Endocrine and Coagulation Labs

Thyroid Hormone Levels

• TSH (Thyroid Stimulating Hormone):
  • Normal Range: 0.4-4.2 \mu U/mL
  • Low TSH indicates Hyperthyroidism.
  • High TSH indicates Hypothyroidism.
• T3 (Triiodothyronine):
  • Normal Range: 80-200 ng/dL
  • High T3 indicates Hyperthyroidism.
  • Low T3 indicates Hypothyroidism.
• T4 (Free Thyroxine):

Adrenal Hormone Levels

• ACTH (Adrenocorticotropic Hormone):
  • Normal Range: 10-60 pg/mL
  • High ACTH indicates Cushing's disease.
  • Low ACTH indicates Addison's disease.
• Cortisol (AM):
  • Normal Range: 6-23 mcg/dL
  • High Cortisol indicates Cushing's.
  • Low Cortisol indicates Addison's.

Pituitary/ADH Disorders

• Serum Na+ (Sodium):
  • Normal Range: 135-145 mEq/L
  • In SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion): Low Serum Na+.
  • In DI (Diabetes Insipidus): High Serum Na+.
• Urine Osmolality:
  • Normal Range: 300-900 mOsm/kg
  • In SIADH: High Urine Osmolality.
  • In DI: Low Urine Osmolality.
• Serum Osmolality:
  • Normal Range: 275-295 mOsm/kg
  • In SIADH: Low Serum Osmolality.
  • In DI: High Serum Osmolality.
• Urine Specific Gravity:
  • Normal Range: 1.005-1.030
  • In SIADH: High Urine Specific Gravity (>1.030), concentrated urine.
  • In DI: Low Urine Specific Gravity (<1.005), diluted urine.
• Summary of SIADH vs. DI:
  • SIADH: Low serum Na+, concentrated urine.
  • DI: High serum Na+, diluted urine.

Coagulation (Disseminated Intravascular Coagulation - DIC)

• Platelets:
  • Normal Range: 150,000-400,000/mm^3
  • In DIC: Decreased (Thrombocytopenia).
• PT (Prothrombin Time):
  • Normal Range: 11-13.5 sec
  • In DIC: Increased.
• INR (International Normalized Ratio):
  • Normal Range: 0.8-1.1 (Warfarin goal 2-3).
  • In DIC: Increased.
• aPTT (Activated Partial Thromboplastin Time):
  • Normal Range: 25-35 sec
  • In DIC: Increased.
• Fibrinogen:
  • Normal Range: 200-400 mg/dL
  • In DIC: Decreased (used up).
• D-Dimer:
  • Normal Range: << 0.5 mcg/mL
  • In DIC: Greatly Increased in clot breakdown.
• ATI Note: Early DIC presents with petechiae, ecchymosis, and bleeding gums.

Other Key Labs

• Lactate:
  • Normal Range: 0.5-2.2 mmol/L
  • Increased in Sepsis, tissue hypoxia.
• ESR (Erythrocyte Sedimentation Rate):
  • Normal Range: < 20 mm/hr
  • Increased in inflammation.
• CRP (C-Reactive Protein):
  • Normal Range: << 1 mg/dL
  • Increased in infection, inflammation.
• Albumin:
  • Normal Range: 3.5-5.0 g/dL
  • Increased with Dehydration.
  • Decreased with liver disease