LABORATORY FINDINGS Complete Blood Count (CBC) Purpose: The complete blood count or CBC test is used as a broad

screening test to check for such disorders as anemia, infection, and many other diseases. 09/11/11 1.43 k/ ul 0.944 65.9%N 0.398 27.8%L 0.075 5.22%M 0.005 0.327%E 0.011 0.776%B DFLT (NLMEB) 4.86 M/uL 12.7 g/dl 38.7% 79.9 fL 09/12/11 1.66 k/ ul 0.435 26.2%N 1.03 61.8%L 0.137 8.21%M 0.053 3.17%E 0.011 0.634%B 09/13/11 2.61 k/ ul 0.602 27.2%N 0.997 45.1%L 0.442 20.0%M 0.159 7.20%E 0.011 0.480%B

WBC NEU LYM MONO EOS BASO

RBC HGB HCT MCV

4.78 M/uL 12.6 g/dl 38.1% 79.7 fL

MCH MCHC RDW PLT MPV

26.1pg 32.7 g/dl 14.1% 97.3 K/uL 7.36 fL

26.3 pg 33.0 g/dl 14.6% 75.4 K/uL 7.68 fL

4.63 M/uL 12.3 g/dl 36.8% 79.4 fL RBC MORPH 26.6 pg 33.5 g/dl 13.5% 66.5K/uL 7.68 fL

NORMAL VALUES WBC 4.10-10.9 Neu 2.5-7.5 Lym 1-4 Mono 0.1-1.2 Eos 0-0.5 Baso 0-0.1 RBC 4.5-5.9 HGB 13.5-17.5 HCT 41-53 MCV 80-100 MCH 26-34 MCHC 31-36 RDW 11.6-18.0 PLT 140-440 MPV 0.00-99.9 IMPLICATIONS: Decreased WBC, Neutrophil and Lymphocyte due to viral infection(dengue) which causes leukopenia, neutropenia and lymphocytopenia. Because when a person is infected with dengue, they develop an immune

response to that dengue subtype. The immune response produced specific antibodies to that subtype specific surface proteins that prevents the virus from binding to macrophage cells (the target cell that dengue viruses infect) and gaining entry. However, if another subtype of dengue virus infects the individual, the virus will activate the immune system to attack it as if it was the first subtype. The immune system is tricked because the four subtypes have very similar surface antigens. Then it binds to and enters white blood cells or antibodies but do not inactivate the virus, and reproduces inside the cells while they move throughout the body. The white blood cells respond by producing a number of signaling proteins, such as interferon, which are responsible for many of the symptoms, such as the fever, the flu-like symptoms and the severe pains. Decreased Platelet is due to the patient's disease dengue fever that can cause thrombocytopenia by direct infection of bone marrow megakaryocytes which destroys the body's capacity to produce new platelets as well as shortened the survival of platelet within the body. Decreased Hemoglobin and Hematocrit due to the disease process of dengue which causes destruction of the blood components by invading the cell thus causing decrease in hematocrit and hemoglobin. Decreased MCV due to destruction of the blood components by dengue virus which causes microcytic hypochromic anemia in which the red blood cells (erythrocytes) are paler than normal. A normal red blood cell will have an area of pallor in the center of it; in hypochromic cells, this area of central pallor is increased. This decrease in redness is due to a disproportionate reduction of red cell hemoglobin (the pigment that imparts the red color) in proportion to the volume of the cell. Urinalysis Purpose: The urinalysis is used as a screening and/or diagnostic tool because it can help detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is ordered widely and routinely to detect any abnormalities that require follow up. Often, substances such as protein or glucose will begin to appear in the urine before patients are aware that they may have a problem. It is used to detect urinary tract infections (UTI) and other disorders of the urinary tract. In patients with acute or chronic conditions, such as kidney disease, the urinalysis may be ordered at intervals as a rapid method to help monitor organ function, status, and response to treatment. Macroscopic Color Appearance pH Specific Gravity Protein Glucose Urobilinogen Bilirubin Nitrite Ascorbic Microscopic RBC/ hpf WBC/ hpf Squamous 09/12/11 Yellow Clear 6.0 1.010 Negative Negative Negative Negative Negative Positive 09/12/11 2/hpf 4/hpf 3/hpf Normal light yellow dark yellow Clear 5.0-8.0 1.001-1.035 <10 mg/dL Negative Negative Negative Negative Negative Normal 0-3/hpf 0-5/hpf (no establish reference range)

Blood Ketone Bacteria Amorphous Material

Negative Negative Negative Few

Negative Negative Negative few