Health sciences and medicine - Case Study Example

Health sciences and medicine Introduction From the case history of the patient, her symptoms continue to worsen, and she demonstrated thrombocytopenia and anaemia conditions. The linking of the different lab test to reach the diagnosis is vital since special investigations are required for the arriving at a sure diagnosis (Lehman 2008). The tests include Blood Urea Nitrogen, Haemoglobin, Haematocrit, Platelet Count, White Blood Cell count, Haptoglobulins, Ketones, Direct Antiglobulin and Urine Analysis that involved the testing of Haematuria and Proteinuria. Further microbiology tests to analyse the blood are necessary, and they include; Grams Staining, MacConkey’s and EMB Agar Plates, OF test, Oxidase Test and Serotyping to analyse the Stool plate. Each test is beneficial since they allow for the undertaking of laboratory evaluations so as to reach the diagnosis and the administering of the appropriate treatment for the patient. Apart from the lab tests, the history and physical evaluation are vital in the diagnosis (Gould, Bopp & Body 2009). The paper will focus on linking the different lab tests to reach the diagnosis. The paper will also identify the benefits associated with each of the tests to arrive at the diagnosis. Finally, the paper will recommend the appropriate treatment for the condition. Blood Urea Nitrogen Test The initial lab evaluation entails the testing of the BUN (Blood Urea Nitrogen). The test determines the volume of nitrogen in the blood that results from the by-product of urea (Desch & Motto 2007). It establishes functioning of the kidney in the elimination urea from the blood. In a situation where the kidney is not functioning well, the blood urea nitrogen level increases. The test is beneficial since it enables the use of creatinine test to enable the finding of the Blood Urea Nitrogen to Creatinine ratio (BUN: creatinine) allowing the identification of dehydration problems in the patient. The laboratory result showed that the Blood Urea Nitrogen of the patient was 9.3 mmol/L. The result falls within the normal range that is recommended for children who are between 5 to18 mg/dL (Lehman, 2008). Haemoglobin Test The test is usually to investigate blood conditions including anaemia together with the hematocrit or complete blood count (Corbett, & Banks 2013). The test is beneficial in the screening, monitoring and diagnosis of diseases and conditions that impact on the red blood cells and the volume of haemoglobin in the blood. Conditions that lead to the loss or destruction of the red blood cells dues to bleeding makes the bone marrow unable to secrete new ones quickly hence leading to haemoglobin reduction and thus leading to anaemia. The haemoglobin test on the patient arrived at a result of 82g/L that is low than the normal level that is between 120 to 140 g/L, hence suggesting that the patient is anaemic (Lehman 2008). Haematocrit test Together with the haemoglobin test, the haematocrit test is important in the investigation of anaemia and thrombocytopenia conditions (Fiorino & Raffaelli 2006). The haematocrit test involves the determination of the volume percentage proportion of blood that comprises of the red blood cells. The test is undertaken by an automated machine that undertakes various measurements over time. The result calculation is attained through the determination of the volume of haemoglobin and red blood cells the mean volume. The result from the patient indicates a percentage level of 30.7%. The recommended percentage for a healthy individual is between 34 and 40% hence implying that the patient is anaemic because of the low result (Lehman 2008). Platelet Count Test Platelet Count Test is used in the measurement of the number of platelets in the blood hence is useful in the investigation of thrombocytopenia condition in patients (Corbett, & Banks 2013). The platelets aid the blood in the blood clot process after one has an injury hence preventing blood loss. A complete blood count under the test establishes some blood cells and, in particular, platelets in the blood sample of the patient. In children, the normal platelet count is and a platelet count of between 150 to 450 × 1000 /mL. The results from the patient indicate that the platelet count is 28 x 109/L implying that the count is lower than the normal range thus confirming that the patient has thrombocytopenia (Lehman 2008). White Blood Cell Count Test As part of the complete blood count, the White Blood Cell Count Test is beneficial since it aids in the diagnosis of symptoms that suggest disorder blood conditions (Corbett, & Banks 2013). The test determines the number of white blood cells that a patient has in her body. The major categories of white blood cells include neutrophils and band cells. The test count reveals all these types of white blood cells. The white blood cell count that is normal for children ranges between 5.5 to 15.5 × 1000/mL comprising of 7% bands and 89% neutrophils. The result from the patient is 22 x 109/L implying that it is below the normal range suggests that the bone marrow may be damaged since it does not produce adequate white blood cells (Elliot & Robins-Browne 2005) Haptoglobulins Test The Haptoglobulins Blood Test determines the levels haptoglobin in the blood sample of a patient. Haptoglobin protein is produced by the liver and combines with haemoglobin located in the red blood cells. It transports the haemoglobin back to the liver for recycling. The Haptoglobulins Test is beneficial because it aids in the diagnosis of haemolytic anaemia disease. The result from the test shows that the Haptoglobulins was absent (Corbett & Banks 2013). It means that red blood cells are destroyed, and the haemoglobin and haematocrit are also low hence pointing to the view that the patient has haemolytic anaemia. Ketones Test The test determines the number of ketones in the blood and urine of a patient. Ketones are produced during the breaking down of fat to produce energy for the body (Garrels 2014). The benefit of the method is that when blood samples are used, it produces the most precise results. The test is ideal because the patient was vomiting and had abdominal pain at the early stages of admission. The patient recorded a result of 150mg/ml from the urinalysis test. For a healthy individual, the ketones are supposed to be absent hence implying that their presence may indicate a condition of general sickness (Elliot & Robins-Browne 2005) Direct Antiglobulin Test test aids in the investigation of the prospect of the haemolytic anaemia being as a result of antibodies that are bonded to the red blood cells (Keir & Coward 2011). In the case where the patient is experiencing fatigue, the test is most appropriate since the cause of the illness might be due to a limited number of red blood cells. The test is advantageous since it allows the doctor to establish whether there are antibodies in the bloodstream of the patient that make the immune system react against the red blood cells hence destroying them. The test on the patient was negative hence implying that the antibodies are not bonded to the red blood cells. It indicates that the symptoms observed in the patient may be as a result other cause hence needing additional investigation (Garrels 2014). Urine Analysis Test The test examines the patient’s urine if it contains blood using a microscopic observation. The analysis establishes the availability of red blood cells in the urine hence implying that the patient has haematuria (Higgins 2013). In the case of proteinuria, the analysis uses the dipstick test to measure the concentrations of albumin and other proteins in the urine that are produced by the nephron. The dipstick urinalysis test is beneficial because it is consistent in its prediction. The urine analysis test result of the patient was four Red blood cells/ low power field of 300mg/dL hence a positive result regarding the presence of proteins in the urine. The normal result is supposed to be negative thus revealing the presence of a slight amount of proteinuria and haematuria. Gram's staining Test The test involves the performing of microbiology tests on a stool for bacterial infections (Higgins 2013). It is beneficial since it enables the analysis of the stool and blood specimen for the presence or absence of bacteria hence is vital in the establishment of a suitable diagnosis and treatment of an infection. A gram stain allows the doctor to establish if the infection is as a result of bacteria and also to know the type of bacteria found in the specimen. The tests from the patient showed gram-negative bacilli. It implies that the stool culture showed no growth. The negative result from the stool showed that there no organism was seen meaning that there was no bacteria present (Garrels 2014). OF test The oxidative-fermentative test establishes the gram bacteria metabolize through fermentation in aerobic and anaerobic conditions (Higgins 2013). The test is beneficial because it offers insights into the ability of bacteria to utilise glucose in both oxidation and fermentation methods. The result from the patient’s specimen was positive as shown by the colour of the culture turning into yellow when an acid is added. Oxidase Test The oxidase test is a test establishes if a bacterium in the specimen secretes certain oxidases (Walker, MacKinnon. & Fazlanie, 2012). The result obtained from the patient urine sample was negative implying that these bacteria do not have the oxidase used to oxidize test reagent. Hence, further analysis would be necessary. Diagnosis From the results of the different lab test conducted, the patient is a Haemolytic uremic syndrome that is a combination of three conditions. The conditions causing her illness include Microangiopathic hemolytic anaemia, renal dysfunction, and thrombocytopenia. The conditions are the top-most cause of renal failure among kids in the world. The majority of the patients established to have Haemolytic uremic syndrome preceded by experiencing diarrhoea (Ruggenenti & Remuzzi 1998). The pathogens that result in the disease are Escherichia coli together with bacteria followed such as Shigella. In a case where diarrhoea does not precede the disease then it is deliberated to be an uncommon Haemolytic uremic syndrome. The disease commonly affects young kids who have attained the age of attending school. Typical Haemolytic uremic syndrome illnesses start being experienced after three to seven days of the start of the gastroenteritis symptoms and signs (Garrels 2014). The intestinal complications may worsen hence requiring the need for one to be admitted to a hospital due to dehydration caused by the diarrhea symptoms. The Microangiopathic hemolytic anemia is one of the major components of the Haemolytic uremic syndrome disease. The condition is characterised by a negative result from the Direct Antiglobulin Test and the haemoglobin volume of below Read More