Urinalysis showed albumin, bacteria,white cell and pus. Why are these findings important and how they relate to the diagnoses? What does TNTC mean?

Basic Clinical Laboratory Techniques 6E
6th Edition
ISBN:9781133893943
Author:ESTRIDGE
Publisher:ESTRIDGE
Chapter6: Basic Clinical Chemistry
Section6.1: Introduction To Clinical Chemistry
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Urinalysis showed albumin, bacteria,white cell and pus. Why are these findings important and how they relate to the diagnoses? What does TNTC mean?
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Admitted: 11/1/19
Discharged: 11/12/19
Chief Complaint: This 66 y.o. male was admitted for nausea, vomiting and anorexia of three days duration.
The patient also complained of recent RUQ pain and pyrosis after heavy meals. This is the second hospital
admission for this 66 y.o. male patient with a known history of chronic kidney disease, hypertension,
osteoarthritis, asthma, gastroesophogeal reflux disease, PUD (with prior hemorrhage), and bilateral total
knee replacement. Prior to admission, the patient had been drinking heavily as he had in the past and he
had tremors prior to admission. He sleeps on two pillows and has dyspnea after climbing one flight of stairs.
He denied recent colds, upper respiratory infections, hematemesis or diarrhea. The patient complained of
some urinary frequency and urgency. There was a rash noted on the forearms, which the patient had been
treating with Benadryl cream.
Physical Examination: The patient was in some distress on examination. Examination of the head revealed
pupils and eye movements to be within normal limits. The chest was clear and the heart rate was normal.
The blood pressure was elevated at 200/120. Tem
and respirations were 16. Examination of the abdomen revealed some distention with pain in the RUQ. The
rectal examination revealed an enlarged prostate of two to three times the normal size. Occult blood was
negative. The rest of the exam was within normal limits.
erature was slightly elevated at 100.6. Pulse was 72
Laboratory Studies: Admission blood tests revealed an elevated white blood cell count as well as an
elevated serum bilirubin. Urinalysis showed albuminuria, the presence of bacteria, TNTC white cells and
pus. Sonography and HIDA scan revealed cholelithiasis. PSA was 19.8.
Impression: Cholelithiasis/cholecystitis. Enlarged prostate with elevated PSA, possible BPH, rule out
tumor. Consider EGD due to history of GERD and PUD.
Hospital Course: The patient was diagnosed with cholelithiasis/cholecystitis. The patient underwent
laparoscopic cholecystectomy under general endotracheal anesthesia. Pathology revealed chronic
cholecystitis and cholelithiasis.
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Transcribed Image Text:AutoSave HINM115CaseStudySU21 (2) - Compatibility Mode - Word 2Search File Home Torres, Amy R Insert Draw Design Layout References Mailings Review View Help Grammarly A Shar Verdana - A A" Aa - A - 11 PFind - AaBbCcl AABBCC AaBbCc[ Paste U - ab x A- 2. A- 三三、 、田、 Replace Emphasis T Heading 1 T Heading 2 Dictate Editor Reuse Creative A Select - Clipboard Font Files Cloud Gr Paragraph Styles wwwwwww w wwww Editing Voice Editor Reuse Files Adobe Gr Admitted: 11/1/19 Discharged: 11/12/19 Chief Complaint: This 66 y.o. male was admitted for nausea, vomiting and anorexia of three days duration. The patient also complained of recent RUQ pain and pyrosis after heavy meals. This is the second hospital admission for this 66 y.o. male patient with a known history of chronic kidney disease, hypertension, osteoarthritis, asthma, gastroesophogeal reflux disease, PUD (with prior hemorrhage), and bilateral total knee replacement. Prior to admission, the patient had been drinking heavily as he had in the past and he had tremors prior to admission. He sleeps on two pillows and has dyspnea after climbing one flight of stairs. He denied recent colds, upper respiratory infections, hematemesis or diarrhea. The patient complained of some urinary frequency and urgency. There was a rash noted on the forearms, which the patient had been treating with Benadryl cream. Physical Examination: The patient was in some distress on examination. Examination of the head revealed pupils and eye movements to be within normal limits. The chest was clear and the heart rate was normal. The blood pressure was elevated at 200/120. Tem and respirations were 16. Examination of the abdomen revealed some distention with pain in the RUQ. The rectal examination revealed an enlarged prostate of two to three times the normal size. Occult blood was negative. The rest of the exam was within normal limits. erature was slightly elevated at 100.6. Pulse was 72 Laboratory Studies: Admission blood tests revealed an elevated white blood cell count as well as an elevated serum bilirubin. Urinalysis showed albuminuria, the presence of bacteria, TNTC white cells and pus. Sonography and HIDA scan revealed cholelithiasis. PSA was 19.8. Impression: Cholelithiasis/cholecystitis. Enlarged prostate with elevated PSA, possible BPH, rule out tumor. Consider EGD due to history of GERD and PUD. Hospital Course: The patient was diagnosed with cholelithiasis/cholecystitis. The patient underwent laparoscopic cholecystectomy under general endotracheal anesthesia. Pathology revealed chronic cholecystitis and cholelithiasis. Page 1 of 7 D Focus 目 尾 909 words 80°F P Type here to search DELL
Torres, Amy R
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The patient tolerated the procedure well. On postop day #2 the patient developed nausea and vomiting,
which was likely due to a postoperative paralytic ileus. The patient was treated conservatively with a
nasogastric tube to low concomitant suction. During the hospitalization, the patient also underwent
transrectal ultrasound of the prostate with biopsy. Operative report revealed that the seminal vesicles were
not dilated and the prostatic capsule was intact. Biopsy results were positive for adenocarcinoma of the
prostate. Patient to be scheduled for TURP on another admission. The patient was treated with IV Levaquin
for UTI. The patient's ileus resolved and he was discharged on postop day #5 with plans for outpatient
follow-up. The patient's prognosis is favorable.
Discharge Diagnoses:
Cholelithiasis/Cholecystitis
Paralytic Ileus
Adenocarcinoma of the Prostate/Gleason's Grade 3
Chronic Kidney Disease
Osteoarthritis
GERD
PUD
Contact Dermatitis
Status Post TKR
UTI
Discharge Medications:
Zofran
Zantac
Levaquin
Tylenol #3
Dulcolax
Flomax
D. Focus
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909 words
80 F
O Type here to search
DELL
<や
Transcribed Image Text:Torres, Amy R Insert Draw Design Home Layout References Mailings Review View Help Grammarly 台Shar Verdana 11 A A Aa- A E-E- PFind - AaBbCcl AaBbCc[ AaBbCcl Paste B U - ab x, x A D- A- 信、 -田。 Emphasis T Heading 1 T Heading 2 Replace Dictate Editor Reuse Creative > Select Files Cloud Gra Clipboard l Font Paragraph Styles Editing Voice Editor Reuse Files Adobe Gre The patient tolerated the procedure well. On postop day #2 the patient developed nausea and vomiting, which was likely due to a postoperative paralytic ileus. The patient was treated conservatively with a nasogastric tube to low concomitant suction. During the hospitalization, the patient also underwent transrectal ultrasound of the prostate with biopsy. Operative report revealed that the seminal vesicles were not dilated and the prostatic capsule was intact. Biopsy results were positive for adenocarcinoma of the prostate. Patient to be scheduled for TURP on another admission. The patient was treated with IV Levaquin for UTI. The patient's ileus resolved and he was discharged on postop day #5 with plans for outpatient follow-up. The patient's prognosis is favorable. Discharge Diagnoses: Cholelithiasis/Cholecystitis Paralytic Ileus Adenocarcinoma of the Prostate/Gleason's Grade 3 Chronic Kidney Disease Osteoarthritis GERD PUD Contact Dermatitis Status Post TKR UTI Discharge Medications: Zofran Zantac Levaquin Tylenol #3 Dulcolax Flomax D. Focus Page 1 of 7 909 words 80 F O Type here to search DELL <や
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