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Running Head: GROUP LAB PROJECT
Laboratory Review Worksheet-Group Project
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GROUP LAB PROJECT
Laboratory testing allows clinicians to have a better understanding of the processes and internal
changes that a patient may be experiencing. Allowing a patient to have a better understanding of why
tests are performed and what the results mean increases satisfaction with care (O’Kane, M., 2015).
Tests are performed for various reasons. These reasons may include: diagnosis- to either
confirm or exclude a specific diagnosis when suggestive symptoms or signs are present; monitoring- as a
way to monitor response to treatment or the progression of a certain disease; screening- to assess the
risk of an occult disease; plan treatment- a method of planning treatment for a disease or condition in
order to determine next steps in a patient’s plan of care (U.S. Food and Drug Administration, 2018).
Below is a synthesis of a group project that has been performed by four graduate students in
the Family Nurse Practitioner (FNP) program of United States University. The most widely used tests are
included as well as normal values, clinical indications, conditions with abnormal low levels and abnormal
high levels, each as appropriate.
Test Name
Normal Values
WBC
4,500 to 11,000
cells/mcL
Hemoglobin
Men- 14 to 17.5
gm/dL
Components of CBC
Clinical Indications Conditions with
abnormal low
levels, if applicable
A complete blood
Bone marrow
count (CBC) is a
disorders,
test that measures autoimmune
the cells that make conditions, sepsis,
up a patient’s
lymphoma or other
blood- consisting of cancers, dietary
red blood cells,
deficiencies,
white blood cells
diseases of immune
and platelets. The
system such as
CBC can check for
HIV/AIDs.
anemia, check for
associated health
issues, monitor any
blood issues that
the patient may
already have as
well as understand
the reaction that
may be
experienced with
medications or
treatments that
affect the patient’s
blood
Same as above
Provides added info
but usually mirrors
RBs results
Conditions with
abnormal high
levels, if applicable
Infection (bacterial
or viral),
inflammation,
leukemia,
myeloproliferative
neoplasms,
Allergies, asthma,
tissue death,
intense exercise or
severe stress
Usually mirrors RBC
results
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GROUP LAB PROJECT
Hematocrit
Women- 12.3 to
15.3 gm/dL
Men- 41.5% - 50.4%
Women- 36.9% 44.6%
Men- 4.5 Million to
5.9 million cells/mcL
Women- 4.1 million
to 5.1 million
cells/mcL
MCV-Normocytic
80- 96
Indicates RBC are
smaller than
normal
Provides added info
but usually mirrors
RBs results
Anemia, acute or
chronic bleeding,
RBC destruction,
Nutritional
deficiency, Bone
Marrow disorders
or damage, chronic
inflammatory
disease, chronic
kidney disease.
Iron deficiency
anemias or
thalassemia
RDW (Red cell
distribution width)
11.5- 14.5
How much your
red blood cells vary
in size
Low value indicates
uniformity in size of
RBCs
Reticulocyte Count
0.5% to 2.5%
This test measures
the number of new
red blood cells in
your body
Platelets
150,000 to 450,000
platelets/mcL
Tests the number
of available
platelets within the
blood. Platelets
help the body form
clots to stop
bleeding.
Differential
Neutrophil- 33-73
56% Mean
There are five
types of white
Issue affecting the
production of red
blood cells such as
bone marrow
disorders or iron or
vit B12 deficiency
Thrombocytopeniaviral infections
(mononucleosis,
measles, hepatitis),
rocky mountain
spotted fever,
platelet
autoantibody,
cirrhosis,
autoimmune
disorders, sepsis,
leukemia,
lymphoma,
myelodysplasia,
chemo or radiation
Sepsis,
Autoimmune
RBC
Same as above
Same as above
Usually mirrors RBC
results
Dehydration,
pulmonary disease,
kidney disease,
smoking, living at
high altitudes,
polycythemia
Anemia caused by
vitamin
deficiencies,
hypothyroidism
May indicate mixed
population of small
or large RBCs. Could
be indicative of iron
deficiency anemia
Bleeding or
hemolysis in
response to
treatment of iron
supplementation
Cancer,
Rheumatoid
arthritis,
Inflammatory
bowel disease,
lupus, iron
deficiency anemia,
Myeloproliferative
disorder
Acute bacterial
infections
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GROUP LAB PROJECT
1800-7800
Absolute count x
109/L
1.8-7.8
disorders, dietary
deficiencies,
reaction to drugs,
immunodeficiency,
myelodysplasia,
bone marrow
damage, cancer
that spreads to the
bone marrow
Inflammation,
trauma, heart
attack, burns,
stress, rigorous
exercise, certain
leukemias, Cushing
syndrome.
Lymphocyte- 13-52
34% Mean
1000-4800
Absolute count x
109/L
1.0-4.8
Autoimmune
disorders Lupus,
rheumatoid
arthritis), Infections
(HIV, Viral Hepatitis,
typhoid fever,
influenza), Bone
marrow damage
(chemotherapy,
radiation)
corticosteroid.
Acute viral
infections: Chicken
pos, CMV, EBV,
Herpes, rubella;
certain infections
(pertussis,
whooping cough,
TB), Toxoplasmosis,
chronic
inflammatory
disorder (ulcerative
colitis), lymphocytic
leukemia, Stress.
Monocyte- 0-10
4%
Mean 0.04
Absolute count x
109/L
0-0.80
One low count is
not medically
significant.
Repeated low
counts can indicate:
Bone marrows
damage or failure,
hairy leukemia,
aplastic anemia.
Chronic infections
(TB, fungal
infections),
Bacterial
endocarditis, Lupus,
scleroderma,
rheumatoid
arthritis, vasculitis,
Myelomonocytic
leukemia.
Eosinophil- 0-5
2.7%
Mean
0-450
Absolute count x
109/L
0-0.45
blood cells. This
test shows how
many of each type:
neutrophils,
lymphocytes,
monocytes,
eosinophils, and
basophils.
Numbers are
normally low in the
blood. One or an
occasional low
number is usually
not medically
significant
Asthma, allergies,
hay fever, drug
reactions, parasitic
infections,
inflammatory
disorders (celiac
disease, IBS), some
cancers, leukemias
or lymphomas,
Addison disease.
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GROUP LAB PROJECT
Basophil- 0-2
0.3%
0-200
Mean
Absolute count x
109/L
0-0.20
Test Name
Sodium
Chloride
Normal
Values
134144
mEq/L
98-107
mEq/L
Potassium
3.5–5
mEq/L
Numbers are
normally low in the
blood. Usually not
medically
significant
Components on a Comprehensive Metabolic Panel
Clinical Indications
Conditions with abnormal low
levels, if applicable
Determine wholeACE inhibitors, acute tubular
body stores of
necrosis, AIDS, adrenal
sodium, because the insufficiency, CHF, Cirrhosis,
ion is predominantly hypothyroidism, diarrhea, SIADH,
extracellular
thiazide diuretics, vomiting, water
Monitor the
intoxication.
effectiveness of drug
therapy, especially
diuretics, on serum
sodium levels.
Rare allergic
reactions (hives,
food allergy),
Inflammation
(rheumatoid
arthritis, ulcerative
colitis), some
leukemias, uremia.
Conditions with abnormal
high levels, if applicable
Burns, Cushing's disease,
dehydration, diabetes, fever,
lactic acidosis, dietary sodium
intake, geriatric population,
oral contraceptive pills,
pregnancy, vomiting.
To evaluate
electrolytes, acidbase balance, and
hydration level.
Adrenal insufficiency, bicarbonates,
Cushing’s syndrome, diabetic
ketoacidosis, diaphoresis, diuretics,
glucocorticosteroids, ADH (SIADH),
renal failure, vomiting.
Diarrhea, dehydration,
hyperparathyroidism, renal
failure and respiratory
acidosis.
Drugs: Hydrochlorothiazide
and Acetazolamide.
To evaluate fluid and
electrolyte balance
related to potassium
levels toward
diagnosing disorders
such as acidosis,
renal failure,
dehydration, and
monitor the
effectiveness of
therapeutic
interventions.
Ascites, burns, chronic
pyelonephritis, Cushing’s
syndrome, diarrhea,
diuretics, insulin, low potassium
intake, metabolic alkalosis,
prolonged corticosteroid
treatment, renal tubular acidosis,
Salicylates, vomiting.
ACE inhibitors, acidosis,
acute/chronic renal
failure, Addison’s disease,
ARB’s Beta blockers,
dehydration, diabetes,
infection, massive tissue
damage, massive hemolysis,
NSAIDS, Spironolactone,
Triamterene.
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GROUP LAB PROJECT
Glucose
fasting
65-100
mg/dL
To assist in the
diagnosis of diabetes
and to evaluate
disorders of
carbohydrate
metabolism such as
malabsorption
syndrome.
Adrenal insufficiency, alcohol,
exogenous insulin, hypopituitarism,
hypothyroidism, insulinoma,
malignancy, malnutrition, oral
hypoglycemic index, sepsis.
Acromegaly, acute/chronic
pancreatitis, Cushing’s
syndrome, diabetes mellites,
glucocorticosteroids,
pheochromocytoma, stress.
Co2
33-45
mmHg
To assess the effect
of total carbon
dioxide levels on
respiratory and
metabolic acid-base
balance.
Chronic hyperventilation, incorrect
ventilator settings, liver disease,
respiratory alkalosis, sepsis.
Alcohol,
barbiturates, benzodiazepines,
Guillain-Barre syndrome,
myasthenia gravis, respiratory
acidosis, respiratory failure.
Magnesium
1.8-3.0
mg/dL
Determine
electrolyte balance in
renal failure and
chronic alcoholism;
Evaluate cardiac
arrhythmias;
Evaluate known or
suspected disorders
associated with
altered magnesium
levels;
Alcoholism, diabetic acidosis,
glomerulonephritis, hemodialysis,
increased aldosterone levels,
hypoparathyroidism, pancreatitis,
pregnancy.
Addison Disease, dehydration,
adrenocortical insufficiency,
diabetic acidosis,
hypothyroidism, massive
hemolysis, overuse of antacids,
renal insufficiency, tissue
trauma.
Phosphorous 2.5-4.5
mg/dL
Assist in establishing
a diagnosis of
hyperparathyroidism;
Assist in the
evaluation of renal
failure
Alcohol, diabetes, hypercalcemia,
diarrhea,
hyperparathyroidism, hypokalemia,
hypomagnesemia, hypothyroidism,,
vit D deficiency, vomiting.
Calcium
8.510.2
mg/dL
To investigate
various conditions
related to
abnormally increased
or decreased calcium
levels.
Alcohol, chronic renal failure,
hypoalbuminemia,
hypoparathyroidism, magnesium
deficiency, osteomalacia,
pregnancy, rickets, tumor lysis
syndrome, Vit D deficiency.
CreatinineFemale
Male
0.8-1.4
mg/dL
0.6-1.2
mg/dL
To assess kidney
function found in
acute and chronic
renal failure
Decreased muscle mass,
myasthenia gravis, muscular
dystrophy
Bone cancer,
cirrhosis, diuretics,
hyperparathyroidism,
hypocalcemia,
hypoparathyroidism, renal
failure, sarcoidosis, tumor lysis
syndrome, Vit D toxicity.
Acute/chronic renal failure,
aluminum toxicity, bone
cancer, hyperparathyroidism,
lymphoma, multiple myeloma,
Pageant’s disease of bone,
sarcoidosis, thiazide diuretics,
vit D toxicity, thyrotoxicosis.
Acute tubular necrosis,
aminoglycosides, CHF,
dehydration, diabetic
nephropathy, eclampsia, renal
failure, shock.
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GROUP LAB PROJECT
Critical
Values:
>5
mg/dL
BUN
5-20
mg/dL
To assess for renal
function toward
diagnosing disorders
such as kidney failure
and dehydration.
Also used in
monitoring the
effectiveness of
therapeutic
interventions such as
hemodialysis.
Test Name
Normal Values
LFT- ALT
8-37IU /L
AST
0-42 U/L
ALP
44-147 IU/L
GGT
0-3 IU/L
Bilirubin
(direct/Indirect)
0-1.0mg/dl
Hemodilution, infancy, liver failure,
low protein intake, malabsorption,
nephrotic syndrome, starvation.
Components of GI Labs
Clinical Indications Conditions with
abnormal low
levels, if applicable
Measurement of
N/A
Liver function and
evaluation of
acute/chronic liver
injury
Jaundice , Dark
Congested Liver,
Urine, Pale colored High Cholesterol
stools, weakness,
Poor appetite
,Abdominal
swelling
Jaundice, Dark
Wilson’s Disease,
Urine, Pale colored Cretinism,
stool, Weakness,
Pernicious anemia,
Fatigue. poor
Aplastic anemia.
appetite
Jaundice, Pale
colored stool,
fatigue and poor
appetite
Jaundice, Severe
itching, Fever chills,
Abdominal pain.
Hyperthyroidism, L
ow magnesium
levels.
Liver disease,
Hepatitis, Ascites,
Malnutrition and
Acute glomerulonephritis,
aminoglycosides, burns,
chronic nephritis, chronic renal
failure, dehydration, GI bleed,
polycystic kidney disease,
stress, shock, etc.
Conditions with
abnormal high
levels, if applicable
Acetaminophen
Overdose, alcohol
overdose/chronic
use, hepatitis, liver
damage.
Liver disease,
Alcoholism,
Myocardial
Infarction, Acute
and chronic disease
Liver disease eg
Cirrhosis, Hepatitis,
Biliary obstruction,
bone tumors,
Osteoporosis,
Leukemias.
Cirrhosis, Alcoholic
liver disease, liver
cancer, Pancreatitis
and SLE.
N/A
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GROUP LAB PROJECT
Clay colored stool,
Fatigue.
Albumin
3.5-5.2g/L
Protein
6.4-8.3g/dl
Amylase
50-123 U/L
Lipase
10-50 UI/L
Test Name
Normal Values
Hgb A1C
4-6%
Liver disease,
severe, suspected
kidney related
pathology.
Fever,
Malnutrition,
Suspected multiple
Myeloma.
Complete Physical
Enzyme secreted
primarily by the
pancreas but also
the mouth and
stomach and
functions to
metabolize lipids.
Used to diagnose
and monitor acute
pancreatitis
Hemoglobin A1C
Clinical Indications
• Assist in the
diagnosis of
insulinoma
• Determine insulin
requirements
• Evaluate
disorders of
carbohydrate
metabolism
• Identify
hypoglycemia
• Screen for
diabetes
Severe burn
Injuries. Gall
Stones, Alcoholic
liver disease.
Liver and Kidney
disease
Dehydration
Liver disease,
Kidney disease,
celiac disease, IBD
Infection, high
albumin and high
globulin.
N/A
Acute Pancreatitis,
Alcohol abuse,
Cholecystitis,
Gallbladder
dysfunction
Acute pancreatitis,
cholecystitis, celiac
disease, cirrhosis
Damage to the
lipase-producing
cells in the
pancreas. Can occur
in chronic diseases
that affect the
pancreas such as
cystic fibrosis
Conditions with
abnormal low
levels, if applicable
Hemorrhage
Conditions with
abnormal high
levels, if applicable
Poorly controlled
diabetes
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GROUP LAB PROJECT
Renal Function Tests
Clinical Indications Conditions with
abnormal low
levels, if applicable
To assess for renal Hemodilution,
function toward
infancy, liver
diagnosing
failure, low protein
disorders such as
intake,
kidney failure and
malabsorption,
dehydration. Also
nephrotic
used in monitoring syndrome,
the effectiveness of starvation.
therapeutic
interventions such
as hemodialysis.
To assess kidney
Decreased muscle
function found in
mass, myasthenia
acute and chronic
gravis, muscular
renal failure,
dystrophy.
related to drug
reaction and
Test Name
Normal Values
BUN
5-20 mg/dL
Creatinine- Female
Male
0.8-1.4 mg/dL
0.6-1.2 mg/dL
Critical Values:
>5 mg/dL
BUN/Cr Ratio
10-20.1
The
BUN/creatinine
ratio is also a
useful indicator of
kidney disease.
Glomerular
Filtration Rate
(GFR)
90 to 120
mL/min/1.73m2
A GFR blood test is
used whenever
there is suspicion
of a kidney disease.
This is usually the
case in patients
who are suffering
from diabetes or
from hypertension
for a prolonged
period of time
Acute tubular
necrosis, cirrhosis,
immediately after
dialysis, liver
disease, low protein
intake, pregnancy,
ADH,
rhabdomyolysis.
Acute/chronic renal
failure,
aminoglycosides,
CHF, decreased
renal perfusion,
dehydration,
hemorrhage, shock.
Sexual /Reproductive Health/STI
Conditions with
abnormal high
levels, if applicable
Acute
glomerulonephritis,
aminoglycosides,
burns, chronic
nephritis, chronic
renal failure,
dehydration, GI
bleed, polycystic
kidney disease,
stress, shock, etc.
Acute tubular
necrosis,
aminoglycosides,
CHF, dehydration,
diabetic
nephropathy,
eclampsia, renal
failure, shock.
Acute renal failure,
GI bleed, increased
catabolism, severe
dehydration, shock,
urinary obstruction.
Acromegaly, early
diabetes mellitus,
exercise, high
cardiac output,
hypothyroidism,
infections.
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GROUP LAB PROJECT
Test Name
Normal Values
Clinical Indications
Chlamydia
Negative (urine test)
Women who are
sexually active and
younger than 25
years old or
women who are
older than 25 years
old but are at risk
for sexually
transmitted
diseases.
Yearly screening
for men who have
sex with other
men.
For anyone who
has symptoms
similar to those of
STI such as pain on
urination (both
men and women);
women with
vaginal discharge
or abdominal pain;
men with discharge
from penis or
painful, swollen
testes.
Gonorrhea
(Neisseria
gonorrhoeae)
Negative (urine) or
could also include a
swab test of
discharge from
penis or vaginal
discharge
Yearly testing for
women who are
sexually active and
younger than 25 or
25 or older and at
an increased risk
for STD; or Men
should have a
yearly testing if
they are men who
have sex with men.
May also include
women who are
pregnant
Conditions with
abnormal low
levels, if applicable
N/A
Conditions with
abnormal high
levels, if applicable
If results are
positive then, begin
antibiotic therapy.
Sexual partners
should be tested
and treated as well.
N/A
Symptoms of an
STD such as pain
during urination,
vaginal discharge or
vaginal bleeding
between menstrual
periods (for
women) or unusual
discharge from the
penis, pain during
urination or painful,
swollen testicles
(for men).
Also, if a newborn
has conjunctivitis.
Treatment includes
dual therapy of
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GROUP LAB PROJECT
Syphilis(Venereal Disease
Research
Laboratory, VDRL)
Negative (blood) or
scraping from a
chancre in the
affected area. Could
also be
cerebrospinal fluid
taken via spinal tap.
When there are
symptoms of a
syphilis infection;
when at risk of
being exposed to
syphilis (another
STD or HIV) or have
engaged in highrisk sexual activity.
May also include
women who are
pregnant.
N/A
Trichomoniasis
Negative (urine
sample) or vaginal
swab (women) or
Urethra swab (men)
N/A
HPV
Negative
When a woman
has symptoms of
infection such as
foul-smelling
vaginal discharge,
genital itching,
and/or pain during
urination or when
a man has genital
itching or irritation,
burning after
urination or
ejaculation and/or
discharge from the
penis.
Screens for
infections of the
high-risk types of
HPV that can cause
cervical cancer or
as a follow up on
an abnormal pap
smear.
N/A
antibioticCeftriaxone and
azithromycin.
Used to screen for
or diagnose an
infection with the
bacterium
Treponema
pallidum which
causes syphilis.
Intramuscular
injection of
Benzathine
penicillin G (2.4
Million units)
administered IM
can cure the
disease.
Treatment includes
used of
metronidazole or
tinidazole to
eradicate the
protozoan parasite
associated with this
disease. Both
patient as well as
sexual partners
should be treated.
Screen every 5
years with a pap
smear or HPV
molecular test
alone for women
aged 30 to 65 with
average risk.
Younger aged
women could be
screened or women
with weakened
immune system or
if they have
precancerous
lesions. Or women
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GROUP LAB PROJECT
BV- (Bacterial
Vaginosis)
Negative
Genital Herpes
Negative
Use of Amsel
criteria with 3 of 4
symptoms present:
Grayish-white
vaginal discharge
Vaginal pH greater
than 4.5
Presence of “clue”
cells via wet prep
Fishy odor present
with the addition
of 10% potassium
hydroxide
Vaginal secretions
are collected and
placed on
unstained wet
mount or as a gram
stained slide.
Testing will detect
the herpes simplex
virus (HSV) in one
of the two main
types (HSV-1 and
HSV-2). A sample
from the blister or
soar can identify an
active herpes
infection or detect
herpes antibodies.
HSV-1 primarily
causes blisters
around the mouth
(cold sores)
whereas HSV-2
usually causes
lesions around the
genital area. It
should be noted
that either one of
the strains can
affect the oral or
genital areas.
N/A
N/A
aged 21 to 29 with
an abnormal Pap
smear result
Treatment can
include preventive
items such as
practice of safe sex,
avoidance of
feminine hygiene
products or
perfumed soaps as
well as irritants or
tight-fitting clothes.
Treatment via
vaginal creams or
suppositories will
depend on results
of items viewed
under microscope.
The herpes simplex
virus can be passed
from person to
person through skin
contact while the
sores are open and
healing and at
times when there
are no visible
sores.The patient
may have obvious
and painful blisters
at the site of
infection which
usually appear
within two weeks
after the virus is
transmitted.
Blisters can appear
in the vaginal area,
on the penis around
the anus, or on the
buttock or thighs.
Can include flu-like
symptoms.
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GROUP LAB PROJECT
Urine hCG- (Human
chorionic
gonadotropine)
Serum hCG(Human chorionic
gonadotropine)
Test Name
hCG levels will
double every 72 hrs
and will reach its
peak in the first 8-11
weeks of pregnancy
then decline and
level off for the
remainder of the
pregnancy.
Less than 5 mIU/mL
is considered
negative
Above 25 mIU/mL is
considered positive
for pregnancy.
Between 6 and 24
mIU/mL should be
retested to confirm
pregnancy.
hCG levels will
double every 72 hrs
and will reach its
peak in the first 8-11
weeks of pregnancy
then decline and
level off for the
remainder of the
pregnancy.
Less than 5 mIU/mL
is considered
negative
Above 25 mIU/mL is
considered positive
for pregnancy.
Between 6 and 24
mIU/mL should be
retested to confirm
pregnancy.
Normal
Values
hCG is a hormone
that is produced
during pregnancy.
It is made by cells
formed in the
placenta which
nourishes the egg
after it has been
fertilized and
attaches to the
uterine wall. Levels
can be detected
12-14 days after
conception by a
urine test.
Low would indicate
patient is not
pregnant
High results should
include referral to
obstetric for
prenatal care.
hCG is a hormone
that is produced
during pregnancy.
It is made by cells
formed in the
placenta which
nourishes the egg
after it has been
fertilized and
attaches to the
uterine wall. Levels
can be detected 11
days after
conception by a
blood test.
Low would indicate
patient is not
pregnant
High results should
include referral to
obstetric for
prenatal care.
Components of Lipid Panel
Clinical Indications
Conditions with
abnormal low levels,
if applicable
Conditions with abnormal
high levels, if applicable
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GROUP LAB PROJECT
Total
Cholesterol
<200 mg/dL
Assist in determining
risk of cardiovascular
disease • Assist in the
diagnosis of
nephrotic syndrome,
hepatic disease,
pancreatitis, and
thyroid disorders •
Evaluate the
response to dietary
and drug therapy for
hypercholesterolemia
• Investigate
hypercholesterolemia
in light of family
history of
cardiovascular
disease
To assess risk and
monitor for coronary
artery disease.
Abetalipoproteinemia,
Acute hepatitis,
cirrhosis,
hyperthyroidism,
malabsorption,
malnutrition,
pernicious anemia,
sepsis, Tay Sachs
disease
Biliary cirrhosis,
cholestasis, corticosteroids,
Cushing’s syndrome,
hepatocellular
carcinomas, hyperlipidemia,
familial hyperlipidemias,
hypothyroidism, increase
dietary fat intake, poorly
controlled diabetes
mellitus, nephrotic
syndrome, pregnancy.
LDL
<100 mg/dL
Abetalipoproteinuria,
chronic illness.
Female
50-100
mg/dL
Male
45-90
mg/dL
To assess risk and
monitor for coronary
artery disease.
Age 10-39
years
54-110
mg/dL
To evaluate
triglyceride levels to
assess cardiovascular
disease risk and
evaluate the
effectiveness of
therapeutic
interventions.
Beta blockers, chronic
renal failure, cigarette
smoking, diabetes
mellitus, diuretics,
hypothyroidism, liver
disease, low physical
activity, obesity, oral
contraceptive
pills, post MI, stress,
uremia.
Hyperthyroidism, liver
disease,
malabsorption,
malnutrition.
Anabolic steroids,
cholestasis, chronic renal
failure, diabetes mellitus,
hypothyroidism, nephrotic
syndrome, poor diet,
pregnancy, familial
hypercholesterolemia.
Estrogen replacement
therapy, exercise, insulin,
phenobarbital, phenytoin.
HDL
Triglycerides
Age 40-59
70-150
mg/dL
Age >60 80150 mg/dL
Alcohol, beta blockers,
biliary tract obstruction,
chronic renal failure,
cigarette smoking, cirrhosis,
corticosteroids, diabetes
mellitus, fatty liver, genetic
factors, etc.
15
GROUP LAB PROJECT
Test Name
Normal Values
TSH
0.4-5.0 mU/L
Free T4
4.6-12 ug/dl
Test Name
Normal Values
Thyroid Function Tests
Clinical Indications Conditions with
abnormal low
levels, if applicable
Please note inverse Hyperthyroidism
relationship. The
with predominant
higher the TSH
symptoms of
value the less
anxiety, sustained
functional thyroid
weight loss,
gland.
insomnia,
Symptomatology
exophthalmos,
should be
mood lability,
considered in
tachycardia
relation to values
and treated
accordingly. TSH
must be evaluated
in the overall
context of other
Thyroid values such
as T3, T4 (both free
and total) as well
as TPO and TG
antibodies.
A high or low level
If the T4 level is low
may not always
and TSH is not
indicate a problem. elevated, the
For example, if the pituitary gland is
patient is pregnant more likely to be
or taking oral
the cause for the
contraceptives,
hypothyroidism.
levels will be
higher. Critical
illness,
corticosteroids and
medicine that treat
asthma, arthritis,
and other health
problems, can
lower T4 levels
Microbiology
Clinical Indications
Conditions with
abnormal low
levels, if applicable
Conditions with
abnormal high
levels, if applicable
Symptomatic
hypothyroidism
with fatigue, dry
coarse hair and
skin, puffy
appearance, anxiety
or depression.
Begin dosage at
50mcg Q daily and
then titrate slowly
while monitoring
response
A high serum T4
may indicate
hyperthyroidism
but the value must
be evaluated with
respect to other
values from the
thyroid panel
Conditions with
abnormal high
levels, if applicable
16
GROUP LAB PROJECT
Urinalysis- Specific
Gravity
1.002 -1.035
pH
4.5-8.0
Nitrites
Negative
Leukocyte
esterase
Negative (no color
change)
A urine specific
gravity test gives
information about
how well the
kidneys
concentrate the
urine and a
person's hydration
status.
Provider may
consider urine pH
with other
symptoms to make
a diagnosis. pH
alone is insufficient
to issue diagnosis
and this value must
be used evaluate in
context of other
tests
This test is done on
the premise that
many bacterial
strains produce an
enzyme called
reductase that
reduces urinary
nitrates to nitrites.
Presence of
nitrates indicates
need for urine
culture
A leukocyte
esterase test
measures the
presence of WBCs
in the urine
associated with
acute infection.
The LE test is also
used to screen for
Neisseria
gonorrhoeae. The
combination of the
LE test with the
urinary nitrite
provides an
excellent screen for
Diabetes insipidus
Kidney failure
Dilute urine
Acute Kidney Injury
Dehydration
Reduced output UTI
CHF
Shock
Vomiting
Glucose or protein
in urine
Diabetic
Ketoacidosis
Vomiting
Kidney Stones
UTI
N/A
Positive test
indicates UTI,
confirm with
culture and
sensitivity
Negative test
cannot exclude
possibility of UTI in
symptomatic
individuals and
must be evaluated
in the context of
other lab values.
Positive Test
indicates UTI,
Gonorrhea and
must be confirmed
with culture and
sensitivity.
17
GROUP LAB PROJECT
Protein
<20 mg/dl
Ketones
Negative
Glucose
0 - 15 mg/dL
establishing the
presence of a UTI.
Healthy adults
normally excrete
less than 150
milligrams of
protein over 24
hours. However,
during a single
point test such as a
UA, amounts
greater than 20
mg/dl protein
require further
investigation.
Values of this test
must be used along
with others to
establish diagnosis
Ketone testing is
most often done
if type 1 diabetes is
present and blood
sugar is higher than
240 mg/dL.
Illnesses such as
pneumonia, heart
attack, or stroke as
well as nausea or
vomiting and
pregnancy may
indicate the
evaluation of
ketones in the
urine in relation to
other lab values
Glucose in the
urine is not a
normal
phenomena but
well understood
and documented
N/A
UTI
Diabetes
Preeclampsia
Kidney disease
HTN
Cancer
N/A
An abnormal result
means you have
ketones in your
urine. The results
are usually listed as
small, moderate, or
large as follows:
Small: 20 mg/dL
Moderate: 30 - 40
mg/dL
Large: > 80 mg/dL
Starvation, fasting,
burns, fever,
vomiting and
anorexia can
produce ketone
bodies in the urine.
N/A
Diabetes and
pregnancy.
18
GROUP LAB PROJECT
Urine Culture
Normal Growth
Stool
Studies/cultures
Normal Growth/
Negative
O&P
Negative
Fecal Leukocytes
Negative
as characteristic of
DM2.
Suspected UTI with N/A
positive nitrite,
leucocytes, protein
and glucose values
should be
confirmed with
Urine Culture and
preferably
Sensitivity to
initiate antibiotic
therapy.
Stool culture test is N/A
indicated in cases
of prolonged
digestive issues,
recent, diarrhea,
vomiting and GI
distress as well as
food poisoning and
exposure to
infectious agents.
Occult stool is
indicated in rule
out of colon
cancer,
diverticulosis, GI
hemorrhage .
When ova or
N/A
parasitic infection
is suspected in
presence of GI
distress and related
to recent travel or
exposure. Positive
identification is
utilized to initiate
targeted therapies.
This test is
indicated in the
event of chronic
inflammatory
diarrhea.
Symptoms may
N/A
Positive growth of
bacteria or yeast in
culture medium
indicate UTI.
Positive growth of
organisms, yeast or
bacteria can
confirm commensal
vs infectious
agents. Positive
occult stool
requires further
investigation and
diagnostics.
Positive
microscopic
evaluation of a
stool sample
identifies parasites
and their ova.
Giardia, Entamoeba
and
Cryptosporidium
infections are
commonly
associated with
positive result.
Watery diarrhea
and positive test
may be indicative of
an infection caused
by bacteria such as
shigella, Clostridium
19
GROUP LAB PROJECT
C-Diff
Negative
Test Name
Normal Values
Salicylate toxicity
>150 mg/kg
include numerous
small loose or
watery stools.
Blood or mucus in
the stool Severe
cramping or pain in
your belly and
fever.
This test is
indicated in the
event of prolonged
broad-spectrum
antibiotic therapy
and prolonged
hospitalization in
the presence of
watery diarrhea
and dehydration.
Toxicology
Clinical Indications
●
●
●
Acetaminophen
10-30 mcg/ ml is
considered normal
Toxic Values:
> 140 mcg/ml at 4
hours post ingestion
N/A
Conditions with
abnormal low
levels, if applicable
N/A
Ingestion of 150
mg/kg or more, or
6.5 g or more, of
aspirin or aspirin
equivalent
oil of wintergreen
ingestion
unknown toxin
ingestion or
exposure
self-harm or
suspected suicide
attempt.
Acetaminophen is
N/A
also often sued in
intentional
overdoses. It is
common ingredient
in many OTC
products, so it’s
easy to take more
than you realize. In
very high doses,
acetaminophen
difficile,
campylobacter, or
salmonella. It may
also occur in
inflammatory
bowel disease, such
as Crohn's disease
or ulcerative colitis.
Positive culture
establishes
pathogenesis of
clostridium difficile
or
pseudomembranos
colitis.
Conditions with
abnormal high
levels, if applicable
Respiratory
alkalosis and
metabolic acidosis,
confusion, sedation,
respiratory
depression
Confusion, Altered
level of
consciousness,
death
20
GROUP LAB PROJECT
Urine Drug Screen
Negative
Blood Alcohol
Normal levels
0-50 mg/Dl or 0% to
0.05% of total blood
volume
Carbon Monoxide
Normal
Levels are
as follows:
●
●
●
●
Adults: less
than 2.3%,
or 0.023
Adult
smokers:
2.1% to
4.2%, or
0.021 to
0.042
Adult heavy
smokers
(more than
2 packs a
day): 8% to
9%
Hemolytic
anemia: Up
to 4%
can damage the
liver.
The urine drug
screen evaluates
the metabolites of
the following drugs
in sterile urine:
Amphetamine
Methamphetamine
Benzodiazepines
Barbiturates
Marijuana
Cocaine
PCP
Methadone
Opioids
Values >100mg/dL
indicates acute
intoxication. Levels
greater than 400
mg/Dl may be fatal
dose
You may need this
test if your
healthcare
provider thinks you
have CO poisoning.
Symptoms of
carbon monoxide
poisoning include:
Headache, Chest
pain, Altered
mental status and
confusion, Nausea
and vomiting,
Dizziness,
Weakness
N/A
Psychosis,
disorientation,
euphoria,
confusion, sedation,
agitation, violence,
ALOC
N/A
Agitation, CNS
depression, coma,
confusion, sedation,
death, seizure,
withdrawal,
delirium
Disorientation,
unconsciousness,
death
N/A
21
GROUP LAB PROJECT
●
Newborn:
greater than
12%
If your levels are
higher, you may
have CO intoxication
or poisoning.
Test Name
PT
INR
(taken via blood
sample or through
venipuncture)
PTT
Components of Coagulation
Normal Values
Clinical Indications Conditions with
abnormal low
levels, if applicable
11-15 seconds
Used to help detect Too much clotting
0.8- 1.2
and diagnose a
factor can lead to
bleeding disorder
excessive clotting.
Therapeutic level for or excessive
patients on warfarin clotting disorder.
A low PT can
may be 2.0-3.0. If
The INR is
indicate that there
patient has
calculated form a
is too much clotting
mechanical valve
PT result and is
factor and clotting
may require levels
used to monitor
can be produced.
of 2.5-3.5
how well the
blood-thinning
A low INR can
medication
indicate also too
(anticoagulant) is
much clotting factor
working to prevent which would
blood clots.
indicate that
Test should be
anticoagulant
done when patient therapy (warfarin)
is on warfarin
may need to be
therapy or when
adjusted
you have
(increased).
unexplained or
prolonged bleeding
or inappropriate
blood clotting.
25-40 seconds
Used when patient A shortened PTT
may have
may indicate
unexplained
disseminated
bleeding,
intravascular
inappropriate
coagulation,
blood clotting or
advanced cancer
Conditions with
abnormal high
levels, if applicable
Too little clotting
factor can lead to
excessive bleeding.
A high PT can
indicate that there
is too little clotting
factor and can
produce excessive
risk for bleeding.
A high INR can
indicate that
bleeding is highly
likely and
medication may
need to be adjusted
to prevent risk of
bleeding
(medication
decreased).
A prolonged PTT
indicates that
clotting is taking
longer to occur
than normal and
may be due to
22
GROUP LAB PROJECT
recurrent
miscarriages. If
patient is on
heparin therapy or
prior to surgery
PTT may be
obtained. Measure
the number of
seconds it takes for
an individual to
form a blood clot.
Test Name
Normal Values
CRP
None Detected
ESR
Male 0-15 mm/hr
Female 0-20 mm/hr
Tumor Markers:
PSA
4g/l
CA 125
35U/L
Lyme Titer
Normal values
varies with assay
(ovarian, pancreatic
or colon) or an
acute reaction
within the body.
Inflammatory Markers
Clinical Indications Conditions with
abnormal low
levels, if applicable
Chronic
N/A
Inflammatory
disease, eg
Rheumatoid
Arthritis, Lupus
To evaluate the
severity of
inflammation
related to
infections, cancers
and autoimmune
disorders.
Useful measure of
response to cancer
therapy of prostate
cancer
Screening for
Ovarian
Cancer. For best
results need to be
done in
conjunction with
Ultrasound and
physical
examination.
To compare acute
and convalescent
Polycythemia,
Sickle cell anemia,
serious leukocytosis
and protein
anomalies.
causes such as: liver
disease, Vit K
deficiency,
malabsorption
disorders, clotting
factor deficiencies,
Hemophilia.
Conditions with
abnormal high
levels, if applicable
Bacterial Infections,
Acute rheumatic
fever, transplant
rejection, oral
contraceptives and
malignancies.
Vascular disease,
Heart disease,
Kidney disease, IBD
and certain cancers.
Radical
prostatectomy,
response to therapy
of prostatic
carcinoma.
N/A
Prostate cancer,
acute prostatitis,
BPH, prostate
surgery and
prostatic infarction.
Ovarian,
Endometrial and
Colon Cancer. PID,
breast lesions and
benign abdominal
masses
(teratomas).
After antibiotic
therapy or during
Infection with
Borrelia
23
GROUP LAB PROJECT
Digoxin Levels
ELISA <1:8 Western
blot non-reactive
0.5-0.9 ng/l
D-Dimer
250ug/L
Lead
5ug/L
EBV
Negative
Vitamin D
8-80 ng/ml
Test Name
Screening
Indications
PAP SMEAR
Screening test for
cervical cancer as
well as certain
vaginal or uterine
infections.
Women averagerisk ages 21 to 29,
every 3 years
Women averagerisk ages 30 to 65,
every 3 years- co
testing with HPV
every 5 years or Pap
smear alone every 3
years
serum levels or
relative titers
To determine
therapeutic doses
in the blood or
determine if toxic
levels are present
To check presence
of DVT and blood
clotting disorders
To screen for
excessive exposure
to lead
To help diagnose
infectious
mononucleosis
To determine
Vitamin D
deficiency
Screening Tests
Clinical Indications
Women with risk
factors for cervical
cancer may begin
screening at a
younger age and
more frequently
When symptoms
such as abnormal
vaginal bleeding
and/or pelvic pain
the first few weeks
of disease.
low levels can lead
to persistent heart
failure
burgdorferi, syphilis
and rickets disease.
high levels suggest
digoxin toxicity
No blood clotting
issues
Infection,
inflammation and
pregnancy
Lead Poisoning,
Occupational
exposure
Combination of
results of
antibodies as well
as symptoms may
indicate a mono
infection
Excess parathyroid
hormone,
sarcoidosis or
lymphomas
N/A
Combination of
results of
antibodies as well
as symptoms may
indicate a mono
infection
Risk for Rickets,
Cardiovascular
disease, Cognitive
impairment,
Asthma and Cancer.
Conditions with
abnormal low
levels, if
applicable
N/A
Conditions with
abnormal high levels,
if applicable
Used to detect
abnormal or
potentially abnormal
cells from the vagina
and the cervix.
Abnormal cells may
indicate infections,
Cervical cancer,
HPV infection
24
GROUP LAB PROJECT
TB Testing
Colonoscopy
To screen for
tuberculosis that is
either active or a
latent infection.
Exposure to
persons with TB.
N/A
Positive result may
indicate active TB
infection or latent
(inactive). A latent
infection may become
active once more if
the body becomes
immunocompromised.
N/A
Positive findings
inform treatment and
stabilization
Can be done either
via skin test (PPD)
or via blood drawQuantiFERON
(IGRA).
High risk groups
may be tested
often or prior to
being exposed to
an at-risk
population, or if
exposed to people
or live in an area
where TB may be
common.
If having
symptoms such as
chronic cough with
phlegm, sputum,
bloody streaks,
fever, chills or
night sweats.
Family history of GI Strong family
cancers, polyps,
history. Diagnosis
diverticulosis or age of inflammatory
>50 to 75.
bowel disease
Recommendations
such as Crohn's,
include stool tests,
Ulcerative Colitis
flexible
or positive
sigmoidoscopy,
identification of
colonoscopy, and CT polyps or
colonography
dysplasia, Celiac
disease
25
GROUP LAB PROJECT
References
American Association of Clinical Chemistry. (n.a.) Lab Tests Online. Retrieved on June 19, 2019 via
https://labtestsonline.org/
Dean AJ, Lee DC. Bedside laboratory and microbiologic procedures. In: Roberts JR, Custalow CB,
Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute
Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 67.
Lab Test: Leukocyte Esterase (Urine) Level. (n.d.). Retrieved June 24, 2019, from
https://www.ebmconsult.com/articles/lab-test-leukocyte-esterase-level
Landry DW, Bazari H. Approach to the patient with renal disease. In: Goldman L, Ausiello D, eds. Cecil
Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 116.
Leeuwen, A.M. V., Bladh, M. L. Davis's Handbook of Laboratory & Diagnostic Tests with Nursing
Implications. [VitalSource Bookshelf]. Retrieved from
https://bookshelf.vitalsource.com/#/books/9780803656741/
O’Kane, M.J. (2015, Dec). Explaining laboratory test results to patients:what the clinician needs to know.
BMJ, 2015;351:h5552. Retrieved June 24, 2019 from
https://www.bmj.com/content/351/bmj.h5552
Runde TJ, Nappe TM. Salicylates Toxicity. [Updated 2019 Jan 13]. In: StatPearls [Internet]. Treasure
Island (FL): StatPearls Publishing; 2019 Jan-. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK499879/
Siddiqi HA, Salwen MJ, Shaikh MF, Bowne WB. Laboratory diagnosis of gastrointestinal and pancreatic
disorders. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by
Laboratory Methods. 23rd ed. St Louis, MO: Elsevier; 2017:chap 22.
United States Food & Drug Administration (n.a.). Tests used in clinical care. Retrieved on June 26, 2019
via https://www.fda.gov/medical-devices/vitro-diagnostics/tests-used-clinical-care
What Should I Know About Screening for Colorectal Cancer? | CDC. (n.d.). Retrieved from
https://www.cdc.gov/cancer/colorectal/basic_info/screening/index.htm