Transcript CBC

ANCILLARY PROCEDURES
Done in the patient
•
•
•
•
•
CBC
Na, K
Creatinine
SGOT, SGPT
12-L ECG
CBC
Complete Blood Count
11/23/09
11/28/09
Unit
NV
Hgb
96
118
g/L
120-170
RBC
2.93
3.73
X10^12/L
4.0-6.0
Hct
0.28
0.35
MCV
94.3
94.60
U^3
87 + -5
MCH
32.6
31.50
pg
29 + -2
MCHC
34.6
33.30
g/dL
34 + -2
RDW
13.40
14.10
481
830
Platelet
0.37-0.54
11.6 – 14.6
X10^9/L
150-450
Complete Blood Count
• Anemia
– Low RBC, Hgb, Hct
– Due to insufficient production of EPO by the
diseased kidneys (CKD stage 3)
• Thrombocytosis
– Occurs as an acute phase response to infection
Complete Blood Count
WBC
Diff ct
Neutrophils
Segmenters
Bands
Metamyelocytes
Lymphocytes
Monocytes
Eosinophils
Basophils
Myelocytes
11/23/09
17.70
11/28/09
15.39
0.75
0.74
0.01
0.24
0.75
0.72
0.01
0.01
0.23
0.01
0.02
Unit
X10^9/L
NV
4.5-10.0
0.50-0.70
0.50-0.70
0-0.05
0.20-0.40
0.00-0.07
0.00-0.05
Complete Blood Count
• Leukocytosis
– With predominance of neutrophils connotes
active bacterial infection
BLOOD CHEMISTRY
Biochemical Blood Tests
• Liver Function test
– AST/ ALT
• Kidney Profile test
– Creatinine
– Electrolytes
• ( Na, K, Ca, PO)
– BUN
– Uric Acid
• Lipid Profile test
– TG
– Total Cholesterol
– LDL, HDL, VLDL
Biochemical Blood Tests
• Liver Function test
– AST/ ALT
• Kidney Profile test
– Creatinine
– Electrolytes
• ( Na, K, Ca, PO)
– BUN
– Uric Acid
• Lipid Profile test
– TG
– Total Cholesterol
– LDL, HDL, VLDL
Biochemical Blood Tests
• Liver Function test
– AST/ ALT
• Kidney Profile test
– Creatinine
– Electrolytes
• ( Na, K, Ca, PO)
– BUN
– Uric Acid
• Lipid Profile test
– TG
– Total Cholesterol
– LDL, HDL, VLDL
Biochemical Blood Tests
• AST / ALT
11/23/09
11/28/09
Unit
N.V.
SGPT-ALT
37.8
U/L
0-31
SGOT-AST
55.3
U/L
0-38
– Active liver insult probably drug induced (aspirin).
Biochemical Blood Tests
• Liver Function test
– AST/ ALT
• Kidney Profile test
– Creatinine
– Electrolytes
• ( Na, K, Ca, PO)
– BUN
– Uric Acid
• Lipid Profile test
– TG
– Total Cholesterol
– LDL, HDL, VLDL
Biochemical Blood Tests
• Creatinine
Creatinine
11/23/09
11/28/09
Unit
N.V.
5.2
3.5
mgl/dL
0.5-1.2
– Impaired Filtering Capacity of the kidneys due to
CKD
Biochemical Blood Tests
• Liver Function test
– AST/ ALT
• Kidney Profile test
– Creatinine
– Electrolytes
• ( Na, K, Ca, PO)
– BUN
– Uric Acid
• Lipid Profile test
– TG
– Total Cholesterol
– LDL, HDL, VLDL
Hyponatremia
• Sodium
Sodium
11/23/09
130
Unit
N.V.
mmol/L
137-147
• Most probably due to impaired kidney
function
Biochemical Blood Tests
• Liver Function test
– AST/ ALT
• Kidney Profile test
– Creatinine
– Electrolytes
• ( Na, K, Ca, PO)
– BUN
– Uric Acid
• Lipid Profile test
– TG
– Total Cholesterol
– LDL, HDL, VLDL
Hyperkalemia
• Potassium
Potassium
11/23/09
5.4
Unit
N.V.
mmol/L
3.8 - 5
• Most probably due to impaired kidney
function
OTHER ANCILLARY PROCEDURE
ECG
• Sinus rhythm
• Left ventricular hypertrophy
– pathological reaction to cardiovascular disease, or high
blood pressure
– increase afterload that the heart has to contract against
– causes of increased afterload that can cause LVH include
aortic stenosis, aortic insufficiency, and hypertension
• Peak T-waves
– Due to hyperkalemia
Requested but not done
Test
Rationale for requesting
Expected result
iCa
Decreased
iPO
Increased
Asses for Kidney injury
BUN
Increased
Uric acid
Increased
LipId Profile
Asses risk of Heart disease
ABG
determination of pH, partial pressure of carbon dioxide Metabolic
and oxygen, and the bicarbonate level
acidosis
U/S of KUBP Assess the size, location, and shape of the kidneys and
related structures, such as the ureters bladder, and
prostate
Sputum GS,
culture
Identify certain pathogens by their characteristic
appearance
Sputum AFB Screening for TB