Laboratory And Diagnostic Tests

Front 1

Red Blood Cells (RBCs)

Back 1

4.2-6.1 million/ unit

* unchanged with aging.
*Low: hemorrhage, anemia, chronic illness, renal failure, pernicious anemia
*High: high altitude, polycythemia, dehydration

Front 2

Hemoglobin

Back 2

12-18 g/dL

*Older adults- values may be slightly decreased.
*Low- anemia, cancer, nutritional deficiency, kidney disease.
*High-high altitude, polycythemia, dehydration, CHF, COPD.

Front 3

Hematocrit

Back 3

37-52%

*Older adults- values may be slightly decreased.
*Low- anemia, cirrhosis, hemorrhage, malnutrition, rheumatoid arthritis.
*High-polycythemia, severe dehydration, severe diarrhea, COPD.

Front 4

White blood cells (WBC)
Total

Back 4

5.0- 10.0 Thousand/mm 3

* unchanged with aging.
*Low: drug toxicity, infections, autoimmune disease, dietary deficiency.
*High: infection, trauma, stress, inflammation.

Front 5

Folic acid

Back 5

5-25 ng/ml

* unchanged with aging.
*Low: malnutrition, folic acid anemia, hemolytic anemia, alcoholism, liver disease, chronic renal disease.
*High: pernicious anemia

Front 6

Vitamin B12

Back 6

160-950 pg/mL

* unchanged with aging.
*Low: pernicious anemia, inflammatory bowel disease, atrophic gastritis, folic acid deficiency.
*High: leukemia, polycythemia, severe liver dysfunction.

Front 7

Total iron binding capacity
(TIBC)

Back 7

250- 460 mcg/dL

* unchanged with aging.
*Low: hypoproteinemia, cirrhosis, hemolytic anemia, pernicious anemia
*High: polycythemia, iron deficiency anemia

Front 8

Iron (Fe)

Back 8

60-180 mcg/dL

* unchanged with aging.
*Low: insufficient dietary iron, chronic blood loss, inadequate absorption of iron
*High: hemochromocytosis, hemolytic anemia, hepatitis, iron poisoning

Front 9

Uric Acid

Back 9

4-8.5 mg/ dL

*May be slightly increased with age
*Low-lead poisoning
*High-gout, increased ingestion of purines, chronic renal disease, hypothyroidism

Front 10

Prothrombin time (PT)

Back 10

11-12.5 sec

* unchanged with aging.
*High: Liver disease, vitamin K deficiency, warfarin ingestion, bile, duct obstruction, salicylate intoxication.
** Warfarin toxicity is determined by an international normalized ratio (INR) or INR with Prothrombin time.**

Front 11

Partial thromboplastin time (PTT)

Back 11

60-70 sec

* unchanged with aging.
*Low: Early stages of disseminated intravascular coagulation metastatic cancer.

Front 12

Platelets

Back 12

150,000-400,000/mm3

* unchanged with aging.
*Low: hemorrhage, thrombocytopenia, systemic lupus erythematosus, pernicious anemia, chemotherapy, infection
*High- malignancy, polycythemia, rheumatoid arthritis, iron deficiency anemia

Front 13

Sodium

Back 13

136-145 mEq/L

* unchanged with aging.
*Low: decreased intake, diarrhea, vomiting, diuretic administration, chronic renal failure, congestive heart failure (CHF), peripheral edema, ascites.
*High- increased intake, cushing's syndrome, extensive thermal burns

Front 14

Potassium

Back 14

3.5-5 mEq/L

* unchanged with aging.
*Low: deficient intake, burns, diuretics, Cushing's syndrome, insulin administration, ascites.
*High- excessive dietary, renal failure, infection, acidosis, dehydration. - NSAIDs such as ibuprofen interfere with potassium excretion.

Front 15

Chloride

Back 15

98-106 mEq/L

* unchanged with aging.
*Low: overhydration, CHF, vomiting, chronic gastric suction, chronic respiratory acidosis, hypokalemia, diuretic therapy.
*High- dehydration, Cushing's syndrome, kidney dysfunction, metabolic acidosis, hyperventilation

Front 16

Calcium

Back 16

9.0-10.5 mg/ dL

*Tends to stay the same or decrease with age.
*Low- renal failure, vitamin D deficiency, osteomalacia, malabsorption.
*High- Paget's disease of the bone, prolonged immobilization, lymphoma

Front 17

Phosphorus

Back 17

3-4.5 mg/dL

*Slightly lower in older adults
* Low: inadequate dietary ingestion, chronic antacid ingestion, hypercalcemia, alcoholism, osteomalacia, malnutrition
*High: renal failure, increased dietary intake, hypocalcemia, liver disease.

Front 18

Magnesium

Back 18

1.3- 2.1 mEq/L

* decrease 15% between third and eighth decade
*Low: malnutrition, malabsorption, alcoholism, chronic renal disease
*High: renal insufficiency, ingestion of magnesium-containing antacids or salt, hypothyroidism

Front 19

Fasting glucose

Back 19

70-105 mg/dL

* increase in normal range after age 50
* Low: hypothyroidism, liver disease, insulin overdose, starvation
* High: diabetes mellitus, acute stress response, diuretic therapy, corticosteroid therapy.

Front 20

Postprandial glucose

Back 20

Less than 140 mg/dL

*Less than 160 mg/dL 2 hr after meal for older adults.
*Low: Hypothyroidism, liver disease, insulin overdose, starvation.
*High: diabetes mellitus, malnutrition, Cushing's syndrome, chronic renal failure, diuretic therapy, corticosteroid therapy.

Front 21

Amylase

Back 21

60-120 Somogyi units/dL

*Slightly increased in elderly
*High: acute pancreatitis, perforated bowel, acute cholecystitis, diabetic ketoacidosis

Front 22

Gyscosylated hemoglobin (Hgb A1c)

Back 22

2.2%-4.8%

*Unchanged with aging
*Low: hemolytic anemia, chronic renal failure
*High: newly diagnosed diabetes, poorly controlled diabetes, nondiabetic hyperglycemia

Front 23

Total Protein

Back 23

6.4 - 8.3 g/dL

*Unchanged with aging
*Low: liver disease, malnutrition, ascites
*High: Hemoconcentration

Front 24

Albumin

Back 24

3.5- 5 g/dL

*decrease slightly with aging
*Low: malnutrition, liver disease over hydration , advanced cirrhosis
*high: dehydration

Front 25

Blood Urea Nitrogen (BUN)

Back 25

7- 22 mg/dL

*May be slightly higher
*Low- liver failure over hydration, malnutrition
*High- hypovolemia, dehydration, alimentary tube feeding, renal disease

Front 26

Creatinine

Back 26

0.7-1.5 mg/dL

* Decrease in muscle mass may cause decreased values with aging.
*Low: debilitation, Decreased muscle mass.
* High: Reduced renal bloodflow, diabetic neuropathy, urinary tract obstruction.

Front 27

Creatinine clearance

Back 27

87-107 mL/min

* Values decrease 6.5 mL/min/decade Of life due to a decline in glomerular filtration rate (GFR) with age.
* Low: impaired kidney function, CHF. Cirrhosis.
*High: high cardiac output syndrome.

Front 28

Cholesterol (total)

Back 28

> 200 mg/ dL

* Increases until about middle-aged but decreases thereafter (Or can increase abruptly in women)
* Low: Malabsorption, malnutrition, cholesterol-lowering medication, pernicious anemia, liver disease, myocardial infarction.
* High: hypercholesteremia, hyperlipidemia, hypothyroidism, uncontrolled diabetes mellitus.

Front 29

High density lipoprotein (HDL)

Back 29

> 45 mg/dL

* Unchanged with aging
*Low: familial low HDL, Liver disease, hypoproteinemia.
*High: familial HDL lipoproteinemia, excessive exercise.

Front 30

Low density lipoprotein (LDL)

Back 30

60-180 mg/dL

* Increases with aging after menopause.
* Low: hypoproteinemia
* High: Hypothyroidism, alcohol consumption, chronic liver disease, Cushing's syndrome.

Front 31

Alkaline phosphatase

Back 31

30-120 U/L

* Slightly higher in normal older adults.
* Low: Hypothyroidism, malnutrition, pernicious anemia.
*High: Cirrhosis, healing fractures, Paget's disease.

Front 32

Acid phosphatase

Back 32

0.13-0.63 U/L

* Unchanged with aging
* Low: thrombosis.
*High: Heparin administration, cirrhosis, prostate cancer.

Front 33

Aspartate transaminase (AST)

Back 33

0-35 U/L

* Values slightly higher in older adults.
* Low: Acute renal disease, diabetic ketoacidosis, chronic renal dialysis.
*High: Myocardial infarction, hepatitis, cirrhosis, multiple trauma, acute hemolytic anemia.

Front 34

Creatinine Kinase (CK)

Back 34

30-170 U/L

*Unchanged with aging
* High: Diseases or injury affecting heart muscle, skeletal muscle, and brain.

Front 35

Thyroxine (T4)

Back 35

4-12 mcg/ dL

* Slightly decreased in older adults.
* Low: Hypothyroidism, malnutrition, real failure, cirrhosis.
*High: Hyperthyroidism, hepatitis.

Front 36

Triiodothyronine (T3)

Back 36

75-220 ng/dL

* Slightly decreased in older adults.
*Low: Hypothyroidism, pituitary insufficiency, protein malnutrition, renal failure, liver disease.
*High: Hyperthyroidism, hepatitis, hypoproteinemia.

Front 37

Thyroid stimulating hormone (TSH)

Back 37

2-10

*Unchanged with aging
* Low: Pituitary dysfunction, hyperthyroidism.
*High: Primary hypothyroidism

Front 38

pH

Back 38

7.35-7.45

* same in older adults
* Low: Respiratory or metabolic acidosis.
*High: Respiratory or metabolic alkalosis

Front 39

PaO2

Back 39

80-100 mm Hg

* Decreases 25% between 30 and 80 years old.
*Low: Cardiac or respiratory disease.

Front 40

PaCO2

Back 40

35-45 mmHg

*same in older adults
*Low: Respiratory alkalosis
*High: Respiratory acidosis

Front 41

HCO3

Back 41

21-28 mEq/L

*Same in older adults
*Low: Metabolic acidosis
*High: Metabolic alkalosis

Front 42

Transferrin

Back 42

250-300 mcg/dL

Low: liver damage
High: Iron deficiency

Front 43

Alpha fetoprotien

Back 43

6-20 ng/mL

Low:
High: hepatocellular carcinoma

Front 44

Respiratory Acidosis Causes

Back 44

Asthma, Atelectasis, Brain trauma, Bronchoniectasis, Bronchitis, Central Nervous system depressants, Emphysema, Hypoventilation, Pneumonia, Pulmonary edema, Pulmonary Emboli

Front 45

Respiratory Alkalosis Causes

Back 45

Fever, Hyperventilation, Hypoxia, Hysteria, Overventilation by mechanical ventilators, Pain

Front 46

Metabolic Acidosis Causes

Back 46

Diabetes mellitus or Diabetes Ketoacidosis, excessive ingestion of acetylsalicylic acid (aspirin), High- Fat diet, Insufficient metabolism of carbohydrates, Malnutrition, Renal insufficient, acute kidney injury, or chronic kidney disease, Severe diarrhea.

Front 47

Metabolic Alkalosis Causes

Back 47

Diuretics, Excessive vomiting or gastrointestinal suctioning, Hyperaldosteronism, ingestion of and/or infusion of excess sodium bicarbonate, Massive transfusion of whole blood.