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Urinalysis Interpretation: Part I

Matthew DeLaney, MD and Doug Wallace, MD
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Both urine dipstick and urine microscopy are reasonable first line tests for patients who have signs of a urinary tract infection. For healthy females with uncomplicated cystitis no further testing is required. For other patients, clinicians should consider ordering a urine culture. For most patients with asymptomatic bacteriuria, the risk of using antibiotics outweighs any benefit.

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Kapil S. -

Hello, Family medicine resident from Alberta Canada here. I was under the impression from my teachings that you need at least a Specific Gravity of >/ (equal to or greater than) 1.015 to ensure a valid negative pregnancy test because if not it can indicate a dilute sample and therefore can be falsely negative. Is this not true?

- Kapil

Mike W., MD -

From Matt Delaney:
Great question. You are right that when you get a low specific gravity you have to start worrying about a false negative urine pregnancy test. In many systems a low specific gravity will trigger some type of warning or error from the lab but if you're looking at your own dipstick then there may be no warning. If you have a patient who you suspect is pregnant and they have a low SG and a negative pregnancy test it make sense to get another urine sample (first void in the morning ideally) or check at serum HCG.

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Hippo Peds RAP - March 2020 Written Summary 305 KB - PDF

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