LABORATORY AND DIAGNOSTIC TESTS

LABORATORY TESTS
NORMAL
VALUES
HEMATOLOGY
COMPLETE BLOOD
COUNT
12-16 mg/dL
Hemoglobin
36-46%
Hematocrit
4,500-11,000
WBC count
40-70%
Neutrophils
20-50%
Lymphocytes
4-8%
Monocytes
0-6%
Eosinophils
0-2 %
Basophils
MICROSCOPY
URINALYSIS
Pale to dark
Color
yellow
Clarity
Clear
Specific Gravity
1.005-1.030
Ph
4.6-8.0
Glucose
Negative
Bilirubin
Negative
Urobilinogen
Negative
Protein
Negative
Nitrate
Negative
Ketone
Negative
WBC
0-2/HPF
RBC
0-2/HPF
Epithelial Cells /Mucus
<10cells HPF
Threads
Bacteria
None/Few
Urine Culture

INTERPRETATION / NECESSITY

Performing a complete blood count is

important in obtaining base line data
that may indicate extent of the disease
of the patient status and may later
help in the management of the patient.
A complete blood cell (CBC) count with
differential may help differentiate
pelvic infection from endometriosis as
well as assess the degree of blood loss

Urinalysis detects substances or

cellular material in the urine associated
with different metabolic and kidney
disorders.
Urinalysis and urine culture should be
sent if urinary tract infection (UTI) is in
the differential diagnosis. In addition,
cervical Gram stain and cultures should
be
considered,
because
sexually
transmitted diseases (STDs) can also
cause pelvic pain and infertility.

No significant
findings

PREGNANCY TEST
KIDNEY FUNCTION TEST
Creatinine clearance 85 125 mL/min

To know if the patient is pregnant or

not and to rule out ectopic pregnancy
Conducting both urine and blood
testing allows for the comparison of the
serum creatinine levels with the
amount of creatinine excreted in the
urine. This is a more sensitive indicator
of
kidney
function
than
serum
creatinine alone. Flank pain could also

be
caused
injury/inflammation.
PELVIC EXAMINATION
Pelvic Examination
No significant
findings

ULTRASONOGRAPHIC EXAMINATION
Transvaginal
No pelvic organ
ultrasonography
abnormalities

by

kidney

Often it's not possible to feel small

areas of endometriosis, unless they've
caused a cyst to form.

Imaging studies, such as ultrasound,

can be helpful in ruling out other pelvic
diseases and
may suggest the
presence of endometriosis in the
vaginal and bladder areas, but still
cannot
definitively
diagnose
endometriosis.
It
can,
however,
identify
cysts
associated
with
endometriosis (endometriomas).
Transvaginal ultrasonography is a
useful method of identifying the classic
chocolate cyst of the ovary. The typical
appearance is that of a cyst containing
low-level homogenous internal echoes
consistent with old blood.

LAPAROSCOPY AND BIOPSY

Laparoscopy
No significant
findings.

Laparoscopy is considered the primary

diagnostic modality for endometriosis
Endometriosis has been described as
protean in appearance. The classic
lesions are blue-black or have a
powder-burned appearance.However,
the lesions can be red, white, or
nonpigmented.

Biopsy

No significant
findings.

Typical
endometriotic
lesions
show histopathologic features
similar
to endometrium,
namely
endometrial stroma,
endometrial

epithelium, and glands that respond to

hormonal stimuli. Older lesions may
display no glands but hemosiderin
deposits.
THERAPEUTIC MANAGEMENT
LIST OF PROBLEMS
1. Right Flank Pain
2. Pallor
3. (+) KPS, bilateral
4. (+) Nodulations at the posterior
vaginal fornix
5. Cervical Deviation to the right

1. Educate the patient and her family

about
her
condition:
possible
etiology, risk factors, course of
disease, signs and symptoms,
complications if left untreated,
prognosis, and medical options for
treatment including its benefits,
side effects, risks and alternatives.
Increasing
patients
knowledge
about
her
condition
improves
medical compliance and assists in
the management of symptoms.
2. Emphasize
the
importance
of
medication compliance in the
optimum management of
her
condition.

THERAPEUTIC OBJECTIVES
1. To identify and treat underlying
cause
of
the
flank
pain
experienced by the patient
2. To relieve pain
3. To provide symptomatic relief
4. To restore the body strength of
the patient