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LPU-ST.

CABRINI SCHOOL OF HEALTH SCIENCES, INC


Km. 54 National Highway, Makiling, Calamba, Laguna, 4027

DEPARTMENT OF MEDICAL TECHNOLOGY

CASE STUDY ANALYSIS IN MDTL10N


Analysis of Urine and Other Body Fluids

Topic Number 3: Kidney Function

Name: Malabanan, Jonathan A. Score: ____________________


Section:BSMED 3-3 Date: 02/08/2018

Answer as briefly as possible

A 52-year-old female with a 25-year history of Type 1 Diabetes Mellitus submits a 24-hour urine collection for testing. A blood
sample was also collected when she brought the urine specimen to the laboratory. The following information and results are
obtained:

Patient Information Results Reference Intervals


 Height: 5′5˝ (165 cm) Creatinine, serum: 2.3 mg/dL 0.8-1.3 mg/dL
 Weight: 160 lb. (72.7 kg) Urine volume, 24-hour: 1000 mL 600-1800 mL/day
Creatinine, urine: 190 mg/dL Varies with hydration
Albumin, urine: 9.5 mg/dL Varies with hydration

1. Calculate this patient’s body surface area using

2. Calculate the normalized creatinine clearance result using the data provided.

3. Calculate the albumin excretion in milligrams per day (mg/day).

4. Calculate the albumin excretion in micrograms per minute (µg/ min).

5. Calculate the urine albumin-to-creatinine ratio in micrograms albumin per milligram of creatinine (µg albumin/mg
creatinine).
A 24-year-old man who had previously sustained a severe head injury in a car accident is seen by his physician. He complains of
polydipsia and polyuria. Neurogenic diabetes insipidus is suspected, and tests are performed to rule out compulsive water ingestion.
The following routine urinalysis is obtained.

PHYSICAL EXAMINATION CHEMICAL EXAMINATION


Color: colorless SG: 1.005
Clarity: clear pH: 6.0
Odor: — Blood: negative
Protein: negative
LE: negative
Nitrite: negative
Glucose: negative
Ketones: negative
Bilirubin: negative
Urobilinogen: normal
Ascorbic acid: —

1. Explain briefly the cause of polyuria in patients with diabetes insipidus.

The antidiuretic hormone production is partially or totally deficient due to the damage to the
hypothalamus or the posterior pituitary that results to the impaired reabsorption of water, resulting to
polyuria.

2. Without fluid restrictions, this patient’s urine osmolality most likely is


a. Less than 200 mOsm/kg.
b. Greater than 200 mOsm/kg.
3. This patient’s polyuria should be classified as
a. Oncotic diuresis.
b. Psychosomatic diuresis.
c. Solute diuresis.
d. Water diuresis.
4. In patients with neurogenic diabetes insipidus, if antidiuretic hormone is given intravenously, the urine osmolality should
a. Remain unchanged.
b. Decrease.
c. Increase.
5. Which of the following tests should be used to evaluate this patient?
a. Free-water clearance test
b. Fluid deprivation test
c. Glucose tolerance test
d. Osmolar clearance test

Indicate whether each of the following statements is true (T) or false (F).
6. Patients with diabetes insipidus often have glucose present in the urine. (False)
7. Patients with diabetes insipidus often have a high urine specific gravity. (False)
8. Patients with diabetes insipidus often have urinary ketones present because of an inability to use the glucose present in the
blood. (False)
9. Diabetes is a general term referring to disorders characterized by copious production and excretion of urine. (True)