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Bicarbonate (HCO3, CO2)
- 20-30 mEq/L
- Second most important anion
- Important plasma buffer
- 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)
- 3.5-5.0 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.
- 10-20 mEq/L
- Difference between unmeasured anions and unmeasured anions.
- (Na + K) - (Cl+CO3)
- 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)
- 100-110 mEq/L
- Main extracellular anion.
- Cl moves with Na or against HCO3
- Reabsorbed in the renal proximal tubules along with sodium
- 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.
- 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
- 8.5-10 mg/dl
- 99% associated with bone tissues
- 5-20 mg/dl
- Byproduct of ATP synthesis in oxygen poor cells.
- Sensitive indicator of oxygen deprivation
- 275-295 mOsm/kg
- Estimate: 2 Na + BUN/3 + Glucose/20
- 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
- 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.
- 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
- 3-7 mg/dl
- Breakdown of purines (nucleic acid/DNA)
- Filtered by glomerulus
- High: gout
- 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
- 3.5-5.5 g/dl
- High concentration of all proteins.
- 80% tissue osmotic pressure.
- Decreased: Poor nutrition, liver and renal disease
- 30-150 mg/dl
- Alpha 2 globulin
- Binds free hemoglobin alpha chains.
- Increased: Inflammatory conditions
- Decreased: Intravascular hemolysis
- *Used for hemolytic transfusion reactions*
- 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*
- 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
- 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
- 0-100 pg/ml
- Hormone heart releases in response to increased heart pressure associated CHF
- 6.5-8.5 g/dl
- Biuret method for methodology
Total Protein (24 hour urine)
0-100 mg/24 hours
0.20-0.50 mg/L FEU
- > 1.0
- Number ratio of albumin to globulin concentration.
- Low: high gamma globulins
- High: dehydration
Total Protein (CSF)
- 15-45 mg/dl
- Increased: Bacterial, Fungal, viral infections, cerebral bleed, MS, traumatic spinal taps
T3 Uptake (T3U)
- Doesn't measure T3
- Reported as % of normal average value or THBR.
- Increased: Primary hyperthyroid, steroids
- Decreased: Primary hyperthyroid, Pregnancy
Total T4 (TT4)
Human Chrorionic Gonadotropin (HCG nonpregnant)
< 3.0 uU/ml
Thyroid stimulating hormone (TSH)
Total T3 (TT3)
Creatine Phosphokinase(CPK, CK)
- 15-150 IU/L
- CK-BB: Brain
- CK-MB: Cardiac
- CK-MM: Skeletal
Hemolyzed specimens must be recollected.
< 6% of total CK IU/L
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
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
Alaine Aminotransferase (ALT)
- High in liver
- Increased: Associated with liver disease
Alkaline phosphatase (ALK, ALK phos)
- Optimal pH @ 9-10
- Removes phosphates from organic comp.
- High: bone and liver
- Best for diagnose bone and liver disease
- Catalyzes breakdown of starch and glycogen to glucose.
- High: Pancrease, saliva
- Excreted in urine.
- High in liver tissue.
- Increased: Alcoholic cirrhosis, Hepatobiliary disease
- Hydrolyze (breaks down) fat
- High in pancrease
: Pancreatitis (more specific)
Glycosylated Hemoglobin (A1C)
< 200 mg/dl
High Density Lipoprotein (HDL)
> 45 mg/dl
Low Density Lipoprotein (LDL)
< 130 mg/dl
TIBC (Total Iron Binding Capacity)
Arterial Blood Gases:
Total Bilirubin (newborn)