Which finding in a urinalysis would suggest a serious illness?

• A. Presence of glucose and protein
• B. Absence of leukocytes
• C. Normal color
• D. Trace ketones

Answer: (A)

Abnormal urine findings that point to kidney or metabolic problems are a red flag. When glucose and protein appear together in the urine, it signals two different disruptions: the kidney’s ability to reabsorb sugar is overwhelmed or impaired, and the filtering barrier is letting larger molecules through. Glucose in the urine (glycosuria) happens when blood glucose is high enough to spill into the urine, as in diabetes, or when kidney transport mechanisms aren’t working properly. Protein in the urine (proteinuria) indicates that the glomerular filter is more permeable than normal or that tubular handling of proteins is disrupted—both of which can reflect kidney damage or disease. Seeing both at once makes the finding much more concerning than the other options, because it combines a metabolic issue with a sign of kidney involvement, pointing to potentially serious illness that needs further evaluation. Absence of leukocytes and a normal urine color are not abnormal findings, and trace ketones can occur for benign reasons like fasting or low-carbohydrate intake, though they can be relevant in other contexts.