Age: 29.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Mean cell volume normal, Mean platelet volume increased, Metabolic function test, Monocyte count, Monocyte percentage increased
Clinical narrative: 1/12/22 30 yr/o G3P1011 female at 39w3d gestation who is being evaluated for body aches, nausea/vomiting, fever, and headache. Her symptoms started ~ 3:30 am today. She had her Covid-19 vaccine series 9/2021 so has not gone for her booster yet.  She has noted some cramping intermittently today as well. Mild maternal tachycardia; no fetal tachycardia. Normal O2 sats noted; labs unremarkable.  She felt better after zofran and IVF; the tylenol reduced but did not resolve her headache. Monoclonal abs (sotrovimab) for Omicron strain are in short supply nation-wide; she is to call her OB provider in am to find out if monoclonal abs are even an option given this current situation.  Reasons to return to OB ED reviewed. 1. Discharge to home from OB ED. 2. Reassuring fetal status w/ reactive NST.  3. Routine PNC: Follow up as scheduled with primary OB.  Call office with additional symptoms or questions. 4. Reasons to return to the OB ED were reviewed with her as well including, but not limited to, leaking of fluid, vaginal bleeding, regular contractions, or decreased fetal movement.  1/1/22   Abdomen: soft, nontender               Uterus: gravid, nontender              Extremities: nontender; no edema                Cervix-not examined,  (A) Dilation: 2.5                                                        A) Station: -3   Effacement (%): 75, no change on repeat exam around 2hrs later                                                                              1/12/22  White blood count 6.98   4.5-11.0                                                                                 Red Blood Count 4.08 4.0 - 5.2 10*6/uL   Hemoglobin 11.4 (L) 12.0 - 16.0 g/dL   Hematocrit 35.4 (L) 36.0 - 46.0 %   Mean Corpuscular Volume 86.8 80.0 - 100.0 fL   Mean Corpuscular Hemoglobin 27.9 26.0 - 34.0 pg   Mean Corpuscular HGB Conc 32.2 31.0 - 37.0 g/dL   Red Cell Distribution Width-CV 13.7 12.0 - 16.8 %   Platelet Count 166 140 - 440 10*3/uL   Mean Platelet Volume 11.4 8.4 - 12.4 fL   Diff Type Hospital CBC w/AutoDiff (arb'U)   Neutrophils % 78.7 45 - 80 %   Lymphocyte % 10.3 (L) 15 - 50 %   Monocyte % 9.6 0 - 15 %   Eosinophil% 0.1 0 - 7 %   BASO% 0.3 0 - 2 %   Immature Granulocyte% 1.0 0.0 - 1.0 %   Nucleated RBC % 0 0 /100(WBC)   Neutrophil Abs 5.49 2.0 - 8.8 10*3/uL   Lymphocyte-Absolute 0.72 0.7 - 5.5 10*3/uL   Monocyte Absolute 0.67 0.0 - 1.7 10*3/uL   EOS-Absolute 0.01 0.0 - 0.8 10*3/uL   Basophil Abs 0.02 0.0 - 0.2 10*3/uL   Immature Granulocyte Abs 0.07 0.00 - 0.10 10*3/uL Comprehensive Metabolic Panel (CMP)   Collection Time: 01/12/22 10:02 PM Result Value Ref Range   Sodium 138 136 - 145 mmol/L   Potassium 3.5 3.5 - 5.1 mmol/L   Chloride 106 98 - 107 mmol/L   Carbon Dioxide 19 (L) 22 - 29 mmol/L   Anion Gap 13 5 - 13 (arb'U)   Glucose 84 74 - 99 mg/dL   Blood Urea Nitrogen (BUN) 6 (L) 7 - 19 mg/dL   Creatinine-Blood 0.77 0.55 - 1.02 mg/dL   BUN/Creatinine Ratio 7.8 RATIO   Estimated GFR >60 >60 /1.73 m2   Estimated GFR if (Privacy) >60 >60 /1.73 m2   Total Protein 6.6 6.4 - 8.2 g/dL   Albumin 3.5 3.5 - 5.2 g/dL   Globulin 3.1 1.5 - 4.5 g/dL   Albumin/Globulin Ratio 1.1 1.1 - 2.5 RATIO   Calcium 9.0 8.4 - 10.2 mg/dL   Total Bilirubin 0.2 0.2 - 1.2 mg/dL   AST/SGOT 28 5 - 34 U/L   ALT/SGPT 14 0 - 55 U/L   Alkaline Phosphatase 189 (H) 40 - 150 U/L     Lab Results Component Value Date   HGB 11.4 (L) 01/12/2022