Clinical Chemistry Normal Values

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Angela6
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199304
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Clinical Chemistry Normal Values
Updated:
2013-02-10 00:18:47
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Clinical Chemistry
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Normal Values
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  1. Electrolytes:
    Bicarbonate (HCO3, CO2)
    • 20-30 mEq/L
    • Second most important anion
    • Important plasma buffer
  2. Phosphate (PO4)
    • 2.5-4.5 mEq/L
    • Originates from diet and bone
    • Hypo: IVs, ketoacidosis, antacids
    • Hyper: Renal failure, over consumption of milk, cellular catabolism (leukemia)
  3. Potassium (K+)
    • 3.5-5.0 mEq/L
    • Main intracellular cation.
    • RBCs have high concentration of K.
    • High: promotes musular excitability.
    • Low: Decreases muscular excitability regulation of K performed by renal secretion.
  4. Anion gap:
    • 10-20 mEq/L
    • Difference between unmeasured anions and unmeasured anions.
    • (Na + K) - (Cl+CO3)
  5. Sodium (Na+)
    • 135-145 mEq/L
    • 90% extracellular cation. Main contributor to plasma osmolality.
    • High: water loss (sweating, diarrhea, burns, diabetes insipidus)
    • Low: aldosterone deficiency, Diabetes mellitus)
  6. Chloride (Cl-)
    • 100-110 mEq/L
    • Main extracellular anion.
    • Cl moves with Na or against HCO3
    • Reabsorbed in the renal proximal tubules along with sodium
  7. Magnesium (Mg2+)
    • 1-2 mEq/L
    • Second most intracellular cation.
    • 2/3 ionized
    • Regulated by PTH
    • Hypo: Diuretics, diabetes, High aldosterone
    • Hyper: Magne. sulfate used to stop labor contractions.
  8. Ionized Calcium
    • 4.5-5.5 mg/dl
    • 45% critical component of cardiac function.
    • Released by PTH
    • Low: inhibits cardiac function
    • High: Causes tetany
    • Hypo: vitamin D deficiency, hypoparathyroidis
    • Hyper: Hyperparathyroid, open heart surgery
  9. Total Calcium
    • 8.5-10 mg/dl
    • 99% associated with bone tissues
  10. Lactate
    • 5-20 mg/dl
    • Byproduct of ATP synthesis in oxygen poor cells.
    • Sensitive indicator of oxygen deprivation
  11. Osmolality
    • 275-295 mOsm/kg
    • Estimate:  2 Na + BUN/3 + Glucose/20
  12. Non-Protein Nitrogen:
    BUN
    • 10-20 mg/dl
    • 50% of NPN
    • Protein catabolism=ammonia
    • Affected by: renal function, diet, protein catabolism
    • High renal: Glomerular nephritis, renal failure from diabetes
    • High post renal: Kidney stones, UTIs, Bladder prostate tumors
  13. Creatinine:
    • 0.5-1.5 mg/dl
    • Formed at constant rate by muscles. Removed from plasma by glomerular filtration
    • Evaluate renal function.
    • High: Decreased glomerular filtration
    • Measured by Jaffee method
    • High bilirubin and hemolysis falsely decrease results.
  14. Creatinine clearance:
    • 90-140 ml/min
    • measurement of rate at which creatinine is removed from plasma by kidneys.
    • Creatinine endogenous substance.
    • Not secreted/reabsorbed by renal tubules
  15. Uric acid:
    • 3-7 mg/dl
    • Breakdown of purines (nucleic acid/DNA)
    • Filtered by glomerulus
    • High: gout
  16. Ammonia:
    • 20-60 ug/dl
    • Amino acid catabolism.
    • Liver converts ammonia--urea
    • High: Reye's syndrome, liver disease, severe renal disease
    • Collected on ice and tested ASAP
  17. Protein:
    Albumin
    • 3.5-5.5 g/dl
    • High concentration of all proteins.
    • 80% tissue osmotic pressure.
    • Decreased: Poor nutrition, liver and renal disease
  18. Haptoglobin:
    • 30-150 mg/dl
    • Alpha 2 globulin
    • Binds free hemoglobin alpha chains.
    • Increased: Inflammatory conditions
    • Decreased: Intravascular hemolysis
    • *Used for hemolytic transfusion reactions*
  19. CRP
    • 0-3 mg/dl
    • Gamma band
    • Enhances complement activity and phagocytosis (opsonization)
    • High: Infection, gout, cancers, tissue necrosis, autoimmune disease
    • *2 average collected at 2 week intervals*
  20. Myoglobin
    • 30-90 ng/ml
    • Heme protein found in skeletal and cardiac muscle
    • Reversibly binds with oxygen
    • High: crash injuries, Renal failure
    • AMI: Elevated 1-3 hrs post
    •         Peaks 5-12 hrs post
    •         Returns to normal 18-30 hrs
  21. Troponin I
    • 0-0.6 ng/ml
    • Closely associated with cardiac tissue useful to evaluate possible AMIs.
    • Elevated: 3-4 post AMI
    •               10-24 hr post AMI
    •               10-14 days remains high
  22. BNP
    • 0-100 pg/ml
    • Hormone heart releases in response to increased heart pressure associated CHF
  23. Total Protein
    • 6.5-8.5 g/dl
    • Biuret method for methodology
  24. Total Protein (24 hour urine)
    0-100 mg/24 hours
  25. D-dimer
    0.20-0.50 mg/L FEU
  26. A/G ratio
    • > 1.0
    • Number ratio of albumin to globulin concentration.
    • Low: high gamma globulins
    • High: dehydration
  27. Total Protein (CSF)
    • 15-45 mg/dl
    • Increased: Bacterial, Fungal, viral infections, cerebral bleed, MS, traumatic spinal taps
  28. Hormones:
    T3 Uptake
    (T3U)
    • 25-35%
    • Doesn't measure T3
    • Reported as % of normal average value or THBR.
    • Increased: Primary hyperthyroid, steroids
    • Decreased: Primary hyperthyroid, Pregnancy
  29. Total T4 (TT4)
    4.5-13 ug/dl
  30. Human Chrorionic Gonadotropin (HCG nonpregnant)
    < 3.0 uU/ml
  31. Thyroid stimulating hormone (TSH)
    0.5-5.0 uU/ml
  32. Total T3 (TT3)
    70-200 ng/dl
  33. Enzymes:
    Creatine Phosphokinase(CPK, CK)
    • 15-150 IU/L
    • CK-BB: Brain
    • CK-MB: Cardiac
    • CK-MM: Skeletal

    Hemolyzed specimens must be recollected.
  34. Creatine Phosphokinase-MB
    (CK-MB)
    < 6% of total CK IU/L
  35. Lactate Dehydrogenase (LDH)
    • 100-225 IU/L
    • Found: skeletal muscle, cardiac, renal, RBCs
    • Elevated: AMI, Liver Disease, Cancers, Hemolytic diseases
    • At pH 9.0 reaction moves to right
    • At pH 6.8 reaction moves to left
  36. Asparate Aminotransferase (AST)
    • 5-30 IU/L
    • High: skeletal, cardiac, liver, lung tissue
    • Post AMI: Rise 6-8 hours
    •                Peaks @ 24 hours
    •                Normal by 5th day
  37. Alaine Aminotransferase (ALT)
    5-35 IU/L

    • High in liver
    • Increased: Associated with liver disease
  38. Alkaline phosphatase (ALK, ALK phos)
    30-90 IU/L

    • Optimal pH @ 9-10
    • Removes phosphates from organic comp.
    • High: bone and liver
    • Best for diagnose bone and liver disease
  39. Amylase (AMYL)
    25-130 IU/L

    • Catalyzes breakdown of starch and glycogen to glucose.
    • High: Pancrease, saliva
    • Excreted in urine.
  40. Gamma-glutaml-transpeptidase (GGT)
    5-45 IU/L

    • High in liver tissue.
    • Increased: Alcoholic cirrhosis, Hepatobiliary disease
  41. Lipase (LIP)
    30-200 IU/L

    • Hydrolyze (breaks down) fat
    • High in pancrease

    Increased: Pancreatitis (more specific)
  42. Carbs:
    Glucose (fasting)
    70-110 mg/dl
  43. Glycosylated Hemoglobin (A1C)
    3-6%
  44. CSF Glucose
    40-70 mg/dl
  45. Plasma ketones
    Negative
  46. Lipoproteins:
    Triglycerides
    <130 mg/dl
  47. Total cholesterol:
    < 200 mg/dl
  48. High Density Lipoprotein (HDL)
    > 45 mg/dl
  49. Low Density Lipoprotein (LDL)
    < 130 mg/dl
  50. Iron

    Total Iron
    60-170 ug/dl
  51. % Fe Saturation
    20-50%
  52. TIBC (Total Iron Binding Capacity)
    260-440 ug/dl
  53. Arterial Blood Gases:

    pH
    7.35-7.45
  54. O2 saturation:
    > 95%
  55. P02
    80-110 mm/Hg
  56. PCO2
    35-45 mm/Hg
  57. Bilirubin

    Total Bilirubin
    0.2-1.0 mg/dl
  58. Conjugated Bilirubin
    0-0.2 mg/dl
  59. Total Bilirubin (newborn)
    2-6 mg/dl

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