VI.

Laboratory Results 9-11-13 Hematology Specimen: Blood Laboratory Hemoglobin Normal Values M: 130-180 g/L F: 125-165 g/L Result 124 Analysis & Interpretation Abnormal Hemoglobin in the blood carries oxygen from the respiratory organs to the rest of the body where it releases the oxygen to burn nutrients to provide energy to power the functions of the organism. A low hemoglobin count is a commonly seen blood test result. In many cases, a low hemoglobin count that is only slightly lower than normal, isn't considered significant and causes no symptoms. The cause of the slight low hemoglobin count of the patient is may be due to the bleeding in the GI tract brought about by an injury. Abnormal The hematocrit is the proportion, by volume, of the blood that consists of red blood cells. The cause of the patients low hematocrit level is due to a bleeding brought about by an injury in the mucous membrane of the gastrointestinal tract. Abnormal. White blood cells, also called leukocytes, are best known for their ability to fight infection. When a foreign bacteria or virus enters the body, a leukocyte is able to recognize the invader and promptly destroy it before it can cause disease. Infection as infection-causing bacteria or viruses multiply in the blood, the bone marrow produces more white blood cells to fight off the infection. Infection can also lead to inflammation, which can in turn cause the number of white blood cells to increase. Abnormal. It promotes protection against infection. It is a type of WBC, normally found in the bloodstream. They are one of the first-responders of inflammatory cells to migrate towards the site of inflammation and infection. They migrate through the blood vessels, then through interstitial tissue. They are the predominant cells in pus, accounting for its whitish/yellowish appearance. Abnormal Lymphocytes are the cells that determine the specificity of the immune response to infectious microorganisms and other foreign substances. The most common cause of temporary lymphocytopenia is a recent infection, which in the patients case, Gastroenteritis. This occurs after an infection in which the lymphocytes were used up to

Hematocrit

M: 0.42-0.48 F: 0.37.0.42

0.36

WBC Count

5-10x10^9/L

15.1

Neutrophil

0.36-0.66

0.89

Lymphocyte

0.22-0.40

0.11

Platelet Count

150.00400.00x10^9/ L

206

destroy the invading pathogens. Normal The platelet initiates clotting and controls blood loss. The organ responsible for platelets is the liver since she doesnt have any wounds and her liver isnt affected, a normal platelet count would manifest.

9-11-13 Urinalysis Specimen: Urine Laboratory Color Normal Values Colorless to yellow Result Dark Yellow Analysis & Interpretation Abnormal. Urine varies in appearance, depending principally upon a body's level of hydration, as well as other factors. Normal urine is a transparent solution ranging from colorless to amber but is usually a pale yellow. Since the patient has episodes of vomiting and increased frequency of passage of stools, it has a result of dark yellow urine which is often indicative of dehydration. Abnormal. Normally, fresh urine is clear to very slightly cloudy. Excess turbidity results from the presence of suspended particles in the urine. Turbidity of the urine may be evidence of suspended particles which are excreted in the urine which, normally, should be retained in the body such as protein and blood cells such as white blood cells and red blood cells. Normal. The glomerular filtrate of blood plasma is usually acidified by renal tubules and collecting ducts from a pH of 7.4 to about 6 in the final urine. It is because of the increasing amount of sodium and excess acid retained by the body. Urinary PH aids in determining the existence of systemic acid-base disorders. Normal. Specific gravity is defined as the density of a solution compared with the density of a similar volume of distilled water at a similar temperature. Urine is water that contains dissolved chemicals therefore, the specific gravity of urine is a measure of the density of the dissolved chemicals in the specimen. It is influenced not only by the number of particles present but also by their size. Normal. Glucose is normally not found in the urine because the kidneys are able to reclaim all of the filtered glucose back into the bloodstream. Glucose test is used to detect and monitor diabetes mellitus in the body and since the

Transparency

Clear

Turbid

PH

4.5 - 8.0

6.0

Specific Gravity

1.001-1.035

1.020

Glucose

Negative

Negative

Protein

Negative

Trace

WBC

0.00 3.00 hpf

60-70/hpf

RBC

0.00 2.00 hpf

>100/hpf

Epithelial Cells

0.00 3.00 hpf

+2

Bacteria

0.00 50.00 hpf

+2

patient isnt diabetic, a result within normal values is expected. Abnormal. Proteinuria or protein in the urine has to do with the way your kidneys are working. Normally no protein should be "spilled" into the urine. Proteinuria resulting from benign, transient causes is called physiologic proteinuria. Intense physical activity, acute illness, fever, emotional stress and dehydration are common causes of physiologic proteinuria. In the patients case, a trace of proteins in her urine is caused by dehydration. Abnormal. WBCs are larger than RBCs. An increase in urinary WBCs is called pyuria and indicates the presence of an infection or inflammation. WBC is excreted in the urine when there is an increase in white blood cells in the body indicating an inflammation which in her case, Gastroenteritis, which involves the gastrointestinal tract that involves both the stomach and the small intestine. Abnormal. An increase in urinary RBCs is called hematuria and indicates the presence of bleeding in the Urinary tract. The patient might have a Urinary tract infection but was undetected. Normal. It is normal to find a few epithelial cells in urine samples. This is because of the regular shedding of cells from the bladder and external urethra. They are derived from the linings of the genitourinary system. The ureters, which carry urine from the kidneys to the bladder, the bladder itself, and the urethra, which carries urine outside the body, are all lined with epithelial tissue. Normal. Urine is normally sterile, which means that it contains no bacteria. However, unless specimens are collected under sterile conditions, a few bacteria are usually present as a result of vaginal, urethral, external genitalia or collection container contamination. These contaminant bacteria will multiply rapidly in specimens that remain at room temperature for extended periods, but are of no clinical significance.

9-14-13 Urinalysis Specimen: Urine Laboratory Color Normal Values Colorless to yellow Result Yellow Analysis & Interpretation Normal. The yellow color of urine is produced when

Transparency

Clear

Slightly Turbid

PH

4.5 - 8.0

6.0

Specific Gravity

1.001-1.035

1.010

Glucose

Negative

Negative

Protein

Negative

+1

WBC

0.00 3.00 hpf

6-8/hpf

hemoglobin is broken down. The color deepens as the concentration of dissolved solutes increases. The color is caused by the presence of a pigment called urochrome which is a product of endogenous metabolism. Under normal conditions, the body produces it at a constant rate. Abnormal. Normally, fresh urine is clear to very slightly cloudy. Excess turbidity results from the presence of suspended particles in the urine. Turbidity of the urine may be evidence of suspended particles which are excreted in the urine which, normally, should be retained in the body such as protein and blood cells such as white blood cells and red blood cells. Normal. The glomerular filtrate of blood plasma is usually acidified by renal tubules and collecting ducts from a pH of 7.4 to about 6 in the final urine. It is because of the increasing amount of sodium and excess acid retained by the body. Urinary PH aids in determining the existence of systemic acid-base disorders. Normal. Specific gravity is defined as the density of a solution compared with the density of a similar volume of distilled water at a similar temperature. Urine is water that contains dissolved chemicals therefore, the specific gravity of urine is a measure of the density of the dissolved chemicals in the specimen. It is influenced not only by the number of particles present but also by their size. Normal. Glucose is normally not found in the urine because the kidneys are able to reclaim all of the filtered glucose back into the bloodstream. Glucose test is used to detect and monitor diabetes mellitus in the body and since the patient isnt diabetic, a result within normal values is expected. Abnormal. Proteinuria or protein in the urine has to do with the way your kidneys are working. Normally no protein should be "spilled" into the urine. Proteinuria resulting from benign, transient causes is called physiologic proteinuria. Intense physical activity, acute illness, fever, emotional stress and dehydration are common causes of physiologic proteinuria. In the patients case, a protein in her urine is caused by dehydration. Abnormal. WBCs are larger than RBCs. An increase in urinary WBCs is called pyuria and indicates the presence of an infection or inflammation. WBC is excreted in the

RBC

0.00 2.00 hpf

3-5/hpf

Epithelial Cells

0.00 3.00 hpf

+2

Bacteria

0.00 50.00 hpf

+2

Amorphous Materials

Negative

+2

Others: Fine Granular Cast

0-1LPF

urine when there is an increase in white blood cells in the body indicating an inflammation which in her case, Gastroenteritis, which involves the gastrointestinal tract that involves both the stomach and the small intestine. Abnormal. An increase in urinary RBCs is called hematuria and indicates the presence of bleeding in the Urinary tract. The patient might have a Urinary tract infection but was undetected. Normal. It is normal to find a few epithelial cells in urine samples. This is because of the regular shedding of cells from the bladder and external urethra. They are derived from the linings of the genitourinary system. The ureters, which carry urine from the kidneys to the bladder, the bladder itself, and the urethra, which carries urine outside the body, are all lined with epithelial tissue. Normal. Urine is normally sterile, which means that it contains no bacteria. However, unless specimens are collected under sterile conditions, a few bacteria are usually present as a result of vaginal, urethral, external genitalia or collection container contamination. These contaminant bacteria will multiply rapidly in specimens that remain at room temperature for extended periods, but are of no clinical significance. Abnormal Crystals are amorphous materials present in the urine. If the body becomes dehydrated (lack of water) it may give rise to crystal formation in urine. When the total water consumption gets reduced obviously the urine may include increased solid particles or crystals. Certain chemical components present in the urine like nitrogen and uric acid may get solidified resulting in the development of crystals in urine. Dehydration is the major cause for the presence of urine crystals in children who dont take enough water. Normal Hyaline casts are formed in the absence of cells in the renal tubular lumen. They have a smooth texture and a refractive index very close to that of the surrounding fluid. When present in lower numbers (0-1/LPF) in concentrated urine of otherwise normal patients, hyaline casts are not always indicative of clinically significant disease.

9-12-13 Fecalysis Specimen: Feces Laboratory Color Normal Values Brown Result Yellowish Brown Analysis & Interpretation Abnormal. The color of stool normally is brown. The reason for the brown color is the presence of bile in the stool. Bile is made by the liver, concentrated and stored in the gallbladder, and secreted into the intestine to aid in the digestion of food. Depending on the amount of bile it contains, the normal stool color can range in color from light yellow to almost black. In the patients case, yellow stool can indicate that food is passing through the digestive tract relatively quickly. Moreover, if the onset is sudden, yellow stool can also be a sign of an infection in the intestines. Abnormal. Normal stool consistency should be semisolid; it is somewhat like toothpaste: neither hard nor very liquid. The stool consistency may change over time and due to various circumstances. The stool may become softer than normal. Watery feces may be the result of an infection or malabsorption. In the patients case, diarrhea, or loose, watery stool, is the body's way of clearing viruses, bacteria or toxins from the digestive tract. Abnormal. White blood cells, also called leukocytes, are immune system cells that can show up in the stool if there is an inflammatory diarrhea. This type of diarrhea may be a symptom of an infection. The white blood cell in the patients stool indicates that there is an inflammation in her gastrointestinal tract. Abnormal The presence of RBC in the stool may indicate bleeding in the GI tract. The blood may be caused by an injury that develops on the mucous membrane such as inside the stomach, and intestines because of an infection. Abnormal. Bacteria that are normally found in the intestines include Pseudomonas and Escherichia coli. These enteric bacteria (bacteria of the gastrointestinal system) are considered normal flora and usually do not cause infection in the digestive tract. Normally, no disease-causing (pathogenic) bacteria, viruses, fungi, or parasites are present or grow in the culture. However, since the patients stool culture is positive for pathogenic bacteria, it is most likely the cause of her diarrhea. Abnormal.

Consistency

Formed

Loose

WBC

0-1/hpf

RBC

0-1/hpf

Bacteria

None

+4

Yeast Cells

+2

Parasites

None

Ova

None

Yeast is normally found in very small amounts in a healthy intestinal tract. Beneficial bacteria, such as Lactobacillus, colonize in the intestines and create an environment unsuitable for yeast by producing acids, such as lactic acid, which lowers intestinal pH. In the patients case, the reason for the yeast cells in her stool is because of Cefuroxime, an antibiotic that she is taking. It is a broad-spectrum type of antibiotic that kills both good and bad bacteria. Ascaris Abnormal. Lumbricoides Parasites should not be seen in the stool. An abnormal result means parasites or eggs are present in the stool which is a sign of a parasitic infection. 0-1/hpf Abnormal Like parasites, ova should not be present in the stool. An abnormal result means parasites or eggs are present in the stool which is a sign of a parasitic infection.

9-12-13 Blood Chemistry Specimen: Blood Laboratory BUN Normal Values 2.14-7.14 mmol/L Result 26.69 Analysis & Interpretation Abnormal. BUN stands for blood urea nitrogen. Urea nitrogen is what forms when protein breaks down. Increased BUN can be caused by excessive protein intake, kidney damage, certain drugs, low fluid intake, intestinal bleeding, exercise, heart failure or decreased digestive enzyme production by the pancreas. An increased level of BUN in the patient is because of low fluid intake and gastrointestinal bleeding caused by the infection that brought injury to the mucous membrane of the stomach and small intestine. Abnormal. Creatinine is a waste product of muscular activity that is secreted into the blood stream. An elevated result of creatinine in the patient doesnt mean she has a problem with her kidneys but because she is dehydrated. Dehydration or inadequate water intake can cause blood concentration and reduced blood flow in the kidneys which results to increased Creatinine levels.

Creatinine

M: 59-104 umol/L F: 45-84 umol/L

630.6