LABORATORIES AND X-RAYS: HEMGPD, WBC 10.8, hemoglobin 14.4, hematocrit 42.5, platelets count 446,000, neutrophils 81.2 and lymphocytes 13.2. PT 9.9, INR 0.99, and PTT 29.7. BMP; sodium 137, potassium 3.4, chloride 105, CO2 of 23, glucose 105, BUN 11, creatinine 0.8, calcium 8.6, total protein 6.3, albumin 3.5, and globulin 2.8. Total bilirubin was 2, repeat was 1.8. Alkaline phosphatase was 159, repeat was 140. ALT was 840, repeat was 412. AST was 581, repeat was 143. Hepatitis panel was nonreactive for hepatitis A IgM, B core IgM, B surface antigen, and C IgG. Amylase was 54 and lipase was 32. Urinalysis; pH 5.4, specific gravity 1.029, ketones +2, blood +3, nitrites negative. Leukocyte esterase was negative, rbc's 8, wbc's 0, and bacteria occasional. Ultrasound of the gallbladder; multiple small gallstones within the gallbladder. Common bile duct at the upper limit of normal.
LABORATORY DATA: WBC 13.8, hemoglobin 10.8, hematocrit 30.7, and platelets 388,000. Differential; segs 34, bands 28, lymphocytes 28, and monocytes 7. Chemistry profile; sodium 139, potassium 4.1, chloride 104, carbon dioxide 21, glucose 99, calcium 10.2, BUN 10, and creatinine 0.3. Urinalysis (catheterized) revealed a specific gravity of less than 1.005 with a pH of 5, 2+ blood, and 0-4 red and white blood cells per high power field. Nasal washings for RSV were negative, and the throat culture was positive for Streptococcus pneumoniae. The urine culture was positive for Klebsiella species, sensitive to Rocephin.
PERTINENT LABORATORY DATA: EKG is within normal limits. The patient had a CT of the abdomen, which showed no evidence of any acute abnormality. There was prominence of the Wirsung duct of the pancreas. CT of the pelvis was normal. Ultrasound of the abdomen showed enlarged spleen, although the pancreas was slightly hyperechoic. Admitting CBC showed a hematocrit of 42, discharge hematocrit was 34. Admitting white count was 6300, discharge white count was 2600. Admitting platelet count was 64,000, discharge platelet count was 68,000. Admitting comprehensive metabolic profile showed serum sodium decreased to 127. The glucose was elevated to 176. The albumin was decreased to 2.3. Alkaline phosphatase was elevated to 192. SGPT elevated to 106. SGOT 107. The day prior to discharge, the patient's liver function tests were relatively same. The bilirubin was elevated to 2.9, normal is 1.5. Direct bilirubin was 2.3, normal is 0.3. Serum sodium had improved to 132. On the day of discharge, CD4 count was done and it was low at 25.8, normal is 36-60. CD8 count was elevated to 60.1, normal is up to 36. CD3 count was elevated to 88, normal is up to 86.
LABORATORY DATA: Triglycerides 257, total cholesterol 204, HDL 48, LDL 104, sodium 131, potassium 3.6, chloride 91, CO2 of 28, glucose 84, BUN 22, creatinine 1.3, calcium 10.3, total protein 6.1, albumin 4.2, total bilirubin 0.7, alkaline phosphatase 62, SGOT 17, and SGPT 15. WBC 10,500, 57 segs, 22 lymphs, 10 monos, and 1 eosinophil. Hemoglobin 13.7, hematocrit 39.6%, MCV 93, platelets 208,000. Tacrolimus level 6.9. Urinalysis: Specific gravity 1.011, pH 6.5, trace blood, greater than 60 wbc's per high-power field, 0-5 squamous cells, and few bacteria.
LABORATORY DATA: On admission showed an elevated white count of 15, H&H that was stable with a slightly elevated platelet count of 371, probably secondary to anticoagulation. By discharge, the patient's CBC showed a white count of 7.1 with hemoglobin 10.4, hematocrit 31.5, and platelets were 254. PT/INR remained normal. Chemistry profile on admission only showed an elevated glucose of 137, no other abnormalities. By discharge, the patient's chemistry profile still showed a slightly elevated glucose of 106. The patient also had magnesium levels that were normal. Her fasting lipid panel was within normal limits. Her BNP was slightly elevated at 825. Urinalysis on admission was normal. Culture showed positive Candida albicans greater than 100,000. Her repeat clean-catch urine showed no growth.
LABORATORY DATA: Hemoglobin 14.8, hematocrit 42.4, WBC 13.7, platelets 229,000. D-dimer less than 0.22. CK-MB 1.7, CK 46. Sodium 134, potassium 4.3, chloride 99, bicarbonate 24, BUN 26, creatinine 0.9, glucose 184, albumin 3.7, calcium 87, alkaline phosphatase 78, ALT 39, AST 18, total bilirubin 0.4, troponin less than 0.02, B-natriuretic peptide 26.
LABORATORY DATA: CBC; WBC 7.2, hemoglobin 14, hematocrit 40, and platelets 279,000. PT 11, PTT 28, and INR 1.14. Sodium 136, potassium 4.7, chloride 103, bicarbonate 25, glucose 101, BUN 18, creatinine 1.1, calcium 9.6. CPKs; 388, 345, and 340. HDL 70, LDL 137, triglycerides 84, cholesterol 184. Three cardiac enzymes were within normal limits. CPK-MB; 12, 9, and 10.
LABORATORY DATA: TSH 0.9, glucose 133, RPR was nonreactive, and hematology was unremarkable. Chemistry profile was abnormal for glucose of 142. Urine toxicology was positive for benzodiazepines and cannabis. Urinalysis was remarkable for 4+ glucose.
LABORATORY DATA: TSH 1.4. RPR nonreactive. CBC was within normal range. Chemistry profile was normal, except for an SGOT of 53. Acetaminophen level on admission was 115.8 and salicylate was 20.3. Toxicology screen was positive for THC. Urinalysis was negative.
LABORATORY DATA: Her CBC showed a WBC of 13.2, but everything else was within normal range. PT and PTT were normal. Chemistry profile was normal. TSH 1.6. Urine toxicity screen was positive for benzodiazepines. RPR was nonreactive. Urinalysis was positive for 2+ blood and trace leukocyte esterase, 13 white blood cells, and 56 rbc's, bacteria occasional.
LABORATORY DATA: His RPR was nonreactive. CBC showed a WBC of 6000, hemoglobin 12.4, and hematocrit 36. Chemistry profile was unremarkable. TSH 1. Urine toxicology was negative. Urinalysis was negative. A CT scan of the abdomen showed thickening of the cecal wall showing interval increase from the prior study and soft tissue density occupying the proximal ascending colon.
LABORATORY DATA: Shows sodium of 140, potassium of 2.6, BUN 10, creatinine 0.7, hemoglobin 14, and hematocrit 43. Head CT without contrast shows a lacuna on the right pons-mesencephalon junction, intermediate in age. Old lacunaes are present in the basal ganglia. There is a deformity in the anterior right pons-mesencephalon junction. These may be because of a very difficult to see epidermoid.
LABORATORY DATA: Sodium 134, potassium 3.9, glucose 109, BUN 19, creatinine 1, ALT elevated at 84, AST 167, amylase and lipase normal. Cardiac enzyme panel normal. Hemoglobin 13.8. White blood cell count 9400. Ultrasound of the gallbladder revealed layering debris within the gallbladder consistent with sludge and small gravel-like material. Common bile duct appears normal in size at 6.5 mm. Electrocardiogram; normal sinus rhythm with rate of 81, nonspecific ST-T wave flattening and inversions, which is minimal and essentially unchanged from previous EKG.
LABORATORIES: White blood cell count 7400. Initial hemoglobin 10.9, at discharge 9.2. Platelets 286,000. Reticulocyte count 1.1. INR 0.88 and PTT 29. Potassium 4, BUN 8, creatinine 0.8, glucose 100, magnesium 2.2, albumin 2.7, phosphorous 1.9. Cholesterol 204, HDL 37, LDL 129, and triglycerides 188. Dilantin level at discharge was 14. B12 level 275. Ferritin 144. Urinalysis normal. Blood type O positive. One stool trace guaiac positive. Two blood cultures negative.
LABORATORIES AND IMAGING: CT brain; parenchymal bleed, right occipital pole, approximately 1.1 cm x 8.1 mm. CT brain next day; mild resolution of hemorrhage. No mass effect. Renal ultrasound was negative. Laboratories: Hemogram, discharging hemogram, WBC 18, hemoglobin 11.7, hematocrit 34.6, and platelets 422. Neutrophils 36, lymphocytes 49, bands 2, monocytes 13. CRP negative. Urine culture negative. UA negative. Basic metabolic panel: Calcium 10.5, sodium 140, potassium 4.4, chloride 107, CO2 of 20, BUN 10, creatinine 0.2, and glucose 83.
LABORATORY DATA: WBC 13.8, hemoglobin 10.8, hematocrit 30.7, and platelets 388,000. Differential; segs 34, bands 28, lymphocytes 28, and monocytes 7. Chemistry profile; sodium 139, potassium 4.1, chloride 104, carbon dioxide 21, glucose 99, calcium 10.2, BUN 10, and creatinine 0.3. Urinalysis (catheterized) revealed a specific gravity of less than 1.005 with a pH of 5, 2+ blood, and 0-4 red and white blood cells per high power field. Nasal washings for RSV were negative, and the throat culture was positive for Streptococcus pneumoniae. The urine culture was positive for Klebsiella species, sensitive to Rocephin.
PERTINENT LABORATORY DATA: EKG is within normal limits. The patient had a CT of the abdomen, which showed no evidence of any acute abnormality. There was prominence of the Wirsung duct of the pancreas. CT of the pelvis was normal. Ultrasound of the abdomen showed enlarged spleen, although the pancreas was slightly hyperechoic. Admitting CBC showed a hematocrit of 42, discharge hematocrit was 34. Admitting white count was 6300, discharge white count was 2600. Admitting platelet count was 64,000, discharge platelet count was 68,000. Admitting comprehensive metabolic profile showed serum sodium decreased to 127. The glucose was elevated to 176. The albumin was decreased to 2.3. Alkaline phosphatase was elevated to 192. SGPT elevated to 106. SGOT 107. The day prior to discharge, the patient's liver function tests were relatively same. The bilirubin was elevated to 2.9, normal is 1.5. Direct bilirubin was 2.3, normal is 0.3. Serum sodium had improved to 132. On the day of discharge, CD4 count was done and it was low at 25.8, normal is 36-60. CD8 count was elevated to 60.1, normal is up to 36. CD3 count was elevated to 88, normal is up to 86.
LABORATORY DATA: Triglycerides 257, total cholesterol 204, HDL 48, LDL 104, sodium 131, potassium 3.6, chloride 91, CO2 of 28, glucose 84, BUN 22, creatinine 1.3, calcium 10.3, total protein 6.1, albumin 4.2, total bilirubin 0.7, alkaline phosphatase 62, SGOT 17, and SGPT 15. WBC 10,500, 57 segs, 22 lymphs, 10 monos, and 1 eosinophil. Hemoglobin 13.7, hematocrit 39.6%, MCV 93, platelets 208,000. Tacrolimus level 6.9. Urinalysis: Specific gravity 1.011, pH 6.5, trace blood, greater than 60 wbc's per high-power field, 0-5 squamous cells, and few bacteria.
LABORATORY DATA: On admission showed an elevated white count of 15, H&H that was stable with a slightly elevated platelet count of 371, probably secondary to anticoagulation. By discharge, the patient's CBC showed a white count of 7.1 with hemoglobin 10.4, hematocrit 31.5, and platelets were 254. PT/INR remained normal. Chemistry profile on admission only showed an elevated glucose of 137, no other abnormalities. By discharge, the patient's chemistry profile still showed a slightly elevated glucose of 106. The patient also had magnesium levels that were normal. Her fasting lipid panel was within normal limits. Her BNP was slightly elevated at 825. Urinalysis on admission was normal. Culture showed positive Candida albicans greater than 100,000. Her repeat clean-catch urine showed no growth.
LABORATORY DATA: Hemoglobin 14.8, hematocrit 42.4, WBC 13.7, platelets 229,000. D-dimer less than 0.22. CK-MB 1.7, CK 46. Sodium 134, potassium 4.3, chloride 99, bicarbonate 24, BUN 26, creatinine 0.9, glucose 184, albumin 3.7, calcium 87, alkaline phosphatase 78, ALT 39, AST 18, total bilirubin 0.4, troponin less than 0.02, B-natriuretic peptide 26.
LABORATORY DATA: CBC; WBC 7.2, hemoglobin 14, hematocrit 40, and platelets 279,000. PT 11, PTT 28, and INR 1.14. Sodium 136, potassium 4.7, chloride 103, bicarbonate 25, glucose 101, BUN 18, creatinine 1.1, calcium 9.6. CPKs; 388, 345, and 340. HDL 70, LDL 137, triglycerides 84, cholesterol 184. Three cardiac enzymes were within normal limits. CPK-MB; 12, 9, and 10.
LABORATORY DATA: TSH 0.9, glucose 133, RPR was nonreactive, and hematology was unremarkable. Chemistry profile was abnormal for glucose of 142. Urine toxicology was positive for benzodiazepines and cannabis. Urinalysis was remarkable for 4+ glucose.
LABORATORY DATA: TSH 1.4. RPR nonreactive. CBC was within normal range. Chemistry profile was normal, except for an SGOT of 53. Acetaminophen level on admission was 115.8 and salicylate was 20.3. Toxicology screen was positive for THC. Urinalysis was negative.
LABORATORY DATA: Her CBC showed a WBC of 13.2, but everything else was within normal range. PT and PTT were normal. Chemistry profile was normal. TSH 1.6. Urine toxicity screen was positive for benzodiazepines. RPR was nonreactive. Urinalysis was positive for 2+ blood and trace leukocyte esterase, 13 white blood cells, and 56 rbc's, bacteria occasional.
LABORATORY DATA: His RPR was nonreactive. CBC showed a WBC of 6000, hemoglobin 12.4, and hematocrit 36. Chemistry profile was unremarkable. TSH 1. Urine toxicology was negative. Urinalysis was negative. A CT scan of the abdomen showed thickening of the cecal wall showing interval increase from the prior study and soft tissue density occupying the proximal ascending colon.
LABORATORY DATA: Shows sodium of 140, potassium of 2.6, BUN 10, creatinine 0.7, hemoglobin 14, and hematocrit 43. Head CT without contrast shows a lacuna on the right pons-mesencephalon junction, intermediate in age. Old lacunaes are present in the basal ganglia. There is a deformity in the anterior right pons-mesencephalon junction. These may be because of a very difficult to see epidermoid.
LABORATORY DATA: Sodium 134, potassium 3.9, glucose 109, BUN 19, creatinine 1, ALT elevated at 84, AST 167, amylase and lipase normal. Cardiac enzyme panel normal. Hemoglobin 13.8. White blood cell count 9400. Ultrasound of the gallbladder revealed layering debris within the gallbladder consistent with sludge and small gravel-like material. Common bile duct appears normal in size at 6.5 mm. Electrocardiogram; normal sinus rhythm with rate of 81, nonspecific ST-T wave flattening and inversions, which is minimal and essentially unchanged from previous EKG.
LABORATORIES: White blood cell count 7400. Initial hemoglobin 10.9, at discharge 9.2. Platelets 286,000. Reticulocyte count 1.1. INR 0.88 and PTT 29. Potassium 4, BUN 8, creatinine 0.8, glucose 100, magnesium 2.2, albumin 2.7, phosphorous 1.9. Cholesterol 204, HDL 37, LDL 129, and triglycerides 188. Dilantin level at discharge was 14. B12 level 275. Ferritin 144. Urinalysis normal. Blood type O positive. One stool trace guaiac positive. Two blood cultures negative.
LABORATORIES AND IMAGING: CT brain; parenchymal bleed, right occipital pole, approximately 1.1 cm x 8.1 mm. CT brain next day; mild resolution of hemorrhage. No mass effect. Renal ultrasound was negative. Laboratories: Hemogram, discharging hemogram, WBC 18, hemoglobin 11.7, hematocrit 34.6, and platelets 422. Neutrophils 36, lymphocytes 49, bands 2, monocytes 13. CRP negative. Urine culture negative. UA negative. Basic metabolic panel: Calcium 10.5, sodium 140, potassium 4.4, chloride 107, CO2 of 20, BUN 10, creatinine 0.2, and glucose 83.
