Clinical Chemistry Analytes Reference Values (Bishop 9th Edition)

Flashcards covering clinical chemistry reference values, SI units, conversion factors, and specimen requirements based on Bishop 9th Edition.

17-Ketosteroids

Urine ($\text{U}$) reference values: males $10 - 20\,\text{mg/24h}$, females $5 - 15\,\text{mg/24h}$.

5-NT (5'-Nucleotidase)

Serum or plasma ($\text{S/P}$) reference value: $3 - 9\,\text{U/L}$.

AFP (α-Fetoprotein)

Serum or plasma ($\text{S/P}$) reference value: $< 10\,\text{ng/mL}$ ($1 \times 10^5$ in SI units).

Albumin

Adult reference values: serum/plasma ($\text{S/P}$) is $3.5 - 5.5\,\text{g/dL}$ ($35 - 55\,\text{g/L}$, conversion factor $10$); CSF is $0 - 35\,\text{mg/dL}$.

Anion Gap

Calculated reference intervals: $\text{AG} = \text{Na} - (\text{Cl} + \text{HCO}_3)$ is $7 - 16\,\text{mmol/L}$; $\text{AG} = (\text{Na} + \text{K}) - (\text{Cl} + \text{HCO}_3)$ is $10 - 20\,\text{mmol/L}$.

Bilirubin (Direct vs. Indirect)

Serum or plasma ($\text{S/P}$) values: Direct (conjugated) is $0.0 - 0.2\,\text{mg/dL}$ ($0 - 3.42\,\mu\text{mol/L}$); Indirect (unconjugated) is $0.2 - 0.8\,\text{mg/dL}$ ($3.42 - 13.68\,\mu\text{mol/L}$) with a conversion factor of $17.1$.

Bilirubin (Total, Adult)

Adult serum or plasma ($\text{S/P}$) reference value: $0.2 - 2.1\,\text{mg/dL}$ ($3.42 - 35.91\,\mu\text{mol/L}$, conversion factor $17.1$).

BNP (B-Type Natriuretic Peptide)

Serum or plasma ($\text{S/P}$) reference limits: males $\le 100\,\text{pg/mL}$, females $\le 150\,\text{pg/mL}$.

Calcium (Ionized)

Adult reference intervals: serum ($\text{S}$) $4.6 - 5.3\,\text{mg/dL}$ ($1.15 - 1.33\,\text{mmol/L}$); whole blood ($\text{WB}$) $4.6 - 5.1\,\text{mg/dL}$ ($1.15 - 1.27\,\text{mmol/L}$); conversion factor $0.25$.

Calcium (Total)

Serum ($\text{S}$) reference intervals: children $8.5 - 10.5\,\text{mg/dL}$ ($2.13 - 2.63\,\text{mmol/L}$); adults $9.0 - 10.1\,\text{mg/dL}$ ($2.24 - 2.53\,\text{mmol/L}$); conversion factor $0.25$.

Chloride

Adult reference values: serum/plasma ($\text{S/P}$) $98 - 107\,\text{mEq/L}$ ($98 - 107\,\text{mmol/L}$, conversion factor $1$); 24-hour urine $110 - 250\,\text{mmol/24h}$ or $35 - 285\,\text{mmol/24h}$.

Cholesterol (Total)

Adult serum/plasma ($\text{S/P}$) reference value: $140 - 200\,\text{mg/dL}$ ($3.6 - 5.2\,\text{mmol/L}$, conversion factor $0.026$).

Cortisol (Total)

Serum ($\text{S}$) diurnal reference ranges: AM is $7 - 25\,\mu\text{g/dL}$ ($193 - 690\,\text{nmol/L}$); PM is $2 - 14\,\mu\text{g/dL}$ ($55 - 386\,\text{nmol/L}$); conversion factor $27.59$.

Creatinine

Adult serum ($\text{S}$) reference ranges: males $0.9 - 1.3\,\text{mg/dL}$ ($80 - 115\,\mu\text{mol/L}$) by Jaffe, $0.6 - 1.1\,\text{mg/dL}$ ($53 - 97\,\mu\text{mol/L}$) by Enzymatic; females $0.6 - 1.1\,\text{mg/dL}$ ($53 - 97\,\mu\text{mol/L}$) by Jaffe, $0.5 - 0.8\,\text{mg/dL}$ ($44 - 71\,\mu\text{mol/L}$) by Enzymatic; conversion factor $88.4$.

Glucose

Reference values: fasting serum/plasma/whole blood ($\text{S/P/B}$) is $70 - 100\,\text{mg/dL}$ ($3.9 - 5.5\,\text{mmol/L}$, conversion factor $0.0555$); CSF is $60\% - 70\%$ of blood glucose; synovial fluid is $< 10\,\text{mg/dL}$.

Glucose Tolerance (2-h PG)

Serum ($\text{S}$) reference cutoff at 2 hours post-load: $\le 140\,\text{mg/dL}$ ($\le 7.8\,\text{mmol/L}$).

Lactate

Adult plasma/whole blood ($\text{P/WB}$) is $2.7 - 18\,\text{mg/dL}$ ($0.3 - 2.0\,\text{mmol/L}$, conversion factor $0.1110$); arterial blood ($\text{AB}$) is $2.7 - 13.5\,\text{mg/dL}$ ($0.3 - 1.6\,\text{mmol/L}$); synovial fluid is $< 25\,\text{mg/dL}$.

Osmolality

Reference ranges: serum ($\text{S}$) $275 - 295\,\text{mOsm/kg}$; 24-hour urine $300 - 900\,\text{mOsm/kg}$; random urine $50 - 1200\,\text{mOsm/kg}$; urine-to-serum ($\text{U/S}$) ratio $1.0 - 3.0$.

Osmolal Gap

Reference value: $5 - 10\,\text{mOsm/kg}$.

Blood Gas Parameters (pH, pCO2, pO2)

Whole blood ($\text{WB}$) reference ranges: pH $7.35 - 7.45$; $p\text{CO}_2$ $35 - 45\,\text{mmHg}$; $p\text{O}_2$ $85 - 105\,\text{mmol/L}$.

Potassium

Reference values: adult serum/plasma ($\text{S/P}$) $3.5 - 5.1\,\text{mmol/L}$; 24-hour urine $33 - 86\,\text{mmol/L/24h}$ or $15 - 105\,\text{mmol/L/24h}$.

Sodium

Reference values: adult serum/plasma ($\text{S/P}$) $135 - 145\,\text{mmol/L}$; 24-hour urine $120 - 240\,\text{mmol/L/d}$; CSF $136 - 150\,\text{mmol/L}$.

Protein (Total)

Reference ranges: adult serum/plasma ($\text{S/P}$) $6.5 - 8.3\,\text{g/dL}$ ($65 - 83\,\text{g/L}$, conversion factor $10$); adult CSF ($> 1\,\text{mo}$) $14 - 45\,\text{mg/dL}$ ($140 - 450\,\text{g/L}$ equivalent notation); adult 24-hour urine $< 150\,\text{mg/24h}$.

Serum Protein Electrophoresis (SPE) Fractions

Serum percentages: Albumin $53 - 65\%$, Alpha 1 Globulin $2.5 - 5.0\%$, Alpha 2 Globulin $7.0 - 13.0\%$, Beta Globulin $8.0 - 14.0\%$, Gamma Globulin $12.0 - 22.0\%$.

Troponin

Serum or plasma ($\text{S/P}$) upper reference limits: males $< 15\,\text{ng/L}$, females $< 10\,\text{ng/L}$.

Urea Nitrogen (Blood / BUN)

Reference intervals: adult serum/plasma ($\text{S/P}$) $6 - 20\,\text{mg/dL}$ ($2.1 - 7.1\,\text{mmol/L}$, conversion factor $0.357$); 24-hour urine $12 - 20\,\text{mg/dL}$ ($0.43 - 0.71\,\text{mol urea/d}$).

Uric Acid (Blood)

Serum/plasma ($\text{S/P}$) values (conversion factor $0.0595$): males $3.5 - 7.2\,\text{mg/dL}$ ($0.21 - 0.43\,\text{mmol/L}$); females $2.6 - 6.0\,\text{mg/dL}$ ($0.16 - 0.36\,\text{mmol/L}$); children $2.0 - 5.5\,\text{mg/dL}$ ($0.12 - 0.33\,\text{mmol/L}$).

Thyroid Stimulating Hormone (TSH)

Serum reference interval: $0.3 - 4.2\,\text{mIU/L}$.

AFP (α-Fetoprotein)

Serum or plasma ($\text{S/P}$) reference value: $< 10\,\text{ng/mL}$ ($1 \times 10^5$ in SI units).

Albumin

Adult reference values: serum/plasma ($\text{S/P}$) is $3.5 - 5.5\,\text{g/dL}$ ($35 - 55\,\text{g/L}$, conversion factor $10$); CSF is $0 - 35\,\text{mg/dL}$.

ALP (Alkaline Phosphatase)

Serum or plasma ($\text{S/P}$) reference intervals: children $54 - 369\,\text{U/L}$; adult males $53 - 128\,\text{U/L}$ ($< 50\,\text{yr}$) and $56 - 119\,\text{U/L}$ ($\ge 60\,\text{yr}$); adult females $42 - 98\,\text{U/L}$ ($< 50\,\text{yr}$) and $53 - 141\,\text{U/L}$ ($\ge 60\,\text{yr}$).

ALT / SGPT (Alanine Aminotransferase)

Serum or plasma ($\text{S/P}$) reference values: males $7 - 55\,\text{U/L}$, females/adults $7 - 45\,\text{U/L}$.

Ammonia

Reference ranges: adult plasma ($\text{P}$) $19 - 60\,\mu\text{g/dL}$ ($11 - 35\,\mu\text{mol/L}$, conversion factor $0.587$); 24-hour urine $140 - 1500\,\text{mg N/d}$ ($10 - 107\,\text{mmol N/d}$).

Amylase

Reference values: adult serum or plasma ($\text{S/P}$) $30 - 220\,\text{U/L}$; urine $6.5 - 48.1\,\text{U/h}$.

Anion Gap

Calculated reference intervals: $\text{AG} = \text{Na} - (\text{Cl} + \text{HCO}<em>3)$ is $7 - 16\,\text{mmol/L}$; $\text{AG} = (\text{Na} + \text{K}) - (\text{Cl} + \text{HCO}</em>3)$ is $10 - 20\,\text{mmol/L}$.

AST / SGOT (Aspartate Aminotransferase)

Serum or plasma ($\text{S/P}$) reference intervals: males $5 - 35\,\text{U/L}$, females $12 - 38\,\text{U/L}$.

Bicarbonate

Reference values: serum or plasma ($\text{S/P}$) $22 - 29\,\text{mmol/L}$; whole blood ($\text{WB}$) $22 - 26\,\text{mEq/L}$ ($22 - 26\,\text{mmol/L}$).

Bilirubin (Total, Adult)

Adult serum or plasma ($\text{S/P}$) reference value: $0.2 - 2.1\,\text{mg/dL}$ ($3.42 - 35.91\,\mu\text{mol/L}$, conversion factor $17.1$).

Calcium (Ionized)

Adult reference intervals: serum ($\text{S}$) $4.6 - 5.3\,\text{mg/dL}$ ($1.15 - 1.33\,\text{mmol/L}$); whole blood ($\text{WB}$) $4.6 - 5.1\,\text{mg/dL}$ ($1.15 - 1.27\,\text{mmol/L}$); conversion factor $0.25$.

Chloride

Adult reference values: serum/plasma ($\text{S/P}$) $98 - 107\,\text{mEq/L}$ ($98 - 107\,\text{mmol/L}$, conversion factor $1$); 24-hour urine $110 - 250\,\text{mmol/24h}$ or $35 - 285\,\text{mmol/24h}$.

Cholesterol (Total)

Adult serum/plasma ($\text{S/P}$) reference value: $140 - 200\,\text{mg/dL}$ ($3.6 - 5.2\,\text{mmol/L}$, conversion factor $0.026$).

CK (Creatine Kinase, Total and MB)

Serum or plasma ($\text{S/P}$) reference intervals: CK-Total for males $46 - 171\,\text{U/L}$, females $34 - 145\,\text{U/L}$; CK-MB for adults $< 5\,\text{ng/mL}$.

Cortisol (Total)

Serum ($\text{S}$) diurnal reference ranges: AM is $7 - 25\,\mu\text{g/dL}$ ($193 - 690\,\text{nmol/L}$); PM is $2 - 14\,\mu\text{g/dL}$ ($55 - 386\,\text{nmol/L}$); conversion factor $27.59$.

Creatinine

Adult serum ($\text{S}$) reference ranges: males $0.9 - 1.3\,\text{mg/dL}$ ($80 - 115\,\mu\text{mol/L}$) by Jaffe, $0.6 - 1.1\,\text{mg/dL}$ ($53 - 97\,\mu\text{mol/L}$) by Enzymatic; females $0.6 - 1.1\,\text{mg/dL}$ ($53 - 97\,\mu\text{mol/L}$) by Jaffe, $0.5 - 0.8\,\text{mg/dL}$ ($44 - 71\,\mu\text{mol/L}$) by Enzymatic; conversion factor $88.4$.

Digoxin (Therapeutic)

Serum ($\text{S}$) therapeutic monitoring range: $0.8 - 2.0\,\text{ng/mL}$.

Ferritin

Serum ($\text{S}$) reference intervals: males $24 - 336\,\mu\text{g/L}$, females $11 - 307\,\mu\text{g/L}$ (conversion factor $1$).

Glucose

Reference values: fasting serum/plasma/whole blood ($\text{S/P/B}$) is $70 - 100\,\text{mg/dL}$ ($3.9 - 5.5\,\text{mmol/L}$, conversion factor $0.0555$); CSF is $60\% - 70\%$ of blood glucose; synovial fluid is $< 10\,\text{mg/dL}$.

Glucose Tolerance (2-h PG)

Serum ($\text{S}$) reference cutoff at 2 hours post-load: $\le 140\,\text{mg/dL}$ ($\le 7.8\,\text{mmol/L}$).

HbA1c (Glycated Hemoglobin)

Adult whole blood ($\text{WB}$) reference range: $4.0 - 5.7\%$.

HDL and LDL Cholesterol

Adult serum or plasma ($\text{S/P}$) reference intervals: HDL-C is $40 - 75\,\text{mg/dL}$ ($1.0 - 2.0\,\text{mmol/L}$); LDL-C is $50 - 130\,\text{mg/dL}$ ($1.3 - 3.4\,\text{mmol/L}$).

Iron and TIBC

Serum ($\text{S}$) reference values: total iron for males is $50 - 150\,\mu\text{g/dL}$, females is $35 - 145\,\mu\text{g/dL}$; TIBC for adults is $250 - 400\,\mu\text{g/dL}$.

Lactate

Adult plasma/whole blood ($\text{P/WB}$) is $2.7 - 18\,\text{mg/dL}$ ($0.3 - 2.0\,\text{mmol/L}$, conversion factor $0.1110$); arterial blood ($\text{AB}$) is $2.7 - 13.5\,\text{mg/dL}$ ($0.3 - 1.6\,\text{mmol/L}$); synovial fluid is $< 25\,\text{mg/dL}$.

Lipase

Adult serum ($\text{S}$) reference limit: $< 38\,\text{U/L}$.

Lithium (Therapeutic)

Serum ($\text{S}$) therapeutic monitoring interval: $0.5 - 1.2\,\text{mmol/L}$.

Magnesium

Adult serum ($\text{S}$) reference interval: $1.7 - 2.4\,\text{mg/dL}$ ($0.69 - 1.07\,\text{mmol/L}$, conversion factor $0.4114$).

Osmolality

Reference ranges: serum ($\text{S}$) $275 - 295\,\text{mOsm/kg}$; 24-hour urine $300 - 900\,\text{mOsm/kg}$; random urine $50 - 1200\,\text{mOsm/kg}$; urine-to-serum ($\text{U/S}$) ratio $1.0 - 3.0$.

Osmolal Gap

Reference value: $5 - 10\,\text{mOsm/kg}$.

Blood Gas Parameters (pH, pCO2, pO2)

Whole blood ($\text{WB}$) reference ranges: pH $7.35 - 7.45$; $p\text{CO}<em>2$ $35 - 45\,\text{mmHg}$; $p\text{O}</em>2$ $85 - 105\,\text{mmol/L}$.

Phenytoin (Therapeutic Free vs. Total)

Serum ($\text{S}$) therapeutic target ranges: Free phenytoin is $1.0 - 2.0\,\mu\text{g/mL}$; Total phenytoin is $10.0 - 20.0\,\mu\text{g/mL}$.

Phosphorus (Inorganic)

Reference ranges: adult serum/plasma ($\text{S/P}$) $2.5 - 4.5\,\text{mg/dL}$ ($0.81 - 1.45\,\text{mmol/L}$, conversion factor $0.3229$); neonatal serum/plasma $4.5 - 9.0\,\text{mg/dL}$ ($1.45 - 2.91\,\text{mmol/L}$); 24-hour urine $0.4 - 1.3\,\text{g/dL}$ ($13 - 42\,\text{mmol/dL}$).

Potassium

Reference values: adult serum/plasma ($\text{S/P}$) $3.5 - 5.1\,\text{mmol/L}$; 24-hour urine $33 - 86\,\text{mmol/L/24h}$ or $15 - 105\,\text{mmol/L/24h}$.

Prealbumin

Adult serum ($\text{S}$) reference interval: $17 - 34\,\text{mg/dL}$ ($0.1 - 0.4\,\text{g/L}$).

Protein (Total)

Reference ranges: adult serum/plasma ($\text{S/P}$) $6.5 - 8.3\,\text{g/dL}$ ($65 - 83\,\text{g/L}$, conversion factor $10$); adult CSF ($> 1\,\text{mo}$) $14 - 45\,\text{mg/dL}$ ($140 - 450\,\text{g/L}$ equivalent notation); adult 24-hour urine $< 150\,\text{mg/24h}$.

Serum Protein Electrophoresis (SPE) Fractions

Serum percentages: Albumin $53 - 65\%$, Alpha 1 Globulin $2.5 - 5.0\%$, Alpha 2 Globulin $7.0 - 13.0\%$, Beta Globulin $8.0 - 14.0\%$, Gamma Globulin $12.0 - 22.0\%$.

Sodium

Reference values: adult serum/plasma ($\text{S/P}$) $135 - 145\,\text{mmol/L}$; 24-hour urine $120 - 240\,\text{mmol/L/d}$; CSF $136 - 150\,\text{mmol/L}$.

Thyroid Stimulating Hormone (TSH)

Serum reference interval: $0.3 - 4.2\,\text{mIU/L}$.

Triglycerides

Adult serum or plasma ($\text{S/P}$) reference interval: $60 - 150\,\text{mg/dL}$ ($0.7 - 1.7\,\text{mmol/L}$, conversion factor $0.0113$).

Troponin

Serum or plasma ($\text{S/P}$) upper reference limits: males $< 15\,\text{ng/L}$, females $< 10\,\text{ng/L}$.

Urea Nitrogen (Blood / BUN)

Reference intervals: adult serum/plasma ($\text{S/P}$) $6 - 20\,\text{mg/dL}$ ($2.1 - 7.1\,\text{mmol/L}$, conversion factor $0.357$); 24-hour urine $12 - 20\,\text{mg/dL}$ ($0.43 - 0.71\,\text{mol urea/d}$).

Uric Acid (Blood)

Serum/plasma ($\text{S/P}$) values (conversion factor $0.0595$): males $3.5 - 7.2\,\text{mg/dL}$ ($0.21 - 0.43\,\text{mmol/L}$); females $2.6 - 6.0\,\text{mg/dL}$ ($0.16 - 0.36\,\text{mmol/L}$); children $2.0 - 5.5\,\text{mg/dL}$ ($0.12 - 0.33\,\text{mmol/L}$).

Vancomycin (Therapeutic)

Serum ($\text{S}$) therapeutic monitoring intervals: Trough is $10 - 20\,\mu\text{g/mL}$; Peak is $20 - 40\,\mu\text{g/mL}$.

Vitamin B12

Adult serum ($\text{S}$) reference interval: $180 - 914\,\text{ng/L}$.