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    Ix Final

    Uploaded by

    Ayushi Singh

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    © All Rights Reserved
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    Ix Final

    Uploaded by

    Ayushi Singh
    6 views17 pages

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    Ix final

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    Download as pptx, pdf, or txt
    6 views17 pages

    Ix Final

    Uploaded by

    Ayushi Singh

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 17

    INVESTIGATION

    S
    1. BLOOD EXAMINATION
    Parameter On 30/05/24 On 31/05/24 Ref. range (× 10 ^3/
    ( × 10^3 /ul) (× 10^3/ul) ul)

    WBC count 24.72 25.23 4 – 12

    Lymphocytes 1.6. (6.6%) 1.56 0.8 – 7 (20-60%)

    Neutrophils 21.17 (87%) 21.96 2-8 (50-70%)

    Monocytes 1.6 (6.3%) 1.66 0.12- 1.2(3-12%)

    Eosinophil 0.01 (0.0%) 0.02 0.02-0.8 (0.5-5%)

    Basophil 0.02 (0.1%) 0.03 0- 0.10 (0.0-1%)


    Paramenter 0n 30/05/24 On 31 /05/24 Ref. Range
    (×10^3/ul)

    RBC count 4.26×10^6 /ul 4.28 × 10^6 /ul 3.5-5.2 ×10^6/ul

    Hb 12.1g/dl 12.2 g/dl 12-16 g/dl

    MCV 86.3 fl 86.7 fl 80-100 fl

    MCH 28.5pg 28.5 pg 27-34 pg

    MCHC 33 g/ dl 32.8 g/dl 31-37 g/ dl


    REPORT
     Leukocytosis
     Neutrophilia
    2. URINE EXAMINATION
    Physics examination Value Ref.

    Color Yellow Pale yellow

    Appearance Turbid Clear

    pH 5 4.6-8

    Sp gravity 1.015 1.003-1.035

    Chemical examination
    Proteins Trace Nil

    Ketone bodies +++ Negative

    Microscopic examination
    Pus cells 4-8 0-5/hpf

    RBC Nil Nil

    Epithelial cells 2-4 0-8/hpf


    Causes of Ketone bodies in urine :
    • Diabetic ketoacidosis
    • Starvation
    • Ketogenic diet : high fat, low
    carbohydrate diet.

    Causes of pus cells in urine :


    • UTI
    • Interstitial nephritis
    • Stones
    • High fever
    3.SEROLOGICAL
    INVESTIGATIONS
    Investigations Report

    CRP Positive (2.4 mg/dl)

    Malaria Ag Negative

    Widal test Negative

    Dengue(card test) Negative

    Scrub typhus Negative


    Inference : CRP is raised

    Causes of raised CRP:


    • Bacterial infection
    • Sepsis
    • Pneumonia
    • Chronic inflammatory disorder :
    Rheumatoid arthritis, IBD
    4. CSF EXAMINATION
     Glucose – 65 /124 mg/dl ( csf glucose against
    plasma glucose )
    <50% ( >50 mg/dl)
     Protein – 118.3 mg/dl ( 20-45mg /dl)
     Cells – 20 cells ( 100% lymphocytes)
     CSF culture : negative
    Parameters Value Normal range Seen in

    Cells 20 cells <5 cells Meningitis

    DLC 100% lymphocytes >75% lymphocytes Partially treated


    bacterialmeningitis
    Viral meningitis
    Tuberculous
    meningitis

    Glucose 65 mg/dl >50 (or 75% serum -


    (>50% serum glucose)
    glucose)
    Protein 118.3 mg/dl 20-45 mg/dl Meningitis ( Acute
    bacterial , partially
    treated , Viral,
    tuberculous
    Contraindications for Lumbar puncture
     Evidence of increased ICP ( other than a bulging fontanelle) such as
    3rd or 6th CN palsy with a depressed level of consciousness or the
    Cushing reflex.
     Severe cardiopulmonary compromise requiring prompt resuscitative
    measures for shock.
     Infection of skin overlying the site of the LP.
     Thrombocytopenia is a relative contraindication for LP.

    Indications for repeat CSF :


     ln all patients with meningitis from Gram negative bacilli .
     In patients infected caused by a Beta lactam resistant S. Pneumonia .
    5. X- RAY ABDOMEN

    Showing:
     Gaseous abdomen
    6. BLOOD CULTURE
     No growth of organisms observed after 48 hrs of aerobic incubation
    at 37°C.
     Comment - sterile
    7. ULTRASOUND ABDOMEN
     Bowel loops appear dilated , loose fecal matter seen inside it ,
    muscle wall appears thickened and shows increased echogenicity.
     Conclusion : bowel pathology /?? Obstruction..
    SUMMARY
     Leukocytosis is seen .( neutrophilia)
     CRP is raised .
     Urine examination showing turbid appearance , pus cells 4-8 ,ketone
    bodies +++.
     CSF examination showing increased protein , cells -20 ( 100%
    lymphocytes .
     Abdomen Xray showing gaseous abdomen.
     USG- dilated bowel loops with fecal matter.

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