labs:diagnostics

8/10/2019 Labs:Diagnostics

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NEUROLOGICAL SYSTEM

INTERCRANIAL PRESSURE (ICP): 10-15 mmHg

GLASCOW COMA SCALE (GCS):o Best possible: 15o Less than 8 severe head injury, Comao 9-12 moderate head injuryo greater than 13 minor head trauma

CEREBRAL PERFUSION PRESSURE (CPP): Maintain above 70-80 mmHgo : o

INTRAOCULAR PRESSURE (IOP): 10-21 mmHgo : Glaucomao

CARDIOVASCULAR SYSTEM

Normal values of Hemodynamic Readings:

Central venous pressure (CVP): 1-8 mmHgo

o

Pulmonary artery systolic (PAS): 15-26 mmHgo o

Pulmonary Artery Diastolic (PAD): 5-15 mmHg


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o o

Pulmonary Artery Wedge Pressure (PAWP): 4-12 mmHgo o

Cardiac Output (CO): 4-6 l/mino o

Mixed Venous Oxygen Saturation (SvO2): 60-80%o o

Sufficient ventricular functioNo Ejection fraction greater than 40-50%o Heart Failure ejection fraction below 40%

CARDIAC ENZYMES Creatine Kinase MB Isoenzyme (CK-MB)

o 0% of total CK (30-170 units/L)o More sensitive to myocardiumo

Elevated levels three dayso First detectable follow myocardial injury 4-6 hrso o

TROPONIN T:


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o ELEVATED 24 hourso First detectable 2 hours following mio o

CHOLESTEROLo


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o M: 0.6-1.2 mg/dlo F: 0.5-1.1 mg/Lo o

Creatinine clearanceo M: 90-139 ml/min/m2o F: 80-125 ml/min/m2o o

24 hour urine creatinine clearance: 80-140 ml/min

RESPIRATORY SYSTEM

INTEGUMENTARY SYSTEM

MUSCULOSKELETAL SYSTEM


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HEMATOLOGICAL SYSTEM

BLOOD COMPATIBILITY BLOOD TYPE ANTIGEN ANTIBODIES

AGAINSTCOMPATIBLE

WITHA A B A, OB B A B, O

AB AB NONE A, B, AB, OO NONE A, B O

ARTERIAL BLOOD GASES (ABGS): PH: 7.35-7.45

o Amount of free hydrogen ions in arterial blood Pac02: 80-100 mmhg

o Partial pressure of O2 PaCo2: 35-45 mmHg

o Partial Pressure of CO2 HCO3-: 22-26 mEq/L

o Concentration of Bicarbonate in arterial blood SaO2: 95-100%

o


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o

Potassium: 3.5-5.0 meq/Lo

o

Chloride: 98-106 meq/Lo

o

Calcium: 9.0-10.5 Mg/DLo

o

Magnesium: 1.3-2.1 meq/Lo

o

Phosphorus: 3.5-4.5 mg/dlo

o

Blood diagnostic Procedures

Serum RBCo M: 4.7-6.1 mil/ulo F: 4.2-5.4 mil/ulo : o : Anemia

SERUM WBC: 5, 000-10,000/uLo : Infectiono : Immunosuppresion


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MCV: 80-95 mm3o : Microlytic (large) cells, Possible Anemiao : Microlytic (small) cells, Possible Iron Deficiency Anemia

MCH: 27-31 pg/cello Same as above; except MCH measures amount of hgb by weight per rbc

TIBC: 250-460 mcg/dlo : Iron deficiencyo : Anemia, Hemolysis, Hemorrhage

Irono M: 80-180 mcg/dlo F: 60-160 mcg/dlo : Hemochromatosis, iron excess, liver disorder, megoblastic anemiao

:

Iron deficiency anemia, hemorrhage

Plateletso 150,000-400,000 mm3o : malignancy or polycthemia verao : Autoimmune disease, bone marrow suppression, enlarged spleen

Hemoglobin (hgb)o M: 14-18 g/dlo F: 12-16 g/Dlo : o :

Hematocrit (Hct)o M: 42-52%o F: 37-47%o o

PT: 11-12.5so 85-100%; 1:1 CLIENT CONTROL RATIOo : EVIDENCE OF DEFICIENCY OR CLOTTINGo : Evidence of Vit K Excess

aPTT: 1.5-2 times normal range of 30-40so (desired range for anticoagulants)o measures intrinsic clotting factors


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o monitored for heparin therapyo Hemophilia, DIC, Liver Diseaseo

INR: 2-3 on Warfarin therapyo Measures mean of PTo Monitored for warfarin (Coumadin) therapyo o

D-Dimer:o 0.43-2.33 mcg/mlo 0-250 ng/dlo measures hypercoagulability of bloodo : Clot formationo

FIBRINOGEN LEVELS: 170-340 mg/dlo Reflects available fibrogen for clottingo o : decreased ability to clot

Fibrin degradation products:


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o : Chronic bacterial or viral infection, viruses (mononucleosis, mumps,measles), bacteria (hepatitis), lymphocytic leukemia, multiple myelomA

o : leukemia, sepsis

monocytes 2-8%o : chronic inflammation, protozoal infections, tb, viral infections

(mononucleosis, mumps, measles)o : corticosteroids

Eosinophils: 1-4%o : allergic reaction, parasitic infections, chronic inflammation, hodgkinso : Stress, corticosteroids

Basophils: 0.5-1.1%o : leukemiao : acute allergic/hypersensitivity, hyperthyroidism

HIVo Stage 1

Cd4 & T lymphocyte count 500 cells/meq/l or more Cd4 & t lymphocyte % of total lymphocytes 29 or more

o Stage 2 1 or more infections of stage 3 Cd4 & T lymphocyte count 200-499 cells/meq/l Cd4 & t lymphocyte % of total lymphocytes 14-28

o Stage 3 (AIDS) Candidiasis of esophagus, bronchi, trachea, or lungs

Cd4 & T lymphocyte count less than 200 cells/meq/l Cd4 & t lymphocyte % of total lymphocytes less than 14

URINARY SYSTEM

Serum ADH: 0-4.7 pg/ML o : SIADHo o patient education:

fast & avoid stress 12 hrs prior to test some meds may interfere with test blood is drawn and transported to lab within 10 mins

Urine electrolytes Osmolarity o Urine sodium: 75-200 meq/day


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o Urine potassium: 26-123 meq/day (intake dependent) o Urine chloride: 110-250 meq/24 hour o Urine osmolarity: 250-900 mosm/kg

Urine specific gravity: 1.003-1.030

o A increase in urine output and an increase in urine specific gravity occur asa result of excess adh production

o Usually performed in lab, but can be done on a clinical unit using calibratedhydrometer or temperature compensated refractometer

o o

Plasma cortisolo Test varies according to time of day. Since has diurnal pattern, increased

levels are present early in the morning, and lowest levels occur aroundmidnight, or 3-5 hrs after onset of sleep

o o

Salivary cortisolo


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REPRODUCTIVE SYSTEM

PSA: 2-4 ng/ml o : Prostatic cancero

ENDOCRINE SYSTEM

Fasting blood glucose:


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T4: 4.0-12.0 mcg/dl

o Low and high levels each indicate hypothyroidism and hyperthyroidism o o

TSH: 0.4-6.15 microunits/mlo Stimulates release of thyroid hormone by the anterior pituitary gland

o o

TRHo Relative to baselineo o

RAIUo 35% of injected amount of radioactive iodine (123I)o measures amount of 123 I absorbed by thyroid glando patients with hyperthyroidism absorb high amounts (>35%) of 123 Io o

labs:diagnostics

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