A.

Blood Chemistry
August 21, 2018
EXAM RESULT NORMAL RESULT S.I NORMAL INDICATIONS
NAME VALUES VALUE S.I
BUN 30.06 8-18 mg/dL 10.07 mmol/L 2.8-6.4 Liver or Kidneys
mg/dL mmol/L are not working
well.
Potassium 3.80 3..3-4.6 3.8 mmol/L 3.3-4.6 Normal
mEq/L mEq/L mmol/L

Creatinine 1.50 0.6- 133 mmol/L 53.04-114.92 Possible

mg/dL 1.3mg/dL umol/L malfunction or
failure of the
kidneys

BUN and Creatinine

- Elevated blood urea nitrogen (BUN) and serum creatinine values reflect the decrease in the
glomerular filtration rate that occurs in the acute phase. The elevation are usually transient. Their
failure to normalize within several weeks or months indicates that the patient may not have a
Acute poststreptococcal glomerulonephritis (APSGN) and suggest seeking an alternative
diagnosis. Patients who have the crescentic form of glomerulonephritis have rapid deterioration
and often, incomplete recovery of renal function.
 EXAM RESULT NORMAL RESULT S.I NORMAL INDICATIONS
NAME VALUES VALUE S.I
SGPT/ALT 23.00 U/L 3-31 U/L 23 U/L 3-31 U/L Normal

SIGNIFICANCE:
This test to screen for liver damage or to help diagnose liver disease. ALT test measures the level
of alanine aminotransference, also called ALT or SGPT. ALT is one of the enzymes that help the
liver convert food into energy. High levels of these enzymes can be a sign that the liver is injured
or irritated, and the enzymes are leaking out of the liver cells.

August 21, 2018

ANTI-STREPTOLYSIN O QUANTITATIVE
Specimen: SERUM
Test Method: NEPHELOMETRY
Detection Threshold: 25-28,800 IU/mL
RESULT: 71.5 IU/mL
Reference Value: <116 IU/mL
SIGNIFICANCE:
To help determine whether you have had a recent strep infection with the bacteria group A
Streptococcus, to help diagnose complications resulting from a strep infection such as
glomerulonephritis a form of kidney disease.
August 21,2018

EXAM RESULT NORMAL RESULT S.I NORMAL INDICATIONS

NAME VALUES VALUE S.I
Albumin 0.80g’dL 3.1-4.3 g/dL 8g/L 31-43g/L Inflammation or
Shock
Calcium 3.80 4.56- 0.95 mmol/L 0.95mmol/L Hypocalcemia can
(ionized) mg/dL 5.4mg/dL be a possible sign of
hypoparathyroidism.

SIGNIFICANCE:
Glomerulo disease also interferes with the clearance of waste product by the kidney, so they
begin to build up in the blood. Loss of Albumin in the urine can result in a fall in their level in
the bloodstream. In normal blood, albumin acts like a sponge, drawing extra fluid from the body
into the bloodstream, where it remains until the kidney’s remove it. But when the albumin leaks
extra fluid from the body . fluid can accumulate outside the circulatory system in the face, hands,
feet, ankles and cause swelling.

August 24, 2018

Exam Name Result Normal Result S.I. Normal Indications
Values Values S.I.
Cholesterol 733. 59 < 201.5 19.00 < 5.2 Hyperlipidemia or
mg/dL mg/dl mmol/L mmol/L Hypercholesterolemia
HDL- 30.89 30-70 0.80 0.77- 1.8 Normal
Cholesterol mg/dL mg/dL mmol/L mmol/L
LDL- 660.23 0-103.5 17.1 0.2.7 Risk for heart attack
Cholesterol mg/dL mg/dL mmol/L mmol/L and stroke
Triglyceride 212.39 10-140 2.40 0.11- 1.58 Risk for heart attack
mg/dL mg/dL mmol/L mmol/L and stroke.
 HEMATOLOGY REPORT
August 21,2018
a. Hematology

TEST RESULTS NORMAL VALUE INDICATIONS

Hematocrit 0.46 0.37- 0.47L/L Normal

Hemoglobin 157 120-160g/L Normal

RBC Count 5.48 4.5-5.5 Normal

WBC Count 11.0 4.5-11 Normal

Differential Count
Segmenters ↑76 50-70% Infection
Lymphocytes ↓18 25-35% Infection
Monocytes 4 0-15% Normal
Eosinophils 1 1-5% Normal
Basophils 1 0-1% Normal
PLT Count 634 150-400 Overproduction of the
bone marrow, may
lead to abnormal
clotting paving the
way for
thrombocytosis

Blood Test

- these can provide information about kidney damage and impairment of the glomeruli by
measuring levels of waste products, such as creatinine and blood urea nitrogen. Low
lymphocytes means that the patient is susceptible to infection. It is beyond the normal range thus,
it may indicate a high level of stress that is placed on the body. the stress can due to many factors
such as nervousness, exercise, or seizures (involuntary muscle movements due to overexcitement
of nerve cells in the brain). Another cause is a sudden infection from bacteria. Damage or
inflammation of tissue can also lead to high neutrophil count.

August 27,2018 3AM

EXAM RESULT NORMAL RESULT S.I NORMAL INDICATIONS

NAME VALUES VALUE S.I
Sodium 134.00 135-145 134 mmol/L 135-145 Normal
mEq/L mEq/dL mmol/L
Potassium ↓2.60 3..3-4.6 2.6 mmol/L 3.3-4.6 Dehydration,
mEq/L mEq/L mmol/L Diarrhea,
Hypokalemia
Creatinine 1.8 mg/dL 0.6- 104mmol/L 53.04-114.92 Possible
1.3mg/dL umol/L malfunction or
failure of rhe
kidneys.

C. Specific Test
August 26,2018

24 Hours 609.38 mg/24 600-800 5.38 mmol/24 hrs 5.3-15.9 Normal

Urine hrs. mg/24 mmol/24
Creatinine hrs. hrs

Remarks: Please correlate clinically for appropriate interpretation of result.

24HR TOTAL URINE VOLUME 1.370mL

COLLECTION STARTED 08/25/2018 02:08PM

COLLECTION ENDED 02:08PM

SIGNIFICANCE:

The 24 hour urine protein excretion and creatinine clearance is helpful to document the degree
of renal dysfunction and proteinuria.

August 26,2018

Total Protein 8190.00 50-100 8.19 g/24 0.05-0.1 g/24 Kidney Damage
– 24 Hr Urine mg/24 mg/24 phagocytic.

Remarks: Please correlate clinically for appropriate interpretation of result.

24HR TOTAL URINE VOLUME 1.370mL

COLLECTION STARTED 08/25/2018 02:08PM

COLLECTION ENDED: 08/26/2018 2:08 PM

SIGNIFICANCE:

The 24 hour urine protein test checks how much protein is being spilled into the urine, which can
help detect disease it is given to a patient who have symptoms of glomerulonephritis.

Patients with glomerular disease have significant amounts of protein in the urine, which may be
referred to as “nephrotic range” if levels are very high. Red blood cells in the urine are a frequent
finding as well, particularly in some forms of glomerular disease.

URINALYSIS

MACROSCOPIC EXAMINATION

Color Straw
Transparency Hazy
 A urinalysis might show red blood cells and red blood cells casts in your urine, an indicator
of possible damage to the glomeruli. Urinalysis result might show white bood cells a common
indicator of infection or inflammation and in increased protein, which can indicate nephron
damage.

August 26,2018

MISCELLANEOUS REPORT

EXAMINATION DESIRED: GRAM STAINING

SOURCE SPECIMEN: URINE

CLINICAL DIAGNOSIS:

RESULT: Unspun:

Gram stained smears show no microorganisms noted.

Spun:

Gram stained smears show occasional gram negative bacilli and occasional pus
cells are noted.

Chemical examination

pH- 6.5 Sp. Gravity- 1.015

Leukocytes- 1+ Blood- 1+

Sugar- negative Nitrite- negative

Protein- 1+ Urobilinogen

Ketone Billirubin
ARTERIAL BLOOD GAS ANALYSIS
Parameters Results Normal Values Indications
pH 7.42 7.35-7.45 Normal
pCo2 27 35.00- 45.00mmHg Respiratory Alkalosis
PO2 82 80.00- 100.00mmHg Normal
HCO3 17.5 22.00- 26.00 Metabolic Acidosis
BEb -5.6 +/- 2.00 mmol/L Metabolic Acidosis
BE ecf -7.0 +/- 2.00 mmol/L Metabolic Acidosis
O2SAT% 96 95.00- 1000.00% Normal
FIO2 ROOM AIR

SIGNIFICANCE:
A blood gas test measures the amount of oxygen and carbon dioxide in the blood. It may also be
used to determine the pH of the blood, or how acidic it is. The test is commonly known as a
blood gas analysis or arterial blood gas (ABG) test. Your red blood cells transport oxygen and
carbon dioxide throughout your body. These are known as blood gases. As blood passes through
your lungs, oxygen flows into the blood while carbon dioxide flows out of the blood into the
lungs. The blood gas test can determine how well your lungs are able to move oxygen into the
blood and remove carbon dioxide from the blood.

August 21, 2018

SERUM COMPLEMENT C3 QUANTITATIVE
Specimen: SERUM
Test Method: TURBIDIMETRY
Detection Threshold: 0.03-2.98g/L
RESULT: C3 0.727g/L
Reference Value: 0.811-1.570g/L
SIGNIFICANCE:
Serum complement levels C3 quantitative this test measures the amount of C3 proteins in your
blood. These proteins are part of your complement system.
August 21, 2018
ANTI-STREPTOLYSIN O QUANTITATIVE
Specimen: SERUM
Test Method: NEPHELOMETRY
Detection Threshold: 25-28,800 IU/mL
RESULT: 71.5 IU/mL
Reference Value: <116 IU/mL

SIGNIFICANCE:
The antistreptolysin O (ASO) test is a blood test that checks for a strep infection. When you
come into contact with harmful bacteria, your body produces antibodies to defend itself against
these bacteria. Your body produces antibodies specific to the bacteria they fight. The ASO titer
test measures antibodies produced by your body in response to a toxin known as streptolysin O.
Streptolysin O is a toxin produced by group A Streptococcus (GAS) bacteria. Your body makes
the antistreptolysin O antibodies when you have a strep infection caused by GAS bacteria.
August 23, 2018
ANTI- NUCLEAR ANTIBODY TEST
SPECIMEN: SERUM
TEST METHOD: IMMUNOFLUORESCENCE
RESULT:
NEGATIVE FOR ANTI-NUCLER ANTIBODY
POSITIVE FOR ANTI-NUCLEAR ANTIBODY
TITER DETECTION THRESHOLD:
1:160
REMARKS:
Please correlate clinically for appropriate interpretation of result.
The above ANA Pattern is observed in the following disease/s.
Systemic Lupus Erythemathosus Dermatomyositis
Sjogren’s Syndrome Rheumatoid Arthritis
Autoimmune Hepatitis Scleroderma
CRESTSyndrome Limited Scleroderma
Mixed Connective Tissue Disease Non- specific
Polymyositis
Juvenile Idiopathic Hepatitis
SIGNIFICANCE:

Antinuclear antibodies (ANA) refer to the unusual antibodies that are detectable in the blood.
ANA are gamma-globulins type of antibodies that are found in patients with certain autoimmune
diseases. ANA are directed against certain components found in the nucleus of a cell in the body.
These antibodies have the capacity of binding certain structures within the nucleus of the cells.

Positive ANA test result is suggestive of autoimmune disease. It can also mean that the patient
has drug induced lupus. Some drugs and infections can also induce false positive ANA test
results. Steroids can cause a false-negative result.
D. Imaging Dx

Ultrasound Report Gynecology

I. UTERUS x 3.5 x 2.6 C ANTEVERTED
m
OTHERS
II. ENDOMETRIUM cm The subendometrial halo is
intact.
Compatible with
Abnormalities The endometrium is hyperechoic measuring
0.1cm each anteriorly and posteriorly with
anechoic fluid interface measuring 0.2cc.
III. ADNEXAE
Right 2.6 x 2.4 x 1.8 cm
Ovary
Follicle:
Abnormalities
Left 2.9 x 2.6 x 14 cm
Ovary
Follicle
Abnormalities
IV.Cervix 2.7 X

SIGNIFICANCE:
A pelvic ultrasound is a test that uses sound waves to make pictures of the organs inside your
pelvis. Your doctor might order this test to diagnose a condition. Find problems with the
structure of your uterus or ovaries. Look for cancer in your ovaries, uterus, or bladder.
Find an intrauterine device (IUD). Look for growths like noncancerous tumors, fibroids, or cysts.
Discover the cause of abnormal bleeding or pain
 ECG
P/PR: -/- ms
QRS: 88ms
QT/ QTc: 280/436 ms
P/QRS/T axis: -/-8/-53 deg
Heart Rate: 146bpm
Sinus Tachycardia
Possible High Lateral Infarct
Minimal but extensive precordial repolarization disturbance, probably aspecific change
Borderline ECG
Unconfirmed Report
SIGNIFICANCE:
Electrocardiogram (ECG). This is a test that records the electrical activity of the heart, shows
abnormal heart rhythms, and detects heart muscle damage.
An electrocardiogram (EKG) is a test that records the electrical impulses of the heart. It assesses
heart rhythm, chamber size, and muscle thickness.
CHEST PA
RESULTS:
Crowding of Pulmonary vascular marking due to poor inspiratory effort.
A linear opacity is seen in the right middle lung zone.
Trachea is at the midline.
Heart is not enlarged.
Hemidiaphragms are smooth.
Indistinct right costophrenic angle.
Other chest structures are unremarkable.
REMARKS:
SUBSEGMENTAL ATELECTASIS VS. FIBROSIS, RIGHT.
RIGHT MINIMAL PLEURAL EFFUSION.
SIGNIFICANCE:
To diagnose a wide range of injuries and conditions affecting the organs and bones in the chest.
It also to determine the underlying causes of symptoms such as chest pain of shortness of breath
or to monitor a condition that may be worsening such as fluid in the fluids.

Assess for a pulmonary- renal syndrome or a pulmonary complication of the glomerular disease
that would influence management. A routine chest X-ray is warranted for any patient presenting
with glomerular disease to search for a pulmonary- renal syndrome, and especially if the patient
has pulmonary symptoms, abnormal lung findings on physical exam or has a low oxygen
saturation by pulse oximeter.
 ULTRASOUND OF THE WHOLE ABDOMEN
The liver is normal in size with a craniocaudal span of 12.8 cm with smooth borders. It has a
homogenous parenchymal echotexture and sharp inferior marginal angles. The intrahepatic ducts
are not dilated. No mass is noted.
The common bile duct is not dilated. No mass/ lithiasis is seen.
The gallbladder is normal in size and configuration, measuring 4.2 x 1.5 cm (L x AP). Its wall is
not thickened and measures 0.2 cm. No mass/ lithiasis is noted.
The pancreas is normal in size and measures as follows: head-2.2cm; body- 0.9cm; and tail-1.1
cm in its AP diameters, respectively. Its parenchymal echotexture is homogenous. The pancreatic
duct is not dilated. No mass/ calcifications seen. The spleen is normal in size, with a length of 8.4
cm. It has a homogenous parenchymal echotexture. No focal lesion/mass noted.
The aorta and inferior vena cava are normal in caliber, with no internal echoes. No para-aortic
masses.
Both kidneys have increased parenchymal echogenicities, grade 1. The cortico-medullary
junctions are well-defined. There is no significant disparity in the size of the kidneys.
The right kidney measures 9.0 x 6.0 x 4.1 cm (LxWXAP) with parenchymal thickness of 1.2 cm.
The left kidney measures 9.1 x 5.3 x4.1 cm (LxWXAP) with parenchymal thickness of 1.3 cm.
The central echo complexes are intact. The ureters are normal in caliber. No mass or lithiasis is
noted.
The urinary bladder is underfilled precluding its adequate assessment.
The uterus is anteverted and measures about 5.2 x 3.0 x 1.5 cm (LxWxAP). The endometrial
stripe is not thickened. No focal lesion is seen.
The ovaries are not visualized.
No adnexal mass is noted.
Minimal free fluid is noted in the abdominopelvic cavity.
REMARKS:
 DIFFUSE RENAL PARENCHYMAL DISEASE, BILATERAL
 MINIMAL ASCITES.
 SONOGRAPHICALLY NORMAL LIVER, BILIARY TREE, GALLBLADDER,
PANCREAS, SPLEEN AND UTERUS

SIGNIFICANCE:
Abdominal ultrasound imaging is performed to evaluate organs such as the kidneys, liver,
gallbladder, pancreas and spleen. It can help to diagnose a number of conditions including
abdominal pains, inflamed appendix, enlarged abdominal organ or aneurysm in the abdominal
aorta or stones in the gallbladder or kidney.