Reference no: EM133505520

Case 4- 5 A 26-year-old man is seen by his physician and complains of sudden weight loss, polydypsia and polyuria. A routine urinalysis and plasma glucose level are obtained. The patient was fasting before blood collection. Chemistry Results Test Results Reference Range Plasma glucose: 230 mg/dL fasting < 110 mg/dL; diabetic >126 mg/dL Results Physical Examination Color: Colorless Clarity: Clear Odor: ----- Chemical Examination SG: 1.010 pH: 5.5 Blood: Negative Protein: Negative LE: Negative Nitrite: Negative Glucose: >2000 Ketone: Small Bilirubin: Negative Urobilinogen: Normal Ascorbic acid: ----- Confirmatory Tests Refractometer: 1.029 Clinitest (2-drop): >5000 Clinitest (5-drop): >2000* * The pass-through effect was noted during the performance of this test.

1. What are the abnormal or discrepant findings?

2. Explain the pass-through effect exhibited by the Clinitest method.

3. What is the concern about observing the pass-through effect?

4. Is the patient showing any signs of renal damage or dysfunction?

5. What diagnosis best accounts for the glucosuria observed in this patient?

6. Explain why the reagent strip ketone test is positive.

7. Explain the two different specific gravity results obtained. Which result most accurately reflects the ability of the kidneys to concentrate renal solutes?