Appendix C

Laboratory Values

The tables in this appendix list some of the most common tests, their normal values, and possible etiologies of abnormal values. Laboratory values may vary with different techniques or different laboratories. Possible etiologies are presented in alphabetic order. Abbreviations appearing in the tables are dened as follows: less than greater than liter milliequivalent milliliter deciliter millimeter of mercury femtoliter millimeter gram

L mEq ml dl mm Hg mm g

mg mcg ng pg U l IU mOsm U mmol mol nmol pmol kPa kat

milligram (10 3) microgram (one millionth of a gram) (10 6) nanogram (one billionth of a gram) (10 9) picogram (one trillionth of a gram) (10 12) microunit microliter international unit milliosmole unit millimole micromole nanomole picomole kilopascal microkatal

Copyright 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Appendix C

Laboratory Values

TABLE C-1

Serum, Plasma, and Whole Blood Chemistries

Appendix C

Test
Acetone Quantitative Qualitative Albumin

Normal Values Conventional Units SI Units

0.3-2.0 mg/dl Negative 3.5-5.0 g/dl 52-344 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

1.0-7.5 U/L 78-200 mg/dl 15 ng/ml 30-70 mcg/dl 0-130 U/L (method dependent) 0.4-1.5 mg/dl

0.02-0.13 kat/L 0.78-2.0 g/L 15 mcg/L 17.6-41.1 mol/L 0-2.17 kat/L

Ammonia Amylase

Ascorbic acid

23-85 mol/L

Skeletal muscle disease Acute and chronic inammation, arthritis, stress syndrome Cancer of testes and ovaries, carcinoma of liver Severe liver disease Acute and chronic pancreatitis, mumps (salivary gland disease), perforated ulcers Excessive ingestion of vitamin C

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

Bicarbonate Bilirubin Total Indirect Direct Blood gases* Arterial pH Venous pH Arterial PaCO2 Venous PaCO2 Arterial PaO2 Venous PaO2 b-Type natriuretic peptide (BNP) Calcium

22-26 mEq/L

22-26 mmol/L

0.2-1.3 mg/dl 0.1-1.0 mg/dl 0.1-0.3 mg/dl 7.35-7.45 7.35-7.45 35-45 mm Hg 42-52 mm Hg 75-100 mm Hg 30-50 mm Hg 100 pg/ml 9-11 mg/dl (4.5-5.5 mEq/L)

3.4-22.0 mol/L 1.7-17.0 mol/L 1.7-5.1 mol/L Same as conventional units Same as conventional units 4.67-6.00 kPa 5.60-6.93 kPa 10.0-13.33 kPa 4.0-6.67 kPa

Compensated respiratory acidosis, metabolic alkalosis Biliary obstruction, hemolytic anemia, impaired liver function, pernicious anemia, prolonged fasting Alkalosis Alkalosis Compensated metabolic alkalosis Respiratory acidosis Administration of high concentration of oxygen Heart failure

Acute alcoholism, cirrhosis of liver, extensive destruction of pancreas Connective tissue disorders, hepatic disease, renal disease, rheumatic fever, vitamin C deciency Compensated respiratory alkalosis, metabolic acidosis

Acidosis Acidosis Compensated metabolic acidosis Respiratory alkalosis Chronic lung disease, decreased cardiac output

2.25-2.74 mmol/L

Acute osteoporosis, hyperparathyroidism, multiple myeloma, vitamin D intoxication

Acute pancreatitis, hypoparathyroidism, liver disease, malabsorption syndrome, renal failure, vitamin D deciency

Calcium, ionized Carbon dioxide (CO2 content) Carotene Chloride

4.5-5.5 mg/dl (2.25-2.75 mEq/L) 20-30 mEq/L 10-85 mcg/dl 95-105 mEq/L

1.13-1.38 mmol/L 20-30 mmol/L 0.19-1.58 mol/L 95-105 mmol/L Same as bicarbonate Cystic brosis, hypothyroidism, pancreatic insufciency Corticosteroid therapy, metabolic acidosis, respiratory alkalosis, uremia Biliary obstruction, hypothyroidism, idiopathic hypercholesterolemia, renal disease, uncontrolled diabetes Dietary deciency, malabsorption disorders Addisons disease, diarrhea, metabolic alkalosis, respiratory acidosis, vomiting Corticosteroid therapy, extensive liver disease, hyperthyroidism, malnutrition

Cholesterol HDL (high-density lipoproteins) Male Female LDL (low-density lipoproteins) Cholinesterase (RBC)

140-200 mg/dl (age dependent)

3.6-5.2 mmol/L

45 mg/dl 55 mg/dl 130 mg/dl 0.65-1.00 pH

1.2 mmol/L 1.4 mmol/L 3.4 mmol/L Same as conventional units 12.6-23.6 mol/L Exercise Acute infections, insecticide intoxication, liver disease, muscular dystrophy Wilsons disease

Copper

80-150 mcg/dl

Cirrhosis, female on contraceptives

*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.

Continued

Copyright 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Appendix C

Laboratory Values

TABLE C-1

Serum, Plasma, and Whole Blood Chemistriescontd

Normal Values Conventional Units SI Units
8 AM: 5-25 mcg/dl 8 PM: 10 mcg/dl 0.2-1.0 mg/dl 0.14-0.69 mol/L 0.28 mol/L 15.3-76.3 mol/L

Appendix C

Test
Cortisol Creatine

Higher

Possible Etiology Lower

Adrenal insufciency, panhypopituitary states Diabetes mellitus

Creatine kinase (CK) Male Female

15-105 U/L 10-80 U/L

0.26-1.79 kat/L 0.17-1.36 kat/L

CK-MB (CK-2) Creatinine Ferritin (serum) Male Female Folic acid (folate)

0-9 U/L 0.5-1.5 mg/dl 20-300 ng/ml 10-120 ng/ml 3-25 ng/ml

0.1 kat/L 44-133 mol/L 20-300 mcg/L 10-120 mcg/L 7-57 nmol/L

Cushing syndrome, pancreatitis, stress Active rheumatoid arthritis, biliary obstruction, hyperthyroidism, renal disorders, severe muscle disease Brain damage, exercise, musculoskeletal injury or disease, myocardial infarction, numerous intramuscular injections, severe myocarditis Acute myocardial infarction Severe renal disease Anemia of chronic disease (infection, inammation, liver disease), sideroblastic anemia Hypothyroidism

Iron-deciency anemia

Gamma-glutamyl transpeptidase (GGT) Glucose, fasting

0-30 U/L

0-0.5 kat/L

Alcoholism, hemolytic anemia, inadequate diet, malabsorption syndrome, megaloblastic anemia Liver disease, infectious mononucleosis Addisons disease, hepatic disease, hypothyroidism, insulin overdosage, pancreatic tumor, pituitary hypofunction, postgastrectomy dumping syndrome Hyperinsulinism

70-100 mg/dl

3.89-5.55 mmol/L

Acute stress, cerebral lesions, Cushing disease, diabetes mellitus, hyperthyroidism, pancreatic insufciency

Glucose tolerance (GTT) Fasting 30 min 60 min 120 min 180 min Haptoglobin

Diabetes mellitus 70-100 mg/dl 30-60 mg/dl above fasting 20-50 mg/dl above fasting 5-15 mg/dl above fasting Fasting level or lower 26-185 mg/dl 3.89-5.55 mmol/L 1.67-3.33 mmol/L 1.11-2.78 mmol/L 0.28-0.83 mmol/L Fasting level or lower 260-1850 mg/L

Insulin

4-24 U/ml

29-172 pmol/L

Iron, total Iron-binding capacity

50-150 mcg/dl 250-410 mcg/dl

9.0-26.9 mol/L 45-73 mol/L

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

Chronic liver disease, hemolytic anemia, mononucleosis, toxoplasmosis Diabetes mellitus, obesity

Anemia of chronic disease, irondeciency anemia Cancer, chronic infections, pernicious anemia, uremia

Lactic acid Lactic dehydrogenase (LDH)

5-20 mcg/dl 50-150 U/L

0.56-2.2 mmol/L 0.83-2.5 kat/L

RBC, Red blood cell.

Copyright 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Appendix C

Laboratory Values

TABLE C-1

Serum, Plasma, and Whole Blood Chemistriescontd

Appendix C

Test
Lactic dehydrogenase isoenzymes LDH1 LDH2 LDH3 LDH4 LDH5

Normal Values Conventional Units SI Units

20%-35% 30%-40% 15%-25% 0%-10% 4%-12% 0.20-0.35 0.30-0.40 0.15-0.25 0-0.10 0.04-0.12

Higher

Possible Etiology Lower

Lipase

0-160 U/L

0-2.66 kat/L

Magnesium

1.5-2.5 mEq/L

0.62-1.03 mmol/L

Myocardial infarction, pernicious anemia Pulmonary embolus, sickle cell crisis Malignant lymphoma, pulmonary embolus 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

Osmolality Oxygen saturation (arterial) pH Phenylalanine Phosphatase, acid

285-295 mOsm/kg 95%-98% See blood gases 0-2 mg/dl 0-0.6 U/L

285-295 mmol/kg 0.95-0.98 saturated

Chronic renal disease, diabetes mellitus Polycythemia

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

0-121 mol/L 0-90 kat/L

Phosphatase, alkaline

30-120 U/L

0.5-2.0 kat/L

Phosphorus, inorganic

2.8-4.5 mg/dl

0.90-1.45 mmol/L

Potassium

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, milk-alkali syndrome Diabetes mellitus, hyperparathyroidism, vitamin D deciency Cushing syndrome, diarrhea (severe), diuretic therapy, gastrointestinal stula, pyloric obstruction, starvation, vomiting Amenorrhea, hypogonadism, ovarian tumor, threatened abortion

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

50 ng/dl 200-2500 ng/dl 40 ng/dl 10-50 ng/dl 4 ng/mL

1.6 nmol/L 6.4-79.5 nmol/L 1.28 nmol/L 0.32-1.6 nmol/L 4 mcg/L

Adrenal hyperplasia, choriocarcinoma of ovary, cysts of ovary, pregnancy

Prostate cancer Burns, cirrhosis (globulin fraction), dehydration Congenital agammaglobulinemia, liver disease, malabsorption

6.0-8.0 g/dl 3.5-5.0 g/dl 2.0-3.5 g/dl 1.5:1-2.5:1

60-80 g/L 35-50 g/L 20-35 g/L Same as conventional units

Multiple myeloma (globulin fraction), shock, vomiting Renal hypertension, volume decrease (e.g., hemorrhage) Corticosteroid therapy, dehydration, impaired renal function, primary aldosteronism

1.4-2.9 ng/ml/hr 0.4-4.5 ng/ml/hr 135-145 mEq/L

0.39-0.81 ng/L/sec 0.11-1.25 ng/L/sec 135-145 mmol/L

Malnutrition, nephrotic syndrome, proteinuria, renal disease, severe burns Increased salt intake, primary aldosteronism Addisons disease, diabetic ketoacidosis, diuretic therapy, excessive loss from gastrointestinal tract, excessive perspiration, water intoxication Continued

Copyright 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Appendix C

Laboratory Values

TABLE C-1

Serum, Plasma, and Whole Blood Chemistriescontd

Normal Values Conventional Units SI Units
300-1200 ng/dl 25-90 ng/dl 5-12 mcg/dl 0.8-2.3 ng/dl 25%-35% Ages 20-50: 70-204 ng/dl Ages 50: 40-180 ng/dl 0.3-5.4 U/ml 10.4-41.6 nmol/L 0.87-3.1 nmol/L 64-154 nmol/L 10-30 pmol/L 0.25-0.35 Ages 20-50: 1.1-3.1 nmol/L Ages 50: 0.6-2.8 nmol/L 0.3-5.4 mU/L Polycystic ovary, virilizing tumors Hyperthyroidism, thyroiditis Cretinism, hypothyroidism, myxedema Hypothyroidism, pregnancy Hypothyroidism

Appendix C

Test
Testosterone Male Female Thyroid hormones T4 (thyroxine), total T4 (thyroxine), free T3 uptake T3 (triiodothyronine)

Higher

Possible Etiology Lower

Hypofunction of testes, hypogonadism

Hyperthyroidism, metastatic neoplasms Hyperthyroidism

Thyroid-stimulating hormone (TSH) Transaminases Aspartate aminotransferase (AST) Alanine aminotransferase (ALT) Triglycerides Urea nitrogen (BUN)

Graves disease, myxedema, primary hypothyroidism Acute hepatitis, liver disease, myocardial infarction, pulmonary infarction Liver disease, shock

Secondary hypothyroidism

7-40 U/L

0.12-0.67 kat/L

5-36 U/L

0.08-0.6 kat/L

40-150 mg/dl 10-30 mg/dl

0.45-1.69 mmol/L 1.8-7.1 mmol/L

Uric acid Male Female Vitamin A Vitamin B12

4.5-6.5 mg/dl 2.5-5.5 mg/dl 15-60 mcg/dl 200-1000 pg/ml

268-387 mol/L 149-268 mol/L 0.52-2.09 mol/L 148-738 pmol/L

Diabetes mellitus, hyperlipidemia, hypothyroidism, liver disease Increase in protein catabolism (fever, stress), renal disease, urinary tract infection Eclampsia, gout, gross tissue destruction, high-protein weight reduction diet, leukemia, renal failure Excess ingestion of vitamin A Chronic myeloid leukemia

Malnutrition Malnutrition, severe liver damage

Administration of uricosuric drugs

Zinc

50-150 mcg/dl

7.6-22.9 mol/L

Vitamin A deciency Malabsorption syndrome, pernicious anemia, strict vegetarianism, total or partial gastrectomy Alcoholic cirrhosis

Copyright 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Appendix C

Laboratory Values

TABLE C-2

Hematology
Appendix C

Test
Bleeding time (Simplate)

Normal Values Conventional Units SI Units

3.0-9.5 180-570 sec

Possible Etiology Higher

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

Lower

Activated partial thromboplastin time (aPTT) Prothrombin time (protime, PT) Fibrinogen Fibrin split (degradation) products D-Dimer

24-36 sec*

Same as conventional units Same as conventional units

10-14 sec*

200-400 mg/dl 10 mcg/ml Same as conventional units Negative

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

Negative

Erythrocyte count (altitude dependent) Male Female Mean corpuscular volume (MCV) Mean corpuscular hemoglobin (MCH) Mean corpuscular hemoglobin concentration (MCHC) Erythrocyte sedimentation rate (ESR), Westergren Male 50 yr 50 yr Female 50 yr 50 yr Hematocrit (altitude dependent) Male Female Hemoglobin (altitude dependent) Male Female Hemoglobin, glycosylated Red cell distribution width (RDW) Platelet count (thrombocytes)

Anemia, leukemia, posthemorrhage

4.5-6.0 4.0-5.0 82-98 27-33 pg

106/ L 106/ L

32%-36%

4.5-6.0 1012/L 4.0-5.0 1012/L Same as conventional units Same as conventional units 0.32-0.36

Macrocytic anemia Macrocytic anemia Spherocytosis

Microcytic anemia Microcytic anemia Hypochromic anemia

15 mm/hr 20 mm/hr 20 mm/hr 30 mm/hr

Same as conventional units Same as conventional units

Moderate increase: acute hepatitis, myocardial infarction; rheumatoid arthritis Marked increase: acute and severe bacterial infections, malignancies, pelvic inammatory disease

Malaria, severe liver disease, sickle cell anemia

Dehydration, high altitudes, polycythemia 40%-54% 38%-47% 0.40-0.54 0.38-0.47 COPD, high altitudes, polycythemia 13.5-18.0 g/dl 12.0-16.0 g/dl 4.0%-6.0% 10.2%-14.5% 150-400 103/ L 135-180 g/L 120-160 g/L Same as conventional units Same as conventional therapy 150-400 109/L

Anemia, hemorrhage, overhydration

Anemia, hemorrhage

Poorly controlled diabetes mellitus

Reticulocyte count (manual)

0.5%-1.5% of total RBCs

Same

Acute infections, chronic granulocytic leukemia, chronic pancreatitis, cirrhosis, collagen disorders, polycythemia, postsplenectomy Hemolytic anemia, polycythemia vera

Chronic kidney disease, pregnancy, sickle cell anemia Anisocytosis, macrocytic anemia, microcytic anemia Acute leukemia, DIC, thrombocytopenic purpura

Hypoproliferative anemia, macrocytic anemia, microcytic anemia

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

Continued

Copyright 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Appendix C

Laboratory Values

TABLE C-2

Hematologycontd
Normal Values Conventional Units SI Units
4.0-11.0 103/ L 4.0-11.0 109/L

Appendix C

Possible Etiology Higher

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

Test
White blood cell (WBC) count WBC differential Segmented neutrophils Band neutrophils Lymphocytes

Lower
Aplastic anemia, side effect of chemotherapy and irradiation Aplastic anemia, viral infections

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

0.50-0.70 0-0.08 0.20-0.40

Corticosteroid therapy, whole-body irradiation

Monocytes

4%-8%

0.04-0.08

Eosinophils

0%-4%

0-0.04

Corticosteroid therapy

Basophils Sickle cell solubility test

0%-2% Negative

0-0.02 Negative

Hyperthyroidism, stress

TABLE C-3

Serology-Immunology
Normal Values Conventional Units SI Units
Negative or titer 1:10 Same as conventional units

Test
Antibodies Antinuclear antibody (ANA)

Higher

Possible Etiology Lower

Anti-DNA antibody Anti-RNP

Negative or titer 1:10 or 20% binding Negative

Same as conventional units Negative

Chronic hepatitis, rheumatoid arthritis, scleroderma, systemic lupus erythematosus Systemic lupus erythematosus

Anti-Sm (Smith) Antistreptolysin-O (ASO) Carcinoembryonic antigen (CEA)

Negative 166 Todd units or 1:85 2.5 ng/ml

Negative Same as conventional units 2.5 mcg/L

Mixed connective tissue disease, rheumatoid arthritis, scleroderma, Sjgren syndrome, systemic lupus erythematosus Systemic lupus erythematosus Acute glomerulonephritis, rheumatic fever, streptococcal infection Carcinoma of colon, liver, pancreas; chronic cigarette smoking; inammatory bowel disease; other cancers Acute glomerulonephritis, rheumatoid arthritis, serum sickness, subacute bacterial endocarditis, systemic lupus erythematosus Acute infections, any inammatory condition, widespread malignancy

Complement components C1q C3 C4 C-reactive protein (CRP)

11-21 mg/dl 80-180 mg/dl 15-50 mg/dl Negative or 1.2 mg/dl

0.11-0.21 g/L 0.8-1.8 g/L 0.15-0.5 g/L Same as conventional units

IV, Intravenous; RNP, ribonuclear protein; RPR, rapid plasma reagin test; VDRL, Veneral Disease Research Laboratory (test).

Copyright 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Appendix C

Laboratory Values

TABLE C-3

Serology-Immunologycontd
Appendix C

Test
Direct antihuman globulin test (DAT) or direct Coombs test Fluorescent treponemal antibody absorption (FTA-Abs) Hepatitis A antibody Hepatitis B surface antigen (HBsAg) Hepatitis C antibody Immunoglobulins IgA

Normal Values Conventional Units SI Units

Negative Negative

Higher

Possible Etiology Lower

Nonreactive

Negative

Acquired hemolytic anemia, drug reactions, hemolytic disease of the newborn, transfusion reactions Syphilis

Negative Negative Negative 90-400 mg/dl

Negative Negative Negative 0.9-4.0 g/L

Hepatitis A Hepatitis B Hepatitis C Autoimmune disorders, chronic infection, chronic liver disease, IgA myeloma, rheumatoid arthritis Chronic infection, connective tissue disease Anaphylactic shock, atopic disease (allergies), parasite infections Hepatitis, IgG monoclonal gammopathy, infections acute and chronic, systemic lupus erythematosus Acute infections, liver disease, rheumatoid arthritis Infectious mononucleosis Rheumatoid arthritis, Sjgren syndrome, systemic lupus erythematosus Febrile diseases, IV drug abuse, leprosy, malaria, rheumatoid arthritis, syphilis, systemic lupus erythematosus Early hypothyroidism, Graves disease, Hashimotos thyroiditis, pernicious anemia, systemic lupus erythematosus, thyroid carcinoma Syphilis Burns, hereditary telangiectasia, malabsorption syndromes

IgD IgE

0.5-12.0 mg/dl 1.0 mg/dl

5-120 mg/L 10 mg/L

IgG

650-1800 mg/dl

6.5-18.0 g/L

IgM

55-300 mg/dl

0.5-3.0 g/L

Acquired deciencies, burns, congenital deciencies, immunosuppression, nephrotic syndromes Congenital and acquired antibody deciencies, lymphocytic leukemia, protein-losing enteropathies

Monospot or monotest Rheumatoid factor (RA factor) RPR

Negative Negative or titer 1:20 Nonreactive

Negative Same as conventional units Same as conventional units

Thyroid antibodies

1:10 titer

Same as conventional units

VDRL

Nonreactive

Same as conventional units

Copyright 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Appendix C

Laboratory Values

TABLE C-4

Urine Chemistry
Normal Values Conventional Units SI Units
Negative Negative

Appendix C

Test
Acetone

Specimen
Random

Higher

Possible Etiology Lower

Aldosterone

24 hr

1-80 mcg/day (depends on urinary sodium)

2.7-222 nmol/day

Amylase Bence Jones protein Bilirubin Calcium

24 hr Random Random 24 hr

1-17 U/hr Negative Negative 100-250 mg/day

Same as conventional units Negative Negative 2.5-6.3 mmol/day

Diabetes mellitus, high-fat and low-carbohydrate diets, starvation states Primary aldosteronism: adrenocortical tumors Secondary aldosteronism: cardiac failure, cirrhosis, large dose of ACTH, salt depletion Acute pancreatitis Biliary duct obstruction, multiple myeloma Hepatitis Bone tumor, hyperparathyroidism, milk-alkali syndrome Heart failure, pheochromocytoma, progressive muscular dystrophy Addisons disease

ACTH deciency, Addisons disease, corticosteroid therapy

Hypoparathyroidism, malabsorption of calcium and vitamin D

Catecholamines Epinephrine Norepinephrine Chloride

24 hr 20 mcg/day 100 mcg/day 110-250 mEq/day 118 nmol/day 591 nmol/day 110-250 mmol/day

24 hr

Burns, diarrhea, excessive perspiration, menstruation, vomiting

Copper Coproporphyrin

24 hr 24 hr

30 mcg/day 50-200 mcg/day

0.5 mol/day 76-305 nmol/day

Creatine

24 hr

100 mg/day

763 mol/day

Creatinine

24 hr

0.8-2.0 g/day

7.1-17.7 mmol/day

Cirrhosis, Wilsons disease Lead poisoning, oral contraceptive use, poliomyelitis Addisons disease, burns, carcinoma of liver, diabetes, hyperthyroidism, infections, muscular dystrophy, skeletal muscle atrophy Anemia, leukemia, muscular atrophy, salmonellae

Hypothyroidism

Renal disease

Creatinine clearance Estrogens Female Ovulation peak Luteal peak Pregnancy Menopause Male Glucose

24 hr 24 hr

85-135 ml/min

1.42-2.25 ml/sec

Renal disease

Gonadal or adrenal tumor 28-100 mcg/day 22-80 mcg/day Up to 45,000 mcg/day 1.4-19.6 mcg/day 5-18 mcg/day Negative 104-370 nmol/day 81-296 nmol/day Up to 166,455 nmol/day 5.2-72.5 nmol/day 18-67 nmol/day Negative

Agenesis of ovaries, endocrine disturbance, menopause, ovarian dysfunction

Random

Hemoglobin

Random

Negative

Negative

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

24 hr

2-9 mg/day

10.5-47.1 mol/day

Diabetes mellitus, low renal threshold for glucose resorption, physiologic stress, pituitary disorders Extensive burns, glomerulonephritis, hemolytic anemias, hemolytic transfusion reaction Malignant carcinoid syndrome Marked ketonuria Lead poisoning Pheochromocytoma Crushing injuries, electrical injuries, extreme physical exertion

24 hr 24 hr 24 hr Random

20-50 mg/day 100 mcg/day 1.3 mg/day Negative

0.34-0.86 mmol/day 0.48 mol/day 7.1 mol/day Negative

ACTH, Adrenocorticotropic hormone.

Copyright 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Appendix C

Laboratory Values

TABLE C-4

Urine Chemistrycontd
Appendix C

Test
pH

Specimen
Random

Normal Values Conventional Units SI Units

4.0-8.0 Same as conventional units

Higher

Possible Etiology Lower

Compensatory phase of acidosis, dehydration, emphysema

Phenylpyruvic acid Phosphorus, inorganic Porphobilinogen

Random 24 hr

Negative 0.9-1.3 g/day

Negative 29-42 mmol/day

Random 24 hr Random

Negative 2.0 mg/day Negative

Negative 9 mol/day Negative

Protein (dipstick)

Protein (quantitative)

24 hr

150 mg/day

0.15 g/day

Sodium Specic gravity Titratable acidity Uric acid Urobilinogen

24 hr Random 24 hr 24 hr 24 hr

40-250 mEq/day 1.003-1.030 20-50 mEq/day 250-750 mg/day 0.5-4.0 mg/day

40-250 mmol/day Same as conventional units Same as conventional units 1.5-4.5 mmol/day 0.8-6.8 mol/day

Chronic renal failure, compensatory phase of alkalosis, salicylate intoxication, vegetarian diet Phenylketonuria Fever, hypoparathyroidism, nervous exhaustion, rickets, tuberculosis Acute intermittent porphyria, liver disorders Heart failure, nephritis, nephrosis, physiologic stress Cardiac failure, inammatory processes of urinary tract, nephritis, nephrosis, toxemia of pregnancy Acute tubular necrosis Albuminuria, dehydration, glycosuria Metabolic acidosis Gout, leukemia Hemolytic disease, hepatic parenchymal cell damage, liver disease Porphyria Pheochromocytoma

Acute infections, nephritis

Hyponatremia Diabetes insipidus Metabolic alkalosis Nephritis Complete obstruction of bile duct

Uroporphyrins Vanillylmandelic acid

Random Random 24 hr

1.0 mg Random 1-8 mg/day 1.5-7.0 mcg/mg creatine

1.7 mol Same as conventional units 5-40 mol/day

TABLE C-5

Gastric Analysis
Normal Values Conventional Units SI Units
0.30 mEq/L 15-45 mEq/L Same as conventional units Same as conventional units

Test
Basal Free hydrochloric acid Total acidity Poststimulation Free hydrochloric acid Total acidity

Higher

Possible Etiology Lower

Pernicious anemia Gastric carcinoma, severe gastritis

Hypermotility of stomach Gastric and duodenal ulcers, Zollinger-Ellison syndrome

10-130 mEq/L 20-150 mEq/L

Same as conventional units Same as conventional units

Copyright 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Appendix C

Laboratory Values

TABLE C-6

Fecal Analysis
Normal Values Conventional SI Units Units
Negative 6 g/24 hr Negative Negative 30-220 mg/100 g of stool Negative Same as conventional units Negative Negative 51-372 mol/100 g of stool

Appendix C

Possible Etiology Higher

Anal ssures, hemorrhoids, inammatory bowel disease, malignant tumor, peptic ulcer Chronic pancreatic disease, malabsorption syndrome, obstruction of common bile duct Mucous colitis, spastic constipation Chronic bacillary dysentery, chronic ulcerative colitis, localized abscesses Hemolytic anemias

Test
Blood* Fecal fat Mucus Pus Urobilinogen Color Brown Clay Tarry Red Black

Lower

Complete biliary obstruction

Various shades 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

*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-7

Cerebrospinal Fluid Analysis

Normal Values Conventional Units SI Units
60-150 mm H2O Negative Same as conventional units Negative

Test
Pressure Blood Cell count (age dependent) WBC RBC Chloride Glucose Protein Lumbar Cisternal Ventricular

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 0 cells/ l 100-130 mEq/L 40-75 mg/dl

0.5 106/L 0 106/L 100-130 mmol/L 2.5-4.2 mmol/L

Uremia Diabetes mellitus, viral infections of CNS Guillain-Barr syndrome, poliomyelitis, traumatic tap Syphilis of CNS Acute meningitis, brain tumor, chronic CNS infections, multiple sclerosis

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

CNS, Central nervous system; RBC, red blood cells; WBC, white blood cells.

Copyright 2007 by Mosby, Inc., an affiliate of Elsevier Inc.