Basic Lab Assessment

BMP fishbone layout

Top row (read left→right, top → bottom):

Na⁺ —> K⁺ —> CI⁻ —> HCO₃⁻ —> BUN —> SCr -> Glucose

BMP lab interpretation, Hypernatremia: What does it mean?

Hyper: a lot,

nat: sodium,

emia: blood condition

↑Increase in sodium levels

BMP lab interpretation, Hypernatremia: Causes of low/high levels

Water loss (dehydration, diarrhea)

BMP lab interpretation, Hyponatremia: What does it mean?

Hypo: less,

nat: sodium,

emia: blood condition

↓Decrease in sodium levels

BMP lab interpretation, Hyponatremia: Causes of low/high levels

Diuretics, Water loss, Water overload

BMP lab interpretation, Hyperkalemia: What does it mean?

Hyper: a lot,

kal: potassium,

emia: blood condition

↑Increase in potassium levels

BMP lab interpretation, Hyperkalemia: Causes of low/high levels

ACE inhibitors, ARBs, aldosterone antagonist (spironolactone = potassium sparing), kidney dysfunction

BMP lab interpretation, Hypokalemia: What does it mean?

Hypo: less,

kal: potassium,

emia: blood condition

↓Decrease in potassium levels

BMP lab interpretation, Hypokalemia: Causes of low/high levels

Diuretics, GI loss

BMP lab interpretation, Hyperchloremia: What does it mean?

Hyper: a lot,

Chlor: chloride,

emia: blood condition

↑Increase in Chloride levels

BMP lab interpretation, Hypochloremia: What does it mean?

Hypo: less,

Chlor: chloride,

emia: blood condition

↓Decrease in chloride levels

BMP lab interpretation, Metabolic Alkalosis : What does it mean?

↑Increase in bicarbonate levels

BMP lab interpretation, Metabolic Alkalosis : Causes of low/high levels

more bicarbonate: (HCO3-) a base → LESS Acidic

BMP lab interpretation, Metabolic Acidosis : What does it mean?

↓Decrease in bicarbonate levels

BMP lab interpretation, Metabolic Acidosis : Causes of low/high levels

less bicarbonate means that more H+ ions in the blood, less base → MORE ACIDIC

BMP lab interpretation, High BUN: Causes of low/high levels

Kidney failure (kidney is not filtering out properly → more urea in bloodstream)

BMP lab interpretation, Low BUN: Causes of low/high levels

Malnutrition/liver disease (less good food intake → less break down of protein from diet in liver)

BMP lab interpretation, High SCr (serum creatinine): What does it mean?

Kidney is not filtering out properly

BMP lab interpretation, High SCr (serum creatinine): Causes of low/high levels

Kidney dysfunction; creatinine amount can also be affected by: age, weight, muscle mass, inactivity/paralysis

BMP lab interpretation, Hyperglyemia: What does it mean?

Hyper: a lot,

gly: glucose,

emia: blood condition

↑Increase in glucose levels

BMP lab interpretation, Hyperglyemia: Causes of low/high levels

Diabetes mellitus

BMP lab interpretation, Hypoglyemia: What does it mean?

Hypo: less,

gly: glucose,

emia: blood condition

↓Decrease in glucose levels

BMP lab interpretation, Hypoglyemia: Causes of low/high levels

Insulin, anti-diabetic agents (ex. metformin)

BMP lab interpretation, Hypercalcemia: What does it mean?

Hyper: a lot,

cal: calcium,

emia: blood condition

↑Increase in calcium levels

BMP lab interpretation, Hypercalcemia: Causes of low/high levels

Vitamin D, Calcium supplements

BMP lab interpretation, Hypocalcemia: What does it mean?

Hypo: less,

cal: calcium,

emia: blood condition

↓Decrease in calcium levels

BMP lab interpretation, Hypocalcemia: Causes of low/high levels

Biphosphonates (ex. Alendronate → prevents bones from breaking → less bone reabsorption → less calcium in blood

stream)

Core RBC/WBC/Hgb/Hct part: WBC

White blood cells

Core RBC/WBC/Hgb/Hct part: RBC

Red blood cells

Core RBC/WBC/Hgb/Hct part: Hemoglobin (Hgb)

O-carrying compound on RBCs

Core RBC/WBC/Hgb/Hct part: Hematocrit (Hct)

volume of blood in RBCs

RBC indices-assess type of anemia, MCV:

volume/size of RBC

RBC indices-assess type of anemia, MCH:

Hgb content of RBC

RBC indices-assess type of anemia, MCHC:

Hgb concentration per RBC

RBC indices-assess type of anemia, RDW:

variations in RBC size

Platelets:

Produces blood clots, Produced in bone marrow

CBC fishbone

WBC->Hgb->Hct->Plt

CBC lab interpretation, Leukocytosis: What does it mean?

Leuko: white,

cyt: cell,

osis: abnormal increase

↑Increase in WBC levels

CBC lab interpretation, Leukocytosis: Causes of low/high levels

Steroids (suppress immune system → neutrophils/WBC

move from walls of blood vessels to blood stream → INCREASES amount of WBC in bloodstream, bacterial

infection (depending on the bug, WBC can increase to fight infection)

CBC lab interpretation, Leukopenia: What does it mean?

Leuko: white,

penia: abnormal decrease

↓Decrease in WBC levels

CBC lab interpretation, Leukopenia: Causes of low/high levels

Chemotherapy (actively killing dividing cells),

bacterial infection (depending on the bug such as severe infection, WBC can be used up more and not keep up with replacing WBC)

CBC lab interpretation, Anemia: What does it mean?

↓Decrease in hemoglobin (Hgb) levels

CBC lab interpretation, Anemia: Causes of low/high levels

Antiplatelets, Anticoagulants

CBC lab interpretation, Thrombocytosis: What does it mean?

Thrombo: clot,

cyt: cell,

osis: abnormal increase

↑Increase in platelet levels

CBC lab interpretation, Thrombocytosis: Causes of low/high levels

Bleeding

CBC lab interpretation, Thrombocytopenia: What does it mean?

Thrombo: clot,

cyt: cell,

penia: abnormal decrease

↓Decrease in platelet levels

CBC lab interpretation, Thrombocytopenia: Causes of low/high levels

Heparin (reduces blood clot→ platelets DECREASE)

CBC lab interpretation, Hyperalbuminemia: What does it mean?

Hyper: a lot,

albumin: protein produced in live,

emia: blood condition

↑Increase in albumin levels

CBC lab interpretation, Hyperalbuminemia: Causes of low/high levels

Dehydration (less water intake → less blood VOLUME → higher CONCENTRATION of albumin)

CBC lab interpretation, Hypoalbuminemia: What does it mean?

Hypo: less,

albumin: protein produced in live,

emia: blood condition

↓Decrease in albumin levels

CBC lab interpretation, Hypoalbuminemia: Causes of low/high levels

Cirrhosis (liver damage)

Na+

extracellular fluid + osmolality

K+

intracellular + cardiac/muscle

HCO₃⁻

metabolic acid-base (metabolic component of acid-base balance)

BUN/SCr

kidney function markers (kidney function biomarker)

-High BUN / High SCr → kidney dysfunction pattern

-Low BUN → malnutrition/cirrhosis pattern