Cards + ECG (D3presnetaionjdenejkk).pptx

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1. Tutorials D3

2. PLEURAL FLUID ANALYSIS

3. PLEURAL FLUID ANALYSIS Appearance Clear Colour Straw yellow Total Leukocytes 150 per cu.mm Protein (Serum Protein) 2.0g/dL (6g/dL) LDH (Serum LDH) 160 IU/L (380 IU/L) Glucose 85mg/ dL Lymphocytes 97% Polymorphs 3% What impression do you make of the above mentioned analysis? What could be the causes for it?

4. PLEURAL FLUID ANALYSIS Appearance Cloudy Colour Yellow Total Leukocytes 1500 per cu.mm Protein (Serum Protein) 3.3g/dL (6.0g/dL) LDH (Serum LDH) 315 IU/L (400 IU/L) Glucose 55mg/ dL Lymphocytes 40% Polymorphs 60% What impression do you make of the above mentioned analysis? Is an Intercostal Tube Drainage required in the above case?

5. CSF ANALYSIS

6. A 43 year old man, post organ transplant, was brought to the OPD with history of fever and headache since 2 weeks. Neurological examination revealed loss of abduction of the right eye. Neck stiffness was present. Urgent CSF Examination revealed the following : CSF ANALYSIS Appearance Cobweb on standing Colour Clear Protein 90mg/dL Chlorides 600mg/dL Glucose 50mg/ dL Cells Predominantly lymphocytes What impression do you make of the above mentioned analysis? How will manage the above case?

7. A 43 year old man, was brought to the OPD with history of fever and headache since 2 days. Neurological examination revealed positive Kernig and Brudzinki’s sign. Neck stiffness was present. Urgent CSF Examination revealed the following : CSF ANALYSIS Appearance Turbid CSF Pressure 230mm Hg Protein 140mg/dL Chlorides 600mg/dL Glucose 20mg/dL Cells Predominantly polymorphs What impression do you make of the above mentioned analysis? How will manage the above case?

8. CSF ANALYSIS Pressure 160 mm of H 2 O Appearance Clear Total Cells 8 per mm 3 Polymorphs - Lymphocytes 8 Protein 90 mg/ dL Sugar (Blood sugar) 88 mg/dL (105) What impression do you make of the above mentioned analysis? How will manage the above case?

9. A 43 year old man, was brought to the OPD with history of fever, headache and projectile vomiting since 2 days. Neurological examination revealed positive Kernig and Brudzinki’s sign. Neck stiffness was present. Urgent CSF Examination revealed the following : Appearance Clear CSF Pressure 270mm Hg Protein 140mg/dL Chlorides 730mg/dL Glucose 60mg/dL Cells Predominantly lymphocytes What impression do you make of the above mentioned analysis? How will manage the above case? CSF ANALYSIS

10. HEMATOLOGY ANALYSIS

11. HEMATOLOGY ANALYSIS Hb 5.8 g/dL WBC 8000 DLC P-57%, L-37%,M-4%, E-1% Platelets 5 Lacs Reticulocyte count 1.5% PBS Microcytic hypochromic RBCs, Anisocytosis, Poikilocytosis MCV 66 MCH 23 MCHC 24 What impression do you make of the above mentioned analysis?

12. HEMATOLOGY ANALYSIS Hb 7 g/dL WBC 5000 DLC P-54%, L-34%,M-4%, E-1% Platelets 1.7L Reticulocyte count 5% PBS Macrocytosis, Hypersegmented neutrophils MCV 114 MCH 37 MCHC 40 What impression do you make of the above mentioned analysis?

13. HEMATOLOGY ANALYSIS What is your diagnosis? What other investigations will you perform to confirm your diagnosis? How will you manage this patient? HEMATOLOGY ANALYSIS Hb : 12 mg/dL PBS: Normochromic, Normocytic, No schistocytes. TLC : 11000 DLC : WNL Platelets : 60000/ cu.mm Bleeding Time : 11 minutes PT: T-14 sec, C-14 sec aPTT : T-40 sec, C-40 sec

14. URINE ANALYSIS Quantity (24 Hrs) 350 mL Colour Smoky Albumin + RBC Numerous, dysmorphic Casts RBC Cast What impression do you make of the above mentioned analysis? What could be the causes for it?

15. URINE ANALYSIS Quantity (24 Hrs) 350 mL Total Proteins 4g / 24 hrs Serum Albumin 2.5 g/dL RBC Absent Casts Waxy cast LDL-CH 130mg/dL What impression do you make of the above mentioned analysis? How is general examination important in such a case?

16. LIVER FUNCTION TEST ANALYSIS

17. LIVER FUNCTION TESTS Serum Bilirubin 4.1mg/Dl Unconjugated ; Conjugated 3.0mg/dL, 1.1mg/dL ALT 1300 U/L AST 1010 U/L ALP 50 U/L What impression do you make of the above mentioned analysis? What could be the causes for it? What points will you focus on while taking history in such a case?

18. LIVER FUNCTION TESTS Ser Bilirubin ( mg / dL ) 5.8 Direct( mg / dL ) 1.1 Indirect( mg / dL ) 4.7 AST (IU/L) 48 ALT(IU/L) 46 ALP (IU/L) 100 GGT (IU/L) 24 LDH (IU/L) 660 Hb (g/ dL ) 8.2 PBS Schistocytes , Fragmented RBC What impression do you make of the above mentioned analysis? What could be the causes for it? What points will you focus on while taking history in such a case?

19. LIVER FUNCTION TESTS Ser Bilirubin ( mg / dL ) 9.8 Direct( mg / dL ) 8.1 Indirect( mg / dL ) 1.7 AST (IU/L) 1190 ALT(IU/L) 1450 ALP (IU/L) 140 GGT (IU/L) 24 LDH (IU/L) 260 What impression do you make of the above mentioned analysis? What could be the causes for it? What points will you focus on while taking history in such a case?

20. LIVER FUNCTION TESTS Ser Bilirubin ( mg / dL ) 20.0 Direct( mg / dL ) 16.0 Indirect( mg / dL ) 4.0 AST (IU/L) 48 ALT(IU/L) 68 ALP (IU/L) 1280 GGT (IU/L) 160 LDH (IU/L) 20.0 What impression do you make of the above mentioned analysis? What could be the causes for it? What points will you focus on while taking history in such a case?

21. A 38year old female with features of cold intolerance, hypertension, bradycardia reported in your medical OPD. Her thyroid function tests were as follows: TSH- 27mU/L Free T4 – 50pmol/L (10-25 pmol /L) What is your interpretation of this report? How will you manage this patient?

22. ASCITIC FLUID ANALYSIS

23. ASCITIC FLUID ANALYSIS Appearance Straw Total Cells 500 per mm 3 Polymorphs 90 % Lymphocytes 10 % Albumin (Serum Albumin) 2.2 g/ dL (3.2 g/ dL ) Protein 3.0 g/dL What impression do you make of the above mentioned analysis? What could be the causes for it? What points will you focus on while taking history in such a case?

24. ASCITIC FLUID ANALYSIS Appearance Straw Total Cells No cells Polymorphs - Lymphocytes - Albumin (Serum Albumin) 2.0 g/dL (3.5 g/dL ) Protein 3.0 g/dL What impression do you make of the above mentioned analysis? What could be the causes for it?

25. ASCITIC FLUID ANALYSIS Appearance Straw Total Cells 50 per mm 3 Polymorphs 5 % Lymphocytes 95 % Albumin (Serum Albumin) 4.0 g/ dL (4.5 g/ dL ) Protein 5.1 g/dL What impression do you make of the above mentioned analysis? What could be the causes for it?

26. Interpret the Given ECG

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