APPENDIX

C
Laboratory Reference Intervals
The tables in this appendix list some of the most common tests, their reference intervals (formally referred to as normal values), and possible etiologies of abnormal results. Laboratory results may vary depending on different techniques or different laboratories. Possible etiologies are presented in alphabetic order. Abbreviations appearing in the tables are defined as follows: mEq = milliequivalent mm Hg = millimeter of mercury mm = millimeter mOsm = milliosmole L dL mL L fL = = = = = liter deciliter (101 liter) milliliter (103 liter) microliter (106 liter, 103 milliliter) femtoliter (1015 liter, 1012 milliliter) g mg mcg ng pg = = = = = gram milligram (103 gram) microgram (106 gram) nanogram (109 gram) picogram (1012 gram)

U = unit U = microunit IU = international unit mmol mol nmol pmol kPa kat = = = = = = millimole (103 mole) micromole (106 mole) nanomole (109 mole) picomole (1012 mole) kilopascal microkatal

Source: Wu HB: Tietz clinical guide to laboratory tests, ed 4, Philadelphia, 2006, Saunders.

TABLE C-1
TEST
Acetone Quantitative Qualitative Albumin

SERUM, PLASMA, AND WHOLE BLOOD CHEMISTRIES

REFERENCE INTERVALS CONVENTIONAL UNITS SI UNITS
<2.0 mg/dL Negative 3.5-5.0 g/dL <344 mol/L Negative 35-50 g/L

HIGHER

POSSIBLE ETIOLOGY LOWER

Diabetic ketoacidosis, high-fat diet, low-carbohydrate diet, starvation Dehydration

Aldolase 1-Antitrypsin 1-Fetoprotein Ammonia Amylase

1.5-8.1 U/L 78-200 mg/dL

1.5-8.1 U/L 0.78-2.0 g/L

Skeletal muscle disease Acute and chronic inammation, arthritis Cancer of testes, ovaries, and liver Severe liver disease Acute and chronic pancreatitis, mumps (salivary gland disease), perforated ulcers Compensated respiratory acidosis, metabolic alkalosis Heart failure Biliary obstruction, impaired liver function, hemolytic anemia, pernicious anemia

Chronic liver disease, malabsorption, malnutrition, nephrotic syndrome Renal disease Chronic lung disease (early onset), malnutrition, nephrotic syndrome

<10 ng/mL 15-45 mcg N/dL 30-122 U/L (method dependent) 22-26 mEq/L <100 mcg/L

<10 mcg/L 11-32 mol N/L 0.51-2.07 kat/L

Bicarbonate b-Type natriuretic peptide (BNP) Bilirubin Total Indirect Direct

22-26 mmol/L <100 pmol/L

Acute alcoholism, cirrhosis of liver, extensive destruction of pancreas Compensated respiratory alkalosis, metabolic acidosis

0.2-1.2 mg/dL 0.1-1.0 mg/dL 0.1-0.3 mg/dL

3-21 mol/L 1.7-17.0 mol/L 1.7-5.1 mol/L

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1795

1796
TABLE C-1
TEST
Blood gases* Arterial pH Venous pH PaCO2 PvCO2 PaO2 PvO2 Calcium (total)

APPENDIX C

Laboratory Reference Intervals

SERUM, PLASMA, AND WHOLE BLOOD CHEMISTRIEScontd

REFERENCE INTERVALS CONVENTIONAL UNITS SI UNITS
7.35-7.45 7.32-7.43 32-48 mm Hg 38-55 mm Hg 80-100 mm Hg 38-42 mm Hg 8.6-10.2 mg/dL 7.35-7.45 7.32-7.43 4.26-6.38 kPa 5.06-7.32 kPa 10.6-13.33 kPa 5.04-5.57 kPa 2.15-2.55 mmol/L

HIGHER
Alkalosis

POSSIBLE ETIOLOGY LOWER

Acidosis Compensated metabolic acidosis Respiratory alkalosis Chronic lung disease, decreased cardiac output Acute pancreatitis, hypoparathyroidism, liver disease, malabsorption syndrome, renal failure, vitamin D deciency

Compensated metabolic alkalosis Respiratory acidosis Administration of high concentration of oxygen Acute osteoporosis, hyperparathyroidism, vitamin D intoxication, multiple myeloma

Calcium (ionized) Carbon dioxide (CO2) Carotene Chloride

4.64-5.28 mg/dL 23-29 mEq/L 10-85 mcg/dL 96-106 mEq/L

1.16-1.32 mmol/L 23-29 mmol/L 0.19-1.58 mol/L 96-106 mmol/L

Cholesterol

<200 mg/dL

<5.2 mmol/L

Same as bicarbonate Cystic brosis, hypothyroidism, pancreatic insufciency Metabolic acidosis, respiratory alkalosis, corticosteroid therapy, uremia Biliary obstruction, hypothyroidism, idiopathic hypercholesterolemia, renal disease, uncontrolled diabetes

Dietary deciency, malabsorption disorders Addisons disease, diarrhea, metabolic alkalosis, respiratory acidosis, vomiting Extensive liver disease, hyperthyroidism, malnutrition, corticosteroid therapy

High-density lipoproteins (HDLs) Low-density lipoproteins (LDLs)

Male: >40 mg/dL Female: >50 mg/dL Recommended: <100 mg/dL Near optimal: 100-129 mg/dL (2.6-3.34 mmol/L) Moderate risk for CAD: 130-159 mg/dL (3.37-4.12 mmol/L) High risk for CAD: >160 mg/dL (>4.14 mmol/L) 80-155 mcg/dL 8 AM: 5-23 mcg/dL 8 PM: <10 mcg/dL 0.2-1.0 mg/dL

>1.04 mmol/L >1.3 mmol/L Recommended: <2.6 mmol/L Near optimal: 2.6-3.34 mmol/L Moderate risk for CAD: 3.37-4.12 mmol/L High risk for CAD: >4.14 mmol/L 12.6-24.3 mol/L 0.14-0.63 mol/L <0.28 mol/L 15.3-76.3 mol/L

Copper Cortisol Creatine

Cirrhosis Cushing syndrome, pancreatitis Active rheumatoid arthritis, biliary obstruction, hyperthyroidism, renal disorders, severe muscle disease Musculoskeletal injury or disease, myocardial infarction, severe myocarditis, exercise, numerous IM injections Acute myocardial infarction Severe renal disease Sideroblastic anemia, anemia of chronic disease (infection, inammation, liver disease) Hypothyroidism

Wilsons disease Adrenal insufciency, panhypopituitary states Diabetes mellitus

Creatine kinase (CK)

Male: 20-200 U/L Female: 20-180 U/L

Male: 20-200 U/L Female: 20-180 U/L

CK-MB Creatinine Ferritin

<4%-6% of total CK 0.6-1.3 mg/dL 10-250 ng/mL

<0.4-0.6 53-115 mol/L 10-250 mcg/L

Iron-deciency anemia

Folate (folic acid)

5-16 ng/mL

11-36 nmol/L

Gamma-glutamyl transferase (GGT) Glucose (fasting)

0-30 U/L

0-0.5 kat/L

70-99 mg/dL

3.9-5.5 mmol/L

Liver disease, infectious mononucleosis, pancreatitis, hyperthyroidism Acute stress, Cushing disease, diabetes mellitus, hyperthyroidism, pancreatic insufciency

Alcoholism, hemolytic anemia, inadequate diet, malabsorption syndrome, megaloblastic anemia Hypothyroidism

Addisons disease, hepatic disease, hypothyroidism, insulin overdosage, pancreatic tumor, pituitary hypofunction

PaCO2, Partial pressure of CO2 in arterial blood; PvCO2, partial pressure of CO2 in venous blood; PaO2, partial pressure of oxygen in arterial blood; PvO2, partial pressure of oxygen in venous blood. *Because arterial blood gases are inuenced by altitude, the value for PaO2 decreases as altitude increases. The lower value is normal for an altitude of 1 mile.

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APPENDIX C
TABLE C-1
TEST
Haptoglobin

Laboratory Reference Intervals

1797

SERUM, PLASMA, AND WHOLE BLOOD CHEMISTRIEScontd

REFERENCE INTERVALS CONVENTIONAL UNITS SI UNITS
26-185 mg/dL 260-1850 mg/L

HIGHER

POSSIBLE ETIOLOGY LOWER

Hemolytic anemia, mononucleosis, toxoplasmosis, chronic liver disease Inadequately treated type 1 diabetes mellitus

Insulin (fasting)

4-24 U/mL

29-172 pmol/L

Iron, total Iron-binding capacity Lactic acid (L-Lactate) Lactic dehydrogenase (LDH)

50-175 mcg/dL 250-425 mcg/dL 6.3-22.5 mcg/dL 140-280 U/L

9.0-31.3 mol/L 44.8-76.1 mol/L 0.7-2.5 mmol/L 0.83-2.5 kat/L

Infectious and inammatory processes, malignant neoplasms Acromegaly, adenoma of pancreatic islet cells, untreated mild case of type 2 diabetes Excessive RBC destruction Iron-decient state, polycythemia Acidosis, heart failure, shock Heart failure, hemolytic disorders, hepatitis, metastatic cancer of liver, myocardial infarction, pernicious anemia, pulmonary embolus, skeletal muscle damage

Iron-deciency anemia, anemia of chronic disease Cancer, chronic infections, pernicious anemia

Lactic dehydrogenase isoenzymes LDH1 LDH2 LDH3 LDH4 LDH5

18%-33% 28%-40% 18%-30% 6%-16% 2%-13%

0.18-0.33 0.28-0.40 0.18-0.30 0.06-0.16 0.02-0.13

Lipase

31-186 U/L

0.5-3.2 kat/L

Magnesium Osmolality Oxygen saturation (arterial) (SaO2) pH Phenylalanine Phosphatase, acid

1.5-2.5 mEq/L 275-295 mOsm/kg >95% See blood gases 0.8-1.8 mg/dL 0-0.6 U/L

0.75-1.25 mmol/L 275-295 mmol/kg >0.95

Myocardial infarction, pernicious anemia Pulmonary embolus, sickle cell crisis Malignant lymphoma, pulmonary embolus Systemic lupus erythematosus, pulmonary infarction Heart failure, hepatitis, pulmonary embolus and infarction, skeletal muscle damage Acute pancreatitis, hepatic disorders, perforated peptic ulcer Addisons disease, hypothyroidism, renal failure Chronic renal disease, diabetes mellitus Polycythemia

Chronic alcoholism, severe malabsorption Addisons disease, diuretic therapy Anemia, cardiac decompensation, respiratory disorders

48-109 mol/L 0-90 kat/L

Phosphatase, alkaline

38-126 U/L

0.65-2.14 kat/L

Phosphorus (phosphate) Potassium

2.4-4.4 mg/dL

0.78-1.42 mmol/L

3.5-5.0 mEq/L

3.5-5.0 mmol/L

Phenylketonuria Advanced Pagets disease, cancer of prostate, hyperparathyroidism Bone diseases, marked hyperparathyroidism, obstruction of biliary system, rickets Healing fractures, hypoparathyroidism, renal disease, vitamin D intoxication Addisons disease, diabetic ketosis, massive tissue destruction, renal failure

Excessive vitamin D ingestion, hypothyroidism Diabetes mellitus, hyperparathyroidism, vitamin D deciency Cushing syndrome, diarrhea (severe), diuretic therapy, gastrointestinal stula, pyloric obstruction, starvation, vomiting

RBC, Red blood cell; SaO2, arterial oxygen saturation.

Continued

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1798
TABLE C-1
TEST

APPENDIX C

Laboratory Reference Intervals

SERUM, PLASMA, AND WHOLE BLOOD CHEMISTRIEScontd

REFERENCE INTERVALS CONVENTIONAL UNITS SI UNITS
15-70 ng/dL 200-2500 ng/dL <40 ng/dL <4 ng/mL 0.5-2.2 nmol/L 6.4-79.5 nmol/L 1.28 nmol/L <4 mcg/L

HIGHER

POSSIBLE ETIOLOGY LOWER

Threatened abortion. hypogonadism, amenorrhea, ovarian tumor

Progesterone (Female) Follicular phase Luteal phase Postmenopause Prostate-specic antigen (PSA) Proteins Total Albumin Globulin Albumin/globulin ratio Sodium

Adrenal hyperplasia, choriocarcinoma of ovary, pregnancy, cysts of ovary Prostate cancer Burns, cirrhosis (globulin fraction), dehydration

Liver disease, malabsorption

6.4-8.3 g/dL 3.5-5.0 g/dL 2.0-3.5 g/dL 1.5:1-2.5:1

64-83 g/L 35-50 g/L 20-35 g/L 1.5:1-2.5:1

Multiple myeloma (globulin fraction), shock, vomiting Dehydration, impaired renal function, primary aldosteronism, corticosteroid therapy

135-145 mEq/L

135-145 mmol/L

Testosterone

Male: 280-1100 ng/dL Female: 15-70 ng/dL

T4 (thyroxine), total T4 (thyroxine), free T3 uptake T3 (triiodothyronine), total Thyroid-stimulating hormone (TSH) Transaminases Aspartate aminotransferase (AST) Alanine aminotransferase (ALT) Transferrin Transferrin saturation (%) Triglycerides

4.6-11.0 mcg/dL 0.8-2.7 ng/dL 24%-34% Ages 20-50: 70-204 ng/dL Ages >50: 40-181 ng/dL 0.4-4.2 U/mL

Male: 10.438.17 nmol/L Female: 0.522.43 nmol/L 59-142 nmol/L 10-35 pmol/L 0.24-0.34 1.08-3.14 nmol/L 0.62-2.79 nmol/L 0.4-4.2 mU/L

Malnutrition, nephrotic syndrome, proteinuria, renal disease, severe burns Addisons disease, diabetic ketoacidosis, diuretic therapy, excessive loss from GI tract, excessive perspiration, water intoxication Hypofunction of testes, hypogonadism

Polycystic ovary, virilizing tumors Hyperthyroidism, thyroiditis

Cretinism, hypothyroidism, myxedema Hypothyroidism Hypothyroidism Secondary hypothyroidism

Hyperthyroidism Hyperthyroidism Myxedema, primary hypothyroidism, Graves disease Liver disease, myocardial infarction, pulmonary infarction, acute hepatitis Liver disease, shock

10-30 U/L

0.17-0.51 kat/L

10-40 U/L 190-380 mg/dL 15%-50% <150 mg/dL

0.17-0.68 kat/L 1.9-3.8 g/L 15%-50% <1.7 mmol/L

Troponins (cardiac) Troponin T (cTnT) Troponin I (cTnI) Urea nitrogen (BUN)

Diabetes mellitus, hyperlipidemia, hypothyroidism, liver disease Myocardial infarction

Malnutrition

<0.5 ng/mL (<0.5 mcg/L) <0.1 ng/mL (<0.1 mcg/L) 6-20 mg/dL

2.1-7.1 mmol/L

Uric acid

Male: 4.4-7.6 mg/dL Female: 2.3-6.6 mg/dL 30-80 mcg/dL 200-835 pg/mL

Male: 262-452 mol/L Female:137-393 mol/L 1.05-2.80 mol/L 148-616 pmol/L

Vitamin A (retinol) Vitamin B12 (cobalamin)

Increase in protein catabolism (fever, stress), renal disease, urinary tract infection Gout, gross tissue destruction, high-protein weight reduction diet, leukemia, renal failure Excess ingestion of vitamin A Chronic myeloid leukemia

Malnutrition, severe liver damage Administration of uricosuric drugs Vitamin A deciency Strict vegetarianism, malabsorption syndrome, pernicious anemia, total or partial gastrectomy Connective tissue disorders, hepatic disease, renal disease, rheumatic fever, vitamin C deciency Alcoholic cirrhosis

Vitamin C (ascorbic acid)

0.4-2.0 mg/dL

23-114 mol/L

Excessive ingestion of vitamin C

Zinc

70-120 mcg/dL

10.7-120 mol/L

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APPENDIX C
TABLE C-2

Laboratory Reference Intervals

1799

HEMATOLOGY
REFERENCE INTERVALS CONVENTIONAL SI UNITS UNITS
2-7 min 120-420 sec

POSSIBLE ETIOLOGY HIGHER

Defective platelet function, thrombocytopenia, von Willebrands disease, aspirin ingestion, vascular disease Deciency factors I, II, V, VIII, IX and X, XI, XII; hemophilia, liver disease; heparin therapy Warfarin therapy; deciency of factors I, II, V, VII, and X; vitamin K deciency; liver disease Burns (after rst 36 hr), inammatory disease Acute DIC, massive hemorrhage, primary brinolysis DIC, myocardial infarction, deep vein thrombosis, unstable angina Dehydration, high altitudes, polycythemia vera Macrocytic anemia Macrocytic anemia Spherocytosis

TEST
Bleeding time

LOWER

Activated partial thromboplastin time (aPTT) Prothrombin time (Protime, PT) Fibrinogen Fibrin split (degradation) products D-Dimer Erythrocyte count (altitude dependent) Mean corpuscular volume (MCV) Mean corpuscular hemoglobin (MCH) Mean corpuscular hemoglobin concentration (MCHC) Erythrocyte sedimentation rate (ESR)

25-35 sec*

25-35 sec*

11-16 sec*

11-16 sec*

200-400 mg/dL <10 mcg/mL <250 ng/mL Male: 4.3-5.7 106/L Female: 3.8-5.1 106/L 80-100 fL 27-34 pg 32%-37%

2-4 g/L <10 mg/L <250 mcg/L Male: 4.3-5.7 1012/L Female: 3.8-5.1 1012/L 80-100 fL 27-34 pg 0.32-0.37

Burns (during rst 36 hr), DIC, severe liver disease

Anemia, leukemia, posthemorrhage Microcytic anemia Microcytic anemia Hypochromic anemia

<30 mm/hr (some gender variation)

<30 mm/hr (some gender variation)

Hematocrit (altitude dependent) Hemoglobin (altitude dependent) Hemoglobin, glycosylated Platelet count (thrombocytes)

Male: 39%-50% Female: 35%-47% Male: 13.2-17.3 g/dL Female: 11.7-15.5 g/dL 4.0%-6.0% 150-400 103/L

Male: 0.39-0.50 Female: 0.35-0.47 Male: 132-173 g/L Female: 117-155 g/L 4.0%-6.0% 150-400 109/L

Moderate increase: acute hepatitis, myocardial infarction; rheumatoid arthritis Marked increase: acute and severe bacterial infections, malignancies, pelvic inammatory disease Dehydration, high altitudes, polycythemia COPD, high altitudes, polycythemia Poorly controlled diabetes mellitus Acute infections, chronic granulocytic leukemia, chronic pancreatitis, cirrhosis, collagen disorders, polycythemia, postsplenectomy Hemolytic anemia, polycythemia vera

Malaria, severe liver disease, sickle cell anemia

Anemia, hemorrhage, overhydration Anemia, hemorrhage Sickle cell anemia, chronic renal failure, pregnancy Acute leukemia, DIC, thrombocytopenic purpura Hypoproliferative anemia, macrocytic anemia, microcytic anemia Aplastic anemia, side effects of chemotherapy and irradiation Aplastic anemia, viral infections Corticosteroid therapy, whole body irradiation

Reticulocyte count

0.5%-1.5% of RBC

0.5%-1.5% of RBC

White blood cell count

4.0-11.0 103/L

4.0-11.0 109/L

Inammatory and infectious processes, leukemia

WBC differential Segmented neutrophils Band neutrophils Lymphocytes

50%-70% 0%-8% 20%-40%

0.50-0.70 0-0.08 0.20-0.40

Monocytes

4%-8%

0.04-0.08

Eosinophils

0%-4%

0-0.04

Basophils

0%-2%

0-0.02

Bacterial infections, collagen diseases, Hodgkins lymphoma Acute infections Chronic infections, lymphocytic leukemia, mononucleosis, viral infections Chronic inammatory disorders, malaria, monocytic leukemia, acute infections, Hodgkins lymphoma Allergic reactions, eosinophilic and chronic granulocytic leukemia, parasitic disorders, Hodgkins lymphoma Hypothyroidism, ulcerative colitis, myeloproliferative diseases

Corticosteroid therapy

Hyperthyroidism, stress

COPD, Chronic obstructive pulmonary disease; DIC, disseminated intravascular coagulation; RBC, red blood cell; WBC, white blood cell. *Values depend on reagent and instrumentation used. Components of complete blood count (CBC).

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1800
TABLE C-3
TEST

APPENDIX C

Laboratory Reference Intervals

SEROLOGY-IMMUNOLOGY
REFERENCE INTERVALS CONVENTIONAL UNITS SI UNITS
Negative at 1:40 dilution Negative at 1:40 dilution

HIGHER

POSSIBLE ETIOLOGY LOWER

Antinuclear antibody (ANA)

Anti-DNA antibody Anti-Sm (Smith) C-reactive protein (CRP)

<70 IU/mL Negative 6.8-820 mcg/dL

<70 IU/mL Negative 68-8200 mcg/L

Carcinoembryonic antigen (CEA)

Nonsmoker: <3 ng/mL Smoker: <5 ng/mL

Nonsmoker: <3 mcg/L Smoker: <5 mcg/L

Chronic hepatitis, rheumatoid arthritis, scleroderma, systemic lupus erythematosus Systemic lupus erythematosus Systemic lupus erythematosus Acute infections, any inammatory condition, widespread malignancy Carcinoma of colon, liver, pancreas; chronic cigarette smoking; inammatory bowel disease; other cancers Acute glomerulonephritis, systemic lupus erythematosus, rheumatoid arthritis, subacute bacterial endocarditis Acquired hemolytic anemia, drug reactions, transfusion reactions Syphilis

Complement, total hemolytic (CH50)

75-160 U/mL

75-160 kU/L

Direct Coombs or direct antihuman globulin test (DAT) Fluorescent treponemal antibody absorption (FTA-Abs) Hepatitis A antibody Hepatitis B surface antigen (HBsAg) Hepatitis C antibody Monospot or monotest Rheumatoid factor (RF)

Negative

Negative

Negative or nonreactive Negative Negative Negative Negative Negative or titer <1:17

Negative or nonreactive Negative Negative Negative Negative Negative or titer <1:17

Hepatitis A Hepatitis B Hepatitis C Infectious mononucleosis Rheumatoid arthritis, Sjgrens syndrome, systemic lupus erythematosus Syphilis, systemic lupus erythematosus, rheumatoid arthritis, leprosy, malaria, febrile diseases, IV drug abuse Syphilis

RPR

Negative or nonreactive

Negative or nonreactive

VDRL

Negative or nonreactive

Negative or nonreactive

RPR, Rapid plasma regain test; VDRL, Veneral Disease Research Laboratory test.

TABLE C-4
TEST
Acetone

URINE CHEMISTRY
SPECIMEN
Random

REFERENCE INTERVALS UNITS SI UNITS

Negative Negative

HIGHER

POSSIBLE ETIOLOGY LOWER

Aldosterone

24 hr

3-30 mcg/day (low sodium diet increases threefold to vefold) 1-17 U/hr Negative Negative 100-250 mg/day

0.08-0.83 nmol/day

Amylase Bence Jones protein Bilirubin Calcium

24 hr Random Random 24 hr

1-17 U/hr Negative Negative 2.5-6.3 mmol/day

Diabetes mellitus, high-fat and low-carbohydrate diets, starvation Primary aldosteronism: adrenocortical tumors Secondary aldosteronism: cardiac failure, cirrhosis, large dose of ACTH, salt depletion Acute pancreatitis Multiple myeloma Liver disorders Bone tumor, hyperparathyroidism Pheochromocytoma, progressive muscular dystrophy, heart failure

ACTH deciency, Addisons disease, corticosteroid therapy

Hypoparathyroidism, malabsorption of calcium and vitamin D

Catecholamines Epinephrine Norepinephrine

24 hr <20 mcg/day 15-80 mcg/day <109 nmol/day 89-473 nmol/day

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APPENDIX C
TABLE C-4
TEST
Creatine

Laboratory Reference Intervals

1801

URINE CHEMISTRYcontd
SPECIMEN
24 hr

REFERENCE INTERVALS UNITS SI UNITS

<100 mg/day <763 mol/day

HIGHER

POSSIBLE ETIOLOGY LOWER

Hypothyroidism

Creatinine Creatinine clearance Estrogens Female Premenopause Postmenopause Male Glucose Hemoglobin

24 hr 24 hr 24 hr

0.6-2.0 g/day 59-137 mL/min/1.73 m2

5.3-17.7 mmol/day 0.59-1.37 mL/sec/m2

Liver cancer, hyperthyroidism, diabetes, Addisons disease, infections, burns, muscular dystrophy, skeletal muscle atrophy Anemia, leukemia, muscular atrophy

Renal disease Renal disease

Gonadal or adrenal tumor 15-80 mcg/day <20 mcg/day 15-40 mcg/day Negative Negative 15-80 mcg/day <20 mcg/day 15-40 mcg/day Negative Negative

Endocrine disturbance, ovarian dysfunction, menopause

Random Random

5-Hydroxyindoleacetic acid (5-HIAA) Ketone bodies Metanephrine Myoglobin

24 hr 24 hr 24 hr Random

2-7 mg/day 20-50 mg/day 92-934 mcg/day Negative

10.5-36.6 mol/day 0.34-0.86 mmol/day 500-5100 nmol/day Negative

Diabetes mellitus, pituitary disorders Extensive burns, glomerulonephritis, hemolytic anemias, hemolytic transfusion reaction Malignant carcinoid syndrome Diabetes mellitus, starvation, dehydration Pheochromocytoma Crushing injuries, electric injuries, extreme physical exertion Dehydration, tubular dysfunction (kidney lost ability to dilute urine) Urinary tract infection, urine allowed to stand at room temperature Acute and chronic renal disease, especially involving glomeruli; heart failure Cardiac failure, inammatory processes of urinary tract, nephritis, nephrosis, strenuous exercise Acute tubular necrosis Albuminuria, dehydration, glycosuria Gout, leukemia Hemolytic disease, hepatic parenchymal cell damage, liver disease Pheochromocytoma

Osmolality

Random

300-1300 mOsm/kg

300-1300 mmol/kg

pH

Random

4.0-8.0

4.0-8.0

Tubular dysfunction (kidney lost ability to concentrate urine) Respiratory or metabolic acidosis

Protein (dipstick)

Random

0-trace

0-trace

Protein (quantitative)

24 hr

<150 mg/day

<0.15 g/day

Sodium Specic gravity Uric acid Urobilinogen

24 hr Random 24 hr 24 hr

40-220 mEq/day 1.003-1.030 250-750 mg/day 0.5-4.0 mg/day

40-220 mmol/day Same as conventional units 1.5-4.5 mmol/day 0.8-6.8 mol/day

Hyponatremia Diabetes insipidus Nephritis Complete obstruction of bile duct

Vanillylmandelic acid

24 hr

1.4-6.5 mg/day

7-33 mol/day

ACTH, Adrenocorticotropic hormone.

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1802
TABLE C-5
TEST
Fecal fat Mucus Pus Blood* Color Brown Clay Tarry Red Black

APPENDIX C

Laboratory Reference Intervals

FECAL ANALYSIS
POSSIBLE ETIOLOGY HIGHER
Chronic pancreatic disease, obstruction of common bile duct, malabsorption syndrome Mucous colitis, spastic constipation Chronic bacillary dysentery, chronic ulcerative colitis, localized abscesses Anal ssures, hemorrhoids, malignant tumor, peptic ulcer, inammatory bowel disease Various color depending on diet Biliary obstruction or presence of barium sulfate More than 100 mL of blood in gastrointestinal tract Blood in large intestine Blood in upper gastrointestinal tract or iron medication

REFERENCE INTERVALS CONVENTIONAL UNITS SI UNITS

<6 g/24 hr Negative Negative Negative Same as conventional units Negative Negative Negative

LOWER

*Ingestion of meat may produce false-positive results. Patient may be placed on a meat-free diet for 3 days before the test.

TABLE C-6
TEST
Pressure Blood Cell count (age dependent) WBC RBC Chloride Glucose Protein Lumbar Cisternal Ventricular

CEREBROSPINAL FLUID ANALYSIS

REFERENCE INTERVALS CONVENTIONAL UNITS SI UNITS
60-150 mm H2O Negative 60-150 mm H2O Negative

HIGHER

POSSIBLE ETIOLOGY LOWER

Head injury, spinal tumor, subdural hematoma

Hemorrhage, intracranial tumor, meningitis Intracranial hemorrhage Inammation or infections of CNS

0-5 cells/L Negative 118-132 mEq/L 40-70 mg/dL

0-5 106 cells/L Negative 118-132 mmol/L 2.2-3.9 mmol/L

Uremia Diabetes mellitus, viral infections of CNS

Bacterial infections of CNS (meningitis, encephalitis) Bacterial infections and tuberculosis of CNS

15-45 mg/dL 15-25 mg/dL 5-15 mg/dL

0.15-0.45 g/L 0.15-0.25 g/L 0.05-0.15 g/L

Guillain-Barr syndrome, poliomyelitis, trauma Syphilis of CNS Acute meningitis, brain tumor, chronic CNS infections, multiple sclerosis

CNS, Central nervous system.

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