1.

20 year old male with history of diabetes mellitus

brought to casualty in an unconscious state.
1) What is your probable diagnosis?
2) Do physical examination for the given sample.
2. 3) Do 2 chemical tests to confirm your diagnosis.
Answer:
1. The probable diagnosis is Diabetic ketoacidosis.
2. Physical Examination of urine
3. Volume - 50 ml
4. Colour - straw yellow
5. Appearance - Clear
6. Odour - fruity odour
7. PH - 7
8. Specific gravity - 1.030

Chemical test

S.No Test Principle Procedure Observation Inference

1. Benedict’s When urine Take 5ml of Reddish Presence

test is boiled in Benedict’s brown of sugar in
Benedict’s qualitative precipitate urine
solution, reagent in a is seen.
blue alkaline test tube.
copper
8 drops of
sulphate is
urine (0.5
reduced to
ml)
red brown
cuprous Heat to
boiling for 2
 oxide, if a minutes,
reducing then,cool in
agent (sugar) running tap
is present. water.

2. Rothera’s Acetoacetic Take 5 ml of Formation Presence

test acid (or) urine in a of purple of ketone
acetone test tube. coloured bodies.
reacts with ring
Saturate it
nitroprussid
with solid
e in alkaline
ammonium
solution to
sulphate
from a
salt.
purple
coloured Add a few
complex. crystals of
sodium
nitroprussid
e and shake.

Add liquor
ammonia
from theside
of test tube.

Interpretation Of Benedict’s test

  No change of blue colour = Negative

 Green colour = Traces (<0.5 g/dl)

 Green / cloudy green ppt = + (1g /dl)

 Yellow ppt = ++ (1-1.5 g/dl)

 Orange ppt = +++(1.5 -2 g /dl)

 Brick red = ++++ ( > 2g/dl)

Questions asked related to above tests

CAUSES OF GLUCOSURIA

 Diabetes Mellitus

 Renal glucosuria

 Severe burns

 Administration of corticosteroids

 Severe sepsis

 Pregnancy

CAUSES OF KETONURIA
 Diabetic ketoacidosis
 Dehydration
 Hyperemesis gravidarum
 Fever
 Cachexia
 After General Anaesthesia
2. A 45 year old lady complaining of weakness, polydipsia,
polyuria and polyphagia of 4 years duration.
Answer:
1. The probable diagnosis is Diabetes mellitus

2. Physical Examination of urine

Volume - 50 ml

Color - straw yellow

Appearance - Clear

Odor - Aromatic

PH -7

Specific gravity - 1.030

Chemical test
S.No Test Principle Procedure Observation Inference

1. Benedict’s When urine Take 5ml of Reddish Presence

test is boiled in Benedict’s brown of sugar in
Benedict’s qualitative precipitate urine
solution, reagent in a is seen.
blue alkaline test tube.
copper
8 drops of
sulphate is
urine (0.5
reduced to
ml)
red brown
cuprous Heat to
oxide, if a boiling for 2
reducing minutes,
agent (sugar) then,cool in
running tap
 is present. water.

2. Rothera’s Acetoacetic Take 5 ml of No Absence

test acid (or) urine in a Formation of ketone
acetone test tube. of purple bodies.
reacts with coloured
Saturate it
nitroprussid ring
with solid
e in alkaline
ammonium
solution to
sulphate
from a
salt.
purple
coloured Add a few
complex. crystals of
sodium
nitroprussid
e and shake.

Add liquor
ammonia
from the
side of test
tube.

Interpretation Of Benedict’s test

  No change of blue colour = Negative

 Green colour = Traces (<0.5 g/dl)

 Green / cloudy green ppt = + (1g /dl)

 Yellow ppt = ++ (1-1.5 g/dl)

 Orange ppt = +++(1.5 -2 g /dl)

 Brick red = ++++ ( > 2g/dl)

Questions asked related to above tests

CAUSES OF GLUCOSURIA

 Diabetes Mellitus

 Renal glucosuria

 Severe burns

 Administration of corticosteroids

 Severe sepsis

 Pregnancy
1. 8-year-old boy after vaccination developed puffiness of
face, generalized edema and is normotensive.
1) What is your probable diagnosis?
2) Do physical examination for the given sample.
3) Do 2 chemical tests to confirm your diagnosis.
Answer:
1. The probable diagnosis is post – Nephrotic syndrome

2. Physical Examination of urine

 Volume - 50 ml

Colour - Reddish

Appearance - Clear

Odour - Aromatic

PH - 7

Specific gravity - 1.030

Chemical test

S.No Test Principle Procedure Observa Inference

tion

1. Heat and Protein in Take 5ml test Urine Presence of

acetic acid the urine tube appears protein in urine
test gets cloudy
Fill the test
precipitate
tube with 2/3
d when
rd of urine
boiled in
an acidic Acidify by
medium adding 10 %
glacial acetic
acid if urine is
alkaline.

Boil the upper

portion for 2
minutes.

If
precipitation
 or turbidity
appears add a
few drops of
10% acetic
acid.

2. Benzidine The Take 2ml of No blue Absence of blood

test peroxide urine colour in the given urine
activity of sample.
Add 2ml of formed
haemoglob
saturated
in
solution of
decompos
benzidine
es
with glacial
hydrogen
acetic acid
peroxide
releasing Add 1ml of
nascent H2O2
oxygen
which in
tern
oxidizes
benzidine
to give
blue
colour.

INTERPRETATION OF HEAT AND ACETIC ACID TEST-

- No cloudiness =Negative
- Cloudiness against dark background = traces <0.1 g/dl

- Cloudiness without granualarity =+ 0.1g /dl

- Granular cloudiness =++ 0.1-0.2 g/dl

- Precipitation and Flocculation- +++ 0.2-0.4 g/dl

-Thick Solid precipitation=++++ 0.5 g/dl

Questions asked related to above tests

Causes of proteinuria-

Normally, there is a very scanty amount of protein in urine

(<150 mg / day)

Heavy Proteinuria-(>3gm /day)

-Nephrotic syndrome

-Renal vein thrombosis

-Diabetes mellitus

-SLE

Moderate Proteinuria –(1-3 gm/day)

-Chronic glomerulonephritis

-Nephrosclerosis

-Multiple Myeloma

-Pyelonephritis

Mild Proteinuria-( <1.0 gm/day)

-Hypertension

-Polycystic kidney

-Chronic pyelonephritis
-UTI

-Fever

Microalbuminuria-It is the excretion of 20-200 mg/l of albumin and it

is indicative of EARLY AND POSSIBLY REVERSIBLE GLOMERULAR
DAMAGE

2. A 10 year old boy gives past history of sore throat 1 month

back.Now complaining of passing cola coloured
Urine and the patient is hypertensive

1) What is your probable diagnosis?

2) Do physical examination for the given sample.
3) Do 2 chemical tests to confirm your diagnosis.
Answer:
1. The probable diagnosis is Post – streptococcal glomerulonephritis
(Nephritic syndrome)

2. Physical Examination of urine

Volume - 50 ml

Colour - Reddish

Appearance - Clear

Odour - Aromatic

PH - 7

Specific gravity - 1.030

S.N Test Principle Procedure Observa Inference
o tion

1. Heat and Protein in Take 5ml test Urine Presence of

acetic acid the urine tube appears protein in urine
test gets cloudy
Fill the test
precipitate
tube with 2/3
d when
rd of urine
boiled in
an acidic Acidify by
medium adding 10 %
glacial acetic
acid if urine is
alkaline.

Boil the upper

portion for 2
minutes.

If
precipitation
or turbidity
appears add a
few drops of
10% acetic
acid.

2. Benzidine The Take 2ml of blue Presence of blood

test peroxide urine colour in the given urine
activity of sample.
Add 2ml of
 haemoglob saturated formed
in solution of
decompos benzidine
es with glacial
hydrogen acetic acid
peroxide
Add 1ml of
releasing
H2O2
nascent
oxygen
which in
tern
oxidizes
benzidine
to give
blue
colour.

Questions asked related to above tests

INTERPRETATION OF BENZIDINE TEST-

Appearance of blue color indicates presence of blood

Causes of blood in urine-

-Renal stones

-Renal tumors

-Polycystic kidney

-Trauma

-Bleeding disorders

Appearance of blue color indicates presence of blood