However, this is a common finding in renal insufficiency/failure associated with malignant hypertension or diabetes. Protein in the urine may be a sign of pyelonephritis or it could be due to dehydration or starvation. A low specific gravity (<1.005) could result in a false-negative pregnancy test. A high specific gravity (>1.035) could be a sign of contamination. The specific gravity should usually be between 1.002 and 1.030. Greater than five epithelial cells on microscopic evaluation is likely a sign of contamination. Beware of ContaminationĪ contaminated urine specimen can give a large amount of false data on a dipstick test. Following is a review of the urinalysis and possible pitfalls. Errors in the interpretation of urinalysis results are common and can be catastrophic. Although ultimately the conclusion may be correct, the opportunity to make an important diagnosis may be lost. A diagnosis is made and the discharge paperwork is completed as we anticipate encountering a simple UTI. We often see the urinalysis results even before we see the patient. Search “Satisficing”: calling off the search when one thing has been found and missing something else.Sutton’s slip: the error of going for the obvious and missing other possibilities.Two different cognitive medical errors come to mind when interpreting the urinalysis. However, as helpful as it is, it has also led many clinicians down the wrong path towards chaos. The urinalysis is a vital tool in evaluating patients. Since the times of ancient medicine, the urinalysis has been used to screen for a host of diseases. The maxim that states “all females between ages 10 and 60 with abdominal pain must have a urine pregnancy test” has been ingrained into our cerebral cortexes.
Every day in the practice of medicine, hundreds of thousands of urine samples are tested.
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