CHAPTER XI

DIAGNOSTIC EXAMINATION

This chapter deals with the procedures and approaches in identifying individual's specific areas of weakness and strength in order
determine a condition, disease or illness.

CLINICAL CHEMISTRY is a quantitative science that is concerned with measurement of amounts of biologically important substances
(called analytes) in body fluids. The methods to measure these substances are carefully designed to provide accurate assessments of
their concentration. (Abbott Laboratories, 2020)

HEMATOLOGY is the study of blood in relation to health and disease. (Kandola, 2020)

EXAM NORMAL VALUES RATIONALE PATIENT’S REMARKS CLINICAL

RESULT SIGNIFICANCE
09/16/20

Random Blood 70-110 mg/dL) A blood sugar test is a 112 mg/dL High Patient may
Sugar (RBS) procedure that develop
measures the amount of hyperglycemia
sugar, or glucose, in which means that
your blood. the blood sugar is
(Prelipcean&De Pietro, elevated beyond
2019) normal.
White Blood Cells 3.50-10.00 To screen a variety of 16.59 (x10^9L) HIGH A high white blood
Count (x10^9L) conditions that can cell count
(WBC) affect the number of (leukocytosis) may
white blood cells indicate that a
(WBCs), such as an bacterial or viral
infection, inflammation infection is stewing
or a disease that affects the body.
WBC.

Red Blood Cells 3.80-6.0 (x10^12L) This test is used 4.13 (x10^12L) Normal RBC count is
Count (RBC) monitor any one of a normal which
variety of diseases and means that
conditions that affect transportation of
blood cells, such as oxygen and carbon
anemia, infection, dioxide in the body
inflammation, bleeding is norma.
disorder or cancer.

Hemoglobin 11.5-17.0 g/dL To evaluate the 12.9 g/dL Normal Normal hemoglobin
hemoglobin content of counts indicates
your blood as part of a absence of iron-
general health checkup; deficiency anemia.
to screen for and help
diagnose conditions that
affect red blood
cells(RBCs); if you have
 anemia (low
hemoglobin) or
polycythemia (high
hemoglobin).
(Maakaron, 2018).

Hematocrit 35-52% A hematocrit test 38.2% Normal Indicates that the

measures the blood contains
proportion of red blood normal no. of RBC
cells in your blood. Red and absence of
blood cells carry oxygen anemia, vitamin and
throughout your body. mineral
deficiencies.

Mean Corpuscular 76-100 cu.u
Volume (MCV)
MCV blood test 92.5 cu.u Normal Normal MCV
measures the average
indicates
size of your red blood
cells. If your red blood normocytic (normal
cells are too small or
average RBC size).
too large, it could be a
sign of a blood disorder
such as anemia, a
vitamin deficiency, or
other medical condition.
Mean corpuscular 27.0-34.0uug MCH test is used to 31.2uug Normal Normal MCH result
hemoglobin (MCH) identify the average indicates the
amount of hemoglobin absence of anemia.
in a person's red blood
cells. (Nelson, 2021)

Mean Corpuscular 32-35g/dL It's a measure of the 33. 7 g/dL Normal Normal result of
Hemoglobin average concentration MCHC indicates
Concentration of hemoglobin inside a absence of anemia.
(MCHC) single red blood cell.

Red Cell 37-49% RDW measures how 47.6% Normal Normal RDW
Distribution Width the sizes of your red indicates absence
RDW-SD blood cells vary. If of anemia and other
there’s a big difference RBC related
in their sizes, you could diseases.
have a problem like
anemia (Ratini, 2019)
Neutrophils 40-73% Neutrophilia test is done 86.0% High High level of
since it can point a neutrophils
number of underlying indicates that there
conditions and factors, is a short term or
including: infection, acute infection.
most likely bacterial.

Lymphocytes 15-45% It is done to identify if 8.3% Low Low counts can

there are some indicate a possible
underlying infections. infection or other
significant illness

Monocytes 4.0-12.0% Absolute monocyte 4.6% Normal People with normal

levels checked as part monocyte count
of a routine blood test is tend to develop
one way to monitor the fewer infections and
health of your immune chronic diseases.
system and your blood.
(Biggers&Roland, 2019
Eosinophils 0-0.50% The eosinophil count 0.5% Normal Normal result
measures the amount of indicates that this
eosinophils in your type of WBC is
blood. It is also done to working well for
check for allergic infections cause by
diseases and certain parasitic worms
infection. ingested in foods
such a raw meat.
Basophils 0.0-2.0% Basophils are 0.6% Normal Normal result
necessary for the indicate that this
immune system’s type of WBC is
natural response to working well for
invaders, such as inflammations
infectious germs. caused by allergic
(Tavella&Johnson,2019 reaction.
)

Platelet Count 150-450 A platelet count is a lab 142 Low Low count of
(x10^9L) test to measure how (x10^9L) platelet indicates
many platelets you have that the patient
in your blood. Platelets developed a
are a type of blood cell. thrombocytopenia
They help form blood which means that
clots by sticking the blood doesn’t
together. A clot is what have enough
stops the bleeding when platelets and the
 you have a wound. body can’t form a
(Samson&Martel, 2019) clots.
(Murrel&Martel,
2018).
Hepa B surface Non-reactive It is an important test Non-reactive Normal Not infected with
Antigen Screening that marks active hepatitis B
infection with hepatitis B
and helps in the
prediction of the clinical
outcome and
management of
hepatitis B virus (HBV)
infection.

URINALYSIS is test that looks at a small sample of your urine.  It can help find problems that need treatment, including infections or
kidney problems.  It can also help find serious diseases in the early stages, like kidney disease, diabetes, or liver disease.  A urinalysis
is also called a “urine test.”

EXAM NORMAL VALUES RATIONALE PATIENT’S REMARKS CLINICAL

RESULT SIGNIFICANCE
09/16/20

Chemical Exam
pH 4.5-8 A urine pH level test 6.0 Normal pH level is normal
 is a test that which means kidney
analyzes the acidity is in good condition.
or alkalin0ity of a
urine sample.
(Kim&Nall, 2020)

Special Gravity 1.001-1.035 A urine specific 1.015 Normal Normal result

gravity test indicates that the
compares the kidney is working
density of urine to well.
the density of water.
This quick test can
help determine how
well your kidneys
are diluting your
urine.
(Stephens&Nall,
2018).
Glucose Negative The glucose urine Negative Negative Normal Normal Negative result
test measures the indicates that the
amount of sugar patient does not
(glucose) in a urine intake excessive
sample. The sugary foods and is
presence of glucose unlikely to
in the urine is called developed d
glycosuria or diabetes mellitus.
 glucosuria.

Protein Negative This test detect 3+ 3+ High High High result indicates
and/or measure that the kidney isn’t
protein being working well.
released into the Proteins are
urine. normally found in
blood.

Microscopic Exam

Pus cells 0-4/hpf Testing for pus cells 3-5/hpf 0-2/hpf High Normal Normal pus cell in
determines if there urine indicates that
is site of infection there is no infection.

Red Blood Cells 0-4/hpf RBC test in urine is 4-7/hpf 1-3/hpf High Normal Normal RBC in
used to identify urine indicates that
infection, trauma, there is no infection
tumors, or kidney or irritation on the
stones. tissues of your
urinary tract.

Squamous Few This test is used to Few Normal The sample is not
Epithelial know if the sample contaminated.
is contaminated. It’s
normal to have one
to five squamous
 epithelial cells per
high power field
(HPF) in your urine.
(Stephens&Robbins,
2018).

Hyaline 0-2/hpf This test is used to 0-1/hpf Normal No signs of kidney

identify if there are related diseases.
some underlying
kidney disease or in-
volvement exists;
the presence of
casts indicates
kidney (renal)
disease rather than
lower urinary tract
disease. (Ringsrud,
2001)
Amorphous Urates Few/negative This test is done for Many High Repeated presence
possible presence of of amorphous urate
kidney stones. crystals in the urine
may indicate the
probable nature of
the stones. It should
be noted, however,
that most patients
with amorphous
urate crystals will
never form stones.

Physical Exam

Color Clear to pale yellow. To help diagnose Dark Not Dark yellow urine
and/or monitor Yellow normal indicates that the
several diseases urine has a solutes
and conditions, such such as nitrogenous
as kidney disorders waste and excess
or urinary tract Substances.
infections (UTIs).

Transparency Clear and To help diagnose Hazy Not Excess protein or

transparent and/or monitor normal crystalline
several diseases substances in the
and conditions, such urine, causing it to
as kidney disorders persistently appear
or urinary tract cloudy or foamy.
infections (UTIs). Infections anywhere
in the urinary tract
(UTIs), including the
bladder or urethra,
in both men and
women.