After the patient's urine is analyzed using dipsticks and based on the information and results obtained during the test, the disease that the patient is suffering from can be diagnosed as anorexia nervosa. In this report, I will explain how I made this diagnosis.
The first indication that led to this decision is from the patient information received prior to the test. It can be seen that the patient is greatly underweight, weighing in at 43kg. Including her height of 165cm, a BMI test can be done which shows that she has a BMI of 15.7, which means she is underweight. Some symptoms that the patient is experiencing include fatigue, bloating, dry skin, and discoloration in her hands due to poor circulation.
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The results of the urine analysis test will be discussed. In the urine test, the following substances were tested: glucose, ketones, specific gravity, blood, pH, protein, nitrites, and leucocytes. The result of glucose received was negative, this is normal as glucose should not be in the urine, giving no cause for concern for this patient. A positive result could indicate diabetes, kidney failure, or pregnancy. However, there were large levels of ketones present in the urine, 80. Ketones are not usually found in urine. They are produced when glucose is not available in the cells of the body as a source of energy. They can form when a person does not eat enough carbohydrates, suggesting fasting or starvation, or when a person's body cannot use carbohydrates correctly. This was the second indication that led to the diagnosis of the disease. In terms of specific gravity, it measures urine concentration. A specific gravity of 1.015 was received for this test, suggesting normal kidney function, yet results above 1.010 show signs of dehydration. Therefore, the patient might not be drinking as much fluids as she should be. Dehydration is caused by not drinking enough fluids and can lead to kidney failure. This is another reason that led to the diagnosis. The result of blood present in the urine was negative, showing that there is no internal bleeding. A negative blood result is common. Blood in urine, known as hematuria, could be caused by urinary tract infections, kidney infections, or possibly cancer. The pH level of the urine was 6, which is slightly acidic, but is average and normal for a urine sample. If the pH level was lower, it could indicate dehydration, acidosis, or diabetic ketoacidosis. If the pH was higher, it could mean the patient has kidney failure, respiratory alkalosis, or a urinary tract infection. The results were negative for protein in the urine, also known as proteinuria, again, this is normal as protein molecules should be too large to pass through the kidneys. The nitrite levels in the urine were negative, which is normal. Lastly, leucocytes were tested for in the urine, and like most other results, the outcome was negative. And like the other results, it is normal for this to be a negative result. Overall, the two substances that led me to my conclusion that the patient was suffering from anorexia nervosa were the high levels of ketones and the specific gravity levels.
Anorexia nervosa is an eating disorder that affects both men and women, but mostly young women. People suffering from the disease try to keep their weight low, usually by not eating enough or by exercising too much. These actions can lead to them becoming sick as they begin to starve. Sufferers usually have a distorted image of their body, believing that they have more weight when in reality they are underweight. Some signs of anorexia include having a low body mass index, thinking your weight is healthy when you are underweight, skipping meals or not eating any food, having dry skin, and feeling tired.
As a pharmacist, several treatment options can be recommended to help a patient who has anorexia. Firstly, cognitive behavioral therapy can be offered, which involves talking to a therapist to design a personal treatment plan, which will help with your feelings, understand nutrition, the effects of starvation, and make healthy food decisions. Maudsley Anorexia Nervosa Treatment for Adults (MANTRA) and Specialist Supportive Clinical Management (SSCM) are other treatments where the patient talks to a therapist to discover what is causing the eating disorder. Advice about a healthy diet will be provided, but therapy is usually needed also. According to Anorexia & Bulimia Care, statistics from sufferers of anorexia show that “50% recover, whereas 30% improve and 20% remain chronically ill”.
To conclude, this laboratory report is an example of how urinalysis using dipsticks can be used to diagnose a patient's illness, in this case, anorexia nervosa. In order to successfully recover and improve her condition, the patient needs treatment.
References
- Anorexia & Bulimia Care. 2014. Statistics. [ONLINE] Available at: http://www.anorexiabulimiacare.org.uk/about/statistics [Accessed 6 March 2019].
- Eating Disorder Hope. 2018. Dehydration and the Treatment of Eating Disorders. [ONLINE] Available at: https://www.eatingdisorderhope.com/information/bulimia/dehydration-and-the-treatment-of-eating-disorders [Accessed 1 March 2019].
- Healthline. 2016. Urine pH Level Test. [ONLINE] Available at: https://labtestsonline.org/tests/urinalysis [Accessed 24 February 2019].
- Healthline. 2018. Urine Specific Gravity Test. [ONLINE] Available at: https://www.healthline.com/health/urine-specific-gravity [Accessed 24 February 2019].
- Lab Tests Online. 2016. Urinalysis. [ONLINE] Available at: https://labtestsonline.org/tests/urinalysis [Accessed 24 February 2019].
- Lab Tests Online. 2018. Blood in Urine (Haematuria). [ONLINE] Available at: https://labtestsonline.org/conditions/blood-urine-hematuria [Accessed 4 March 2019].
- Medline Plus. 2017. Glucose in Urine Test. [ONLINE] Available at: https://medlineplus.gov/lab-tests/glucose-in-urine-test/ [Accessed 1 March 2019].
- NHS. 2018. Anorexia Nervosa. [ONLINE] Available at: https://www.nhs.uk/conditions/anorexia/ [Accessed 3 March 2019].
- NHS. 2018. Treatment - Anorexia Nervosa. [ONLINE] Available at: https://www.nhs.uk/conditions/anorexia/treatment/ [Accessed 3 March 2019].
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