Chemistry Specimen Processing - Revision history

Admin: /* Lab Test Reference Intervals */

2025-05-18T16:15:57Z

Lab Test Reference Intervals

← Older revision		Revision as of 12:15, 18 May 2025
Line 124:		Line 124:
	!Test		!Test
	!Reference Interval		!Reference Interval
	!~~Clinical Relevance~~		!↑ Conditions
			!↓ Conditions
	!Interferences		!Interferences
	!Notes		!Notes
Line 130:		Line 131:
	\|Sodium		\|Sodium
	\|135 - 145 mmol/L		\|135 - 145 mmol/L
			\|Hypernatremia
	\|		\|
	\|		\|
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	\|		\|
	\|		\|
			\|
			* ↑↑↑ Hemolysis
	\|		\|
	\|-		\|-
	\|Chloride		\|Chloride
			\|
			\|
			\|
			\|
			\|
			\|-
			\|Bicarbonate
			\|
	\|		\|
	\|		\|
			\|
			\|
			\|-
			\|Anion Gap
			\|10 - 20 mmol/L
			\|
			* Ketoacidosis (diabetes, starvation)
			* Renal failure
			* Lactic acidosis
			* Hypernatremia
			* Poisoning (methanol, ethanol, ethylene glycol, salicylates)
			\|Rare

			* Hypoalbuminemia
			* Severe hypercalcemia
	\|		\|
	\|		\|
	\|-		\|-
	\|pH		\|pH
			\|
	\|		\|
	\|		\|
Line 153:		Line 181:
	\|-		\|-
	\|pO<sub>2</sub>		\|pO<sub>2</sub>
			\|
	\|		\|
	\|		\|
Line 159:		Line 188:
	\|-		\|-
	\|pCO<sub>2</sub>		\|pCO<sub>2</sub>
			\|
	\|		\|
	\|		\|
Line 165:		Line 195:
	\|-		\|-
	\|[HCO<sub>3</sub><sup>-</sup>]		\|[HCO<sub>3</sub><sup>-</sup>]
			\|
	\|		\|
	\|		\|
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	\|		\|
	\|-		\|-
			\|
	\|		\|
	\|		\|
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	\|Glucose, fasting		\|Glucose, fasting
	\|4.1 - 5.6 mmol/L		\|4.1 - 5.6 mmol/L
			\|
	\|		\|
	\|		\|
Line 183:		Line 216:
	\|-		\|-
	\|Glucose, random		\|Glucose, random
			\|
	\|		\|
	\|		\|
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	\|-		\|-
	\|Total Bilirubin		\|Total Bilirubin
			\|
	\|		\|
	\|		\|
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	\|-		\|-
	\|Unconjugated Bilirubin		\|Unconjugated Bilirubin
			\|
	\|		\|
	\|		\|
Line 201:		Line 237:
	\|-		\|-
	\|Conjugated Bilirubin		\|Conjugated Bilirubin
			\|
	\|		\|
	\|		\|
Line 208:		Line 245:
	\|eGFR		\|eGFR
	\|>2.0 mL/s		\|>2.0 mL/s
			\|
	\|		\|
	\|		\|
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	\|Urine flow rate		\|Urine flow rate
	\|0.05 mL/s		\|0.05 mL/s
			\|
	\|		\|
	\|		\|
Line 221:		Line 260:
	\|62 - 115 μmol/L (male)		\|62 - 115 μmol/L (male)
	53 - 97 μmol/L (female)		53 - 97 μmol/L (female)
			\|
	\|		\|
	\| rowspan="3" \|		\| rowspan="3" \|
Line 233:		Line 273:
	\|9 - 18 mmol/d (male)		\|9 - 18 mmol/d (male)
	7 - 16 mmol/d (female)		7 - 16 mmol/d (female)
			\|
	\|		\|
	\|Inaccuracies may arise from improper urine measurement or tubular secretion.		\|Inaccuracies may arise from improper urine measurement or tubular secretion.
Line 239:		Line 280:
	\|1.42 - 2.08 mL/s (male)		\|1.42 - 2.08 mL/s (male)
	1.24 - 1.92 mL/s (female)		1.24 - 1.92 mL/s (female)
			\|
	\|		\|
	\|<0.63 mL/s is markedly decreased		\|<0.63 mL/s is markedly decreased
Line 245:		Line 287:
	\|[[Cardiac Testing#C-reactive protein\|C-reactive protein]]		\|[[Cardiac Testing#C-reactive protein\|C-reactive protein]]
	\|<10 mg/L		\|<10 mg/L
			\|
	\|		\|
	\|		\|
	\|		\|
	\|-		\|-
			\|
	\|		\|
	\|		\|

Admin: /* Lab Test Reference Intervals */

2025-03-03T03:41:09Z

Lab Test Reference Intervals

@@ Line 242: / Line 242: @@
 |<0.63 mL/s is markedly decreased
 High serum creatinine may over-estimate CC.
 |}
 Blood Gas Results

Admin: /* Lab Test Reference Intervals */

2025-02-27T05:07:37Z

Lab Test Reference Intervals

← Older revision		Revision as of 01:07, 27 February 2025
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	\|		\|
	\|}		\|}
			Heme -> bilirubin -> unconjugated bilirubin (transport via albumin) -> conjugated bili -> urobilinogen (in GI) -> urobilin excreted

			Hepatic Jaundice

			* ↑ AST, ALT, GGT
			* ALP N/↑
			* ↑ Total, unconj., conj. bilirubin

			Obstructive (post-hepatic) jaundice

			* ↑↑ ALP and GGT
			* ↑ Bilirubin
			* ALT, AST vary

			Enzymes

			* ALT most liver specific
			** Except alcoholic cirrhosis AST 2x ALT
			* AST more general (liver, skeletal muscle, heart, RBCs)
			* GGT sensitive to liver injury, but not specific (high in alcoholic liver cirrhosis)
			* LD not specific
			* ALP non-specific
			* ↓ albumin, ↑ gamma globulins (IgG, IgM hepatitis; IgA alcoholic cirrhosis)
			** Beta-gamma bridging

			Pancreatitis

			* Amylase
			* Lipase (more specific than amylase)

			Affected by HIL

			* K<sup>+</sup>
			* LD very sensitive!!! and unstable!!!
			* AST
			* Bilirubin
			** ↓ Hemolysis
			** ↑ Lipemia

			Less Affected

			* Na (dilutional effect)
			* Cl (dilutional effect)
			* ALP
			* CK (gross hemolysis false ↑)

			CSF Tubes

			# Chemistry
			# Microbiology
			# Hematology
			# Other (e.g., cytology)

			Hashimoto = low T3,T4 and high TSH

			Grave's = hyperthyroidism = excess T4, low TSH

			Cushing's = high cortisol =

			* High ACTH with ACTH-dependent (pituitary)
			* Low ACTH with independent (adrenal cancer, etc.)
			* Higher part of the body is high ACTH and dependent (pituitary); lower part of the body is low ACTH and independent (adrenal)

			Cardiac Markers

			* Myoglobin = earliest marker (but declines quickly)
			* CK elevated in cardiac and skeletal disorders
			** CK-MB/CK2 most specific isoenzyme for cardiac issues (but also skeletal)
			* Cardiac troponin 1 is very cardiac-specific!
			** High sensitivity cTnI used for investigating heart attacks
			** Detectable quickly (3-12 hours), and remain elevated >1 week
			* NT-proBNP elevated in heart failure
			* CRP acute marker of inflammation, can help evaluate risk for CVD

Admin at 01:57, 27 February 2025

2025-02-27T01:57:34Z

← Older revision		Revision as of 21:57, 26 February 2025
Line 118:		Line 118:
	** Bilirubin		** Bilirubin
	** Vitamin B12		** Vitamin B12

			== Lab Test Reference Intervals ==
	{\| class="wikitable"		{\| class="wikitable"
	\|+		\|+
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	\|		\|
	\|		\|
	\|		\|Preferred over creatinine clearance
	\|-		\|-
	\|Urine flow rate		\|Urine flow rate
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	7 - 16 mmol/d (female)		7 - 16 mmol/d (female)
	\|		\|
	\|		\|Inaccuracies may arise from improper urine measurement or tubular secretion.
	\|-		\|-
	\|Creatinine Clearance		\|Creatinine Clearance

Admin at 01:54, 27 February 2025

2025-02-27T01:54:53Z

@@ Line 123: / Line 123: @@
 !Reference Interval
 !Clinical Relevance
 !Notes
 |-
 |Sodium
 |135 - 145 mmol/L
+|
+|
@@ Line 132: / Line 134: @@
 |Potassium
 |3.5 - 5.0 mmol/L
+|
+|
 |-
 |Chloride
+|
+|
@@ Line 142: / Line 176: @@
 |Glucose, fasting
 |4.1 - 5.6 mmol/L
+|
+|
 |-
 |Glucose, random
+|
+|
@@ Line 151: / Line 187: @@
 |-
 |Total Bilirubin
+|
+|
@@ Line 156: / Line 193: @@
 |-
 |Unconjugated Bilirubin
+|
+|
@@ Line 162: / Line 200: @@
 |Conjugated Bilirubin
+|
+|
+|
 |}

Admin at 08:39, 26 February 2025

2025-02-26T08:39:17Z

@@ Line 47: / Line 47: @@
+|
 |-
+|
+|
+|
+|
+|
 |-
 | rowspan="3" |Urea
@@ Line 100: / Line 118: @@
 ** Bilirubin
 ** Vitamin B12

Admin at 17:05, 5 February 2025

2025-02-05T17:05:45Z

@@ Line 12: / Line 12: @@
 !Collection Notes
 !Reference Interval
 |-
 | rowspan="2" |Glucose

Admin at 16:47, 30 January 2025

2025-01-30T16:47:00Z

@@ Line 12: / Line 12: @@
 !Collection Notes
 !Reference Interval
 |-
 | rowspan="2" |Creatinine
@@ Line 21: / Line 32: @@
 |Blood serum
 |Lithium heparin
+|
+|
@@ Line 55: / Line 72: @@
+|
 |Fresh samples <2h old
+|
 |}

Admin at 16:09, 30 January 2025

2025-01-30T16:09:43Z

← Older revision		Revision as of 12:09, 30 January 2025
Line 2:		Line 2:

	* For serum, need to wait for specimen to clot first (20-30 min)		* For serum, need to wait for specimen to clot first (20-30 min)
			Store samples at 4C when not being run

			For longer-term storage, store at minimum -20C
	{\| class="wikitable"		{\| class="wikitable"
	\|+		\|+

Admin at 15:57, 30 January 2025

2025-01-30T15:57:26Z

@@ Line 1: / Line 1: @@
 {| class="wikitable"
 |+
@@ Line 51: / Line 55: @@
+|
 |}