Fever (Lecture 3 of 4) ( HINDI) : Interpretation of Lab Reports

In a case of fever, certain lab investigations should be ordered right on the first day. Tests for Urine Routine and Microscopy, CBC-ESR, Malarial antigens and Dengue serology, particularly NS-1 antigen should be ordered. In certain geographical areas such as Uttarakhand, where Scrub Typhus is also quite common; this also should be included on the first day.
Presence of Albumin in urine indicates possibility of urine infection. Large quantities of Albumin are present in urine in Nephrotic syndrome . WBCs are found in large numbers, they are called pus cells. Casts form in the renal tubule where at a certain point down the renal tubule where the pH of the glomerular filtrate changes to acidic, if there were any soluble proteins in the filtrate, they are coagulated and take up the shape of the renal tubules. coagulated proteins give rise to uniformly staining, transluscent "Hyaline' casts. If at the time of formation of the casts, there are pus cells, they also get entrapped in the protein coagulum. Their staining granules impart the cast a granular appearance. When RBCs get entangled in the same way, they give rise to RBC casts. Presence of casts suggests leakage of proteins, RBCs and WBCs from the glomerulus.

Hemoglobin if low, indicated that either the fever has been of some duration, or anemia existed previously- could be because of poor nutrition due to which the immunity of the patient was low. In tuberculosis the hemoglobin is found to be low.
TLC is increased in Bacterial infections and Amoebic liver abscess. In viral infections, TLC is suppressed. Platelets are reduced in Malaria, Dengue fever, and also in some other viral infections e.g.German measles (Rubella).
In tuberculosis, the differential count shows relative lymphocytosis.

ESR is increased in Tuberculosis, Rheumatic Fever, Rheumatoid arthritis, Systemic Lupus Erythematosus (SLE) and other autoimmune disorders. For this reason, it has no diagnostic value. It has prognostic value; i.e., when the treatment goes in the right direction, the ESR gradually comes down and indicates that the therapy is successful.
It is useful to reaffirm that the fever patient has a normal blood sugar. Sometimes Diabetes is first detected during fever. Therefore it is wise to order Blood sugar while ordering other blood tests.


#Links for other videos of Dr Prakash C. Malshe:

#PAIN In English)#
https://youtu.be/eRXeJ04aYBA
https://youtu.be/bOJAJyUxrow


#PAIN ( IN Hindi)#
https://youtu.be/5baAr4_Bizw
https://youtu.be/l-laqOhalT0


#PAIN in abdomen ( In English)#
https://youtu.be/nBHKC4M6kTY



#FEVER ( In Hindi)#
https://youtu.be/548O0f5S1Ks
https://youtu.be/pfiOaNI-dwI
https://youtu.be/GxhGwfO2cCM
https://youtu.be/s1Bu3GhHTjg


#FEVER (In English)#
https://youtu.be/saS5VhTA1ac
https://youtu.be/mNYKUMfLd-o
https://youtu.be/GxhGwfO2cCM
https://youtu.be/s1Bu3GhHTjg


#HYPERTENSION ( In English)#
https://youtu.be/OCGlDOVfhHo
https://youtu.be/BvJ8Au7aEd8
https://youtu.be/IgCQJB7pnL8
https://youtu.be/ZmmEOPc934Y


#HYPERTENSION (In Hindi)#
https://youtu.be/HgLPkOQbD3c
https://youtu.be/cwT9GRx8W-U
https://youtu.be/ycKID5wrjgI


#NAFLD: Non alcoholic Fatty Liver Disease ( In English)#
https://youtu.be/Twg5njWbuKI


#NAFLD: Non alcoholic Fatty Liver Disease ( In English)#
https://youtu.be/aLfZdWinQYc