Chemistry Reference ranges

Question 1

Sodium

Answer 1

133 - 146 mmol/L
Crit <125 >155

I: aldosteronism, cushing (hyperaddrenalism), diabetes insipidus

D: electrolyte exclusion effect, hyperglycemic state, liver, kidney, heart disease, addison’s, diuretics, syndrome of inappropriate antidiuretic hormone

Question 2

Potassium

Answer 2

3.5 - 5.0 mmol/L
Crit <2.6 >6.2

I: pseudohyperkalemia, acidosis, IVH, rhabdomylosis, burns, addison’s disease, hypoaldsteronism

D: Insulin therapy, renal tubular acidosis, tubular necrosis, decreased intake and excessive loss

Question 3

Chloride

Answer 3

96 - 109 mmol/L

I: aldosteronism, cushing (hyperaddrenalism), diabetes insipidus, respiratory alkalosis

D: electrolyte exclusion effect, hyperglycemic state, liver, kidney, heart disease, addison’s, diuretics, syndrome of inappropriate antidiuretic hormone

Question 4

Bicarbonate (total CO2)

Answer 4

23 - 31 mmol/L

I: metabolic alkalosis

D: metabolic acidosis

Question 5

Calcium

Answer 5

2.10 - 2.60 mmol/L
Crit <1.65 >3.25

I: hyperparathyroidism, malignancy, tumour in bone, hyper/hypothyroidism, acromegaly, renal failure

D: pseudohypocalcemia (hypoalbuminemia), liver, renal, heart disease, chronic renal failure, hypothyroidism

Question 6

Magnesium

Answer 6

0.70 - 1.00 mmol/L
Crit <0.40 >1.90

I: renal failure, administration of antacids, enemas, fluids containing magnesium

D: loss in intestinal origin (diarrhea, bowel surgery, vomiting), loss in renal origin (diabetes mellitus, diuretics, antibiotics, alcoholism)

Question 7

Phosphorus (Phosphate)

Answer 7

0.80 - 1.45 mmol/L
Crit <0.40

I: hypoparathyroidism, pseudohypoparathyroidism, acromegaly

I: respiratory alkalosis, glycose administration, insulin, hyperparathyroidism, fanconi syndrome, inherited rickets, osteomalacia

Question 8

Anion Gap

Answer 8

4 - 16 mmol/L

I: diabetic ketoacidosis, lactic acidosis, renal failure, renal tubular acidosis, diarrhea, decreased absorption of bicarbonate, intoxication of organic compounds (ethanol, methanol, ethylene glycol), starvation, respiratory or metabolic alkalosis

D: hypoalbuminemia, hypercalcemia, hypermagnesemia, hypergammaglobulinemia, error in lab measurement

Question 9

Osmolality (Serum)

Answer 9

280 - 300 mmol/kg

Question 10

Osmolal Gap

Answer 10

<10 mmol/L

I: exogenous substances like ethanol, methanol, isopropanol, ethylene glycol, ketone, and mannitol

D: lab error

Question 11

Iron

Answer 11

8 - 35 umol/L

Question 12

TIBC

Answer 12

40 - 75 umol/L

Question 13

Saturation Index

Answer 13

F: 0.12 - 0.60
M: 0.10 - 0.55

Question 14

Ferritin

Answer 14

F: 20-300 ug/L
M: 30-500 ug/L

Question 15

Transferrin

Answer 15

1.8-3.5 g/L

Question 16

Total Bilirubin

Answer 16

< 20 umol/L

Question 17

Conjugated Direct Bilirubin

Answer 17

< 7umol/L

Question 18

Fasting glucose serum/plasma

Answer 18

3.3 - 6.0 mmol/L
Crit < 2.6 > 24.9

Question 19

Random glucose serum/plasma

Answer 19

3.3 - 11.1 mmol/L
Crit < 2.6 > 24.9

Question 20

OGTT fasting glucose serum/plasma

Answer 20

3.3 - 6.0 mmol/L

Question 21

OGTT 2 hours glucose serum/plasma

Answer 21

< = 7.8 mmol/L

Question 22

CSF glucose

Answer 22

2.2 - 4.4 mmol/L

Question 23

HbA1C

Answer 23

4.3 - 6.1%

Question 24

Serum total protein

Answer 24

64 - 84 g/L

Question 25

Serum albumin

Answer 25

30 - 45 g/L

Question 26

24 hour Urine Total Protein

Answer 26

< 0.5g/volume

Question 27

CSF Total Protein

Answer 27

0.15 - 0.45 g/L

Question 28

Alkaline Phosphatase (ALP)

Answer 28

30 - 130 U/L

Osteoblasts, hepatocytes

Question 29

Lactase Dehydrogenase (LD)

Answer 29

100 - 225 U/L

nonspecific: anemia, liver disease, viral hepatitis, cirrhosis,

Question 30

Alanine Aminotransferase (ALT)

Answer 30

Female: < 40 U/L
Male: < 60 U/L

Hepatic diseases, acetaminophen toxicity

Question 31

Y-Glutamyl Transferase (GGT)

Answer 31

< 80 U/L

hepatobiliary disease, biliary obstruction, alcoholic hepatis

If both GGT and ALP is increased = hepatobiliary

If only ALP increased = bone disorder

Question 32

Creatine Kinase (CK)

Answer 32

Female < 200 U/L
Male < 250 U/L

skeletal muscle disease, heart disease

Question 33

Amylase

Answer 33

30 - 150 U/L

salivary gland inflammation, acute pancreatitis, ectopic pregnancy

Question 34

Lipase

Answer 34

0 - 60 U/L

acute pancreatitis

Question 35

pH

Answer 35

7.35 - 7.45

Question 36

pCO2

Answer 36

35 - 45 mm Hg

I: Respiratory Acidosis

D: Respiratory Alkalosis

Question 37

pO2

Answer 37

70 - 90 mm Hg

Question 38

HCO3-

Answer 38

20 - 27 mmol/L

I: Metabolic Alkalosis

D: Metabolic Acidosis

Question 39

Ammonia

Answer 39

< 35 umol/L
Crit: >199 umol/L

Increased in: liver disease, renal disease, Reye’s syndrome

Question 40

Urea

Answer 40

2.5 - 8.0 mmol/L

Increased in: increased dietary intake, tissue breakdown, GI bleeds

Decreased in: Liver disease, low protein intake

Question 41

Uric Acid

Answer 41

F: 150 - 400 umol/L
M: 200 - 500 umol/L

Increased in: chronic renal failure, hypertension, metabolic syndrome, chemotherapy of leukemia,

Decreased in: allopurinol drug, decreased liver enzymes, fanconi syndrome

Question 42

Creatinine

Answer 42

F: 40 - 100 umol/L
M: 50 - 120 umol/L

Increased in: kidney disease

Decreased in: muscular dystrophy

Question 43

eGFR

Answer 43

< 60 mL/min/1.73m2

Question 44

Creatinine Clearance

Answer 44

1.30 - 2.30 mL/min/1.73m2

D: renal disease, heart disease

Question 45

ACR

Answer 45

< 3mg/mmol

I: chronic kidney disease