl
Microscopic Examination:
Crystals were present in his urine sample.
Patient # 2
Sheila M. is a 74-year-old female who is a chronic cigarette smoker and is overweight.
Lately she has been experiencing swelling in her hands and feet and has been
experiencing problems sleeping. She is also complaining of nausea and occasional
vomiting. Her physician has determined that she has high blood pressure and has pain
and tenderness in her lower back.
Macroscopic Urinalysis:
Color: dark amber
Clarity: cloudy
Odor: slight odor
Leukocytes: negative
Nitrite: negative
Urobilinogen: negative
Protein: 300+
pH: 5
Blood: moderate
Specific Gravity: 1.005
Ketone: moderate
Bilirubin: negative
Glucose: negative
Microscopic Examination:
A significant amounts of red blood cells and casts were found in her urine sample.
Patient #3
Patrick T. is a 35-year-old male who went to the emergency room complaining of severe
pain in his left side and back. He states that the pain comes in waves and fluctuates in
intensity. He also feels the need to urinate frequently, but then can only urinate in small
amounts.
Macroscopic Urinalysis:
Color: Yellow
Clarity: slightly cloudy
Odor: slight odor
Leukocytes: negative
Nitrite: negative
Urobilinogen: negative
Protein: trace
pH: 8
Blood: small
Specific Gravity: 1.005
Ketone: negative
Bilirubin: negative
Glucose: negative
Microscopic Examination:
A small amount of red blood cells and a significant number of crystals were found
in his urine sample.
Patient #4
Susan K is a 20-year-old female. She has experienced an increased urge to urinate and
uncomfortable pressure in her lower back. She has also been having occasional chills
Macroscopic Urinalysis:
Color: Yellow
Clarity: slightly cloudy
Odor: slight odor
Leukocytes: positive/moderate
Nitrite: positive
Urobilinogen: negative
Protein: trace
pH: 7
Blood: negative
Specific Gravity: 1.020
Ketone: negative
Bilirubin: negative
Glucose: negative
Microscopic Examination:
A significant number of leukocytes, bacteria and crystals were found in her urine
sample.
Analysis Results:
Indicate your diagnosis for each patient
1. What kind of crystals would you expect to see in:
a. Patient #1- (Danny S.) urine sample?
b. Patient #3- (Patrick T.) urine sample?
c. Patient #4- (Susan K.) urine sample?
2. A patient’s urine is red in color, but microscopic examination of the sample shows
no evidence of blood, crystals, or bacteria. What other factor(s) might explain the
color of the urine?
3. What is the difference between diabetes mellitus and diabetes insipidus?
4. Why are kidney problems so serious?
5. The presence of ketones in urine can be caused by what two types of
conditions?
6. What are the three important hormones produced by the kidneys and what are
their functions?