VII.

Laboratory Results

Laboratory (July 12, 2012) Hemoglobin

Normal Values 140 180

Results 117.0

Analysis and Interpretation Low - High blood losses could lead to low levels of hemoglobin and anemia. It can also lead to a lack of oxygen supply to the tissues. Low results can lead to have anemia Normal Low decreased number of RBC may lead to have anemia ; Poor diet and nutritional deficiencies may lead to a low red blood cell count High it indicates of inflammation that correlates with the disease. It also indicates spontaneous bacterial peritonitis, in this case in the context of decompensate hepatitis C liver disease Low - lymphocytes may/get trapped in the spleen or lymph nodes, resulting in a drop in the count. Viral infections can cause a temporary drop in lymphocytes as more of them are drawn away to fight the infection Low there can be an infection because of the symptom like fever. Normal High - Drugs that may increase ALT levels include acetaminophen. Values are significantly increased in obstructive jaundice. High - High levels may indicate liver cell damage. It can indicate that it also the cause of alcohol liver disease Low - Decreased urinary sodium levels may indicate dehydration, liver disease. A low level of blood sodium is usually due to loss of too much sodium, too much water intake or to excess fluid accumulation in the body (edema). If the sodium level falls quickly, the person may feel weak and fatigued Normal High - it indicates that the liver has been damaged High - Increased PT may indicate liver damage. A prolonged PT means that the blood is taking too long to form a clot. This may be caused by conditions such as liver disease, vitamin K deficiency High cause of elevated of PTT because of alcohol abuse. It also indicates of liver damage or disease.

Hematocrit WBC Count RBC Count

0.40 0.54 5.0 10.0 x 109/L 4.5 6.5 x 1012/L

0.35 7.4 3.78

Neutrophil

0.50 0.75

0.87

Lymphocyte

0.25 0.49

0.12

Monocyte Creatinine SGPT (ALT)

0.02 0.06 35.36 123.76 umol/L 0.40 1.40 mg/dL 5 34 U/L

0.01 123.76 1.40 80.0

SGOT (AST)

5 34 U/L

64.0

Sodium

135 145 mEq/L

125.80

Potassium Alkaline Phosphatase Prothrombin Time

3.5 5.5 mEq/L 35 123 IU/L 10 15 seconds

4.33 137 19.12

Partial Thromboplastin Time

24 34 seconds

50.14

Laboratory (July 15, 2012) Hemoglobin

Normal Values 140 180

Results 105

Analysis and Interpretation Low - High blood losses could lead to low levels of hemoglobin and anemia. It can also lead to a lack of oxygen supply to the tissues. Low results can lead to have anemia High it could indicate that there can be increased infection. Low decreased number of RBC may lead to have anemia ; Poor diet and nutritional deficiencies may lead to a low red blood cell count High it indicates of inflammation that correlates with the disease. It also indicates spontaneous bacterial peritonitis, in this case in the context of decompensate hepatitis C liver disease Low - lymphocytes may/get trapped in the spleen or lymph nodes, resulting in a drop in the count. Viral infections can cause a temporary drop in lymphocytes as more of them are drawn away to fight the infection Low there can be an infection because of the symptom like fever.

Hematocrit WBC Count RBC Count

0.400 0.540 5.0 10.0 x 109/L 4.5 6.5 x 1012/L

0.306 12.40 3.31

Neutrophil

50.0 70.0

91.4%

Lymphocyte

20.0 40.0

4.9%

Monocyte

3.0 12.0

0.01

Laboratory (July 18, 2012) BUN

Normal Values 2.18 8.33 mmol/L

Results 16.15 mmol/L

Potassium

3.50 5.30 mmol/L

2.91 mmol/L

Sodium Albumin

135 148 mmol/L 35.00 50.00 R/L

140.30 mmol/L 16.63 R/L

Globulin

23 35 R/L

53.13 R/L

Creatinine

53 106 ummol/L

124.7 ummol/L

Urinalysis

Color: light yellow amber

Amber

Analysis and Interpretation High presence of dehydration, blood protein breakdown, decrease blood flow to kidneys Low decrease of electrolyte imbalance in the body, it can also indicate that it is because of the side effect of the drugs like antibiotics, Normal Low it indicates malnutrition, dehydration, liver dysfunction (the liver shrinks), High presence of liver dysfunction, dehydration, alcoholism, High presence of renal damage or impairment to the body, dehydration, Normal

Transparency: clear

Cloudy

S.G: 1.005 1.025 RBC: 0 3

1.0200 12 15

WBC: 0 2

8 12

Cloudy urine may imply that it is because of dehydration, as well as infection, and there is a present of blood in the urine. There is a presence of dehydration There is apresence of blood in the urine, it can have a sign of infection There is a presence of infection in the urine

Ultrasound Report (July 12, 2012) Whole Abdominal Sonography: The live is small in size with dense and nodular echo patter. The portal vein and its tributaries are not dilated. Gallbladder is contracted with thickened walls. The pancreas is obscured by bowel gas. The spleen is normal size and echo patter. No mass or any discrete lesion is noted. Both kidneys are within normal size. The cortico medullary junctions are well delineated. The renal calices are dense and intact. No stone, mass or any sign of hydronephrosis is noted. Urinary bladder is adequately distended with smooth mucosal outline. No intravesical echo is noted. Massive free fluid is noted in peritoneal cavity. IMPRESSION: Reaction Cholecystitis- contracted liver secondary to liver cirrhosis Normal Spleen, Kidneys and Urinary Bladder Massive Ascites