Contains fibrinogen, clotting factors

Lacks fibrinogen, clotting factors used up

70-105mg/dl

100-125 mg/dl

150-180 mg/dl

glucosria, ketones, dehydration, Kussmauls

2.2% -4.8%

<6%

6-8%

monitor glucose levels over a a 4-8 week period

glycated serum proteins

monitor; rapid treatment adjustments, diabetic pregnancy

shortened RBC lifespan, <120 days, hemolytic anemia, hemoglobinopathies

monitor 2-3 week glucose, rapid assessment diet changes

high levels of Vitamin C, hyperthyroidism

detects early signs of kidney malfunction

DM, Cushings, Steroid use Stress, :Pheochromocytoma

Insulin overdose, Addisons, sepsis

measures total dissolved solutes in blood or urine

abnormally high urea nitrogen (BUN)

Increased BUN and Creatinine in kidney insufficiency

Renal disease, Urinary obstruction, dehydration,shock,infection,DM

.6 - 1.2 mg/dl

10-20mg/dl

low GFR, poor perfusion of kidney, dehydration,shock,CHF, fever,stress, severe burns

diminished GFR, associated with acute or chronic glomerulonephritis, polycystic kidney

result of obstruction, stones, enlarged prostate

Directly proportional to renal function and more reliable as single index of renal function

creatinine

107-139 ml/min

24 hour urine collection

best overall indicator of kidney function, normal >60

less than 10mg/dl

product of purine catabolism

overproduction versus under excretion insoluble precipitates in joints

Gout, turnover of malignant cells, renal stones

normal 6.4-8.3 g/dl

increased loss, decreased formation or intake

hemoconcentration, malignant tumor, multiple myeloma

nephrotic syndrome, severe liver disease, malabsortion severe burns, diarrhea

Normal values 3.5 - 5.0 g/dl

monoclonal gammopathy

malignant proliferation of plasma cells

increased ESR,RBC rouleaux, bence jones protein, M spike in SPEP

Troponin, creatine kinase -MB,Myoglobin

Troponins

homocysteine, c reactive protein, natriuretic peptide (BMP)

Heart MB, skeletal MM, brain BB

rise 4-8hrs, peaks 12-24 normal 72-96 hours

release 1-3 hours elevated for only 12 hours

release 3-4 hours elevated up to 14 days

Troponin I is more specific than Troponin T

more specific for cardiac. elevate sooner, remain longer

breakdown product of hemoglobin

known as indirect, albumin bound, insoluble ppt out in tissue

known as direct, excreted in bile converted tpo fecobilinogen and urobilinogen

sum of indirect (75%-85%) and direct

associated with hemolysis, increased indirect bilirubin

liver disease, inability to conjugate bilrubon

Biliary obstruction, increased indirect, direct and total bilirubin

AST and ALT are examples

examples include acetaminnophen toxicity, wilsons disaease hepatitis celiac disease

usual marker for hepatocellular injury, usually higher than AST in liver disease except alcoholic hepatitis AST/ALT ratio greater 2

suggests cardiac or skeletal muscle disease

acute heptitis, viral hepatitis and mono

MAjor source Bone and liver

liver disease, biliary obstruction cholestasis, paget's, multiple myeloma, bone breakage

5 isoenzymes

seen in MI,Hepatic disease, cancer, acute leukemia, skeletal muscle neecrosis

helps detect etoh induced liver disease with AST/ALT 2:1

amylase/lipase

source saliva and pancreatic juice, breaks starch to simple sugar

indicate Acute pancreatitis and Mumps (parotiditis)

pancreas, normal in mumps

glycoprotein specific for prostate epitehlium increased in prostate cancer

NA, K, CL, CO2

Ca,phosphate, magnesium

135-145 mmol/l

major extracellular cation

excess dietary,aldosteronism, cushings, DI

addisons, diarrhea, vomiting, diuretics

3.5-5.0 mmol/l

DKA, renal failure, hemolysis

decreased dietary, GI disorders

98-106 mmol/l

dehydration, Cushing metabolic acidosis

sever vomiting, diarrhea, DKA diuretics, burns

23-30 mmol/l

increased with alkalosis decreases with acidosis, regulated by kidney

difference between cations and anions

may indicate DKA, ethylene glycol lactic acidosis salicylate overdose

regulated by PTH 50% ionized (active) 50% albumin bound inactive

cancer, hyperparathyroid, excess vuit D

renal diseasem, hypo parathyroidism, Rickets

inverse relationship with Calcium, controled by PTH

caused by kidney dysfunction or uremia

protein nucleic acid, rare deficincy in nromal doet clotting muslce contraction

less than 200 mg.dl

greater than 55mg/dl

less than 130 mg/dl

40-160 mg/dl

t cholesterol-HDL-Trig

types of increased lipids

Thyroxine

Triiodothronine

normal .5-4 mu/l, best test for thyroid function