indication of lab values, blood, plasma, and serum (high or low levels)

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acetoacetate plus acetone

hyperketonemia and ketonuria (Ketones are
Poisonous acidic chemicals produced by the body when fat instead of glucose is burned for energy. Breakdown of fat occurs when not enough insulin is present to channel glucose into body cells, "Diabetic Ketoacidosis".)

acid phosphatase, serum (thymolphthalein monophosphate subsrate)

primarily in the prostate gland. The enzyme is an essential requirement to trigger any specific chemical reactions within the body. An acid phosphate test is primarily performed in order to diagnose if prostate cancer has spread to any other parts of the body. is used primarily to identify the level to which prostate cancer has progressed. When the cancer spreads to other parts of the body, these levels rise.

alanine aminotransferase (ATL), serum (SGPT)

Identify liver disease, especially cirrhosis and hepatitis caused by alcohol, drugs, or viruses.

albumin, serum

used in a variety of settings to help diagnose disease, to monitor changes in health status with treatment or with disease progression, and as a screen that may indicate the need for other kinds of testing. maybe ordered as part of a liver panel to evaluate liver function, along with a creatinine and BUN (Blood Urea Nitrogen) to evaluate kidney function, or along with a prealbumin to evaluate a person's nutritional status. A physician may order when a person has symptoms of a liver disorder such as jaundice, fatigue, or weight loss, or symptoms of nephrotic syndrome such as swelling around the eyes, belly, or legs.

aldolase, serum

is an enzyme found throughout the body, particularly in muscles. Like all enzymes, it is needed to trigger specific chemical reactions. Aldolase helps muscle turn sugar into energy. Testing for aldolase is done to diagnose and monitor skeletal muscle diseases. Dermatomyositis or muscle inflamation.

aldosterone, plasma

to Find the cause of high blood pressure or low blood potassium levels. This is done when overactive adrenal glands or an abnormal adrenal growth are suspected. this hormone will be high while renin levels will be low.The kidney hormone renin normally stimulates the adrenal glands to release this.

alkaline phosphatase (ALP), serum

is an enzyme in the liver and bile ducts, as well as some other tissues. Higher than normal levels may indicate liver damage or disease.

ammonia nitrogen, plasma

An elevated blood ammonia level occurs when the kidneys or liver are not working properly, allowing waste to remain in the bloodstream. Ammonia, like many other waste products in the body, can be poisonous to your cells, and an elevated blood ammonia level can affect your entire body. In children, it may be related to Reye's syndrome, while in adults, an elevated blood ammonia level may indicate kidney or liver damage or an underlying metabolic disease. In some cases, an elevated blood ammonia level will resolve on its own without treatment. In addition to an increased level of ammonia in the blood, other symptoms of elevated blood ammonia include muscle weakness, fatigue, or other symptoms of liver and kidney damage and failure. If left untreated, elevated blood ammonia can affect brain tissue, leading to symptoms such as confusion and delirium (rapid change in cognitive function).

amylase, serum

is an enzyme that helps digest carbohydrates. It is produced in the pancreas and the glands that make saliva. When the pancreas is diseased or inflamed, amylase releases into the blood. "pancreatitis"

anion gap, serum calulated

can be normal, high, or low. A high anion gap indicated metabolic acidosis, the increased acidity of the blood due to metabolic processes. A low anion gap is relatively rare but may occur from the presence of abnormal positively charged proteins, as in multiple myeloma - is a cancer in which abnormal cells collect in the bone marrow and form tumors.

ascorbic acid, blood

Lack of vitamin C can lead to a condition called scurvy, which causes muscle weakness, swollen and bleeding gums, loss of teeth, and bleeding under the skin, as well as tiredness and depression. Wounds also do not heal easily.

asparate aminotransferase (AST), serum (SGOT)

Low levels are normally found in the blood. When body tissue or an organ such as the heart or liver is diseased or damaged, additional is released into the bloodstream. The amount in the blood is directly related to the extent of the tissue damage. Check for liver damage.
•Help identify liver disease, especially hepatitis and cirrhosis. Liver disease may produce symptoms such as pain in the upper abdomen, nausea, vomiting, and sometimes jaundice.
•Check on the success of treatment for liver disease.
•Find out whether jaundice was caused by a blood disorder or liver disease.
•Keep track of the effects of cholesterol-lowering medicines and other medicines that can damage the liver.

base excess, arterial blood, calculated

Blood gas measurements are used to evaluate your oxygenation and acid/base status. They are typically ordered if you have worsening symptoms of an acid/base imbalance, difficulty breathing, or shortness of breath. Abnormal results of any of the blood gas components may mean that: you are not getting enough oxygen, not getting rid of enough carbon dioxide, and there is a problem with kidney function.
- Respiratory acidosis is characterized by a lower pH and an increased PCO2 and is due to respiratory depression - not enough oxygen in and carbon dioxide out. This can be caused by many things, including pneumonia, chronic obstructive pulmonary disease (COPD), and over-sedation from narcotics.
- Respiratory alkalosis, characterized by a raised pH and a decreased PCO2, is due to over ventilation caused by hyperventilating, pain, emotional distress, or certain lung diseases that interfere with oxygen exchange.
- Metabolic acidosis is characterized by a lower pH and decreased HCO3-; the blood is too acidic on a metabolic/kidney level. Causes include diabetes, shock, and renal failure.
- Metabolic alkalosis is characterized by an elevated pH and increased HCO3- and is seen in hypokalemia, chronic vomiting (losing acid from the stomach), and sodium bicarbonate overdose.

bicarbonate

More than 90% of carbon dioxide in your blood exists in this form. is a chemical (buffer) that keeps the pH of blood from becoming too acidic or too basic.
~When is it ordered?
- usually as part of an electrolyte panel when.
- Someone is having a routine blood screen
- a patient may be retaining water or is dehydrated, upsetting their electrolyte balance.
- to evaluate a patient's acid-base balance (pH).
- to monitor a condition or treatment that might cause an electrolyte imbalance .

~Some of the causes of a low bicarbonate level include:
Addison's disease
Chronic diarrhea
Diabetic ketoacidosis
Metabolic acidosis
Kidney disease
Ethylene glycol or methanol poisoning
Salicylate (aspirin) overdose

~Increased levels may be due to:
Severe vomiting
Lung diseases, including COPD
Cushing syndrome
Conn syndrome
Metabolic alkalosis

bile acids, serum

will detect liver changes before the formation of more advanced clinical signs of illness. is an indicator of a liver function.
DIAGNOSTIC IMPLICATIONS: Liver diseases that can elevate these levels include: hepatic neoplasia, portosystemic shunt, hepatitis, bile duct obstruction, canine adenovirus, slowed gastrointestinal transit and almost any condition that causes a defect in hepatic uptake or portal circulation. Test results that appear low are usually due to normal variation or prolonged fasting, but can also indicate intestinal malabsorption or increased gastric motility.

bilirubin, serum

when someone shows signs of abnormal liver function. may be ordered when a person:
- Shows evidence of jaundice.
- Has a history of drinking excessive amounts of alcohol.
- Has suspected drug toxicity.
- Has been exposed to hepatitis viruses.

*Other symptoms that may be present include:
- Dark, amber-colored urine.
- Nausea/vomiting.
- Abdominal pain and/or swelling .
- Fatigue and general malaise that often accompany chronic liver disease.
*Increased total amount that is mainly unconjugated (indirect) may be a result of:
- Hemolytic or pernicious anemia.
- Transfusion reaction.
- Cirrhosis.
- A common metabolic condition termed Gilbert syndrome, due to low levels of the enzyme that attaches sugar molecules to this.
- If conjugated (direct) is elevated more than unconjugated (indirect), there typically is a problem associated with decreased elimination by the liver cells. Some conditions that may cause this include:
- Viral hepatitis.
- Drug reactions.
- Alcoholic liver disease.
- Conjugated (direct) is also elevated more than unconjugated (indirect) when there is some kind of blockage of the bile ducts. This may occur, for example, with:
- Gallstones getting into the bile ducts.
- Tumors.
- Scarring of the bile ducts.

calcium, serum

All cells need it in order to work. this helps build strong bones and teeth. It is important for heart function, and helps with muscle contraction, nerve signaling, and blood clotting.

*Higher than normal levels may be due to a number of health conditions. Common causes include:
-Being on bed rest for a long time.
-Taking too much calcium or vitamin D.
- HIV/AIDS.
- Hyperparathyroidism.
- Infections that cause granulomas such as tuberculosis and certain fungal and mycobacterial infections.
-Metastatic bone tumor.
- Multiple myeloma.
- Overactive thyroid gland (hyperthyroidism) or too much thyroid hormone replacement medication.
- Paget's disease.
- Sarcoidosis.
- Tumors producing a parathyroid hormone-like substance.
- Use of certain medications such as lithium, tamoxifen, and thiazides.
*Lower than normal levels may be due to:
- osteoporosis
- Hypoparathyroidism
- Kidney failure
- Liver disease
- Magnesium deficiency
- Disorders that affect absorption of nutrients from your intestines
- Osteomalacia
- Pancreatitis
- Vitamin D deficiency
*Drugs that can increase calcium levels include:
- Calcium salts (may be found in nutritional supplements or antacids).
- Lithium.
- Thiazide diuretics.
- Thyroxine.
- Vitamin D.
- Drinking too much milk (two or more quarts a day) or taking too much vitamin D as a dietary supplement can also increase blood calcium levels.

calcium, ionized, serum

is freely flowing in your blood and not attached to proteins. It is also called free calcium.
*Higher-than-normal levels of ionized calcium may be due to:
- Decreased levels of calcium in the urine from an unknown cause.
- Hyperparathyroidism-is excessive production of parathyroid hormone (PTH) by the parathyroid glands.
- Lack of mobility.
- Milk-alkali syndrome-is an acquired condition in which there are high levels of calcium (hypercalcemia) and a shift in the body's acid/base balance towards alkaline (metabolic alkalosis).
- Multiple myeloma-is cancer that starts in the plasma cells in bone marrow. Bone marrow is the soft, spongy tissue found inside most bones. It helps make blood cells.
- Paget's disease- is a disorder that involves abnormal bone destruction and regrowth, which results in deformity.
- Sarcoidosis-is a disease in which inflammation occurs in the lymph nodes, lungs, liver, eyes, skin, or other tissues.
- Thiazide diuretics
- Tumors
- Vitamin D excess
*Lower-than-normal levels may be due to:
- Hypoparathyroidism-
- Malabsorption
- Osteomalacia
- Pancreatitis
- Renal failure
- Rickets- is a disorder caused by a lack of vitamin D, calcium, or phosphate. It leads to softening and weakening of the bones.
- Vitamin D deficiency.

carbon dioxide, total, serum or plasma

is most often done as part of an electrolyte or basic metabolic panel. Changes in your level may suggest that you are losing or retaining fluid, which causes an imbalance in your body's electrolytes. levels in the blood are influenced by kidney and lung function. The kidneys are mainly responsible for maintaining the normal bicarbonate levels.
*Lower-than-normal levels may be due to:
- Addison disease-is a disorder that occurs when the adrenal glands do not produce enough of their hormones.
- Diarrhea
- Ethylene glycol poisoning
- Ketoacidosis- is a problem that occurs in people with diabetes. It occurs when the body cannot use sugar (glucose) as a fuel source because there is no insulin or not enough insulin. Fat is used for fuel instead.Byproducts of fat breakdown, called ketones, build up in the body.
- Kidney disease
- Lactic acidosis
- Metabolic acidosis
- Methanol poisoning
- Salicylate toxicity (such as aspirin overdose)
*Higher-than-normal levels may be due to:
- Breathing disorders
- Cushing syndrome- is a disorder that occurs when your body is exposed to high levels of the hormone cortisol. It may also occur if you take too much cortisol or other steroid hormones.Upper body obesity (above the waist) and thin arms and legs. Purple marks (1/2 inch or more wide) called striae on the skin of the abdomen, thighs, and breasts.
- Hyperaldosteronism-conditions in which the adrenal gland releases too much of the hormone aldosterone.
- Vomiting
*The following conditions may also alter bicarbonate levels:
- Alkalosis
- Delirium-lack of oxygen to brain.
- Dementia
- Renal tubular acidosis; distal
- Renal tubular acidosis; proximal

carbon dioxide tension (Pco2), blood

35 - 45 mm Hg

B-carotene, serum

60 - 260 ug/dL

ceruloplasmin, serum

23 - 44 mg/dL

choride

96 - 106 mEq/L

cholesterol, serum or EDTA plasma

- desirable range - <200 mg/dL
- low density lipoprotein (LDL) "bad" - 60 - 180 mg/dL
- highdensity lipoprotien (HDL) "good" - 30 - 80 mg/dL

copper

70 - 140 ug/dL

corticotropin (ACTH), plasma, 8am

10 - 80 pg/mL

cortisol, plasma

- 8am - 6 - 23 ug/dL
- 4pm - 3 - 15 ug/dL
-10pm - <50% of 8am value

creatine, serum

- males - 0.2 - 0.5 mg/dL
- females - 0.3 - 0.9 mg/dL

creatine kinase (CK), serum

- males - 55 - 170 U/L
- females - 30 - 135 U/l

creatine kinase MB isoenzyme, serum

<5% of total CK activity
<5.0 ng/mL by immunoassy

creatinine, serum

0.6 - 1.2 mg/dL

erythrocytes

145 - 540 ng/mL

estradiol-17 B, adult

- males - 10 - 65 pg/mL
-females - follicular - 30 - 100 pg/mL
- ovulatory - 200 - 400 pg/mL
- lutteal 50 - 140 pg/mL

ferritin, serum

20 - 200 ng/mL

fibrinogen, plasma

200 - 400 mg/dL

folate, serum

3 -18 ng/mL

follicle stimulating hormone (FSH), plasma

- males - 4 - 25 mU/mL
- feamles, premenopausal 4 - 30 mU/mL
- females, postmenopausal 40 - 250 mU/mL

gastrin, fasting, serum

0 - 100 pg/mL

glucose, fasting, plasma or serum

70 - 115 mg/dL

Y-glutamyltransferase (GGT), serum

5 - 40 U/L

growth hormone (hGH), plasma, adult, fasting

0 - 6 ng/mL

haptoglobin, serum

20 - 165 mg/dL

iron, serum

75 - 175 ug/dL

iron binding capacity, serum

- total - 250 - 410 ug/dL
- saturation - 20 - 50%

lactate

- venous whole blood - 5.0 - 20.0 mg/dL
- arterial whole blood - 5.0 - 15.0 mg/dL

lactate dehydrogenase (LD, serum

- males - 1 -9 U/L
- females - follicular phase 2 - 10 U/L
- midcycle peak - 15 - 65 U/L
- luteal phase 1 -12 U/L
- postmenopausal 12 - 65 U/L

magnesium, serum

1.3 - 2.1 mg/dL

osmolality

275 - 295 mOsm/kg water

oxygen, blood, arterial, room air

- partial pressure (PaO2) - 80 - 100 mm Hg
- saturation (SaO2) - 95 - 98%

pH, arterial blood

7.35 - 7.45

phosphate, inorganic, serum

- adult - 3.0 - 4.5 mg/d/L
- child - 4.0 - 7.0 mg/dL

potassium

- serum - 3.5 - 5.0 mEq/L
- plasma - 3.5 - 4.5 mEq/L

progesterone, serum, adult

- males - 0 - 0.4 ng/mL
- females - follicular phase - 0.1 - 1.5 ng/mL
- luteal phase - 2.5 - 28.0 ng/mL

prolactin, serum

- males - 1.0 - 15.0 ng/mL
- females - 1.0 - 20.0 ng/mL

proteins, serum, electrophoresis

- total - 6.0 - 8.0 g//dL
- albumin - 3.5 - 5.5 g/dL
- globulins - X1 - 0.2 - 0.4 g/dL
- X2 - 0.5 - 0.9 g/dL
- B - 0.6 - 1.1 g/dL
- Y - 0.7 - 1.7 g/dL

pyuvate, blood

0.3 - 0.9 mg/dL

rheumatiod factor

0 - 30.0 IU/mL

sodium, serum or plasma

135 - 145 mEq/L

testosterone, plasma

- men - 300 - 1200ng/dL
- women - 20 - 75 ng/dL
- pregnant - 40 - 200 ng/dL

thyroglobulin

3 - 42 ng/mL

thyrotropin (hTSH), serum

0.4 - 4.8 uIU/mL

thyrotropin releasing hormone (TRH)

5 - 60 pg/mL

thyroxine free (FT4), serum

0.9 - 2.1 ng/dL

thyroxine (T4), serum

4.5 - 12.0 mg/dL

thyroxine binding globulin (TBG)

15.0 - 34.0 ug/mL

transferrin

250 - 430 mg/dL

tryglycerides, serum, 12-hr fast

40 - 150 mg/dL

triiodothryonine (T3), serum

70 -190 ng/dL

triiodothryonine uptake, resin (T3RU)

25% -38%

troponin 1

0.05 - 0.50 ng/mL

urate

- (FT4) males - 2.5 - 8.0 mg/dL
- (FT4) females - 2.2 - 7.0 mg/dL

urea, serum or plasma

24 - 49 mg/dL

urea nitrogen, serum or plasma

11 - 23 mg/dL

viscosity, serum

1.4 - 1.8 water

vitamin A, serum

20 - 80 ug/dL

vitamin B 12, serum

180- 900 pg/mL

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