Test

Name

Chem Basic
8/BMP Metaboli
c Panel

Compon Name
ents
Sodium
Na +

K+

Potassium

Units Norma Norm Peds

Newb Critical
l Adult al
orn
values
mEq/L
136-145 Adult 134-150 134<120 or
144
>160

mEq/L 3.5-5

3.4-5.3

Cl -

Chloride

CO 2

Bicarbonat mEq/L 23-30

e

20-28

Blood Urea mg/dL 10-20

Nitrogen

5-18

BUN

Cr

Ca 2+

Creatinine

Calcium
(Total)

Glucose

mEq/L 98-106

mg/dL 0.6-1.2

mg/dL 9-10.5

mg/dL <110

90-110

3.9-5.9

Adult: <2.5
or >6.5;
Newborn:
<2.5 or >8

96-106 <80 or 115

(premat
ure 95110)

13-22

Increased

Decreased

Interfering Factors

Intake (dietary intake, excessive Na in

IVF); Decreased Na loss (Cushing
syndrome, hyperaldosteronism);
Excessive free body H2O loss (GI
loss, excessive sweating, extensive
thermal burns, diabetes insipidus,
osmotic diuresis)

Intake (deficient dietary intake, deficient Na in

IVF); Increased Na loss (Addison disease,
Diarrhea, vomiting or nasogastric aspiration,
Intraluminal bowel loss, Diuretic administration,
Chronic renal insufficiency, Large-vol aspiration
of pleural or peritoneal fluid); Increased free
body H2O (excessive oral H2O intake,
hyperglycemia, excessive IV H2O intake, CHF,
Peripheral edema, ascites, pleural effusion,
SIADH)

recent trauma, surgery or shock; Increased (anabolic

steroids, antibiotics, clonidine, corticosteriods, cough
medicines, laxatives, methyldopa, carbenicillin, estrogens,
oral contraceptives); Decreased (carbamazepine, diuretics,
Na-free IVFs, sulfonylureas, triamterene, ACE inhibitors,
captopril, haloperidol, heparin, NSAIDs, tricyclic
antidepressants, vasopressin)

excessive dietary intake, excessive IV

intake, acute/chronic renal failure,
Addison disease, hypoaldosteronism,
aldosterone-inhibiting diuretics, crush
injury to tissues, hemoysis,
transfusion of hemolyzed blood,
infection, acidosis, dehydration

opening & closing of hand with tourniquet, blood hemolysis

during venipuncture or lab processing, Increased
deficient dietary intake, deficient IV intake, burns, (aminocaproic acid, antibiotics, antineoplastic drugs,
GI disorders, diuretics, hypderaldosteronism,
captopril, epinephrine, heparin, histamine, isoniazid (INH),
Cushing syndrome, renal tubular acidosis,
lithium, mannitol, K-sparing diuretics, K supplements,
licorice ingestion, alkalosis, insulin adminstration, succinylcholine); Decreased (acetazolamide, aminosalicylic
glucose administration, ascites, renal artery
acid, glucose infusions, amphotericin B, carbenicillin,
stenosis, cystic fibrosis, trauma/surgery/burns
cisplatin, diuretics, insulin, laxatives, litium carbonate,
penicillin G sodium [high doses], phenothiazines, salicylates
(aspirin), sodium polystyrene sulfonate )

Dehydration, excessive infusion of

normal saline, metabolic acidosis,
renal tubular acidosis, Cushing
syndrome, Kidney dysfunction,
Hyperparathyroidism, Eclampsia,
Respiratory alkalosis

Overhydration, SIADH, CHF, vomiting/prolonged

gastric suction, chronic diarrhea or high-output
GI fistula, Chronic respiratory acidosis, Saltlosing nephritis, Addison disease, Diuretic
therapy, Hypokalemia, Aldosteronism, Burns

<6
Severe vomiting, high-vol gastric
Chronic diarrhea, chronic loop diuretic use,
suction, Aldosteronism, Use of
Renal failure, Diabetic ketoacidosis, Starvation,
mercurial diuretics, COPD, Metabolic
Metabolic acidosis, Shock
alkalosis

0.5-1.1

0.2-1

8.8-10.8

30-100

3-12

0.3-1.2

>100

>4

7.6-10.4 <6 or >13

Newborn (<30
or >300),
Infant (<40),
Adult (<50
or >400), Adult
(<40 or
>400)

Cost

Excessive saline infusions, Increased (acetazolamide,

ammonium chloride, androgens, chlorothiazide, cortisone
preparations, estrogens, guanethidine, hydrochlorothiazide,
methyldopa, NSAIDs), Decreased (Aldosterone,
bicarbinates, corticosteroids, cortisone, hydrocortisone,
loop diuretics, thiazide diuretics, triamterene)
Underfilling blood tube, Increased (aldosterone,
barbiturates, bicarbonates, ethacrynic acid, hydrocortisone,
loop diuretics, mercurial diuretics, steroids), Decreased
(methicillin, nitrofurantoin, paraldehyde, phenformin,
tetracycline, thiazide diuretics, triamterene)

Prerenal (hypovolemia, shock, burns,

dehydration, CHF, MI, GI bleeding,
excessive protein ingestation,
excessive protein catabolism,
starvation, sepsis); Renal (renal
disease, renal failure, nephrotoxic
drugs); Postrenal azotemia (ureteral
obstruction, bladder outlet
obstruction)

Changes in protein intake, muscle mass, advanced

pregnancy, GI bleeding, Overhydration & underhydration,
Increased (allopurinol, aminoglycosides, cephalosporins,
chloral hydrate, cisplatin, furosemide, guanethidine,
Liver failure, overhydration (SIADH), Negative
indomethacin, methotrexate, methyldopa, nephrotoxic
nitrogen balance, pregnancy, nephrotic syndrome drugs [aspirin, amphotericin B, bacitracin, carbamazepine,
colistin, gentamicin, methicillin, neomycin, penicillamine,
polymyxin B, probenecid, vancomycin], propranol, rifampin,
spironolactone, tetracyclines, thiazide diuretics,
triamterene); Decrease (chloramphenicol & streptomycin)

Diseases affecting renal function

(glomerulonephritis, pyelonephritis,
actute tubular necrosis, urinary tract
obstruction, reduced renal blood
flow), rhabdomyolysis, acromegaly,
gigantism

debilitation, decreased muscle mass

diet high in meat, Increase (aminoglycosides, cimetidine,

heavy-metal chemotherapeutic agents, nephrotoxic drugs
such as cephalosporins)

Hypoparathyroidism, Renal failure,

Hyperphosphatemia 2 to renal failure, Rickets,
Vit D deficiency, Osteomalacia, Malabsorption,
Pancreatitis, Fat embolism, Alkalosis

Vit D intoxication, Excessive milk ingestion, Decrease in

serum pH (Decreases), prolonged tourniquet time,
hypoalbuminemia, Increased (calcium salts, hydralazine,
lithium, thiazide diuretics, PTH, thyroid hormone, alkaline
antacids, ergocalciferol, androgens,Vit D); Decreased
(acetazolamide, anticonvulsants, asparaginase, asprin,
calcitonin, cisplatin, corticosteroids, heparin, laxatives, loop
diuretics, magnesium salts, thiazide diuretics, estorgens,
albuterol, oral contraceptives)

Insulinoma, Hypothyroidism, Hypopitutarism,

Addison disease, Extensive liver disease, Insulin
overdose, Starvation

many forms of stress, caffeine, most IVFs, pregnancy

(glucose interolerance), Increased (antidepressants
[tricyclics], beta-adrenergic blocking agents,
corticosteroids, IV dextrose infusion, dextrothyroxine,
diazoxide, diuretics, epinephrine, estrogens, glucagon,
isoniazid, lithium, phenothiazines, phenytoin, salicylates,
triamterene), Decreased (acetaminophen, alcohol, anabolic
steroids, clofibrate, disopyramide, gemfibrozil, insulin,
monoamine oxidase inhibitors, pentamidine, propranolol,
tolazamide, tolbutamide)

Hyperparathyroidism, Nonparathyroid PTH-producing tumor,

Metastatic tumor to bone, Paget
disease of bone, Prolonged
immobilization, Milk-alkali syndrome,
Vit D intoxication, Lymphoma,
Granulomatous infections such as TB
& sarcoidosis, Addison disease,
Acromegaly, Hyperthyroidism

DM, Acute stress response, Cushing

syndrome, Chronic renal failure,
Glucagonoma, Acute pancreatitis,
Diuretic therapy, Corticosteroid
therapy, Acromegaly

Run Time
in minutes
1.5 minutes or
90 seconds

Test

Name

Compone Name
nts

Normal Normal Peds

Adult Adult

Newbor Critical
n
values

Increased

Decreased

CBC

Complete
Blood
Count

RBC

Red Blood
10 6 /L
Cell
Count/Eryth
rocyte
Count

4.7-6.1

4.2-5.4

3.5-6
(depending
on age)

4.8-7.1

Erythrocytosis, Congenital heart disease, severe

COPD, Polycythemia vera, severe deyhydration,
hemoglobinopathies

Anemia, Hemoglobinopathy, Cirrhosis, Hemolytic anemia,

Pregnancy, High altitudes, Hydration status, Increased
Hemorrhage, Dietary deficiency, Bone marrow failure,
(gentamicin & methyldopa), Decreased (chloramphenicol,
Prosthetic valves, Renal disease, Normal pregnancy,
hydantoins, quinidine)
Rheumatoid/collagen-vascular diseases, Lymphoma, Multiple
myeloma, Leukemia, Hodgkin disease

Hb or Hgb

Hemoglobin g/dL

14-18

12-16

9.5-24
(depending
on age)

14-24

<5 or >20

Erythrocytosis, Congenital heart disease, severe

COPD, Polycythemia vera, severe deyhydration

Anemia, Hemoglobinopathy, Cirrhosis, Hemolytic anemia,

Pregnancy, slight diurnal variation, smoking, high altitudes,
Hemorrhage, Dietary deficiency, Bone marrow failure,
increased (gentamincin & methyldopa), decreased
Prosthetic valves, Renal disease, Normal pregnancy,
(antibiotics, antineoplastic drugs, aspirin, indomethacin,
Rheumatoid/collagen-vascular diseases, Lymphoma, Multiple rifampin, sulfonamides)
myeloma, Leukemia, Hodgkin disease

Hct

Hematocrit

42-52

37-47

29-59

44-64

<15 or >60 Erythrocytosis, Congenital heart disease, severe

COPD, Polycythemia vera, severe deyhydration

Mean
mm 3
Corpuscular
Volume

80-95

80-95

80-95

96-108

Pernicious anemia, Folic acid deficiency,

Antimetabolite therapy, Alcoholism, Chronic liver
disease

Fe deficiency anemia, Thalassemia, Anemia of chronic illness

Abnormal RBC size, extremely elevated WBC count

(>50,000), large RBC precursors abnormally high,
elevated lipid levels (>2,000 mg/dL) high hemoglobin
levels in automated machines, cold agglutinins falsely
elevated levels, Increased (zidovudine, phenytoin,
azathioprine)

2 (automated)

MCH

Mean
pg
Corpuscular
Hemoglobin

27-31

27-31

27-31

32-34

Macrocytic anemias

Microcytic anemias, Hypochromic anemia

Extremely elevated WBC count (>50,000), elevated lipid

levels (>2,000 mg/dL) high hemoglobin levels in
automated machines, cold agglutinins falsely elevated
levels

2 (automated)

MCHC

Mean
Corpuscular
[Hemoglobin]

g/dL

32-36

32-36

32-36

32-33

Spherocytosis, Intravascular hemolysis, Cold

agglutinins

Fe deficiency anemia, Thalassemia

Abnormal RBC size, elevated lipid levels (>2,000 mg/dL)

high hemoglobin levels in automated machines, cold
agglutinins falsely elevated levels

RDW

Red blood
cell
distribution
width

11-14.5

RBC Indices MCV

WBC count WBC

w/ or w/o
differential

Units

Cost

Run Time in
Minutes

$78.00

2 (automated)

2 (automated)

Anemia, Hemoglobinopathy, Cirrhosis, Hemolytic anemia,

RBC size abnormalities, extreme elevated WBC count,
Hemorrhage, Dietary deficiency, Bone marrow failure,
hemodilution & dehydration, pregnancy, high altitudes,
Prosthetic valves, Renal disease, Normal pregnancy,
values not reliable after hemorrhage, Decrease
Rheumatoid/collagen-vascular diseases, Lymphoma, Multiple (chloramphenicol & penicillin)
myeloma, Leukemia, Hodgkin disease

Fe deficiency anemia, B 12 or folate deficiency

anemia, Hemoglobinopathies, Hemolytic anemias,
Posthemorrhagic anemias

White blood cells/mm 5,0003

cell count
10,000

Neutrophils %

Interfering Factors

9,00030,000

< 2500 or
>30,000

55-70

2 (automated)

Leukocytosis = Infection, Leukemic neoplasia or

other myeloproliferative disorders, Other
malignancy, Trauma, Stress, Hemorrhage, Tissue
necrosis, Inflammation, Dehydration, Thyroid storm

Leukopenia = Drug toxicity, Bone marrow failure,

overwhelming infections, Dietary deficiency, Congenital
marrow aplasia, Bone marrow infiltration, Autoimmune
disease, Hypersplenism

Neutrophilia = Physical or emotional stress, Acute

suppurative infection, Myelocytic leukemia, Trauma,
Cushing syndrome, Inflammatory disorders,
Metabolic disorders

Neutropenia = Aplastic anemia, Dietary deficiency,

Overwhelming bacterial infection (esp elderly),Viral
infections, Radiation therapy, Addison disease, Drug therapy:
myelotoxic drugs

eating, physical activity, stress, last month of pregnancy (),

labor (), splenectomy (mild-moderate ), lower in morning,
higher in afternoon, age related, Increased (adrenaline,
allopurinol, aspirin, chloroform, epinephrine, heparin,
quinine, steroids, triamterene), Decreased (antibiotics,
anticonvulsants, antihistamines, antimetabolites, antithyroid
drugs, arsenicals, barbiturates, chemotherapeutic agents,
diuretics, sulfonamides)

2 (automated)

Segs

2 (automated)

Bands

Platelets

Thrombocyt
e count

MPV

Retic
Count

Reticulocyte
Count

Reticulocyte
index

2 (automated)

Lymphocyte %
s

20-40

Lymphocytosis = Chronic bacterial infection,Viral

infection, Lymphocytic leukemia, Multiple myeloma,
Infectious mononucleosis, Radiation, Infectious
hepatitis

Lymphocytopenia = Leukemia, Sepsis, Immunodeficiency

diseases, Lupus erythematosus, Later stages of HIV infection,
Drug therapy (andrenocorticosteroids, antineoplastics),
Radiation therapy

2 (automated)

Monocytes

2-8

Monocytosis = Chronic inflammatory disorders,

Viral infections, TB, Chronic UC, Parasites

Monocytopenia = Drug therapy (prednisone)

2 (automated)

Eosinophils

1-4

Eosinophilia = Parasitic infections, Allergic rxns,

Eczema, Leukemia, Autoimmune diseases

Eosinopenia = adrenosteroid production

2 (automated)

Basophils

0.5-1

Basophilia = Myeloproliferative disease, Leukemia

Basopenia = Acute allergic rxns, Hyperthyroidism, Stress

rxns

2 (automated)

Platelet
count

plts/mm3 150,000400,000

Thrombocytosis = Malignant disorders,

Polycythemia vera, Postsplenectomy syndrome,
Rheumatoid arthritis, Fe deficiency anemia or
following hemorrhagic anemia

Thrombocytopenia = Hypersplenism, Hemorrhage, Immune

thrombocytopenia, Leukemia & other myelofibrosis
disorders, Thrombotic thrombocytopenia, Graves disease,
Inherited disorders, DIC, SLE, Pernicious anemia, hemolytic
anemia, Cancer chemotherapy, Infection

Mean
Platelet
Volume

fL

7.4-10.4

0.5-2

1.0

150,000475,000

150,000300,000

<50,000 or
>1,000,000

High altitudes (), 10-15% error in automated counting

(clumping), Strenuous exercise (), before menstruation,
Increased (estrogens, oral contraceptives), Decreased
(acetaminophen, aspirin, chemotherapeutic agents,
chloramphenicol, colchicine, H2-blocking agents (cimetidine,
Zantac), hydralazine, indomethacine, INH, quinidine,
streptomycin, sulfonamides, thiazide diuretics, tolbutamide)

Aplastic anemia, Chemotherapy-induced myelosuppression,

Valvular heart disease, Immune thrombocytopenia, Wiskott-Aldrich syndrome
Massive hemorrhage,Vit B 12 or folate deficiency,
Myelogenous leukemia
0.5-3.1
(infant)

2.5-6.5

Hemolytic anemia, Hemorrhage, Erythroblastosis

fetalis, Treatment (for Fe, vit B 12 or folate
deficiency)

Pernicious anemia & folic acid deficiency, Fe deficiency

anemia, Aplastic anemia, Radiation therapy, Malignancy,
Marrow failure, Adrenalocortical hypofunction, Anterior
pituitary hypofunction

Retic Index = Retic count (%) x (Pt's Hct/Normal

Hct)

inadequate bone marrow response

Pregnancy (), falsely elevated automated count from

Howell-Jolly bodies in severe anemia or hemolytic anemia

$49.00

2 (automated)

NA

NA (calculated
value)

$39.00

45

NA

Calculated value

Name

Chem
12/CMP
(Comprehe
nsive
Metabolic
Panel)

Comp Name
onent
s

Units

Normal
Adult

Normal Peds
Adult

Newborn

Critical values

Increased

134-144

<120 or >160

Intake (dietary intake, excessive Na in

IVF); Decreased Na loss (Cushing
syndrome, hyperaldosteronism); Excessive
free body H2O loss (GI loss, excessive
sweating, extensive thermal burns,
diabetes insipidus, osmotic diuresis)

Decreased

Na+

Sodium

mEq/L

136-145

134150

K+

Potassium

mEq/L

3.5-5

3.4-5.3 3.9-5.9

Adult: <2.5 or Excessive dietary intake, excessive IV

>6.5; Newborn: intake, acute/chronic renal failure, Addison
disease, hypoaldosteronism, aldosterone<2.5 or >8

Cl-

Chloride

mEq/L

98-106

90-110

96-106
(premature
95-110)

<80 or 115

CO2 Bicarbonate mEq/L

23-30

20-28

13-22

<6

BUN Blood Urea mg/dL

Nitrogen

10-20

5-18

3-12

>100

Prerenal (hypovolemia, shock, burns, dehydration, CHF, MI, GI

bleeding, excessive protein ingestation, excessive protein catabolism,
starvation, sepsis); Renal (renal disease, renal failure, nephrotoxic
drugs); Postrenal azotemia (ureteral obstruction, bladder outlet
obstruction)

Cr

mg/dL

0.6-1.2 0.5-1.1 0.2-1

0.3-1.2

>4

Diseases affecting renal function (glomerulonephritis, pyelonephritis, debilitation, decreased muscle

actute tubular necrosis, urinary tract obstruction, reduced renal
mass
blood flow), rhabdomyolysis, acromegaly, gigantism

Ca2+ Calcium
(Total)

mg/dL

9-10.5

Glucose

mg/dL

<110

Albumin

g/dL

3.5-5

4.4-5.9 3.5-5.4

Total
Protein

g/dL

6.4-8.3

6.2-8

Intake (deficient dietary intake, deficient Na in IVF); Increased Na loss

(Addison disease, Diarrhea, vomiting or nasogastric aspiration,
Intraluminal bowel loss, Diuretic administration, Chronic renal
insufficiency, Large-vol aspiration of pleural or peritoneal fluid);
Increased free body H2O (excessive oral H2O intake, hyperglycemia,
excessive IV H2O intake, CHF, Peripheral edema, ascites, pleural
effusion, SIADH)

Deficient dietary intake, deficient IV intake, burns, GI disorders,

diuretics, hypderaldosteronism, Cushing syndrome, renal tubular
acidosis, licorice ingestion, alkalosis, insulin adminstration, glucose
inhibiting diuretics, crush injury to tissues, administration, ascites, renal artery stenosis, cystic fibrosis,
hemoysis, transfusion of hemolyzed blood, trauma/surgery/burns

infection, acidosis, dehydration

Creatinine

ALP Alkaline

units/L 30-120

ALT
Alanine
(SGPT aminotransfera
)
se (Serum
glutamicpyruvic
transaminase)
AST
Aspartate
(SGOT aminotransfer
)
ase (Serum

internati 4-36
onal
units @
37C

phosphatase

units/L 0-35

8.8-10.8 7.6-10.4

Dehydration, excessive infusion of normal

saline, metabolic acidosis, renal tubular
acidosis, Cushing syndrome, Kidney
dysfunction, Hyperparathyroidism,
Eclampsia, Respiratory alkalosis
Severe vomiting, high-vol gastric suction,
Aldosteronism, Use of mercurial diuretics,
COPD, Metabolic alkalosis

recent trauma, surgery or shock; Increased (anabolic steroids, antibiotics,

clonidine, corticosteriods, cough medicines, laxatives, methyldopa,
carbenicillin, estrogens, oral contraceptives); Decreased (carbamazepine,
diuretics, Na-free IVFs, sulfonylureas, triamterene, ACE inhibitors,
captopril, haloperidol, heparin, NSAIDs, tricyclic antidepressants,
vasopressin)

140

21 minutes

Opening & closing of hand with tourniquet, blood hemolysis during venipuncture or lab
processing, Increased (aminocaproic acid, antibiotics, antineoplastic drugs, captopril, epinephrine,
heparin, histamine, isoniazid (INH), lithium, mannitol, K-sparing diuretics, K supplements,
succinylcholine); Decreased (acetazolamide, aminosalicylic acid, glucose infusions, amphotericin B,
carbenicillin, cisplatin, diuretics, insulin, laxatives, litium carbonate, penicillin G sodium [high
doses], phenothiazines, salicylates (aspirin), sodium polystyrene sulfonate )

Chronic diarrhea, chronic loop diuretic use, Renal

failure, Diabetic ketoacidosis, Starvation, Metabolic
acidosis, Shock

Underfilling blood tube, Increased (aldosterone, barbiturates, bicarbonates, ethacrynic

acid, hydrocortisone, loop diuretics, mercurial diuretics, steroids), Decreased (methicillin,
nitrofurantoin, paraldehyde, phenformin, tetracycline, thiazide diuretics, triamterene)

Liver failure, overhydration

(SIADH), Negative nitrogen
balance, pregnancy, nephrotic
syndrome

Changes in protein intake, muscle mass, advanced pregnancy, GI bleeding, Overhydration &
underhydration, Increased (allopurinol, aminoglycosides, cephalosporins, chloral hydrate, cisplatin,
furosemide, guanethidine, indomethacin, methotrexate, methyldopa, nephrotoxic drugs [aspirin,
amphotericin B, bacitracin, carbamazepine, colistin, gentamicin, methicillin, neomycin,
penicillamine, polymyxin B, probenecid, vancomycin], propranol, rifampin, spironolactone,
tetracyclines, thiazide diuretics, triamterene); Decrease (chloramphenicol & streptomycin)

diet high in meat, Increase (aminoglycosides, cimetidine, heavy-metal chemotherapeutic

agents, nephrotoxic drugs such as cephalosporins)

Hypoparathyroidism, Renal failure,

Hyperphosphatemia 2 to renal failure,
Rickets,Vit D deficiency, Osteomalacia,
Malabsorption, Pancreatitis, Fat
embolism, Alkalosis

Vit D intoxication, Excessive milk ingestion, Decrease in serum pH (Decreases), prolonged tourniquet time,
hypoalbuminemia, Increased (calcium salts, hydralazine, lithium, thiazide diuretics, PTH, thyroid hormone, alkaline
antacids, ergocalciferol, androgens,Vit D); Decreased (acetazolamide, anticonvulsants, asparaginase, asprin,
calcitonin, cisplatin, corticosteroids, heparin, laxatives, loop diuretics, magnesium salts, thiazide diuretics,
estorgens, albuterol, oral contraceptives)

Insulinoma, Hypothyroidism,
Hypopitutarism, Addison
disease, Extensive liver disease,
Insulin overdose, Starvation

many forms of stress, caffeine, most IVFs, pregnancy (glucose interolerance), Increased
(antidepressants [tricyclics], beta-adrenergic blocking agents, corticosteroids, IV dextrose
infusion, dextrothyroxine, diazoxide, diuretics, epinephrine, estrogens, glucagon, isoniazid, lithium,
phenothiazines, phenytoin, salicylates, triamterene), Decreased (acetaminophen, alcohol, anabolic
steroids, clofibrate, disopyramide, gemfibrozil, insulin, monoamine oxidase inhibitors, pentamidine,
propranolol, tolazamide, tolbutamide)

Malnutrition, Pregnancy, Liver disease, Protein-losing enteropathies,

Protein-losing nephropathies, 3rd-space losses, Overhydration,
Increased capillary permeability, Inflammatory disease, Familial
idiopathic dysproteinemia

4.6-7.4

Aspirin, Bicarbonates, Chlorpromazine, Corticosteroids, Isoniazide, Neomycin,

Phenacemide, Salicylates, Sulfonamides, Tolbutamide
Aspirin, Bicarbonates, Chlorpromazine, Corticosteroids, Isoniazide, Neomycin,
Phenacemide, Salicylates, Sulfonamides, Tolbutamide

85-300

1 cirrhosis, Intra/extrahepatic biliary obstruction, 1/metastatic liver

tumor, Normal pregnancy, Normal bones of growing children,
Metastatic tumor to bone, Healing fracture, Hyperparathyroidism,
Paget disease, Rheumatoid arthritis, Intestinal ischemia/infarction, MI,
Sarcoidosis

Hypophosphatemia,
Malnutrition, Milk-alkali
syndrome, Pernicious anemia,
Scurvy

35-140

Heart Diseases (MI, Cardiac operations, Cardiac cath & angioplasty), Liver diseases
(Hepatitis, Hepatic cirrhosis, Drug-induced liver injury, Hepatic mets, Hepatic
necrosis [initial stages only], Hepatic surgery, Infectious mononucleosis w/ hepatitis,
Hepatic infiltrative process), Skeletal muscle diseases (Skeletal muscle trauma, recent
noncardiac surgery, Multiple traumas, severe deep burns, Progressive muscular
dystrophy, Recent convulsions, Heat stroke, 1 muscle diseases), Other diseases
(Acute hemolytic anemia, Acute pancreatitis)

glutamicoxaloacetic
transaminase)

Total
bilirubin

mg/dL

0.3-1.0

Direct
(Conjugated)
bilirubin

mg/dL

0.1-0.3

Gallstones, Extrahepatic duct obstruction, Extensive liver metastasis,

Cholestasis from drugs, Dubin-Johnson syndrome, Rotor syndrome

Indirect
(Unconjugated)
bilirubin

mg/dL

0.2-0.8

Erythroblastosis fetalis, Transfusion rxn, Sickle cell anemia, Hemolytic jaundice,

Hemolytic anemia, Pernicious anemia, Large-vol blood transfusion, Resolution
of large hematoma, Hepatitis, Cirrhosis, Sepsis, Neonatal hyperbilirubinemia,
Crigler-Najjar syndrome, Gilbert syndrome

Recent meal ingestion, Age, Increased (albumin made from placental tissue, allopurinol,
antibiotics, azathioprine, colchicine, fluorides, indomethacin, INH, methotrexate,
methyldopa, micotinic acid, phenothiazine, probenecid, tetracycline, verapamil),
Decreased (arsenicals, cyanides, fluorides, nitrofurantoin, oxalates, zinc salts)
Previous IM injections, Increased (acetaminophen, allopurinol, aminosalicylic acid, ampicillin,
azathioprine, carbamazepine, cephalosporins, chlordiazepoxide, chlorpropamide, clofibrate,
cloxacillin, codeine, dicumarol, indomethacin, INH, methotrexate, methyldopa, nafcillin, nalidixic
acid, nitrofurantoin, oral contraceptives, oxacillin, phenothiazines, phenylbutazone, phenytoin,
procainamide, propoxyphene, propranolol, quinidine, salicylates, tetracyclines, verapamil)

Significantly (Hepatitis, Hepatic necrosis, Hepatic ischemia),

Moderately (Cirrhosis, Cholestasis, Hepatic tumor, Hepatotoxic
drugs, Obstructive jaundice, Severe burns, Trauma to striated
muscles), Mildly (Myositis, Pancreatitis, MI, infectious mononucleosis,
Shock)

1.0-12.0

Run Time

Excessive saline infusions, Increased (acetazolamide, ammonium chloride, androgens,

chlorothiazide, cortisone preparations, estrogens, guanethidine, hydrochlorothiazide,
methyldopa, NSAIDs), Decreased (Aldosterone, bicarbinates, corticosteroids, cortisone,
hydrocortisone, loop diuretics, thiazide diuretics, triamterene)

Hyperparathyroidism, Non-parathyroid PTH-producing tumor,

Metastatic tumor to bone, Paget disease of bone, Prolonged
immobilization, Milk-alkali syndrome,Vit D intoxication, Lymphoma,
Granulomatous infections such as TB & sarcoidosis, Addison disease,
Acromegaly, Hyperthyroidism
Newborn (<30 or >300), DM, Acute stress response, Cushing
30-100
Infant (<40), Adult (<50 or syndrome, Chronic renal failure,
>400), Adult (<40 or >400) Glucagonoma, Acute pancreatitis, Diuretic
therapy, Corticosteroid therapy,
Acromegaly

10-60

Cost

Overhydration, SIADH, CHF, vomiting/prolonged gastric

suction, chronic diarrhea or high-output GI fistula, Chronic
respiratory acidosis, Salt-losing nephritis, Addison disease,
Diuretic therapy, Hypokalemia, Aldosteronism, Burns

<6 or >13

Dehydration

Interfering Factors

Acute renal disease, beriberi, Pregnancy (), Exercise (), Increased (antihypertensives, cholinergic agents, coumarinDKA, Pregnancy, Chronic renal type anticoagulants, digitalis preparations, erythromycin, isoniazid, methyldopa, oral
dialysis
contraceptives, opiates, salicylates, hepatotoxic medications, verapamil); Falsely
decreased in pts w/ pyridoxine deficiency (beriberi, pregnancy), severe long-standing
liver disease, uremia or DKA

Adult (>12);
Newborn (>15)

Blood hemolysis & lipemia can produce erroneous results, Increased (allopurinol, anabolic steroids, antibiotics,
antimalarials, ascorbic acid, azathioprine, chlorpropamide, cholinergics, codeine, dextran, diuretics, epinephrine,
meperidine, methotrexate, methyldopa, MAO inhibitors, morphine, nicotinic acid [arge doses], oral
contraceptives, phenothiazines, quinidine, rifampin, salicylates, steroids, sulfonamides, theophylline,Vit A),
Decreased (barbiturates, caffeine, penicillin, salicylates [high doses])

Chem 12

Test

Name

LDH

Lactic
dehydrogenase

Amylase

Lipase

PT

aPTT

Compone Units
nt
units/L @
37C

LDH-1
LDH-2
LDH-3
LDH-4
LDH-5

%
%
%
%
%
units/L

17-27
27-37
18-25
3-8
0-5
30-220

units/L

0-160

Prothrombin
time

Partial
thromboplastin
time, activated

Normal
Adult
100-190

seconds

Normal
Adult

Peds
100-250

Newborn Critical
values
60-170

6-65

>3 times
upper limit
of normal

Increased

Decreased

MI, Pulmonary disease, Hepatic disease, RBC

disease, Skeletal muscle disease & injury, Renal
parenchymal disease, Intestinal ischemia &
infarction, Neoplastic states, Testicular tumors,
Lymphoma & other reticuloendothelial system
(RES) tumors, Advanced solid tumor
malignancies, Pancreatitis, Diffuse disease or
injury

Pancreatic diseases, Biliary diseases, Renal

failure, Intestinal diseases, Salivary gland
inflammation or tumor, Peptic ulcer
disease

> 20 seconds;
full
anticoagulant Liver disease, Hereditary factor deficiency,
therapy = 3
Vit K deficiency, Bile duct obstruction,
times control
Coumarin ingestion, DIC, Massive blood
value

APTT = 30-40; PTT =

60-70; pts receiving
anticoagulant therapy
= 1.5-2.5 times
control value

APTT > 70; Congenital clotting factor deficiencies,

PTT > 100 Liver cirrhosis,Vit K deficiency, DIC,
Heparin administration, Coumarin
administration

Cost in
dollars
$82.00

Run Time
in
minutes
10

IV dextrose, serum lipemia, Increased (aminosalicylic acid,

aspirin, azathioprine, corticosteroids, dexamethasone, ethyl
alcohol, glucocorticoids, iodine-containing contrast media,
loop diuretics, methyldopa, narcotic analgesics, oral
contraceptives, prednisone
Increased (bethanechol, cholinergics, codeine,
indomethacin, meperidine, methacholine, morphine),
Decreased (calcium ions)

$80.00

15

$77.00

15

alcohol can prolong, lesser quanities of liver produced factors can prolong,
diet high in fat/leaf vegetables may shorten, diarrhea/malabsorption
syndromes can prolong, Increased (allopurinol, aminosalicylic acid,
barbituates, beta-lactam antibiotics, chloral hydrate, cephalthins,
chloramphenicol, chlorpromazine, cholestryamine, cimetidine, clofibrate,
colestipol, ethyl alcohol, glucagon, heparin, methyldopa, neomycin, oral
anticoagulants, propylthiouracil, quinidine, quinine, salicylates, sulfonamides),
Decreased (anabolic steriods, barbiturates, chloral hydrate, digitalis,
diphenydramine, estrogens, griseofulvin, oral contraceptives, vit K)

$51.00

4 plus test
result

Prolong (antihistamines, ascorbic acid, chlorpromazine,

heparin, salicylates)

$49.00

4 plus test
result

$49.00

4 plus test
result

blood hemolysis (false-pos because RBCs contain LDH),

strenuous exercise, Increased (alcohol, anesthetics, aspirin,
clofibrate, fluorides, mithramycin, narcotics, procainamide),
Decreased (ascorbic acid)

Acute pancreatitis, Chronic relapsing pancreatitis,

Penetrating peptic ulcer into pancreas, GI disease,
Acute cholecystitis, Parotiditis (mumps), Ruptured
ectopic pregnancy, Renal failure, DKA, Pulmonary
infarction, After endoscopic retrograde
pancreatography

11-12.5 seconds;
85-100%; full
anticoagulant
therapy = >1.5-2
times control
value; 20-30%

Interfering Factors

transfusion, Salicylate intoxication

Early stages of DIC,

Extensive cancer

Thrombin
Time
Fibrinogen

mg/dL

200-400

125-300

ESR

Erythrocyte
Sedimentation
Rate

mm/hr

up to 15

ANP

Atrial natriuretic
peptide

pg/mL

22-77

CHF, MI, Systemic htn, Cor pulmonale

BNP

Brain natriuretic
peptide

pg/mL

<100

CHF, MI, Systemic htn, Cor pulmonale

CNP

C-type natriuretic
peptide

undetermined

CHF, MI, Systemic htn, Cor pulmonale

PSA

Prostate-specific
antigen

ng/mL

<4

Prostate cancer, BPH, Prostatitis

hCG

human chorionic
gonadotropin

milli<5
internationa
l units/mL

PAB

Prealbumin

mg/dL

15-36

C peptide

Connecting
peptide (insulin)

ng/mL

0.78-1.89 (fasting), 512 (1 hour after

glucose load)

up to 20

up to 10

<100 can
Acute inflammatory rxns, Trauma, Acute Liver disease, Consumptive
be assoc w/ infection such as pneumonia, CHD, Stroke, coagulpathy (DIC), Fibrinolysis,
Congenital afibrinogenemia,
spontaneou PVD, Cigarette smoking, Pregnancy
Advanced sarcoma, Malnutrition,
s bleeding
Large-vol blood transfusion

0-2

Chronic renal failure, Malignant disease,

Bacterial infection, Inflammatory diseases,
Necrotic diseases, Diseases associated w/
increased proteins, Severe anemia

<5
(nonpregnant
), 5-200,000
depending on
gestation
week

Falsely (Sickle cell anemia,

Spherocytosis,
Hypofibrinogenemia,
Polycythemia vera

Pregnancy, Ectopic pregnancy, Hydatiform Threatened abortion,

mole of uterus, Choriocarcinoma of
Incomplete abortion,
uterus, Germ cell tumors of testes or
Dead fetus
ovaries, Other tumors (poorly
differentiated tumors)

blood transfusions w/I past month, fibrinolysins, diets rich

in omega-3 & omega-6 fatty acids, Increased (estrogens,
oral contraceptives), Decreased (anabolic steroids,
androgens, asparaginase, phenobarbital, streptokinase,
urokinase, valproic acid)

$64.00

artificially results can occur if specimen stands longer than

3 hours prior to testing, pregnancy (2nd & 3rd trimesters),
menstruation, tilted sedimentation tube, some anemias,
polycythemia, diseases w/ elevated proteins, Increased
(dextran, methyldopa, oral contraceptives, penicillamine,
procainamide, theophylline, vit A), Decreased (aspirin,
cortisone, quinine)

$46.00

60 minutes

NA

NA

generally higher in than , higher in older pts, values

depend on method used for measurement, natrecor will
increase for several days

$228.00

10

NA

NA

$76.00

15

$101.00

20

$51.00
$65.00

4 plus test
result
15

$96.00

20

rectal exams, prostatic manipulation by biopsy or TURP,

ejaculation w/I 24 hrs of blood testing
False-neg if test performed too early in pregnancy,
hematuria & proteinuria may yield false-pos, blood
hemolysis, Dilution of urine, False-neg (diuretics,
promethazine), False-pos (anticonvulsants, antiparkinsonian
drugs, hypnotics, tranquilizers [esp promazine & its
derivatives])

INR
14-45

6-21 (< 5
days old)

<10.7 indicates
severe
nutritional
deficiency

Some cases of nephrotic syndrome,

Hodgkin's disease, Pregnancy

Malnutrition, Liver
damage, Burns,
Inflammation

Insulinoma, Pancreas transplant, Renal

failure, Administration of oral
hypoglycemic agents

Factitious hypoglycemia,
DM, Total
pancreatectomy

Coexistent inflammation may render test results

uninterpretable, Increased (estrogen, anabolic steroids,
androgens, prednisolone), Decreased (amiodarone,
estrogens, oral contraceptives)