Lab Values

Front 1

alanine transaminase (ALT)

Back 1

Male 7-55 U/L
Female 7-45 U/L

present in liver cells and more liver specific than AST

think destructionof hepatocytes

ALT/AST>1 in inflamm liver dz; viral hep

usually elevated before signs and sx of dz are present

Front 2

aspartate aminotransferase (AST)

Back 2

8-48 U/L

found in liver, heart, skeletal muscle, kidneys

elevated in acute pancreatitis, Muscular dystrophy, crush muscle injury, dermatomyositosis, hemolysis

increased AST with MI and alcohol usage

AST>ALT = ETOH hep

Front 3

calcium

dz assoc with low and high?

Back 3

2.2-2.5mmmol/L

low = impaired PTH glands, impaired Vit D synth, chronic renal failure, hyperphophatemia, PTH resistance -- lat sx is latent or manifest tetany or osteomalacia

high = hyperparathyroidism or bone mets of CA of breast, prostate, thyroid, lung, arrythmias -- >12 = medical emergency

Front 4

phosphate

Back 4

2.5-4.5 mg/dL (0.8-1.5mmol/L)

low = renal phosphate wasting, loss from GI, loss from intracellular stores, EC to IC stores -- common in hospitalized pt (levels < 1.5mg/dL associated with muscle weakness, RBC hemolysis, coma, bone deformity, impaired bone growth); <1 = ER

high: acute/rapid elevation -- think low Ca + tetany, seizure, hypotension; long term = calcification of soft tissue

high = usually 2ndary to kidneys ability to excrete phosphate

reflected by diet

Front 5

chlorine

Back 5

100-108mmol/L (95-105meq/L)

increased by: dehydration, renal tubular acidosis, acute renal failure, metabolic acidosis assoc with prolonged dairrhea and loss of Na bicarb, diabetes insipidus, adrenocortical hyperfunction, aspirine tox, excessive infusion of isotonic saline, high salt intake

decreased in overhydration, chronic resp acidosis, salt losing nephritis, metabolic alkalosis, CHF, Addison's crisis, prolonged vomit, aldosteronism, SIADH, expanded fluid volume

Front 6

glucose - fasting

Back 6

10-100mg/dL

>/= 125 = diagnostic for DM for 2 consec days following 8hr fast

>200mg/dl for other test (+/-) sx (wt loss, polyuria, incr glc in blood and urine, constant hunger and thirst....only if random) = dx for DM

Front 7

postassium

Back 7

3.5 - 5 meq/L

monitor with diabetic ketoacidosis and any IV tx for fluid replacement

decrease = irritable, muscle weakness, paralysis, tachy, cardiac arrest -- caused by vomiting, ETOHism, folic acid def, htn + aldosteronism
(<2.5 is life threatening)
'
increase = metnal confusion, weak, numb, tingling of extremities, weak resp muscles, flaccid paralysis, brady, cardiac arrest -- caused by end stage renal failure, hemolyis, trauma, Addison's disease, metabolic acidosis, acute starvation, rapid K infusion, or dehydration

>7 can be life threatening; >10 fatal

Front 8

sodium

Back 8

135-145 mmol/L

low values: low intake, high loss (vomit, diarrhea, renal loss due to diuretics, sweat), prim or second aldosteronism, polyuria, nephrotic syndrome -- sx = brain swelling, weakness, seizure, coma death

high values - osmotic diuresis, PG, hypokalemia, hypercalcemia, dec ADH, diabetes insipidus, high salt intake, dehydration, Cushings, diabetic acidosis -- sx increased HCT, confsion, siezure, coma, thirst

Front 9

BUN

Back 9

Males = 8-24 mg/dL (2.8-8.6mmol/L)
Females = 6-21 mg/dL (2.1-7.5 mmol/L)

evaluates kidney function - final degradation product of protein and aa metabolism = elimination of nitrogen through BUN

Front 10

CR

Back 10

0.6-1.2 mg/dL

inversely correlated with GFR

Front 11

GGT

Back 11

inidcation of intra or extra hepatic obsturciton to bile flow

induction of CYP450 (eg ETOH) causes increase

Front 12

ALP

Back 12

found in liver and osteoblastic bone

high GGT and ALP think liver cholestasis

normal GGT and high ALP think source of ALP other than liver (bone, PG)

increased with blocked bile ducts and with viral hepatitis