27

III. LABORATORY AND DIAGNOSTIC EXAMINATIONS

HEMATOLOGY
October 24, 2014
EXAMINATION

RESULT

NORMAL

Hemoglobin

140

VALUES
120.00 150.00 Normal. Red blood cells
g/L

INTERPRETATION

carry

oxygen

from

the lungs to the rest of

the body. They also carry
carbon dioxide back to
the lungs so it can be
exhaled.

If

the

RBC

count is low (anemia),

the body may not be
getting

the

oxygen

it

needs. If the count is too

high

(a

condition

called polycythemia),
there is a chance that the
red blood cells will clump
together and block tiny
blood
(capillaries).

vessels
This

also

makes it hard for your

28

red blood cells to carry

Hematocrit

0.42

0.40 0.54

oxygen.
Normal.

This

test

measures the amount of

space (volume) red blood
cells take up in the blood.
The value is given as a
percentage of red blood
cells in a volume of
blood.

For

example,

a hematocrit of 38 means
that 38% of the blood's
volume is made of red
blood cells. Hematocrit
and hemoglobin values
are the two major tests
that show if anemia or
Leukocytes

No. 9.84

Concentration

polycythemia is present.
5.00 10.00 x White blood cells protect
10^ 9/L

the

body

against

Segmenters

0.67

0.40 0.60

infection. If an infection

Lymphocytes

0.27

0.25 0.40

develops,

Monocytes

0.05

0.01 0.12

cells attack and destroy

Eosinophils

0.01

0.01 0.05

the bacteria, virus, or

white

blood

29

Basophils

0.005

other organism causing

Stabs

0.01 0.05

it. White blood cells are

bigger than red blood
cells

but

fewer

in

number. When a person

has a bacterial infection,
the number of white cells
rises

very

quickly.

Segmenters

or

neutrophils
primary

are
cells

the
that

respond to a bacterial
infection. High levels of
your neutrophils usually
represent and ongoing
infection,

an

inflammation,

physical

stress and malignancy,

caused by some drug,
etc.

Low

lymphocytes

count indicates that the

body is low on infection
resistance. This means

30

the body is susceptible to

infections like tumors and
cancer. Low lymphocytes
count can also lead to
the damage of various
body organs.
Thrombocytes

316

150.00 440.00 Normal.

x 10 ^9/L

Platelets

(thrombocytes) are the

smallest type of blood
cell. They are important
in blood clotting. When
bleeding

occurs,

platelets

swell,

together,

and

the
clump

form

sticky plug that helps

stop the bleeding. If there
are too few platelets,
uncontrolled

bleeding

may be a problem. If
there

are

too

platelets,

there

chance

of

many
is

a blood

clot forming in a blood

31

vessel.
may

Also,
be

platelets

involved

in

hardening of the arteries

BLOOD CHEMISTRY
October 24, 2013
ELECTROLYTES
EXAMINATION
S. SODIUM

RESULT

NORMAL

141

VALUES
136.00 145.00 Normal. This portion of
mmo/L

INTERPRETATION

the

test

shows

amount

of

the

sodium

present in the blood.

The kidneys work to
excrete

any

excess

sodium that is ingested

in food and beverages.
Sodium levels fluctuate
with

dehydration

or

over-hydration, the food

and
consumed,

beverages
diarrhea,

32

endocrine

disorders,

water retention (various

causes),
S.POTASSIUM

3.17

3.50
mmo/L

trauma

and

bleeding.
5.00 Decreased. This may
be seen in the following
conditions:
Gastrointestinal
disorders
with

associated

diarrhea

and

vomiting;
Hyperaldosteronism;
Deficient
intake

potassium
(rare);

complication

As

a
of

acetaminophen
overdose; In diabetes,
the potassium level may
fall after someone takes
insulin, particularly if the
person

has

not

managed their diabetes

well.; Low potassium is
commonly due to "water

33

pills"
wasting

(potassiumdiuretics);

someone

is

if

taking

these, their doctor will

check their potassium
level

regularly.;

Additionally,
drugs

certain

such

as

corticosteroids,
adrenergic

betaagonists

such as isoproterenol,
alpha-adrenergic
antagonists

such

as

clonidine,

antibiotics

such as gentamicin and

carbenicillin,

and

antifungal

agent

amphotericin
cause
potassium.

the

loss

can
of

34

BLOOD CHEMISTRY
October 25, 2014
EXAMINATION

RESULT

NORMAL

INTERPRETATION

FBS

6.57

VALUES
4.11-5.89 mmo/L

Elevated. High levels of

glucose most frequently
indicate diabetes,

but

many other diseases

and conditions can also
cause elevated blood
glucose. Moderately
increased

blood

glucose levels may be

seen in those with prediabetes.

Left

addressed,

unpre-

diabetes increases the

risk of developing type
2 diabetes. Some other
diseases
conditions

and
that

can

result in an elevated
blood
include:

glucose

level

Acromegaly;

35

Acute stress (response

to trauma, heart attack,
and stroke for
instance);

Chronic

kidney failure; Cushing

syndrome;

Excessive

food

intake;

Hyperthyroidism;
Pancreatic cancer; and
Pancreatitis
Creatinine

48.4

45-84 umol/L

Normal.

Creatinine,

done along with BUN

(Blood Urea Nitrogen),
may
routinely

be

ordered

as

part

of

comprehensive or basic
metabolic panel, during
a health examination. It
may be ordered when a
person has non-specific
health
when
is acutely ill,

complaints,
someone
and/or

36

when a doctor suspects

that a person's kidneys
are

not

working

properly.

If

the

creatinine

and

BUN

tests are found to be

abnormal or if someone
has

an

underlying

disease,

such

as diabetes,
known

to

that

is

affect

the

kidneys, then these two

tests may be used to
monitor the progress of
kidney dysfunction and
the
SGPT (ALT)

11

Up to 32 u/L

effectiveness

treatment.
The

of

alanine

aminotransferase (ALT)
test is typically used to
detect liver injury. It is
often

ordered

conjunction
aspartate

in
with

37

aminotransferase
(AST) or

as

part

of

a liver panel to screen

for
Total Cholesterol
Triglycerides

190
85
46

15-200 mg/dL
<325 mg/dL
45-65 mg/dL

HDL (High Density

127

66-178 mg/dL

and/or

help

diagnose liver disease.

A total cholesterol test
measures all types of
cholesterol

in

your

Lipoprotein)

blood. The result of this

LDL (Low Density

test tells your doctor

Lipoprotein)

whether

your

cholesterol is too high.

If your total cholesterol
levels are high, your
doctor will want to know
your

LDL

cholesterol

and

HDL

cholesterol

levels before deciding

whether

you

need

treatment. HDL stands

for
lipoprotein.
sometimes

high-density
It's

also
called

"good" cholesterol. You

38

want

your

HDL

cholesterol to be high.
Studies of both men
and

women

have

shown that the higher

your HDL, the lower
your risk of coronary
artery disease. This is
why HDL is sometimes
referred to as "good"
cholesterol. LDL stands
for

low-density

lipoprotein.

It's

also

sometimes called "bad"

cholesterol. Your LDL
level is what doctors
watch most closely. You
want your LDL to be
low. Too much LDL is
linked to cardiovascular
disease. If it gets too
high,

you

treatment.

will

need

39

URINALYSIS
October 25, 2014
Examination
Color

Normal Values
Pale yellow
amber

Result

to Yellow

Interpretation
Normal urine color is due to the
presence of a pigment called
urochrome. Urine color varies
based

on

concentration

the
and

urine
chemical

composition. Normal urine can

vary from pale light yellow to a
dark amber color. How dark or
light the color is tells you how
Sugar

Negative

Trace

much water is in it.

Normally the amount of sugar
(glucose) in urine is too low to
be detected. Glucose present in
the urine is termed glucosuria.
Most commonly, this indicates
diabetes mellitus but is also
often seen in pregnancy. It is
due to either a high blood
glucose level or a decreased
kidney threshold concentration.
When
exceed
mg/dL,

blood

glucose

approximately
the

proximal

levels
180
tubules

40

become

overwhelmed

cannot

reabsorb

the

and
excess

glucose. As a result, glucose is

Albumin

Negative

Negative

then excreted in the urine.

Normal. Low levels of protein in
urine

are

normal.

Small

increases in protein in urine

usually

aren't

cause

for

concern, but larger amounts

SP-Gravity

1.015-1.025

1.010

Epithelial cells

Few

Few

may indicate a kidney problem.

Often specific gravity is reflective
of hydration status; however, it
can be inaccurate. Low specific
gravity is seen in patients with
impaired urinary concentrating
ability (eg, diabetes insipidus,
sickle cell nephropathy, acute
tubular necrosis). In addition,
low values may be seen due to
glucose, urea, or alkaline urate.
Normal. Cells that line your
hollow organs and form your
skin in your urine may be a
sign of a tumor. But more often,
they indicate that the urine
sample

was

contaminated

during the test, and a new

Pus Cells

<5

0-2

sample is needed.
Normal. There is no presence of
infection.

41

October 28, 2013

ELECTROLYTES
EXAMINATION
S.POTASSIUM

RESULT

NORMAL

4.66

VALUES
3.50

mmo/L

INTERPRETATION
5.00 Normal.
testing
ordered,

Potassium
is

frequently
along

with

other electrolytes, as part

of a routine physical. It is
used

to

detect

concentrations that are

too high (hyperkalemia)
or too low (hypokalemia).
The most common cause
of hyperkalemia iskidney
disease, but many drugs
can decrease potassium

42

excretion from the body

and

result

condition.

in

this

Hypokalemia

can occur if someone

has

diarrhea

and

vomiting or if is sweating
excessively.

Potassium

can be lost through the

kidneys in urine; in rare
cases, potassium may be
low because someone is
not getting enough in
their diet. The potassium
test may be ordered at
regular

intervals

to

monitor effects of drugs

that

can

kidneys

cause
to

the
lose

potassium,
particularly diuretics.
Monitoring may also be
done if someone has a
condition

or

disease,

43

such
as acute orchronic kidne
y failure, that can be
associated with abnormal
potassium levels.

MISCELLANEOUS
October 28, 2014
Specimen: Blood
Exam desired: Troponin-T
Findings: Positive
Blood Chemistry
October 31, 2013
EXAMINATION

RESULT

NORMAL

INTERPRETATION

S.POTASSIUM
Creatinine

2.92
57.40

VALUES
3.50-5.00 mmol/L
45-84 umol/L

Decreased.
Normal.
Creatinine,
done along with BUN
(Blood Urea Nitrogen),
may
routinely

be
as

ordered
part

of

comprehensive or basic

44

metabolic panel, during

a health examination. It
may be ordered when a
person has non-specific
health

complaints,

when

someone

is acutely ill,

and/or

when a doctor suspects

that a person's kidneys
are

not

working

properly.

If

the

creatinine

and

BUN

tests are found to be

abnormal or if someone
has

an

underlying

disease,

such

as diabetes,
known

to

that

is

affect

the

kidneys, then these two

tests may be used to
monitor the progress of
kidney dysfunction and
the

effectiveness

of

45

treatment.

November 4, 2014
ELECTROLYTES
EXAMINATION
S. SODIUM

RESULT

NORMAL

123

VALUES
135.00 148.00 Decreased.
mmo/L

INTERPRETATION
Indicates

hypokalemia and may

due to lose stool or
urine and with the use

S.POTASSIUM
S.CALCIUM

4.03
1.00

of Diuretics.
3.5 5.5 mmo/L
Normal.
1.12

1.32 Decreased. A low level

mmo/L

of

blood

sodium

is

usually due to loss of

too much sodium, too
much water intake or
retention, or to excess
fluid

accumulation

the

body

in

(edema).

Sodium levels may get

too low if your body is

46

losing too much water

and electrolytes. It may
also be a symptom of
certain

medical

conditions. Causes of
low

sodium

severe

include:

vomiting

or

diarrhea; taking certain

medications,

including

anti-depressants

and

pain medications; use

of diuretics (water pills);
drinking too much water
during

exercise

(although this is very

rare);

dehydration;

kidney
failure;

disease
liver

heart

disease;
problems

adrenal
disorders,

or

gland
such

Addisons
hypothyroidism

as

disease

47

(underactive thyroid)

October 24, 2014

2DECHO

Left Ventricle

Left Function

IVSD 1.5 (8.00-11 mm)

LV EDV 102 (92-125 mm)

A 2.8

LVEDD 4.4 (46.00-5.00 mm)

LV ESV 38

LA 4.1

PWD 1.3 (8.00-11.00 mm)

SV 64

LA/AD

PWS 1.1

EF 62.9

AvO 1.1

IVSS 1.7

FS 34.0

ET

LV MASS

PEP

HR 112 BPM

PA 2.8

CO 1.7

PA/AQ

Right Ventricle
RV-EDD 2.3

RA 3.4
Conclusion
1.
2.
3.
4.
5.

Coronary Artery Disease

Concentric LV Hypertrophy
LA Dilation
Aortic Sclerosis
Normal LV Systolic Function

November 4, 2014
CHEST AP PORTABLE
Chest Supine: Heart appears enlarged. Both lung fields are clear.
Impression: Cardiomegaly

48