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TEST REFERENCE CLINICAL SIGNIFICANCE

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INTERFERING FACTOR
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Sodium 135 – 145 meq/L Hypernatremia:
Diabetes insipidus
Severe vomiting
Diarrhea
Aldosteronism (Sodium
Retention)
Hyponatremia:
Sweating in diuretic
treatment
Drugs that can increase
sodium:
1. Lithium
2. Vasopressin
3. Corticosteroids
4. Methyldopa
5. Hydralazine
6. Reserpine
Drugs that can lower sodium
levels:
1. Diuretics
Potassium 3.8 – 5.5 meq/L Hyperkalemia Hypokalemia Increase K levels:
1. Repeated fist
clenching before blood
extraction.
2. Delaying blood flow
after tourniquet.
3. Spironolactone
4. Pen G Therapy (IM)
5. Renal toxicity from
amphotericin B and
tetracycline.
Decrease K levels:
1. Insulin and glucose
administration
2. Diuretics
Chloride 100 – 108 meq/L Hyperchloremia:
Bicarbonate loss due to
diarrhea / primary
aldosteronism

Hypochloremia: Increase of
bicarbonate
Increase chloride levels:
1. Ammonium chloride
2. Cholestyramine
3. Boric acid
4. Phenylbutazone
5. Oxyphenbutazone
Decrease chloride levels:
1. Thiazide diuretics
2. Furosemide
3. Bicarbonate
4. Prolong infusion of
D5 W.
Calcium Unionized:
8.9 – 10.1 mg/dL
Ionized:
4 – 5 mg/dL
Hypercalcemia:
Hyperparathyroidism
Paget’s Bone
Myeloma (fracture)
Hypocalcemia:
Hypoparathyroidism
Parathyroidectomy
Acute pancreatitis
Malabsorption of calcium
Increase calcium levels:
1. Excessive ingestion of
Vitamin D
2. Use of androgens
3. Calciferol (Rowachol:
Activated calcium
salts)
4. Estrogen
5. Thiazide diuretics
False decrease calcium:
1. Chronic laxative use
2. Excessive transfusion
of blood
3. Corticosteroids
4. Prolong tourniquet
application
RBC 4 – 6 million/mcL Anemia and Bleeding Mixing with anticoagulants
Hemoglobin

M: 14 – 18 g/dL
F: 12 – 16 g/dL

Polycythemia vera Anemia Mixing with anticoagulants
Hematocrit M: 42 – 54%
F: 38 – 47%
Polycythemia vera Anemia Mixing with anticoagulants
RBC Index MCV: 84 – 99 pg
MCH: 26 – 32 pg
MCHC: 30 – 36 g/dL
MCV:
Macrocytic anemia
- deficiency in folate
Megaloblastic anemia
- deficiency in Vit. B12

MCV & MCHC:
Microcytic anemia
- due to iron deficiency
(Thalassemia)

WBC 4000 – 10000 / mcL
Differential count:
Neutrophils 48 – 77%
Lymphocytes 16 –43%
Monocytes 0 – 1%
Eosinophils 0 – 7%
Basophils 0 – 2%



Infection
Decrease in WBC:
- Bone marrow depression
(leukopenia)
due to viral infection or
reaction to drugs.

Leukocytosis – bacterial
infection
 Leukopenia
 Gangrene
 Tissue necrosis
(due to burns)
 Acute MI


Platelets 140,000 – 400,000
per mcL
Thrombocytosis
- hemorrhage infection
& cancer iron deficiency
Anemia.
Thrombocytopenia
- a plastic / hypoplastic
bone marrow depression
 Dengue



“I can do all things through Christ who strengthens me.” – Phil 4:13 [