Complete Metabolic Panel (CMP):
Lab:
Sodium
(Na+)
Normal:
Primary factor in maintaining
osmotic pressure of the ECF
(serum). H2O goes where Na+ is.
It also functions in the body to
maintain acid-base balance and to
transmit nerve impulses.
High value:
May be caused by inadequate
water intake, water loss in
excess of sodium (diabetes
insipidus, impaired renal
function, prolonged
hyperventilation, severe
vomiting or diarrhea), and
sodium retention.
1
Low value:
Decreased levels could be due
to diarrhea, vomiting, and
excess H2O related to
increased ADH (increases total
body H2O), compulsive H2O
drinking and H2O intoxication
or salt free IV fluids (D5W).
Decreases may be seen in renal
failure where salt wasting
occurs, diabetic acidosis where
polyuria causes Na+ loss, or
vigorous exercise. Also a S.E.
of Ampicillin, Ancef,
Clarithromycin, Tetracycline,
Nystatin, Glyburide, KCl,
Magnesium, Dilantin, vitamin E
& C, Zantac, Maalox, Reglan,
Prevacid, Zinc, Lasix,
Dopamine, Spironolactone, KDur, Digoxin, Vasotec,
Dopamine, Toradol, Levaquin,
and Albuterol.
Reference:
136-146
mEq/L
Lab:
Potassium
(K+)
Normal:
Main ICF cation. Potassium is vital
to homeostasis, it maintains
cellular osmotic equilibrium, helps
regulate muscle activity, enzyme
activity, cardiac function, and
acid-base balance, influences
kidney function.
High value:
Increased value may be due to
inadequate renal output, too
rapid administration of IV K+ as
replacement, tissue destruction,
burns, lack of insulin, RBC
destruction.
Chloride
(Cl-)
Major ECF anion. Interacting with
sodium, chloride helps maintain the
osmotic pressure of blood and
helps to regulate blood volume and
arterial pressure. Chloride levels
also affect acid-base balance.
Increased values may be seen in
renal failure where the kidneys
are unable to excrete Cl-,
dehydration, Cushing’s
syndrome, respiratory alkalosis,
hyperparathyroidism, diabetes
insipidus. Elevated levels could
also be related to acidosis as
well as too much water crossing
the cell membrane.
Total CO2
Indirect measurement of serum
bicarbonate. The CO2 level is
related to the respiratory
exchange of carbon dioxide in the
lungs and is part of the bodies
buffering system. Generally when
used with the other electrolytes,
it is a good indicator of acidosis
and alkalinity.
Increased values may be from
respiratory depressions due to
hypoventilation, hypoxia,
pneumonia, or from drug
overdose.
2
Low value:
Decreased levels could be due
to diarrhea, diuresis, vomiting,
and decreased Na level. Also
caused by diuretics (except
aldactone), or antibiotics
(Ancef). Hormone changes
cause a decrease in K+.
Corticosteroids cause Na+
retention and K+ excretion.
Decreased levels could be due
to diarrhea, vomiting, gastric
suctioning, diuretics, burns,
metabolic alkalosis, salt losing
renal disorders, diabetes,
Addison’s disease,
overhydration. Decreased
levels with decreased serum
albumin may indicate water
deficiency crossing the cell
membrane (edema).
Decreased values often due to
severe anxiety causing
hyperventilation. Physical
conditions, such as fever, pain,
or hypoxia, also can cause
hyperventilation.
Reference:
4.0-5.5
mEq/L
97-106
mEq/L
21-29
mmol/L
Lab:
Glucose
Calcium
Normal:
Most of the glucose comes from
dietary intake of carbohydrates.
The liver can convert fats and
protein into glucose when not
enough glucose is available for the
cells. The liver may store extra
glucose in the form of glycogen.
When there’s extra glucose intake,
the glucose that’s not stored as
glycogen is converted into adipose
(fat) tissue.
Circulates in free or ionized state
bound to plasma proteins, carried
mainly by albumin. Affects
neuromuscular function. Calcium is
also involved in bone metabolism,
protein absorption, fat transfer,
muscular contraction, transmission
of nerve impulses, blood clotting
and cardiac function. Regulated by
parathyroid.
High value:
Increased value could be due to
stress, diabetic state, acute
pancreatitis or side effect of
Lasix.
Increased values seen in
dehydration (pseudo high),
increased PTH, metastatic bone
disease as bone is destroyed,
endocrine disorders, cancer,
prolonged immobility, renal
transplant,
hyperparathyroidism,
hyperthyroidism, or excessive
vitamin D, milk, and antacids.
3
Low value:
Reference:
Decreased values are due to
70-110
decreased or absent glucose-6mg/dL
phosphatase activity which is
the enzyme necessary to
convert glycogen to glucose in
the liver. Could be due to side
effects of Glyburide,
Glucophage, and regular insulin,
too little food intake, or
increased exercise without
additional food intake.
Decreased values seen with
8.7-11.0
reduced albumin levels,
mg/dL
hyperphosphatemia,
hypoparathyroidism,
malabsorption of calcium and
vitamin D, alkalosis, acute
pancreatitis, in endocrine
disorders, GI disturbances,
diarrhea, osteomalaria,
metastatic bone disease, renal
failure, alcoholism.
Lab:
Total Bili
Normal:
High value:
Bilirubin is a brownish yellow
substance found in bile. Bilirubin is
produced when the liver breaks
down hemoglobin, the oxygencarrying substance in red blood
cells. Bilirubin is then removed
from the body through the stool
(feces) and gives stool its normal
brown color.
The breakdown of RBC’s can
increase, causing and increase
of free bilirubin in the
bloodstream. Jaundice is
caused by the buildup of
bilirubin in the blood and skin
from hepatitis, blood disorders
(hemolytic anemia), or blockage
of the bile ducts that allow bile
to pass from the liver to the
small intestine (due to
gallstones or pancreatic cancer).
May also be seen in sickle cell
disease, mononucleosis,
digestive system problems that
result in excessive reabsorption
of bilirubin, or an infected
gallbladder. Excessive buildup
of bilirubin in a newborn baby
sometimes causes brain damage
and even death. Therefore,
some babies who develop
jaundice may be treated with
special lights or a blood
transfusion to reduce their
bilirubin levels.
Bilirubin circulates in the
bloodstream in two forms:
Indirect (or unconjugated)
bilirubin. This form of bilirubin
does not dissolve in water (it is
insoluble). Indirect bilirubin
travels through the bloodstream
to the liver, where it is changed
into a soluble form.
Direct (or conjugated) bilirubin.
After indirect bilirubin has been
changed by the liver into a form
that dissolves in water (soluble), it
is called direct or conjugated
bilirubin.
Total bilirubin and direct bilirubin
levels are measured directly in the
blood, whereas indirect bilirubin
levels are derived from the total
and direct bilirubin measurements.
Low value:
4
Reference:
0.0-1.5
mg/dL
Lab:
BUN
Normal:
Serum test that measures urea, a
waste product of protein
metabolism. Urea is formed in the
liver and travels in the blood to
the kidneys for excretion. Used
as a test of renal function.
Protein catabolism, dehydration,
overhydration, and liver failure all
invalidate BUN as a test for renal
dysfunction.
High value:
Increased values seen in
diseased or damaged kidneys,
decreased renal perfusion
(without diseased kidneys),
shock, CHF (causing poor
circulation in the kidneys),
severe dehydration, excessive
protein intake, low fluid intake,
exercise, bleeding into the GI
tract (digested blood is a
source of protein), pt on tube
feedings (high in protein), Side
effect of antibiotics
(Pipercillin) or Lasix.
Creatinine Waste product of creatine
Increased value may be due to
phosphate, a high energy
possible damage to nephrons,
compound found in skeletal muscle due to side effect of antibiotics
tissue. Serum creatinine evaluates (Pipercillin), ketone bodies, or
any type of renal dysfunction,
due to muscle trauma which
where a large number of nephrons increases load for renal
have been destroyed.
clearance.
5
Low value:
Decreased value could be due
to overhydration, increase in
ADH, poor diet, malabsorption,
liver damage, low nitrogen
intake., or decrease protein
breakdown. Side effect of
antibiotics (Clarithromycin,
Neomycin, Polymyxin).
Reference:
5-25
mg/dL
Decreased value could be due
to atrophy of muscle tissue,
decreased clearance due to
decreased glomerular function
kidney damage, protein
starvation, liver disease or
pregnancy. Side effect. of
antibiotics (neomycin,
polymixin).
0.3-0.8
mg/dL
Lab:
Albumin
Normal:
Produced by the liver, maintains
the oncotic pressure in the
vascular system (maintains acidbase balance). Important in the
transportation of many substances
in the bloodstream such as ions,
pigments, bilirubin, hormones,
fatty acids, enzymes, and certain
drugs.
High value:
Increased value could be due to
dehydration, IV infusions.
Total
Protein
Helps to identify dysproteinemia,
hypogammaglobulinemia, acute and
chronic inflammatory disorders,
nephrotic syndrome, liver disease,
and GI loss.
Increases may be seen due to
hemoconcentration as a result
of dehydration w/body fluid
loss (vomiting, diarrhea, & poor
kidney function). Also seen in
liver disease, multiple myeloma,
Waldenstrom’s
macroglobulinemia, tropical
disease, sarcoidosis, collagen
disorders, chronic infections, &
inflammatory states.
6
Low value:
Decrease could be due to
chronic liver dysfunction
(caused by cirrhosis), loss of
albumin in the urine caused by
renal dysfunction, or
inadequate protein (as seen in
severe burns when a large loss
of proteins include albumin d/t
damage to capillaries and blood
vessels). A lack of albumin in
the serum allows fluid to leak
out into the interstitial spaces
and into the peritoneal cavity.
Decreased value could be due
to decreased albumin level.
It’s a screening tool for
multiple myeloma. Decreased
values may also be seen
w/insufficient nutritional
intake (starvation,
malabsorption), liver disease,
alcoholism, prolonged
immobilization (trauma,
orthopedic surgery),
neoplasms, & other chronic
diseases.
Reference:
3.8-4.8
g/dL
6.4-8.2
g/dL
Lab:
AST
(SGOT)
ALT
(SGPT)
Normal:
Enzyme found in the heart, liver,
kidney, pancreas & muscle tissue.
It’s important for energy
transformation. Used to detect
liver necrosis before there are any
signs of jaundice.
High value:
Increased values could be due
to hepatitis, hepatocellular
disease, alcohol abuse,
infectious mononucleosis, Reyes’
syndrome, myocardial
infarction, pancreatitis,
dermatomycosis, polymyositis,
recent brain trauma, crushing
injuries, muscular dystrophy,
and mushroom poisoning.
ALT in the largest concentration is Levels could increase due to
present in the liver tissue, but is
chronic hepatitis and cirrhosis,
also present in kidney, heart, and
infectious mononucleosis, shock,
skeletal muscle tissue.
Reye’s syndrome, alcoholism,
kidney infection, chemical
pollutants, myocardial infarction
or CHF.
7
Low value:
Normally the levels of AST are
low, if it is further decreased
then it is a sign that the liver
can’t make the enzyme,
azotemia, or chronic renal
dysfunction.
Reference:
10-45
IU/L
Decreased levels are the same
as AST in the liver can’t make
the enzyme (for energy
transformation).
10-45
IU/L
Lab:
Alk Phos
Normal:
Alkaline phosphatase influences
bone calcification and lipid and
metabolite transport. Found in
tissues of the liver, bone,
intestine, and kidney. The test is
a primary indicator of spaceoccupying hepatic lesions.
High value:
Increased with new bone
formation, liver (tissue damage)
or bone abnormality (cancer,
healing fracture), biliary
obstruction since alkaline
phosphatase from the liver
tissue is normally excreted into
the bile. Increased levels may
also be seen when there’s a
stone in the common bile duct or
cancer of the head of the
pancreas, or side effect of
meds (estrogens,
phenothiazines,
anticonvulsants). The ingestion
of a fatty meal temporarily
increases the level.
8
Low value:
Reference:
Decreased level may be due to
135-530
lack of normal bone formation.
IU/L
This may be caused by
pathologic conditions such as
hypothyroidism, celiac disease,
cystic fibrosis, chronic
nephritis, genetic defect,
scurvy. In adults a decreased
level is seen with a lack of bone
formation caused by
malnutrition or excessive vit. D
intake.
Complete Blood Count (CBC):
Lab:
Platelet Count
Normal:
Platelets are not intact
cells, they’re fragments
of cytoplasm that
function in blood
coagulation. They’re
formed by the bone
marrow and removed by
the spleen when old or
damaged.
High value:
Increased values may be
seen in malignant
tumors, thrombocytosis,
polycythemia vera,
splenectomy (temporary
increase), rheumatoid
arthritis, acute
infections, inflammatory
disease, iron deficiency,
post-hemorrhagic
anemia, heart disease,
recovery from bone
marrow suppression.
Hemogram
9
Low value:
Decreases values may be
seen after viral
infections, AIDS, SLE,
anemia or hemolytic
disorder, chemo,
radiation, heparin, toxic
effects of many drugs,
bone marrow lesion. An
overactive spleen or an
enlarged spleen destroys
platelets.
Reference:
Lab:
WBC
Normal:
Fights infection.
Promote clotting.
High value:
Could be due to bacterial
infection. WBC’s
respond to inflammation
within the body, abscess,
meningitis, appendicitis,
tonsillitis, increases in
fever, stress response
after trauma, tissue
necrosis, burns,
gangrene, myocardial
infarction, hemorrhage,
leukemia (in rare cases).
10
Low value:
Low counts could be due
to bone marrow or
immune system
problems, viral
infections,
hypersplenism, exposure
to benzene or arsenicals
or heavy metal
intoxication. Could also
be due to a side effect
of antibiotic therapy
(Ampicillin), because it
binds to bacterial cell
wall causing death or
Compazine. Fever over
101 may need to be
reported to the M.D.
Reference:
5-14.5 10e3/uL
Lab:
RBC
Normal:
Play an important factor
in providing oxygen to
cells and carry nutrients.
Give energy to the body.
Provide color to the skin
and lips.
High value:
Increased values may
mean heart disease,
dehydration,
polycythemia vera,
erythrocytosis
erythemia (increased
production in bone
marrow), renal disease,
extrarenal tumors, high
altitude, pulmonary
disease, cardiovascular
disease, alveolar
hypoventilation,
tobacco/carboxyhemoglo
bin, or other conditions.
11
Low value:
Reference:
Decreased values could
4.0-5.2 10e6/uL
be due to loss of RBC’s,
destruction of RBC’s lack
of needed hormones for
RBC production, bone
marrow suppression
(aplastic anemia may be
due to chemo, radiation,
drug tx). also due to a
side effect of antibiotic
therapy (Ampicillin,
Aztreonam, Amoxicillin),
vitamin C, aspirin,
Lovenox, Ecotrin,
Toradol or Lasix.
Transfusion may be
necessary. Pt may be
tired and irritable.
Lab:
HGB
Normal:
An indicator of the
ability of the RBC’s to
carry oxygen to tissues
and to carry carbon
dioxide from the tissues
to the lungs to be
expelled. Assesses for
various anemias.
High value:
Low value:
Decreased levels would
A high hemoglobin
value means the blood be indicative of
contains too many red hemolytic anemia, blood
loss, low RBC count, bone
blood cells. High
marrow suppression (due
values can be caused
to chemo). Also could be
by a lack of oxygen,
smoking, exposure to due to side effect of
antibiotic meds
carbon monoxide,
(Pipercillin), Dilantin,
long-term lung
Lovenox, vitamin K,
disease, certain
Spironolactone, Lasix,
forms of heart
Zantac, and aspirin.
disease, kidney
Platelet transfusion may
disease, or
be necessary. Watch
polycythemia vera, a
for bleeding from nose,
rare disorder of the
bone marrow. A high gums, and other places.
hemoglobin value can Pt may bruise easily.
also be caused by
dehydration,
diarrhea, vomiting,
excessive sweating,
severe burns, or the
use of diuretics.
12
Reference:
11.5-13.5 g/dL
Lab:
HCT
MCV
(Mean
Corpuscle
Volume)
Normal:
% of RBC to plasma
volume also called
packed cell volume (PVC).
Useful measure of the
RBC only if the
hydration of the pt is
normal, otherwise it’s an
indication of hydration.
Normally approximately
3 x the Hgb when
RBC/Hgb is normal.
Average size of an RBC.
It indicates whether the
size appears normal
(normocytic), smaller
(microcytic), or larger
(macrocytic). MCV
results are the basis for
classification of anemias.
High value:
Increased value could be
due to decrease in
plasma volume (burns
where fluid lost through
damaged capillaries
leads to
hemoconcentration as in
polycythemia. Hydrate
with IVF to prevent
stasis of blood and
thrombi formation.
Increased values may be
due to dietary
deficiency or
malabsorption such as
vitamin B12 deficiency
or folic acid deficiency.
Macrocytic-large RBC,
seen in pernicious
anemia, pathological
failure of the stomach
to release enough
intrinsic factor to
ensure intestinal
absorption of B12
(extrinsic factor). Pt
needs B12 injections for
the rest of their life.
13
Low value:
Decreased value could
be due to overhydration,
true decrease in # of
RBC, heat damage to
vascular endothelium,
anemia, leukemia,
hyperthyroidism,
cirrhosis, hemolytic
reaction or hemorrhage.
Reference:
34-40 %
Microcytic-small RBC
occurs in iron deficiency
anemia. Hypochromicpale color, less red due
to iron deficiency, not
correctable by diet
alone, may need FeSO4.
77-95 fL
Lab:
MCH
(Mean
Corpuscular
Hemoglobin)
MCHC
(Mean
Corpuscle
Hemoglobin
Concentration)
RDW
(Red cell
Distribution
Width)
Normal:
The amount of hgb in
one cell. Determines if
RBC is normal.
High value:
May be falsely elevated
in the presence of
hyperlipidemia & high
heparin concentrations.
WBC counts greater
than 50,000 mm3 may
falsely elevate the Hgb
value and then falsely
elevate the MCH.
The proportion of each
High values may be
cell occupied by hgb.
present in newborns &
infants. Increased
levels may also be due to
leukemia or cold
agglutinins. It may be
falsely elevated with
high heparin blood
concentration.
Calculated from the
Occurs in iron
MCV & RBC. Variations
deficiency, vit B12 or
in width of the cell may
folate deficiency,
help to diagnose types of abnormal hemoglobin,
anemia.
thalassemia, and immune
hemolytic anemia. It can
be useful in
distinguishing the
different types of
anemia.
14
Low value:
Microcytic anemia.
May indicate anemia
caused by a lack of iron,
thalassemia, lead
poisoning, or long-term
infection, or certain
chronic diseases (such as
diabetes or arthritis).
Reference:
25-35 pg
32-36 g/dL
11.5-14.0
Lab:
Plt Count
Normal:
Platelets are also known
as thrombocytes. Helps
to stop bleeding and
prevent bruising.
Necessary for vascular
integrity and
vasoconstriction.
Platelet development
takes places primarily in
the bone marrow.
High value:
Increased value could be
due side effect of
increased amounts of
vitamin C which could
cause DVT’s,
hemorrhage, infectious
disorders, cancer, iron
deficiency anemia,
recent surgery,
pregnancy, splenectomy,
inflammatory disorders.
MPV
Average platelet size.
Its value is used to
study various
hematologic disorders
such as
thrombocytopenic
purpura and leukemia.
Thrombocytopenia
caused by sepsis, ITP,
DIC, massive
hemorrhage,
myeloproliferative
disorders, myelogenous
leukemia, splenectomy,
megaloblastic anemia,
vasculitis.
Plt Estimate
Low value:
Reference:
Decreased value could
145-400 10e3/uL
be due to meds
(Pipercillin, Dilantin,
Zantac) viral infection,
anemia,
thrombocytopenia,
Toradol (increases
bleeding), and when
heparin is involved
(Lovenox). May also be
due to viral infection,
anemia, chemo, radiation,
thrombocytopenia.
Wiskott-Aldrich.
6.0-10.5 fL
Adequate
15
Lab:
ANC
ANC Auto
Differential
# WBC
Counted
Segs
Normal:
Measurement of % of
neutrophils x WBC. It’s
an indicator of the
body’s ability to handle
bacterial infection.
Provides evidence of
effectiveness of
Filgrastim (stimulates
immature neutrophils to
divide and differentiate
& decreases chance of
infection).
High value:
Low value:
Keep pt away from sick
people when less that
1,000. May need to call
M.D. with fever above
101.
Reference:
1500- /uL
1500- /uL
Mature neutrophils that
fight bacteria.
Mature neutrophils
increase d/t primary
defense in bacterial
infection. They
phagocytize and kill
bacteria. May also be
due to gout, uremia,
poisoning by chemicals
and drugs, acute
hemorrhage and
hemolysis of RBC’s,
myelogenous leukemia,
and tissue necrosis.
16
Decreased values may be
due to acute bacterial
infection, viral
infections, some
parasitical, blood,
aplastic, and pernicious
anemia, acute
lymphoblastic leukemia,
hormonal causes, and
anaphylactic shock.
31-61 %
Lab:
Stabs (Bands)
Normal:
Immature neutrophils
that fight bacteria.
Lymphs
Important part of the
body’s immune system.
Fight viruses.
High value:
Immature neutrophils
increase due to primary
defense in bacterial
infection, physical stress
or emotional stress.
They also phagocytize
and kill bacteria.
Increased because they
are involved in antibody
production and delayed
hypersensitivity.
Increased values may be
due to viral infection
(mumps), chronic
bacterial infection,
infectious hepatitis,
pertussis mono, some
tumors, TB.
17
Low value:
Decreased values seen in
positive HIV, chemo,
radiation, increased loss
via the GI tract, aplastic
anemia, Hodgkin’s
disease,
immunosuppression due
to drug tx such as
steroids and severe
malnutrition.
Reference:
0-11 %
28-48 %
Lab:
Monos
Normal:
Body’s second line of
defense against invasion
of foreign substances.
They’re phagocytic cells
and ingest bacteria,
foreign particles,
cellular debris remaining
after an infection.
Monos encourage the
growth of neutrophils.
When they begin to
appear after being
absent, this is a sign
that the bone marrow is
again beginning to
produce vital protective
white blood cells such as
neutrophils.
High value:
Increased values are
seen with chronic
diseases, TB, malaria,
rocky mountain spotted
fever, monocytic
leukemia, chronic
ulcerative colitis,
regional enteritis, some
collagen disease.
Low value:
May be due to HIV
infections, hairy cell
leukemia, rheumatoid
arthritis, and in
prednisone treatment.
Morphology
Micro
Aniso
Ovalo
Reference:
0-10 %
None
Routine Urinalysis (UA):
Lab:
Macroscopic UA
Color
High value:
Low value:
Abnormal colored urine may be due to
presence of red blood cells (smoky),
18
Reference:
Lab:
Appearance
Spec Gravity
Leukocytes
Nitrite
PH
High value:
bilirubin (brownish-yellow to yellowgreen), melatonic tumor or Addison’s
(black), alkaptonuria (black), and
porphyria (port wine). Color darkens
on standing, certain foods
(red/beets), meds (all colors),
physiologic factors (stress/clear),
excessive exercise (red), large fluid
intake and alcohol (straw), or fever
(dark amber).
Cloudy urine may be due to presence
of pus, RBC’s, bacteria due to UTI, or
shreds. Appearance may be affected
by foods, urates, phosphates, vaginal
contamination, degree of hydration,
or dehydration.
Increased values may be due to
elevated protein levels, low fluid
intake, excessive water loss, fever,
vomiting, diarrhea, meds (stool
softeners), increased secretion of
ADH, or diabetes mellitus.
May indicate infection.
Indication of possible urinary tract
infection.
Alkaline urine may be found in
bacteriuria, urinary tract infections,
chronic renal failure, respiratory
Low value:
Indicative of dilute urine (due to
increased amount of fluids). A
continuous low level is due to a
deficiency of ADH (the kidneys then
excrete too much water—diabetes
insipidus). Low values may also be seen
w/cystic fibrosis, glomerulonephritis,
or pyelonephritis.
Reference:
1.003-1.035
Negative
Negative
Acidic urine may be found in acidosis,
uncontrolled diabetes, diarrhea,
dehydration, starvation, respiratory
19
5.0-8.0
Lab:
Protein
Glucose
High value:
disease w/loss of carbon dioxide,
pyloric obstruction, renal tubular
acidosis, & meds (salicylate
intoxication & some antibiotics).
Increased urine protein levels may
occur in urinary tract infections,
renal diseases such as nephritis,
glomerulonephritis, nephrosis, renal
vein thrombosis, malignant
hypertension, SLE, and
pyelonephritis. Increased values may
also be seen in fever, acute
infections, traumas, leukemia,
toxemia of pregnancy, diabetes,
vascular disease; poisoning from
turpentine, phosphorus, mercury,
sulfosalicylic acid, lead, phenol,
opiates, multiple myeloma, and
Waldenstrom’s macroglobulinemia.
Other factors may be due to
strenuous exercise, severe emotional
stress, cold baths, drugs may cause
false (-) or false (+) (cephalosporins,
sulfonamides, penicillin, gentamicin,
tolbutamide, acetazolamide, &
contrast media).
Increased amounts may be seen in
diabetes mellitus, brain injury,
myocardial infarction, infections
lowered renal threshold (positive
Low value:
disease w/retention of carbon dioxide,
meds (mandelamine & ammonium
chloride), foods (cranberry juice,
pineapple juice, & vitamin C).
Reference:
Negative
Negative g/dL
20
Lab:
Ketone
Urobilinogen
Bilirubin
Blood
High value:
urine glucose, normal blood glucose),
pituitary diseases, pregnancy,
lactation, stress, excitement,
ketonuria, testing after a heavy meal,
IV glucose, meds (vitamin C, keflex).
Increased values may be seen in
ketonuria, occur in acute illness,
anorexia, starvation, fasting,
diarrhea, prolonged vomiting,
diabetes, pregnancy,
hyperthyroidism, stress, or following
anesthesia.
Urobilinogen is a degradation product
of bilirubin which is formed by
intestinal bacteria. Increased levels
may be seen in hepatic disease or
hemolytic disease.
Bilirubin is a breakdown product of
hemoglobin. Increased values may be
seen in hepatitis, liver disease (due to
infection or toxic agent), obstructive
biliary tract, or parenchymal injury.
Presence of blood may occur in
excessive burns and crushing injuries,
transfusion reaction, febrile
intoxication, chemical agents, snake
venom, malaria and other parasites,
hemolytic disorders (sickle cell
anemia), hypertension, paroxysmal
hemoglobinuria, kidney infarction,
Low value:
Reference:
Negative
mg/dL
0.2 to 1.0
mg/dL
Negative
Negative
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Lab:
Microscopic UA
WBC/HPF
RBC
Casts
EPI
Bacteria
Crystals
High value:
DIC, and fava bean sensitivity.
Increased RBC’s may occur in lower
UTI’s, benign prostatic hypertrophy,
glomerulonephritis, SLE, hemophilia,
benign familial
Low value:
Increased values may be due to
urinary tract infections. The
presence of WBC’s indicates the need
for a urine culture.
Presence may indicate hematuria due
to disease or trauma.
Casts are formed when protein
accumulates and precipitates in the
kidney tubules and is washed into the
urine. May indicate renal disease.
Reference:
<10 /HPF
4 or less /HPF
None /LPF
Rare /LPF
None /HPF
The presence of bacteria indicates
the need for a urine culture.
A variety of crystals may be found in
normal urine. The formation of
crystals is influenced by pH, specific
gravity, and the temperature of the
urine.
None /HPF
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