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Normal Values Brunner PDF
Normal Values Brunner PDF
2–3
(for therapy in AFib, DVT and
Used to standardize the prothrombin time and
INR pulmo embolism)
anticoagulation therapy
2.5 – 3.5
(for therapy in prosthetic heart
valves)
Males:
Increased in severe diarrhea and DHN,
4.6 – 6.2 million/mm3
Erythrocyte Count 4.6 – 6.2 x 1012/ L polycythemia, acute poisoning, pulmonary fibrosis
(Red Blood Cells) 4.2 – 5.4 x 1012/ L Decreased in all anemias, in leukemia and after
Females:
hemorrhage when blood volume has been restored
4.2 – 5.4 million/ mm3
ERYTHROCYTE INDICES
Increased in macrocytic anemias
Mean corpuscular volume (MCV) 84 – 96 cu µm 84 – 96 fL
Decreased in microcytic anemia
Mean corpuscular hemoglobin Increased in macrocytic anemias
28 – 33 µµg/cell 28 - 33 pg
(MCH) Decreased in microcytic anemia
Mean corpuscular hemoglobin Concentration fraction:
33 – 35% Decreased in severe hypochromic anemia
concentration (MCHC) 0.33 – 0.35
Males under 50: < 15mm/h < 15 mm/h
Males over 50: < 20 mm/h < 20 mm/h Increased in tissue destruction (inflammatory or
Erythrocyte Sedimentation Rate
degenerative), during menstruation and pregnancy
(ESR) – Westergren method
Females under 50: <25 mm/h < 25 mm/h and in acute febrile disease
Females over 50: <30 mm/h < 35 mm/h
Erythrocyte Sedimentation Rate – < 50 y/o: < 55% Volume fraction: <0.55
Significance similar to ESR
Zeta centrifuge 50 – 80 y/o: 40 – 60% Volume fraction: 0.4 – 0.6
Decreased in severe anemias, anemia of
pregnancy, acute massive blood loss
Males: 42 – 52% Volume fraction: 0.42 – 0.52
Hematocrit
Females: 35 – 47% Volume fraction: 0.35 – 0.47
Increased in erythrocytosis of any cause, and in
DHN or hemoconcentration associated with shock
Decreased in various anemias, pregnancy, severe
or prolonged hemorrhage and with excessive fluid
intake
Males: 13 – 18 g/dL 2.02 – 2.79 mmol/L
Hemoglobin
Females: 12 – 16 g/dL 1.86 – 2.48 mmol/ L
Increased in polycythemia, COPD, failure of
oxygenation because of CHF, and normally in
people living at high altitudes
LEUKOCYTE COUNT 4,500 – 11,000/ mm3 4.5 – 11 x 109/L
Increased with acute infections, trauma or surgery,
leukemia, malignant disease, necrosis
Neutrophils 45 – 73% Number fraction: 0.45 – 0.73
Decreased with viral infections, bone marrow
suppression, primary bone marrow disease
Increased in allergy, parasitic disease, collagen
disease, subacute infections
Eosinophils 0 – 4% Number fraction: 0.00 – 0.004
Decreased with stress, use of some medications
(ACTH, epinephrine, thyroxine)
Increased with acute leukemia and following
surgery or trauma
Basophils 0 – 1% Number fraction: 0.00 – 0.01
Decreased with allergic reactions, stress, allergy,
parasitic disease, use of corticosteroids
Increased with infectious mononucleosis, viral and
some bacterial infections, hepatitis
Lymphocytes 20 – 40% Number fraction: 0.2 – 0.4
Decreased with aplastic anemia, SLE,
immunodeficiency including AIDS
Increased with viral infections, parasitic disease,
collagen and hemolytic disorders
Monocytes 2 – 8% Number fraction: 0.02 – 0.08
Decreased with use of corticosteroids, RA, HIV infx
Increased in malignancy, myeloproliferative
disease, RA and post-operatively; about 50% of
patient with unexpected increase of platelet count
will be found to have a malignancy
Platelet count 150,000 – 450,000/ mm3 0.15 – 0.45 x 1012/L
Decreased in thrombocytopenic purpura, acute
leukemia, aplastic anemia and during cancer
chemotherapy
NORMAL VALUES – Serum, Plasma, and Whole Blood Chemistries
Normal Adult Reference Range Clinical Significance
Determination
Conventional Units SI Units Increased Decreased
DKA
Toxemia of pregnancy
Acetone 0.3 – 2.0 mg/dL 51.6 – 344.0/ µmol/L
Carbohydrate-free diet
High-fat diet
Pituitary-dependent
Adenocorticotropic Adenocortical tunor
Cushing’s syndrome
Hormone (ACTH) (Plasma) < 50 pg/mL <50 ng/L Adrenal insufficiency secondary
Ectopic ACTH syndrome
- RIA to hypopituitarism
Primary adrenal atropy
Supine: 3 – 10 ng/dL 0.08 – 0.30 nmol/L
Primary aldosteronism
Aldosterone (Plasma) - RIA Upright: 5 – 30 ng/dL 0.14 – 0.90 nmol/L Addison’s disease
Secondary aldosteronism
Adrenal vein: 200 – 800 ng/dL 5.54 – 22.16 nmol/L
Hepatocarcinoma
Metastatic Carcinoma of liver
Germinal cell carcinoma of the
Alpha-1-fetoprotein < 15 ng/mL < 15 µg/L
testicle or ovary
Fetal neural tube defects –
elevation in maternal serum
15 – 45 µg/dL Severe liver disease
Ammonia (Plasma) 11 – 32/ µmol/L
(varies with method) Hepatic decompensation
Large doses of ascorbic acid as a
Ascorbic Acid
0.4 – 1.5 mg/dL 23 – 85 µmol/L prophylactic against common
(Vitamin C)
cold
ALT (Alanine Same conditions as AST (AGOT),
Males: 10 – 40 U/mL 0.17 – 0.68 µkat/L
aminotransferase) but increase is more marked in
Females: 8 – 35 U/mL 0.14 – 0.60 µkat/L
Formerly SGPT liver disease than AST (SGOT)
AST (Aspartate Myocardial infarction
Males: 10 – 40 U/L 0.34 – 0.68 µkat/L
aminotransferase) Skeletal muscle disease
Females: 15 – 30 U/L 0.25 – 0.51 µkat/L
Formerly SGOT Liver disease
Hemolytic anemia (indirect)
Biliary obstruction and disease
Total: 0.3 – 1.0 mg/dL 5 – 17 µmol/L
Hepatocellular damage
Bilirubin Direct: 0.1 – 0.4 mg/dL 1.7 – 3.7 µmol/L
(Hepatitis)
Indirect: 0.1 – 0.4 mg/dL 3.4 – 11.2 µmol/L
Pernicious anemia
Hemolytic disease of newborn
BLOOD GASES
Oxygen
Anemia
Partial pressure (PaO2) 85 – 95 mm Hg 10.64 – 12.64 kPa Polycythemia
Cardiac or pulmonary disease
Cardiac Decompensation
Saturation (SaO2) 95% - 99% 0.95-0.99
Chronic obstructive lung disease
Carbon Dioxide
Respiratory Acidosis Respiratory Alkalosis
Partial Pressure (PaCO2) 35 – 45 mm Hg 4.66 – 5.99 kPa
Metabolic Alkalosis Metabolic Acidosis
Vomiting Uremia
Hyperventilation Diabetic ketoacidosis
pH (whole blood, arterial) 7.35 – 7.45 7.35 – 7.45
Fever Hemorrhage
Intestinal Obstruction Nephritis
Tumor or hyperplasia of
parathyroid
Hypervitaminosis D Hyperthyroidism
Multiple myeloma Diarrhea
Nephritis with uremia Celiac disease
Calcium 8.6 – 10.2 mg/dL 2.15 – 2.55 mmol/L Malignant tumours Vitamin D deficiency
Sarcoidosis Acute pancreatitis
Hypoparathyroidism Nephrosis
Skeletal immobilization After paathyroidectomy
Excess calcium intake: Milk alkali
syndrome
Diabetes mellitus
Diarrhea
Nephrosis
Vomiting
Nephritis
Pneumoia
Chloride 97 – 107 mEq/L 97 – 107 mmol/L Urinary obstruction
Heavy metal poisoning
Cardiac decompensaton
Cushing’s syndrome
Anemia
Intestinal obstruction
Febrile Condition
Pernicious aemia
Lipemia Hemolytic anemia
Obstructive jaundice Hypothyroidism
Cholesterol 150 – 200 mg/dL 3.9 – 5.2 mmol/L
Diabetes Severe infection
Hyperthyroidism Terminal stages of debilitating
disease
Nephritis
Creatinine 0.7 – 1.4 mg/dL 62 – 124 µmol/L
Chronic renal disease
Diabetes mellitus
Nephritis Hyperinsulinism
Fasting:
Hypothyroidism Hyperthyroidism
60 – 110 mg/dL 3.3 – 6.05 mmol/L
Early hyperpituitarism Late hyperpituitarism
Glucose
Cerebral lesions Pernicious vomiting
Postprandial (2h):
Infections Addison’s disease
65 – 140 mg/dL 3.58 – 7.7 mmol/L
Pregnancy Extensive hepatic damage
Uremia
Normal Response:
1. Normal fasting 2-hour value >200 mg/dL (11.1 Decreased 2- and 3-hour values
Glucose Tolerance (oral) between 60-110 mg/dL mmol/L) is diagnostic for Diabetes may occur with hypoglycemia in
2. No sugar in urine 3.3 – 6.05 mmol/L mellitus diabetes mellitus
3. Upper limits of normal:
Fasting = 125 6.88 mmol/L
1 hour = 190 10.45 mmol/L
2 hours = 140 7.70 mmol/L
3 hours = 125 6.88 mmol/L
Transfusion reactions
Anemia
Paroxysmal nocturnal
Hemoglobin (plasma) 0.5 – 5 mg/dL 5 – 50 mg/L Pregnancy
hemoglobinuria
Chronic renal failure
Intravascular hemolysis
High-density lipoprotein HDL cholesterol is lower in
Males: 35 – 70 mg/dL 0.91 – 1.81 mmol/L
cholesterol (HDL patients with risk for coronary
Females: 35 – 85 mg/dL 0.91 – 2.20 mmol/L
Cholesterol) heart disease
mg/dL
desirable levels:
Low-density lipoprotein <160 if no CAD and <2 risk LDL cholesterol is higher in patients
cholesterol (LDL factors with increased risk for coronary
Cholesterol) <130 if no CAD and 2 or more heart disease
risk factors
<100 if CAD is present
Chronic alcoholism
Excess ingestion of magnesium- Severe renal disease
Magnesium 1.3 – 2.3 mg/dL 0.62 – 0.95 mmol/L
containing antacids Diarrhea
Defective growth
Diabetes mellitus
Phospholipids 125-300 mg/dL 1.25 – 3 g/L
Nephritis
Chronic nephritis
Phosphorous, inorganic 2.5 – 4.5 mg/dL 0.8 – 1.45 mmol/L
Hypoparathroidism
Renal Failure Hyperparathyroidism
Acidosis Vitamin D deficiency
Potassium 3.5 – 5 mEq/L 3.5 – 5 mmol/L
Cell lysis GI losses
Tissue breakdown or hemolysis Diuretic administration
PROTEIN
TROPONIN
Obstructive uropathy
Urea Nitrogen (BUN) 10 – 20 mg/dL 3.6 – 7.2 mmol/L Mercury poisoning Pregnancy
Neprotic syndrome
Gouty arthritis
Acute leukemia
Uric Acid 2.5 – 8 mg/dL 0.15 – 0.5 mmol/L Lymphomas treated by Defective tubular reabsorption
chemotherapy
Toxemia of pregnancy
Coronary artery disease Metastatic liver disease
Zinc 55 – 150 µg/dL 7.65 – 22.95 µmol/L Arteriosclerosis Tuberculosis
Industrial exposure Sprue
Uric Acid 250 – 750 mg/ 24 h 1.48 – 4.43 mmol/24 h Gout Nephritis
Complete or nearly
Random urine: <0.25 mg/dL <0.42 mol/ 24 h Liver and biliary tract disease complete biliary
Urobilinogen
24-hr urine: up to 4 mg/ 24 h Up to 6.67 µmol/ 24 h Hemolytic anemia obstruction
Diarrhea
Diazepam Zero Therapeutic level = 0.2 – 1.0 µg/mL 0.2 – 1.0 mg/L
Lidocaine Zero Toxic (48 h after high dose) 454 mg/mL 1000 mmol/L
Additional Values:
HCO3 22 – 26 mEq/L
Cardiac Enzymes
Creatinine Kinase Males: 55 – 160 µ/L
Females: 30 – 135 µ/L
Myoglobin < 90 mcg/L