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- Increased: Liver failure, Reye's syndrome.
- A Complement-fixation fungal antibody screen usually detects antibodies to Histoplasma, Blastomyces, Aspergillus, and Coccidioides.
- pH = 6.1 + LOG ([HCO3]/ 0.03 x pCO2)
- For screening infants for PKU
- Ammonia, Serum
- Adult:11-35 uMol/L,Child:40-80
- Barbiturate, long acting
- >215=fatal micromol/l
- Barbiturate, Medium acting
- >105=fatal micromol/l
- Barbiturate, short acting
- >35=fatal micromol/l
- Fungal Serologies
- Negative <1:8
- Hb (blood)
- M:13.5-17.5 F:12.0-16.
- Hb (plasma)
- 1-4 mg/dL
- Lead
- 0.3-1.8 micromol/l
- PaO2
- >10.6 kPa (75-105 mmHg)
- pH Arterial Blood
- 7.36 - 7.44
- Phenylalanine, infants
- 42-73 micromol/l
- RBC
- M:4.3-5.9 F:3.5-5.5 x10^12/L
- Urea
- 3.0-8.2 mg/dL
- lab study
- Normal Value
- &Note
- All Fields
- lab study:
- Normal Value:
- Note:
- Name and Business Phone
- clip 2 labusa
- Anion G
- Increased: Ca of prostate, Prostate surgery, bone
- disease, myeloid leukemia.
- Acid phosphatase
- 0-1 IU/l
- Increased:Addison's Disease, Oat Cell Carcinoma,
- Pancreatic islet cell tumors,thymic
- tumors,renal cell carcinoma.
- Decreased:Adrenal adenoma or carcinoma, nodular adrenal
- hyperplasia, pituitary insufficiency
- ACTH Adrenocorticotropic H.
- 20-140 pg/mL @8 AM
- Increase: liver disease, liver metastasis, biliary
- obstruction, pancreatitis, liver congestion.
- (AST > ALT in alchoholic hepatitis)
- (ALT > AST in viral hepatitis)
- Alanine aminotransferase
- 5-35 IU/l
- Decreased: Malnutrition,Nephrotic Syndrome,Cystic
- Fibrosis, Multiple Myeloma, Hodgkin's Disease, Leukemia, Protein-losing enteropathies,
- chronic glomerulonephritis, alcoholic
- cirrhosis hyperthyroidism, Collagen-Vascular
- disease, Inflammatory Bowel disease.
- Albumin
- Adult:3.5-5.5 g/dL Child:>3.8
- Increased: Hyperaldosteronism (primary or secondary)
- Decreased: Adrenal Insufficiency, panhypopituitarism
- Aldosterone
- 5-30 ng/dL early AM
- Increased: hyperparathyroidism, Paget's disease,
- osteoblastic bone tumors, osteomalacia,
- rickets, pregnancy, childhood, biliary
- obstruction, hyperthyroidism.
- Decreased: Malnutrition, excessive vitamin D ingestion.
- (heat-stable=Liver,heat-labile=bone)
- Alkaline phosphatase
- 20-70 U/L, Child: 20-150 U/L
- Increased: acute pancreatitis, pancreatic duct
- obstruction, EtOH ingestion, mumps,
- parotiditis, renaldisease, macroamylasemia,
- cholecystitis,peptic ulcers, intestinal
- obstruction,mesenteric thrombosis, post
- surgery.
- Decreased: pancreatitis, cystic fibrosis, hepatitis,
- cirrhosis
- Alpha-amylase
- 25-125 Units/L
- Increased: hepatoma, testicular tumor(embryonal Ca,
- Malignant teratoma) spina bifida(in mother's
- serum)
- Decreased: Down's Syndrome (in mother's serum)
- Alpha-Fetoprotein
- <25 ng/mL
- Increase: liver disease, liver metastasis, biliary
- obstruction,pancreatitis, liver congestion.
- (AST > ALT in alchoholic hepatitis)
- (ALT > AST in viral hepatitis)
- ALT
- 8-20 IU/l
- for evaluation of metabolic acidosis.
- Increased:
- Endogenous causes;lactic acidosis,ketoacidosis (due to diabetes, EtOH or starvation), uremia
- Exogenous Causes; salicylates, methanol,paraldehyde, ethylene glycol, hyperalimentation.
- Normal:
- From renal causes; renal tubular acidosis,
- carbonic anhydrase inhibitors, post hypercapnic From gut problems; diarrhea, fistula, ileal loop.
- Calculations:
- Anion Gap = [Na]-([Cl]+[HCO3])
- HCO3 needed = Base Deficit x weight (Kg) / 4
-
- Note: give HCO3 over 8-12 hours
- Anion Gap
- 12-17 mmol/l
- Positive: SLE, Procainamide side-effect, scleroderma,
- rheumatoid arthritis.
- Antinuclear antibodies
- (negative)
- Increased: Streptococcal Infections (Pharyngitis, Scarlet Fever, Rheumatic Fever, Poststreptococcal
- Glomerulonephritis) Rheumatoid Arthritis, and
- other Collagen Diseases.
- ASO Titer(antistreptolysin O)
- <166 Todd Units
- Increased: acute MI,liver disease,Reye's syndrome, muscle trauma, pancreatitis, intestinal trauma,
- erythromycin tx, opiate tx, burns cardiac
- cath., brain damage, renal infarct.
- Decreased: beriberi, diabetes w/ ketoacidosis, liver
- disease.
- Aspartate aminotransferase
- 8-20 U/L
- Increase: acute MI,liver disease,Reye's syndrome, muscle
- trauma, pancreatitis, intestinal trauma,
- erythromycin tx, opiate tx, burns cardiac
- cath., brain damage, renal infarct.
- Decreased: beriberi, diabetes w/ ketoacidosis, liver
- disease.
- AST
- 8-20 Units/L
- BE = [BB measured] - [BB normal]
- where: [BB normal] = 48 mEq/L
- BB is total buffer base including bicarb, protein, and
- hemoglobin
- BE increased: metabolic alkalosis
- BE decreased: metabolic acidosis
- Base Excess
- -2 to +2 mmol/Litre
- Increased: chronic myeloid leukemia, Polycythemia rubra
- vera.
- Decreased: acute rheumatic fever, lobar pneumonia, post
- steroid therapy, thyrotoxicosis, stress.
- Basophiles
- 0-1 % ( <110 cells/
- Increased: respiratory acidosis,compensation for
- metabolic acidosis,emphysema, severe vomiting, primary aldosteronism, volume contraction,
- Bartler's syndrome.
- Decreased: respiratory alkalosis, compensation for
- metabolic acidosis,starvation, diabetic
- ketoacidosis, toxins (methanol, ethylene
- glycol, paraldehyde), severe diarrhea, renal
- failure, drugs (salicylates, acetazolamide),
- dehydration, adrenal insufficiency.
- Important tips:
- Respiratory Acidosis PCO2- >45
- Respiratory Alkalosis PCO2- <35
- Metabolic Acidosis HCO3- <22 mmol/l
- Metabolic Alkalosis HCO3- >26 mmol/l
- Use pH to differentiate Primary from compensatory disorder. If Mixed Disorder, pH will never correct to
- normal.
- Calculations:
- [HCO3]needed (MEq)=(Base deficit(MEq/L) x Pt.Wt.(Kg))/4
- Anion Gap=[Na+]-([Cl-]+[HCO3-])
- Bicarbonate
- 22-28 mEq/L (23-26 mmol/l)
- Increased Total: Hepatic damage, biliary obstruction
- (stone or tumor), hemolysis, fasting.
- Increased Direct (conjugated): biliary obstruction/
- cholestasis (gallstone, tumor,
- stricture, drugs), Dubin-Johnson or
- Rotor's syndrome.
- Increased Indirect (unconjugated): hemolytic jaundice
- (hemolytic anemia), transfusion
- reaction, sickle cell, Gilbert's
- disease, Crigler-Najjar syndrome,
- physiological jaundice of newborn.
- Bilirubin
- 0.1-1.0 mg/dL(T):0-0.3 (D)
- Increased: leukemia, polycythemia vera.
- Decreased: pernicious anemia, pregnency, malabsorption
- B-12 vitamin
- 140-970 micrograms/Litre
- Increased: thrombocytopenia, DIC, Von Willibrand's
- disease, defective platelet function (aspirin)
- Bleeding time
- < 6 min. (Duke,Ivy)
- Increased: renal failure, prerenal azotemia, postrenal
- obstruction, GI bleed, stress, aminoglycoside
- side-effect, CHF,Volume Depletion, shock.
- Decreased: Starvation, liver failure, pregnancy, infancy, nephrotic syndrome,overhydration.
- BUN
- 7-18 mg/dL
- Increased: Medullary Carcinoma of Thyroid, Newborns,
- Pregnancy, Chronic renal insufficiency,
- Zollinger-Ellison Syndrome, Pernicious anemia
- Calcitonin
- Male:<155ng/L, Female:<105ng/L
- corrected Ca = 0.8*(normal albumin - measured albumin) +
- reported Ca. (norm.range 2.20-2.60)
- Increased: primary hyperparathyroidism,
- Parathyroid-secreting tumors, VitD excess,
- Metastatic bone tumors, osteoporosis,
- immobilization, milk-alkali syndrome, Paget's
- disease, infantile hypophosphatasia, thiazide
- drugs, chronic renal failure, sarcoidosis,
- multiple myeloma.
- Decreased: hypoparathyroidism, pseudo-H., no vita.D,
- calcium and phosphorus ingestion,
- hypomagnesemia, renal tubular acidosis,
- hypoalbuminemia,(cachexia,nephrotic S.,cystic
- fibrosis),chronic renal failure, acute
- pancreatitis, factitious 2nd to low protein
- and albumin.
- Calcium (total)
- 4.2-5.3.mEq/L 8.5-10.5 mg/dL
- Corrected Total= 0.8(Norm.Albumin - measured albumin) +
- Ionized Ca.
- Increased: Primary hyperthyroidism, Vita D excess,
- PTH-secreting tumors, metastatic bone tumors,
- osteoporesis, Milk-Alkali syndrome, Paget's
- disease, chronic renal failure, infantile
- hypophosphatasia, multiple myeloma,
- sarcoidosis, thiazide drugs,
- Decreased: hypoparathyroidism, Vitamin D insufficient, Ca & P ingestion (in pregnancy, osteomalacia and
- rickets)hypomagnesemia, renal tubular
- acidosis,hypoalbuminemia (due to cachexia,
- nephrotic syndrome & cystic fibrosis), chronic renal failure (phosphate retention) Acute
- pancreatitis.
- Calcium (ionized)
- 2.24-2.46 mEq/L 4.48-4.92mg/dL
- Decreased: Cardiac failure. Consider Inotrope like
- dobutamine. if less than 2.5
- Cardiac Index
- >2.5 L/Min/Sq.Metre
- Increased:carcinoma (colon, pancreas, lung, stomach),
- smokers, liver disease, Crohn's disease, and
- ulcerative colitis.
- CEA Carcinoembryonic Antigen
- Nonsmoke:<3.0mg/mL,Smoker:<5.0
- Increased: diarrhea, renal tubular acidosis,
- mineralocorticoid deficiency,
- hyperalimentation, acetazolamide, ammonium
- chloride.
- Decreased: vomiting, diabetes w/ ketoacidosis,
- mineralocorticoid excess, renal disease w/
- sodium loss.
- Chloride
- 95-105 mEq/L
- Increased: idiopathic, biliary obstruction, nephrosis,
- hypothyroidism, pancreatic disease
- (diabetes), pregnancy, hyperlipoproteinemia
- (types IIb,III,V)
- Decreased: liver disease (hepatitis), hyperthyroidism,
- malnutrition (cancer,starvation), chronic
- anemias, steroid therapy, lipoproteinemias.
- Cholesterol
- 140-250 mg/dL
- (See bicarbonate, also called: Total CO2 )
- Increased: respiratory acidosis, compensation for
- metabolic acidosis, emphysema, severe
- vomiting, primary aldosteronism, volume
- contraction, Bartler's syndrome.
- 22-28 mEq/L
- Increased: Atypical pneumonia (mycoplasma), viral
- infections (mononucleosis, measles, mumps)
- cirrhosis, some parasites.
- Cold Agglutinins
- <1:32
- Positive: Autoimmune hemolytic anemia (leukemia,
- lymphoma, collagen vascular Diseases),
- hemolytic transfusion reaction, drug
- sensitizations (methyldopa, levodopa,
- cephalothin), Erythroblastosis fetalis
- (hemolytic disease of the newborn)
- Coomb's Test, Direct
- Neg. (no antibody on Pt's RBC)
- Positive: Isoimmunization from previous trasfusion,
- incompatible blood due to improper
- cross-matching.
- Coomb's Test, Indirect
- neg.(no antibody in Pts serum)
- Increased: Wilson's disease, oral contraceptives.
- Copper
- 12-26 micromol/l
- Increased: any muscle damage, acute MI, myocarditis,
- muscular dystrophy, post-surgical, brain
- infartion, defibrillation, cardiac
- catheterization,rhabdomyolysis, polymyositis,
- hypothyroidism.
- Isoenzymes: MB;heart muscle <6%
- MM;skeletal muscle 94-100%
- BB:brain & CNS <1%
- Creatine phosphokinase 1
- M:25-90 F:10-70 Units/L
- Decreased: Diabetes (decreased endogenous insulin),
- factitious insulin administration.
- C-Peptide
- Fasting <4.0ng/ml ,>60y/o:<5.5
- Overnight Test: for Cushing's Disease.
- Give 1mg PO Dexamethasone at 11PM; measure fasting serum cortisol at 8AM
- g/dL = Normal
- g/dL = Cushing's syndrome
- (false positives with obesity, alcoholism, depression)
- Dexamethasone Suppression Test
- g/dL Cortisol at 8AM
- High Dose Test: Adrenal Hyperplasia vs. Tumor.
- Dexamethasone,2mg PO q6h X 8 doses.
- Measure urinary 17-OH Corticsteroid before and after drug
- *Bilteral Adrenal Hyperplasia: drop in urinary 17-OH
- corticosteroids to 50% of baseline.
- *Adrenal Tumors or Ectopic ACTH Production:
- No drop in levels.
- Dexamethasone Suppression Test - High dose
- 17-OH Cort.Steroids drop 50%
- Fresh Surgical Specimens, if Positive then better survivability and cure rate for Breast Carcinoma with better response to endocrine therapy.
- Estrogen Receptors
- see Note
- Decreased: iron deficiency anemia (even before RBC
- morphology changes)
- a measure of bone marrow Iron stores
- Ferritin
- 15-200(M),12-150(F) ng/mL
- Decreased: Congenital, disseminated intravascular
- coagulation (sepsis, amnionic fluid embolism,
- abruptio placentae), surgery (prostate, open
- heart) neoplastic and haematological
- conditions, acute severe bleeding, burns,
- snake bite.
- Fibrinogen
- 150-450 mg/dL
- Increased: any thromboembolic condition(deep vein
- thrombosis, MI, pulmonary embolus), DIC
- (disseminated intravascular coagulation)
- Fibrin Degradation(Split)Products
- <10 micrograms/mL
- Increased: folic acid administration.
- Decreased: malnutrition, carcinoma, hemolytic anemia,
- megaloblastic anemia, malabsorption.
- Folate (Folic Acid)
- 2.0-21 ng/mL
- Flourescent Treponemal Antibody- Absorbed
- Positive: Syphilis (test of choice to confirm diagnosis), other treponemal infections.
- FTA-ABS
- nonreactive
- Increased: Zollinger-Ellison Syndrome, pyloric stenosis,
- pernicious anemia, atrophic gastritis,
- ulcerative colitis, renal insufficiency,
- steroid and calcium administration.
- Gastrin
- Male:<100 pg/mL Female:<75
- Gamma Glutamyl Transpeptidase
- Note: parallels changes in serum alkaline phosphatase and
- 5'nucleotidase in liver disease.
- Increased: liver disease (hepatitis, cirrhosis,
- obstructive jaundice), pancreatitis.
- Male:9-50 IU/L,Female:8-40 IU/L
- Increased: Obstructive liver disease, any cause if
- combined with increased ESR (erythrocyte
- sedimentation rate)
- Decreased: Any type of hemolysis (transfusion reaction,
- etc.), liver disease.
- Haptoglobin
- 26-185 mg/mL
- HDL-C has best correlation w/ development of coronary artery Disease. A decreased level->increased risk
- Increased: estrogen (females)
- Decreased: Males, Uremia, Obesity, diabetes, Liver
- Disease, Tangier's Disease.
- HDL-C = High Density Lipoprotein Cholesterol
- Fasting 45 (+/-12) mg/dL
- HDL-C has best correlation w/ development of coronary artery Disease. A decreased level->increased risk
- Increased: estrogen (females)
- Decreased: Males, Uremia, Obesity, diabetes, Liver
- Disease, Tangier's Disease.
- HDL-C = High Density Lipoprotein Cholesterol
- HDL-C
- Fasting 45 (+/-12) mg/dL
- AKA: glycohemoglobin
- Increased: Diabetes Mellitus (uncontrolled; reflects mean glucose levels over preceding 4-6 weeks)
- Decreased: Chronic renal failure.
- Mean Glucose=10x(HgbA1C + 4)
- Hemoglobin A-1c
- 4.6-7.1 %
- Also called glycohemoglobin
- Increased: Diabetes Mellitus (uncontrolled; reflects
- levels over preceding 3-4 months)
- Decreased: Chronic renal failure.
- Mean Glucose=10x(HgbA1C + 4)
- HbA1c
- 4.6-7.1 %
- also called Hemoglobin A-1c
- Increased: Diabetes mellitus (uncontrolled; reflects
- levels over preceding 3-4 months)
- Decreased: Chronic renal failure
- Mean Glucose=10x(HgbA1C + 4)
- GlycoHemoglobin
- 4.6-7.1%
- HDL-C has best correlation w/ development of coronary artery Disease. A decreased level->increased risk
- Increased: estrogen (females)
- Decreased: Males, Uremia, Obesity, diabetes, Liver
- Disease, Tangier's Disease.
- HDL-C = High Density Lipoprotein Cholesterol
- High Density Lipoprotein
- Fasting 45 (+/-12) mg/dL
- Increased: hemochromatosis, hemosiderosis (caused by
- excessive iron intake), excess destruction of
- RBC's, decreased production of RBC's, liver
- necrosis, oral contraceptives.
- Decreased: Iron deficiency anemia, hepatitis, nephrosis
- (loss of iron binding proteins), normochromic
- anemia of chronic disease and infections.
- 50-170 micrograms/dL
- The normal iron/TIBC ratio is 20-50%
- <15% is diagnostic of Iron Deficiency Anemia.
- Increased:Acute&Chronic Blood loss, Iron deficiency
- Anemia, Hepatitis, Oral Contraceptives
- Decreased:Anemia of Infection or Chronic Disease,
- cirrhosis, Nephrosis, Hemochromatosis.
- Iron Binding Capacity
- 250-450
- Increased: Lactic Acidosis due to Hypoxia, hemmorhage,
- Shock, sepsis, cirrhosis, exercise.
- Lactate
- 0.5-2.2 mMol/L
- Increased: Lactic Acidosis due to Hypoxia, hemmorhage,
- Shock, sepsis, cirrhosis, exercise.
- Lactic Acid
- 0.5-2.2 mMol/L
- (lactate dehydrogenase)
- Increased:acute MI, cardic surgery, prosthetic valves,
- hepatitis, pernicious anemia, malignant
- tumors, pulmonary embolus, hemolysis (anemias
- or factitious, renal infarction, muscle injury.
- 45-90 U/L
- If LDH1/LDH2 > 1.0 : Then Poss. Acute MI
- If LDH5 > LDH4 : Suspect liver Disease
- With Acute MI: Levels start to rise 12-24 Hrs post MI and Peak 3-6 Days then return to normal in
- 8-14 Days.
- LDH Isoenzymes
- LDH1/LDH2 Ratio <0.6 - 0.7
- (toxic >2.0) mmol/l
- Increased: treatment for manic phase of manic-depressive
- disorder.
- Lithium
- theraputic 0.5-1.5
- Increased: renal failure, hypothyroidism, Mg-containing
- antacids, Addison's disease, diabetic coma,
- severe dehydration, lithium intoxication.
- Decreased: malabsorption, steatorrhea, alcoholism,
- cirrhosis, hyperthyroidism, aldosteronism,
- diuretics, acute pancreatitis, hyperPTHism,
- hyperalimentation, nasogastric suctioning,
- chronic dialysis, renal tubular acidosis,
- drugs(cis-platinum, amphotericin B,
- aminoglycosides), hungry bone syndrome,
- hypophospatemia, intracellular shifts with
- respiratory or metabolic acidosis.
- Magnesium
- 1.6-2.6 mg/dL
- (mean cellular hemoglobin concentration)
- =hemoglobin (gm/dL) / hematocrit
- Increased: severe & prolonged dehydration, spherocytosis.
- Decreased: iron-deficiency anemia, overhydration,
- thalassemia, sideroblastianemia.
- MCHC
- 30-36 g/dl
- (mean cellular hemoglobin )
- = hemoglobin(g/l) / RBC (million/microlitre)
- Increased: macrocytosis (megaloblastic anemias, high
- reticulocyte count)
- Decreased: microcytosis (Fe-deficiency, sideroblastic
- anemias, thalassemia)
- 27-32 pg
- MCV=HCT x 1000/ RBC (millions/microlitre)
- Increased: megaloblastic anemia(B-12 or folate
- deficiency), macrocytic (normoblastic) anemia,
- reticulocytosis, Down's syndrome, chronic liver disease.
- Decreased: Iron deficiency, thalassemia, lead poisoning.
- MCV (mean cell volume)
- 76-96 fl
- Increased: bacterial infections(TB, subacute bacterial
- endocarditis, brucellosis, typhoid fever,
- recovery from acute infection), protozoal
- infections, infectious mononucleosis,
- leukemia, Hodgkin's disease, ulcerative
- colitis, regional enteritis.
- Monocytes
- 2-10 % ( <800 cells/
- Osm = (2(sodium)+ BUN/2.8 +Glucose/18)
- Increased: hyperglycemia, alcohol ingestion, water loss
- (diabetes, hypercalcemia, diuresis), ethylene
- glycol ingestion, mannitol.
- Decreased: low serum sodium,diuretics,Addison's disease,
- inappropriate ADH (SIADH is seen in
- bronchogenic carcinoma & hypothyroidism),
- iatrogenic(poor water balance).
- Osmolality, plasma
- 278-305 mosm/kg
- Respiratory Acidosis PCO2- >45
- Respiratory Alkalosis PCO2- <35
- Metabolic Acidosis HCO3- <22 mmol/l
- Metabolic Alkalosis HCO3- >26 mmol/l
- Use pH to differentiate Primary from compensatory disorder. If Mixed Disorder, pH will never correct to
- normal.
- PaCO2
- 4.4 - 5.9 kPa (33-44 mmHg)
- (Polymorphonuclear Neutrophils)
- Increased:
- Normal: severe exercise, last months of pregnancy,
- labor, surgery, newborns.
- Pathological Increase: bacterial infections, tissue
- damage( MI, pulmonary infarction, crush
- injury, burn injury), metabolic disorders
- (eclampsia, diabetic ketoacidosis, uremia,
- acute gout), leukemias.
- Decreased: pancytopenia, aplastic anemia, PMN depression
- (mild = neutopenia, severe = agranulocytosis), marrow damage( due to x-rays, benzene
- poisoning or antitumor drugs), disseminated
- TB, septicemia, acute malaria, severe
- osteomyelitis, infectious mononucleosis,
- atypical pneumonias, viral infections, marrow
- obliteration (osteosclerosis, myelosclerosis,
- myelofibrosis, malignant infiltrate), over 70
- different drugs (chloramphenicol,
- phenylbutazone ,chlorpromazine, quinine), B-12 and folate deficiencies, hypoadrenalism,
- hypopitutarism,dialysis.
- PMN's
- 40-75 %
- Increased: factitious( hemolysis of specimen,
- thrombocytosis), renal failure, Addison's
- disease, acidosis, spironolactone,
- triamterene, dehydration, hemolysis, massive
- tissue damage, excess intake, acidosis.
- Decreased: diuretics, decreased intake, vomiting,
- nasogastric suction, villous adenoma,
- diarrhea, Zollinger-Ellison syndrome, chronic
- pyelonephritis, renal tubular acidosis,
- metabolic alkalosis (primary aldoseronism,
- Cushing's syndrome)
- Potassium
- 3.5-5.0 mEq/L (same in mmol/L)
- Increased: Multiple myeloma, macroglobulinemia,
- hypergammaglobulinemia, sarcoidosis.
- Decreased: malnutrition, inflammatory bowel disease,
- Hodgkin's disease, leukemias, decreased
- albumin from any cause.
- Protein(total Plasma)
- 6.0-7.8 g/dL
- (prothrombin time)
- Prolonged: Drugs(Warfarin), Vitamin K deficiency, fat
- malabsorption,liver disease, disseminated
- intravascular coagulation (DIC), Factitious
- due to prolonged use of tourniquet before
- drawing sample.
- NOTE: PT measures activity of factors I,II,V,VII,IX,X and fibrinogen. (extrinsic clotting mechanism)
- PT (prothrombin time)
- 11.5-13.5 seconds
- (Partial Thromboplastin Time)
- Prolonged: Hemophilia A and B, Heparin administration,
- Factitious from Tourniquet on too long,
- Note: PTT measures Defects in clotting factors I,II,V,VIII,IX,X,XI,and XII
- PTT (Partial Thromboplastin Time)
- 35-45 Secs.
- (red cell distribution width)
- a measure of variation in cell size.
- Increased: in many anemias; esp. Iron Deficiency Anemia
- (normal in Anemia of Chronic Disease) in
- setting of a microcitic(or normocytic)
- hypochromic anemia.
- RDW
- 11.5-14.5%
- Increase: acute MI,liver disease, Reye's syndrome, muscle trauma, pancreatitis, intestinal trauma,
- erythromycin tx, opiate tx, burns cardiac
- cath., brain damage, renal infarct.
- Decreased:beriberi, diabetes w/ ketoacidosis, liver
- disease.
- 5-35 IU/l
- Increase: liver disease, liver metastasis, biliary
- obstruction, pancreatitis, liver congestion.
- (SGOT > SGPT in alchoholic hepatitis)
- (SGPT > SGOT in viral hepatitis)
- SGPT
- 5-35 IU/l
- Increased:
- *low total body sodium: (gycosuria, mannitol, urea,
- sweating)
- *normal body Na: (diabetes insipidus; central and
- nephrogenic, respiratory losses,
- sweating)
- *increased total body Na: (hypertonic H2CO3,
- Cushing's syndrome,
- hyperaldosteronism).
- Decreased:
- *excess total Na and H2O: (nephrotic syndrome,
- congestive heart failure,
- cirrhosis, renal failure),
- *excess H20 only: (SIADH, hypothyroidism, adrenal
- insufficiency),
- *with decreased Na and H2O: ( diuretics, renal
- tubular acidosis, mannitol, urea,
- mineralocorticoid deficiency,
- vomiting,diarrhea, pancreatitis),
- *with pseudohyponatremia (hyperlipidemia,
- hyperglycemia, multiple myeloma).
- Total Body Water calc for rehydration:
- Current TBW = 0.6 X Current Weight(Kg.)
- Desired TBW = Serum Na+(mEq/L.) X Current TBW
- -------------------------------
- Normal Serum Na+(mEq/L.)
- Body Water Deficit = Desired TBW - Current TBW
- Note: Correct SLOWLY; 1/2 BWD over first 24 Hrs.
- Then the rest over 1-2 days.
-
- Repeat calc. daily to reach steady-state.
- Sodium
- 135-145 mEq/L
- The normal iron/TIBC ratio is 20-50%
- <15% is diagnostic of Iron Deficiency Anemia.
- Increased:Acute&Chronic Blood loss, Iron deficiency
- Anemia, Hepatitis, Oral Contraceptives
- Decreased:Anemia of Infection or Chronic Disease,
- cirrhosis, Nephrosis, Hemochromatosis.
- 250-450
- g/dL(54-75
- Mol/l)
- The normal iron/TIBC ratio is 20-50%
- <15% is diagnostic of Iron Deficiency Anemia.
- Increased:Acute&Chronic Blood loss, Iron deficiency
- Anemia, Hepatitis, Oral Contraceptives
- Decreased:Anemia of Infection or Chronic Disease,
- cirrhosis, Nephrosis, Hemochromatosis.
- Total Iron Binding Capacity
- 250-450
- Increased: hyperlipoproteinemias (types I,IIb,III,IV,V),
- hypothyroidism,liver diseases, alcoholism,
- pancreatitis, acute MI,nephrotic syndrome,
- familial increase.
- Decreased: malnutrition, congenital abetalipoproteinemia.
- Triglycerides:
- 115-190 ng/dL
- Increased: renal failure, prerenal azotemia, postrenal
- obstruction, GI bleed, stress, aminoglycoside
- side-effect.
- Decreased: Starvation, liver failure, pregnancy, infancy, nephrotic syndrome, overhydration.
- Urea nitrogen
- 7-18 mg/dL
- Increased: gout,renal failure,leukemia, anemia,
- chemotherapy,toxemia of pregnancy, diuretics,
- lactic acidosis, hypothyroidism,polycystic
- kidney disease, parathyroid diseases.
- Decreased: uricosuric drugs (salicylatesprobenecid,
- allopurinol), Wilson's disease, Fanconi's
- syndrome.
- Uric acid
- M:210-480 F:150-390 micromol/l
- Increased: macroglobulinemia, multiple myeloma,Plasma
- cell myeloma,
- Note: usually >4 Cp before symptoms of fundal
- hemmorrhage,epistaxis,drowsiness, and confusion are seen.
- The units are in centipoises.
- Viscosity, Plasma
- 1.4-1.8 Cp
- Increased: In many inflammatory and bacterial infective
- processes. Look at individual leukocyte
- subpopulations for some indication of the
- exact infective process involved.
- WBC
- 4-11 x10^9/l
- If >15, increased:give Dobutamine or other inotrope.
- Means left atrial pressure is too high.
- Wedge Pressure
- <15 mmHg
- All Lab Study Entries
- Increased: Rheumatoid arthritis, rheumatic fever,
- neoplasms (GI, Prostate, others)
- Decreased: Systemic Lupus, glomerulonephritis
- (Poststreptococcal and membranoproliferative)
- sepsis, subacute bacterial endocarditis,
- chronic active hepatitis.
- Complement C3
- 80-160 mg/dL
- Increased: Rheumatoid arthritis (juvenile), neoplasms
- (gastrointestinal, lung, others)
- Decreased: Systemic Lupus, Chronic active hepatitis,
- cirrhosis, glomerulonephritis, hereditary
- angioedema.
- Complement C4
- 20-50 mg/dL
- Test for complement deficiency in classical pathway.
- Increased: Acute phase reactants (tissue injury,
- infections, etc.)
- Decreased: hereditary complement deficiencies
- Complement CH50 (total)
- 33-61 mg/mL
- Increased: Adrenal adenoma, adrenal Carcinoma, Cushing's
- disease, ACTH-producing tumor, steroid
- therapy, oral contraceptives.
- Decreased: Addison's disease, Congenital adrenal
- hyperplasia, Waterhouse-Friderichsen syndrome, pituitary insufficiency.
- Cortisol
- 8AM:5.0-23.0
- g/dL 4PM:3.0-15.
- Increased: renal failure( pre-renal, renal, or postrenal
- obstruction), gigantism, acromegaly, ingestion of roasted meat, aminoglycosides or other
- drugs, false positives with ketones (DKA)
- Decreased: pregnancy, loss of muscle mass.
- Creatinine
- 0.6-1.3 mg/dL
- Increased: allergy, parasites, skin diseases,
- collagen-vascular diseases (NAACP=
- neoplasm,allergy,addison's, collagen-vascular, parasites), pulmonary diseases(loffler's
- syndrome & PIE)
- Decreased: after steroids, ACTH, after stress, Cushing's
- syndrome.
- Eosinophiles
- 1-6 % ( <400 cells/
- Increased: diabetes mellitus, Cushing's syndrome,
- acromegaly, epinephrine (inj.,
- pheochromocytoma, stress, burns), acute
- pancreatitis, ACTH administration, elderly
- patients, pancreatic gluagonoma.
- Decreased: pancreatic disorders (pancreatitis, islet-cell tumors), extrapancreatic tumors (carcinoma
- of the adrenals, stomach), hepatic disease
- (hepatitis, cirrhosis, tumors), endocrine
- disorders (early diabetes, hypothyroidism,
- hypopituitarism), post-gastrectomy,
- prematurity, infant of a diabetic mother,
- ketotic hypoglycemia, exogenous insulin, oral
- hypoglycemics, malnutrition, sepsis.
- Glucose (fasting)
- 70-110 mg/dL
- Increased: Primary polycythemia, polycythemia vera,
- secondary polycythemia (decr.fluid intake,
- incr. fluid loss), heart disease, high
- altitude, heavy smokers, renal cell carcinoma, hepatoma, renal cysts.
- Decreased: megaloblastic anemia (due to folate or B-12
- deficiency), Iron deficiency anemia, sickle
- cell anemia, acute or chronic blood loss,
- hemolysis, alcohol, drugs.
- Hematocrit
- male:40-54% female:37-47%
- Increased: measles, German measles, mumps, whooping
- cough, smallpox, influenza, hepatitis,
- infectious monucleosis, acute infectious
- lymphocytosis, any viral infection, and
- chronic lymphocytic leukemias.
- Decreased: post-stress, uremia, some viral infections,
- normal in 22% of Pop.
- Lymphocytes
- 20-45 %
- (Polymorphonuclear Neutrophils)
- Increased:
- Normal: severe exercise, last months of pregnancy,
- labor, surgery, newborns.
- Pathological Increase: bacterial infections, tissue
- damage( MI, pulmonary infarction, crush
- injury, burn injury), metabolic disorders
- (eclampsia, diabetic ketoacidosis, uremia,
- acute gout), leukemias.
- Decreased:
- pancytopenia, aplastic anemia, PMN depression
- (mild = neutopenia, severe = agranulocytosis), marrow damage( due to x-rays, benzene
- poisoning or antitumor drugs), disseminated
- TB, septicemia, acute malaria, severe
- osteomyelitis, infectious mononucleosis,
- atypical pneumonias, viral infections, marrow
- obliteration (osteosclerosis, myelosclerosis,
- myelofibrosis, malignant infiltrate), over 70
- different drugs (chloramphenicol,
- phenylbutazone ,chlorpromazine, quinine), B-12 and folate deficiencies, hypoadrenalism,
- hypopitutarism,dialysis.
- Neutrophiles
- 40-75 % (2K-9K cells/
- Decreased: megaloblastic anemia (due to folate or B-12
- deficiency), Iron deficiency anemia, sickle
- cell anemia, acute or chronic blood loss,
- hemolysis, alcohol, drugs.
- Increased: Primary polycythemia, polycythemia vera,
- secondary polycythemia (decr.fluid intake,
- incr. fluid loss), heart disease, high
- altitude, heavy smokers, renal cell carcinoma, hepatoma, renal cysts.
- PCV (hematocrit)
- M:0.4-0.54 F:0.37-0.47 (to one
- Increased: hypoparathyroidism, excess vitamin-D,
- secondary hyperparathyroidism, renal failure,
- bone disease, healing fractures, Addison's
- disease, childhood, factitious from specimen
- hemolysis.
- Decreased: hyperparathyroidism,alcoholism, diabetes,
- hyperalimentation,acidosis, alkalosis, gout,
- salicylate poisoning, IV steroid, glucose or
- insulin injection, hypokalemia,
- hypomagnesemia, diuretics, Vitamin D
- deficiency, posphate-binding antacids
- Phosphate (inorganic)
- 3.0-4.5 mg/dL
- abnormalities of platelet function are measured by
- bleeding time.
- Increased: sudden exercise, after trauma bone fracture,
- after asphyxia,after surgery, acute
- hemmorrhage, polycythemia vera, primary
- thrombocythemia, leukemias, carcinoma,
- post-childbirth.
- Decreased: disseminated intravascular coagulation (DIC),
- idiopathic thrombocytopenic purpura,
- congenital disease, bone marrow suppressants
- (chemotherapy, thiazide diuretics, alcohol,
- estrogens, x-rays), burns, snake and insect
- bites, leukemias, aplastic anemia,
- hypersplenism, infectious mononucleosis, viral
- infections, cirrhosis, massive transfusions,
- eclampsia, preeclampsia, over 30 different
- drugs.
- Platelets
- 150-400 x10^9/l
-