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58 Cards in this Set

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Total protein
6.5 - 8.3 g/dl
Serum albumin
3.5 - 5.0 g/dl
CSF total protein
15 - 45 mg/dl (1% of serum TP)
<2.5% = normal
>2.5% = perform biopsy

Lower % free PSA = higher risk of prostate cancer
alphafetoprotein (AFP)
1. during 1st trimester?
2. at birth?
3. during adulthood?
1st trimester: 2-3 mg/ml (peak)
at birth: 50 ug/ml
Adult: <20 ng/ml
6 - 20 mg/dl
Serum Creatinine
0.9 - 1.3 mg/dl
Creatinine clearance (formula and reference range)
Creatinine clearance = [(U * V)/P] * (1.73sq m/body surface area)

Males: 105 +/- 20 mL/min/1.73sqm
Females: 95 +/- 20 mL/min/1.73sqm
TP measurement: biuret vs. dye binding vs. kjeldahl
Biuret: cupric ions complex with peptide bonds, causing color change

Bye binding: Protein binds a dye, such as Coomasie

Kjeldahl: Quantification of Nitrogen; reference method; not routine
BUN measurement: Kinetic vs. Chemical
Kinetic: Urease converts urea to ammonium and bicarbonate; glutamate dehydrogenase oxidizes NADH to NAD+, causing chang in absorbance

Chemical: Diacetyl reacts with urea to produce a yellow diazine compound
Creatinine measurement: Jaffe vs. enzymatic
Jaffe: creatinine reacts with picric acid to produce red creatinine picrate

Creatinine converted to creatine (creatininase)
Creatine converted to sarcosine (creatinase)
Sarcosine oxidized to glycine, formaldehyde and peroxide (sarcosine oxidase)
peroxidase reaction detects color change to oxidized reagent
Uric acid measurement: chemical vs enzymatic
Chemical: Uric acid and phosphotungstic acid react to form allantoin and TUNGSTEN BLUE in the presence of oxygen

Enzymatic: URICASE oxidizes uric acid, oxygen, and water to allantoin, peroxide and CO2. Decrease in absorbance at 293nm is read.
Uric acid reference range
Males: 3.5-7.2 mg/dl
Females: 2.6-6.0 mg/dl
Ammonia measurement
Alpha-ketoglutarate is reduced to glutamate in the presence of ammonium and NADPH via GLUTAMATE DEHYDROGENASE
Reference range
74-99 mg/dl
Hyperglycemic vs. hypoglycemic
Hyperglycemic: >100 mg/dl
Hypoglycemic: <50 mg/dl
Ammonia reference range
11- 32 umol/L
"Impaired fasting glucose" range
Fasting glucose: 100< [glucose] <125 mg/dl
"Diabetes mellitus diagnosis" level
Fasting glucose >126 mg/dl
Casual glucose >200 mg/dl
OGTT glucose @ 2hrs, >200 mg/dl
Hb A1c reference range
4-6%; <7% indicates effective treatment
Glucose measurement: glucose oxidase vs. hexokinase
Glucose oxidase: Glucose oxidized to gluconic acid (glucose oxidase); yields peroxide. Peroxide reduced to water via Peroxidase; dye is oxidized and measured.

Hexokinase: Hexokinase phosphorylates glucose to glucose-6-phosphate. Glucose-6-phosphate is oxidized to 6-phosphogluconate by G6P-dehydrogenase; NADP+ is reduced to NADPH (change in abs is read)
Lactate reference range
0.5 - 1.3 mmol/L
Lactate measurement method
Lactate oxidized to pyruvate and peroxide; peroxide is used to oxidize a chromogen via peroxidase reaction
% trig?
% cholesterol?
% protein? [what is primary lipoprotein?]
86% trig
5% cholesterol
2% apolipoprotein (B-48)
% trig?
% cholesterol?
% protein? [what is primary lipoprotein?]
55% triglyceride
19% cholesterol
8% apolipoprotein (B-100)
% trig?
% cholesterol?
% protein? [what is primary lipoprotein?]
50% cholesterol
6% triglyceride
22% protein (B-100)
% trig?
% cholesterol?
% protein? [what is primary lipoprotein?]
50% protein (A-I)
19% cholesterol
3% triglyceride
Triglyceride reference range
<150 mg/dl = normal
150-199 = borderline high
200-499 = high
>500 = very high
Total cholesterol reference range
<200 = normal
200-239 = borderline high
>240 = high
HDL cholesterol reference range
>60 mg/dl= protective against heart disease
40-59 = intermediate; higher is better
<40 = risk factor for CVD
LDL cholesterol reference range
<100 mg/dl= optimal
100-190 = high
>190 = very high
Cholesterol measurement method
1. Cholesteryl esters hydrolyzed to cholesterol and fatty acid by cholesteryl esterase
2. Cholesterol oxidized by cholesterol oxidase to cholestenone and peroxide
3. Peroxide measured via colorimetric peroxidase method
Friedwald formula
Total cholesterol = HDL + LDL + VLDL

Total cholesterol is measured (enzymatic method)
HDL cholesterol is measured (precipitate LDL/VLDL, then enzymatic method)
VLDL = Trigylcerides/5 (if triglycerides < 400 mg/dl)
LDL is then calculated
HDL cholesterol measurement method
LDL and VLDL are precipitate via Dextran Sulfate-Magnesium Chloride or Heparin Sulfate-Magnesium Chloride; then, cholesterol in supernatant is measured via enzymatic technique.
Trigylceride measurement method
1. Trigylceride is hydrolyzed to glycerol and 3 fatty acids [Lipase]
2. Glycerol is phosphorylated to glycerophosphate [Glycerokinase]
3. Glycerophosphate is oxidized to dihydroxyacetone and peroxide [glycerophosphate oxidase]
4. Peroxide reacts in colormetric peroxidase reaction
Apolipoprotein reference ranges:
Apo-A: 120-160 mg/dl
Apo-B: <120 mg/dl
Lp(a): <30 mg/dl (CHD risk factor)
Lactate dehydrogenase reference range
100 - 225 U/L
Reference range of total CK, CK-MB, CK-MB index
Total CK: 15-150 U/L
CK-MB: 0-5 ng/mL
CK-MB index: <6% of total CK
Reference range: ALT and AST
~5-30 U/L

(ALT more specific for hepatocellular disease)
ALP reference range
50 - 115 U/L
GGT reference range
<55 U/L for males
<38 U/L for females
Amylase reference range
28 - 100 U/L
Lipase reference range
< 38 U/L
Pseudocholinesterase reference range
40-78 U/L
Sodium reference range
135 - 145 mmol/L
Potassium reference range
3.5 - 5.0 mmol/L
Chloride reference range
95 - 105 mmol/L
Ionized calcium reference range
1.1 - 1.3 mmol/L
Total calcium reference range
8.5 - 10.5 mg/dl
Serum iron reference range (male vs female)
Male: 75 - 200 ug/dl
Female: 26 - 170 ug/dl
TIBC reference range
250 - 450 ug/dl
Transferrin saturation reference range
20 - 50%
Phosphate reference range
0.8 - 1.5 mmol/L
pH reference range
7.35 - 7.45
Bicarbonate reference range
18 - 23 mmol/L
Total CO2 reference range
23 - 30 mmol/L
B-type Natriuretic Peptide "reference ranges"
<100 pg/mL = CHF unlikely
>500 = CHF likely

between 100-500 = "grey zone"
TSH reference range
0.5 - 4.0 mIU/L