SECTION III
COMMON MEDICAL ABBREVIATIONS
AND LABORATORY TESTS
COMMON MEDICAL ABBREVIATIONS
To discuss a therapeutic regimen with a physician you must speak his language. The terminology
that will confront you in the patient care areas is different from that to which you have previously been
exposed. A typical conversation you might hear at the patient's bedside would go something like, " I hear
an S-2 and S-4 with no split sounds or opening snap. Since there has been no history of dyspnea and the
ASO was negative, I suspect an ASD or VSD, but we will not know for sure until after the results of the
cath." An admission order written by the physician might read "up ad lib, ADA diet (2000 cal), S&A,
MOM 30 ml, hs, pm. Lab tests as follows: CBC, Crit., Amylase, CPK, PBI, Blood Gases, BUN,
Creatinine, LDH, SGOT, SGPT and Lytes." The language of the physician is oriented toward disease,
diagnostic tests and treatment.
The most commonly encountered abbreviations and terminology will be helpful to you as a
reference source. If you are not familiar with a term that is used, you should consult a medical dictionary
or ask the physician.
Abbreviations
Abbreviation
Explanation
ABE
ABS
ADA
AF
ad lib
A/G
AHCA
AMA
AK
A.L.T.
Amb
Ant
ANA
ASCVD
ASD
ASHD
ASO
A.S.T.
AV
Acute bacterial endocarditis
Admitting blood sugar
American Dietetic Association
Acid Fast
As desired
Albumin-globulin ratio
Agency for Healthcare Administration
Against Medical Advice
Above knee amputation
Alanine Aminotransferase (formerly called SGPT)
Ambulant
Anterior
Antinuclear antibody
Anterioscherotic cardiovascular disease
Atrial septum defect
Arteriosclerotic heart disease
Antistreptolysin 0
Aspartate Aminotransferase (formerly SCOT)
Atrioventricular
BBB
BBT
BE
BJ
BKA
BM
BMR
BP
BRP
BS
Bundle branch block or blood brain barrier
Basal body temperature
Barium enema
Bone and joint
Below knee amputation
Bowel movement
Basal Metabolic rate
Blood pressure
Bathroom privileges
Breath sounds or bowel sounds
III.1
BSA
BSP
BUN
BW
Bx
Body surface area
Bromsulphalein
Blood urea nitrogen
Body weight
Biopsy
Ca
Cal
C and S
CBC
CC
Ceph Floc
CFT
CHF
CHO
chr
c/o
CNS
COLD
CONG
COPD
CPK
CSF
CST
CT
CV
CVA
CVD
CVP
Carcinoma
Calorie
Culture and sensitivity
Complete blood count
Chief complaint
Cephalin Flocculation
Complement fixation test
Congestive heart failure
Carbohydrate
Chronic
Complains of
Central nervous system
Chronic obstructive lung disease
Congenital
Chronic obstructive pulmonary disease
Creatinine phosphokinase
Cerebrospinal fluid
Convulsive shock therapy
Circulation time
Cardiovascular
Cerebrovascular accident
Cardiovascular disease
Central venous pressure
D/C
D and C
Derm
diff
DM
DOA
DOE
DTR
DQA
DX
Discontinue
Dilation and curettage
Dermatology
Differential blood count
Diabetes mellitus
Dead on arrival
Dyspnea on exertion
Deep tendon reflex
Division of Quality Assurance
Diagnosis
ECG
ECT
EEG
EENT
EKG
eg
EMG
EPS
ER
Electrocardiogram
Electroconvulsive therapy
Electroencephalogram
Eye, ear, nose and throat
Electrocardiogram
For example
Electromyography
Extra pyramidal syndrome
Emergency room
III.2
ESR
EST
Ext
Erythrocyte sedimentation rate
Electroshock therapy
Extremities
FBS
F and R
FH
Fld
FRC
FTA
FUO
Fx
Fasting blood sugar
Force and rhythm of pulse
Family history
Fluid
Functional residual capacity
Fluorescent treponemal antibody
Fever of undetermined origin
Fracture
GB
Gc
GFR
GI
G-6-PD
GSW
GTT
GU
GYN
Gallbladder
Gonorrhea
Glomerular filtration rate
Gastrointestinal
Glucose-6 phosphate dehydrogenase
Gun shot wound
Glucose tolerance test
Genitourinary
Gynecology
H
h
Hb
HCT
HCVD
Hgb
H and P
HPI
HT
HTVD
Hx
Hypodermic
Hour
Hemoglobin
Hematocrit
Hypertensive cardiovascular disease
Hemoglobin
History and physical
History of present illness
Height
Hypertensive vascular disease
History
ICS
ICU
I and D
I and 0
IM
Imp
inf
int
Int Med
IOP
IP
IPPB
IV
IVP
IVT
Intercostal space
Intensive care unit
Incision and drainage
Input and output
Intramuscular
Impression
Inferior
Interval
Internal medicine
Intraocular pressure
Intraperitoneal
Intermittent positive pressure breathing
Intravenous
Intravenous pyelogram
Intravenous transfusion
III.3
JVD
Jugular Venous distention
K
Kg
KO
KUB
KVO
Potassium
Kilogram
Keep open
Kidney, ureter, bladder
Keep vein open
lat
L and A
LBBB
LCM
LBCD
LDH
LE
LLQ
LMD
LMP
LOA
LUQ
LP
LVH
L and W
Lateral
Light and accommodation (of pupils)
Left bundle branch block
Left costal margin
Left border cardiac dullness
Lactic acid dehydrogenase
Lupus erythematosus
Left lower quadrant
Local medical doctor
Last menstrual period
Leave of absence
Left upper quadrant
Lumbar puncture
Left ventricular hypertrophy
Living and well
MCH
MCV
Med
MH
MI
rnm
MOM
MRXI
MS
MSE
MMSE
Mean corpuscular hemoglobin
Mean corpuscular volume
Medicine
Menstrual history
Myocardial infarction
Millimeter
Milk of magnesia
May repeat times one
Mitral stenosis or multiple schlerosis or morphine sulfate
Mental status examination
Mini Mental Status Exam
N
NB
Neg
NM
NG
No.
NPN
NPO
N/S
NSR
NTP
NTG
NYD
Normal
Newborn
Negative
Neuromusclar
Nasogastric tube
Number
Nonprotein nitrogen
Nothing by mouth
Normal saline
Normal sinus rhythm
Normal temperature and pressure
Nitroglyercin
Not yet diagnosed
III.4
OB
OB-GYN
Out of bed
OR
OT
Obstetrics
Obstetrics and gynecology
P
p
PAC
P and A
Para 1
PAT
PBI
PVC
Pulse
After
Premature atrial contraction
Percussion and auscultation
Having bom one child
Paroxysmal atrial tachycardia
Protein - bound iodine
Packed Cell Volume
Carbon dioxide partial pressure
Physical examination
Post mortem
Post hospital care
Past medical hospital
Present illness
Pelvic inflammatory disease
By mouth
Post operative
Post partum
Purified protein derivative of tuberculin
Partial prothrombin time
Plasma renin activity
before surgery
Pulse and respiration
When necessary
Prognosis
Posterior
Phenosulfonphthalein
Patient
Physical therapy
Premature ventricular contraction
qd
qh
qod
Every day
Every hour
Every other day
R
RA
RBBB
RBC
Right
Agglutinins or right atrium
Right bundle branch block
Red blood cell
PCV
PCO2
PE
PM
PHC
PMH
PI
PID
PO
Post Op
PP
PPD
PPT
PRA
Pre Op
P and R
PRN
Prog
Ps
PSP
Pt
PT
Operating room
Occupational therapy
III.5
RHD
RLQ
R/O
ROM
RPF
Rheumatic heart disease
Right lower quadrant
Rule out
Range of motion exercise
Renal plasma flow
RR
ROS
RV
RVH
RUQ
Rx
Recovery room
Review of systems
Right ventricle
Right ventricular hypertrophy
Right upper quadrant
Treatment
s
S-A
SBE
SC
SGOT
SGPT
SH
Sig
SOB
s/p
Sp gr
SR
STAT
STS
sup
Sx
Without
Sino-atrial
Subacute bacterial endocarditis
Subcutaneous
Serum glutamic oxalacetic transaminase
Serum glutamic pyruvic transaminase
Social history
Let it be labeled
Shortness of breath
Status Post
Specific gravity
Sedimentation rate
At once
Serologic test for syphilis
Superior
Symptoms
T
T and A
TB
TBW
TCA's
TIBC
TP
TPN
TPR
TUR
TV
Tx
Temperature
tonsillectomy and adenoidectomy
Tuberculosis
Total body water
Tricyclic antidepressants
Total iron binding capacity
Total protein
Total parenteral nutrition
Temperature, pulse and respiration
Transurethral resection
Trial visit
Treatment
URI
UTI
Upper respiratory infection
Urinary tract infection
VC
VD
VDH
VDRL
Vital capacity or vena cava
Venereal disease
Valvular disease of heart
Venereal disease research laboratory
III.6
VF
vis
VMA
VP
VS
VSD
Visual field
Namely
Vanilmandelic acid
Venous pressure
Vital signs
Ventricular septal defect
WBC
WNL
Wt
White blood cells
Within normal limits
Weight
III.7
LABORATORY TESTS
BLOOD CHEMISTRY
SERUM ENZYMES
ACID PHOSPHATASE - NV* = 0-4.0 (King Armstrong)
This enzyme occurs primarily in the adult prostate gland and in erythrocytes. The enzyme
liberated from each system differs slightly. Elevated serum acid phosphatase may indicate
metastatic carcinoma. Approximately 10-25% of patients with prostate tumors without metastasis
will also have an elevated acid phosphatase. Within three or four days after removal of the tumor
or after three or four weeks of estrogen therapy, the enzyme levels will decline.
ALDOLASE - NV 3-8
This is a glycolytic enzyme present in significant quantities in skeletal and heart muscle. Skeletal
muscle damage results in high levels of aldolase, particularly in muscular dystrophy. The
aldolase level does not rise in neurogenic disease such as muscular atrophy, myasthenia gravis
and multiple sclerosis.
ALKALINE PHOSPHATASE - NV = Adult 4-13, Child 13-20 Method = King-Armstrong (K-A)
The phosphatases are hydrolytic enzymes which catalyze the cleavage of phosphate esters. Most
of the alkaline phosphatase is made in the osteoblasts and the liver. An elevation of serum
alkaline phosphatase implies a disease either in the skeletal or the hepatobiliary system. It is also
elevated in hyperthyroidism. Children have a higher alkaline phosphatase as a result of
osteoblastic activity due to bone growth. Alkaline phosphatase is excreted through the biliary
system and obstructive diseases may cause elevation.
AMYLASE - NV 60-160 (Somogyi Units)
Amylase splits starch into individual sugars. The pancreas and salivary glands secrete the enzyme
into the pancreatic and salivary fluids where its activity is extracellular. An elevated serum
amylase normally indicates pancreatic disease or obstruction of the pancreatic duct. Elevations
are also observed in mumps and acute abdominal pain of peptic ulcer or intestinal strangulation.
CHOLINESTERASE - NV 1-5 IU
Cholinesterases hydrolyze acetylcholine to choline and acetic acid. Two of these enzymes have
been described as "true cholinesterase and pseudocholinesterase." Serum levels of cholinesterases
are low in hepatitis, chronic cirrhosis and poisoning from organic phosphates.
*NV = Normal Value
III.8
CREATINE PHOSPHOKINASE (CPK) - NV 0-35
This enzyme catalyzes the transfer of high energy phosphate. The skeletal and cardiac muscles
are the principal sites of activity but smaller amounts are found in the brain. C.P.K. levels are
elevated in muscular dystrophy, myocardial necrosis and thyrotoxicosis.
LACTIC DEHYDROGENASE (LDH) - NV 80-120
This is one of the glycolytic enzymes and is present in nearly all metabolizing cells. Its highest
concentrations occur in the liver, heart, skeletal muscle and erythrocytes. It is fairly nonspecific
indicator and damage to nearly any tissue can result in an elevated LDH. The enzyme is elevated
in myocardial infraction, liver disease such as acute and toxic hepatitis, hepatic neoplasms,
obstructive jaundice, and in pernicious anemia.
LIPASE - NV < 1.0
Lipase is a hydrolytic enzyme secreted by the pancreas into the duodenum where it splits fatty
acids from triglycerides with the aid of bile salts and calcium ions. Lipase, like amylase, occurs
within the secretary cells and enters the blood stream as a result of damage to the pancreas. The
most common cause of an elevated lipase is acute pancreatitis.
SERUM GLUTAMIC-OXALACETIC TRANSAMINASE (SGOT) - NV 10-40 units/ml
The transaminase enzymes catalyze the transfer of amino groups. High concentrations of G.O.T.
are found in the heart and liver, with smaller amounts in the skeletal muscles, kidney and
pancreas. After myocardial necrosis, large quantities of G.O.T. are released into the circulation.
Significant levels appear in the serum within 6 to IO hours following a myocardial infract.
SERUM GLUTAMIC-PYRUVIC TRANSAMINASE (SGPT) - NV 5-35 units/ml
The liver contains the highest concentration of G.P.T. while the kidney, heart, and skeletal muscle
also have significant quantities. Hepatic cellular damage releases both G.O.T. and G.P.T. The
S.G.P.T. is frequently highly elevated in acute hepatitis and obstructive jaundice and moderately
elevated in chronic hepatitis, cirrhosis of the liver and neplastic metastatic disease of the liver.
SERUM ELECTROLYTES
AMMONIA - NV 30-70 mcg/dl
Ammonia is formed from the action of bacteria on the proteins in intestinal contents. The liver
detoxifies ammonia by converting it to urea. Since ammonia is removed by the liver, elevated
levels of ammonia normally indicate severe liver disease.
BLOOD pH - NV 7.35-7.45
The blood pH has a critical effect on the body and must be maintained within narrow limits.
III.9
CALCIUM - NV 9-1 1.0 mg/dl
Most calcium of the body exists within the skeletal system. Calcium ions effect neuromuscular
excitability, cellular and capillary permeability and are required for clotting of blood. Serum
calcium is elevated in hyperparathyroidism and vitamin D excess.
CARBON DIOXIDE CONTENT NV 24-30 mEq/L (venous)
Total carbon dioxide content measures the sum of bicarbonate, carbonic acid and dissolved
carbon dioxide present in the serum. This is elevated in metabolic alkalosis and respiratory
acidosis. It is reduced in metabolic acidosis and respiratory alkalosis.
CHLORIDE - NV 98-109 mEq/L (355-376 mg/dl)
Chloride is the principal anion of the body. Chlorides are excreted with cations during massive
diuresis and are also lost by vomiting and diarrhea. Serum chlorides are elevated in renal
insufficiency, and excessive salt intake. Excessive loss of fluid due to vomiting or diarrhea,
diuretics and metabolic alkalosis decrease serum chloride levels.
PHOSPHORUS NV 3-4.5 mg/dl
Phosphorus also is found predominately in the skeletal system. It is required in the storage and
liberation of energy. Serum phosphorus will be elevated in renal insufficiency and
hypoparathyroidism.
POTASSIUM - NV 3.1-5.3 mEq/L (1 6-22 mg/dl)
Potassium is the primary intracellular cation. The serum potassium may be elevated in renal
insufficiency or from excessive intake of potassium supplements. Decrease serum potassium may
result from renal tubular disorder, diarrhea and vomiting and massive diuresis.
SODIUM - NV 135-145mEq/L (315-335 mg/dl)
Sodium is the predominant extracellular cation. Serum sodium levels may be increased in severe
vomiting, sweating or diuresis. Low serum sodium may be observed in water intoxication or in
inappropriate secretion of antidiuretic hormone.
MISCELLANEOUS SERUM CONTENTS
ALBUMIN - NV 4-5 g/dl
This protein fraction normally comprises from 52 to 68 percent of the total protein value.
Albumin elevation is infrequently elevated, but is observed in dehydration and shock. More
commonly albumin will be decreased such as in malnutritions, chronic diseases of the liver, and
excessive protein loss as in nephrosis, nephritis or bums.
BILIRUBIN TOTAL - NV 0. I- 1.2 mg/dl
Bilirubin is the predominant pigment of human bile and gives the yellow color. Bilirubin is
formed from hemoglobin of destroyed erythrocytes. Elevated levels of bilirubin occur in
hemolysis, malaria, hepatitis and septicemia.
III.10
BLOOD UREA NITROGEN (BUN) - NV 8-18 mg/dl
Urea is the end product of protein metabolism and is produced only in the liver. After its
production in the liver it is normally excreted through the kidneys. The most common cause of
elevated BLJN levels is renal disease. Other disease states can result in abnormal levels of urea.
These include diseases in which protein catabolism is marked such as in bums, massive
hemorrhage into body cavities and carcinoma etc.
CHOLESTEROL - NV 130-230 mg/dl
The liver stores cholesterol and excretes esterified cholesterol into the plasma. Normally, half to
three quarters of the serwn cholesterol is present in the esterified form. A decrease in the
percentage of esters indicates liver disease, especially acute hepatitis and active cirrhosis.
CREATININE - NV 0.6-1.2 mg/dl
Creatine is found in skeletal muscle as creatine phosphate. Creatine is converted to creatinine in
a nonenzymatic and irreversible reaction. The creatinine is excreted through the kidneys in
quantities proportional to serum levels. By comparing serum creatinine concentration with the
total quantity excreted within a certain time, the creatinine clearance of the renal system can be
calculated. A rising serum creatinine signals diminished renal fimction. Specifically, the serum
creatinine will be elevated in acute and chronic renal insufficiency.
FIBRINOGEN (Plasma) - NV 0.2-0.4 g/dl
Fibrinogen may be elevated in renal diseases such as glomerularnephritis, nephrosis and
infectious diseases. Decreased levels may occur in hepatic insufficiency.
GLOBULIN (Serum) - NV 65-100 mg/dl
The globulins (gamma) contain the antibodies of the body. Low levels of gamma globulin occur
as a congenital abnormality and these patients have frequent bacterial infections. Chronic
infections may elevate gamma globulin levels.
GLUCOSE (Fasting) - NV 65-100 mg/dl
The primary storage form of glucose is in the form of glycogen. When needed the glucose can be
mobilized from glycogen. Glucose can also be derived from fat or protein sources, both this
method results in the production of acidic by-products. Diabetes mellitus is the most common
cause of hyperglycemia, however, other diseases such as Cushing's or hyperthyroidism may also
product the effect. Any circumstances which mobilizes epinephrine may also cause
hyperglycemia. Hypoglycemia is observed in hyperinsulinism, adrenalinsufficiency, or pituitary
disease.
GLUCOSE TOLERANCE TEST (GTT)
This test is conducted by administration of 75 GMS of glucose to a fasting patient. Blood and
urine are collected before the test and at stated intervals. Diabetics will characteristically show
initial high elevated glucose levels with a slow return to fasting level. In severe liver disease, the
initial glucose level may be high with a rapid fall to below fasting levels in three to four hours.
III.11
ICTERUS INDEX - NV 3-8 units
The icterus index is a measure of the dejzree of Jaundice. This test is an approximation of
the bilirubin levels.
PROTEFN-BOUND IODINE (pbi - 3.7-7.6 mcg/dl
Most circulating iodine exists in the form of thyroid hormone bound to serum proteins.
Nearly all of the iodine results from the hormone thyroxine. An elevated level indicates
hyperthyroidism, thyroiditis or hepatitis. A decreased PBI value is found in nephrosis,
chronic liver disease, and pancreatic malabsorption.
SERUM IRON - 75-150 mcg/dl
Serum iron can be elevated as a result of multiple transfusions, hemolytic diseases and as
a result of excess iron administration.
TEYMOL TURBIDITY - 0.5 SH units
This test reflects normal liver function and protein synthesis. The value is increased in
hepatocellular damage and negative in obstructive or hemolytic jaundice.
TOTAL IRON BINDING CAPACITY (TIBC) - NV 250-350 mcg/dl
This test is elevated in the presence of low serum iron and iron deficiency states
and is decreased in the presence of high serum iron.
TOTAL PROTEINS (Serum) - NV 6.7-8.3 g/dl
The normal serum contains approximately 7 grams of protein per I 00 ml. Various
diseases may affect the amount of total protein in the serum of one of the individual
protein fractions (Albumin, Globulin or Fibrinogen).
TRIGLYCERIDES - NV 30-140 mg/dl
The concentration of total lipids in the blood is quite variable and depends on many
factors including diet, age and sex. Variations in the concentration of lipids are rarely
characteristic of any particular disease. A great increase in the plasma triglycerides does
occur in essential familiar hyperlipemia.
URIC ACID - NV Male 3.4-7.8, Female 2.5-6.2 mg/dl (in general, 3-7 mg/dl)
Uric acid production in the body results from degradation of purine containing compounds
(nucleic acids of RNA and DNA). Since uric acid is poorly soluble it may precipitate out
of solution when the concentration in the body fluids rises. The serum uric acid is
elevated in gout, leukemia, renal insufficiency and as a result of cytolysis as in treatment
with antileukemic drugs.
HEMATOLOGY VALUES
BASOPHILS - NV O.-l percent
Few conditions cause an increase in the number of basophils. Chronic myelocytic
leukemia, colitis and myxedema have reportedly caused these increases.
III.12
BLEEDING TIME - IVY Method NV 1-5 Minutes
This test measures the time necessary for active bleeding to cease from a clean, superficial
wound. The bleeding time is prolonged when the platelet count is low or if the platelets are
defective. This procedure tests only the response to superficial injury, and in this instance
bleeding can be controlled by platelets and vascular response. Therefore, the hemophilia patient
may have non-nal values.
CLOT RETRACTION - NV Gross Observation of Clot
This procedure evaluates platelet function by the observation of retraction of clot formations.
When platelet function or number decreases, the clot retraction is impaired.
CLOTTING TIME - (Lee-White) NV 6-12 minutes
This test measures the time required for clotting to occur in a test tube. Clotting time can be
prolonged by deficiencies of any intrinsic factor or by the presence of a circulating anticoagulant.
EOSINOPHILS - NV 1-3 percent
The most common cause of eosinophilia are allergic reactions, skin diseases and infections with
parasites.
ERYTHROCYTE COUNT - Male 4.5-6.5, Female 4.0-5.6 million celIS/mm 3
The erythrocyte count is decreased in various anemias and may be increased in a rare condition of
polycythemia.
ERYTHROCYTE SEDIMENTATIONS RATE - NV Female 0.20, Male 0. IO mm, per hour
This test measures the speed with which red blood cells settle in fluid blood. In this test
anticoagulated blood must be used. A column of blood 100mm high is allowed to settle for one
hour. The rate of settling depends on the concentration of plasma proteins and concentration of
the red cells. When plasma proteins are high and red cell content is low - the cells settle rapidly.
Increased sedimentation rates are observed during pregnancy and multiple myeloma while
decreased values occur in sickle cell disease.
HEMATOCRIT - NV Male 40-54, Female 37-47 percent
The hematocrit represents the portion of total blood volume occupied by red blood cells and
provides a visual means of estimating the red cell count. Hematocrit levels will be decreased as a
result of hemorrhage or red blood cell destruction.
III.13
HEMOGLOBIN - NV Male 13-17, Female 11-16 g/dl
The hemoglobin value expresses the total amount in 1 00 ml of blood. Adequate production of red blood
cells requires that ftmctioning hemoglobin be produced and incorporated into the red cells. Only
a few conditions result in an increased hemoglobin content of the blood. Conversely, numerous
conditions result in a decrease in the oxygen-carrying capacity of the blood (decrease in
hemoglobin). The increased loss or destruction of the hemoglobin red cell mass is seen in all
types of blood loss and destruction of red cells.
LEUKOCYTE COUNT - NV 4,000-1 1,000 cells/mm' (5,000-10,000 often used)
Three principal types of white cells are found in the body. These are the granulocytes,
lymphocytes, and the monocytes. Granulocytes include important as is the proportion of cell
types present. The white cell count is elevated in inflammations, fevers and anemias.
LYMPHOCYTES - NV 25-33 percent
Lymphocyte production occurs in the lymphoid tissue rather than in the bone marrow.
Lymphocytes play a major role in the antigen antibody reaction. Adrenal steroids have a
suppressant effect on the lymphocytes. Increased numbers of lymphocytes are common after viral
and bacterial infections.
MONOCYTES - NV 3-7 percent
Neither the function nor the origin of the monocyte has been determined. An increased number of
monocytes occurs frequently in tuberculosis.
NEUTROPHILES - NV Juvenile 0-1%, Band 0-5%, Segmented 40-60%
Neutrophilic granulocytes are the most numerous circulating white cells in normal adults. The
neurtophils appear to be the body's first line of defense in infection and other trauma. They
perform their fimction by phagocytosis. Neutrophils respond quickly to stimulation and increased
numbers of neutrophils occur in gram-positive and many gram-negative infections. Neutrophilia
also occurs in some virus and rickettsiae infections. These cells also increase during
inflammatory processes, neoplasms and acute hemorrhage.
PLATELET COUNT - NV 140,000-440,000 cells/mm'
Thrombocytes or platelets appear to be essential for normal hemostasis.
Decreased platelets occur in many disorders including leukemias, aplastic anemia, septicemia and
after exposure to certain drugs. Bleeding does not normally occur unless the platelet count drops
below 80,000 per cu. mm.
PROTHROMBIN TIME - NV 70-1 1 0 percent of control (within 2 sec. of control)
In the sequence of coagulation of fluid blood, prothrombin reacts with ionized calcium to form
thrombin. The time in which a mixture of blood from the patient clots is compared to a control
sample. This test is often used to monitor the effects of coumarin anticoagulants.
III.14
RETICULOCYTE COUNT - NV 0.5-1.5 percent
Normal red cells are non-nucleated, biconcave disks. At the time red cells enter the blood stream from
the bone marrow, all evidence of nucleated material have normally disappeared. In the presence
of massive erythropoietic stimulation, immature red cells may be released into the circulation.
These cells (Reticulocytes) contain nuclear material. The percentage of reticulocytes increases
after blood loss. An absence of reticulocytes following extensive blood loss indicates decreased
bone marrow function.
SICKLE CELL - NV Negative
Sickle cell disease results from a genetically determined abnormal type of hemoglobin known as
hemoglobin S. Approximately 8 percent of the American Negroes produce some hemoglobin S in
their cells but have no symptoms of disease. This is called sickle cell trait. A much smaller
percent of the race (0.2%) produce high concentration of hemoglobin S and, therefore, have sickle
cell disease. The disease results in hyperhemolytic crisis and vascular occlusion.
URINE
AMINO ACID NITROGEN NV 50-200 mg/24hr
The amount of amino acids excreted in the urine of adults ranges from 0.4 to 1.0 Gm. per 24
hours. This is equivalent to from 100 to 200 mg of amino acid nitrogen. In the normal individual,
protein is hydrolyzed in the small intestine, and metabolized by the liver. Various metabolic
defects may cause large quantities of certain amino acids to appear in the urine
BILIRUBIN NV 0
In certain pathologic conditions pigments may be found in the urine. Bilirubin is formed from
hemoglobin and the bilirubin which has passed through the liver is more diffusible that prehepatic
bilirubin. Bilirubin resulting from obstructive jaundice occurs in the urine earlier than that
resulting from hemolytic disease. Hepatitis and biliary tract obstruction will normally produce
increased values of bilirubin in the urine.
CALCIUM NV < 160 mg/24 hr
The patient on a normal diet excretes less than 160 mg of calcium per day. A decreased urinary
calcium indicates hypocalcemia or hypoparathyroidism or osteomalacia while increased values
may signal hy-perparathyroidism or bone neoplasms.
CASTS
Casts are cylindrical structures which form in the renal tubules as a result of coagulation of
protein. The occurrence of casts in the urine is termed cylindruria. The casts which form may
entrap cellular elements or be free of cells. The composition of the cast indicates various types of
disease processes. For instance, casts made up of white cells indicate pyelonephritis while the
inclusion of red cells indicates hemorrhage from the glomeruli.
CHLORIDE NV 75-200 mEq/24 hr
A decreased excretion of chlorides usually indicates decreases in blood chlorides, excessive
sweating, heart failure or nephritis, etc.
CREATININE NV 1.0-1.8 g/24 hr
Creatinine is a product of endogenous metabolism of muscle tissue and is filtered and secreted
into the urine. The excretion of urinary creatinine does not vary greatly with the nutritional state
III.15
of the patient or his general state of health. In patients with prolonged decreased urinary function, the
serum creatinine levels increase while the urinary excretion decreases.
CREATININE CLEARANCE NV 100- 150 ml/min
Since the excretion and serum creatinine levels are constant, a determination of creatinine
clearance can be estimated over a 24 hour period. The formula for estimating clearance is
Clearance = UV
P
U = urine creatinine in mg per 1000 ml
V = urine volume in liters per 24 hours
P = serum creatinine in mg per liter
CRYSTALS
Normal urine sediment will frequently contain crystals. The crystals are usually of phosphates,
uric acid, calcium carbonate or sodium urate.
ERYTHROCYTES
The presence of a large number of red cells in the urine indicates that some type of trauma to the
urinary tract has occurred. This may include glomerulonephritis, tumors, calculi, or hemorrhagic
disease.
GLUCOSE NV 0
Glucose may be detected in the urine under certain conditions in normal individuals. Some of the
pathologic conditions which can produce glucose in the urine are diabetes mellitus,
hyperthyroidism, hypertension and chronic liver disease.
HEMOGLOBIN NV 0-3 mg/dl
Hemoglobin is normally absent from the urine, however, when it is present it is called
hemoglobinuria. This condition results from excessive hemolysis of red blood cells. Hemolysis
may be present in such conditions as malaria and chemical poisoning, etc.
17-HYDROXYCORTICOSTEROIDS NV 2-12 mg/24 hours
The hormones secreted from the adrenal cortex have a 17-carbon structure
(cyclopentanoperhydrophenanthrene ring) as their basic structure. The urinary free cortisol
excretion is the urinary reflection of unbound plasma 17-hydroxycorticosteroids. The value of
this test will be elevated in Cushing's syndrome, adrenal adenomas, adrenal carcinoma, in severe
hypertension and in thyrotoxicosis. Decreased values are observed in Addison's disease.
5-HYDROXY INDOLE ACETIC ACID (5-HIAA) - NV 2-9 mg/24 hours
The majority of serotonin (90%) is found in the gastrointestinal mucosa. The remainder is found
in blood platelets, spleen and the brain. Serotonin is metabolized to 5-H.I.AA and is found in the
urine. In patients with carcinoid tumors the level of 5-H.I.A.A. will be elevated.
KETONES - NV Negative
In the body fatty acids are normally completely to carbon dioxide and water. Intermediate
products of this metabolic process are not found to any great extent in the blood or urine.
However, in acidosis these by-products of fat metabolism (ketone bodies) accumulate in the blood
and are excreted into the urine. The most commonly observed causes of ketonuria is diabetes
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mellitus. It is also observed in starvation and other conditions in which the carbohydrate intake has been
reduced.
17-KETOSTEROIDS - NV Male 7-15 mg, Female 4-10 mg/24 hours
This test reflects the amount of weakly androgenic secretions of the adrenal cortex and does not
measure overall adrenal cortical activity. This test may be elevated in tumors of the testicles,
adrenal cortical hyperplasia and lute in cell tumors of the ovary.
LEUKOCYTES
A few leukocytes are found in the normal urine. Increased numbers of leukocytes present in the
urine is indicative of bacterial infection.
pH VALUE - NV 6.0 Range 4.8-8.5
Fresh urine normally has an acid reaction of pH 6.0. As urine stands it becomes alkaline as
ammonia is formed from urea. In acidosis, diabetes mellitus, gout and leukemia the urine is
strongly acid. Ingestion of acids, and many drugs also produce an acid urine.
PHOSPHORUS - NV 900-1800 mg/24 hours
Phosphate excretion through the urinary system is increased in alkalosis and decreased in patients
in nephritis or hypoparathyroidism.
PROTEIN (Albumin) - NV 0.025-0.070 mg/dl
Normal urine contains minute quantities of protein. Albumins and globulins are the most
important proteins found in the urine. Albumin in the urine can be produced in renal disease,
hypertension and infections of the kidney.
SEDIMENT Normal Findings - Few desquamated epithelial cells, rate erythrocytes, leukocytes and cast
cells.
The sediments test consists of a microscopic examination of urine sediment after centrifuging. A
pathologic process may cause an increase in the number of cells found in the urine.
SODIUM - NV 75-200 mEq/24 hours
The sodium intake and output varies considerable. The loss of sodium may occur through the
renal system or from sweating.
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SPECIFIC GRAVITY - NV 1.010-1.030
The specific gravity of the urine depends upon the concentrating ability of the kidneys. The
morning specimen is more concentrated and is usually greater than 1.020. The specific gravity
may be elevated in diabetes mellitus, fever, sweating and glomerulonephritis. It is low in diabetes
insipidus and chronic nephritis.
UREA NITROGEN - NV 12-16 g/24 hr
The average adult excretes about 20-35 grams of urea in 24 hours. Of the total nitrogen of human
urine approximately 85% is in the form of urea. Excretion of urea may result from increased
catabolism, such as in febrile reactions or wasting disease.
URIC ACID - NV 400-800 mg/24 hours
Uric acid is formed in the liver and approximately one-half is also metabolized in the liver. The
excretion of uric acid is increased in leukemia, liver disease and high fever. Excretion is
decreased in the urine before a gout attack.
UROBILINOGEN - NV 0. 1 - 1.2 units/2 hours
When bilirubin enters the intestine, it's acted upon by bacteria which convert the substance to
urobilinogen. Normally from 1-4 mg of urobilinogen are excreted in the urine during a 24 hour
period. The values may be increased if excessive hemolysis occurs or if there is liver pathology
present such as hepatitis or cirrhosis.
VANILMANDELIC ACID (VMA) - NV 0.7-6.8 mg/24 hours
Epinephrine is the major hormone of the medulla. Norepinephrine and epinephrine circulate in
quantities sufficient for biologic activity but in insufficient quantities for biologic determinations.
Norepinephrine is found predominately in the urine. Catecholamines are degraded to acid end
products and are found in the urine. Vanilmandelie acid is one of these metabolites and is
frequently used to indicate catecholamine production. These levels may be elevated in
pheochromocytoma, neuroblastoma and ganglioneuroma.
VOLUME - NV 1000- 1500 ml
The normal adult secretes from 1000 to 1500 ml of urine in a 24 hour period. The output of urine
can be increased by increasing fluid intake and also by maintaining a high protein diet. Sweating,
diarrhea and vomiting also decrease urine output.
SPINAL FLUID
The cerebrospinal fluid (CSF), originates in the choroid plexus of the ventricles. The
concentration of most electrolytes in the CSF varies with the plasma levels and is usually
somewhat lower than the plasma levels. Red and white blood cells are normally excluded from
the CSF but may occur from rupture of blood vessels or from inflammation of the meninges.
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GLUCOSE - NV 50-75 mg/dl
The CSF glucose may be reduced in meningitis due to disturbance of the active transport systems
in the meninges which are responsible for getting glucose into the CSF.
PRESSURE - NV 120 mm of water
The pressure will vary from 75 to 200 mm of water. Elevation of pressure may indicate
intracranial tumors, infection and inflammation.
PROTEIN - NV 15-45 mg/dl
Since serum proteins are large molecules which do not pass the blood-brain barrier, the spinal
fluid normally contains very little protein. In the presence of inflammation the effectiveness of
the blood-brain barrier may be decreased and permit the entry of all types of serum protein. This
condition may occur in meningitis, and in tumors of the brain and spinal cord.
STOOL
STOOL GUAIAC - NV Negative
Gross appearance of blood in the stool is not observed in bleeding lesions of the upper intestinal
tract because of the effect on digestion. Gum guaiac has been used to detect the presence of
hemoglobin in the stool. The test is not specific and may be positive in numerous circumstances.
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