Lab results - looking for opinions [PLEASE READ 1ST POST]

Peter Flores said:A little while back, I dealt with a bout of cystitis—basically a urinary tract infection caused by bacteria. It eventually cleared up after some time, but the last time I had my urine tested, the lab results mentioned something that sounded like "salad" was in there. Now, I obviously don't mean actual lettuce or vegetables, but rather some kind of component you might find in a salad. Since then, I haven't bothered with any more tests because everything seems to have resolved itself and I feel perfectly fine.

But what I'm wondering is, what does that "salad" comment actually mean in a medical context? Could it be linked to those bacteria I had earlier?

Oxalates?

hey

if anyone can help me out, I'd really appreciate it
about 10 days ago I ended up in the ER with pain on my right side, vomiting, and headaches. The doctor at the hospital put me on Augmentin, Voltaren, and Buscopan

since then, basically once a day when I go to the bathroom to pee, I get an automatic headache

did some more urine tests today

CLINICAL BIOCHEMISTRY
Urinalysis (dipstick test)
Test Result Unit Reference Interval
U-Appearance clear clear
U-Color pale yellow pale yellow
U-Specific Gravity 1.010 g/dL 1.002 to 1.03
U-Leukocyte Esterase pos (+) Lkcx10^6/L < 10
U-Nitrites 0 μmol/L 0
U-pH 6.5 pH units 5 to 9
U-Erythrocytes/Hemoglobin 0 Eritrx10^6/L < 10
U-Glucose normal mmol/L < 0.8
U-Ketones 0 mmol/L < 0.5
U-Urobilinogen normal μmol/L < 17
U-Bilirubin 0 μmol/L 0
U-Ascorbic Acid 0 g/L 0
U-Protein 0 g/L < 0.2

Microscopic Sediment Examination
Reference Interval - count
Test Result Unit particles/field of view
Leukocytes 12 - 15 up to 2
Erythrocytes 1 - 2 up to 2
Casts - up to 1
Epithelial Cells - up to 1
Crystals - 0/neg
Amorphous urate salts 0/neg
urates
Mucus some 0/neg
Bacteria rare 0/neg
Yeast - 0/neg

hoping for a quick reply, don't want any confusion—I'm male

jadelynx16 said:She’s incredibly thirsty, drinking liters of fluids, but her kidney profile looks fine... except this all started when she began taking gabapentin.

But nobody will refer her anywhere! They just insist she didn't collect enough urine—as if she’s incompetent! The woman has a Master's degree!

I don't understand why they can't just issue the results exactly as they are,

My sister needs surgery for a deviated septum; is it recommended given these findings?

She needs to be sent to a nephrologist or even an endocrinologist. We can rule out diabetes mellitus for now, but you have to look into diabetes insipidus along with other potential issues involving the pituitary, kidneys, or adrenal glands.
If she is hemodynamically stable, then personally, I don't see any contraindications for the surgery.
And she should check in with a neurologist to adjust her epi. meds.

lonehawk924 said:hey there

If anyone can help me out, I would really appreciate it.
Ten days ago, I ended up in the ER with pain on my right side, vomiting, and headaches. The doctor at the ER prescribed Augmentin, Voltaren, and Buscopan.

Since then, at least once a day whenever I go to the bathroom to urinate, I automatically get a headache.

I did more urine tests today.
...............................................
Hoping for a quick response, and just so we're clear, I'm male.

Did you finish the antibiotic course?
If the answer is yes, then you need to pause for three days before doing the tests.
The results aren't quite right; she needs a urinalysis.

vividsailor7 said:They really need a referral to a nephrologist or maybe an endocrinologist. We’ve ruled out diabetes mellitus for now, but they should look into diabetes insipidus along with other potential issues involving the pituitary gland, kidneys, or adrenal glands.
If her hemodynamics are stable, I don't see any reason why she shouldn't go through with the surgery.
And someone should probably loop in a neurologist to tweak the epilepsy therapy.

Oh, we are definitely working on getting that sorted out...

Hemodynamically??

Well, there isn't actually epilepsy; we're looking at suspected muscular dystrophy instead. (All four of us nurses have the EMG results to back that up, but the formal diagnosis is still pending.)

vividsailor7 said:Is the ABT finished?
If so, you gotta wait three days before doing any tests.
The results aren't great... might need a blood culture.

What's ABT?
And I'm guessing blood culture means a urine culture?

Peter Flores said:A while back, I dealt with a bladder infection—basically a UTI caused by bacteria. It eventually cleared up, but the last time I had my urine tested, they told me there was something like "salad" in it. Obviously, they didn't mean actual salad, just some components of one. Since then, I haven't bothered with any more tests because everything feels totally fine and back to normal.

I'm curious, though—what does "salad" in your urine actually mean? Does it have anything to do with those bacteria?

I can promise you the lab report didn't literally say "salad."
What usually happens is that when they look at the urine sediment, they find calcium oxalate crystals..

Take a look at this article about urine analysis; check out the section on sediment and crystals.

http://www.mayoclinic.org/tests-procedures/urinalysis/about/if-results-are-abnormal

jadelynx16 said:Well, looks like we’re going to have to roll up our sleeves and work extra hard to get this sorted out...

Hemodynamically speaking? What on earth does that even mean in this context? You can't just throw around medical jargon like that without explaining what you're actually getting at!

It’s honestly disgusting. There’s no sign of epilepsy, but now they’re throwing around a suspected diagnosis of muscular dystrophy. All four of my sisters have EMG results that prove otherwise, but please, go ahead—just ignore the medical evidence. It’s just ridiculous.

Look, we're talking about the basics here—vital signs. I mean blood pressure, pulse, all that essential stuff. You can't just ignore them.
They need to go see a neurologist immediately. Seriously.

lonehawk924 said:What on earth is ABT? Is someone actually asking this? I feel like I’m losing my mind here. If you don't know what ABT stands for, we really need to have a serious talk about how much information is available at our fingertips these days. It's basic stuff!
USA, I’m assuming you mean a urine culture?

Antibiotic therapy. Let’s get into it.
You’re making some pretty solid assumptions there.

vividsailor7 said:So, you're talking about vitals—blood pressure, heart rate, and things like that.
She really needs to go see a neurologist.

She’ll get there,,,

honestly, her blood pressure is tanking and her pulse is slow,,,,

jadelynx16 said:she'll show up,,,

Anyway, blood pressure is extremely low, pulse is slow,,,,

Basically, she'll just have to wait and see what the anesthesiologist decides.

Hi everyone,

My infectious disease specialist gave me a diagnosis of lymphadenopathy under observation, likely just recovering from tonsillitis. My lab work showed monocytosis (mono at 18%), CRP at 28, L at 4.9, seg 37, ly 42, eos 2, baso 1.56, E 4.5, Hgb 125, and Trc 239. For my urine analysis: E 15-20, L 2-3.

After seeing the specialist, I went ahead and had a peripheral blood smear done, and here are the results:
Eosinophilic granulocyte 0.03
Segmented neutrophilic granulocyte 0.54
Lymphocyte 0.33
Monocyte 0.10.

The report doesn't list any reference ranges, so if anyone happens to know them, I would really appreciate it if you could share.

Microbiology test results (test performed: adenovirus swab from the throat)
Paul-Bunnell antibodies negative
VCA IgM negative
VCA IgG +/-
EBNA IgG +/-
It looks like a latent, but past infection.
They recommended following up with an ELISA test at the Mayo Clinic.

I’ve got a question for any doctor who might be hanging out here. I was hoping someone could take a look at this ECG and give me their take on my situation. Basically, for about a week now, I’ve been dealing with constant pain just to the left of my breastbone—right where the heart is. The ache travels up toward my shoulder and hits that spot between my spine and my shoulder blade. It doesn't matter how I sit or stand; the discomfort is always there. I also get palpitations every now and then, and my circulation feels totally off—my hands and feet are constantly freezing.🙂Since I’m a total panic monster😁, I went ahead and paid out of pocket for an Ultrasound heart, which came back totally fine. My doctor is telling me it’s probably just rheumatic issues since the area is tender to the touch. He ran an ECG, but honestly, he didn't even really look at it—just handed it over. My blood pressure usually sits somewhere between 100/60 and 120/80, so that seems okay, and my pulse stays between 60 and 70 bpm. Also, they occasionally find respiratory sinus arrhythmia on my ECG, though they told me that’s actually a good thing and perfectly normal. Last week, I actually ended up in the hospital because an MRI showed two demyelinating lesions. I originally had the MRI done because of these nagging headaches in my neck and the base of my skull (there was some suspicion of MS since my aunt has it), but while I was inpatient, they did another MRI and those lesions were gone. The verdict was that the headaches were just a byproduct of a super stressful period in my life. My blood work was mostly fine, except I noticed that during my last three tests over the past month, my creatine kinase levels have been creeping up—it was 70, then 80, and the most recent was 104. So, my big question is: is it possible that stress or anxiety is driving all of this? Because that theory is starting to sound more and more plausible to me... I'll attach a photo of my discharge papers so you can see all the results from the hospital stay.
ecg scan:
discharge papers

Sorry for the novel! Thanks in advance for any help.

Nancy Mendoza17 said:Hey everyone,

The infectious disease specialist gave me a diagnosis: lymphadenopathy under observation, basically just recovering from tonsillitis. My labs showed monocytosis (mono at 18), CRP at 28, L 4.9, seg 37, ly 42, eos 2, baso 1.56, E 4.5, Hgb 125, and Platelets 239. Urine work: E 15-20, L 2-3.

After seeing the specialist, I went ahead and got a peripheral blood smear done, and here are the results:
Eosinophilic granulocyte 0.03
Segmented neutrophilic granulocyte 0.54
Lymphocyte 0.33
Monocyte 0.10.

They didn't list any reference ranges anywhere, so if anyone knows them, please let me know.

Microbiology test results (test performed: adenovirus in throat swab)
Paul-Bunnell antibodies negative
VCA IgM negative
VCA IgG +/-
EBNA IgG +/-
Latent, but a past infection
They recommend doing an ELISA test at the Mayo Clinic.

The CBC looks fine to me.

Michelle Harris19 said:I’d love to get an opinion from any doctor available here—could you look at this ECG and give me your thoughts on this long post? For about a week now, I’ve had constant pain just to the left of my breastbone—right where my heart is. The pain or discomfort radiates upward toward my shoulder and into my shoulder blade, right between my spine and the scapula. It stays constant regardless of how I move. I also get palpitations occasionally, and my circulation feels terrible; my hands and feet are always freezing. 🙂Since I’m a massive worrier😁, I paid for a private Ultrasound heart, which came back normal. My doctor claims the pain is just rheumatic in nature because it gets worse when I press on the area. He barely even looked at my ECG, he just ran it and handed it back. My blood pressure is usually between 100/60 and 120/80, so that's fine, and my pulse is between 60 and 70 bpm. Also, they occasionally find respiratory sinus arrhythmia on my ECG, though they told me that's actually a normal, even desirable thing. A couple of weeks ago, I was hospitalized because they found two demyelinating lesions on an MRI of my brain. I had the scan due to headaches in the back of my head and neck (there was a suspicion of MS since my aunt has it), but while I was in the hospital, they did another MRI which showed the lesions were gone. The conclusion was that the headaches were also just a result of a high-stress period in my life. My blood work was mostly fine, except I noticed that over the last three tests—taken a month apart—my Creatine Kinase (CK) levels have been creeping up: first 70, then 80, and most recently 104. So, my question is: is it possible that stress and anxiety are causing all of this? Because honestly, that theory is starting to sound more and more plausible to me... I'll attach a photo of my discharge papers, which include all the lab results from the hospital stay.
ECG scan:
Discharge summary

My apologies if this turns into a novel; thanks for bearing with me.

The ECG looks a bit messy, but it appears to be sinus rhythm (maybe one of you colleagues can get a clearer look at it).
I’m not going to dive into the ophthalmology details from the discharge summary from St. Jude’s. I’ll just focus on the rest: there are signs of a urinary tract infection present, which I assume has been handled. All other lab results are normal. Brain MRI and cervical spine MRI were unremarkable. ECG and X-ray? Also unremarkable.

vividsailor7, would you mind taking a look at the peripheral blood cytology results I mentioned above? I'm wondering what your take is on them... do they seem to be within a normal range, or is there anything that looks a bit off to you?

Michelle Harris19 said:.........I'll attach a photo of the discharge summary; it contains all the test results from the hospital. ..............

Ma'am,

If you'll permit, I'd like to weigh in as well.

Regarding the Internal Medicine side of things, a colleague has already noted this, but I will reiterate: your CBC and basic biochemistry look fine.

Aside from the urinalysis, which points to a urinary tract infection—as previously noted—there is also a slight deviation in your lipid profile. Your LDL cholesterol is borderline and your HDL cholesterol is low; lifestyle adjustments should address this.

Based on the discharge papers you provided and your mention of a normal Ultrasound heart, I would suggest those chest pains lean more toward an osteomuscular etiology—essentially, they are musculoskeletal in origin.

In this entire picture, however, I would focus most heavily on the ophthalmological findings because those are where the actual deviations lie.

The workup indicates risk factors for glaucoma, and the visual field test showed abnormalities consistent with it. It is vital that you prioritize this specific issue right now.

Best regards. 🙂

Nancy Mendoza17 said:...........
After seeing an infectious disease specialist, I had a peripheral blood smear done. These are the results:
Eosinophil 0.03
Segmented neutrophil 0.54
Lymphocyte 0.33
Monocyte 0.10.

No reference ranges were provided. If anyone knows them, please let me know.

Nancy Mendoza17 said:vividsailor7, could you tell me what you think of the peripheral blood cytology results I listed above? Are they within normal limits or is something off?

Ma'am,

Your peripheral blood smear shows normal cell counts. The distribution of individual cells is as follows*:

Segmented neutrophils (42-72%)
Unsegmented (0-2%)
Eosinophils (0-7%)
Lymphocytes (20-46%)
Monocytes (2-12%)

*according to data from M. Dominis (Internal Medicine, Mayo Clinic and associates, 2003, p. 1001)

Thanks for all the input, everyone. I already know about the eye stuff—I’ve actually already scheduled those specific tests they asked for. I’m fully aware of the whole situation regarding eye pressure and visual fields, even if the doctors at the clinic say it doesn't necessarily mean I have glaucoma, though apparently, I still need to go through with those extra scans... SOCT, RFL, PNO, whatever those acronyms are supposed to be. Honestly, even my primary care doctor was stumped! xD Anyway, my main concern was getting someone to help me make sense of this ECG. I don't know the first thing about reading these, but I noticed a weird difference between my old ones and this latest one. Specifically, on the V3 wave, the T-wave didn't look as "jagged" as it usually does, if that makes sense? Maybe it’s just because the doctor didn't even bother pressing the electrodes down properly against my skin and just kind of laid them on top? ...But look, I’m a total amateur when it comes to this stuff, so I immediately started spiraling and searching for every possible scary answer online -.- So, thanks again for the replies, you guys really helped calm my nerves 🙂 LP

Dear lady,

It seems you took my response as a commentary on your attached ECG. Unfortunately, I can't get the image of the ECG to enlarge properly; it just stays tiny on my screen. Because of that, I can't offer any insight into that specific ECG finding, which I know you mentioned is your primary concern.

My previous remarks were actually directed at the discharge summary and your description of the physical exam—specifically that the pain increases upon pressure—noting that the ultrasound heart came back normal. 😉

Based on that, it looks to me like the discomfort or chest pain points more toward a musculoskeletal issue rather than anything revealed by the ECG, just as a side note.

That being said, my comment was somewhat incidental. If I understood you correctly, these chest pains started after you were discharged from the hospital, and we haven't seen any of the tests performed since the symptoms began (aside from the ECG, which remains unreadable for me).

vividsailor7 said:It doesn't require emergency processing, but it certainly should be done.

In addition to seeing a nephrologist, an ultrasound of the thyroid and parotid glands is necessary. Depending on those results, a possible endocrinology consult might follow. We also need to repeat the current labs and check 24-hour urine calcium and phosphorus levels, along with that high calcium reading.

Thyroid ultrasound findings: mild diffuse changes in a borderline enlarged thyroid, with a hypoechoic nodule measuring 9x7 mm in the lower pole of the right lobe (possible parathyroid nodule?).
TSH and T4 hormone levels are normal and within standard reference ranges.
We are waiting on a fine-needle aspiration biopsy and repeated calcium and phosphorus tests.
The excessive daytime sweating, fatigue, and tremors persist.
Joint pain and occasional discomfort on the right side of my neck fluctuate from day to day.

What does it actually mean when a urinalysis shows "moderate mucus"? All my other numbers are pretty low: leukocytes at 1-2, squamous epithelial cells at 1-3, and just a tiny bit of bacteria.

lonefalcon41 said:What does it mean when my urinalysis shows "mucus present"? Other values are: leukocytes: 1-2; squamous epithelial cells: 1-3; bacteria: few.

Ma'am,

Mucus in urine can be perfectly normal. The urinary tract contains glands that naturally secrete mucopolysaccharides.

That said, mucus can also suggest the sample was contaminated by vaginal secretions during collection.

Was this part of a routine checkup, or have you been experiencing specific symptoms?

Austin Jackson55 said:Thyroid ultrasound results: slight diffuse changes in a borderline enlarged thyroid, plus a hypoechoic nodule measuring 9x7 mm in the lower part of the right lobe (possibly a parathyroid?).
TSH and T4 hormone levels are normal and within the standard reference ranges.
Waiting on a fine-needle aspiration biopsy for further processing, along with a follow-up test for calcium and phosphorus levels.
The excessive sweating during the day, lack of energy, and tremors are still happening.
Joint pain and occasional discomfort on the right side of my neck vary from day to day.

What I really need to get done, alongside what’s already been recommended, is a full immunological and rheumatological workup—testing for RF, WR, ANA, ANCA, and anti-TPO antibodies. It’s also necessary to do a follow-up check on thyroid hormones once a year.