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XII.

Laboratory/Diagnostic Results and Interpretations (Ordered by date)

11/21/13 EXAMINATION: Troponin-T Quantitative SPECIMEN: Heparinized Whole Blood RESULT: 332 ng/L INTERPRETATION: 100-2000ng/L = acute MI likely; consider differential diagnosis and other causes of Troponin T elevation

11/21/13 ARTERIAL BLOOD GAS * O2 @ 2LPM RESULT pH= 7.473 PCO2= 13.2 PO2= 106.3 HCO3= 16.4 BE= -14.1 O2= 99.3 NORMAL RANGE 7.35-7.45 35-45 mmHg 80-100 mmHg 22-26 mmol 2 mmol 97% Interpretation The result indicates Uncompensated Respiratory Alkalosis

11/21/13 CHEST X-RAY > Hazy densities in the bases. Heart enlarged with CI ratio of .62. Tortuous thoracic aorta, trachea, diaphragm & soft tissue unremarkable. Conclusion: Cardiomegaly, with CT ratio of .62, LU form. Atheromatous thoracic aorta. Edema, bases.

11/21/13 Ultrasound Conclusion: Gallstones with cholecystitis, pelvocaliecasia & ureterectasia, minimal, likely due to stone in the ureter, left side. Umbilical hernia Atheromatous abdominal aorta. Normal liver, pancreas, spleen, right kidney, urinary bladder, uterus.

11/21/13 COAGULATION Clotting line Bleeding line result 548 257 unit min. & sec min. & sec range 2-6 1-3 interpretation The results indicate normal clotting time and it is within boarder line

BLOOD CHEMISTRY result range interpretation

Magnesium

1.2 mg/dL

1.57-2.47

Calcium

6.15 mg/dL

8.6-10

Low magnesium level may indicate of inadequate consumption of magnesium in the body Low levels of calcium may indicate kidney damage

11/21/13 Fecalysis Color: greenish Consistency: soft Interpretation Greenish color from diet intake and medication, and increase in fecal content

11/22/13 Fecalysis Color: yellowish-brown Consistency: soft Interpretation Normal color, with increased fecal content

11/22/13 TEST Chemistry RESULT UNIT RANGE Interpretation

Albumin

L 2.3

g/dL

3.4-5.5

Reduced levels of albumin may reflect a variety of conditions, including primary liver disease,increased breakdown of macromolecules resulting from tissue damage or inflammation, malnutrition, malabsorption syndromes, andrenal

diseases

ALT (SGPT)

H 58

u/L

0-34

CK-MB

12.4

mg/dL

< 24

Uric Acid

H 15.1

mg/dL

2.6-6

Ionized Calcium

1.06

mmol/ L

1.0-1.4

Elevated levels of thisenzyme can be an indication of viral hepatitis and other forms of liver disease. CK MB is one of the cardiac markers. Elevated levels may indicate heart damage. Any kind of heart muscle damage can cause an increase in CK and CK-MB, including physical damage from trauma, surgery, inflammation, and decreased oxygen (ischemia). Kidney failure can also cause a high CK-MB level. Increase in waste product of cell metabolism in the bodies. Along with BUN and creatinine, uric acid is excreted by the kidneys Low ionized calcium values are often seen in renal disease, critically ill patients, or patients receiving rapid transfusion

Potassium

L .30

MEQ/L

3.5-5.5

Creatinine

H 2.99

Mg/dL

0.6-1.20

of citrated whole blood or blood products. Decrease in serum potassium is seen usually in states characterized by excess K+ loss, such as in vomiting, diarrhea, villous adenoma of the colorectum, certain renal tubular defects and hypercorticoidism Indicative of renal functional impairment

Hematology ESR H 135.0 mm/hr 0-2 high ESR count could mean that one is suffering from some kind of infection, an inflammation of the major arteries, lupus, or even anemia. The entire premise of the test is that during an inflam high ESR count could mean that one is suffering from some kind of

infection, an inflammation of the major arteries, lupus, or even anemia. The entire premise of the test is that during an inflammatory phase the levels of coagulant fibrinogen in the blood causes the red blood cells to clump together and fall to the bottom of a measuring tube. However, this same effect can also happen in conditions like anemia as well.matory phase the levels of coagulant fibrinogen in the blood causes the red blood cells to clump together and fall to the bottom of a measuring tube. However, this same effect can also

happen in conditions like anemia as well. CBC

Total WBC

H 21.5

x10^9/L

4.50-11.00

Total RBC

4.15

x10^12/L

3.69-5.90

Hemoglobin

L 11.80

g/dL

12-16

Hematocrit

L 33.60

36-46

MCV

81.0

Fl

80-100

High level of WBC is indicative of infection May indicate anemia, a common blood disorder that is defined as a decrease in the number of red blood cells. Low hemoglobin levels indicate low-oxygen carrying capacity in the blood Decrease in volume percentage of RBC in blood due to impaired erythropoietin production; may also be caused by acute blood loss. Caused by Vitamin B12 deficiency associated with macrocytic anemia. A

MCH

28.40

Pg

26.10-33.30

MCHC Platelet count

35.1 L 140

g/dL x10^9/L

31-37 150-390

high MCV may also be a sign of bone marrow stress in these patients. It does not have independent prognostic significance. Low levels of Mean Corpuscular Hemoglobin level indicates too little hemoglobin concentrations in the blood Indicative of Anemia. Uncontrolled bleeding may be a problem. Clotting is deficient.

Differential Count Neutrophils Lymphocytes H 84.6 L 8.4 37-72 20-50 Indicates infection Low lymphocyte count may indicate high susceptibility to infection It may be indicative of various disease states

Monocytes

L 6.8

8-14

Eosinophils

0.2

0-6

Basophils

0.0

0-1

RDW-OV

H 15.4

11.5-14.5

Uncontrolled bleeding may be a problem. Clotting is deficient. Basophils are chiefly responsible for allergic and antigen response by releasing the chemical histamine causing vasodilation Elevated RDW helps provide a clue for a diagnosis of early nutritional deficiency such as iron, folate, or vitamin B12 deficency as it becomes elevated earlier than other red blood cell parameters.