How to write a letter to Levy hospital

1. LABORATORY
INVESTIGATION SURGERY
Presentation by Grandford Nyirenda

2. OBJECTIVES
• Blood ( fbc, urea, creatinine, electrolytes panel,)
• Cerebral spinal fluid (CSF)
• Urine MCS
• Sputum
• INDICATION
• CONTRA INDICATION
• AND COMPLICATIONS

3. BLOOD TESTS
• Blood is a connective tissue in liquid form driven
from the born marrow ( hemopoitic stem cell)
• Composition of blood
• RBCs, WBCs, Platelets and plasma..
• CBC it's an important blood investigation that
focuses on blood cells platelets and their
parameters, it can also be used as a screening test
for many disorders.

4. Erythrocytes
• Normal values in men are 4.7-6.2
• Women 4.2-5.4 cells per microliters.
• Low levels indicates anemia caused by
• Hemorrhage, hemolytic, nutritional difficency (iron
and vitamins b 12)
• Kidney disease

5. HEMATOCRIT
The measure of the percentage of the
total blood volume that is made up of
RBC, Buffy coat(WBC, platelets)
Plasma.
Decreased levels indicates anemia,
Increased levels indicates erythrocytosis.
The hematocrit reflects the hemoglobin,
and RBC.
Normal finding
Males 42-50 pret
Females 37 -47
Pregnant women 33percent
New borns 44-64

6. MEAN CARPUSUR VOLUME/ MEAN
CARPUSUR HEMOGLOBIN
CONCENTRATION
• MCV
• Normal 77-95femto liters.
• Low MCV indicates microcytic due to iron difficency
anemia.
• High MCV indicates macrocytic anemia vit12,
pernicious anemia.
• MCHC this test measures the proportion of each
cell taken up by hemoglobin.

7. LEUCOCYTES (WBCs)
• 4500-11000 WBCs per microliters
• Leukopenia decreased levels of leukocytes due to
aplastic disorders.
• Leukocytosis increased levels of leukocytes due to
multifactorial reason infections, burns, trauma (fracture),
severe stress. Exercise..

8. DIFFERENTIAL BLOOD COUNT
• Neutrophil DIFFERENTIAL50-70
• Eosinophils 0.3
• Basophils 0.1
• Lymphocytes 20-40
• Monocytes2-6
• Platelets normal count 150,000-400,000 per
microliters

9. DBC
A blood test that measure the
percentage of WBCs ( Individual)
it also says ndicates if they are
abnormal or immature.

10. BUN,CREATININE& ELECTROLYTES
TEST OR SET
• Urea is a major end product of protein metabolism in
the human body.
• The liver produces ammonia after protein metabolism,
ammonia combines with carbon, nitrogen and oxygen
to produce urea which is water soluble.
• Ammonia is toxic to the brain.
• The conversion of ammonia to urea is a
DETOXIFICATION process.
• 90 percent of urea is excreted by the kidney the
remains is removed by the skin and GIT.

11. Causes of increased urea levels
• Dehydration
• Intestinal obstruction with vomiting
• Prolonged diarrhea
• Acute glomerulonephritis.
• EFFECTS OF UREA IN BLOOD.
• Seizure, loss of consciousness, heart attack,
and liver dysfunction.

12. Causes of reduced urea levels
• Liver cirrhosis
• Pregnancy
• Severe
• UREA NORMAL LEVEL 7-20m/dL

13. CREATININE
• conversation of phosphocreatine is an indicator of metabolic of muscle
contraction.
• Store creatine phosphate which is high energy compound is stored in the
muscles to serve as an immediate store of energy.
• EFFECTS INCREASE CREATIN
• Muscle cramps
• Diarrhea
• Dizziness
• Weight gain
• Normal levels 0.1-0.3mg/L
• DECREASED LEVEL OF CREATININE
• Starvation
• Muscle disorder
• Myasthenia gravis..

14. ELECTROLYTES PANELS (SET)
• Electrolytes panel test is a blood test that measures levels of the body's
main electrolytes.
• Electrolytes are eletrically charge minerals that help control the
amount to fluid and balance acid base in the body. They also help in the
control of muscle and nerve activity.
• SODIUM helps control the amount of fluid in the body and helps nerve
and muscle work work properly 130-144mmol/L
• Chloride which also control the amount of fluid in the body help
maintain healthy blood volume and pressure 96-106mmo/L
• POTASSIUM helps in muscle work properly 3.1-5.1mmol/L
• ABNORMAL levels high or low is a sign of serious health problem such
as kidney disease, hbp, seizures and irregular heartbeat or arrhythmia.

15. CONT__
• SET is carried out when there is a suspected electrolytes
imbalance or have symptoms subjective of electrolytes
imbalance such as;
• Nausea, vomiting, confusion weakness arrhythmias,
confusion and seizures.
• CAUSES OF ELECTROLYTES IMBALANCE
• Dehydration, kidney disease
• Diabetes, acidosis (vomiting, muscle twitching and
tingling)
• Alkalosis(irritability,muscle twitching, tingling finger toe.

16. Cont__
• ONION GAP measure the difference bet the
negative charged and positively charged
electrolytes inthe blood.
• High onion gap means ACIDOSIS
• Too low means blood is not acidic enough.
• 4-12 mE/L