Which urinalysis combination supports a diagnosis of hematuria?

Which urinalysis combination supports a diagnosis of hematuria?

• A. Positive nitrites with few RBCs
• B. Proteinuria with no RBCs
• C. Positive dipstick for blood and 20-30 RBCs per high-power field
• D. Glycosuria

Answer: (C)

Identifying true hematuria relies on both the dipstick result and microscopic examination. A positive dipstick for blood can come from red blood cells, free hemoglobin, or myoglobin, so you need to see red blood cells on microscopy to confirm actual blood in the urine. When you have a positive dipstick for blood plus a substantial count of red blood cells—20 to 30 per high-power field—that combination supports hematuria. The other patterns don’t fit: nitrites with few RBCs could point to infection but doesn’t confirm blood in urine; proteinuria with no RBCs shows protein loss without bleeding; glycosuria reflects glucose in the urine, not blood.

Identifying true hematuria relies on both the dipstick result and microscopic examination. A positive dipstick for blood can come from red blood cells, free hemoglobin, or myoglobin, so you need to see red blood cells on microscopy to confirm actual blood in the urine. When you have a positive dipstick for blood plus a substantial count of red blood cells—20 to 30 per high-power field—that combination supports hematuria. The other patterns don’t fit: nitrites with few RBCs could point to infection but doesn’t confirm blood in urine; proteinuria with no RBCs shows protein loss without bleeding; glycosuria reflects glucose in the urine, not blood.