ASSESSMENT

ASSO. PROF. MA. CRISTINA C. DORIA Faculty of Pharmacy University of Santo Tomas

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VITAL SIGNS Most frequent measurement obtained by health practitioners Indicators of health status Indicate the effectiveness of functions: circulatory, respiratory, nervous and endocrine Provides data to determine a clients usual state of health (baseline data)

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VITAL SIGNS Temperature Blood pressure Pulse rate/cardiac rate Respiratory rate

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VITAL SIGNS Pain Fifth vital sign As decided by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and pain management experts

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VITAL SIGNS FACTORS CAUSING VITAL SIGNS TO CHANGE Temperature of the environment Patients physical exertion Effects of illness

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VITAL SIGNS Change in vital signs - indicates a change in physiological function Allows the pharmacist Assess response to drug and non-drug nontherapy Identify diagnoses Implement planned interventions Evaluate success when vital signs have returned to acceptable values

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VITAL SIGNS Essential ingredient when pharmacists, nurses and physicians collaborate to determine the patients health status

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VITAL SIGNS Need for hands-on proficiency in specific handsphysical assessment skills varies according to the type of patient care setting All pharmacists should have at least a basic understanding of these skills

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VITAL SIGNS BASIC TECHNIQUES TO DETERMINE VITAL SIGNS (IPPA) Inspection (check-up) (check Palpation (feel) Percussion (beating) Auscultation (stethoscope)

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VITAL SIGNS GUIDELINES FOR MEASURING VITAL SIGNS Part of the database/record that a pharmacist collects during assessment Baseline for future assessments

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VITAL SIGNS GUIDELINES FOR MEASURING VITAL SIGNS Patients needs and condition determine when, where, how and by whom vital signs are measured Pharmacist must analyze vital signs to interpret their significance and make decisions about interventions

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VITAL SIGNS GUIDELINES FOR MEASURING VITAL SIGNS 1. Equipment Appropriate for the size and the age of the patient Functional to ensure accurate findings Selected based on the patients condition

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VITAL SIGNS GUIDELINES FOR MEASURING VITAL SIGNS 2. Patient Usual range of vital signs should be established Medical history, therapies and prescribed medications should be known

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VITAL SIGNS GUIDELINES FOR MEASURING VITAL SIGNS 3. Control and minimize environmental factors affecting vital signs 4. Organized, systematic approach when taking vital signs
.

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VITAL SIGNS ACCEPTABLE RANGES FOR ADULTS
Temperature range Oral/tympanic Rectal Axillary Pulse rate Respiratory rate Blood pressure 36 to 37 C 37C 37.5C 36.5C 60 to 100 beats per minute 12 to 16 breaths per minute 110/70 mm Hg

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VITAL SIGNS EQUIPMENTS Thermometer Stethoscope Sphygmomanometer

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COMPLETE PHYSICAL EXAMINATION Subjective Everything is important, depending on the chief complaint Consider everything Document the essential

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COMPLETE PHYSICAL EXAMINATION HISTORY OF PRESENT ILLNESS (HPI) P What provokes discomfort? Q What is the quality of the discomfort? R Where is the region of the discomfort? S What is the severity of the discomfort? T What is the time sequence?

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COMPLETE PHYSICAL EXAMINATION HISTORY OF PRESENT ILLNESS (HPI)
What was the mechanism of injury? injury? What was the patient doing prior to incident? incident? Are there any associated symptoms? symptoms? Are there any aggravating/relieving factors? factors? Is this a recurrent illness or injury? injury? Is the patient on any medications? medications? Notes patients eating habits, caffeine and smoking habits Allergies? ASK FOR YOURSELF

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COMPLETE PHYSICAL EXAMINATION REVIEW OF SYSTEM (ROS) General Nutritional status, weight gain/loss, weakness, fatigue, hydration status & overall condition Skin Changes in skin/nail/hair texture appearance and color, rashes, itching, lumps or infection

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COMPLETE PHYSICAL EXAMINATION REVIEW OF SYSTEM (ROS) Head Loss of consciousness, lightheadedness, vertigo (dizziness), headaches, history of injury, sinus, pain, visual disturbances Eyes Visual changes, diplopia, pain, discharge, diplopia, trauma, photophobia, glaucoma, cataracts, last eye exam, use of eyeglasses/contacts lenses

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COMPLETE PHYSICAL EXAMINATION REVIEW OF SYSTEM (ROS) Ears Hearing loss, tinnitus, drainage, pain, tinnitus, infection, discharge, vertigo, hearing aids Nose/Sinuses Stuffiness, drainage, olfactory changes, itching, obstruction, history of trauma, hay fever, nosebleeds, sinus problems

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COMPLETE PHYSICAL EXAMINATION REVIEW OF SYSTEM (ROS) Throat Hoarseness, dysphagia, enlarged tonsils, dysphagia bleeding gums, sores, dental condition, caries, tongue changes, dry mouth, history of sore throat, history of trauma Neck Goiter, pain, masses, nodules, adenopathy, adenopathy, thyroid problems, stiffness, history of injury

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COMPLETE PHYSICAL EXAMINATION REVIEW OF SYSTEM (ROS) Respiratory Cough, dyspnea, sputum (amount, type, color), dyspnea, asthma, bronchitis, COPD (chronic (chronic obstructive pulmonary disease), emphysema, disease), TB, last CXR (chest x-ray), smoking history (chest x-ray),

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COMPLETE PHYSICAL EXAMINATION REVIEW OF SYSTEM (ROS) Cardiac Hypertension, hyperlipidemia, rheumatic fever, hyperlipidemia, murmurs, murmurs, chest pain/discomfort, dyspnea, dyspnea, edema, last ECG/stress test, CHF (congestive (congestive heart failure), history of surgeries, procedures, failure), monitors

COMPLETE PHYSICAL EXAMINATION REVIEW OF SYSTEM (ROS) Peripheral vascular Nocturnal pain, varicose veins, leg cramps, CHF (congestive heart failure), swelling, (congestive failure), tenderness Gastrointestinal Heartburn, dysphagia, appetite, indigestion, dysphagia, melena, belching, flatulence, stool changes, melena, diarrhea, constipation, nausea, regurgitation, regurgitation, vomiting, history of gallbladder or liver disease

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COMPLETE PHYSICAL EXAMINATION REVIEW OF SYSTEM (ROS) Genital (male) Hernias, Hernias, sores, lesions, penile discharge, pain, testicular/mass discomfort, scrotal mass/discomfort, history of STDs, sexual history, function, problems

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COMPLETE PHYSICAL EXAMINATION REVIEW OF SYSTEM (ROS) Genital (female) Birth control, sexual history/function, STDs, itching, sores, discharge, dyspareunia, last dyspareunia, PAP/pelvic exam, menarche, menopause, menarche, LMP (last menstrual period), obstetric history, (last period), menstrual regularity, frequency, duration, amount, dysmenorrhea, amenorrhea, PMS dysmenorrhea, amenorrhea, (pre(pre-menstrual syndrome)

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COMPLETE PHYSICAL EXAMINATION REVIEW OF SYSTEM (ROS) Urinary Dysuria, polyuria, Dysuria, polyuria, frequency, stones, pattern change, incontinence, nocturia, STD, nocturia, hematuria, hesitancy, dribbling, hematuria, infections, flank discomfort Hematologic Bleeding, bruising, anemia, history of transfusions

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COMPLETE PHYSICAL EXAMINATION REVIEW OF SYSTEM (ROS) Endocrine Thyroid, adrenal, hormonal, heat/cold intolerance, edema, hirsutism, sweating, hirsutism, excessive thirst, hunger, polyuria, pigment polyuria, changes Musculoskeletal Myalgia, Myalgia, stiffness, gout, arthritis, backache, erythema, swelling, pain, erythema, tenderness, history of trauma

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COMPLETE PHYSICAL EXAMINATION REVIEW OF SYSTEM (ROS) Neurologic Syncope, vertigo, seizures, blackouts, paresthesias, paresthesias, paralysis, tremors, weakness, involuntary movements, equilibrium Psychiatric Anxiety, mood swings, mania, depression, memory loss, insomnia, suicidal ideations, delusions, hallucinations

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COMPLETE PHYSICAL EXAMINATION PAST MEDICAL HISTORY (PMH) Consider any other problems which are currently active, comments should include functional impairment, childhood/adult illnesses, history of trauma, surgeries, and hospitalizations FAMILY HISTORY (FH)

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COMPLETE PHYSICAL EXAMINATION
Always start your objective with an opening statement concerning the patients general appearance and condition
WellWell-developed, well-nourished male not in distress. wellPatient is ambulatory, alert , cooperative, and shows no gross mental status changes. Vital signs noted. Consider listing a minimum of 3-4 physical exam findings for each complaint Check the system above and below, and include the possibility of cutaneous, musculoskeletal and occult cutaneous, findings Document the absence of critical findings

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LABORATORY & DIAGNOSTIC TESTS Biochemical, chemical, or physical methods of measuring biologic or physiologic functions of the body Important part of health care and have become indispensable for routine screening and the diagnosis of disease

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LABORATORY & DIAGNOSTIC TESTS Used routinely to assess compliance, compliance, monitor both the efficacy of prescribed treatment and the advent of adverse or toxic reactions, diagnosis of specific disease reactions, and at times, to help determine the drug of choice

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LABORATORY & DIAGNOSTIC TESTS Ordered appropriately and performed and interpreted correctly Results of initial screening or diagnostic tests usually suggest the specific follow-up tests follownecessary for a definitive diagnosis

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LABORATORY & DIAGNOSTIC TESTS THE PHARMACISTS ROLE Involved in monitoring patient care, and a care, growing number now have input into the management of patient therapy Understand why laboratory tests are used and of the information to be gained from them

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LABORATORY & DIAGNOSTIC TESTS THE PHARMACISTS ROLE Drugs may influence the results of laboratory tests in a variety of ways, they are in good position to anticipate and advise on such interactions

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LABORATORY & DIAGNOSTIC TESTS DEFINITION: Using word beginnings (prefixes) and endings (suffixes) as clues to procedures
-Graphy -Scopy -Centesis -Metry SonoSonoElectroElectroGlucoGlucoEndoEndoTo record an image To look through a lensed instrument To puncture To measure with an instrument To assess using sound To assess using electrical impulses Sugar Inside

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LABORATORY & DIAGNOSTIC TESTS DEFINITION Endoscopy Visual examination of internal structures using optical scopes Paracentesis Puncturing the skin and withdrawing fluid from the abdominal cavity

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LABORATORY & DIAGNOSTIC TESTS DEFINITION Lumbar Puncture Inserting a needle between lumbar vertebrae in the spine but below the spinal cord Positron Emission Tomography (PET) Combines technology of radionuclide scanning with the layered analysis of tomography

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LABORATORY & DIAGNOSTIC TESTS DEFINITION Sonogram or Echogram Examination of soft tissue using sound waves beyond human hearing Visual image produced by the reflection of the sound waves back from the tissues being assessed and into the machine

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LABORATORY & DIAGNOSTIC TESTS DEFINITION Electrical Graphic Recordings
Electrocardiography (ECG) Examination of the electrical activity in the heart Electroencephalography (EEG) Examination of the energy emitted by the brain Electromyography (EMG) Examination of the energy produced by stimulated muscles

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LABORATORY & DIAGNOSTIC TESTS DEFINITION Culture To collect from the body a sample suspected to contain infectious microorganisms, growing the microbes in a nutrient substance, and examining the resulting growth under a microscope

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LABORATORY & DIAGNOSTIC TESTS DEFINITION Pelvic examination Physical inspection of the vagina and cervix and palpation of uterus and ovaries Papanicolaou (Pap Smear) Screening of cells from the cervix and canal to detect abnormal cells, hormonal status, and presence of abnormal microorganisms

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LABORATORY & DIAGNOSTIC TESTS FACTORS THAT INVALIDATE TEST RESULTS
Incorrect diet preparation Failure to remain fasting Insufficient bowel cleansing Drug interactions Inadequate specimen volume Failure to deliver specimen to lab in timely manner Incorrect or missing request form

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LABORATORY & DIAGNOSTIC TESTS COMMON DIAGNOSTIC PROCEDURES Radiography or Roentgenography (X-ray) (X Fluoroscopy Computerized Tomography (CT Scan) Magnetic Resonance Imaging (MRI)

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LABORATORY & DIAGNOSTIC TESTS COMMON DIAGNOSTIC PROCEDURES Endoscopic examinations
Bronchoscopy Gastroscopy Colonoscopy Laparoscopy Cystoscopy inspection of the bronchi inspection of stomach inspection of colon inspection of the abdominal cavity inspection of urinary bladder

 Hematology or haematology - branch of biology (physiology), pathology, pathology, clinical laboratory, internal medicine, and laboratory, medicine, pediatrics that is concerned with the study of blood, blood, the blood-forming organs, and blood blooddiseases. - includes the study of etiology, diagnosis, etiology, diagnosis, treatment, prognosis, and prevention of blood prognosis, diseases.

LABORATORY TESTS
HEMATOLOGY *
Test Normal Values

White Blood Cell (WBC) Red Blood Cell (RBC) Hemoglobin (Hb) Hematocrit (Hct) ESR (erythrocyte sedimentation rate) Differential Count

5 x 109/L 4-6 x 1012/L Male: 140-170 g/L Female: 120-170 g/L Male: 37 54% Female: 0 20 mm/hr Neutrophils: 54 75% Eosinophils: 0 4% Lymphocytes: 2 35% Monocytes: 6% Basophils: 0 0.5% 75 97 fl 26 33 pg

Mean Corpuscular Volume Mean Corpuscular Hemoglobin

Classification of hematologic diseases

Major categories of hematologic disease include: Hemoglobinopathies (congenital abnormality of the hemoglobin molecule or of the rate of hemoglobin synthesis) Anemias (lack of red blood cells or hemoglobin) hemoglobin) Hematological malignancies Coagulopathies (disorders of bleeding and coagulation) coagulation)

Treatments include:
Diet advice Oral medication - tablets or liquid medicines Anticoagulation therapy Intramuscular injections (for example, Vitamin B12 injections) Blood transfusion (for anemia) anemia) Venesection also known as therepeutic phlebotomy (for iron overload or polycythemia) polycythemia) Bone marrow transplant (for example, for leukemia) leukemia) Chemotherapy (for example, for leukemia) leukemia) Radiotherapy (in decline, for example, for leukemia) leukemia)

Coagulation
complex process by which blood forms clots. clots. important part of hemostasis (the cessation of blood loss from a damaged vessel), wherein a damaged blood vessel wall is covered by a platelet and fibrin-containing clot to stop fibrinbleeding and begin repair of the damaged vessel. Disorders can lead to an increased risk of bleeding (hemorrhage) and/or clotting (hemorrhage) thrombosis). (thrombosis).

Coagulation
begins almost instantly after an injury to the blood vessel has damaged the endothelium (lining of the vessel). Primary hemostasis - Platelets immediately form a plug at the site of injury; Secondary hemostasis occurs simultaneously: Proteins in the blood plasma, called coagulation plasma, factors or clotting factors, respond in a complex factors, cascade to form fibrin strands, which strengthen the platelet plug.[1]

LABORATORY TESTS
COAGULATION *
Test ACT (activated coagulation time) APTT(activated partial thromboplastin time) Bleeding time (BT) Clotting time FDP (d-dimmer) Fibrinogen level Partial thromboplastin time (PTT) Platelet Count Prothrombin time (PT) Thrombin time Normal Values 70 120 seconds 30 40 seconds 1 3 min 8 -15 mins < 25 mg/dl 200 400 mg/dl 30 40 seconds 200 400 x 109 L 12 15 seconds 10 14 seconds

 Problems with coagulation may dispose to hemorrhage, hemorrhage, thrombosis, and occasionally both, depending on the nature of the pathology. Thrombosis is the pathological development of blood clots. These clots may break free and become mobile, forming an embolus or grow to such a size that occludes the vessel in which it developed.

 Most cases of thrombosis are due to acquired extrinsic problems (surgery, cancer, immobility, (surgery, cancer, immobility, obesity, obesity, economy class syndrome), but a small syndrome), proportion of people harbor predisposing conditions known collectively as thrombophilia

Cofactors
Various substances are required for the proper functioning of the coagulation cascade: Calcium and phospholipid (a platelet membrane constituent) Vitamin K

BLOOD CHEMISTRY
Types: Serum albumin - most abundant blood plasma protein and is produced in the liver and forms a large proportion of all plasma protein. - human serum albumin, and it normally albumin, - constitutes about 70% of human plasma protein; - Globulins - all other proteins present in blood plasma  bovine serum albumin (cattle serum albumin) or BSA, often used in medical and molecular biology labs.

 Low albumin (hypoalbuminaemia) may be (hypoalbuminaemia) caused by liver disease, nephrotic syndrome, syndrome, burns, protein-losing enteropathy, proteinenteropathy, malabsorption, malabsorption, malnutrition, late pregnancy, artefact, genetic variations and malignancy. High albumin is almost always caused by dehydration Amylase is an enzyme that breaks starch down into sugar. Amylase is present in human saliva, sugar. saliva, where it begins the chemical process of digestion

 Blood serum amylase may be measured for purposes of medical diagnosis. A normal diagnosis. concentration is in the range 21-101 U/L. A 21higher than normal concentration may reflect one of several medical conditions, including acute inflammation of the pancreas, macroamylasemia, macroamylasemia, perforated peptic ulcer, and ulcer, mumps. mumps. Amylase may be measured in other body fluids, including urine and peritoneal fluid.

 Blood sugar regulation is the process by which the levels of blood sugar, primarily glucose, are maintained sugar, glucose, by the body. When levels of blood sugar rise, a different hormone is released from beta cells found in the Islets of Langerhans in the pancreas. This hormone, insulin, insulin, causes the liver to convert more glucose into glycogen glycogenesis), (this process is called glycogenesis), and to force about 2/3 of body cells (primarily muscle and fat tissue cells) to take up glucose from the blood, thus decreasing blood sugar levels. Insulin also provides signals to several other body systems, and is the chief regulatory metabolic control in humans.

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BLOOD CHEMISTRY *
Test Albumin Amylase Fasting Blood Sugar Glycosylated Haemoglobin Normal Values* 30 50 g/L 10 130 U/L 3.89 5.88 mmol/L < 7% 7 8 % Excellent Control 8 9 % Good Control 9 10% Fair Control > 10% Poor Control 23 35 g/L : 11 -35 Umol/L

Globulins Serum Ammonia

RENAL PROFILE TESTS Nephrology concerns itself with the diagnosis and treatment of kidney diseases: - electrolyte disturbances and hypertension, and hypertension, the care of those requiring renal replacement therapy, therapy, including dialysis and renal transplant patients. Many diseases affecting the kidney are systemic disorders not limited to the organ itself, and may require special treatment. Examples include systemic vasculitides and autoimmune diseases such as lupus. lupus.

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RENAL PROFILE TESTS
Test Blood Urea Nitrogen * Serum Bicarbonate Serum Calcium* Serum Chloride Serum Creatinine* Serum Magnesium Serum Phosphorus Serum Potassium* Serum Sodium* Serum Uric Acid* Normal Values 3.2 8 mmol/L 22 26 mEq/L 2.02 2.60 mmol/L 99.9 110 mmol/L 53 133 mmol/L 1.4 2.1 mmol/L 0.42 1.97 mmol/L 4 4.5 mmol/L 135 145 mmol/L 0,13 0.44 mmol/L

Conditions requiring a nephrologist

Acute renal failure, a sudden loss of renal function failure, Chronic kidney disease, declining renal function, usually disease, function, creatinine. with an inexorable rise in creatinine. Hematuria, blood loss in the urine Hematuria, Proteinuria, the loss of protein especially albumin in the Proteinuria, urine Kidney stones, usually only recurrent stone formers. stones, Chronic or recurrent urinary tract infections Hypertension that has failed to respond to multiple forms of anti-hypertensive medication or could have a secondary anticause Electrolyte disorders or acid/base imbalance

Therapy
Many kidney diseases are treated with: steroids, steroids, DMARDs (disease-modifying antirheumatic (diseasedrugs), antihypertensives (many kidney diseases feature hypertension). Often erythropoietin and hypertension). vitamin D treatment is required to replace these two hormones, the production of which stagnates in chronic kidney disease. When chronic kidney disease progresses to stage five, dialysis or transplant is required.

LIPID PROFILE
The VAP (Vertical Auto Profile) is a cholesterol, lipid cholesterol, and lipoprotein test. In addition to the basic scores (total cholesterol, high-density lipoproteins, low-density highlowlipoproteins, and triglycerides), the VAP test includes triglycerides), categories of cholesterol measurement. The VAP has a unique ability to identify far more areas of risk than the standard lipid panel. People with a family history or an existing condition of diabetes, high blood pressure or heart disease -- or who are already taking cholesterol lowering medication -- are candidates for the comprehensive VAP (Vertical Auto Profile) Test.

LABORATORY TESTS
LIPID PROFILE *
Test Serum cholesterol Normal Values* up to 200 mgs/dl Borderline: Up to 239 mgs/dl Elevated if>240 mgs/dL on repeated values < 180 mgs/dl 30 60 mgs/dl Borderline: 100 190 mgs/dl Risk: > 190 mgs/dl Note: Formula for calculating LDL Cholesterol is INVALID if TGL > 400 mgs/dl :<4 Low Risk: 4 6 High Risk: > 6

Serum triglycerides HDL Cholesterol LDL Cholesterol

Total/HDL ratio

HEPATIC ENZYMES

(Liver function tests)

groups of clinical biochemistry laboratory blood assays designed to give information about the state of a patient's liver. Most liver diseases cause liver. only mild symptoms initially, but it is vital that these diseases be detected early. Hepatic (liver) involvement in some diseases can be of crucial importance.

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HEPATIC ENZYMES *
Test SGOT / Aspartate Aminotransferase (AST) SGPT / Alanine Aminotransferase (ALT) Serum Alkaline Phospatase (ALP) Normal Values* Up to 34 34 U/L Up to 30 U/L 36 92 U/L

Thyroid function tests (TFTs)

collective term for blood tests used to check the function of the thyroid. thyroid. includes thyroid-stimulating hormone (TSH, thyroidthyrotropin) thyrotropin) and thyroxine (T4), and triiodothyronine (T3) depending on local laboratory policy.

TFT
requested if a patient is thought to suffer from hyperthyroidism (overactive thyroid) or hypothyroidism (underactive thyroid), or to monitor the effectiveness of either thyroidthyroidsuppression or hormone replacement therapy. It is also requested routinely in conditions linked to thyroid disease, such as atrial fibrillation. fibrillation.

LABORATORY TESTS
THYROID FUNCTION TEST
Test Free T4* Free T3* TSH * Serum T3 Serum T4 Normal Values 0.8 2.0 ng/dl 2.3 4.2 pg/ml 0.25 4.30 microunits/ml 70 200 ng/dl 4.0 11.0 micrograms/dl

Cardiac markers
evaluate heard function. often discussed in the context of myocardial infarction, infarction, but other conditions can lead to an elevation in cardiac marker level. early markers identified were enzymes, and as a enzymes, result, the term "cardiac enzymes" is sometimes used. However, not all of the markers currently used are enzymes.

LABORATORY TESTS
CARDIAC ENZYMES AND PROTEINS
Test CPK * CK MB (creatine kinase isoenzyme MB)* LDH LDH - 1 LDH - 2 SGOT (Serum glutamic oxaloacetic *
Transaminase) SGPT (Serum glutamic pyruvic transaminase)*

Normal Values 25 2000 U/L 0 9 ng/ml or < 3% of total CPK 0 280 U/L 20 36% of total LDH: <LDH2 32 50% of total LDH: > LDH1 < 42 U/L 0 48 U/L 0 85 ng/ml 0,0 0.1 ng/ml < 0.18 ng/ml

Myoglobin * Troponin 1 Troponin T

Urinalysis (or "UA")

array of tests performed on urine and one of the most common methods of medical diagnosis.[1] diagnosis. A part of a urinalysis can be performed by using dipsticks, urine dipsticks, in which the test results can be read as color changes.

LABORATORY TESTS
URINALYSIS *
Color Odor Appearance Specific gravity pH protein Glucose Na K Straw dark yellow Slightly aromatic Clear Infants: 1.002 1.006 Adult: 1.016 1.022 4.6 6.5 negative negative 10 40 mEq/L < 8 mEq/L

LABORATORY TESTS
URINALYSIS
Color Cl bilirubin Urobilinogen Ketones * Occult Blood * RBCs * WBCs * Bacteria * Casts * Crystals * Straw dark yellow < 8 mEq/L negative 0.1 1 EU/100 ml negative negative Female: 0 2/hpf, Male: 0/hpf Female: 0 5/hpf, Male: 0 2/hpf Negative on spun specimen Hyaline, coarse, fine granular, RBC, WBC, waxy casts Interpreted by physician

numbers & types of cells/material such as cells/material urinary casts yield a detail information and suggest a specific diagnosis.
Hematuria - associated with kidney stones, infections, stones, infections, tumors and other conditions Pyuria - associated with urinary infections eosinophiluria - associated with allergic interstitial nephritis, nephritis, atheroembolic disease RBC casts - associated with glomerulonephritis, glomerulonephritis, vasculitis, vasculitis, malignant hypertension

numbers & types of cells/material such as cells/material urinary casts yield a detail information and suggest a specific diagnosis.
WBC casts - associated with acute interstitial nephritis, nephritis, exudative glomerulonephritis, severe pyelonephritis glomerulonephritis, (heme) granular casts - associated with acute tubular heme) necrosis crystalluria -- associated with acute urate nephropathy (or "Acute uric acid nephropathy", AUAN) calcium oxalate - associated with ethylene glycol toxicity

Fecalysis/stool Fecalysis/stool analysis

laboratory tests done on fecal samples to analyze the condition of a person's digestive tract performed to check for the presence of any reducing substances such as white blood cells (WBCs), sugars, or bile and signs of poor absorption as well as screen for colon cancer.

LABORATORY TESTS
FECALYSIS *
Parameter Character Color Mucus Results/Normal Values Formed Brown Negative Parameter Pus Blood Occult Blood Results/Normal Values Negative Negative Negative

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