Abnormal Resuls: we drained 7.5 LITRES out of his bladder

Helen:
5L frank pus!
Drained out of a walled-off ovarian abcess present for YEARS in an old lady...the scan looked malignant, the poor O+G reg was trying to carefully dissect this enormous thing out, when they accidentally nicked it and it essentially exploded with pus fountaning out of her abdomen. I know it was 5L because that's how many containers the suction drained into. We had a poor orderly sprinting down the corridor to find fresh containers after only 2 mins of suction.

Nadia:
I saw a guy in EAU and we drained 7.5 LITRES out of his bladder!!!! MENTAL.

Heather:
40 year old woman Hb 1.6 on admission, asymptomatic and then throughly worked up by the haematologists and the GI physicians.

Will:
Not really an abnormal test result, but most abnormal examination finding.
Motorcyclist involved in an RTA.
Discovered 3 bags of skunk tied to his penis with cotton thread.

Jill:
T cell leukaemia with neutropenic sepsis:
Initial WCC 351 on diagnosis.

Then got septic with:
Platelets 1 (post platelet transfusion!)
Total WCC 0.04
Neuts 0.00
Eosins 0.00
Lymph 0.02

Karen:
A 16 year old girl who came to A&E with the sniffles who we wanted to discharge but the nurses had taken blood from so we stuck her in CDU to await the results:

Hb 4.3
Plt 12
WCC 1.2
Neut 0
Eosin 0
Lymphs 1.2

Key Words:
abcess, bladder, Haemoglobin, skunk, Platelet Count, Lymphocyte Counts, Neutrophil Count, White blood cell count

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Abnormal results: TSH of >100 in a patient who was actually very well and is currently still alive

Madeline:
21 year old guy who had been pumping iron for a week and drinking protein shakes. CK of 748660! His presenting complaint was solely dark urine - scored a urology review in ED before being seen by the medics!

Kanaan:
Hb 1.8 in a 32 yr old lady with extensive psych hx ... believes blood is toxic, & therefore recurrently bleeds herself !

Emma:
I've seen patients who bleed themselves. From our point of view the biggest problem is they probably have red cell antibodies from the multiple transfusions they get when they reach Hb that low.

Bernadette:
Had a woman last weekend with COPD, usually runs sats 70-80% at home, noted 'very oxygen sensitive'. She came in with sats of 40%, PO2 4, PCO2 12.

After 12 hours on BiPAP PO2 7, PCO2 23 pH 7.0
After 36 hours on BiPAP PO2 8, PCO2 9, pH 7.4, sitting up and eating breakfast!

Cath:
TSH of >100 in a patient who was actually very well and is currently still alive.

Lactate of 17 in a patient who was very septic-went to itu but didnt survive

Na of 189 in a very very dry demented old lady who perked up with a lot of fluid!

Lisa:
I work in a lab, lowest Hb I've seen was 2.6, on a patient who WALKED to his GP because he was feeling breathless. Patient was both B12 and Folate deficient (MCV 130), he was admitted to A&E, then to ward for a four unit blood transfusion, within 2 hours of his test results being phoned to the GP - best bit, he complained that he only went to the GP because his wife nagged him and did he really need to come to hospital!

Lionel:
In one patient
Hb - 3.5
WCC - 0.1,
Neut 0,
Platelets 1,
Grand total 4.6!

Others (not in the same patient):
Na 97
K 9.9
Creat- around 3400ish

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Most Abnormal medical Test Results: Once drained 42 litres off poor man looked 12 months pregnant

Lauren Young:
'I don't feel very well'
ALT 22876!!!!!
'Oh yes, I forgot, I did take 140 paracetamol tablets 3 days ago'

Patient was transferred to liver transplant centre, don't know the outcome.

Priscilla Ng:
Patient with prostate cancer and constipation x 10 days, c/o urinary retention, catheterised, 4.2 litres!!! (creatinine was only 286 amazingly)

Rebecca Croke:
Once saw a lady with psychogenic polydipsia with Na 99 who survived..
Also saw DKA with pH 6.7, bicarb 1.4 and co2 8! also survived!

Amanda Brooks Was Caluori:
Once drained 42 litres off poor man looked 12 months pregnant.

Karen Faulkner:
Not an abnormal result, but by far the most impressive patient. We have a frequent attender, where he turns up drunk, falls asleep, wakes up again and leaves. New Years Eve he was brought in by police unrespnsive. GCS 9. Was sedated, intubated and ventilated. After a few hours his sedation was turned off and his blood alcohol level was taken - 800mg/ml!!! He was off sedation for 8hours before he started to gag on his tube!!! I'd love to know what his blood alcohol level was when he first came in!?!?!

Emma Chambers:
I've seen our full blood count analysers give neut count 0. I then had to confirm this by blood film, and I didn't find a sinlgle neutrophil.

Have also seen haemoglobins of 2-3 (the story of the sickler with Hb 0.5 is pretty scary!). We have a regular patient who blood lets into coke cans and will only accept transfusions of the volume she knows she has lost. She generally has 2 units every 6 weeks or so, and lives with a haemoglobin of about 4-5.

We had a new ITP over Christmas who actually had no platelets at all. I spent a long time looking at that blood film in the hope I might find one somewhere!

Helen Steele:
HbA1c: 20.2
Total cholesterol: 12

In a 15yo type 1 diabetic with "Mauriac" sydrome of acute fatty liver related to poor sugar control. Her liver edge was in her RIF and as such was missed on initial physical exam. An ARX showed complete white-out due to the liver.

Also 3 weeks later her HbA1c reduced to 11. According to everyone this is physically impossible, but we checked it twice!


Key Words:
paracetamol, prostate cancer and constipation, GCS, blood alcohol level, haemoglobin, HbA1c

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Most Abnormal Medical Tests Results: I drained 1600 mls after which he said he felt a lot better

Graham N. de Bever:
First catheter I put in (as a 4th year medical student) - old guy with BPH (benign prostatic hypertrophy) - I drained 1600 mls after which he said he felt a lot better and would say a special prayer for me in church! Never felt better myself!

Laura Power:
I've drained 3 litres of a female once, she had a mass in her uterus and hadn't peed for about a week.

Michelle Clarke:
19 yo female presented Wednesday with acute urinary retention & pelvic pain. Was in agony , waited 1.5 hours before being seen. At which time we drained 885mls!!!!

Richie Chan:
Hb 1.6 from a patient with haemorrhoid, no anaemic symptom at all, just complained of PRB, subsequent endoscopy revealed no other bleeding source!

Lee Ming:
PSA of over nine thousand. The cancer actually grew forward into the rectum and obstructed it.

Suzanne MacDonald;
Most grateful patient ever, elderly chap in retention - 1750mls. Once drained 600mls off a three-year old too.
Tim Clay:
Doing haematology. New diagnosis of CML in a young adult presenting to ophthalmology outpatients with visual disturbance
WCC 486.27 x10^9/L (normal 4 - 11)

Key Words:
medical student, catheter, benign prostatic hypertrophy, uterus, haemorrhoids

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Most abnormal medical test results: A person having Blood alcohol of 0.55% but still alive

Victoria:
Na 174 (I think) in a very crispy elderly person. pCO2 of 20 in someone with muscular dystrophy and too much morphine on board.

Laura:
I've seen a Na of 107 before, highest K Ive seen is 8, highest Creatinine just under 3,000 and a Trop T of 17.

Cara:
wbc 55
neutro 52
a young women with atypical pneumonia.

Will:
I saw a guy in the royal with a trop T of 35, worse still it was about his fifth MI in six months, and the lowest Trop was 9, plus he didnt have renal failure contributing to the tropnin count.

I had a lady in AE who's sample was so lipaemic it was unmeasurable, we literally broke two of the labs very expensive UE analysers whcih caused chaos for the whole night... I remember taking the sample, there was about a half centimeter of fat visible floating on the top.

Tim:
Troponin of 960... 2 weeks post CABG... vein graft to LCx clotted off, clot propogated back up to the LM, then down the LAD... no renal failure... yes nine hundred and sixty.
Didn't survive...

Laura:
Neutrophil count of 0 in a patient with no known haematological problems, scared the bejeesus out of me as a a new house officer.

Tim:
Blood alcohol of 0.55%... chronic alcoholic...
The police didn't believe us that someone could be alive with a blood alcohol over 0.3, so we faxed the result to them... The patient was awake, alive and swearing at us.
The legal limit for driving in Australia is 0.05%.

Suzanne:
Our labs stop at the following -
K >10
Trop I >50
I've seen them both (different patients), and they survived

Other exciting ones...
Na 176 (dementia, NH resident)
Urea 72, Creatinine 860 (obstructed...)
Platelets 1 (ITP)
WCC 110 (CLL)
ABG pH 6.79 (DKA)

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Most abnormal medical test results: A person having Blood Sugar of >1200 & pH of 6.8 and he did not know he was diabetic

Will:
1) Alcoholic with refeeding syndrome - magnesium undetectable
2) COPD and CCF - ABG PaO2 3.2
3) TB peritonitis - White cells 86, CRP 1332
4) Octogenerian living on tinned soup - MCV 149.6, Hb 4.2, Folate 0.1
5) 3 days unrecognised DKA - Base XS -35, pH 6.69, pCO2 0.1 Lactate 21

Michael:
Hb 3.2 - last week, bleeding DU. Still conscious!

Mark:
Creatine Kinase of 326,000 in a 22 year old student who'd suffered prolonged seizures following overdose of a TCA - did very well on intensive IV fluid therapy on HDU and went home reasonably quickly thereafter.

Adegbenga:
1. H/H 1.2/3.5 walked into ED with swollen feet. Died following 2 units of blood over rapid transfuser, Clever ED!!

2. Blood Sugar of >1200 and pH of 6.8, Na of 177 in the same Px with DKA and he did not know he was diabetic

Tom:
Sickler mid-crisis - hB undetectable by haemocue or ABG. Lab result confirmed haemoglobin of 0.5. He was still awake, alert, and refusing treatment (violently).

Clare:
Urea 70 Creat 1000 K 7.something, after 3/52 urinary retention.

Patricia:
Ur 68 Cr 2100 K7.5 generally not feeling well but only came to hospital because wife wouldn't go by herself in the ambulance and thought he'd get checked out in A&E too. He had bilateral hydronephrosis due to renal stones. There was another lady the same week with a K of 10 who survived.

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