Patient’s blood glucose levels were normal by GOD – POD method. But urine shows positive Benedict’s test. The reason for disparity in results is :
First, I need to recall what each test measures. The GOD-POD method is a blood test that uses glucose oxidase and peroxidase enzymes to measure glucose levels. It's specific for glucose in blood. Benedict's test, on the other hand, is a chemical test for reducing sugars in urine. It detects any reducing sugars like glucose, but also other substances like galactose or fructose.
So, if blood glucose is normal, but Benedict's is positive, there must be another reducing sugar present in the urine. The most likely culprit is galactose. Galactosemia is a condition where galactose accumulates in the blood and is excreted in urine. Since galactose is a reducing sugar, it would give a positive Benedict's test even if glucose levels are normal.
Looking at the options, I need to see which one points to another reducing sugar. Other possibilities could be fructose or lactose, but galactosemia is a classic example. The incorrect options might suggest issues with the tests themselves, like hemolysis affecting GOD-POD, but the question states that the blood test was normal. So, the problem isn't with the blood test method but the presence of another sugar in urine.
Wait, could there be other reasons? Maybe if the patient has a high intake of fruits with fructose, but galactosemia is more specific. Also, considering that Benedict's test uses heat and copper ions to detect reducing sugars, the presence of ascorbic acid might interfere, but the question doesn't mention that. So the most likely answer is the presence of galactose in the urine, leading to a false positive in Benedict's test despite normal blood glucose.
**Core Concept**
This question tests understanding of urine glucose testing and the biochemical basis of Benedict’s test. The GOD-POD method measures blood glucose specifically, while Benedict’s test detects **reducing sugars** (e.g., glucose, galactose, fructose) in urine. A discrepancy may arise when non-glucose reducing sugars are present.
**Why the Correct Answer is Right**
A positive Benedict’s test despite normal blood glucose indicates **galactosemia**. Galactose, a reducing sugar, is excreted in urine in conditions like galactose-1-phosphate uridyltransferase deficiency. The GOD-POD method measures glucose via enzyme-specific reactions and does not detect galactose. Thus, galactoseuria (not hyperglycemia) explains the disparity.
**Why Each Wrong Option is Incorrect**
**Option A:** Hemolysis causes false elevations in blood glucose via GOD-POD, not false negatives.
**Option B:** Benedict’s test is not affected by ascorbic acid; this interferes with **iodometric titration**, not Benedict’s.
**Option C:** Lactose is not a common urinary constituent and would require massive intake to affect Benedict’s test.
**Option D:** Fructoseuria (e.g., essential fructosuria) causes false positives, but fructose is not a reducing sugar in the same way as galactose.
**Clinical Pearl / High-Yield Fact