Diagnostic Laboratory Tests HEMATOLOGY White Blood Cell Count (WBC) Red Blood Cell Count (RBC) Hemoglobin

(Hb) Hematocrit (Hct) Platelet Count

Normal Values 5-10 x 109/L

Possible Medical Condition Increased Decreased infection, leukemia, tissue necrosis bone marrow depression, influenza, typhoid fever, measles, infectious hepatitis, mononucleosis, rubella anemia, fluid overload of 24 hrs anemia, recent hemorrhage, fluid retention anemia, hemodilution

Red Blood Cell Count (RBC) M: 140-170 g/L F: 120-170 g/L M: 0.40 -0.50 F: 0.38 0.48 200-400 x 109/L

Erythrocyte Sedimentation Rate (ESR) Bleeding Time (BT)

M: 0-10 mm/hr F: 0-20 mm/hr 1-3 min

Prtothrombin Time (Protime; PT) Clotting Time (CT) Neutrophils

12-15 sec
5-15 min 0.54-0.75

Eosinophils

0-0.4

Basophils Lymphocytes

0-0.005 0.2-0.35

Monocytes BLOOD CHEMISTRY Electrolytes Sodium Potassium

0.06

absolute/relative polycythemia polycythemia or dehydration polycythemia, hemoconcentration hemorrhage, iron aplastic/hyyploplastic bone deficiency, anemia, marrow leukemia, vit B12 inflammatory disease, deficiency, immune disorders primary thrombocythemia, myelofibrosis w/ myeloid metaplasia, polycythemia vera, chronic myelogenous leukemia TB, acute or chronic polycythemia, sickle cell inflammation, blood cell anemia dyscrasias, rheumatic fever, RA, anemia Prolonged BT Hodgkins Disease, acute leukemia, disseminated intravascular coagulation, hemolytic disease of the neonate, Schonlein-Henoch purpura, severe hepatic disease, severe deficiency factors I,II, V, VII, VIII, IX or XI, platelet function disorder Prolonged PT hepatic disease, deficiencies in fibrinogen, prothrombin, vit K, or factors V, VII or X Infection, ischemic Bone marrow depression, neurosis, metabolic thyphoid, hepatitis, influenza, disorders, RA, acute gout measles, mumps, rubella, hepatitic disease, SLE, vit B12 deficiency Asthma, hay fever, Cushings Syndrome parasitic infections, chronic myelocytic leukemia, Hodgkins Disease, metastasis Chronic myelocytic Hyperthyroidism, ovulation, leukemia, Hodgkins pregnancy Disease, Ulcerative colitis TB, hepatitis, infectious mononucleosis, mumps, rubella, thyrotoxicosis, lymphocytic leukemia TB, malaria, hepatitis, SLE, RA, carcinomas, monocytic leukemia, lyphomas Diabetes insipidus, impaired renal function, aldosteronism Acidosis, insulin deficiciency, diabetic ketoacidosis, MI, renal failure Adrenal insuffiency, chronic renal insuffieciency w/ acidosis GI & renal disorders

135-145 mmol/L 4-4.5 mmol/L

Calcium

2.02 2.60 mmol/L

Diagnostic Laboratory Tests Phosphates

Normal Values 0.42-1.97 mmol/L

Magnesium Chloride Protein & Metabolites Blood Urea (BUN) Creatinine Uric Acid Protein Nitrogen

1.4-2.1 mmol/L 99.9-110 mmol/L

Hyperparathyroidism, Hypoparathyroidism, parathyroid tumors, Cushings syndrome, renal Pagets disease of the failure, acute bone, multiple myeloma, pancreatitis/peritonitis metastatic carcinoma, adrenal insufficiency, renal failure Possible Medical Condition Increased Decreased Skeletal disease, Malnutrition, malabsorption hypoparathyroidism, syndromes, acromegaly, diabetic hyperparathyroidism, renal acidosis, high intestinal tubular acidosis, diabetic obstruction, renal failure, acidosis Renal failure, Addisons Chronic alcoholism, acute disease pancreatitis, primary aldosteronism Severe dehydration, Chronic renal failure, complete renal shutdown, Addisons disease primary aldosteronism Renal disease, dehydration, urinary tract obstruction Renal disease (> 50% neutrons) Gout, impaired renal function, von Gierkes disease, hemolytic/sickle cell anemia, polycythemia, neoplasms, psoriasis Diabetic acidosis, fulminating & chronic infections, multiple myeloma, monocytic leukemia, early-stage Laennecs cirrhosis, RA Multiple myeloma Severe hepatic malnutrition damage,

3.2-8 mmol/L 53-133 mmol umol/L 0.13-0.44 mmol/L

Defective tubular absorption (Fanconis syndrome & Wilsons disease); aute hepatic atrophy GI disease, blood dyscrasias, essential hypertension, Hodgkins disease, uncontrolled DM, nephrosis Nephritis, nephrosis, Hodgkins disease, hypogammaglobulinemia, peptic ulcer, acute cholecystitis, sarcoidosis, collagen diseases, SLE, RA, essential hypertension, metastatic cancer Neoplastic & renal diseases, hepatic dysfunction, blood dyscrasias

Total Protein

64-83 g/L

Albumin

30-50 g/L

Globulins

23-25 g/L

Multiple myeloma, chronic syphilis, TB, subacute bacterial endocarditis, collagen diseases, SLE, Hodgkins disease, DM, RA > 5% MI Acute MI

Cardiac Enzymes & Proteins Creatinine Kinase (CK) Lactate Dehydrogenase (LDH)

45-235 U/L 50-285 U/L

Carbohydrates Fasting Plasma Glucose/Fasting Blood Sugar

3.89-5.88 mmol/L

Amylase

10-130 U/L

Pancreatitis, Cushings syndrome, acromegaly, pheochromocytoma, hyperlipoproteinemia, chronic hepatic disease, nephrotic syndrome, brain tumor, sepsis, seizure disorders Hyperinuslinism, von Gierkes disease, hypoglycemia, myxedema, adrenal insufficiency, hypopituitarism Moderate: pancreatic Chronic pancreatitis, injury pancreatic cancer, cirrhosis, hepatitis, toxemia of pregnancy Very high: (>20 times normal) viral hepatitis, severe skeletal muscle trauma High: (10-20 times normal) severe MI, severe infectious mononucleosis, alcoholic cirrhosis Moderate to high (5-10 times normal) Duchennes muscular dystrophy, dermatomyositis or chronic hepatitis Low to moderate ( 2-5 times normal) hemolytic anemia, metastatic hepatic tumors, acute pancreatitis, pulmonary emboli, alcohol withdrawal syndrome, fatty liver Possible Medical Condition Increased Decreased Very high (up to 20 times normal) viral or severe druginduced hepatitis Moderate to high infectious mononucleosis, chronic hepatitis, intrahepatic cholestasis or cholecystitis Slight to moderate (w/ high AST) acute hepatocellular injury Marginal: acute MI Significant : skeletal Hypophosphatasis, protein or disease, extra or magnesium deficiency intrahepatic biliary obstruction Moderate: acute biliary obstruction, inactive cirrhosis, mononucleosis, viral hepatitis Sharp: Pagets disease Moderate: Gauchers disease Dangerously high: tumor that has spread beyond the prostatic capsule Mild to moderate: biliary obstruction, diabetes, nephrotic syndrome, endocrine disorders, over consumption of alcohol Severe: (>11.29 mmol/L) pancreatitis CAD, heapatitis, lipid disorders, bile duct blockage, nephrotic syndrome, obstructive jaundice, pancreatitis, hypothyroidism CAD Chronic hepatitis, early stage primary biliary Malnutrition, abetalipoproteinemia

Hepatic Enzymes Aspartate Aminotransferase (AST)

0-34 U/L

Diagnostic Laboratory Tests Alanine Aminotransferase (ALT)

Normal Values 0-30 U/L

Alkaline Phosphatase (ALP)

36-92 U/L

Acid Phosphatase Lipids & Lipoproteins Triglycerides

0.10-1.90 U/L

0.11-2.37 mmol/L

Total Cholesterol

3.40-7.77 mmol/L

Low Density Lipoprotein (LDL) High Density Lipoprotein (HDL)

1.10-3.81 mmol/L 0.25-2.65 mmol/L

Inflammatory joint disease, chronic pulmonary disease, myeloma hypertriglyceridemia

cirrhosis Bilirubin Indirect Bilirubin 3.4-13.7 umol/L Hepatic damage, severe hemolytic anemia, congenital enzyme deficiency e.g. Gilberts disease & Crigler-Naijar syndrome biliary obstruction 257 ummol/L indicates a need for an exchange transfusion Acute infection or inflammation (+) RA (+) rubella specific IgM indicates adult or congenital rubella in an infant (+) hepatitis B Color change due to drugs, diet or disease Unusual odor - infection Turbidity kidney infection Nephrotic syndrome

Direct Bilirubin Total Bilirubin (in neonates) IMMUNOPATHOLOGY C - reactive Protein (CRP) Rheumatoid Factor (RF) Rubella HBsAg URINE CHEMISTRY Color Odor Appearance Specific Gravity

0.0-3.4 umol/L 0.0-17 umol/L

< 6 mg/L < 30 IU/mL Negative Negative Straw to dark yellow Slightly aromatic clear Newborn: 1-1.02 Infants: 1.0021.006 Adults: 1. 016 -1.022 4.6-6.5 None Normal Values Negative Negative 0.1-1 Erlich units/100 ml none 0-2/hpf (F); 0(M) 0-5/hpf (F); 0-2/hpf (M) Small amounts Hyaline, coarse, fine granular, RBC, WBC, waxy casts Present Acidic: uric acid, Ca oxalate, amorphous urate Alkaline: triple phosphate, ammonium biurate,

pH Protein Diagnostic Laboratory Tests Glucose Ketones Urobilinogen Hb, nitrite RBC WBC Epithelial cells Casts

Diabetes insipidus, acute tubular necrosis, pyelonephritis Fixed specific gravity chronic glomerulonephritis w/ severe kidney damage Renal TB, pyrexia, Fanconis syndrome, UTI phenylketonuria, alkaptonuria or acidosis If present proteinuria, renal failure or myeloma Possible Medical Condition Increased Decreased (+) DM, pheochromocytoma, Cushings syndrome, impaired tubular reabsorption, advanced kidney disease, increased ICP (+) DM, starvation Liver damage, hemolytic Biliary obstruction disease, severe infection Blood cells infection, inflammation trauma, tumors

Excessive renal disease

Crystals

Ca oxalate crystals hypercalcemia Cystine crystals inborn error of metabolism

Bacteria, yeast cells, parasites Amylase

amorphous phosphate none 64.75-490.25 U/L

Sodium Chloride Potassium Calcium

80-216 mmol/L 80-340 mmol/L 25-100 mmol/L 2.5-7.5 mmol/24 hrs 22.4-33.6 mmol/24 hrs 4.42-5.90 mmol/24hrs

Phosphates

Uric Acid

Creatinine

0.65-0.70 g/L

If present GUT infection/contamination of external genitalia Acute pancreatitis, acute Chronic pancreatitis, injury to the spleen, renal cachexia, alcoholism, liver disease, perforated peptic cancer, cirrhosis, hepatitis, or duodenal ulcers, hepatic abscess gallbladder disease adrenal failure, diabetic Primary Aldosteronism, acute acidosis, water-deficient enal failure, heart failure dehydration Water-deficient Excessive diaphoresis, heart dehydration, diabetic failure, hypochloremic acidosis, Addisons disease metabolic alkalosis Cushings disease, Aldosteronism, renal tubular salicylate intoxication acidosis, chronic renal failure Hyperparathyroidism, Hypoparathyroidism, metastatic carcinoma, vit nephrosis, acute nephritis, D intoxication, sarcoidosis, renal insufficiency multiple myeloma Hyperparathyroidism, Vit D intoxication, sarcoidosis, multiple myeloma hypoparathyroidism, nephrosis, acute nephritis, renal insufficiency Chronic myeloid leukemia, Gout, chronic polycythemia vera, glomerulonephritis, diabetic multiple myeloma, early glomerulosclerosis, collagen remission in pernicious disorders anemia, lymphosarcoma, lymphatic leukemia, Fanconis syndrome, Wilsons disease Urinary obstruction, chronic bilateral pyelonephritis, acute/chronic glomerulonephritis, polycystic kidney disease

Diagnostic Laboratory Tests STOOL CULTURE Parasites

Normal Values Negative

Possible Medical Condition Increased Decreased Aeromonas hydrophila gastroenteritis Bacillus cereus food poisoning Campylobacter jejuni gastroenteritis Clostridium botulini food poisoning & infant botulism Clostridium perfringens food poisoning E. coli gastroenteritis Salmonella gastroenteritis, thyphoid fever, non-typhoidal salmonellosis, paratyphoid fever, enteric fever Shigella shigellosis, bacillary dysentery Staph aureus food poisoning V. cholerae cholera V. parahemolyticus food poisoning from seafoods Yersinia enterocolitica gastroenteritis, enterocolitis, (resembling appendicitis), mesenteric lymphadenitis, ileitis > 6 mg og hemoglobin/feces early diagnosis of colorectal cancer

Occult Blood

Negative

CEREBROSPINAL FLUID (CSF) Color

Clear, colorless

Pressure Protein RBC WBC

50-80 mm H20 15-50 mg/dl Negative 0-5 x 106/L (Adults) 0-30 x 106/L (Neonates)

Cloudy infection Bloody subarachnoid intracerebral or intraventricular hemorrhage; spinal cord obstruction, traumatic lumbar puncture Brown, orange high protein levels, yellow or RBC breakdown Increased ICP Spinal subarachnoid obstruction above puncture site Tumors, trauma, Rapid CSF production hemorrhage, DM, polyneuritis, blood in CSF (+) hemorrhage, traumatic lumbar puncture Meningitis, acute infection, onset of chronic illness, tumor, abscesses, infarction, demyelinating disease

kianamd269-21-11