Abnormal Function/Role Why is it Abnormal?

Implication
Labs
BUN (mg/dL) A blood urea nitrogen (BUN) test is used to determine how well your kidneys are working. It does this by
measuring the amount of urea nitrogen in the blood. Urea nitrogen is a waste product that's created in the
liver when the body breaks down proteins.
Creatinine Creatinine is a waste product that comes from the normal wear and tear on muscles of the body. 
Serum (mg/dL) The patient is dehydrated.
Creatinine is a waste product that forms when creatine, which is found in your muscle, breaks down.
Creatinine levels in the blood can provide your doctor with information about how well your kidneys are It is also possible that there is
working. Each kidney has millions of small blood-filtering units called nephrons. acute kidney injury (AKI)
https://www.healthline.com/health/creatinine-blood
Dehydration caused by
A creatinine test is a measure of how well your kidneys are performing their job of filtering waste from your excessive alcohol intake Acute kidney injury is a rapid
blood. and vomiting as evidenced decrease in renal function
by amber color of urine, over days to weeks, causing
Creatinine is a chemical compound left over from energy-producing processes in your muscles. Healthy skin turgor tenting, and dry an accumulation of
kidneys filter creatinine out of the blood. Creatinine exits your body as a waste product in urine. skin. nitrogenous products in the
A patient who is severely blood (azotemia) with or
dehydrated may also have without reduction in amount
A measurement of creatinine in your blood or urine provides clues to help your doctor determine how well the a high BUN due to the of urine output.
kidneys are working. An increased level of creatinine may be a sign of poor kidney function. lack of fluid volume to creatinine and urea build up in
excrete waste products the blood over several days,
https://www.mayoclinic.org/tests-procedures/creatinine-test/about/pac-20384646 and fluid and electrolyte
disorders develop
Creatine is a chemical that your body uses to supply your muscles with energy. As you muscles use energy
the tissue that makes up your muscles breaks down. This natural breakdown of muscle tissue
causes creatinine to be released into your bloodstream ‘
https://my.clevelandclinic.org/health/diagnostics/16380-creatinine-clearance-test#:~:text=Creatinine%20is
%20actually%20a%20waste,be%20released%20into%20your%20bloodstream.

Glucose your body uses it for energy. As it travels through your bloodstream to your cells, it's called  blood glucose or The patient is in flow Since the patient has acute
(mg/dL) blood sugar. Insulin is a hormone that moves glucose from your blood. into the cells for energy and storage. phase of metabolic pancreatitis, the beta cells that
Your body is designed to keep the level of glucose in your blood constant. Beta cells in your pancreas monitor response to stress wherein produce insulin to regulate the
your blood sugar level every few seconds. When your blood glucose rises after you eat, the beta cells release the glucose production is blood sugar levels are
insulin into your bloodstream. Insulin acts like a key, unlocking muscle, fat, and liver cells so glucose can get upregulated via damaged that is why there is
inside them. Gluconeogenesis, still hyperglycemia. It also
 Alpha cells in the pancreas begin to produce a different hormone called glucagon. It signals the liver to break Glycogenolysis, & indicates that the patient will
down stored glycogen and turn it back into glucose. Proteolysis. have an increase energy
https://www.webmd.com/diabetes/glucose-diabetes#:~:text=Glucose%20comes%20from%20the expenditure to repair any
%20Greek,cells%20for%20energy%20and%20storage. damaged cells, tissues, or
organs because the patient is
 in Flow phase of metabolic
response to stress.
Bilirubin total Bilirubin is made during the normal process of breaking down red blood cells. It is a yellowish substance Excessive alcohol intake Elevated levels of Bilirubin
(mg/dL) found in bile, a fluid in your liver. This fluid helps digest food. A healthy liver moves most of the bilirubin from by the patient lead to liver indicate liver damage.
Bilirubin, direct your body. If the liver is damaged, bilirubin can leak out into your blood. dysfunction that lead
(mg/dL) bilirubin build-up.
Bilirubin is a brownish yellow substance found in bile. It is produced when the liver breaks down old red
blood cells. Bilirubin is then removed from the body through the stool (feces) and gives stool its normal
color.

Bilirubin circulates in the bloodstream in two forms:

Indirect (or unconjugated/Total) bilirubin.
This form doesn't dissolve in water. (It is insoluble.) Indirect bilirubin travels through the bloodstream
to the liver, where it is changed into a soluble form (direct or conjugated).
Direct (or conjugated) bilirubin.
Direct bilirubin dissolves in water. (It is soluble.) It's made by the liver from indirect bilirubin

As red blood cells age, they are broken down naturally in the body. Bilirubin is released from the destroyed
red blood cells and passed on to the liver. The liver releases the bilirubin in fluid called bile. If the liver is not
functioning correctly, the bilirubin will not be properly released. Therefore, if the bilirubin level is higher than
expected, it may mean that the liver is not functioning correctly.
https://www.hepatitis.va.gov/hcv/patient/diagnosis/labtests-bilirubin.asp

Albumin (g/dL) Albumin carries substances such as hormones, medicines, and enzymes throughout your body. -May be caused by low Hypoalbuminemia may signal
Albumin is a protein made by your liver. Albumin helps keep fluid in your bloodstream so it doesn't leak protein intake as that there is a liver and kidney
into other tissues. evidenced by the patient’s problem.
eating very little for 3 days
because of the pain,
It is also a marker of inflammation. nausea, and vomiting May also implicate that there is
an ongoing inflammation in the
Acute phase reactants (APR) are inflammation markers that exhibit significant changes in serum The decrease of such body.
concentration during inflammation. These are also important mediators produced in the liver during acute proteins may be used as
and chronic inflammatory states. markers of inflammation.

Negative acute phase reactants are downregulated, and their concentrations decrease during inflammation.

There patient is in Flow Phase of metabolic response to Stress wherein proteolysis is upregulated. ALT and
AST is high due to the breakdown of albumin. Hyperglycemia is also evident because the body is breaking
down stored glycogen to turn into glucose (Gluconeogenesis, Glycogenolysis, & Proteolysis are upregulated)
Alkaline ALP is an enzyme found in your bloodstream. It helps break down proteins in the body and exists in Excessive alcohol intake High levels of ALT, AST, &
Phosphatase different forms, depending on where it originates. Your liver is one of the main sources of ALP, but some is by the patient as Alkaline Phosphatase indicate
(U/L) also made in your bones, intestines, pancreas, and kidneys. evidenced by his alcohol a liver disease.
 ALP is often considered a liver enzyme because it’s primarily found in your liver. However, it also exists in
the following places:

 Your bile duct.

 Your bones.
 Your kidneys.
 Your intestines.
 The placenta in pregnant people.
use of 6 pack beer, 4-5
Abnormal levels of ALP in your blood can reflect damage to tissue or disruption of normal bodily processes. “shots” of bourbon daily,
and drinking beer,
ALT (U/L) Alanine transaminase bourbon, wine, & other
mixed drinks.
-Old Name: SGPT = Serum Glutamic-Pyruvic Transaminase

an enzyme found mostly in the liver. When liver cells are damaged, they release ALT into the bloodstream
Your body uses ALT to break down food into energy. The function of ALT is to convert alanine into pyruvate,
for cellular energy production
AST (U/L) Aspartate aminotransferase
When your liver is damaged, it releases AST into your bloodstream
enzyme that helps metabolize amino acids
AST catalyzes a reaction between the amino acids aspartate and glutamate and is an important enzyme in
amino acid metabolism.
CPK (U/L) Creatine phosphokinase (CPK) is an enzyme in the body. It is found mainly in the heart, brain, and skeletal
Creatinine muscle
Phosphokinase When muscle tissue is damaged, CPK leaks into your blood.
Lactate Lactate dehydrogenase (also called lactic acid dehydrogenase, or LDH) is an enzyme found in almost all High LDH indicates multiple
dehydrogenase body tissues. It plays an important role in cellular respiration, the process by which glucose (sugar) from food organ failure.
(U/L) is converted into usable energy for our cells.
Lactate dehydrogenase (LDH) is an enzyme required during the process of turning sugar
into energy for your cells. LDH is present in many kinds of organs and tissues
throughout the body, including the liver, heart, pancreas, kidneys, skeletal muscles,
lymph tissue, and blood cells.

Different LDH isoenzymes are found in different body tissues. The areas of highest
concentration for each type of isoenzyme are:
  LDH-1: heart and red blood cells
 LDH-2: heart and red blood cells
 LDH-3: lymph tissue, lungs, platelets, pancreas
 LDH-4: liver and skeletal muscle
 LDH-5: liver and skeletal muscle

Lipase (U/L) Lipase helps your body absorb fats. It’s released by the pancreas, a long, flat gland between Can be caused by
--pancreatic your stomach and spine. excessive alcohol intake,
enzyme Elevated cholesterol,
When your pancreas is inflamed or injured, it releases more lipase than usual. hypertriglyceridemia, and
Lipase is an enzyme the body uses to break down fats in food so they can be absorbed in the intestines. Gluconeogenesis as the
Lipase is produced in the pancreas, mouth, and stomach. function of lipase is to help
break down fats.
Hyperlipasemia may be described as an excess of the pancreatic enzyme, lipase, in the blood. High levels
may indicate a problem related to your pancreas.
lipase from your gastric secretions breaks down the fats. The salivary and gastric lipases work to stabilize
fats from food while the food is being digested in the stomach. Hyperlipasemia and
Hyperamylasemia level may
indicate acute pancreatitis.

Amylase (U/L) Digestion of your dietary intake of carbohydrates and fat, rely on the action of the pancreatic Caused by excessive
-pancreatic enzyme amylase, found in the saliva, to begin the digestion of starches alcohol intake and swelling
enzyme of the pancreas.
Amylase and lipase are digestive enzymes normally released from the acinar cells of the exocrine pancreas
into the duodenum. Following injury to the pancreas, these enzymes are released into the circulation. While
amylase is cleared in the urine, lipase is reabsorbed back into the circulation. 

Amylase is a digestive enzyme that helps the body break down carbohydrates/starches. Both the salivary
glands and the pancreas produce amylase
CRP (mg/dL) -example of positive acute-phase proteins There is an Abdominal High C-reactive protein
C-Reactive distention and it is highly indicates an inflammation
Protein Positive acute phase reactants are upregulated, and their concentrations increase during inflammation.  possible that the
inflammation is brought
C-reactive protein (CRP) is a substance the liver produces in response to inflammation. about by the acute
 pancreatitis.
While a CRP blood test can’t say what exactly is causing your inflammation, your doctor may be able to use
it to help them diagnose your issue.
Cholesterol Cholesterol is a fat-like, waxy substance that helps your body make cell membranes, many hormones, and
(mg/dL) vitamin D. The cholesterol in your blood comes from two sources: the foods you eat and your liver. Your liver
makes all the cholesterol your body needs.
The two most commonly known lipoproteins are low-density lipoproteins (LDL) and high-density lipoproteins
(HDL).
Elevated Cholesterol, High LDL,
Excessive intake of
and Hypertriglyceridemia
LDL (mg/dL) LDL (“bad") cholesterol can contribute to the formation of plaque buildup in the arteries (atherosclerosis). alcoholic beverages that
increase the risk of acquiring
Low density This is linked to higher risk for heart attack and stroke. are very high in fat and
Coronary Artery Disease or
lipoproteins lack of physical activity as
Atherosclerosis which can lead
Triglycerides Triglycerides are a type of fat (lipid) found in your blood. evidenced by patient’s
to myocardial infarction and
(mg/dL) history.
When you eat, your body converts any calories it doesn't need to use right away into triglycerides. The stroke.
triglycerides are stored in your fat cells. Later, hormones release triglycerides for energy between meals.
If you regularly eat more calories than you burn, particularly from high-carbohydrate foods, you may have
high triglycerides (hypertriglyceridemia).

WBC Can be caused by the Leukocytosis, Neutrophilia,

(x103/mm3) ongoing inflammation in Bandemia, & High Segmented
Neutrophil (%) Neutrophils are a type of white blood cell that help heals damaged tissues and resolves infections. the body like abdominal Neutrophils indicate the
distention or acute presence of inflammation and
 Neutrophils are the most common type of white blood cell in the body, which makes them a first line pancreatitis and a possible infection in the body.
of defense to heal injuries and fight infections. possible infection in the
body.
 The amount of neutrophils in the blood typically increases if a person is sick or injured to help their
body heal.

They can move freely through the walls of veins and into the tissues of your body to immediately attack all
antigens. Examples of antigens include:

 bacteria
 viruses
 fungi
 poisons
 cancer cells

They capture and destroy invading microorganisms, through phagocytosis and intracellular degradation,
 release of granules, and formation of neutrophil extracellular traps after detecting pathogens. Neutrophils
also participate as mediators of inflammation. 

Segs(%) Segmented Neutrophils are mature neutrophils that responds to inflammation and infection.
Bands (%) immature form of neutrophil produced when your body is fighting an infection or inflammation. 
Protein (mg/dL) Proteins – which help build muscle and bone, regulate the amount of fluid in blood, combat infection and Protein gets into the urine Protenuria indicates kidney
repair tissue – should remain in the blood. If proteins enter the urine they ultimately leave the body, which because kidneys are not damage.
isn’t healthy. working properly due to
damage.
Protein gets into the urine if the kidneys aren’t working properly. Normally, glomeruli, which are tiny loops of
capillaries (blood vessels) in the kidneys, filter waste products and excess water from the blood.

Glomeruli pass these substances, but not larger proteins and blood cells, into the urine. If smaller proteins
sneak through the glomeruli, tubules (long, thin, hollow tubes in the kidneys) recapture those proteins and
keep them in the body.

However, if the glomeruli or tubules are damaged, if there is a problem with the reabsorption process of the
proteins, or if there is an excessive protein load, the proteins will flow into the urine.

Ketones Ketones are chemicals made in your liver. You produce them when you don't have enough of the Ketonuria is caused by Fat is being used as the primary
hormone insulin in your body to turn sugar (or “glucose”) into energy. You need another source, so your body inadequate carbohydrate source of energy of the body.
uses fat instead. (gluconeogenesis - process that transforms non-carbohydrate substrates (such as intake as evidenced by the
lactate, amino acids, and glycerol) into glucose) patient’s food history of
Your liver turns this fat into ketones, a type of acid, and sends them into your bloodstream. Your muscles and eating very little for the
other tissues can then use them for fuel. past 3 days.
It is also caused by
When the body does not have enough glucose, or when it does not have sufficient insulin to use the glucose, Gluconeogenesis.
it begins to use fat for energy instead. This results in the production of ketones.
Bilirubin Excessive alcohol intake Elevated levels of Bilirubin and
Urobilinogen Urobilinogen is a byproduct of bilirubin that is eventually eliminated through the stool and urine. by the patient lead to liver Urobilinogen indicate liver
(EU/dL) Although urobilinogen is normally found in the urine, higher or lower levels may be a sign of a liver problem dysfunction that lead damage.
Urobilinogen is a colorless pigment produced from the breakdown of bilirubin by gut bacteria. The majority of bilirubin build-up.
this compound is excreted in feces, and a small amount is reabsorbed and excreted in the urine 
When bilirubin production increases because of red blood cell destruction (hemolysis) or liver disease,
urobilinogen levels rise in the urine. 

Prot chk