CASE STUDY:

Andrea, a 22-year old MLT student, performed a macroscopic urinalysis on her own urine as part of the
macroscopic urinalysis laboratory. She noted some dysuria, frequency, and urgency of urination. The
program director recommended that Andrea contact her physician for a complete routine urinalysis and
possible culture and sensitivity.

URINALYSIS

Day 1 Day 2 Reference Range

MACROSCOPIC
Color Yellow Yellow Colorless to amber
Appearance Cloudy Cloudy Clear
SG 1.013 1.016 1.001-1.035
pH 7.0 7.5 5-7
Protein Neg Neg Neg
Glucose Neg Neg Neg
Ketones Neg Neg Neg
Bilirubin Neg Neg Neg
Blood Neg Neg Neg
Urobilinogen Normal Normal Normal
Nitrite Positive Positive Neg
Leukocyte esterase 2+ 2+ Neg

MICROSCOPIC
WBCs Not tested 25-40/ HPF 0-5/HPF
RBCs Not tested 0-3/HPF 0-2/HPF
Epithelial cells Not tested Squamous-Few /LPF Few to moderate/LPF
Transitional-Few/LPF
Casts Not tested Neg Few- hyaline
Bacteria Not tested Moderate Negative

QUESTIONS:

1. Identify the abnormal or discrepant urinalysis result(s).

2. A. Do the abnormal results indicate an upper or lower urinary tract infection?

B. What single finding is most helpful in determining the source of the infection? Why?

3. What is the probable disease/condition?

4. Would you change your answer if either the leukocyte esterase or nitrite were negative and the
microscopic remained the same? Explain why or why not.

5. Explain the presence of increased transitional epithelial cells in this condition.

6. What bacteria are most commonly identified in this condition?

7. What fruit juice is often recommended to reduce pyuria and bacteriuria?

8. Why are patients instructed to increase their fluid intake?

9. Why are women more prone to this condition than men?

10. What conditions are associated with an increased incidence of this infection?