Jimmy Sparacello

HITT1349 LESSON 8 APPLICATION

LABORATORY AND DIAGNOSTIC TESTS IN DISEASES OF THE ENDOCRINE, RESPIRATORY, CARDIOVASCULAR, AND
REPRODUCTIVE SYSTEMS

Disease Lab or
Reference Values Description Purposes Clinical Problems
Diagnostic Test
Schilling Test Greater than 7% Primarily ordered to diagnose To determine vitamin Decreased level in
excretion of pernicious anemia – a B12 deficiency and pernicious anemia
radioactive vitamin macrocytic anemia; The test pernicious anemia
B12 within 24 hours. determine if the client lacks the
Anemias
Usual range 10-40% intrinsic factor in the gastric
(pernicious,
of vitamin B12 mucosa necessary for
iron
excretion absorption of vitamin B12.
deficiency)
Collecting 24-hour urine
specimen after taking radioactive
B12 capsule and intramuscular
B12.
Reticulocyte Reticulocyte count: The reticulocyte count is a test To measure the Pernicious anemia Folic
Adult/elderly/child: for determining bone marrow level of acid deficiency Iron
0.5%-2% Infant: function and evaluating deficiency anemia
0.5%-3.1% erythropoietic activity. This test is
reticulocytes in your Adrenocortical
Newborn: 2.5%- also useful in classifying blood hypofunction Aplastic
6.5% Reticulocyte anemias anemia Radiation
index: 1.0 therapy Marrow failure
Anterior pituitary
hypofunction Chronic
infection Cirrhosis
Malignancy
Total iron-binding TIBC is a measurement of all Measures the blood's Polycythemia vera Iron
capacity (TIBC) 250-460mcg/dL or proteins available for binding ability to attach itself to deficiency anemia
45-82μmol/L (SI mobile iron. Transferrin iron and transport it Hypoproteinemia
units) represents the largest quantity of around the body. A Inflammatory diseases
iron binding proteins. Therefore, transferrin test is Cirrhosis Hemolytic
TIBC is an indirect yet accurate similar anemia Pernicious
measurement of transferrin anemia Sickle cell
anemia

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 Jimmy Sparacello

Ferritin Male: 12-300ng/mL The serum ferritin study is a Decreases in ferritin Hemochromatosis
or 12-300 mcg/L (SI good indicator of available iron levels indicate a Hemosiderosis
units) Female: 10- stores in the body decrease in iron Megaloblastic anemia
150ng/mL or 10-150 storage associated with Hemolytic anemia
mcg/L (SI units) iron deficiency anemia. Alcoholic/inflammatory
Children Newborn: A ferritin level less than hepatocellular disease
25-200ng/mL 10ng/100mL is Inflammatory disease
≤1month: 200- diagnostic of iron Advanced cancers
600ng/mL 2- deficiency anemia. Chronic illnesses (e.g.,
5months: 50- leukemias, cirrhosis,
200ng/mL 6months- chronic hepatitis)
15years: Collagen vascular
7-142ng/mL diseases
Hemophagocytic
syndromes Congenital
and acquired
sideroblastic anemia
Troponins Cardiac troponin T: Cardiac troponins are important This test is used to Myocardial injury
<0.1 ng/mL biochemical markers for cardiac assist in the evaluation Myocardial infarction
Angina Cardiac troponin I: disease of patients with
pectoris <0.03 ng/mL suspected acute
(adult) coronary ischemic
syndromes.
Creatine Male: 55-170 units/L Creatine kinase is found This test is used to Acute myocardial
phosphokinase or 55-170 units/L (SI predominantly in the heart support the diagnosis infarction Cardiac
Isoenzyme units) muscle, skeletal muscle, and of myocardial muscle aneurysm surgery
(CPK-MB) Female: 30-135 brain. Serum CK levels are injury (infarction). It can Cardiac defibrillation
units/L or 30-135 elevated when these muscle or also indicate neurologic Myocarditis Ventricular
units/L (SI units) nerve cells are injured. or skeletal muscle arrhythmias Cardiac
Newborn: 68-580 diseases ischemia
units/L (SI units)

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 Jimmy Sparacello

Echocardiography Normal position, In diagnostic ultrasonography, a Used to evaluate the Valvular stenosis
size, and movement harmless, high-frequency sound structure and function Valvular regurgitation
of the cardiac valves wave emitted from a transducer of the heart. Mitral valve prolapse
and heart muscle penetrates the heart. Sound Pericardial effusion
wall Normal waves are bounced off the heart Ventricular or atrial
directional flow of structures and reflected back to mural thrombi Myxoma
blood within the the transducer as a series of Poor ventricular muscle
heart chambers echoes motion Septal defects
Ventricular hypertrophy
Endocarditis
Arterial blood Partial pressure of Measurement of ABGs provides Blood gases are a Hypokalemia
gases (ABGs) oxygen (PaO2): 75 valuable information in measurement of how Ketoacidosis
to 100 millimeters assessing and managing a much oxygen and Hypochloremia Lactic
of mercury (mm patient’s respiratory (ventilation) carbon dioxide are in Acidosis Chronic and
and metabolic (renal) acid/base high-volume gastric
Hg), or 10.5 to 13.5 your blood. They
and electrolyte homeostasis. It is suction Severe diarrhea
kilopascal (kPa) also used to assess adequacy of
also determine the Renal failure Chronic
Partial pressure of oxygenation acidity (pH) of your vomiting Aldosteronism
carbon dioxide blood. Mercurial diuretics
(PaCO2): 38 to 42
mm Hg (5.1 to 5.6
Asthma
kPa)
Arterial blood pH:
7.38 to 7.42
Oxygen saturation
(SaO2): 94% to
100%
Bicarbonate
(HCO3): 22 to 28
milliequivalents per
liter (mEq/L)

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 Jimmy Sparacello

Pulmonary 80% -120% This is a lung function test that is This is used to Pulmonary fibrosis
function tests – measured with spirometry. measure the lung Interstitial lung
Forced expiratory function for diagnosis diseases Tumor Chest
volume timed of obstructive lung wall trauma
diseases such as Emphysema Chronic
asthma and chronic bronchitis Asthma
obstructive pulmonary Inhalation pneumonitis
disease. Postpneumonectomy
Bronchiectasis Airway
infection Pneumonia
Neuromuscular disease
Hypersensitivity
bronchospasm
Serum alpha-1- 85-213mg/dL or Serum alpha1 -antitrypsin (AAT) To measure level of Acute inflammatory
antitrypsin 0.85-2.13g/L (SI determinations should be alpha-1 trypsin (AAT) disorders Early onset of
units) obtained when an individual has in the blood. emphysema (in adults)
a family history of emphysema Chronic inflammatory
because a familial tendency to disorders Neonatal
have a deficiency of this respiratory distress
antienzyme exists. Deficient or syndrome Stress
Emphysema absent serum levels of this Cirrhosis (in children)
enzyme are found in some Infection Low serum
patients with early onset of proteins Thyroid
emphysema. infections (e.g.,
nephrotic syndrome,
malnutrition, end-stage
cancer, protein-losing
enteropathy)

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 Jimmy Sparacello

Lactic/lactate Adult/elderly: 100- Lactate dehydrogenase (also To detect for signs of Myocardial infarction
dehydrogenase 190 units/L at 37 °C called lactic acid dehydrogenase damage to the body’s Pulmonary disease
LDH (lactate → pyruvate) , or LDH) is an enzyme found in tissues. (e.g., embolism,
or 100-190 units/L almost all body tissues. It plays infarction, pneumonia)
(SI units) Child: 60- an important role in cellular Hepatic disease (e.g.,
170 units/L (30 °C) respiration, the process by which hepatitis, active
Infant: 100-250 glucose (sugar) from food is cirrhosis, neoplasm)
units/L Newborn: converted into usable energy for Red blood cell disease
160-450 units/L our cells. (e.g., hemolytic or
megaloblastic anemia
or red blood cell
destruction from
prosthetic heart valves)
Skeletal muscle
disease and injury (e.g.,
muscular trauma)
Heart Failure
Renal parenchymal
disease (e.g., infarction,
glomerulonephritis,
acute tubular necrosis)
Intestinal ischemia and
infarction Testicular
tumors (seminoma or
dysgerminomas)
Lymphoma and other
reticuloendothelial
system tumors
Advanced solid tumor
malignancies
Pancreatitis Diffuse
disease or injury (e.g.,
heatstroke)

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 Jimmy Sparacello
Brain natriuretic <100pg/mL Brain natriuretic peptide (BNP)
peptic (BNP) test is a blood test that measures
levels of a protein
called BNP that is made by your
heart and blood vessels.
Prothrombin Time 11.0-12.5 seconds; A test that is done to gauge the
(PT) 85%-100% integrity of part of the blood
clotting process.
Pulmonary
embolism
Plasminogen 2.4-4.4 Committee Plasmin functions in the fibrolytic
on Thrombolytic mechanism to dissolve blood
Agents (CTA) clots, whether formed normally in
units/mL cases of injury or abnormally in
cases of
thrombosis. Plasmin levels must
be carefully regulated; increased
levels of plasmin may result in
excessive bleeding and
decreased levels of plasmin may
result in thrombosis.
Venography No evidence of A venography is a test that lets
venous thrombosis your healthcare provider see the
or obstruction veins in your body, especially in
your legs. A special dye is
injected that can be seen on an
X-ray.
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It measures the cardiac Congestive heart failure
function of an Myocardial infarction
individual. BNP levels Systemic hypertension
are higher than normal Cor pulmonale Heart
when you have heart transplant rejection
failure.
It measures how long it Cirrhosis Hepatitis
takes a blood of a Vitamin K deficiency
person to clot. It can Salicylate intoxication
check for bleeding Bile duct obstruction
problems. Coumarin ingestion
Disseminated
intravascular
coagulation Massive
blood transfusion
Hereditary factor
deficiency
Plasminogen levels Pregnancy
drop in patients Inflammatory conditions
undergoing Hyperfibrinolytic state
thrombolytic therapy (e.g., DIC, fibrinolysis)
with TPA, UPA, or SK Primary liver disease
and measurement of Syndrome associated
plasminogen activity with hypercoagulation
can be used to monitor (e.g., venous and
the therapeutic efficacy arterial clotting) Rare
of this treatment. congenital deficiencies
Malnutrition
To diagnose deep vein Obstructed venous
thrombosis (DVT) or systems Acute deep
other abnormalities of vein thrombosis
the veins; it can also
help diagnose for other
health problems.
 Jimmy Sparacello

Glucose, fasting less than 100 mg/dL A test to determine how This test will measure Diabetes mellitus Acute
blood sugar, (5.6 mmol/L) much glucose (sugar) is in the blood sugar levels stress response
serum a blood sample after an or glycosylated Cushing syndrome
overnight fast. The fasting blood hemoglobin. The result Pheochromocytoma
glucose test is commonly used of this test will show Chronic renal failure
to detect diabetes mellitus. blood sugar levels over Glucagonoma Acute
A blood sample is taken in a lab, the previous 90 days. pancreatitis Diuretic
physician's office, or hospital therapy Corticosteroid
Diabetes therapy Acromegaly
mellitus Decreased levels
(hypoglycemia)
Insulinoma
Hypothyroidism
Hypopituitarism
Addison disease
Extensive liver disease
Insulin overdose
Starvation
Insulin and insulin < 1:4 titer; no Type I diabetes mellitus (DM) is To check if the body Insulin-dependent
antibody antibody detected insulin dependent (IDDM). It is has produced diabetes mellitus Insulin
becoming increasingly antibodies against resistance Allergies to
recognized that this disease is insulin. insulin Factitious
an organ-specific form of hypoglycemia
autoimmune disease that results
in destruction of the pancreatic
islet cells and their products.
These antibodies are used to
differentiate type I DM from type
II non– insulin-dependent DM.
Acetone, serum 1.5 or less A serum acetone test is done in To determine the Diabetes mellitus
a laboratory setting using a acetone levels in blood
sample of your blood. and confirms the
condition of Ketonuria,
Diabetic Acidosis, and
starvation.

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 Jimmy Sparacello

Estrone (E1) 37 pg/mL (low point This blood test is also known as To measure and postmenopausal
serum during periods) and E1 and does not require fasting monitor estrogen levels women
229 pg/mL (high in preparation. Results are and help explain breast cancer
point during delivered within four to six days abnormal menstrual
Gynecologic ovulation) of taking the test. cycles, infertility
problems symptoms of
menopause, abnormal
or heavy bleeding,
infertility, or any other
hormonal alterations.
Estrogen 60–400 picograms Estrogens are responsible for Used to determine if Feminization
per milliliter (pg/mL) female sexual development and the woman is preparing syndromes Precocious
function, such as breast to enter menopause or puberty Ovarian tumor
development and the menstrual already through the Testicular tumor
cycle. In women, estrogens are transition. Adrenal tumor Normal
made mainly in the ovaries and pregnancy Hepatic
in the placenta during cirrhosis Hepatic
pregnancy. necrosis
Hyperthyroidism
Decreased levels
Failing pregnancy
Turner syndrome
Hypopituitarism Primary
and secondary
hypogonadism Stein-
Leventhal syndrome
Menopause Anorexia
nervosa
Cervigraphy No cervical lesion Cervigraphy is a This is an alternative Cervical cancer
found diagnostic medical procedure in for cervical cancer
which a non-physician takes screening.
pictures of the cervix and
submits them to a physician for
interpretation.

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 Jimmy Sparacello
Colposcopy Normal vagina and Colposcopy (kol-POS-kuh-pee)
cervix is a procedure to closely
examine your cervix, vagina and
vulva for signs of disease.
During colposcopy, your doctor
uses a special instrument called
a colposcope.
Alpha fetoprotein 10 ng/mL to 20 An AFP blood test is used to
ng/mL is normal for check a developing fetus for risk
adults of birth defects and genetic
disorders, such as neural tube
defects or Down syndrome.
Pregnancy
and fetal
distress
Human chorionic Negative: All pregnancy tests are based on
gonadotropin 20 to 50 (reportedly the detection of human chorionic
HCG as low as 6.3 to gonadotropin (hCG), which is
12.5)[19] mIU/mL secreted by the placental
trophoblast after the ovum is
fertilized. hCG appears in the
blood and urine of pregnant
women within days after
conception. In the first few
weeks of pregnancy, hCG rises
markedly, and serum levels are
higher than urine levels. After
about 1 month, hCG is about the
same in either specimen.
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Used to find cancerous Dysplasia Carcinoma in
cells or abnormal cells situ Invasive cancer
that can become Cervical lesions
cancerous in the
cervix, vagina, or vulva.
AFP is an effective Neural tube defects
screening serum (e.g., anencephaly,
marker for fetal body encephalocele, spina
wall defects. The most bifida,
notable of these are myelomeningocele)
neural tube defects, Trisomy 21 (Down
which can vary from a syndrome) Fetal
small wastage Abdominal
myelomeningocele to wall defects (e.g.,
anencephaly gastroschisis or
omphalocele) Multiple
pregnancy Threatened
abortion Fetal distress
or congenital anomalies
Fetal death
To measure the Increased levels
amount of the Pregnancy Ectopic
hormone hCG in blood pregnancy Hydatidiform
or urine to see if a mole of the uterus
woman is pregnant. Choriocarcinoma of the
HCG may also be uterus, testes, or
measured to see if ovaries Tumor
cancer of the ovaries or Decreased levels
testicles is present. (inappropriate rise in
hCG levels)
Spontaneous abortion
Fetal death Ectopic
pregnancy
Jimmy Sparacello
Fetal nonstress Reactive fetus (heart The NST is a method of
test rate acceleration evaluating the viability of a fetus.
associated with fetal It documents the function of the
movement) placenta in its ability to supply
adequate blood to the fetus. The
NST can be used to evaluate
any high-risk pregnancy in which
fetal well-being may be
threatened.
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To evaluate a baby's Fetal stress
health before birth. The Fetal death
goal of a nonstress
test is to provide useful
information about your
baby's oxygen supply
by checking his or her
heart rate and how it
responds to your
baby's movement.