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Prefixes used with SI Units Body Mass Index (BMI)

10-18 atto - White European Asian Interpretation

10 -15 femto - <18.5 Underweight
pico - 18.5–24.9 18.5-23 Normal
10-12
25–29.9 23-27.5 Overweight
10-9 nano -
30 or higher 27.5 or higher Obese
10 -6 micro 0.000001
10-3 milli 0.001
10 -2 centi 0.01 NFPA (National Fire Protection Association) Hazards
Identification System
10 -1 deci 0.1
10 Liter, meter, gram 1.0 Position Color Indication
101 deka 10 Right Yellow Reactivity-Stability*
102 hecto 100
3 kilo 1000 Bottom White Special/Specific
10 (Such as water reactivity, strong
106 mega - oxidizer, corrosivity, radioactivity)
109 giga - Left Blue Health Hazard
10 12 tera -
Top Red Flammability
1015 peta -
1018 exa -
4 Extreme hazard
3 Serious hazard
Conversion Factors and Units of Reporting 2 Moderate hazard
1 Slight hazard
Analyte Factor Conv. SI 0 No or minimal hazard
Albumin 10 g/dL g/L
Hemoglobin 10 g/dL g/L
Immunoglobulins 10 mg/dL mg/L WESTGARD MULTIRULE PROCEDURES
(Ig) 0.01 mg/dL g/L WARNING RULE
Total protein 10 g/dL g/L
Protein N to protein content = 6.54 (preferred) or 6.25
12S – One control observation exceeding the mean ±2s; only
rule that is not used to reject a run; results are reportable
RANDOM ERROR or IMPRECISION
Analyte Factor Conv. SI
Glucose 0.0555 mg/dL mmol/L 13S – One control observation exceeding the mean ±3s
R4S – One control exceeding the +2s & –2s
Analyte Factor Conv. SI SYSTEMATIC ERROR or BIAS
Cholesterol 0.026 mg/dL mmol/L
0.0259 22S – Two control observations consecutively exceeding the
Triglycerides 0.0113 mg/dL mmol/L same ±2s
41S – Four consecutive control observations exceeding the
Analyte Factor Conv. SI mean ±1s
Ammonia 0.587
BUN 0.357
μg/dL
mg/dL
μmol/L
mmol/L
10X – Ten consecutive control observations falling on one
side or the other of the mean
Creatinine 88.4 mg/dL μmol/L
Uric acid 0.0595 mg/dL mmol/L
BUN to UREA = 2.14 Urea to BUN = 0.467
“68–95–99 Rule”
Analyte Factor Conv. SI ≈68% (68.3%) = ±1 SD from the mean
Chloride 1.0 mEq/L mmol/L ≈95% (95.4%) = ±2 SDs from the mean
Potassium 1.0 mEq/L mmol/L ≈99% (99.7%) = ±3 SDs from the mean
Sodium 1.0 mEq/L mmol/L
Bicarbonate 1.0 mEq/L mmol/L
Lithium 1.0 mEq/L μmol/L Spectra of light
Calcium 0.25 mg/dL mmol/L Ultraviolet (UV)
0.2495 4 nm to 400 nm
Magnesium 0.5 mEq/L mmol/L Visible light (VIS)
Phosphorous 0.323 mg/dL mmol/L 400 nm to 700 nm
pCO2 0.133 mmHg kPa Infrared (IR)
pO2 0.133 mmHg kPa 750 nm to 0.3 cm

Analyte Factor Conv. SI

Bilirubin 17.1 mg/dL μmol/L Protein MW
Iron 0.179 μg/dL μmol/L a2-macroglobulin 725,000
Thyroxine (T4) 12.9 μg/dL nmol/L Fibrinogen 341,000
Transferrin 76,000
a1-antitrypsin 53,000

By Dr. Krizza-Almond Sarmiento Aguilar-Salido, RMT, MT (ASCPi)

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ENZYMES ELEVATED IN MYOCARDIAL INFARCTION Density (g/mL)
CM VLDL LDL HDL
Enzymes Onset (h) Peak (h) Duration (d) <0.93 0.93– 1.006 1.019–1.063 1.063–1.21
CK 6 to 8 24 3 to 4
CK-MB 4 to 8 12 to 24 2 to 3
AST 6 to 8 24 5 ATP III Classification
LD 12 to 24 48 to 72 10
HDL Cholesterol
Other Myocardial Infarction Markers Low <40 mg/dL
Proteins Onset (h) Peak (h) Duration (d) High ≥60 mg/dL
Myoglobin 1 to 3 5 to 12 18 to 30 h Protective against heart disease
Troponin T 3 to 4 10 to 24 7
Troponin I 3 to 6 12 to 18 5 to 10 Total Cholesterol
Desirable <200 mg/dL
Borderline high 200 to 239 mg/dL
DIAGNOSTIC CRITERIA FOR DIABETES MELLITUS High ≥240 mg/dL

Fasting PG ≥126 mg/dL Triglycerides

Normal <150 mg/dL
2-h PG ≥200 mg/dL during OGTT
Borderline high 150 to 199 mg/dL
Random PG ≥200 mg/dL + symptoms High 200 to 499 mg/dL
HbA1C ≥6.5% Very high ≥500 mg/dL

Interpretation Fasting Glucose Glucose Tolerance LDL Cholesterol

Normal ≥70 to 99 mg/dL ≤140 mg/dL Optimal <100 mg/dL
Near optimal/above optimal 100 to 129 mg/dL
Impaired 100 to 125 mg/dL ≥140 to 199 mg/dL Borderline high 130 to 159 mg/dL
Provisional ≥126 mg/dL ≥200 mg/dL High 160 to 189 mg/dL
diabetes dx Very high ≥190 mg/dL

Recommended Cutoff Points for Serum Cholesterol

DIAGNOSTIC CRITERIA FOR GESTATIONAL DIABETES Age (years) Moderate Risk High Risk
MELLITUS 2 to 19 >170 mg/dL >185 mg/dL
20 to 29 >200 mg/dL >220 mg/dL
ONE-STEP APPROACH 30 to 39 >220 mg/dL >240 mg/dL
Fasting ≥92 mg/dL 40 and over >240 mg/dL >260 mg/dL
1-h plasma glucose ≥180 mg/dL
NCEP Guidelines for Acceptable Measurement Error
2-h plasma glucose ≥153 mg/dL
Analyte Total Error Bias CV
Cholesterol ≤9% ≤3% ≤3%
TWO-STEP APPROACH Triglyceride ≤15% ≤5% ≤5%
Fasting ≥95 mg/dL HDL-cholesterol ≤13% ≤5% ≤4%
1-h plasma glucose ≥180 mg/dL LDL-cholesterol ≤12% ≤4% ≤4%
2-h plasma glucose ≥155 mg/dL
3-h plasma glucose ≥140 mg/dL
Risk Factors Determined by the NCEP Adult Treatment
Panels
Clinical Chemistry Critical Values
POSITIVE RISK FACTORS
Bilirubin >18 mg/dL (newborn) • Age: ≥ 45 y for men;
Glucose <40 mg/dL ≥ 55 y or premature menopause for women
>500 mg/dL • Family history of premature CHD
Sodium <120 mEq/L • Current cigarette smoking
>160 mEq/L • Hypertension (blood pressure ≥ 140/90 mmHg or taking
Potassium <2.5 mEq/L antihypertensive medication)
>6.5 mEq/L • LDL-C concentration ≥160 mg/dL (≥ 4.1 mmol/L), with ≤1
risk factor
• LDL-C concentration ≥130 mg/dL (3.4 mmol/L), with ≥2
Composition of Lipoproteins risk factors
• LDL-C concentration ≥100 mg/dL (2.6 mmol/L), with CHD
LP CHON CHOLE CHOLE TAG or risk equivalent
ESTERS • HDL-C concentration <40 mg/dL (< 1.0 mmol/L)
CM 1 to 2 1 to 3 2 to 4 80 to 95 • Diabetes mellitus = CHD risk equivalent
VLDL 6 to 4 to 8 16 to 22 45 to 65 • Metabolic syndrome (multiple metabolic risk factors)
10 NEGATIVE RISK FACTORS
IDL Intermediate between VLDL and LDL • HDL-C concentration ≥ 60 mg/dL (≥ 1.6 mmol/L)
LDL 18 to 6 to 8 45 to 50 4 to 8 • LDL-C concentration < 100 mg/dL (< 2.6 mmol/L)
22
HDL 45 to 3 to 5 15 to 20 2 to 7
55

By Dr. Krizza-Almond Sarmiento Aguilar-Salido, RMT, MT (ASCPi)

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Triglyceride levels Epithelial cells/LPF
Clear <200 mg/dL None: 0 Rare: Few: Moderate: Many:
Hazy or turbid >300 mg/dL 0–5 5–20 20–100 >100
Opaque and milky >600 mg/dL Crystals/HPF
None: 0 Rare: Few: Moderate: Many:
0–2 2–5 5–20 >20
Blood Gas Analysis Reference Ranges Bacteria/HPF
pH pCO2 HCO3 pO2 O2 sat. None: 0 Rare: Few: Moderate: Many:
7.35 to 7.45 35 to 45 22 to 26 80 to 92 to 0–10 10–50 50–200 >200
100 100 Mucous threads
None: 0 Rare: Few: Moderate: Many:
0–1 1–3 3–10 >10
Blood Alcohol Signs and Symptoms Casts/LPF
(% w/v) None: 0 0–2, 2–5, 5–10, >10
0.01 – 0.05 No obvious impairment, some changes
RBCs/HPF
observable on performance testing
None: 0 2–5, 5–10, 10–25, 25–50, 50–100, >100
0.03 – 0.12 Mild euphoria, decreased inhibitions, some
impairment of motor skills WBCs/HPF
0.09 – 0.25 Decreased inhibitions, loss of critical None: 0 0–2, 2–5, 5–10, 10–25, 25–50, 50–100, >100
judgment, memory impairment,
diminished reaction time
0.18 – 0.30 Mental confusion, dizziness, strongly Appearance Dilution
impaired motor skills (staggering, slurred Clear Undiluted
speech) Slightly hazy 1:10
0.27 – 0.40 Unable to stand or walk, vomiting, Hazy 1:20
impaired consciousness Slightly Cloudy 1:100
0.35 – 0.50 Coma and possible death Cloudy/Slightly bloody 1:200
Bloody/Turbid 1:10,000
Whiskey Blood Influence
(ounces) Conc
(mg/dL)
Grade WHO Sperm Motility Action
1-2 10-50 None to mild euphoria
4.0 a Rapid, straight-line motility
3-4 50-100 Mild influence on stereoscopic vision
3.0 b Slower speed, some lateral movement
and dark adaptation
2.0 b Slow forward progression, noticeable lateral
4-6 100-150 Euphoria; disappearance of
movement
inhibition; prolonged reaction time
1.0 c No forward progression
6-7 150-200 Moderately severe poisoning;
0 d No movement
reaction time greatly prolonged; loss
of inhibition and slight disturbances
in equilibrium and coordination
8-9 200-250 Severe degree of poisoning; LILEY GRAPH
disturbances of equilibrium and
coordination; retardation of the
thought processes and clouding of
consciousness
10-15 250- Deep, possibly fatal, coma
400

Zone Interpretation Management

I Non-affected or None
FLUORESCENCE INTENSITY USING FITC
mildly affected
Intensity Interpretation II Moderate Careful monitoring
Negative No apple-green fluorescence hemolysis Anticipate early delivery or
exchange transfusion upon
1+ Faint yet unequivocal apple-green delivery
fluorescence III Severe Induction of labor or intrauterine
2+ Apple-green fluorescence hemolysis exchange transfusion
3+ Bright apple-green fluorescence
4+ Brilliant apple-green fluorescence
QUEENAN CURVE – modified Liley curve
Lowest zone – Rh-negative (unaffected) fetus
Indeterminate and Rh-positive (affected) fetus indicate increasing
PROTEIN hemolytic severity
Negative Trace 1+ 2+ 3+ 4+
None <30 30 100 300 2000
mg/dL mg/dL mg/dL mg/dL mg/dL

By Dr. Krizza-Almond Sarmiento Aguilar-Salido, RMT, MT (ASCPi)

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Parameters Transudate Exudate % Macrocytic RBCs present per HPF
Appearance Clear Cloudy 1+ Slight 25%
Fluid:Serum PROTEIN <0.5 >0.5 2+ to 3+ Moderate 25% to 50%
Fluid:Serum LD <0.6 >0.6 4+ Marked >50%
SAAG >1.1 <1.1

WBC COUNT DILUTION

PLATELET COUNT ESTIMATE (Brown)
Platelet Estimate of Report as: Anticipated WBC count Recommended dilution
0 – 49,000/uL Marked Decrease (x 109/L)
50,000 – 99,000/uL Moderate Decrease 0.1 to 3.0 1:10
100,000 – 149,000/uL Slight Decrease 3.1 to 30.0 1:20
150,000 – 199,000/uL Low Normal >30.0 1:100
200,000 – 400,000/uL Normal ≥100.0 1:200
401,000 – 599,000/uL Slight Increase
600,000 – 800,000/uL Moderate Increase WBC DIFFERENTIAL COUNT
Above 800,000/uL Marked Increase
ROUTINE 100-cell
WBC count below 1.0 x 109/L 50-cell
WBC count above 40 x 109/L 200-cell
NORMAL VALUES of BLEEDING TIME
WBC count 100 x 109/L 300 or 400-cell
Universal 2 to 9 minutes
Abnormal distribution of cells such as 200-cell
Ivy method 3 to 6 minutes
the following:
Template bleeding time 6 to 10 minutes Over 10% eosinophils
Over 2% basophils
Over 11% monocytes
Gradings More lymphocytes than neutrophils
MORPHOLOGY GRADE AS (except in children)
Spherocytes 1+ = 1 to 5/field
Teardrop RBC 2+ = 6 to 10/field
Acanthocytes 3+ = >10/field Reticulocyte Maturation Time (for RPI)
Polychromatophilia Hct (L/L) Maturation Time (Days)
Helmet cells
0.40 to 0.45 1.0
Schistocytes
0.35 to 0.39 1.5
Stomatocytes 1+ = 3 to 10/field
0.25 to 0.34 2.0
Target cells 2+ = 11 to 20/field
Ovalocytes 3+ = >20/field 0.15 to 0.24 2.5
Poikilocytosis <0.15 3.0
Burr cells
Elliptocytes
Bizarre-shaped RBC Treponema pallidum immobilization test
Rouleaux 1+ = aggregates of 3 to 4 RBC
2+ = aggregates of 5 to 10 RBC Negative <20% immobilized
3+ = numerous aggregates with Doubtful 20 to 50% immobilized
only few free RBC
Positive ≥50% immobilized
Basophilic stippling Grade as positive only
Howell-Jolly bodies
Sickle cells
Pappenheimer bodies RF latex agglutination test
Titer of 80 or greater POSITIVE REACTION
Hypochromia
Titer of 20 to 40 WEAKLY POSITIVE REACTION
1+ Area of central pallor is one-half of cell diameter
2+ Area of pallor is two-thirds of cell diameter No agglutination at 1:20 NEGATIVE FOR RF
3+ Area of pallor is three-quarters
4+ Thin rim of hemoglobin

Erythrocyte Morphology
0 Normal appearance or slight variation in erythrocytes
1+ Only a small population of erythrocytes displays a
particular abnormality; the terms slightly increased or
few would be comparable
2+ More than occasional numbers of abnormal erythrocytes
can be seen in a microscopic field; an equivalent
descriptive term is moderately increased.
3+ Severe increase in abnormal erythrocytes in each
microscopic field; an equivalent descriptive term is
many.
4+ The most severe state of erythrocytic abnormality, with
the abnormality prevalent throughout each microscopic
field; comparable terms are marked or marked
increase.

By Dr. Krizza-Almond Sarmiento Aguilar-Salido, RMT, MT (ASCPi)

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ISBT NUMBER AND CHROMOSOME NUMBER

001 ABO 9q
002 MNS 4q
003 P 22q
004 Rh 1p
005 Lutheran 19q
006 Kell 7q
007 Lewis 19p
008 Duffy 1q
009 Kidd 18q
010 Diego 17q
011 Cartwright 7q
012 Xga Xp
013 Scianna 1p
014 Dombrock 12p
015 Colton 7p
016 Landsteiner-Wiener 19p
017 Chido/Rodgers 6p
018 H 19q
019 Kx Xp
020 Gerbich 2q
021 Cromer 1q
022 Knops 1q
023 Indian 11p
024 Ok 19p
025 Raph 11p
026 John-Milton Hagen 15q
027 I 6p
028 Globoside 3q
029 GIL 9p
030 RHAG 6p
031 FORS 9q
032 JR 4q
033 LAN 2q
034 L 1p
035 CD59 11p
036 Augustine 6p

AGGLUTINATION REACTION IN THE GEL TEST

4+ Solid band of agglutinated red cells at the top

of the gel column.
Usually no red cells are visible in the bottom of the
microtube.
3+ Predominant amount of agglutinated red cells
towards the top of the gel column with a few
agglutinates staggered below the thicker band.
The majority of agglutinates are observed in the
top half of the gel column.
2+ Red cell agglutinates dispersed throughout the
gel column with few agglutinates at the bottom of
the microtubes.
Agglutinates should be distributed through the
upper and lower halves of the gel.
1+ Red cell agglutinates predominantly observed
in the lower half of the gel column with red cells
also in the bottom.
These reactions may be weak, with a few
agglutinates remaining in the gel area just above
the red cell pellet in the bottom of the microtube.
Negative Red cells forming a well-delineated pellet in the
bottom of the microtube.
The gel above the red cell pellet is clear and free
of agglutinates.
Mixed- Layer of red cell agglutinates at the top of the
field gel column accompanied by a pellet of
unagglutinated cells in the bottom of the
microtube.

By Dr. Krizza-Almond Sarmiento Aguilar-Salido, RMT, MT (ASCPi)

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