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discuss paper please, references in the bottom The 40-year old patient’s physical uranalysis examination provided preliminary information for the physician to make a diagnosis. The physical examination provides that although the patient’s urine color is normal, the urine has an acidic pH that can be affected by diet, exercise, and hydration. In the chemical strip examination, the patient’s urine was negative for glucose, ketones, bilirubin, nitrite, leukocytes, and normal urobilinogen levels. Since the strips tests were negative for the aforementioned chemical test strips, the patient can be determined to have no health issues related to diabetes, cystitis, UTIs, liver damage, hepatitis, cirrhosis, and hemolytic disease. However, the sample presents a positive result for the presence of protein representative of transient proteinuria due to small amounts of protein being leaked into the urine, a high specific gravity level meaning dehydration, hazy clarity of the urine sample meaning cellular/ noncellular components will be found, and blood representing possible renal problems associated to renal calculi, pyelonephritis, renal lithiasis, trauma, or exposure to toxic chemicals. The microscopic examination demonstrated large amounts of red blood cells (15-20/hpf) varying from the normal range of 0-5 intact RBC, within range of the normal amounts of white blood cells (2-5/hpf), and a few tissue cells within the urine. The condition associated with the patients’ physical symptoms and urinal examinations is renal lithiasis. After dinner consumption, the patient exhibited severe back pain, which turned transient after a few hours but returned in the morning. Due to the significant, moderate results of the chemical strip tests, the patient has an issue regarding the renal system, and something is causing bleeding. However, since the patient’s urine is not pink nor red, the renal issue is not chronic in form. Cystitis disease results in the positive presence of leukocytes, nitrite, blood, basic pH, and light protein trace in the chemical strip test. It is a UTI primarily seen in women and affects the bladder, with symptoms of frequent urination, abdominal pain, and dysuria (painful urination). Bladder carcinoma is cancer within the bladder showing symptoms of orange-pink-red urine color. There are no physical symptoms, frequent urination, dysuria, and anuria at an early stage. Acute pyelonephritis is caused by an infection of the upper part of the kidney tubules, which causes little urine flow to be excreted and occurs mainly in children. Since these three urine diseases do not relate to the patient’s symptoms, “develops severe back pain and abdominal pain after dinner. The pain subsides during the night but returns in the morning”, the correct diagnosis would be renal lithiasis. Renal lithiasis is a post renal disorder that affects the kidneys filtration system through the deficiency of the absorption, metabolism, excretion of the crystals that form kidney stones, and the imbalance of the pH within the body. The symptoms include severe lower back pain, pain that comes and goes at irregular intervals, and is affected by diet and exercise. The crenated red blood cell level (15-20 RBC/HPF) indicates glomerular bleeding is occurring. The correlation between urine color and specific gravity is vital because both represent the body’s hydration state through the urine sample; a dark yellow color is a sign of dehydration and the state of the kidneys’ filtration ability. In renal lithiasis, microscopically, one can observe granular, waxy, and broadcasts and crystals, mainly of calcium oxalate, followed by calcium phosphate, struvite, and cystine. There are varied forms of the disease like calcium oxalate calculi, struvite calculi, brushite calculi, uric acid calculi, and cystine calculi. The patient is recommended to increase his water consumption to aid in the filtration of the stones formed in his urine. The dietary consumption concentration varies depending on the cause of stone formation, avoiding or increasing food ingestion rich in proteins, citrus, soft drinks, vegetables, salts, vitamin D, Vitamin C, and calcium. In chronic cases of renal lithiasis, the treatment is subjected to medication, IV fluid medication, expulsive medical therapy, urethral endoscopy, or lithotripsy, and varies depending on the size and location of the stones within the kidney. REFERENCES: American Cancer Society. Bladder Cancer Signs and Symptoms. Bladder Cancer Signs and Symptoms Castillo Hernandez, Anna, MD. Osmosis from Elsevier. Nephrolithiasis: What is it, Types, Signs and Symptoms, Diagnosis, Treatment, and more. Nephrolithiasis: What Is It, Types, Signs and Symptoms, Diagnosis, Treatment, and More | Osmosis Clinica De Universidad de Navarra. Renal Lithiasis. Renal Lithiasis: Symptoms, Diagnosis and Treatment . ClĂnica Universidad de Navarra (cun.es) J, Nutr. Renal Lithiasis and Nutrition. National Library of Medicine. September 6th, 2006. National libraryofmedicine.gov. Renal lithiasis and nutrition – PMC (nih.gov)
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