BLOOD CP, URINE RE, RFTs

GROUP MEMBERS
• Arshia Maryam (19169)
• Areeba Manzoor (18865)
• Asma Parveen (19719)
• Sumaiya Shahzad (18701)
• Sundus Zafar (17688)
 Urine RE
Blood CP
*Color
*Hb level *Appearance
*ESR *Specific Gravity
*pH
RFTS
*RBC count
*Hct
*Glusoce *Serum Creatinine
*Reducing Substances
*MCV *Billirubin Count *Blood Urea
*Ketones
*MCH *Serum uric acid
*Occult Blood
*MCHC *Protein
*TLC *Nitrite
*Sodium level
*Neutrophil count *Leucocyte Esterase *Potassium level
*WBC count
*Lymphocite Count *RBC count *Chloride level
*Eosinophil Count *Squamous Epithelial Cell Count
*Transitional Epithelial cell Count
*Bicarbonate level
*Monocyte Count
*Basophil Count
*Renal Epithelial Cell Count
*Arterial blood pH
*Bacteria Count
*Metamyelocyte Count *Calcium Oxalate Crystal Count *Arterial
*Triple Phosphate Crystal count
*Promyelocyte Count *Arterial
*Hyaline Cast
*Myelocyte Count *Granular Cast
*Platelet Count *casts
*Yeast
 Blood CP
1. Hb level
2. ESR
3. RBC count
4. Hct
5. MCV
6. MCH
7. MCHC
8. TLC
9. Neutrophil count
10. Lymphocyte Count
11. Eosinophil Count
12. Monocyte Count
13. Basophil Count
14. Metamyelocyte Count
15. Promyelocyte Count
16. Myelocyte Count
17. Platelet Count
 1) Hb level
• Hemoglobin Level
• *Male = 13.8 – 17.2 gm/dl
*Female = 12.5 – 15.1 gm/dl
• Low Hb level :
o Anemia
o Blood loss
o Water retention (edema, pregnancy)
• High Hb level :
o Heart conditions
o Acute dehydration
o Emphysema
 2) ESR level
• Erythrocyte Sedimentation Rate
• *Male = 3 – 6 mm/l
* Female = 8 – 10 mm/l
• Low ESR level :
o Hyperfibrinogenemia
o Dysproteinemia
o Extreme leukocytosis
o Polycythemia
• High ESR level :
o Old age
o Pregnancy
o Anemia
o RBC abnormalities
 3) RBC level
• Red blood cell level
• *Male = 4.7 – 6.1 million cells/ mL
* Female = 4.2 – 5.4 million cells/ mL
• Low RBC level :
o Anemia
o Acute/ chronic bleeding
o Nutritional deficiency
o Bone marrow disorders
o Kidney failure
• High RBC level :
o Polycythemia
o Dehydration
o Pulmonary diseases
o Smoking
 4) Hct level
• Hematocrit level
• * Male = 47 - -5%
*Female = 42 - -5%
• Low Hct level :
o Anemia
o Hemolysis
o Nutritional deficiencies
o Bleeding
o Renal failure
o Pregnancy
• High Hct level :
o Polycythemia
o Lung/ heart/ kidney problems
o Dehydration
o Diarrhea
o Smoking
 5) MCV level
• Mean Corpuscular volume level
• * Male/ Female = 80 – 96 fL/ red cell (adult)
• Low MCV level :
o Iron deficiency
o Chronic blood loss
o Thalassemia
o Anemia
o RBC enzyme deficiency
o Lead toxicity
• High MCV level :
o Vitamin B12 deficiency
o Alcohol excess
o Liver disease
o Cytotoxic drug use
o Myelodysplasia
 6) MCH level
• Mean Corpuscular Hemoglobin
• * Male/ Female = 27 – 33 pg/ cell (adult)
• Low MCH level :
o Iron deficiency
o Thalassemia
o Sideroblastic anemia
• High MCH level :
o Acute blood loss
o Anemia
o Bone marrow failure
o Renal failure
o Hypothyroidism
o Hemolysis
o Pregnancy
 7) MCHC level
• Mean Corpuscular Hemoglobin Concentration level
• *Male/ Female = 33 – 36 g/dl (adult)
• Low MCHC level :
o Iron deficiency
o Regenerative anemia
• High MCHC level :
o Intramuscular hemolysis
o Heinz bodies present
o Lipoma
 8) TLC level
• Total Leucocyte count/ WBC count level
• * Male/ Female = 4,000 – 10,000 cells/
• Low TLC level :
o Liver/ spleen disorders
o Vitamin / mineral deficiencies
• High TLC level :
o Stress
o Smoking
o Allergy
o Asthma
o Pregnancy
o TB infections
o Tumors in bone marrow
o Leukemia
o Arthritis
o Tissue damage
 9) Neutrophil count level
• * Male/ Female = 40 -75% (adult)
• Low Neutrophil count level:
o Viral
o Auto-immune/ idiopathic
o Drugs
• High Neutrophil count level:
o Infection/ inflammation
o Necrosis/ malignancy
o Stress/ heavy exercise
o Drugs
o Pregnancy
 10) Lymphocyte count level
• * Male/ Female = 20 – 45%
• Low Lymphocyte count level:
o Usually not clinically significant
• High Lymphocyte count level:
o Acute infection
o Smoking
o Hyposplenism
o Auto-immune thyroiditis
 11) Eosinophil count level
• * Male/ Female = 1 - 4%
• Low Eosinophil count level:
o No real cause for concern
• High Eosinophil count level:
o Allergy
o Parasites
o Hodgkin's disease
 12) Monocyte count level
• * Male/ Female = 2 - 6%
• Low Monocyte count level:
o Acute stress reaction
o Steroids
o Chemotherapy and immunosuppressant therapies
• High Monocyte count level:
o Infection
o Granulomatous disease
o Collagen vascular disease
 13) Basophil count level
• * Male/ Female = 0 - 1%
• Low Basophil count level:
o Difficult to demonstrate
• High Basophil count level:
o Myeloproliferative disorders
o Allergy
o Leukemia
14) Metamyelocyte count level
• * Male/ Female = 0%
• Low Metamyelocyte count level:
o Difficult to demonstrate
• High Metamyelocyte count level:
o Severe inflammation
o Leukemia
 15) Myelocytes count level
• * Male/ Female = 0%
• Low Myelocute count level:
o Difficult to demonstrate
• High Myelocyte count level:
o Acute myeloid leukemia
 16) Platelet count level
• * Male/ Female =150,000 – 450,000 platelets/ ml
• Low Platelet count level:
o Bone marrow disorders
o Chemotherapy
o Congenital
o Lupus
o Hemodilution
o Cardiac valve dysfunction
• High Platelet count level:
o Thrombocythemia/ thrombocytosis
o Chronic myeloproliferative disorders
o Tumors
o Infection
o Iron deficiency
o Splenectomy
o Auto-immune diseases
1. Color
Urine RE17. Renal Epithelial Cell Count
2. Appearance 18. Bacteria Count
3. Specific Gravity 19. Calcium Oxalate Crystal
4. pH Count
5. Glucose 20. Triple Phosphate Crystal
6. Reducing Substances count
7. Bilirubin Count 21. Hyaline Cast
8. Ketones 22. Granular Cast
9. Occult Blood 23. casts
10. Protein 24. Yeast
11. Nitrite
12. Leucocyte Esterase
13. WBC count
14. RBC count
15. Squamous Epithelial Cell
Count
16. Transitional Epithelial cell
Count
 1) Color
• * Male/ Female = yellow
• Different colors of urine:
o Cloudy or murky
 Urinary tract infections
 Kidney stones
o Red
 Tumor in bladder/ kidney
o Orange
 Mild dehydration
 Liver/ bile duct problem
o Brown
 Diet
 Medications
 Health issues
o Dark yellow
 Severe dehydration
 Medications
o Green
 Asparagus/ green beer/ artificial food coloring consumption
o Blue
 Congenital anomaly with excess calcium
 Medications containing blue dye
 2) Appearance
• * Male/ Female = clear
• Different appearance of urine:
o Pale
 Diabetes myelitis/ insipidus
 Excessive water consumption
o Cloudy
 Bacterial infection
o Red discoloration + cloudy
 Schistosomiasis
 Renal tract malignancy/ stones
 Bacterial infections
o Rusty
 Acute glomerulonephritis
 Malaria with hemoglobinuria
 Rhadomyolysis
 Other intravascular hemolysis
o Milky white (chyluria)
 Obstruction of lymphatics caused by filariasis
 3) Specific gravity level
• * Male/ Female = 1.010 – 1.030
• low specific gravity level:
o Renal failure
o Pyelonephritis
o Diabetes insipidus
o Acute tubular necrosis
o Interstitial nephritis
o Excessive fluid intake
• High specific gravity level:
o Dehydration
o Diarrhea
o Emesis
o Excessive sweating
o Urinary tract/ bladder infection
o Glucosuria
o Renal artery stenosis
o Hepatorenal syndrome
 4) pH level
• * Male/ Female = 7.0
• low pH level:
o Chronic obstructive pulmonary disease
o Diabetic ketoacidosis
o Diarrhea
o Starvation
• High pH level:
o Gastric suction
o Renal failure
o Renal tubular acidosis
o Urinary tract infection
o Vomiting
 5) Glucose count level
• * Male/ Female = 0 - 0.8 mmol/L or negative
• High glucose count level or positive:
o Renal glycosuria
o Gestational glycosuria
o Alimentary glycosuria
o Diabetes mellitus
6) Reducing substance count level
• * Male/ Female = negative
• High reducing substance count level or positive:
o Galactosuria
o Fructosuria
o Lactosuria
 7) Bilirubin count level
• * Male/ Female = 0.2 – 0.8 mg/ dL or negative
• High Bilirubin count level or positive:
o Biliary strictures
o Cirrhosis
o Gallstones in biliary tract
o Hepatitis with associated biliary obstruction
o Surgical trauma affecting biliary tract
o Tumors of liver/ gall bladder
o Jaundice
 8) Ketone count level
• * Male/ Female = negative
• High ketone count level or positive:
o Diabetes mellitus
o Pregnancy
o Starvation
o Ketosis
 9) Occult blood level
• * Male/ Female = negative
• High occult blood level or positive:
o Coagulopathy
o Collection method (catheterization or cystocentesis)
o Drugs
o Estrus
o Genital tract hemorrhage
o Inflammatory renal disease
o Kidney neoplasia
o Kidney or ureter calculi
o Polycystic kidneys
o Prostatic disease
o Sterile inflammation
o Trauma
o Urinary bladder tumor
o Urinary tract infection
o Urolithiasis
 10) Protein count level
• * Male/ Female = negative
• High protein count level or positive:
o Pre-renal proteinuria
 Multiple myeloma
 Intestinal obstruction
 Intra-abdominal tumor
 Haemoglobinemia
o Renal protenuria
 Glomerulonephritis
 Tuberculosis of kidney
 Nephrosclerosis
 Renal failure
o Post-renal proteinuria
 Renal pelvic lesions
 Urinary tract lesions
 Urinary bladder lesions
 Prostrate gland lesions
 Urethra lesions
 11) Nitrite count level
• * Male/ Female = negative
• High nitrite count level or positive:
o Bacterial urinary tract infection
 Escherichia coli
 Staphylococcus
 Klebsiella
12) Leukocyte esterase count level
• * Male/ Female = negative
• High leukocyte esterase count level or positive:
o Bladder infections/ urinary tract infections
o Kidney stones
o Kidney infections
o Urinary system blockage
o Some cancers
o Blood diseases (sickle cell anemia)
o Some pain relieving medicines
o Interstitial cystitis
13) White blood cell count level
• * Male/ Female = 0 – 5 wbc/ hpf
• High white blood cell count level :
o Calculous disease
o Strictures
o Glomerulonephropathy
o Interstitial cystitis
 14) Red blood cell count level
• * Male/ Female = 0 – 3 rbc/ hpf
• High red blood cell count level :
o Menstruation
o Trauma of bladder catheritization
o Infection
o Tumors
o Kidney stones
15) Squamous epithelial cell count level
• * Male/ Female = 0 – 5 sec/ hpf
• High squamous epithelial cell count level :
o Acute tubular necrosis
o Acute glomerulonephritis
o Pyelonephritis
16) Transitional epithelial cell count level
• * Male/ Female = 0 – 5 tec/ hpf
• High transitional epithelial cell count level :
o Kidney stones
o Weakened immune system
o Diabetes
o High blood pressure
o Inherited chronic kidney disease
o Enlarged prostrate
o Pregnancy
17) Renal epithelial cell count level
• * Male/ Female = 0 – 3 rec/ hpf
• High renal epithelial cell count level :
o Acute tubular necrosis
o Acute interstitial nephritis
o Acute cellular allograft rejection
o Acute nephritic/ nephrotic syndrome
 18) Bacterial cell count level
• * Male/ Female = negative
• High bacterial cell count level or positive:
o Urinary tract infections
 Escherichia coli
 Staphylococcus
 Proteus
 Pseudomonas
 Klebsilella spp
 Citrobacter
 Enteococcus
19) Calcium oxalate crystal count level
• * Male/ Female = negative
• High calcium oxalate crytsal count level or positive:
o Chronic renal disease
o Ethylene glycol toxicity
o Small bowel resection – crohns disease
20) Triple phosphate crystal count level
• * Male/ Female = negative
• High triple phosphate crytsal count level or positive:
o Staghorn calculi
o Urinary tract infections
o Vericoureteral reflux
21) Uric acid crystal count level
• * Male/ Female = negative
• High uric acid crytsal count level or positive:
o Chemotherapy for leukemia
o Uric acid stones in ureter
o Urate nephropathy of gout
22) Amorphous sediment count level
• * Male/ Female = negative
• High amorphous sediment count level or positive:
o Urinary tract infections
o Liver diseases
o Congenital cystinuria
o Congenital tyrosinosis
o Maple syrup urine disease
 23) Hyaline cast level
• * Male/ Female = negative
• High hyaline cast level or positive:
o Dehydration
o Exercise
o Diuretic medicines
 24) Granular cast level
• * Male/ Female = negative
• High granular cast level or positive:
o Kidney diseases
 25) Cast level
• * Male/ Female = negative
• High cast level or positive:
o Fatty casts
 Nephrotic syndrome
o Red blood cell casts
 Nephrotic syndrome
o White blood cell casts
 Interstitial cell kidney disease
 Interstitial inflammation
 Pyelonephritis
 Parenchymal infection
o Renal tubular epithelial cell casts
 Renal tubular necrosis
 26) Yeast cell count level
• * Male/ Female = negative
• High yeast cell count level or positive:
o Diabetes
o Structural abnormalities
o Indwelling catheters
o Prolonged antibiotic treatment
o Immunosuppression
 RFTs
1. Serum Creatinine
2. Blood Urea
3. Serum uric acid
4. Sodium level
5. Potassium level
6. Chloride level
7. Bicarbonate level
8. Arterial blood pH
9. Arterial
10. Arterial
1) Serum Creatinine count level
• * Male = 0.7 – 1.3 mg/ dL
* Female = 0.6 – 1.1
• Low serum creatinine count level:
o Small stature
o Debilitation
o Decreased muscle mass
o Severe hepatic disease
• High serum creatinine count level:
o muscular disorders
o Myasthenia gravis
o Different myositis
o Starvation
o High fever
o Diabetes mellitus
o Hyperthyroidism
o Kidney dysfunction
 2) Blood Urea count level
• * Male/ Female = 15 – 40 mg/ dL
• Low blood urea count level:
o Not a cause of concern
o Over-hydration
o Very low protein diet
• High bood urea count level:
o Renal diseases
o High protein diet
o Mild dehydration
o Increased protein catabolism
3) Serum uric acid count level
• * Male = 3.4 – 7.0 mg/ dL
* Female = 2.4 – 6.0 mg/ dL
• Low serum uric acid count level:
o Genetic mutations
o Renal reabsorption problem
o Low dietary zinc intakes
o Molybdenum deficiency
o High Cu level
o High estrogen
o Drugs
o Liver failure
o Multiple sclerosis
o Xanthine stones
• High serum uric acid count level:
o Dietary purine intake
o Kidney dysfunction
o Drugs
o Genetics
o Urate crystallization
o Oxidative stress
o Inflammation
o Endothelial dysfunction
o Gout
o Kidney stone/ renal failure
o Hypertension
o Atherosclerosis
o Heart failure
o Stroke
o Type 2 diabetes
o Metabolic syndrome
o Non-alcoholic fatty liver disease
 4) Sodium count level
• * Male/ Female = 135 – 145 mmol/ L
• Low sodium count level:
o Kidney failure
o Hear t failure
o Cirrhosis
o Use of diuretics
• High sodium count level:
o Dehydration
o Diarrhea
o Kidney dysfunction
o Diuretics
 5) Potassium count level
• * Male/ Female = 3.5 – 5.0 mmol/ L
• Low potassium count level:
o Vomiting
o Diarrhea
o Adrenal gland disorders
o Diuretics use
• High potassium count level:
o Acute kidney failure
o Chronic kidney disease
o Addison’s disease
o Dehydration
o Excessive use of potassium supplements
o Type 1 diabetes
 6) Chloride count level
• * Male/ Female = 96 - 106 mmol/ L
• Low chloride count level:
o Vomiting
o Dehydration
o Congestive heart failure
o Burns
o Addison’s disease
o Metabolic acidosis
o Hyperaldosteronism
o Chronic lung disease
• High chloride count level:
o Chemotherapy
o Gastrointestinal problems
o Diabetes insipidus
o Medications
 7) Bicarbonate count level
• * Male/ Female = 23 - 27 mmol/ L
• Low bicarbonate count level:
o Metabolic acidosis
o Diarrhea
o Kidney disease
o Liver failure
• High bicarbonate count level:
o Metabolic alkalosis
o Vomiting
o Dehydration
o Anorexia
o Chronic obstructive pulmonary disease
 8) Arterial blood pH level
• * Male/ Female = 7.35 – 7.45
• Low arterial blood pH count level:
o Renal failure
o Diabetic ketoacidosis
o Anaerobic metabolism
o Stravation
o Convulsions
o Drugs
o Diarrhea
• High arterial blood pH count level:
o Respiratory alkalosis o Hypochloremic alkalosis
 Hyperventilation  Prolonged vomiting
 Salicylate poisoning  Prolonged sweating
 Liver disease o Hypokalemic alkalosis
 Lung disease  Kidney disease
o Metabolic alkalosis  Excessive sweating
 Vomiting  Diarrhea
 Overuse of diuretics  Potassium deficiency
 Adrenal disease
 Alcohol abuse
 9) Arterial level
• * Male/ Female = 35 – 45 mm of Hg
• Low arterial level:
o Hyperventilation
o Cerebral vasoconstriction
o Decreased blood flow
o Cerebral hypoxia
• High arterial level:
o Cerebral dilation
 10) Arterial level
• * Male/ Female = 80 – 100 mm of Hg
• Low arterial level:
o Respiratory muscle paralysis
o Chronic obstructive pulmonary disease
o Restrictive lung disease
o Depression of respiratory center
o anemia
• High arterial level:
o Increased oxygen levels in inhaled air
o Polycythemia