Archer #1: Lab Values

CBC

• HgB

• Hct

• RBCs

• WBCs

• Platelets

Hemoglobin (HgB)

• protein in RBCs

• transports O2

• acts as the “uber”

• the higher the HgB, the more the body is able to transport

Hematocrit (HcT)

• ratio or the percentage of blood cells in body that are RBCs

• RBCs / blood cells

• the higher the %, the more the body is able to transport O2

• dehydration causes increased % = more concentrated

• bleeding = decreased HcT (anemia; hemorrhage)

WBCs

• fights infection

• decreased number = immunosuppression

• increased number = infection

Platelets

• clotting; stop bleeding

• “to achieve homeostasis”

• increased = too much clots = thrombus / DVT to cut off O2 supply

• decreased = bleeding risk

HgB values

• Females: 12-16

• Males: 14-18

HcT

• F: 37-47%

• M: 42-52%

RBCs

• 4.6 to 5.5

WBCs

• 5 - 10

Platelets

• 150 - 400

Coagulation Panel

• Partial thromboplastin time (PTT)

• prothrombin time (PT)

• international normalized ration (INR)

partial thromboplastin time (PTT)

• tests the intrinsic coagulation cascade to see how long that clot takes to form

• used for heparin

PTT normal

• 20-30 seconds

heparin therapeutic aPTT

• 1.5 - 2.5 x normal

• heparin slows clotting

Prothrombin time (PT)

• tests the extrinsic coagulation cascade

  • used for warfarin

PT normal value

• 10-12 seconds

international normalized ratio (INR)

• calculated from a PT and used to monitor how well warfarin is working

INR normal

• 0.9 - 1.2

INR for warfarin

2-3

Na

135-145

K

3.5 to 5

Calcium

9-10.5

Mg

1.5 - 2.5

Cl

98 -106

Phosphorus

2.5 to 4.5

Glucose

70 - 110

Renal Labs

• Glomerular Filtration Rate (GFR)

• Blood urea nitrogen (BUN)

• Creatinine (CR)

glomerular filtration rate

• filters the blood

• rate of the filtration in the glomerulus

• decreased rate = increased waste products (BUN/creatinine)

GFR normal

> 90

Blood urea nitrogen (BUN)

• urea from protein

• broken into ammonia → urea

• toxic waste = neuro changes

BUN normal

10-20

creatinine

• muscles

• toxic waste product = neuro changes

Creatinine normal

0.6 to 1.2

liver function test

• excreted by liver

  • bilirubin

  • ammonia

• made by liver

  • ALP

  • AST

  • ALT

  • total protein

  • albumin

Bilirubin

• waste product from RBC broken down A

ammonia

• increased = liver dysfunction

Goes up when there’s a problem

• ALP

• AST

• ALT

Goes down when there’s a problem

• Total protein

• Albumin

Albumin

• holds water in our veins in the intravascular space to keep BP up and to perfuse properly

• decreased = decreased BP, ascites, and 3rd spacing out: water leaks out

albumin normal

• 3.5 to 5

cardiac labs

• troponin

• BNP

• creatinine phosphokinase (CPK)

• cardiac cell isoenzyme (CPK-MB)

• Myoglobin

troponin

• proteins found in skeletal and cardiac muscle fibers

• regulates muscular contraction

• measures the level of cardiac-specific troponin in blood to detect heart injury

troponin normal

0 to 0.4

BNP

• fluid retention = heart senses the need to pump harder to move fluid forward and releases BNP

• tests for CHF

BNP normal

• <100

creatinine phosphokinase (CPK)

• enzyme

• generates for energy

• elevated = tissue damage

cardiac cell isoenzyme (CPK-MB)

• elevated = damage of the heart muscle = heart attack

myoglobin

• protein

• skeletal and heart muscles

• damage = increased myoglobin

lipid panel

• fatty deposits living in our blood vessels

  • total cholesterol

    • high density lipoproteins

    • low density lipoproteins

  • triglycerides

total cholesterol normal

<200

high density lipoproteins (HDL)

• “heroes should be high”

• >55

low density lipoproteins (LDL)

• lousy ones should be low

• <130

triglycerides

• also LDLs

• <160

HDL and LDL analogy

Pacman

• LDL are the dots because they are taking up space in the vessels (fatty deposits)

• HDL are the pacmans by preventing buildup

thyroid panel

• energy and metabolism

• TSH (thyroid stimulating hormone)

• T4

• T3

hypothyroidism

• Low T3 and T4 causes the release of TSH to make more

• Elevated TSH

hyperthyroidism

• low TSH

• Elevated T3 and T4

Thyroid Diagram

• Hypothalamus → TRH → Pituitary Gland → TSH → Thyroid gland → T3/T4

• T3/T4 sends signal to pituitary gland to either increase/decrease TSH if needed

Hemoglobin A1c (HgA1c)

• glucose attached to HgB

• O2 carrying capacity is decreased because of an extra “passenger”

nondiabetic HgA1c

• 4-5.6%

Pre-diabetes HgA1c

• 5.7 - 6.4%

Diabetic HgA1c

• >6.5%

target level for diabetics HgA1c

• <7%

D-dimer

clotting

CRP and ESR

inflammation

urine studies

• specific gravity

• osmolarity

• albumin

• WBC

• protein

• glucose

• ketones

specific gravity

• 1.005 to 1.030

• measures the concentration

• increased = dehydration

• decreased = dilute

osmolarity

• 300 - 900

• measures the concentration

• increased = dehydration

• decreased = dilute

albumin

• 50-80

  • kidney disease

WBC

• 0 - 4

• inflammation or UTI

protein

• negative

• KD and preeclampsia

glucose

• negative

  • diabetes and KD

ketones

• negative

• diabetes and KD