ICU Case Pre - Labs Drft
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Transcript of ICU Case Pre - Labs Drft
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7/29/2019 ICU Case Pre - Labs Drft
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Date: 08/17/13
TYPE OF
EXAM
NORMAL
VALUES
UNIT RESULTS RESULTS RESULTS RESULTS SIGNIFICANCE
08/25/13 08/28/13 08/31/13 09/04/13Physical Properties
Color Straw,
Amber
- Straw Straw Straw Straw
Transparency Clear - Hazy Hazy Hazy Hazy
Reaction 4.5-8 pH 5.0 6.5 6.5 6.0
SpecificGravity
1.010-1.025 - 1.020 1.015 1.015 1.020
Chemical TestSugar Negative - (-) (-) (-) (-)
Albumin Negative - trace (-) (-) (+)
Pus Cells 0-5 /hpf 1-3 0-1 1-2 1-4
RBC 0-2/hpf /hpf 25-30 20-30 70-90 60-80
Crystals
Amorphous
Urates
Occasional-
Few
- Many Few Occasional Occasional
Squamous
EpithelialCells
Occasional-
Few
- Few Few Occasional Occasional
Yeast Cell None - Many
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RESULTS NORMAL
VALUES
SIGNIFICANCE
08/25/13 08/26/13 08/29/13 09/01/13
Hemoglobin 172 g/L 142 g/L 133 g/L 126g/L 135180 g/L
Hematocrit 0.54 L/L 0.44 L/L 0.40 L/L 0.38 L/L 0.40.54 L/L
Red BloodCells
6.23(1012/L)
5.29(1012/L)
4.80(1012/L)
4.53(1012/L)
4.66.2(1012/L)
White Blood
Cells
10.44
(109/L)
12.48
(109/L)
21.38
(109/L)
29.94
(109/L)
4.5 - 11
(109/L)
RESULTS NORMALVALUES
SIGNIFICANCE
08/25/13 08/26/13 08/29/13 08/25/13Differential CountNeutrophil NumberFraction
0.79 0.84 0.82 0.75 0.500.70Segmenters
Lymphocytes 0.16 0.10 0.10 0.22 0.20 -0.40
RESULTS NORMAL
VALUES
SIGNIFICANCE
08/25/13 08/26/13 08/29/13 08/25/13
Eosinophils 0.01 0.01 0.01 0.02 0.010.04
Monocyte 0.02 0.05 0.06 0.01 0.040.08
Basophil 0.01 0.01 0.01 0.00 0.000.01
MCH 27.60 27.80 27.70 27.80 26.2036.68
fmol
MCV 86.60 83.80 82.80 82.80 82.75100.5
fL
MCHC 31.90 33.20 33.70 33.60 31.6533.75g/L
Platelet 361 276 237 273 150450(109/L)
ESR 55mm/hr _____ _____ _____ 0-10mm/hr
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RESULTS NORMAL VALUES SIGNIFICANCE
ALT/SGPT 368.29 U/L 12-78 U/L
RESULTS NORMAL VALUES SIGNIFICANCE
Uric Acid 770.30 Umol/L 155-428 Umol/L
Date: 08/25/13
RESULTS NORMAL VALUES SIGNIFICANCE
FBS 15.50 mmol/L 4.1-5.9 mmol/L
RESULTS NORMAL VALUES SIGNIFICANCE
Cholesterol 5.46 mmol/L 1.3-5.2 mmol/L
Triglycerides 2.13 mmol/L 0.17-1.70 mmol/L
HDL 1.09 mmol/L 0.90-1.55 mmol/L
LDL 3.40 mmol/L 0-3.9 mmol/L
RESULTS NORMAL
VALUE
SIGNFICANCE
Creatinine
08/25/13 08/26/13 08/29/13 08/31/13 09/03/13
53-115
Umol/L162.90
Umol/L
159.40
Umol/L
93.70
Umol/L
99.80
Umol/L
90.40
Umol/L
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RESULTS NORMAL VALUES SIGNIFICANCE
Total Protein 86.20 g/L 64-82 g/L
Date: 08/25/13
RESULTS NORMAL VALUES SIGNIFICANCEAlbumin 49.30 g/L 34-50 g/L
Date: 08/25/13
RESULTS NORMAL VALUES SIGNIFICANCE
Globulin 36.90 g/L 23-35 g/L
Date: 08/25/13
RESULTS NORMAL VALUES SIGNIFICANCE
A/G Ratio 1.3 1.5-2.4 ..
RESULTS NORMAL
VALUES
SIGNIFICANCE
08/25/13 08/26/13 08/29/13 08/31/13 09/03/13
Sodium 147.6
mmol/L
146.2
mmol/L
142.4
mmol/L
136.2
mmol/L
139.1
mmol/L
135-148
mmol/L
Potassium 4.07
mmol/L
3.92
mmol/L
3.75
mmol/L
3.78
mmol/L
3.83
mmol/L
3.5-5.3
mmol/L
Calcium 2.01mmol/L
1.73mmol/L
_____ 3.50 1.95 2.12-2.52mmol/L
09/01/13
Magnesium 0.60mmol/L
0.74 -0.99mmol/L
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Date: 08/25/13
TYPE OF
EXAM
NORMAL
VALUES
UNIT RESULT SIGNIFICANCE OF ABNORMAL
RESULTS
Protime
Patient 11.5-15.5 sec 13.7 Within Normal Limits.% Activity - - 89%
INR - - 1.08
Normal Control 75-101 % 92
Date: 08/25/13
TYPE OF
EXAM
NORMAL
VALUES
UNIT RESULT SIGNIFICANCE OF ABNORMAL
RESULTS
Protime
APTT 24 - 35 sec 30.8 Within Normal Limits.
Normal Control 25 - 36 sec 32.9 Within Normal Limits
Date: 8-26-13
RESULTS VALUES SIGNIFICANCE
Hb1AC 5.3 % 4.05.6 % (normal)5.76.4 % (pre diabetes)
6.5 % and higer(diabetic)
Within normal limits.
Name of Examination: ETA, Gram stain, KOH
Results:
Date: 09/01/13
Gram stain > 500 polymorphonuclear cells/lpf
< 5 squamous epithelial cells/lpf
Occasional gram (+) cocci singly and pairsFew gram (-) bacilli
KOH: (-) fungi
Date: 08/25/13
Gram stain > 100 polymorphonuclear cells/lpf
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< 5 squamous epithelial cells/lpf
Occasional gram (-) bacilli and gram (+) cocci singly
Name of Examination: Culture and Sensitivity Testing
Specimen: Blood
Results:
Date: 08/28/13
No growth after 12 hours of incubation
No growth after 3 days of incubation
Date: 08/30/13
Mg 0.60 mmol/L 0.740.99 with specimen done twice
Date: 09/01/13
No growth after 7 days of incubation
Date: 09/04/13
MedicationHeavy Growth of
P. aeruginosaInterpretation Medication
Heavy Growth of
P. aeruginosaInterpretation
amikacin 21mm strong aztreonam 6mm resistant
cefepime 18mm strong ceftazidine 6mm resistant
ciprofloxacin 6mm resistant gentamycin 15mm strong
levofloxacin 14mm intermediate meroperem 6mmresistant
piperacillin 14mm resistantpiperacillin/
tazobactam9mm intermediate
ricarcillin 6mm resistant
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Fecalysis
Actual ValueNormal Value
Significance
08/25/13
ColorBrown Yellow-Brown
ConsistencyMucoid Solid and formed
Occult Blood------- Negative
MicroorganismNo ova or parasites
seenNegative
Utz
Results:
a. Liver: The liver is normal in size and parenchymal echopattern. No focal mass lesion.The intrahepatic ducts not dilated.
b. Common Bile Duct: The common bile duct is 0.4cm in its widest visualized diameter.c. Gallbladder: The gallbladder is not enlarged. The wall is not thickened. No
intraluminal ehoes seen.
d. Pancreas: The pancreas is obscured.e. Spleen: The spleen is normal in size and parenchymal echopattern. No focal masses
seen.
f. Kidneys: There is no significant disparity in the size of the kidneys. Right kidneymeasures 11.0 x 5.1 x 4.3 (L x W x AP) with cortical thickness of 1.0cm. Central echocomplex intact. Cortico- medullary demarcation well defined. No lithiasis or focal
lesions seen
g. Urinary Bladder: The urinary bladder is partially distended. Its wall is not thickened.No intraluminal echoes noted. Inflated FC 3 is seen intraluminally
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h. Prostate: The prostate is not enlarged, measuring 2.7 x 4.2 x 3.9 cm with approximateweight of 23.0g. No focal mass seen. There is no peripheral assymetry. Prostatic
capsule intact.
i. No ascitesRemarks:
NORMAL LIVER, GALLBLADDER, SPLEEN, KIDNEYS, PROSTATE
ULTRASOUND.
Cranial CTResults:
Plain tomographic sections of the head reveal no focal lesion on The ventricles are unenlarged Cerebral sulci and cisterns are intact. No extra- axial fluid demonstrated. The midline structures are undisplaced. The posterior fossa, brainstem,and sellon region do not appear unusual. The petromastoids, included orbits, paranasal sinuses and bony calvarium appear
unremarkable.
Impression
Essentially unremarkable plain cranial CT study.
CXR AP
Definition:
Results:
Follow- up study done as compared with previous film taken on 8/25/13 shows regression
of the hazy densities in both lungs.
ET is still seen with its tip approximately 1.5cm above the carina.
The rest of the findings are unremarkable.
Impression:
Pulmonary edema with regression.
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s/p ET insertion
Follow- up is suggested.
Doppler Echocardiography
Date: 09/02/13
i. Results and Findings:Actual Value Normal Value
EF% (m-mode) 65% (53.077.0) %
Impression:
Trivial mosaic color flow display across tricuspid valve during systole.
Normal mitral flow velocity E/A ratio
Normal pulmonary artery pressure by right ventricular acceleration time.
Conclusion:
Normal left ventricle with good wall motion contractility and systolic function
Trivial tricuspid regurgitation.
Normal pulmonary artery pressure.