Lab Tests

4 Important Groups

(1) FBC:
1. HB: anaemia MCV 60 thalassaemia, 60 80 iron deficiency anaemia dehydration, smoking, COPD 2. Platelets: infection, inflammation leukaemia, ITP & infection 60 risk alert 3. Neutrophils: infection, stress & surgery or very sick people (severe sepsis), chemotherapy 4. MCV: alcohol, B12/folate deficiency IDA/thalassaemia, chronic disease 5. Reticulocytes: erythropoiesis 6. Lymphocytes: infection with EBV, leukaemia/CLL steroid therapy, chemotherapy 7. Eosinophils: allergies 8. Basophils: IgE mediated hypersensitivity

(2) U&E:
1. Na+ : dehydration, cranial diabetes insipidus (ADH), nephrogenic DI (ADH) hypervolaemic RF, SIADH (malignancy, trauma) non-hypervolaemic urine Na+ Addisons, old age & 0.9% saline + furosemide 2. K+ : skeletal muscle breakdown, artefact & drugs management * ECG monitoring + 10ml calcium gluconate (cardio-protection) + (glucose + insulin) + resin (remove K+ from colon) + fluid infusion * Dialysis 3.0 replacement, vomiting/diarrhea 3. Creatinine: CRF 4. Uric Acid: gout 5. Ca+ : malignancy, hyperparathyroidism

(3) LFTs:
1. ALT/AST: ALT hepatitis AST hepatitis, MI, muscle breakdown 2. ALP/GGT: ALP cholestasis, bone disease, pregnancy GGT alcoholic hepatitis, cholestasis, drugs 3. Bilirubin: unconjugated haemolysis conjugated obstruction of bile duct 4. Albumin: chronic liver disease 5. Lipids: LDL coronary heart disease 6. Amylase: acute pancreatitis

(4) Coagulation:
1. INR (1.0 1.2): coagulation factors with liver disease, warfarin, K+ & DIC coagulation factors clotting PE/DVT 2. APTT: heparin , DIC & liver disease 3. PT: same as INR 4. Fibrin: coagulation factors clotting 5. D-dimers: fibrin breakdown by consuming, caused by DIC/DVT/inflammation

(5) Other markers:

1. ESR/CRP: infection/inflammation CRP faster and last shorter than ESR (1 day) CRP is not affected by pregnancy while ESR is affected ESR , CRP temporal arteritis, polymyalgia rheumatic 2. Iron study: Ferritin iron deficiency Transferrin saturation + Ferritin haemochromatosis