Urinalysis and Body Fluids 6th Edition by Majorie DiLorenzo, Susan Strasinger

Exercise 34

A premature infant develops jaundice. Laboratory tests are negative for hemolytic disease of the newborn, but the infant’s bilirubin level continues to rise. Abnormal urinalysis results include a dark yellow color, positive bilirubin, and needle-shaped crystals seen on microscopic examination.

a. What is the most probable cause of the infant’s jaundice?

b. Could these same urine findings be associated with an adult? Explain your answer.

c. What kinds of crystals are present? Name another type of crystal with a spherical shape that is associated with this condition.

d. When blood is drawn from this infant, what precaution should be taken to ensure the integrity of the specimen?

Step 1 of 4

a.

Tyrosinemia type 1 is seen in premature infants caused by poor development of liver function.

• Liver is damaged due to hepatitis or cirrhosis condition

• The conjugated bilirubin only occurs in urine when degradation phase is disturbed due to bile duct obstruction (post hepatic jaundice)

• Absence or presence of bilirubin in urine helps to identify clinical jaundice

• Urinary bilirubin provides premature indication of liver disease. Urine bilirubin may show +ve or -ve result for liver damage

• Negative result is seen in urine bilirubin for hemolytic disease