M.A.S
Forum Senior
Topics: 28
Posts: 56
|
Is there any vluable pdf file / Word doc / Website or hardware-book that talks about DDx of ABNORMAL LAB VLAUES?
Please help me, Thanks in advance.
|
| Mleian
Forum Junior
Topics: 7
Posts: 36
|
Guide to common Medical tests
a-1 FETOPROTEIN (ALPHA-I-FETOPROTEIN )
Elevated in:
Hepatocellular carcinoma (usually values >1000 ng/ml), germinal
neoplasms (testis, ovary, mediastinum, retroperitoneum), liver disease
(alcoholic cirrhosis, acute hepatitis, chronic active hepatitis), fetal
anencephaly, spina bifida
------------------------------------------------------------------------
----------------------------
ACETONE (serum or plasma)
Elevated in:
DKA, starvation, isopropanol Ingestion
------------------------------------------------------------------------
----------------------------
ACID PHOSPHATASE (serum)
Elevated in:
Carcinoma of prostate, other neoplasms (breast, bone), Paget's disease,
osteogenesis imperfecta, malignant invasion of bone, Gaucher's disease,
multiple myeloma, myeloproliferative disorders, benign prostatic
hypertrophy, prostatic palpation or surgery, hyperparathyroidism, liver
disease, chronic renal failure
------------------------------------------------------------------------
----------------------------
ALANINE AMINOTRANSFERASE (ALT, SGPT)
Elevated in:
Liver disease (hepatitis, cirrhosis, Reye's syndrome), hepatic
congestion, infectious mononucleosis, Ml, myocarditis, severe muscle
trauma, dermatomyositis/polymyositis, muscular dystrophy, drugs
(antibiotics, narcotics, antihypertensive agents, heparin, labetalol,
lovastatin, NSAIDs, amiodarone, chlorpromazine, phenytoin), malignancy,
renal and pulmonary infarction, convulsions, eclampsia, shock liver
------------------------------------------------------------------------
----------------------------
ALBUMIN (serum)
Elevated in:
Dehydration
Decreased in:
Liver disease, nephrotic syndrome, poor nutritional status, rapid IV
hydration, protein-losing enteropathies (inflammatory bowel disease),
severe bums, neoplasia, chronic inflammatory diseases, pregnancy, oral
contraceptives, prolonged immobilization
------------------------------------------------------------------------
----------------------------
ALDOLASE (serum)
Elevated in:
Muscular dystrophy, rhabdomyolysis, dermatomyositis/polymyositis,
trichinosis, acute hepatitis and other liver diseases, Ml, prostatic
carcinoma, hemorrhagic pancreatitis, gangrene, delirium tremens
Decreased in:
Loss of muscle mass, late stages of muscular dystrophy
------------------------------------------------------------------------
----------------------------
ALKALINE PHOSPHATASE (serum)
Elevated in:
Biliary obstruction, cirrhosis (particularly primary biliary cirrhosis),
liver disease (hepatitis, infiltrative liver diseases, fatty
metamorphosis), Paget's disease of bone, osteitis deformans, rickets,
Guide to common Medical tests. AIPPG.COM Read our disclaimer Before contuining
osteomalacia, hypervitaminosis D, hyperparathyroidism, hyperthyroidism,
ulcerative colitis, bowel perforation, bone metastases, healing
fractures, bone neoplasms, acromegaly, infectious mononucleosis, CMV
infections, sepsis, pulmonary infarction, CHF, hypernephroma, leukemia,
myelofibrosis, multiple myeloma, drugs (estrogens, albumin, erythromycin
and other antibiotics, cholestasis-producing drugs [phenothiazines])
Decreased in:
Hypothyroidism, pernicious anemia, hypophosphatemia, hypervitaminosis D,
malnutrition
------------------------------------------------------------------------
----------------------------
AMMONIA (serum)
Elevated in:
Hepatic failure, hepatic encephalopathy, Reye's syndrome, portacaval
shunt, drugs (diuretics, polymyxin B. methicillin)
Decreased in:
Drugs (neomycin, lactulose, tetracycline), renal failure
------------------------------------------------------------------------
----------------------------
AMYLASE (serum)
Elevated in:
Acute pancreatitis, pancreatic neoplasm, abscess, pseudocyst, ascites,
macroamylasemia, perforated peptic ulcer, intestinal obstraction,
intestinal infarction, acute cholecyshtis, appendicitis, ruptured
ectopic pregnancy, salivary gland inflammation, peritonitis, burns,
diabetic ketoacidosis, renal insufficiency, drugs (morphine),
carcinomatosis of lung, esophagus, ovary, acute ethanol ingestion
Decreased in:
Advanced chronic pancreatitis, hepatic necrosis
------------------------------------------------------------------------
----------------------------
ANGIOTENSIN CONVERTING ENZYME (ACE level)
Elevated in:
Sarcoidosis, primary biliary cirrhosis, alcoholic liver disease,
hyperthyroidism, hyperparathyroidism, diabetes mellitus, amyloidosis,
multiple myeloma, lung disease (asbestosis, silicosis, berylliosis,
allergic alveolitis, coccidioidomycosis), Gaucher's disease, leprosy
------------------------------------------------------------------------
----------------------------
ANION GAP
Elevated in:
Lactic acidosis
Ketoacidosis (DKA, alcoholic starvation)
Uremia (chronic renal failure)
Ingestion of toxins (paraldehyde, methanol, salicylates, ethylene
glycol)
Decreased in:
Hypoalbum nemia, severe hypermagnesem a, IgG myeloma, littaum toxicity,
lab error (falsely
Decreased sodium or overestimation of bicarbonate or chloride)
------------------------------------------------------------------------
----------------------------
ANTI-DNA
Present in:
SLE, chronic active hepatitis, infectious mononucleosis, biliary
cirrhosis
------------------------------------------------------------------------
----------------------------
ANTI-STREPTOLYSIN O TITER (STREPTOZYME, ASLO titer)
Elevated in:
Streptococcal upper airway infection, acute rheumatic fever, acute
glomerulonephritis, increased levels of B-lipoprotein
NOTE: A fourfold increase in titer between acute and convalescent
specimens is diagnostic of streptococcal upper airway infection
regardless of the initial titer.
------------------------------------------------------------------------
----------------------------
ANTIMITOCHONDRIAL ANTIBODY
Elevated in:
Primary biliary cirrhosis (85-95%), chronic active hepatitis (25%-30%)
cryptogenic cirrhosis (25-30%)
------------------------------------------------------------------------
----------------------------
ANTINUCLEAR ANTIBODY (ANA)
Positive test:
SLE (more significant if titer >1: 160), drugs (phenytoin, ethosuximide,
pnmudone, methyldopa, hydralazine, carbamazepine, penicillin,
procainamide, chlorpromazine, griseofulvin, thiazides), chronic active
hepatltis, age over 60 yr (particularly age over 80), rheumatoid
arthritls, scleroderma, mixed connective tissue disease, necrotizing
vasculitis, Sjogren's syndrome (SS), tuberculosis, pulmonary
interstitial fibrosis
------------------------------------------------------------------------
----------------------------
ANTITHROMBIN III
Decreased in:
Hereditary deficiency of antithrombin III, DIC, pulmonary embolism,
cirrhosis, thrombolytic therapy, chronic liver failure, post-surgery,
third trimester of pregnancy, oral contraceptives, nephrotic syndrome,
IV heparin >3 days, sepsis
Elevated in:
Warfarin drugs, post-MI
------------------------------------------------------------------------
----------------------------
ASPARTATE AMINOTRANSFERASE (AST, SGOT)
Elevated in:
Liver disease (hepatitis, cirrhosis, Reye's syndrome), hepatic
congestion, infectious mononucleosis, MI, myocarditis, severe muscle
trauma, dermatomyositis/polymyositis, muscular dystrophy, drugs
(antibiotics, narcotics, antihypertensive agents, heparin, labetalol,
lovastatin, NSAIDs, phenytoin, amiodarone, chlorpromazine), malignancy,
renal and pulmonary infarction, convulsions, eclampsia
------------------------------------------------------------------------
----------------------------
BASOPHIL COUNT
Elevated in:
Leukemia, inflammatory processes, polycythemia vera, Hodgkin's Iymphoma,
hemolytic anemia, after splenectomy, myeloid metaplasia
Decreased in:
Stress, hypersensitivity reaction, steroids, pregnancy, hyperthyroidism
------------------------------------------------------------------------
----------------------------
BILIRUBIN, DIRECT (conjugated bilirubin)
Elevated in:
Hepatocellular disease, biliary obstruction, drug-induced cholestasis,
hereditary disorders (Dubin-Johnson syndrome, Rotor's syndrome)
------------------------------------------------------------------------
----------------------------
BILIRUBIN, INDIRECT (unconjugated bilirubin)
Elevated in:
Hemolysis, liver disease (hepatitis cirrhosis, neoplasm), hepatic
congestion secondary to congestive heart failure, heredltary dlsorders
(Gilbert's disease, Crigler-Najjar syndrome)
------------------------------------------------------------------------
----------------------------
BILIRUBIN, TOTAL
Elevated in:
Liver disease (hepatitis, cirrhosis, cholangitis, neoplasm, biliary
obstruction, infectious mononucleosis), hereditary disorders (Gilbert's
dsease, Dubin-Johnson syndrome), drugs (steroids, diphenylhydanton,
phenothiazines, penicillin, erythromycin, clindamycin, captopril,
amphotericin B. sulfonamides, azathioprine, isoniazid, 5-aminosalicylic
acid, allopurinol, methyldopa, indomethacin, halothane, oral
contracepuves, procainamide, tolbutamide, labetalol), hemolysis,
pulmonary embolism or infarct, hepatic congestion secondary to CHF
------------------------------------------------------------------------
----------------------------
BLEEDING TIME (modified Ivy method)
Elevated in:
Thrombocytopenia, capillary wall abnormalities, platelet abnormalities
(Bernard-Soulier, Glamzmann's), drugs (aspirin, warfarin,
antinflammatory medications, streptokinase, urokinase, dextran, B lactam
antibiotics, moxalactam), DIC, cirrhosis, uremia, myeloproliferative
dlsorders, Von Willebrand's
------------------------------------------------------------------------
----------------------------
C-REACTIVE PROTEIN
Elevated in:
Rheumatoid arthritis, rheumatic fever, inflammatory bowel disease,
bacterial infections, Ml, oral contraceptives, third trimester of
pregnancy (acute phase reactant), inflammatory and neoplastic diseases
------------------------------------------------------------------------
----------------------------
CALCITONIN (serum)
Elevated in:
Medullary carcinoma of the thyroid (particularly if level >1500 pg/ml),
carcinoma of the breast, APUDomas, carcinolds, renal failure,
thyroiditis
------------------------------------------------------------------------
----------------------------
CALCIUM (serum)
Increased in:
-Hyperparathyroidism, primary (due to hyperplasia or adenoma of
parathyroids) or secondary
-Hyperparathyroidism due to parathormone-secreting cancer -Hematologic
malignancies (e.g., myeloma, lymphoma, leukemia)
-Excess vitamin D intake
-Bone tumor (Metastatic carcinoma (10% of patients))
-Acute osteoporosis (e.g., immobilization of young patients or in
Paget's disease)
-Milk-alkali (Burnett's) syndrome
-Idiopathic hypercalcemia of infants
-Infantile hypophosphatasia
-Berylliosis
-Hyperthyroidism (some patients)
-Cushing's syndrome (some patients)
-Addison's disease (some patients)
-Myxedema (some patients)
-Hyperproteinemia (Sarcoidosis, -Multiple myeloma (some patients))
-Thiazide drugs
-Artifactual (e.g., venous stasis during blood collection, use of corkstoppered
test tubes)
Decreased in:
-Hypoparathyroidism (Surgical; Idiopathic; Pseudohypoparathyroidism)
-Malabsorption of calcium and vitamin D (Obstructive jaundice)
-Hypoalbuminemia (Cachexia, Nephrotic syndrome, Sprue, Celiac disease,
Cystic fibrosis of pancreas)
-Chronic renal disease with uremia and phosphate retention
-Acute pancreatitis with extensive fat necrosis
-Insufficient calcium, phosphorus, and vitamin D ingestion (Bone disease
(osteomalacia, rickets); Starvation; Late pregnancy)
Total serum protein should always be known for proper interpretation of
serum calcium levels.
------------------------------------------------------------------------
----------------------------
CARBOXYHEMOGLOBIN (CARBON MONOXIDE; CO)
Elevated in:
Smoking, exposure to smoking, exposure to automobile exhaust fumes
malfunctioning gas-burning appliances
------------------------------------------------------------------------
----------------------------
CARCINOEMBRYONIC ANTIGEN (CEA)
Elevated in:
Colorectal carcinomas, pancreatic carcmomas, and metastatic disease
usually produce higher elevations (>20 ng/ml)
Carcinomas of the esophagus, stomach, small intestine, liver, breast
ovary, lung and thyroid usually produce lesser elevations
Benign conditions (smoking, inflammatory bowel disease hypothyroidism,
cirrhosis, pancreatitis, infections) usually produce ievels <10 ng/ml
------------------------------------------------------------------------
----------------------------
CAROTENE (serum)
Elevated in:
Carotenemia, chronic nephritis, diabetes mellitus, hypothyroidism,
nephrotic syndrome
Decreased in:
Fat malabsorption, steatorrhea, pancreatic insufficiency, lack of
carotenoids in diet
------------------------------------------------------------------------
----------------------------
CEREBROSPINAL FLUID (CSF)
------------------------------------------------------------------------
----------------------------
CERULOPLASMIN (serum)
Elevated in:
Pregnancy, estrogens, oral contraceptives, neoplastic diseases
(leukemias, Hodgkin's Iymphoma, carcinomas), inflammatory states, SLE,
prirnary biliary cirrhosis, rheumatoid arthritis
Decreased in:
Wilson's disease (values often <10 mg/dl), nephrotic syndrome, advanced
liver disease, malabsorption, total parenteral nutrition, Menkes'
syndrome
------------------------------------------------------------------------
----------------------------
CHLORIDE (serum)
Elevated in:
-Dehydration, excessive infusion of normal saline
-Hyperparathyroidism, renal tubular disease, metabolic acidosis,
prolonged diarrhea
-Drugs (ammonium chloride administration, acetazolamide, boric acid,
triamterene)
Decreased in:
CHF, SIADH, Addison's disease, vomiting, gastric suction, salt-losing
nephritis, continuous infusion of D5W, thiazide diuretic administration,
diaphoresis, diarrhea, burns
------------------------------------------------------------------------
----------------------------
CHOLESTEROL, TOTAL
Elevated in:
Primary hypercholesterolemia, biliary obstruction, diabetes melhtus,
nephrotic syndrome, hypothyroidism, primary biliary cirrhosis, high
cholesterol diet, third trimester of pregnancy, Ml, drugs (steroids,
phenothiazines, oral contraceptives)
Decreased in:
Starvation, malabsorption, sideroblastic anemia, thalassemia,
abetalipoproteinemia, hyperthyroidism, Cushing's syndrome, hepatic
failure, multiple myeloma, polycythemia vera, chronic myelocytic
leukemia, myeloid metaplasia, Waldenstrom's macroglobulinemia,
myelofibrosis
------------------------------------------------------------------------
----------------------------
CIRCULATING ANTICOAGULANT (lupus anticoagulant)
Detected in:
SLE, drug-induced lupus, long-term phenothiazine therapy, multiple
myeloma, ulcerative colhis, rheumatoid arthritis, postpartum,
hemophilia, neoplasms, chronic inflammatory states
------------------------------------------------------------------------
----------------------------
COLD AGGLUTININS TITER
Elevated in:
Primary atypical pneumonia (mycoplasma pneumonia), infectious
mononucleosis, CMV infection
Other: hepatic cirrhosis, acquired hemolytic anemia, frostbite, multiple
myeloma, Iymphoma, malaria
------------------------------------------------------------------------
----------------------------
COMPLEMENT (C3, C4)
C3 is increased in:
Acute and chronic inflammation (slightly), obstructive jaundice
C3 is decreased in:
Acute glomerulonephritis, systemic lupus erythromatosis
------------------------------------------------------------------------
----------------------------
COOMBS, DIRECT
Positive:
Autoimmune hemolytic anemia, erythroblastosis fetalis, transfusion
reactions, drugs (a-methyldopa, peniecllins, tetraeyeline, sulfonamides,
levodopa, cephalosporins, quinidine, insulin)
False positive:
May be seen with cold agglutinins
------------------------------------------------------------------------
----------------------------
COOMBS, INDIRECT
Positive:
Acquired hemolytic anemia, incompatible cross-matched blood, anti-Rh
antibodies, drugs (methyldopa, mefenamic acid, levodopa)
------------------------------------------------------------------------
----------------------------
COPPER (serum)
Increased in:
-Anemias (Pernicious anemia, Megaloblastic anemia of pregnancy, Iron
deficiency anemia, Aplastic anemia, Leukemia, acute and chronic,
Infection, acute and chronic, Malignant lymphoma, Hemochromatosis)
-Collagen diseases (including SLE, rheumatoid arthritis, acute rheumatic
fever, glomerulonephritis)
-Hypothyroidism
-Hyperthyroidism
-Frequently associated with increased C-reactive protein
Decreased in:
-Nephrosis (ceruloplasmin lost in urine)
-Wilson's disease
-Acute leukemia in remission
-Some iron deficiency anemias of childhood (that require copper as well
as iron therapy)
-Kwashiorkor
------------------------------------------------------------------------
----------------------------
CORTISOL (plasma)
Elevated in:
-Ectopic ACTH production (i.e., oat cell carcinoma of lung), loss of
normal diurnal variation, pregnancy, chronic renal failure
-Iatrogenic, stress, adrenal or pituitary hyperplasia or adenomas
Decreased in:
Primary adrenocortical insufficiency, anterior pituitary hypofunction,
secondary adrenocortical insufficiency, adrenogenital syndromes
------------------------------------------------------------------------
----------------------------
CREATINE KINASE (CK, CPK)
Elevated in:
MI, myocarditis, rhabdomyolysis, myositis, crush injury/trauma,
polymyositis, dermatomyositis, vigorous exercise, muscular dystrophy,
myxedema, seizures, malignant hyperthermia syndrome, IM injections, CVA,
pulmonary embolism and infarction, acute dissection of aorta
Decreased in:
Steroids, decreased muscle mass, connective tissue disorders, alcoholic
liver disease, metastatic neoplasms
------------------------------------------------------------------------
----------------------------
CREATINE KINASE ISOENZYMES
CK-MB
Elevated in: Mi, myocarditis, pericarditis, muscular dystrophy, cardiac
defibrillation, cardiac surgery, extensive rhabdomyolysis, strenuous
exercise (marathon runners), mixed conmective tissue disease,
cardiomyopathy, hypothermia
CK-MM
Elevated in: crush injury, seizures, malignant hyperthermia syndrome,
rhabdomyolysis, myositis, polymyositis, dermatomyositis, vigorous
exercise, muscular dystrophy, IM injections, acute dissection of aorta
CK-BB
Elevated in: CVA, subarachnoid hemorrhage, neoplasms (prostate, Gl
tract, brain, ovary, breast, lung), severe shock, bowel infarction,
hypothermia
------------------------------------------------------------------------
----------------------------
CREATININE (serum)
Elevated in:
Renal insufficiency (acute and chronic),
Decreased renal perfusion (hypotension, dehydration, CHF), urinary tract
infection, rhabdomyolysis, ketonemia
Drugs (antibiotics [aminoglycosides, cephalosporins], hydantoin,
diuretics, methyldopa)
Falsely elevated in:
DKA, administration of some cephalosporins (e.g., cefoxitin,
cephalothin)
Decreased in:
Decreased muscle mass (including amputees and older persons), pregnancy,
prolonged debilitation
------------------------------------------------------------------------
----------------------------
CREATININE CLEARANCE
Elevated in:
Pregnancy, exercise
Decreased in:
Renal insufficiency, drugs (cimetidine, procainanude, antibiotics,
quinidine)
------------------------------------------------------------------------
----------------------------
CRYOGLOBULINS (serum)
Present in:
Collagen-vascular diseases, CLL, hemolytic anemias, multiple myeloma,
Waldenstrom's macroglobulinemia, chronic active hepatitis, Hodgkin's
disease
------------------------------------------------------------------------
----------------------------
D-XYLOSE ABSORPTION
Decreased in:
Malabsorption syndrome
------------------------------------------------------------------------
----------------------------
EOSINOPHIL COUNT
Elevated in:
Allergy, parasitic infestations (trichinosis, aspergillosis,
hydatidosis), angmneurotic edema, drug reactions, warfarin sensitivity,
collagen-vascular diseases, acute hypereosinophilic syndrome,
eosinophilic nonallergic rhinitis, myeloproliferative disorders,
Hodgkin's Iymphoma, radiation therapy, NHL, L-tryptophan ingestion
------------------------------------------------------------------------
----------------------------
ERYTHROCYTE SEDIMENTATION RATE (Westergren)
Elevated in:
Collagen-vascular diseases, infections, MI, neoplasms, inflammatory
states (acute phase reactant)
------------------------------------------------------------------------
----------------------------
EXTRACTABLE NUCLEAR ANTIGEN (ENA complex, anti-RNP antibody, anti-Sm,
anti-Smith)
Present in:
SLE, rheumatoid arthritis, Sjogren's syndrome, MCTD
------------------------------------------------------------------------
----------------------------
FECAL FAT, QUANTITATIVE (72 hr collection)
Elevated in:
Malabsorption syndrome
------------------------------------------------------------------------
----------------------------
FERRITIN (serum)
Elevated in:
Hyperthyroidism, inflammatory states, liver disease (ferritin elevated
from necrotic hepatocytes), neoplasms (neuroblastomas, Iymphomas,
leukemia, breast carcinoma), iron replacement therapy, hemochromatosis
Decreased in:
Iron deficiency anemia
------------------------------------------------------------------------
----------------------------
FIBRIN DEGRADATION PRODUCT (FDP)
Elevated in:
DIC, primary fibrinolysis, pulmonary embolism, severe liver disease
NOTE: The presence of rheumatoid factor may cause falsely elevated FDP
------------------------------------------------------------------------
----------------------------
FIBRINOGEN
Elevated in:
Tissue inflammation/damage (acute-phase protein reactant), oral
contraceptives, pregnancy, acute infection, MI
Decreased in:
DIC, hereditary afibrinogenemia, liver disease, primary or secondary
fibrinolysis, cachexia
------------------------------------------------------------------------
----------------------------
FOLATE (FOLIC ACID)
Decreased in:
Folic acid deficiency (inadequate intake, malabsorption), alcoholism,
drugs (methotrexate, trimethoprim, phenytoin, oral contraceptives,
azulfadine), vitamin B12 deficiency (defective red cell folate
absorption)
------------------------------------------------------------------------
----------------------------
FTA-ABS (serum)(FLUORESCENT TREPONEMAL ANTIBODY)
Reactive in:
Syphilis, other treponemal diseases (yaws, pinta, bejel)
------------------------------------------------------------------------
----------------------------
GASTRIN (serum)
Elevated in:
Zollinger-Ellison syndrome (gastrinoma), pernicious anemia,
hyperparathyroidism, retained gastric antrum, chronic renal failure,
gastric ulcer, chronic atrophic gastritis, pyloric obstruction,
malignant neoplasms of the stomach, H2 blockers, omeprazole
------------------------------------------------------------------------
----------------------------
GLOMERULAR BASEMENT MEMBRANE ANTIBODY (ANTIGLOMERULAR BASEMENT ANTIBODY)
Present in:
Goodpasture's syndrome
------------------------------------------------------------------------
----------------------------
GLUCOSE-6-PHOSPHATE DEHYDROGENASE SCREEN (blood)
Abnormal:
If a deficiency is detected, quantitation of G6PD is necessary; a G6PD
screen may be falsely interpreted as abnormal
------------------------------------------------------------------------
----------------------------
GLUCOSE TOLERANCE TEST
Elevated in:
Glucose intolerance, diabetes mellitus, Cushing's syndrome, acromegaly,
pheochromocytoma
------------------------------------------------------------------------
----------------------------
GLUCOSE, FASTING
Elevated in:
Diabetes mellitus, stress, infections, MI, CVA, Cushing's syndrome,
acromegaly, acute pancreatitis, glucagonoma, hemocbromatosis, drugs
(glucocorticoids, diuretics [thiazides, loop diuretics]), glucose
intolerance
------------------------------------------------------------------------
----------------------------
GLUCOSE, POSTPRANDIAL
Elevated in:
Diabetes mellitus, glucose intolerance
Decreased in:
Post-gastrointestinal resection, reactive hypoglycemia, hereditary
fructose intolerance, galactosemia, leucine sensitivity
------------------------------------------------------------------------
----------------------------
GLYCATED (GLYCOSYLATED) HEMOGLOBIN (HbA1c)
Elevated in:
Uncontrolled diabetes mellitus (glycated hemoglobin levels reflect the
level of glucose control over the preceding 120 days)
Decreased in:
Hemolytic anemias,
Decreased RBC survival, pregnancy, chronic blood loss, chronic renal
failure, insulinoma
------------------------------------------------------------------------
----------------------------
HAM TEST (acid serum test)
Positive in:
Paroxysmal nocturnal hemoglobinuria (PNH)
False positive in:
Hereditary or acquired spherocytosis, recent transfusion with aged RBC,
aplastic anemia, myeloproliferative syndromes, leukemia, hereditary
dyserythropoietic anemia type II (HEMPAS)
------------------------------------------------------------------------
----------------------------
HAPTOGLOBIN (serum)
Elevated in:
Inflammation (acute phase reactant), collagen-vascular diseases,
infections (acute phase reactant), drugs (androgens)
Decreased in:
Hemolysis (intravascular > extravascular), megaloblastic anemia, severe
liver disease, large tissue hematomas, infectious mononucleosis, drugs
(oral contraceptives)
------------------------------------------------------------------------
----------------------------
HEMATOCRIT
Elevated in:
Polycythemia vera, smoking, COPD, high altitudes, dehydration,
hypovolemia
Decreased in:
Blood loss (GI, GU), anemia, pregnancy
------------------------------------------------------------------------
----------------------------
HEMOGLOBIN
Elevated in:
Hemoconcentration, dehydration, polycythemia vera, COPD, high altitudes,
false elevations (hyperlipemic plasma, WBC >50,000 mm3), stress
Decreased in:
Hemorrhage (GI, GU), anemia
------------------------------------------------------------------------
----------------------------
HEPATITIS A ANTIBODY
Present in:
Viral hepatitis A, can be IgM or IgG (if IgM, acute hepatitis A; if IgG,
previous infection with hepatitis A)
------------------------------------------------------------------------
----------------------------
HEPATITIS B SURFACE ANTIGEN (HBsAg)
Detected in:
Acute viral hepatitis Type B. Chronic hepatitis B
------------------------------------------------------------------------
----------------------------
HIGH DENSITY LIPOPROTEIN (HDL) CHOLESTEROL
Increased:
Use of gemfibrozil, nicotinic acid, estrogens, regular aerobic exercise,
small (1 oz) daily alcohol intake
Decreased:
Deficiency of apoproteins, liver disease, probucol ingestion, Tangier
disease
NOTE: A cholesterol/HDL ratio >4.5 is associated with increased risk of
coronary artery disease.
------------------------------------------------------------------------
----------------------------
IMMUNE COMPLEX ASSAY
Detected in:
Collagen-vascular disorders, glomerulonephritis, neoplastic diseases,
malaria, primary biliary cirrhosis, chronic acute hepatitis, bacterial
endocarditis, vasculitis
------------------------------------------------------------------------
----------------------------
IMMUNOGLOBULINS
Elevated in:
-IgA: Iymphoproliferative disorders, Berger's nephropathy, chronic
infections, autoimmune disorders, liver disease
-IgE: allergic disorders, parasitic infections, immunological disorders
IgE myeloma
-IgG: chronic granulomatous infections, infectious diseases,
inflammation, myeloma, liver disease
-IgM: primary biliary cirrhosis, infectious diseases (brucellosis,
malaria), Waldenstrom's macroglobulinemia, liver disease
Decreased in:
-IgA: nephrotic syndrome, protein-losing enteropathy, congenital
deficiency, Iymphocytic leukemia, ataxia-telengiectasia, chronic
eosinopulmonary disease
-IgE: hypogammaglobulinemia, neoplasm (breast, bronchial, cervical)
ataxia, telengiectasia
-IgG: congenital or acquired deficiency, Iymphocytic leukemia,
phenytoin, methylprednisolone, nephrotic syndrome, protein-losing
enteropathy
-IgM: congenital deficiency, Iymphocytic leukemia, nephrotic syndrome
------------------------------------------------------------------------
----------------------------
IRON-BINDING CAPACITY (TIBC)
Elevated in:
Iron deficiency anemia, pregnancy, polycythemia
Decreased in:
Anemia of chronic disease, hemochromatosis, chronic liver disease,
hemolytic anemias, malnutrition (protein depletion)
------------------------------------------------------------------------
----------------------------
LACTATE (blood)
Increased in:
(Without signifigant acidosis): Muscular exercise, hyperbentilation,
glucaon, glycogen storage disease, severe anemia, pyruvate infusion,
HCO3 infusion, glucose and insulin infusion.
(With hypoxia and acidosis): Acute hemorrage, circulatory collapse,
cyanotic heart disease, severe acute CHF, acute anoxemia, extracorpeal
circulation, epinephrine
(Idiopathic): Mild uremia, infections (esp. pyelonephritis), septicemia,
cirrhosis, acute pancreatitis (+/-), third trimester of pregnancy,
severe vascular disease, leukemia, anemia, chronic alcoholism, subacute
bacterial endocarditis, poliomyelitis
------------------------------------------------------------------------
----------------------------
LACTATE DEHYDROGENASE (LDH)
Elevated in:
Infarction of myocardium, lung, kidney
Diseases of cardiopulmonary system, liver, collagen, CNS
Hemolytic anemias, megaloblastic anemias, transfusions, seizures, muscle
trauma, muscular dystrophy, acute pancreatitis hypotension shock,
infectious mononucleosis, inflammation, neoplasia, intestinai
obstruction, hypothyroidism
------------------------------------------------------------------------
----------------------------
LACTATE DEHYDROGENASE ISOENZYMES
Abnormal values:
LDH1 > LDH2: MI (can also be seen with hemolytic anemias, pernicious
anemia, folate deficiency, renal infarct)
LDH5 > LDH4: liver disease (cirrhosis, hepatitis, hepatic congestion)
------------------------------------------------------------------------
----------------------------
LEGIONELLA TITER
Positive in:
Legionnaire's disease (presumptive: > 1:256 titer; definitive: fourfold
titer increase to >1: 128)
------------------------------------------------------------------------
----------------------------
LEUKOCYTE ALKALINE PHOSPHATASE (LAP SCORE)
Elevated in:
Leukemoid reactions, neutrophilia secondary to infections (except in
sickle cell crisisƒ€no significant increase in LAP score), Hodgkin's
disease, polycythemia vera, hairy cell leukemia, aplastic anemia, Down's
syndrome, myelofibrosis
Decreased in:
Acute and chronic granulocytic leukemia, thrombocytopenic purpura,
paroxysmal nocturnal hemoglobinuria (PNH), hypophosphatemia, collagen
disorders
------------------------------------------------------------------------
----------------------------
LIPASE
Elevated in:
Acute pancreatitis, perforated peptic ulcer, carcinoma of pancreas
(early stage), pancreatic duct obstruction
------------------------------------------------------------------------
----------------------------
LOW DENSITY LIPOPROTEIN (LDL) CHOLESTEROL
Elevated in:
Primary hyperlipoproteinemia, diet high in saturated fats, acute MI,
hypothyroidism, primary biliary cirrhosis, nephrosis, driabetes mellitus
Decreased in:
Abetalipoproteinemia, advanced liver disease, malabsorption,
malnutrition
------------------------------------------------------------------------
----------------------------
LYMPHOCYTES
Elevated in:
Chronic infections, infectious mononucleosis and other viral infections,
CLL, Hodgkin's disease, ulcerative colitis, hypoadrenalism, ITP
Decreased in:
AIDS, ARC, bone marrow suppression from chemotherapeutic agents or
chemotherapy, aplastic anemia, neoplasms, steroids, adrenocortical
hyperfunction, neurologic disorders (multiple sclerosis, myasthenia
gravis, Guillain-Barre syndrome)
------------------------------------------------------------------------
----------------------------
MAGNESIUM (serum)
Increased in:
-Renal failure
-Diabetic coma before treatment
-Hypothyroidism
-Addison's disease and after adrenalectomy
-Controlled diabetes mellitus in older patients
-Administration of antacids containing magnesium
Decreased in:
-GI disease showing malabsorption and abnormal loss of GI fluids (e.g.,
nontropical sprue, small bowel resection, biliary and intestinal
fistulas, abdominal irradiation, prolonged aspiration of intestinal
contents, celiac disease and other causes of steatorrhea)
-Acute alcoholism and alcoholic cirrhosis
-Insulin treatment oof diabetic coma
-Hyperthyroidism
-Aldosteronism
-Hyperparathyroidism
-Lytic tumors of bone
-Diuretic drug therapy (e.g., ethacrynic acid, furosemide)
-Some cases of renal disease (e.g., glomerulonephritis, pyeloneI
phritis, renal tubular acidosis)
-Acute pancreatitis
-Excessive lactation
-Idiopathic disorders
Magnesium deficiency may cause apparently unexplained hypocalcemia and
hypokalemia; the patients may have neurologic and GI symptoms
------------------------------------------------------------------------
----------------------------
MEAN CORPUSCULAR VOLUME (MCV)
Elevated in:
Vitamin B12 deficiency, folic acid deficiency, liver disease, alcohol
abuse, reticulocytosis, hypothyroidism, marrow aplasia, myelofibrosis
Decreased in:
Iron deficiency, thalassemia syndrome and other hemoglobinopathies,
anemia of chronic disease, sideroblastic anemia, chronic renal failure,
lead poisoning
------------------------------------------------------------------------
----------------------------
MONOCYTE COUNT
Elevated in:
Viral diseases, parasites, infections, neoplasms, inflammatory bowel
disease, monocytic leukemia, Iymphomas, myeloma, sarcoidosis
Decreased in:
Aplastic anemia, Iymphocytic leukemia, glucocorticoid administration
------------------------------------------------------------------------
----------------------------
NEUTROPHIL COUNT
Elevated in:
Acute bacterial infections, acute MI, stress, neoplasms, myelocytic
leukemia
Decreased in:
Viral infections, aplastic anemias, immunosuppressive drugs, radiation
therapy to bone marrow, agranulocytosis, drugs (antibiotics,
antithyroidals), Iymphocytic and monocytic leukemias
------------------------------------------------------------------------
----------------------------
OSMOLALITY, SERUM
It can be estimated by the following formula:
2([Na] + [K]) + Glucose/18 + BUN/2.8
Elevated in:
Dehydration, hypernatremia, diabetes insipidus, uremia, hyperglycemia,
mannitol therapy, ingestlon of toxins (ethylene glycol, methanol
ethanol)
Decreased in:
SIADH, hyponatremia, overhydration
------------------------------------------------------------------------
----------------------------
pH, BLOOD
Increased in:
Metabolic alkalosis, respiratory alkalosis
Decreased in:
Metabolic acidosis, repiratory acidosis
------------------------------------------------------------------------
----------------------------
PARTIAL THROMBOPLASTIN TIME (PTT), ACTIVATED PARTIAL THROMBOPLASTIN TIME
(APTT)
Elevated in:
Heparin therapy, coagulation factor deficiency (I, II, V, VIII, IX, X,
XI XII), liver disease, vitamin K deficiency, DIC, circulating
anticoagulant, warfarin therapy, specific factor inhibition (PCN
reaction, rheumatoid arthritis), thrombolytic therapy
NOTE: Useful to evaluate the intrinsic coagulaion system.
------------------------------------------------------------------------
----------------------------
PHOSPHATASE, ALKALINE; see ALKALINE PHOSPHATASE PHOSPHORUS (serum)
Elevated in:
Renal failure, dehydration, Addison's disease, myelogenous leukemia,
hypervitaminosis D, hypoparathyroidism, pseudohypoparathyroidism, bone
metastases, sarcoidosis, milk-alkali syndrome, immobilization, magnesium
deficiency, transfusions, hemolysis
Decreased in:
Starvation (e.g., alcoholics), DKA, TPN, continuous IV dextrose
administration, vitamin D deficiency, hyperparathyroidism,
pseudohyperparathyroidism, antacids containing aluminum hydroxide,
insulin administration, nasogastric suctioning, vomiting, diuretics,
steroids, gram-negative septicemia
------------------------------------------------------------------------
----------------------------
PHOSPHORUS (serum)
Increased in:
-Hypoparathyroidism (Idiopathic, Surgical, Pseudohypoparathyroidism)
-Excess vitamin D intake
-Secondary hyperparathyroidism (renal rickets)
-Bone disease (Healing fractures, Multiple myeloma (some patients),
Paget's disease (some patients), Osteolytic metastatic tumor in bone
(some patients))
-Addison's disease
-Acromegaly
-Childhood
-Myelogenous leukemia
-Acute yellow atrophy
-High intestinal obstruction
-Sarcoidosis (some patients)
-Milk-alkali (Burnett's) syndrome (some patients)
-Artifactual increase by hemolysis of blood
Decreased in
-Alcoholism*
-Diabetes mellitus*
-Hyperalimentation*
-Nutritional recovery syndrome* (rapid refeeding after prolonged
starvation)
-Alkalosis, respiratory (e.g., gram-negative bacteremia) or metabolic
-Acute gout
-Salicylate poisoning
-Administration of glucose intravenously (e.g., recovery after severe
burns, hyperalimentation)
-Administration of anabolic steroids, androgens, epinephrine, glucagon,
insulin
-Acidosis (especially ketoacidosis)
-Hyperparathyroidism
-Renal tubular defects (e.g., Fanconi syndrome)
-Hypokalemia
-Hypomagnesemia
-Administration of diuretics
-Prolonged hypothermia (e.g., open heart surgery)
-Malabsorption
-Vitamin D deficiency and/or resistance, osteomalacia
-Malnutrition, vomiting, diarrhea
-Administration of phosphate-binding antacids*
-Primary hypophosphatemia
*Indicates conditions associated with severe hypophosphatemia.
Mechanisms of hypophosphatemia are intracellular shift of phosphate,
increased loss (via kidney or intestine), or decreased intestinal
absorption; usually associated with prior phosphorus depletion. Often,
more than one mechanism is operative.
------------------------------------------------------------------------
----------------------------
PLATELET COUNT
Elevated in:
Neoplasms (GI tract), CML, polycythemia vera, myelofibrosis with myeloid
metaplasia, infections, after splenectomy, postpartum, after hemorrhage,
hemophilia, iron deficiency, pancreatitis, cirrhosis
------------------------------------------------------------------------
----------------------------
POTASSIUM (serum)
Increased in:
-Renal failure: (Acute with oliguria or anuria; Chronic end-stage with
oliguria (glomerular filtration rate <3-5 ml/minute); Chronic
nonoliguric associated with dehydration, obstruction, trauma, or excess
potassium)
-Decreased mineralocorticoid activity: (Addison's disease; Hypofunction
of renin-angiotensin-aldosterone system; Pseudohypoaldosteronism;
Aldosterone antagonist (e.g., spironolactone))
-Increased supply of potassium: (Red blood cell hemolysis (transfusion
reaction, hemolytic anemia); Excess dietary intake or rapid potassium
infusion; Striated muscle (status epilepticus, periodic paralysis);
Potassium-retaining drugs (e.g., triamterene); Fluid-electrolyte
imbalance (e.g., dehydration, acidosis))
-Laboratory artifacts (e.g., hemolysis during venipuncture, conditions
associated with thrombocytosis, incomplete separation of serum and clot)
Decreased in:
-Renal and adrenal conditions with metabolic alkalosis: (Administration
of diuretics, Primary aidosteronism, Pseudoaldosteronism, Salt-losing
nephropathy, Cushing's syndrome)
-Renal conditions associated with metabolic acidosis: (Renal tubular
acidosis, Diuretic phase of acute tubular necrosis, Chronic
pyelonephritis, Diuresis following relief of urinary tract obstruction)
-Gastrointestinal conditions: (Vomiting, gastric auctioning; Villous
adenoma; Cancer of colon; Chronic laxative abuse; Zollinger-Ellison
syndrome; Chronic diarrhea; Ureterosigmoidostomy)
------------------------------------------------------------------------
----------------------------
PROLACTIN
Elevated in:
Prolactinomas (level >200 highly suggestive), drugs (phenothiazines,
cimetidine, tricyclic antidepressants, metoclopramide, estrogens,
antihypertensives [methyldopa], verapamil, haloperidol), postpartum,
stress, hypoglycemia, hypothyroidism
------------------------------------------------------------------------
----------------------------
PROTEIN (serum)
Elevated in:
Dehydration, multiple myeloma, Waldenstrom's macroglobulinemia,
sarcoidosis, collagen-vascular diseases
Decreased in:
Malnutrition, low-protein diet, overhydration, malabsorption, pregnancy,
severe bums, neoplasms, chronic diseases, cirrhosis, nephrosis
------------------------------------------------------------------------
----------------------------
PROTEIN ELECTROPHORESIS (serum)
Elevated:
-Albumin: dehydration
-a-l: neoplastic diseases, inflammation
-a-2: neoplasms, inflammation, infection, nephrotic syndrome
-b: hypothyroidism, biliary cirrhosis, diabetes mellitus
-y: see IMMUNOGLOBULINS
Decreased:
-Albumin: malnutrition, chronic liver disease, malabsorption, nephrotic
syndrome, burns, SLE
-a-I: emphysema (a-l antitrypsin deficiency), nephrosis
-a-2: hemolytic anemias (
Decreased haptoglobin), severe hepatocellular damage
-b: hypocholesterolemia, nephrosis
-y: see IMMUNOGLOBULINS
------------------------------------------------------------------------
----------------------------
PROTHROMBIN TIME (PT)
Elevated in:
Liver disease, oral anticoagulants (Warfarin), heparin, factor
deficiency (I, II, V, VII, X), DIC, vitamin K deficiency,
afibrinogenemia, dysfibrinogenemia, drugs (salicylae, chloral hydrate,
diphenylhydantoin, estrogens, antacids, phenylbutazone, quinidine,
antibiotics, allopurinol, anabolic steroids)
Decreased in:
Vitamin K supplementation, thrombophlebitis, drugs (gluthetimide,
estrogens, griseofulvin, diphenhydramine)
------------------------------------------------------------------------
----------------------------
PROTOPORPHYRIN (free erythrocyte)
Elevated in:
Iron deficiency, lead poisoning, sideroblastic anemias, anemia of
chronic disease, hemolytic anemias, erythropoietic protoporphyria
------------------------------------------------------------------------
----------------------------
RED BLOOD CELL COUNT
Elevated in:
Polycythemia vera, smokers, high altitude, cardiovascular disease, renal
cell carcinoma and other erythropoietin-producing neoplasms, stress,
hemoconcentration/dehydration
Decreased in:
Anemias, hemolysis, chronic renal failure, hemorrhage, failure of marrow
production
------------------------------------------------------------------------
----------------------------
RED BLOOD CELL DISTRIBUTION WIDTH (RDW)
Normal RDW and...
Elevated MCV: aplastic anemia, preleukemiaNormal MCV: normal, anemia of
chronic disease, acute blood loss or hemolysis, CLL, CML, nonanemic
enzymopathy or hemoglobinopathy
Decreased MCV: anemia of chronic disease, heterozygous thalassemia
Elevated RDW and...
Elevated MCV: vitamin Bl2 deficiency, folate deficiency, immune
hemolytic anemia, cold agglutinins, CLL with high count, liver disease
Normal MCV: early iron deficiency, early vitamin Bl2 deficiency, early
folate deficiency, anemic globinopathy
Decreased MCV: iron deficiency, RBC fragmentation, Hb H. thalassemia
intermedia
------------------------------------------------------------------------
----------------------------
RED BLOOD CELL MASS (VOLUME)
Elevated in:
Polycythemia vera, hypoxia (smokers, high altitude, cardiovascular
disease), hemoglobinopathies with high 2 B affinity, erythropoietinproducmg
tumors (renal cell carcinoma)
Decreased in:
Hemorrhage, chronic disease, failure of marrow production anemias,
hemolysis
------------------------------------------------------------------------
----------------------------
RETICULOCYTE COUNT
Elevated in:
Hemolytic anemia (sickle cell crisis, thalassemia major, autoimmune
hemolysls, hemorrhage, postanemia therapy (folic acid, ferrous sulfate,
vitamin B12)
Decreased in:
Aplastic anemia, marrow suppression (sepsis, chemotherapeutic agents
radlation), hepatic cirrhosis, blood transfusion, anemias of disordered
maturation (iron deficiency anemia, megaloblastic anemia, sideroblastlc
anemua, anemna of chronic disease)
------------------------------------------------------------------------
----------------------------
RHEUMATOID FACTOR
Present in titer >1:20:
Rheumatoid arthritis, SLE, chronic inflammatory processes, old age,
infection, liver disease
------------------------------------------------------------------------
----------------------------
SMOOTH MUSCLE ANTIBODY (ANTI- SMOOTH MUSCLE ANTIBODY)
Present in:
Chronic active hepatitis (>1:80), primary biliary cirrhosis (<1:80),
infectious mononucleosis
------------------------------------------------------------------------
----------------------------
SODIUM (serum)
Increased in:
Excess loss of water...
-Conditions that cause loss via gastrointestinal tract (e.g., in
vomiting), lung (hyperpnea), or skin (e.g., in excessive sweating)
-Conditions that cause diuresis (Diabetes insipidus, Nephrogenic
diabetes insipidus, Diabetes mellitus, Diuretic drugs, Diuretic phase of
acute tubular necrosis, Diuresis following relief of urinary tract
obstruction, Hypercalcemic nephropathy, Hypokalemic nephropathy)
Excess administration of sodium (iatrogenic), e.g., incorrect
replacement following fluid loss.
""Essential"" hypernatremia due to hypothalamic lesions
Decreased in (serum osmolality is decreased):
-Dilutional: (e.g., congestive heart failure, nephrosis, cirrhosis with
ascites)
-Sodium depletion: (Loss of body fluids (e.g., vomiting, diarrhea,
excessive sweating) with incorrect or no therapeutic replacement,
diuretic drugs (e.g., thiazides); Adrenocortical insufficiency; Saltlosing
nephropathy; Inappropriate secretion of antidiuretic hormone)
-Spurious (serum osmolality is normal or increased): (Hyperlipidemia;
Hyperglycemia (serum sodium decreases 3 mEq/L for every increase of
serum glucose of 100 mg/100 ml))
------------------------------------------------------------------------
----------------------------
SUCROSE HEMOLYSIS TEST (sugar water test)
Positive in:
Paroxysmal nocturnal hemoglobinuria (PNH)
False positive: autoimmune hemolytic anemia, megaloblastic anemnas
False negative: may occur with use of heparin or EDTA
------------------------------------------------------------------------
----------------------------
T3 (TRIIODOTHYRONINE)
Decreased in:
Starvation, trauma, surgery, may be an adaptive response to illness,
drugs (PTU)
------------------------------------------------------------------------
----------------------------
T3 RESIN UPTAKE (T3RU)
This test should be used only with a simultaneous measurement of serum
T4 to exclude the possibility that an increased T4 is due to an increase
in T4-binding globulin. Measurement of serum T-3 concentration should
be done by radioimmunoassay for diagnosis of hyperthyroidism
Increased in:
-Hyperthyroidism
-Certain drugs (e.g., testosterone, androgens, anabolic steroids,
prednisone, heparin, Dicumarol, salicylates, Butazolidin, penicillin,
Dilantin)
-Threatened abortion
-Infants (up to about age 2 months)
-Severe nephrosis
-Metastatic neoplasms
Decreased in_
-Hypothyroidism
-Pregnancy (from about tenth week of pregnancy until up to 12th week
postpartum)
-Certain drugs (e.g., estrogens alone or in birth control pills, large
amounts of iodine, propylthiouracil in hyperthyroidism)
Normal in:
-Pregnancy with hyperthyroidism
-Nontoxic goiter
-Carcinoma of thyroid
-Diabetes mellitus
-Addison's disease
-Anxiety
-Certain drugs (mercurials, iodine)
Variable in:
Liver disease
------------------------------------------------------------------------
----------------------------
T4, FREE (free thyroxine)
This determination gives corrected values in patients in whom the total
thyroxine (T-4) is altered on account of changes in serum proteins or in
binding sites. (Pregnancy; Drugs (e.g., androgens, estrogens, birth
control pills, Dilantin); Altered levels of serum proteins (e.g.,
nephrosis))
This is the best single screening test for thyroid dysfunction. It is
paralleled by the free thyroxine factor.
Increased in:
-Hyperthyroidism
-Hypothyroidism treated with thyroxine -Very ill euthyroid patients
(frequently)
Decreased in:
-Hypothyroidism
-Hypothyroidism treated with triiodothyronine
------------------------------------------------------------------------
----------------------------
THROMBIN TIME (TT)
Elevated in:
Thrombolytic and heparin therapy, DIC, hypofibrinogenemia,
dysfibrinogenemia
------------------------------------------------------------------------
----------------------------
THYROID STIMULATING HORMONE (TSH)
Elevated in:
Hypothyroidism, drugs (haloperidol, chlorpromazme, metoclopramide,
domperidone), TSH antibodies, pituitary resistance to thyroid hormone
Decreased in:
Hyperthyroidism, acute medical illness, drugs (dopamine,
corticosteroids, bromocriptine, levodopa, pyridoxine), hyponatremia,
malnutrition
Normal in:
Cushing's syndrome
Acromegaly
Pregnancy at term
------------------------------------------------------------------------
----------------------------
THYROXINE-BINDING GLOBULIN (TBG)
Increased in:
-Pregnancy
-Excess TBG, genetic or idiopathic -Hypothyroidism (sorr-te patients)
-Certain drugs (estrogens, birth control pills)
-Gross iodine contamination
-Acute intermittent porphyria
Decreased in:
-Nephrosis and other causes of marked hypoproteinemia Deficiency of TBG,
genetic or idiopathic
-Certain drugs (androgenic and anabolic steroids)
An increase of TBG is associated with an increase in PBI, BEI, and T-4
by column and a decrease in T-3; converse association for decrease of
TBG.
------------------------------------------------------------------------
----------------------------
THYROXINE (T4)
Increased in:
-Hyperthyroidism
-Pregnancy
-Certain drugs (estrogens, birth control pills, d-thyroxine, thyroid
extract, TSH)
Decreased in:
-Hypothyroidism
-Hypoproteinemia
-Certain drugs (phenytoin sodium [Dilantin], triiodothyronine,
testosterone, ACTH, corticosteroids)
Not affected by:
-Radiopaque substances for x-ray studies -Mercurial diuretics
-Nonthyroidal iodine
------------------------------------------------------------------------
----------------------------
TRANSFERRIN
Elevated in:
Iron deficiency anemia, oral contraceptive administration, viral
hepatitis
Decreased in:
Nephrotic syndrome, liver disease, hereditary deficiency, protein
malnutrition, neoplasms, chronic inflammatory states, chronic illness
thalassemia
------------------------------------------------------------------------
----------------------------
TRIGLYCERIDES
Elevated in:
Hyperlipoproteinemias (Types I, IIb, III, IV, V), hypothyroidism,
pregnancy, estrogens, acute MI, pancreatitis, alcohol intake, nephrotic
syndrome, diabetes mellitus, glycogen storage disease
Decreased in:
Malnutrition, congenital abetalipoproteinemias, drugs (e.g.,
gemfibrozil, nicotinic acid, clofibrate)
------------------------------------------------------------------------
----------------------------
UREA NITROGEN (BUN)
Elevated in:
-Drugs (aminoglycosides and other antibiotics, diuretics, lithium,
corticosteroids), dehydration, gastrointestinal bleeding,
-Decreased renal blood flow (shock, CHF, MI), renal disease
(glomerulonephritis pyelonephritis, diabetic nephropathy), urinary tract
obstruction (prostatic hypertrophy)
Decreased in:
Liver disease, malnutrition, third trimester of pregnancy, overhydration
------------------------------------------------------------------------
----------------------------
URIC ACID (serum)
Elevated in:
Renal failure, gout, excessive cell Iysis (chemotherapeutic agents,
radiation therapy, leukemia, Iymphoma, hemolytic anemia), hereditary
enzyme deficiency (hypoxanthine-guanine-phosphoribosyl transferase)
acidosis, myeloproliferative disorders, diet high in purines or protein
drugs (diuretics, low doses of ASA, ethambutol, nicotinic acid), lead
poisoning, hypothyroidism, Addison's disease, nephrogenic diabetes
insipidus, active psoriasis, polycystic kidneys
Decreased in:
Drugs (allopurinol, high doses of ASA, probenecid, warfarin,
corticosteroid), deficiency of xanthine oxidase, SIADH, renal tubular
deficits (Fanconi's syndrome), alcoholism, liver disease, diet deficient
in protein or purines, Wilson's disease, hemochromatosis
------------------------------------------------------------------------
----------------------------
URINE 5-HYDROXYINDOLE-ACETIC ACID (URINE 5-HIAA)
Elevated in:
Carcinoid tumors, after ingestion of certain foods (bananas, plums,
tomatoes, avocados, pineapples, eggplant, walnuts), drugs (MAO
inhibitors, phenacetin, methyldopa, glycerol guaiacolate,
acetaminophen,salicylates, phenothiazines, imipramine, methocarbamol,
reserpine, metamphetamine)
------------------------------------------------------------------------
----------------------------
URINE AMYLASE
Elevated in:
Pancreatitis, carcinoma of the pancreas
------------------------------------------------------------------------
----------------------------
URINE BILE (BILIRUBIN, URINE)
Abnormal:
Urine bilirubin: Hepatitis (viral, toxic, drug-induced), biliary
obstruction
Urine urobilinogen: Hepatitis (viral, toxic, drug-induced), hemolytic
jaundice, liver cell dysfunction (cirrhosis, infection, metastases)
------------------------------------------------------------------------
----------------------------
URINE CALCIUM
Elevated in:
Primary hyperparathyroidism, hypervitaminosis D, bone metastases
multlple myeloma, increased calcium intake, steroids, prolonged
immobilization, sarcoidosis, Paget's disease, idiopathic hypercalciuria
renal tubular acidosis
Decreased in:
Hypoparathyroidism, pseudohypoparathyroidism, vitamin D deficiency
vitanun D-resistant rickets, diet low in calcium, drugs (thiazide
diuretics, oral contraceptives), familial hypocalciuric hypercalcemia,
renal osteodystrophy
------------------------------------------------------------------------
----------------------------
URINE CATECHOLAMINES
Elevated in:
Pheochromocytoma, neuroblastoma, severe stress
------------------------------------------------------------------------
----------------------------
URINE CHLORIDE
Elevated in:
Corticosteroids, Bartter's syndrome
Decreased in:
Chloride depletion (vomiting, diuretics), colonic villous adenoma
------------------------------------------------------------------------
----------------------------
URINE COPPER
Increased in:
Wilson's disease
------------------------------------------------------------------------
----------------------------
URINE CORTISOL, FREE
Elevated:
Refer to CORTISOL (serum)
------------------------------------------------------------------------
----------------------------
URINE CREATININE (24 hr)
NOTE: Useful test as an indicator of completeness of 24 hr urine
collection.
------------------------------------------------------------------------
----------------------------
URINE GLUCOSE (qualitative)
Present in:
Diabetes mellitus, renal glycosuria (decreased renal threshold for
glucose), glucose intolerance
------------------------------------------------------------------------
----------------------------
URINE HEMOGLOBIN, FREE
Present in:
Hemolysis (with saturation of serum haptoglobin binding capacity and
renal threshold for tubular absorption of hemoglobin)
------------------------------------------------------------------------
----------------------------
URINE HEMOSIDERIN
Present in:
Paroxysmal noctumal hemoglobinuria (PNH), chronic hemolytic anemia,
hemochromatosis
------------------------------------------------------------------------
----------------------------
URINE INDICAN
Present in:
Malabsorption secondary to intestinal bacterial overgrowth
------------------------------------------------------------------------
----------------------------
URINE KETONES (semiquantitative)
Present in:
DKA, alcoholic ketoacidosis, starvation, isopropanol ingestion
------------------------------------------------------------------------
----------------------------
URINE METANEPHRINES
Elevated in:
Pheochromocytoma, neuroblastoma, drugs (caffeine, phenothiazines, MAO
inhibitors), stress
------------------------------------------------------------------------
----------------------------
URINE MYOGLOBIN
Present in:
Severe trauma, hyperthermia, polymyositis/demmatomyositis, carbon
monoxide poisoning
------------------------------------------------------------------------
----------------------------
URINE NITRITE
Present in:
Urinary tract infections
------------------------------------------------------------------------
----------------------------
URINE OCCULT BLOOD
Positive in:
Trauma to urinary tract, renal disease (glomerulonephritis,
pyelonephritis), renal or ureteral calculi, bladder lesions (carcinoma,
cystitis), prostatitis, prostatic carcinoma, menstrual contamination,
hematopoietic disorders (hemophilia, thrombocytopenia), anticoagulants,
ASA
------------------------------------------------------------------------
----------------------------
URINE OSMOLALITY
Elevated in:
SIADH, dehydration, glycosuria, adrenal insufficiency, high-protein diet
Decreased in:
Diabetes insipidus, excessive water intake, IV hydration with D5W acute
renal insufficiency, glomerulonephritis
------------------------------------------------------------------------
----------------------------
URINE pH
Elevated in:
Bacteriuria, vegetarian diet, renal failure with inability to form
ammonia, drugs (antibiotics, sodium bicarbonate, acetazolamide)
Decreased in:
Acidosis (metabolic, respiratory), drugs (ammonium chloride, methenamine
mandelate), diabetes mellitus, starvation, diarrhea
------------------------------------------------------------------------
----------------------------
URINE POTASSIUM
Elevated in:
Aldosteronism (primary, secondary), glucocorticoids, alkalosis, renal
tubular acidosis, excessive dietary potassium intake
Decreased in:
Acute renal failure, potassium-sparing diuretics, diarrhea, hypokalemia
------------------------------------------------------------------------
----------------------------
URINE PROTEIN (quantitative)
Elevated in:
Renal disease (glomerular, tubular, interstitial), CHF, hypertension,
neoplasms of renal pelvis and bladder, multiple myeloma, Waldenstrom's
macroglobulinemia
------------------------------------------------------------------------
----------------------------
URINE SODIUM (quantitative)
Elevated in:
Diuretic administration, high sodium intake, salt-losing nephritis,
acutetubular necrosis, vomiting, CHF, hepatic failure. Addison's
disease, SIADH, hypothyroidism
------------------------------------------------------------------------
----------------------------
URINE SPECIFIC GRAVITY
Elevated in:
Dehydration, excessive fluid losses (vomiting, diarrhea, fever) x-ray
contrast media, diabetes mellitus, CHF, SIADH, adrenal insufficiency,
Decreased fluid intake
Decreased in:
Diabetes insipidus, renal disease (glomerulonephritis, pyelonephritis),
excessive fluid intake or IV hydration
------------------------------------------------------------------------
----------------------------
URINE VANILLYLMANDELIC ACID (VMA)
Elevated in:
Pheochromocytoma, neuroblastoma, ganglioblastoma, drugs (isoproterenol,
methocarbamol, levodopa, sulfonamides, chlorpromazine), severe stress,
after ingestion of bananas, chocolate, vanilla, tea, coffee
Decreased in:
Drugs (MAO inhibitors, reserpine, guanethidine, methyldopa)
------------------------------------------------------------------------
----------------------------
VDRL
Positive test:
Syphilis, other treponemal diseases (yaws, pinta, bejel)
NOTE: A false-positive test may be seen in patients with SLE and other
autoimmune diseases, infectious mononucleosis, atypical pneumonia,
malaria, leprosy.
------------------------------------------------------------------------
----------------------------
VISCOSITY
Elevated in:
Monoclonal gammopathies (Waldenstrom's macroglobulinemia, multiple
myeloma), hyperfibrinogenemia, SLE, rheumatoid arthritis, polycythemia,
leukemia
------------------------------------------------------------------------
----------------------------
y-GLUTAMYL TRANSFERASE (GGT; GAMMA-GLUTAMYL TRANSFERASE )
Elevated in:
Chronic alcoholic liver disease, neoplasms (hepatoma, metastatic disease
to the liver, carcinoma of the pancreas), SLE, CHF, trauma, nephrotic
syndrome, sepsis, cholestasis. drugs (phenytoin, barbiturates)
|
| M.A.S
Forum Senior
Topics: 28
Posts: 56
|
W O N D E R F U L
Thank you very much my friend!
|
| Mleian
Forum Junior
Topics: 7
Posts: 36
|
u r welcome MAS.!
Mleian
|
| helpful
Forum Junior
Topics: 4
Posts: 49
|
where did you get all this Mleian? Where are you from Pakistan.?
|
| Mleian
Forum Junior
Topics: 7
Posts: 36
|
yup helpful....am from Karachi, Pakistan.....
in 5th year MBBS...( last year of Med school)...plan to give step 2 first... in March/April 2005....
and oh....! i don't remember exactly where i got it from :?: ..but it was surely a website :P
cheers
Mleian
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