1. By Naomi, Rayvin, and Miranda
Patient #4
By Naomi, Rayvin, and Miranda

2. Case study
A 15-year-old female comes in for her annual physical. Her mom informs you that she is worried because the girl has been on a strict diet and has lost a great deal of weight in the past few months. She has very little energy and does not seem interested in hanging out with her friends. The girl mentions that she has been losing some hair lately and she has not menstruated over three months. Microscopic analysis of her urine does not reveal anything abnormal.

3. Macroscopic and Microscopic Analysis
Macroscopic Analysis
The urine was almost colorless and clear.
Microscopic analysis
No erythrocytes or leukocytes were found present.

4. Chemical analysis The pH was Low. The specific gravity was normal.
The protein level was normal.
The glucose level was normal.
The Ketone level was elevated.

5. Low ph could indicate acidosis dehydration diabetic ketoacidosis
diarrhea
starvation

6. Elevated ketones could indicate
Abnormal food or nutrition intake due to: anorexia nervosa (an eating disorder), fasting, high protein or low carbohydrate diet, starvation, vomiting over a long period
Disorders of increased metabolism
Acute or severe illness
Burns
Fever
Hyperthyroidism
Nursing a baby (lactation)
Pregnancy

7. Symptoms Extreme weight loss Insomnia Abnormal blood count
Thin hair or hair that falls out
Dry skin
Irregular heart rhythms
Low blood pressure
Irregular Menstruation