Lab Values

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Author:
jenmillsie
ID:
222990
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Lab Values
Updated:
2013-06-09 16:19:30
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lab values
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Lab values and what could cause a change.
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  1. RBC
    M4.6-6 ml           F 4.0-5 ml
  2. Causes of decreased RBC's
    • Anemias (possibly due to):        
    • Loss of RBC’s- hemorrhage
    • Destruction of RBC’s- hemolytic action Reduced production of RBC’so  
    • Lack of elements (Vit B12, Iron def.)  
    • Lack of hormones (renal disease, CRF)  
    • Bone marrow suppression        
    • Overhydration (IV fluids)
  3. Causes of increased RBC's
    • Dehydration
    • Chronic lung disease (COPD)        
    • Cor pulmonale
    • High altitude
  4. Hemoglobin (Hgb)- 1/3 of Hct
    • M 13.5-18 g/dl                  
    • F 12-16 g/dl
  5. Causes of decreased Hgb
    • Anemias (possibly due to):
    • Loss of RBC’s- hemorrhage
    • Destruction of RBC’s- hemolytic action        
    • Reduced production of RBC's
    • Lack of elements (Vit B12, Iron def.)  
    • Lack of hormones (renal disease, CRF)  
    • Bone marrow suppression        
    • Overhydration (IV fluids)
    • Acute blood lossCirrhosis
  6. Causes increased Hgb
    • Dehydration
    • Chronic lung disease (COPD)
    • Cor pulmonale
    • High altitude
    • COPD
    • CHF
  7. Hematocrit (Hct)- 3X the Hgb
    • M 40-54%                           
    • F 36-46%
  8. Causes of decreased Hct
    • Anemias (possibly due to):
    • Loss of RBC’s- hemorrhage
    • Destruction of RBC’s- hemolytic action
    • Reduced production of RBC’s
    • Lack of elements (Vit B12, Iron def.)
    • Lack of hormones (renal disease, CRF)
    • Bone marrow suppression
    • Overhydration (IV fluids)
    • Cirrhosis
  9. Causes of increased Hct
    • Dehydration
    • Chronic lung disease (COPD)
    • Cor pulmonale
    • High altitude
    • Severe diarrhea
  10. Platelets
    150,000-400,000 ml
  11. Causes of decreased platelets (thrombycytopenia)
    • Hemorrhage                                          
    • Anemias
    • Kidney disease                                
    • Chemo therapy
    • Liver disease                                             
    • DIC (disseminated intravascular coagulation)
    • Leukemia, myeloma                               
    • Systemic lupus
  12. Causes of increased platelets (thrombocytosis)
    • Trauma (surgery, fx)                               
    • Spleenectomy
    • Metastatic cancer                   
    • Rheumatoid arthritis
    • Polycythemia vera                  
    • Strenuous exercise
    • Pulmonary embolus
  13. WBC
    4,500-10,000 ml
  14. Causes of decreased WBC (leukopenia)
    • Anemias                                     
    • Systemic lupus
    • Viral infections                                       
    • Rheumatoid arthritis
    • Bone marrow suppression  
    • Alcoholism
  15. Causes of increased WBC (leukocytosis)
    • Acute infections                      
    • Stress (surgery,fever)
    • Inflammation                                            
    • Anemias, leukemias
    • Tissue necrosis (MI, cirrhosis, cancers)
  16. PT
    INR
    • 10-13 sec
    • 2-3 (usually for pt. stable on Coumadin)
  17. Causes of decreased PT/INR (hypoprothrombinemia)
    • Thrombophlebitis
    • MI
    • PE
  18. Causes of increased PT/INR (hyperprothombinemia)
    • Liver disease                                              
    • Leukemias
    • Coumadin therapy (1.5-2.0 X control)
    • Various blood factor deficiencies
  19. APTT
    PTT
    • 20-35 sec.
    • 60-70 sec.
  20. Causes of decreased APTT/PTT
    Extensive cancer
  21. Causes of increased APTT/PTT
    • Heparin therapy (1.5-2.0 X control)  
    • Cirrhosis
    • Various blood factor deficiencies      
    • Vit. K deficiency
  22. Sodium (Na)
    135-145mEq/L
  23. Causes of decreased Na (hyponatremia)
    • Decreased Na in IV fluids                      
    • CHF
    • Diuretics                                                     
    • SIADH
    • Renal insufficiency/disease                
    • Ascites
    • GI loss (vomit, diarrhea, gastric suction)
  24. Causes of increased Na (hypernatremia)
    • Increased dietary intake
    • CHF
    • Liver failure
    • Impaired renal functionDehydration (sever vomiting, diarrhea)
  25. Potassium (K)
    3.5-5.3 mEq/L
  26. Causes of decreased K (hypokalemia)
    • Decreased K diet intake malnutrition)           
    • Renal disease
    • Stress (trauma/surgery)                                
    • Diabetic acidosis
    • Dehydration (vomit, diarrhea, gastric suctioning)
  27. Causes of increased K (hyperkalemia)
    • Increased diet intake                                            
    • Renal failure (ARF)
    • Increased IV K fluids                               
    • Crush injury, burns
    • Acidotic state
  28. Chloride (Cl)
    95-105mEq/L
  29. Causes of decreased chloride (hypochloremia)
    • Hypokalemia, hypoatremia                              
    • Decreased Na diet
    • Overhydration                                                         
    • Colitis
    • Acute infections                                       
    • GI loss: vomit, diarrhea, GI suction
  30. Causes of increased Cl (hyperchloremia)
    • Dehydration                                                              
    • Kidney dysfunction
    • Hyperventilation                                     
    • Myeloma
    • Hypernatremia                                                        
    • Stomach cancer
    • Increased Na IV fluids                
    • Hyperparathyroidism
  31. Carbon Dioxide (CO2)
    22-30mEq/L
  32. Causes of decreased CO2
    • Dehydration                                                              
    • ARF
    • Chronic diarrhea                                       
    • DKA
    • Metabolic acidosis                                   
    • Shock
  33. Causes of increased CO2
    • Severe vomiting                                       
    • Hypothyroidism
    • Hi-volume gastric suctioning
    • Decreased K
    • Metabolic alkalosis                                   
    • Hypoventilation
  34. Calcium (Ca)
    9-11mg/dl
  35. Causes of decreased Ca (hypocalcemia)
    • Vit. D deficiency                                       
    • Alcoholism
    • Hypparathyroidism                                 
    • Pancreatitis
    • Malabsorption, anorexia                     
    • Diarrhea
    • Renal failure (phosphorus retention)
  36. Causes of increased Ca (hypercalcemia)
    • Prolonged immobility                                             
    • Myeloma
    • Fractures (multiple)                                                
    • Vit. D toxicity
    • Hyperparathyroidism                                            
    • Decreased phosphorus
    • Cancers (bone, lung, breast, kidney)
  37. Glucose (BG)
    70-110mg/dl
  38. Causes of decreased BG (hypoglycemia)
    • Hypothyroid                                                              
    • Liver disease
    • Insulin excess                                                           
    • Alcoholism
    • Cancer (stomach, liver, lung)   
    • Malnutrition
  39. Causes of increased BG (hyperglycemia)
    • DM                                                                
    • Renal failure (CRF)
    • Infections                                                   
    • CHF
    • Steroid therapy                                                     
    • AMI
    • Acute pancreatitis                                  
    • Stress
  40. Hemoglobin A1C (Hgb A1C)  
    • non-diabetic 2-5%    
    • diabetic control 2.5-6%    
    • diabetic uncontrolled #8%
  41. Causes of decreased Hgb A1C
    • Anemias
    • Long term blood loss
    • CRF
  42. Causes of increased Hgb A1C
    • Uncontrolled DM (or new Dx)
    • Hyperclycemia
    • Hemodialysis
    • Alcohol ingestion
  43. BUN
    5-25mg/dl
  44. Causes of decreased BUN
    • Overhydration
    • Liver failure
    • Malabsorption, malnutrition
    • Decreased protein diet
  45. Causes of increased BUN
    Renal- renal failure/disease, nephrotoxic drugs

    • Non-renal
    • Dehydration                               
    • CHF
    • Increased age                            
    • DM
    • Tube feedings                           
    • GI bleed
  46. Creatinine
    0.5-1.5 mg/dl
  47. Causes of decreased Creatinine
    • Decreased muscle mass, atrophy
    • Debilitation
  48. Causes of increased Creatinine
    • Renal failure (ARF/CRF)  
    • Dehydration
    • Cancers, leukemias                                
    • CHF, increased BP
    • Diabetic nephropathy  
    • Rhabdomyolysis
    • Systemic lupus
  49. Magnesium (Mg)
    1.5-2.5 mEq/L
  50. Causes of decreased Mg (hypomagnesemia)
    • Malabsorption, malnutrition
    • Cirrhosis
    • Hypoparathyroidism                                              
    • Decreased K
    • GI loss: vomit, diarrhea, suction
    • Dehydration
  51. Causes of increased Mg (hypermagnesemia)
    • Renal failure
    • Early DM
    • Leukemia
  52. Phosphorus (P)
    2.5-4.5 mg/dl
  53. Causes of decreased P (hypophosphatemia)
    • Malabsorption                                                          
    • Alcoholism
    • Hyperparathyroidism                                             
    • Hypercalcemia
    • Hypomagnesemia                   
    • Decreased Vit. D intake
  54. Causes of increased P (hyperphosphatemia)
    • Renal insufficiency/failure                   
    • Fractures
    • Bone tumors
    • Hypocalcemia
    • Hypoparathryroidism                                            
    • Increased Vit. D intake
  55. Amylase (pancreas/liver)
    30-170units/L
  56. Causes of decreased amylase
    • IV’s-D5W
    • Liver necrosis
    • Chronic pancreatitis
    • Alcoholism
    • Hepatitis
  57. Causes of increased amylase
    • Renal failure
    • Cholecystitis
    • BPH                                                                               
    • DM
    • Pancreatitis (gall stones, cancer)       
    • Alcoholism
  58. Alk Phos (ALP) (liver/bone)
    20-130 units/L
  59. Causes of decreased ALP
    • Malnutrition                                                              
    • Hypothyroidism
    • Pernicious anemia                  
    • Hypophosphatemia
    • Vit. C deficiency
  60. Causes of increased ALP
    • Cirrhosis, hepatitis                  
    • Healing fractures
    • Liver cancer
    • Hyperparathyroidism
    • Biliary obstruction                   
    • RA
    • Bone cancer
    • Leukemia, Myeloma
  61. AST (heart/liver)
    8-38units/L
  62. Causes of decreased AST
    DKA (diabetic keto-acidosis)
  63. Causes of increased AST
    • Heart: MI, Heart cath, angio, operation
    • Liver: Hepatitis, Liver cancer or mets, cirrhosis
    • Skeletal Muscle: trauma, burns, surgery, convulsions
    • Pancreatitis
  64. ALT (liver)
    10-35units/L
  65. Causes of decreased ALT
    Exercise
  66. Causes of increased ALT
    • Pancreatitis
    • CHF
    • Cirrhosis, liver cancer
    • Viral hepatitis
  67. Thyroid Stimulating Hormone (TSH)  
    less than 3 ng/ml
  68. Causes of decreased TSH
    Secondary hypothyroidism: pituitary dysfunction
  69. Causes of increased TSH
    • Primary hypothyroidism: thyroid dysfunction
    • Cirrhosis
  70. Brain Natriuretic Peptide (BNP) (from cardiacventricles)
    0-100 pg/ml
  71. Causes of increased BNP
    • Heart failure (detects early heart failure)Prolonged systemic increased BP
    • Renal failure
    • AMI, myocarditis

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