Ob/Gyn and General medicine

Date
r/o condition
Labs
Lab Results
Recommendation
1/4/11
Blood chemistry abnormalities related to seizure
General Chemistry& hematology panel
normal

1/13/11
heavy metal toxicity
heavy metal blood panel
"normal and safe mercury, lead, arsenic levels"

3/24/10
cervical malignancy/chronic infection
Pap smear
normal

3/29/10
Urine Infection
urine analysis
"2+ WBC esterase, Bacteria visualized"
urine culture
3/31/10
Urine Infection
urine culture
greater than 100.000 E.Coli colonies
antibiotic treatment
3/30/10
fetus abnormalities
transvaginal ultrasound
normal 8 week 4 day fetus

4/5/10
genetic fetal abnormalities
prenatal screening
"neg for Down's, Neural tube, SLO and tri18"

4/7/10
fetal abnormalities
obstetrical ultrasound-1st trimester screening
normal pregnancy and fetal size

5/26/10
fetal abnormalities
obstetrical ultrasound-Fetal anatomy survey
normal

9/30/10
proteinuria/preeclampsia
24 hour urine collection
positive for proteinuria 406 (normal up to 149)
treat for preeclampsia
10/1-2/10
Blood chemistry abnormalities-labor
General Chemistry& hematology panel
mild abnormalities-no clinical significance
IV fluids during labor
11/23/10
abdominal pathology related to seizure
ultrasound of abdomen and pelvis
"normal, with question of excess fluid near stomach"
consider CT of abdomen to assess fluid
11/23/10
urine Infection related to seizure
urine analysis
normal
urine culture
11/23/10
urine Infection related to seizure
urine culture
"25-50,000 Grp B strep, other mixed flora"

11/23/10
Blood chemistry abnormalities related to seizure
General Chemistry& hematology panel
normal
repeat after treat seizure with magnesium
11/23/10
Blood chemistry abnormalities f/u magnesium
General Chemistry& hematology panel
elevated Mg 7.2 (1.7-2.6)

11/23/10
Heart disease(ischemia)
CPK/ Troponin 1 levels
normal

11/23/10
proteinuria
24 hour urine collection
positive for proteinuria 351 (normal up to 149)

8/12/11
body mineral abnormalities
heavy metal and additional metal levels
no heavy metal or additional metal levels found

11/30/11
Blood chemistry abnormalities related to seizure
General Chemistry& hematology panel
normal

7/19/12
Pregnancy
Urine pregnancy test
negative

7/19/12
Hypercholesterolemia/hypertriglyceridemia
Lipid profile
all within normal limits

7/9/12
preeclampsia and miscarriages
lupus anticoagulant
not detected


Cardiac/Pulmonary

Date
r/o condition
Labs
Lab Results
Recommendation
11/23/10
heart or lung disease related to seizure
chest x-ray
normal

11/23/10
cardiac arrhythmia related to seizure
ECG
sinus tach (103) otherwise normal

11/24/10
renal artery stenosis
renal ultrasound
normal

11/30/10
cardiac pathology causing hypertension
ECHO transthoracic
normal; mild tricuspid regurgitation

7/9/12
"addisons, renal artery stenosis, renal tumor"
plasma renin level
normal


Neurological

Date
r/o condition
Labs
Lab Results
Recommendation
11/23/10
"brain tumor, stroke or hemorrhage"
CT of brain w and w/o contrast
"normal brain, no pathology"

11/24/10
seizure disorder
EEG
"mild slowing, no epileptiform activity"

1/14/11
seizure disorder
EEG
normal

1/4/11
"seizure focus (stroke, tumor. Hemorrhage)"
"MRI w/ contrast, diffusion weighted imaging"
"normal brain, no pathology"

2/4/11
"seizure focus (stroke, tumor. Hemorrhage)"
MRI with 3 Tesla magnet for higher resolution
"normal brain, no pathology"

2/4/11
neurotransmitter abnormalities (non-standard test)
blood neurotransmitter levels
"elevated dopamine, DOPAC, glycine levels"
medical significance is questionable
7/23/12
seizure disorder
MRI of brain
subtle signal abnormality in right hippocampus on flair
possible right hippocampal sclerosis

Infectious/Immunological

Date
r/o condition
Labs
Lab Results
Recommendation
11/23/10
nasal methicillin resistant staph aureus
nasal culture
negative for methicillin resistant staph

1/13/11
signs of inflammation or infection
sedimentation rate (ESR)
normal

1/13/11
signs of inflammation or infection
C-reactive protein
normal

8/31/11
immune system deficiency
CD8 and CD57 T-cell levels
normal

8/31/11
lyme disease
IFA for antibodies
no evidence of lyme infection

8/31/11
lyme disease
western blot for anti-bodies
"negative (only band 41 +, bands 31, 39 were intermediate)"

8/31/12
lyme disease
PCR for presence of lyme (B. burgdorferi) DNA
negative

9/1/11
lyme disease
Lyme immune tolerance test
normal for all cell mediated responses to B. burgdorferi

11/29/11
lyme disease
Spirochete/Borrelia culture
positive for polyclonal antibody for B. burgdorferi

7/9/12
antiphospholipid syndrome
"cardiolipin IgG, IgM, IgA levels"
not elevated

7/12/12
antiphospholipid syndrome
"phos serine IgG, IgM, IgA, cardiolipin screen"
normal



Endocrine

Date
r/o condition
Labs
Lab Results
Recommendation
1/14/11
adrenal gland dysfunction
blood cortisol level
normal

6/27/12
adrenal gland dysfunction
"a.m. blood cortisol level, 24 hr cortisol level"
normal

1/20/11
pituitary or ovarian dysfunction
"estrogen, prolactin, progesterone, LH levels"
normal

1/13/11
adrenal gland dysfunction
DHEA sulfate level
minimal elevation for age 240 (normal up to 220)

11/23/10
hyper and hypothyroidism
TSH level
normal

6/27/12
repeat hyper and hypothyroidism @NIH
"T3, Free T4, TSH"
normal

11/23/10
pheochromocytoma
metanephrine and normetanephrine levels
normal

11/28/10
hyperaldosteronism
blood aldosterone level
normal

11/28/10
"pregnancy, abnormal uterine growth, choriocarcinoma"
beta-HCG level
normal

3/31/11
pituitary or ovarian dysfunction
DHEA and testosterone levels
normal

11/30/11
hyperthyroidism
"thyroxine, free, direct level"
normal

7/9/12
syndrome of inappropriate antidiuretic hormone secretion (SIADH)
arginine vasopressin level
not elevated

7/10/12
pheochromocytoma
CT of abdomen
2.4 cm solid left adrenal mass
referred to NIH for pheo evaluation
7/19/12

"MRI of chest, abdomen, pelvis (with multihance)"
"2 cm left enhancing adrenal mass, not consistent with adenoma"

7/20/12

PET scan of abdomen
left adrenal mass with uptake of benign tumor

7/24/12

PET F-Dopa scan of adrenal mass
adrenal mass was Dopa negative

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