Question

Pre-admission lab work on a patient scheduled for surgery shows a fasting blood sugar of 200 mg/dl. Results of the routine UA are:

Color: pale yellow     Appearance: Clear    Sp. Gravity:   1.030    pH: 5.0    Protein: 1+    Glucose: 100 mg/dL   Ketones: trace     Bilirubin: neg     Blood: neg     Urobilinogen:  normal     Nitrite: neg     Leukocyte: neg

Which answer below explains the correlation between the patient's blood and urine glucose results.

	A.	The patient's blood results was higher because it was drawn prior to collecting the urinalysis.
	B.	The patient's blood glucose level exceeds the renal threshold for glucose causing the sugar to spill into the urine.
	C.	C The testing procedure for blood glucose is more sensitive therefore more accurate that the chemical dipstick.
	D.	The chemicals on the dipstick may have deteriorated and are not performing accurately. The urine should be tested by another method.

5 points

Question 2

What is the most probable metobolic disorder associated with this aptient?

	A.	Diabetes insipidus
	B.	Renal tubular reabsorption problem
	C.	Diabetes melitus
	D.	Cannot be determined, more testing needed.

5 points

Question 3

Considering the patient's condition, what is the significance of the patient's protein result.

	A.	No significance
	B.	Glomerular capillary damage
	C.	Renal tubular damage
	D.	Renal pelvis damage

5 points

Question 4

What could have been done to delay the onset of proteinuria in this patient?

	A.	Nothing
	B.	Control of blood glucose
	C.	None of the above
	D.	None of the above

5 points

Question 5

If the patient in this study had a normal blood sugar, to what would the urinary glucose be attributed?

	A.	Idiopathic (unknown cause
	B.	Too many donuts
	C.	Defective renal tubular reabsorption in the PCT
	D.	A renal threshold that is too high

Answer 1

1.The blood test reveals the patient has an elevated fasting glucose in the blood.When the blood glucose is excess in the blood and cannot be used by the body it is generally expelled in the urine and makes the metabolism balanced in the body.

The sample collected before UA has no relation to each other because blood is the first product and urine the last product of a metabolism

The blood test are always more accurate than other type of tests lo

The dipstick tests are usually done after expiry checking so it cannot be inaccurate in reading a result

Ans:B.The patient's blood glucose levels exceeds the renal threshold for glucose causing the sugar to spill in the urine

2.The metabolic problems related here is diabetes mellitus

In diabetes insipidus the specific gravity should be less than 1.005

In renal tubular reabsorption problems the solutes and water cannot be filtered properly

Ans:Diabetes Mellitus

3.When there is a problem in the glomerular filtration rate,the small blood vessels namely the capillaries are affected causing the protein to leak via urine.

In tubular damage the protein should be more than 2 and cannot be identified if it is less than two in dipstick test

Ans:B.Glomerular capillary damage

4.The best way to control the expulsion of protein in the urine is by controlling the blood glucose level.

Ans:B.Control of blood glucose