Hgb

All of these values may vary slightly between laboratories. Some laboratories do not differentiate between
adult and "after middle age" hemoglobin values.

No signs of anemia present

• Fatigue
• Weakness
• Pale skin and gums
• Shortness of breath
• A fast or irregular heartbeat

Lymphocyte is only slightly decreased. This is usually not significant.

Note : diff count is 77

Where is the other 23 hahaha

Specific gravity (Hypersthenuria)

The first and most common reason for an increase in urine specific gravity is dehydration. The second
reason for a high specific gravity is an increased secretion of anti-diuretic hormone (ADH). ADH causes
increased tubular water re-absorption and decreased urine volume. Trauma, stress reactions, surgery,
and many drugs cause an increase in ADH secretion.

A value >1.035-1.040 suggests possible contamination, very high levels of glucose, or recently received
low-molecular-weight dextran or high-density radiopaque dyes.

Related Findings:
Dehydration
Elevated hematocrit and total protein
Elevated sodium and chloride

In diabetes insipidus, there is an absence or decrease of anti-diuretic hormone. Without anti-diuretic

hormone, the kidneys produce an excessive amount of urine, often up to 15 to 20 liters per day with a low
specific gravity.

FBS:

According to ADA

FBS - Prediabetes - 100 mg/dl to 125 mg/dl

Serum Na - People with diabetes mellitus and high blood sugar levels may urinate excessive amounts,
causing dehydration. Dehydration can also be caused by kidney disorders and by diabetes insipidus,
which also causes people to urinate excessive amounts although without high blood sugar levels,and is
due to inadequate or ineffective vasopressin secretion or action.

Rarely, adrenal gland disorders can cause mild hypernatremia without dehydration.
Hypernatremia typically causes thirst. The most serious symptoms of hypernatremia result from brain
dysfunction. Severe hypernatremia can lead to confusion, muscle twitching, seizures, coma, and death.

Look out for symptoms

2ND SLIDE
If prolactin levels are higher than normal, it often means there is a type of tumor of the pituitary
gland, known as a prolactinoma. This tumor makes the gland produce too much prolactin. Excess
prolactin can cause the production of breast milk in men and in women who are not pregnant or
breastfeeding.

Large pituitary tumors can paradoxically elevate blood prolactin levels due to the "stalk
effect." This elevation occurs as a result of the compression of the pituitary stalk, which
interferes with the brain's control of prolactin production.

MRI FIRST SLIDE

Review of common mri sequence

For describing the MRI appearance of the parts of the brain we use the terms
hyperintense and hypointense, with the gray matter being the reference point. This
means that everything that is brighter than the grey matter is hyperintense, while
everything that is darker is hypointense.
For example, in all sequences, the bone is the dimmest structure on the scan since it
has the lowest density of the protons. Hence, we say that the bone is hypointense.

If there are tumors and other abnormalities in your body, they will absorb the contrast dye, and this
area will glow on the MRI scan. Small tumors, which may not be visible on X-ray or CT Scan, may
be detected by MRI. The contrast helps detect even the smallest tumors, and it can give your doctor
more clarity regarding the location and size of a tumor and which organs or tissues are involved.

Magnetic resonance imaging (MRI) scans sometimes involve an injection of a gadolinium contrast
dye to create highly detailed images.

The optimal timing is about 30 minutes and it is better to give contrast at the start of the
examination and to do the enhanced T1WI at the end.

the presence of calcification is often of diagnostic significance. It is shown that CT is

superior to MR in the detection of calcification.

CORONAL VIEW

For coronal scans, everything that’s on the left side is actually the patient’s right, and
vice versa.
The dominant signal intensities of different tissues are:

• fluid (e.g. urine, CSF): low signal intensity (black)

• muscle: intermediate signal intensity (grey)
• fat: high signal intensity (white)
• brain
o grey matter: intermediate signal intensity (grey)
o white matter: hyperintense compared to grey matter (white-ish)

The sellar region includes the sella turcica and the pituitary gland, together with the
ventral adenohypophysis and dorsal neurohypophysis. The parasellar region
encompasses the cavernous sinuses, suprasellar cistern, hypothalamus, and ventral
inferior third ventricle.

The suprasellar cistern is a cerebrospinal fluid filled space between the top of the pituitary and
bottom of the hypothalamus. The pituitary stalk normally courses through this space to enter the
pituitary gland and is critical for the normal operation of the pituitary.

Hyperintense thick peripheral rim

The T1 hyperintensity is usually secondary to high protein content in the cyst fluid. However, other
causes of T1 hyperintensity in craniopharyngiomas have been described—fat, cholesterol, hemorrhage, or
even mild calcification

The most common abnormalities that arise in the pituitary gland are pituitary adenoma, Rathke's
cleft cyst and craniopharyngioma.

SAGITTAL VIEW

The pituitary sits in a saddle-like compartment in the skull called the sella turcica.

young adult (<50)

• male: 8 mm
The pituitary stalk is not identifiable, however, due to a round mass in this area.
Sagittal T1 image mass of mixed hyper- and hypointensity

AXIAL

For axial scans, imagine as if you are looking at the patient through their feet while
facing the opposite directions. Then everything that’s on your left is on the patient’s
right, and everything that you anteriorly is on the patient’s posterior side.
• fluid (e.g. urine, CSF): high signal intensity (white)
• muscle: intermediate signal intensity (grey)
• fat: high signal intensity (white)
• brain
o grey matter: intermediate signal intensity (grey)
o white matter: hypointense compared to grey matter (dark-ish)
MRI ANALYSIS

The criteria for carotid encasement included narrowing of vessel lumen and enveloping of the artery by
tumor.

The T1 hyperintensity is usually secondary to high protein content in the cyst fluid. However, other
causes of T1 hyperintensity in craniopharyngiomas have been described—fat, cholesterol, hemorrhage, or
even mild calcification

• fluid (e.g. urine, CSF): low signal intensity (black)

• muscle: intermediate signal intensity (grey)
• fat: high signal intensity (white)
• brain
o grey matter: intermediate signal intensity (grey)
o white matter: hyperintense compared to grey matter (white-ish)

iso- to slightly hypointense to brain