Erythrocytes: ♂ = 4.5 - 6.

0 million/µl (x1012/l)
♀ = 4.0 - 5.2 million/µl (x1012/l)

Haematocrit: ♂ = 42% - 52%

♀ = 37% - 47%

Haemoglobin (Hb): ♂ = 140 - 170g/l

♀ = 130 - 160g/l

MCV: Mean corpuscular volume (HCT/ RBC), Volume of

one RBC, 85-100fl/ery (Femto = 10-15)
MCH: Mean corpuscular hemoglobin (Hb / RBC),
Haemoglobin content in one RBC, 30-32pg/ery (Pico = 10-12)

MCHC: Mean corpuscular hemoglobin concentration (Hb /

HCT), Haemoglobin concentration in RBCs 32-36%/320-
360g/L
Erythrocyte Sedimentation Rate (ESR): Measurement of
rate of settling of erythrocytes in anticoagulated blood
♂ = 3-6mm/h Factors that affect sedimentation rate:
Fibrinogen  Elevated fibrinogen: helps formation of stacked erythrocytes
♀ = 8-10mm/h 1.called rolleaux that are relatively heavier and settle fastest.
2. Number of erythrocytes (anemia/polycytemia)
3. Size of erythrocytes (macrocytosis/microcytosis, spherocytosis)
4. Albumin concentration

↑ ESR = Decreased Htc, decreased blood viscosity; Increased

[fibrinogen] (i.e. pregnancy, vascular diseases, heart diseases),
haptoglobulin, lipoproteins, immunoglobulins; Macrocytic
RBC; Extreme elevation of WBC count (leukemia)

↓ ESR = Increased Htc; Change in the RBC shape (i.e. sickle

cell anemia, poikilocytosis – non-uniformatiy of shape);
Increased albumin concentration
Reticulocytes: Adults = 0.5% - 2.5%
 Children = 2% - 6%

Thrombocytes: 150,000 – 400,000/µl

Leukocytes: 4,000-10,000/µl (4-10x109/L)

Leukogram (%): Counted from blood smear

ADULT CHILDREN
GRANULOCYTES Neutrophils Up to 5 Up to 6
(Band form)
Neutrophils 40 - 70 25 - 60
(Lobar form)
Eosinophils 2 - 10 1-5
Basophils 0-1 0-1
AGRANULOCYTES Lymphocytes 20 - 40 25 - 50
Monocytes 2 - 10 1-6

Heynek’s Number: Average number of segments in

neutrophilic granulocytes = 2.7 - 3.1

Arneth’s Count: The ratio of neutrophilic granulocytes based

on the number of nuclear lobes
Normal = predominance of 2-3 lobed nuclei
Shift to left = predominance of young forms (banded, 2 lobed nuclei)
Shift to right = predominance of old forms (4 - 5 lobed nuclei)

Ferritin: 12-200µg/l
B12 (Cobalamin): 197-866pg/ml
B9 (Folate): 2-20µg/l
Total Cholesterol: < 5.2mmol/l
LDL: < 3.4mmol/l
TAG: < 1.7mmol/l
HDL: ♂ = >1mmol/l, ♀ = >1.2mmol/l
CRP: <5mg/l
Evaluation of glycaemia measured in venous blood:
Fasting Glycaemia in HbA1C evaluation of long-
 glucose 120min of term compensation
concentratio OGTT
n (mmol/l) (mmol/l)
Normal < 5.6 < 7.8 DCCT (%) IFCC
(mmol/mol)
< 5.7 < 39
Impaired glucose ≥ 5.6 and < 7.0 ≥ 7.8 and < 11.1 ≥ 5.7 and < 6.5 ≥ 39 and < 48
tolerance (Pre-diabetes)
Diabetes Mellitus ≥ 7.0 ≥ 11.1 ≥ 6.5 ≥ 48

Clotting:
PT and INR = Extrinsic = Normal value (12-13s) to get the INR for ease of
comparison (normal 0.8-1.2). (WEPT = Warfarin Extrinsic Prothrombin Time)
APTT = Intrinsic = 40-50s
Bleeding time = Platelet Function (conditions involving platelet
quantity/function), 1-4 minutes (< 4 minutes)
Thrombin time = Fibrinogen Test (tests the level and function of fibrinogen)
Warfarin Therapy INR aim = 2-3
D-dimer = < 0.3mg/ml (< 300ng/ml)

Cardiac Markers:
Troponin = ↑MI (raised after 6-12hr), small rise may be seen with CRF, PE,
septicaemia, blunt chest trauma
CK = (25-195units/l) ↑MI, rhabdomyolysis (muscle breakdown – check renal
function), exercise, recent surgery, hypothyroidism, blunt chest trauma

Surface markers of lymphocytes:

T
B NK
TH TC
CD2 - + + +
CD3 - + + -
CD4 - + - -
CD5 (+) + + +
CD8 - - + (+)
CD16 (FcγRIII) - - - +
CD19 + - - -
CD20 + - - -
CD21 (CR2) + - - -
CD28 - + + -
CD32 (FcγRII) + - - -
CD35 (CR1) + - - -
CD40 + - - -
CD45 + + + +
CD56 - - - +
BCR (Ig) + - - -
TCR - + + -
ALanine aminoTransferase (ALT): Mostly in liver
hepatocytes (∴ specific), some in muscle cells (7 – 56 units/l)

ASpartate aminoTransferase (AST): Liver, heart, muscle

kidney, brain cells (5 – 40 units/l)

ALkaline Phosphatase (ALP): Enzyme found in bile ducts

of the liver, kidney, bone, intestinal mucosa, placenta (30 -
130 units/l)

Gamma-glutamyltransferase (γGT): Mirrors ALP so can be

used to confirm if a rise in ALP is of hepatic origin. Raised
with alcohol abuse of enzyme-inducing drugs (10-55 units/l)

Bilirubin: Normal: 2-17 µmol/l; Subicterus: 17-30 µmol/l;

Icterus: >30 µmol/l

Albumin: (35-50g/l)
↑ Albumin = Dehydration
↓ Albumin = Inflammation, Cirrhosis, Pregnancy, Chronic
Disease

Total Protein: 60-80g/l

Amylase: (0-120units/l), ↑ Amylase = Acute or chronic

pancreatitis, Abdominal disease (e.g. perforation), burns, anorexia,
salivary adenitis, renal disease

Lipase: (5.0-65units/l), ↑↑↑ Lipase = Acute Pancreatitis (e.g. 3x

upper limit of normal)
Creatinine: (70-150µmol/L) Creatine is produced in liver, as an energy store for fast
twitch muscle fibres. Phosphorylated to make creatine phosphate, which can then be
phosphorylated to produce ATP (for energy) and creatinine (waste product). Creatinine is
transported to the kidney for excretion, therefore, creatinine blood concentration is specific
for determining kidney injury (but baseline depends on muscle mass)

Urea: (2.5-7.8mmol/L) The urea cycle converts ammonia (toxic product of deamination
reactions of amino acids) to urea in the liver. Urea is then transported to the kidneys where it
is excreted. Urea blood concentration is not specific for determining kidney injury; other
causes:
↑ Urea = dehydration, GI bleed, increased protein breakdown
(surgery, trauma, infection, malignancy), high protein intake,
drugs
↓ Urea = malnutrition, liver disease, pregnancy

Osmolarity: 275-295mOsmol/kg

Na+: 133-146mmol/l
K+: 3.5-5.3mmol/l
Ca2+: 2.2-2.6mmol/l
PO43-: 0.8-1.5mmol/l
Mg2+: 0.7-1.0mmol/l

ABG:
pH: 7.35-7.45 SaO2 >95%
pCO2: 4.5-6.0 kPa PaO2 should ̴ FiO2 % - 10
pO2: 11-13 kPa Alveolar arterial gradient: <10
HCO3-: 22-26 mmol/l (increased in emphysema,
BE (Surrogate marker of metabolic fibrosing alveolitis, age)
component): -2 to +2 Lactate: < 2

Respiratory component Metabolic component (HCO3- or BE):

(PaCO2):Respiratory acidosis (pH↓, Metabolic acidosis (pH↓, HCO3-
PaCO2↑) ↓)Metabolic alkalosis (pH↑, HCO3-↑)
Respiratory alkalosis (pH↑, PaCO2↓)
CSF:
Normal Normal Viral Bacterial Fungal TB
Neonate Meningitis Meningitis Meningitis Meningitis
Appearance Clear Clear Clear Cloudy and Fibrin Web Cloudy and
Turbid Viscous
White Cells Normal Normal ↑ ↑↑↑ N/↑ ↑
(x106L or (< 5) (< 20) (5-1000) (100- (0-1000) (< 500)
/cumm or /µL) 50,000)

Predominant All Mainly Lymphocytes Neutrophils Lymphocytes Lymphocytes

(NB: Some bacteria
White Cell Lymphocytes Lymphocytes, can cause a
Type 5% Neutrophils lymphocytic CSF e.g.
Listeria, Mycoplasma,
Lyme, Syphilis)

Red Cells Normal

(x106L or (< 10)
/cumm or /µL)
Protein Normal Normal N/↑ ↑↑ N/↑ ↑↑
(g/L) (0.2-0.4) (< 1) (0.4-1) (> 1) (0.2-5) (1-5)
Glucose Normal ↓ N/↓ ↓↓
(CSF:Blood (> 60% Plasma) (< 40% (< 40% (< 30%
Ratio) Plasma) Plasma) Plasma)
(NB: Patients who
have had antibiotics
prior to LP, CSF may
be more lymphocytic
and have a normal
glucose)

Opening CSF Normal Normal/Slightly High High/Very High

Pressure (10-20) High High
(cmH2O)
CSF Pressure ≥ 25cmH2O =
Intracranial Hypertension
(Idiopathic, Meningitis,
Intracranial haemorrhage,
tumours etc)