ICU Labs Flashcards
Liver Labs
Bilirubin
ALT
AST
Alkaline Phosphatase
Albumin
Total Protein
PT
Bilirubin normal lab
< 1mg/dL
Bilirubin level if jaundice occurs
> 2.5
What is bilirubin?
byproduct of RBC breakdown
PT normal
11-12.5 seconds
PT measures
clotting ability
Hematologic Labs
PT/INR
CBC
Cirrhosis can cause
deficiency in clotting factors
Cirrhosis does what to PT
PROLONGS
PT critical level
> 46
- means NO CLOTTING and will bleed out if hit or fall
INR normal level
0.8-1.1
If on an anticoagulant, what is the normal INR level for them?
2-3
INR is used to
measure the accuracy of PT
INR critical level
> 5
AST normal
0-35
AST sensitive to
heart and liver
AST shows what
when the liver is diseased/damaged and to what extent
AST is released into the bloodstream within
6-10 hours
AST lasts how long in the bloodstream
4 days
ALT sensitive to
liver, kidneys, heart, pancreas, and muscles
ALT normal
4-36
ALT measures
the liver is damaged/diseased
AST/ALT over 10000 weans
acetaminophen OD
Glucose normal
74-106 (70-110 in other places)
if glucose is low, this is caused by
liver impairment of glycogen release
If the liver is in failure then what happens to glucose
no glucose is released but the pancreas still secretes insulin
resulting in dangerously low glucose levels
WBC normals
5000-10000
WBC >10,000 means what r/t liver
Acute liver injury
- infection
- trauma
- stress
- inflammation
WBC <5,000 means what r/t liver
splenomegaly
(CHRONIC FAILURE / CIRRHOSIS)
- spleen retains WBCs and platelets
- pt susceptible to infection/bleeding
splenomegaly with low WBCs leads mainly to what 2 infections
meningitis
pneumonia
WBC critical levels
< 2000
> 40000
CMP Labs affected by liver
Na, K, Mg (ALL LOW)
electrolyte imbalances occur in liver due to
hepatorenal syndrome
use of diuretics
Hypokalemia
<3.5
K is passed through
kidneys
Mg follows
K (HYPOMAGNESMIA)
low Mg occurs in
kidney impairment
low Na results from what
unable to release free water
sodium in the body becomes diluted
- low serum sodium
Platelet normal
150-400
Platelet critical
<50 or >1 million
serious bleeding risk if platelets are
< 20
what is often present with low platelets
petechiae
ecchymosis
The spleen stores
platelets and WBCs
sequestration occurs with hypersplenism
-liver failure and cirrhosis
Ammonia normal
10-80
Ammonia does what
byproduct of protein metabolism in the gut
Ammonia > 80 build-up results in
hepatic encephalopathy
Lactic Acid normal
0.6-2.2
How is lactic acid formed?
normally glucose is metabolized into CO2 and H2O for energy
- when there is limited O2 = anaerobic metabolism of glucose occurs and lactate is formed
When the liver fails, what happens to lactase?
the liver fails to excrete lactate and furthers compound build-up = lactic acidosis = tissue hypoxia
Creatinine normal
0.5-1.21
Creatinine > 4 =
severe renal impairment
Alkaline Phosphatase normal
30-120
Alkaline Phosphatase increases in
cirrhosis (greatly)
less in
- hepatic tumors
- hepatotoxic drugs
- hepatitis
Alkaline Phosphatase is sensitive to
metastatic cancer in the liver
Hemoglobin normal
12-16
Hemoglobin reflects
number of RBCs in the blood
transports O2 and CO2
Hemoglobin/Hemtocrit is low in
anemia
bleeding
When do you transfuse blood
< 7 Hgb - critical
Hct normal
males
females
males 0.42-0.52
females 0.37-0.47
Hct is what
percentage of total blood vol made up of RBCs
Hct critical
< 21%
