Normal Lab Values of Medical Investigations: C

Showing posts with label C. Show all posts

Thursday, February 28, 2013

CALCIUM - serum

CALCIUM - serum

Application:

Diagnosis/investigation of patients with clinical features of hypercalcemia or other features of hyperparathyroidism; malignancy esp lung, multiple myeloma, kidney, bony metastases; sarcoidosis: vitamin D or vitamin A toxicity.

Diagnosis/investigation of patients with clinical features of hypocalcemia or other features of hypoparathyroidism, renal failure, osteomalacia or rickets.

Evaluation of patients after thyroid or parathyroid surgery, or during massive blood transfusion.

Explanation: Calcium in the blood exists in ionized (free) and protein bound forms (bound to albumin). It can be measured as total calcium, ionized calcium, or corrected calcium (in which total calcium is corrected, usually in relation to the patient’s albumin level).
   Serum calcium should be measured with serum albumin.

Corrected calcium depends on correction algorithm, typically:

corrected calcium (mg/dL) =
total calcium (mg/dL) +
0.02 (40 - albumin [g/L]).

Ionized calcium is generally required only if protein-bound calcium is likely to be very high (eg during massive transfusion), if pH is abnormal, or if an abnormality in calcium is marginal.

Specimen: 7 ml blood in a red-top tube

Reference Interval:
Total calcium:
            9-10.5 mg/dL    (Adult)
            8.8-10.8 mg/dL (Child)
            9-10.6 mg/dL    (10 days-2 yrs.)
            7.6-10.4 mg/dL (Neonate)

Ionized calcium:
            4.5-5.6 mg/dL   (Adult)
            4.8-5.52 mg/dL (2 mos.-18 yrs.)
            4.2-5.58 mg/dL (Neonate)

CREATININE CLEARANCE

CREATININE CLEARANCE

Application: Assessment of glomerular filtration rate, and hence glomerular function.

Explanation: Creatinine is is entirely excreted by the kidneys and so is directly proportional to glomerular filtration rate (GFR), or ml of filtrate made by the kidneys per minute. Creatinine clearance is more sensitive than serum creatinine for the detection of early glomerular dysfunction, but significant decreases in creatinine clearance may not occur until up to 30% of glomeruli cease to function. Complete and accurately timed urine collections are essential.

Creatinine clearance (ml/min) =

urine creatinine (mg/dL) x urine volume (ml/min)
                 serum creatinine (mg/dL)

Specimen: 24 hour urine collection for creatinine measurements. The patient should not eat meat at the meal immediately prior to, or during, the procedure.

Reference Interval:
107-139 ml/min (Male)
87-107 ml/min   (Female)
values decrease 6.5 ml/min per decade of life due to decreased GFR

40-65 ml/min     (Neonate)

CREATININE

CREATININE - serum

Application: Detection of decreased glomerular filtration.

Explanation: Creatinine is a catabolic product of creatine phosphate, which is used in skeletal muscle contraction. Creatinine is excreted entirely by the kidneys, and so is a direct measure of renal excretory function.

   Increased creatinine levels occur in conditions which decrease the glomerular filtration rate. These may be pre-renal (hypovolemia, hypotension), renal or post-renal (obstruction). Levels are lower in patients with a reduced muscle mass, this may conceal impairment of renal function. Levels may be increased by up to 50% in normal individuals after a large meat meal.

Specimen: 5 ml blood in red- or green-top tube.

Reference Interval: Dependent on age.
            0.5-1.1 mg/dL   (Adult Female)
            0.6-1.2 mg/dL   (Adult Male)
            0.5-1.1 mg/dL   (Adolescent)
            0.3-0.7 mg/dL   (Child)
            0.2-0.4 mg/dL   (Infant)
            0.3-1.2 mg/dL   (Neonate)

Tuesday, February 26, 2013

CHLORIDE

CHLORIDE - serum

Application: To assess the possible cause of acid-base disturbances; calculation of anion gap.

Explanation: Chloride is the major extracellular anion. Chloride levels will follow sodium losses sodium excesses to maintain electrical neutrality. Low serum chloride values are observed in prolonged vomiting with loss of HCl, in metabolic alkalotic states, respiratory acidosis,etc. Hypernatremia, metabolic acidosis and respiratory alkalosis are associated with high serum chloride. An increased anion gap indicates accumulation of an anion other than chloride (eg lactate, hydroxybutyrate); this usually occurs with metabolic acidosis.

Specimen: 5 ml blood in red- or green-top tube.

Reference Interval:
95-106 mEq/L.

Thursday, January 31, 2008

Cytomegalovirus Isolation (CMV)

Negative

Cytomegalovirus IgM Antibody (CMV)

Negative

Cytomegalovirus IgG Antibody (CMV)

Negative

Cytomegalovirus (quantitative PCR)

Negative (< 50 copies of virion)

Cyclosporin A (Parent & Total)

Whole blood levels - Parent (ug/L)

Kidney
< 6 mths 250-375
> 6 mths 100-200

Liver
< 1 mths 00-450
2-6 mths 250-350
> 6 mths 150-250

B.M 150-250

Cardiac
< 6 wks 300-420
6-12 wks 180-300
12 wks 120–180

Whole blood levels - Total (ug/L):

Kidney
< 6 mths 400-800
> 6 mths 200-400

Liver
< 1 mths 775-1300
> 6 mths 300-500

B.M 200-450

Cardiac
< 6 wks 857-1125
6-12 wks 600-800
>12 wks 400-600