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1. PRESENTACION
DE CASO
CLINICO.

2. FICHA DE
IDENTIFICACION.

3. APNP

4. APP

5. PADECIMIENTO
ACTUAL.

6. PACIENTE ES RECIBIDO CON
SIGNOS VITALES DENTRO DE
PARÁMETROS NORMALES
FC 90LPM, FR 20 RPM, TA
100/50 MMHG TEMP 36°C
A SU LLEGADA.

7. CONTINUACION.

9. EXPLORACION
FISICA

10. DIAGNOSTICOS
SINDROMATICOS
POSIBLES.

11. LABORATORIOS.

12. P H
P C O 2
H C O 3
B E
P A 0 2
S 0 2
7 . 4 9
4 1 . 3
2 5 . 9
1 . 7 0
3 0 6
9 8
GASOMETRIA ARTERIAL
P H
P C O 2
H C O 3
B E
P A 0 2
S 0 2
7 . 3 5
4 6 . 5
2 6
0 . 8 0
4 6 . 4
7 9 . 5
GASOMETRIA VENOSA

13. L E U
N E U T
L I N F
E R I T
H B
H T O
P L A Q
1 5 . 8 0
8 7 . 2 0
6 . 1 0
3 . 5 1
1 0 . 3 0
3 1 . 4 0
1 7 7 . 0 0
BIOMETRIA HEMATICA

14. G L U C O S A
B U N
U R E A C A L C U L A D A
C R
A C U R I C O
1 5 5
8 . 5
1 8 . 2
0 . 8
6 . 3
QUIMICA SANGUINEA
T R O P O N I N A 2 2 . 9 0
TROPONINA

15. C K
C K M B
1 6 4
2 2
PERFIL CARDIACO

16. S O D I O
C L O R O
C A L C I O
F O S F O R O
P O T A S I O
M A G N E S I O
1 3 7
1 0 2 . 7
8 . 2
3 . 6
3 . 9
1 . 5
ELECTROLITOS II

17. T P
T T P
I N R
1 3 . 4
2 4 . 5
1 . 1 8
TIEMPOS

18. C O L E S T E R O L
P R O T E I N A S T O T A L E S
A L B U M I N A
G L O B U L I N A
R E L A C I O N A / G
B I L I R R U B I N A T O T A L
B I L I R R U B I N A D I R E C T A
B I L I R R U B I N A I N D I R E C T A
T G O
T G P
F O S F A T A S A A L C A L I N A
D E S H I D R O G E N A S A L A C T I C A
1 4 0
7 . 6
3 . 9
3 . 7
1 . 1
0 . 7
0 . 2
0 . 5
2 7
1 1
7 1 . 4 0
1 6 5 . 4 1
PRUEBAS FUNCIONALES HEPATICAS

19. SOSPECHA
DIAGNOSTICA.

21. EXPLORACION FISICA.

22. 03/06
04/06
04/06 TV
05/06
07/06

23. 08/06
09/06
10/06
11/06
14/06

24. 15/06
21/06

29. 17-jun RESULTADO
PROTEINA C
REACTIVA HIGH
16.96

31. PROTEINA
C REACTIVA
06-jun 07-jun 09-jun 10-jun 17-jun
PCR 19.23 24.86 17.88 16.24 16.96

32. PERFIL
CARDIACO
02-jun 04-jun 09-jun
CK 164 1282 657
CKMB 22 41 25

33. BIOMETRI
A
HEMATICA
02-jun 03-jun 04-jun 05-jun 06-jun 07-jun 08-jun 09-jun 10-jun 11-jun 12-jun 13-jun 14-jun 15-jun 16-jun
LEUCOCIT
OS
15.8 7.9 11.9 13.1 13.7 13.5 12.7 12.9 17.1 21.9 15.7 14.2 12.2
NEUTROFI
LOS
13.7 5.1 9.7 12.3 11.4 11.1 9.9 11.8 16.6 93.1 13.6 12.6 10
LINFOCIT
OS
1 1.5 1 0.3 1 0.8 1.1 0.4 0.8 0.6 1 0.7 0.9
MONOCIT
OS
0.9 1 1.1 0.5 1.2 1.5 1.8 0.7 0.7 0.9 0.9 0.8 0.8
HEMOGLO
BINA
10.3 11.2 11.3 12.3 11.8 10.9 10.5 930 9.2 9.6 8.8 9.3 9.3
HEMATOC
RITO
31.4 33 87.7 36.3 34.3 31.9 31.3 27.4 27.6 28.3 26.8 26.9 27.3
MCV 89.6 88 87.7 88.9 88.4 87.5 89.1 88.9 89.1 88 8.1 85.8 87.4
Hgb
CORPUSC
ULAR
MEDIA
29.4 29.9 29.9 30.1 30.2 29.9 30 30.1 29.8 29.8 29.1 29.6 29.2
CONT.
MED Hbg
CORPUSC
ULAR
32.8 3 34.1 33.8 34.2 34.1 33.7 33.9 33.4 33.8 33 34.4 33.4
PLAQUET
AS
177 173 64 151 156 137 119 96 91 102 129 162 341
VOL PLAQ
MEDIO
10.5 9.8 9.6 9.7 9.7 9.3 9.6 8.8 10.2 9.5 11.5 11.5 11.1

34. QUIMICA
SANGUIN
EA
02-jun 03-jun 04-jun 05-jun 06-jun 07-jun 08-jun 09-jun 10-jun 11-jun 12-jun 13-jun 14-jun 15-jun 16-jun 17-jun
GLUCOSA 155 124 139 96 144 147 147 170 151 121 169 147 123 113
BUN 8.5 11.4 13.3 17.9 29.1 30.1 27.2 17 27.2 17.7 17.5 13.9 12.7 14.3
UREA
CALCULA
DA
18.2 24.4 28 38.3 62.3 64.4 58.2 36.4 58.2 37.9 37.5 29.7 27.2 30.6
CREATINI
NA
0.8 0.8 0.8 1.1 1.2 0.9 0.6 0.6 0.3 0.6 0.6 0.6 0.9 0.5
ACIDO
URICO
6.3 2.3 1.9 2.1 2.6 2.2 2.2 2.9 4.2 3.5 2.3 2.5 2.7 2.2

35. ELECTROLIT
OS
II
02-jun 03-jun 04-jun 05-jun 06-jun 07-jun 08-jun 09-jun 10-jun 11-jun 12-jun 13-jun 14-jun 15-jun 16-jun 17-jun
SODIO 137 140 140 137 145 144 149 153 152 145 145 145 145
CLORO 102.7 107 107.7 105.4 11.8 111.3 111.7 111.9 111.4 107.1 107.7 111.4 111.6
CALCIO 8.2 8 7.7 7.3 8 8 7.7 7.5 8.3 7.4 7.4 7.6 7
FOSFORO 3.6 3.6 6.2 5 2.2 1.6 4.9 3.4 1.5 2 1.5 1.9 5.3
POTASIO 3.9 3.2 3.8 4.1 4.1 4 4.5 3.7 3.3 2.7 2.5 3.4 4.3
MAGNESIO 1.5 2 1.8 1.9 2.2 2.1 1.9 1.9 1.8 1.8 1.6 1.6 1.5

36. PRUEBAS
FUNCIONALE
S HEPATICAS
02-jun 03-jun 04-jun 05-jun 06-jun 07-jun 08-jun 09-jun 10-jun 11-jun 12-jun 13-jun 16-jun 17-jun
PROTEINS
TOTALES
7.6 7.1 6.9 6.3 6.4 6.4 6.3 5.9 6.4 5.3 6 5.4
ALBUMINA 3.9 3.5 3.3 3.1 2.9 2.9 2.9 2.6 2.9 2.2 2.2 2.1
GLOBULINAS 3.7 3.6 3.6 3.2 3.5 3.5 3.4 3.3 3.5 3.1 3.8 3.3
RELACION
A/G
1.1 1 0.9 1 0.8 0.8 0.9 0.8 0.8 0.7 0.6 0.6
BILIRRUBINA
TOTAL
0.7 0.8 0.5 0.6 0.8 0.6 0.7 0.6 0.6 0.7 0.7 0.5
BILIRRUBINA
DIRECTA
0.2 0.2 0.1 0.2 0.4 0.2 0.4 0.3 0.3 0.4 0.3 0.2
BILIRRUBINA
INDIRECTA
0.5 0.6 0.4 0.4 0.4 0.4 0.3 0.3 0.3 0.3 0.4 0.3
TGO 27 20 43 53 43 38 44 35 40 35 113 71
TGO 11 10 16 19 22 21 26 24 28 18 29 24
FOSFATASA
ALCALINA
71.4 64.8 81.22 80.14 73 72.9 66.44 59.92 74.3 65.4 80.1 74
DESHIDROGE
NASA
LACTICA
165.4 145.76 242.7 187.5 161.03 191.91 238.32 262.3 288.7 263.31 267.21 216.36
COLESTEROL 140 129 143 134 126 121 110 95 115 74 103 107