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CBC Increased Decreased

(Complete Blood
Count)

RBC polycythemia or abnormal loss of


erythrocytosis usually erythrocytes
caused by oxygen need
(e.g. lung disease, bone marrow suppression
congenital heart
defects)

polycythemia

Hgb
blood loss

hemolytic anemia

bone marrow suppression


polycythemia sickle cell anemia

Hct - % of RBC to dehydration


Plasma
burns blood loss,

overhydration

dietary deficiency

liver disease anemia


RBC indices:
alcoholism
Mean corpuscular
volume (MCV) pernicious anemia iron deficiency anemia

The average size of the lead poisoning


individual RBC

rarely seen
Mean corpuscular
haemoglobin (MCH)
amount of Hgb present
in one cell
iron deficiency anemia
Mean Corpuscular rarely seen
Hgb concentration
(MCHC) proportion of
each cell occupied by
Hgb
iron deficiency anemia

WBC

leukocytosis

infection

leukopenia

Differential count:
autoimmune disease

Neutrophils

stress

acute infection
viral diseases

some drugs (e.g


chemotherapy, antibiotics
such as penicillin, nafcillin
and cephalosporins)

Lyphocytes
radiation therapy
viral infection

mononucleosis
adrenal corticosteroids,
immunosuppressive
tuberculosis
drugs,

chronic bacterial
autoimmune diseases
infections

severe malnutrition
lymphocytic anemia
Monocytes

chronic inflammatory
disorders
drug therapy: prednisone

tuberculosis
protozoan infections

Eosinophils

allergic reactions

parasitic infections corticosteroid therapy

Basophils

leukemia

acute allergic reaction

corticosteroids

Platelet count acute infections

malignant tumors

polycythemia vera viral infections,


thrombocytic purpura,
AIDS, SLE

chemotherapy drugs,
some types of anemias,
Idiopathic

Tests Significance Increased Decreased

Liver
Function
Tests:

ALT (alanine marker of hepatitis; infectious not significant


amino hepatic injury; mononucleosis;
transferase) more specific acute pancreatitis;
of liver acute myocardial
SGPT (serum damage than infarction; heart
pyruvic AST failure
transaminas
e)

liver diseases, acute


myocardial
AST found in the infarction, anemias,
(aspartate heart, liver, skeletal muscle
amino and skeletal diseases chronic renal
transferase) muscle. can be dialysis
used to
SGOT (serum indicate liver vitamin B6
glutamic injury. deficiency
oxaloacetic
transaminas
e)

Albumin

an increased level
protein reflects dehydration
produced by
the liver

chronic liver
dysfunction; AIDS,
severe burns,
malnutrition, renal
disease; acute and
Alkaline chronic infections
phosphatase
Liver disease, bone
disease,
found in hyperparathyroidis
tissues of the m, myocardial malnutrition,
pernicious anemia
liver, bone, infarction, chronic and severe
intestine, renal failure, heart anemias,
kidney and failure hypothyroidism,
intestine. magnesium and
liver disease, zinc deficiency
cirrhosis, Reye’s
syndrome, GI renal failure
Ammonia
hemorrhage

The liver
converts
ammonia, a
by-product of
protein
metabolism,
into urea
which is
excreted by
the kidneys

Total: hepatitis,
obstruction of the
common or hepatic
Results from
bile ducts,
the breakdown not significant
Blirubin pernicious anemia,
of Hgb in the
sickle cell anemia
red blood cell;
removed from
the body by Direct: cancer of the
the liver which head of the
excretes it into pancreas,
bile choledocholithiasis

Indirect: hemolotic
anemias, drug
toxicity, transfusion
reaction

liver disease,
alcohol abuse

found
primarily in
the liver,
kidney,
prostate, and
spleen, is
more specific
for the
hepatobiliary
system
GGT not significant
(gamma-
glutamyl
transferase) liver disease,
a protein
damage; vitamin K
produced by
deficiency,
the liver for obstruction of
clotting blood common bile duct;
deficiency of factors
II, V, VII or X

Prothrombin
an enzyme acute myocardial
found in the infarction,
thrombophlebitis,
heart and myocarditis, after
malignant tumor
skeletal open heart surgery,
muscles. has acute
three cerebrovascular
isoenzymes: disease, muscular
BB or CK1, MB dystrophy and
or CK2, and chronic alcoholism
MM or CK3
CK isoenzymes:

Cardiac MB: myocardial


Markers: infarct,
myocardialischemia
, angina pectoris
CK not significant
(creatinine
kinase)

MI, angina, other


muscle injury
after an MI, (trauma), renal
serum levels failure,
of myoglobin rhabdomyolysis
rise in 2-4
hours making
it an early
marker for
muscle
damage in MI

cardiac
troponin is
highly
concentrated Troponin I: small
in the heart infarct, myocardial
muscle. this injury
test is used in
the early Troponin T: acute
diagnosis of MI, unstable angina,
MI. after an MI myocarditis
Troponin I
Myoglobin begins to rheumatoid
increase in 4-6 arthritis
hrs and
remains
myasthenia gravis
elevated for 5-
7 days.
Troponin T
begins to
increase in 3-4
hrs and
remains
elevated for
10-14 days

hormone
produced by
Troponin I the ventricles
of the heart not significant
Troponin T and is a
marker of
ventricular
systolic and
diastolic
dysfunction.
This test is
useful in heart failure,
diagnosing symptomatic
and guiding cardiac volume
treatment of overload,
heart failure paroxysmal atrial
tachycardia

important
screening for
heart disease

type II familial
BNP (brain
natriuretic hypercholesterolemi not significant
peptide) a; biliary cirrhosis;
good chronic renal
cholesterol failure; poorly
controlled diabetes
mellitus;
alcoholism; diet
high in cholesterol
and fats

HDL excess, chronic


liver disease, long
term aerobic or
vigorous exercises

bad
cholesterol

Lipoprotein
Profile: familial type 2
hyperlipidemia; diet
high in cholesterol
Cholesterol and saturated fat,
nephritic syndrome,
multiple myeloma,
DM, chronic renal
failure
severe
hepatocellular
disease;
hyperthyroidism;
hyperlipoproteinemi malnutrition,
a; liver disease, chronic anemias,
renal disease, severe burns
this test hypothyroidism,
evaluates pancreatitis,
suspected myocardial
atherosclerosis infarction
and measures
the body’s
ability to
metabolize fat

HDL

familial
hypolipoproteinemi
a,
hypertriglyceridemi
a (familial), poorly
controlled diabetes
mellitus, chronic
renal failure

hypolipoproteinemi
a; hyperthyroidism,
chronic anemias,
severe
hepatocellular
LDL
disease

malnutrition,
hyperthyroidism,
brain infarction,
COPD

Triglycerides
Hemoglobin A1C (HBA1C)

– glycosylated hemoglobin

– measurement of blood glucose that is bound to hemoglobin


HBA1C is a reflection of how well blood glucose levels have been
controlled during the prior 3 – 4 months
Guaiac test

– test for occult blood


– false-positive results can occur if the client has recently ingested (a)
red meat (beef, lamb, liver, and processed meats); (b) raw
vegetables or fruits particularly radishes, turnips, horseradish, and
melons or (c) certain medications that can irritate the gastric
mucosa and cause bleeding such as aspirin or other NSAIDS,
steroids, iron preparations, and anticoagulants.
– false-negative results can occur if the client has taken more than
250 mg per day of vitamin C from all sources up to 3 days before the
test

Urine Testing:

Specific gravity

– indicator of urine concentration or the amount of solutes (metabolic


wastes and electrolytes) present in urine
– normal range 1.010 – 1.025
– high sp. gravity may indicate fluid deficit or dehydration
– excess fluid intake or diseases affecting the ability of the kidneys to
concentrate urine can result in low sp. gravity

Urinary pH

– measured to determine urine alkalinity or acidity and assess the


client’s acid-base status
– normally acidic w/ an average pH of 6 (>7 alkaline, <7 acidic)
Glucose

– urine is tested for glucose to screen clients for DM and to assess


during pregnancy for abnormal glucose tolerance

Ketones

– ketone bodies are a product of the breakdown of fatty acids,


normally not present in the urine
– may be found in clients w/ poorly controlled DM
– also used to evaluate ketoacidosis in clients who are alcoholic,
fasting, starving, or consuming high protein diets

Protein

– protein molecules are normally too large to pass through glomerular


capillaries into the filtrate but in cases of glomerulonephritis it
becomes leaky and allows the passage of protein

Occult blood

– normally not present in urine

Osmolality
– measure of solute concentration of urine that is a more exact
measurement of urine concentration than sp. gravity.
– also used to monitor fluid and electrolyte balance
– an increase in urine osmolality indicates fluid volume deficit; a
decreased urine osmolality reflects fluid volume excess