MA. KYNE O.

PAGAY

CASE ANALYSIS 1: A Construction worker is pinned under a collapsed scaffolding for several hours prior to being taken to the
emergency room. His abdomen and upper legs are severely bruised, but no fractures are detected. A specimen for urinalysis
obtained by catheterization has the following results:

Color: Red-brown Protein: Trace Bilirubin: Negtive

Clarity: clear Glucose: Negatve Urobilinogen: 0.4 EU
SG: 1.017 Ketones: Negative Nitrite: Negative
pH 6.5 Blood: 4+ Leukocytes: Negative

51. What is the most probable cause of the positive blood reaction?

A. Hematuria C. Myoglobinuria

B. Hemoglobinuria D. Improperly collected urine

ANSWER: “C”

RATIONALE: The situation has indicate that the construction worker was pinned under a collapsed scaffolding where he produced a
bruised on his legs and abdomen, which is suspected that the patient condition might be associated with muscle destruction.
Myoglobinuria not only reacts positively with reagent strip test for blood but also produces a clear red-brown urine.

Rationale on wrong answer:

A. Hematuria is associated with renal disorder and it did not indicate that the patient is bleeding or has damaged its organs. And its
physical appearance in urine is usually cloudy red urine.

B. Hemoglobinuria results from intravascular hemolysis and it did not indicate that the patient undergo haemolytic reaction or a
transfusion reaction. And also it occurs negative reaction in blood rgt srip and may appear a clear red urine.

D. It can’t be improperly collected urine because it was obtained by cathetherization which is collected under sterile condition.

52. What is the source of the substance causing the positive blood reaction and what is the condition?

A. Glomerular Nephritis C. Rhabdomyolysis

B. Hemolytic Reaction D. Blood contamination upon collection

ANSWER: “C”

RATIONALE: In myoglobinuria, the presence of myoglobin should be suspected in patients with conditions associated with muscle
destruction (“Rhabdomyolysis”).

A. Glomerular Nephritis is a condition for hematuria.

B. Hemolytic Reaction is for hemoglobinuria

D. It can’t be blood contamination upon collection because it was catheterized which is collected under sterile condition.

53. What is the principle used in the urine reagent strip test for blood?

A. Greiss reaction C. Diazo reaction

B. Pseudoperoxidase activity D. Change in dissociation constant

ANSWER: “B”

RATIONALE: Principle of Blood is Pseudoperoxiase activity of haemoglobin.

A. Greiss Reaction is the principle of Nitrite

C. Diazo reaction is the principle of Bilirubin

D. Change in dissociation constant is the principle of Specific gravity.

REFERENCES:

Susan King Strasinger and Marjorie Schaub Di Lorenzo (2001). Urinalysis and Body Fluid 4 th Edition. Metro Manila: F.A. Davis
Company
MA. KYNE O. PAGAY

51. ANSWER: C. Myoglobinuria

RATIONALE: The situation has indicate that the construction worker was pinned under a collapsed scaffolding where he produced a
bruised on his legs and abdomen, which is suspected that the patient condition might be associated with muscle destruction.
Myoglobinuria not only reacts positively with reagent strip test for blood but also produces a clear red-brown urine.