Canadian Society for Medical Laboratory Science (CSMLS) Practice Exam

Which urine chemistry test may be positive in a patient with uncontrolled diabetes mellitus?

1. Nitrate and protein

2. Glucose and ketone bodies

3. Glucose and nitrate

4. Protein and ketone bodies

The correct answer is: Glucose and ketone bodies

In the context of uncontrolled diabetes mellitus, the presence of glucose and ketone bodies in urine is indicative of the body’s inability to utilize glucose effectively due to insufficient insulin. In uncontrolled diabetes, the blood sugar levels can become exceedingly high, leading to glucosuria, or the excretion of glucose in urine, as the kidneys cannot reabsorb all of the excess glucose. Moreover, when the body starts to break down fat as an alternative energy source due to insufficient glucose uptake, it produces ketones. This process can result in ketonuria, which is the presence of ketone bodies in urine. Therefore, both glucose and ketone bodies can be expected to be positive in patients with uncontrolled diabetes mellitus, reflecting metabolic derangements that can lead to serious complications such as diabetic ketoacidosis. The other options do not align with the typical manifestations of uncontrolled diabetes. For instance, while nitrates can indicate bacterial infection, they are not directly related to diabetes management issues. The presence of protein can indicate several conditions but is not specifically connected to the acute metabolic state of diabetes.