Lab Tests & Values Flashcards
CBC with diff test includes:
Hgb
Hct
RBC
WBC (neutophils, bands, lymphocytes, monocytes, eosinophils, basiphils, platelets, reticulocyte, MCV, MCHC)
CBC with diff values (Hgb, Hct, RBC, WBC, plt)
Hgb Newborn: 14-24 Infant/Toddler: 11-15 School-aged: 11-15 Teens: M 12-16, F 11.5-16
Hct Newborn: 42-60 Infant/Toddler: 33-55 School-aged: 34-42 Teens: M 37-50, F 36-44
RBC Newborn: 4.1-7.5 Infant/Toddler: 4.1-5.1 School-aged: 3.9-5.3 Teens: M 4.5-5.3, F 4.1-5.1
WBC Newborn: 9-30 Infant/Toddler: 6-17 School-aged: 5-15.5 Teens: 4.5-13.5
PLTS
Newborn: 84-478
Everyone else: 150-400
Increased Hgb indications
High Hgb: Dry BP
Dehydration
Burns
Polycythemia
Decreased Hgb indications
Low Hgb: HARD BILL
Hodgkin’s, hemorrhage, hyperthyroidism
Anemia/Sickle cell
Renal
Disease
Bleeding
Iron low
Leukemia
Liver disease
Increased RBC indications
High RBC: DASH
Dehydration
Acute poisoning
Severe diarrhea
Hemorrhage
Decreased RBC indications
Low RBC: BIL3 ER
Bleeding Intake low Fe Lead poisoning, Lupus, Leukemia Endocarditis (subacute bacterial) Rheumatic fever
Increased WBC indications
Tx before pt SAILS high in Wbc
Sepsis Acute hemorrhage Infection bacteria (tonsillitis, sepsis, meningitis, appendicitis) Leukemia Steroids
Decreased WBC indications
Chronic low Wbc: NO CAALLL DR HIMS
Neutropenia Oncology patient (bone marrow depression) Cancer Anemia aplastic Autoimmune (RA) Lymphoma Lupus Leukemia
Drugs (anti-seizure meds, abx, antihistamines, diuretics, analgesics, TCA)
Infection Ricketts
Hemolysis
Infection bacteria, injury burn
Metabolic disorders (DKA)
Stress response
Increased neutrophil indications
Viral infections (hepatitis, mono)
Chemo/Radiation
Immune deficiencies
Malignancies
Decreased neutrophil (neutropenia) indications
Viral infections (hepatitis, mono)
Chemo or radiation
Immune deficiencies
Malignancies
Increased lymphocytes indications
Viral infection
Lymphocytic leukemia
Ulcerative colitis
Immune diseases
Decreased lymphocytes indications
Severe deliberating illness (CHF, renal failure, TB) Immunosuppressive therapy Hodgkin's disease Post burns/trauma Cushing syndrome Corticosteroid usage HIV infection
Increased monocyte indications
Recovery from acute infection Subacute bacterial endocarditis (SBE) Leukemia Hodgkin's disease Rickettsial infection SLE RA Hepatitis
Decreased monocyte indications
RA
HIV infection
Prednisone usage
Increased eosinophil indications
Allergic disorders (asthma, allergic rhinitis, eczema) Parasite infection
Decreased eosinophil indications
Stress responses d/t trauma, shock, burns, stress
Cushing syndrome
Increased basophil indications
Leukemia Hodgkin's disease Inflammatory conditions (UC) Polycythemia Chronic hemolytic anemia Infections (TB, varicella, influenza)
Decreased basophil indications
Hyperthyroidism Pregnancy Stress Prolonged steroid use Allergic reaction
Increased platelet indications
Acute infection Malignancy Postsplenectomy Trauma RA Kawasaki disease
Decreased platelet (thrombocytopenia) indications
Leukemia
Idiopathic thrombocytopenia purpura (ITP)
Autoimmune disorders
Drugs (penicillins, ampicillin, cephalothin)
Hemolytic uremic syndrme
Disseminated intravascular coagulation (DIC)
Viral infection
HIV infection
Increased reticulocyte indications
Hemorrhage/blood loss
Increased RBC destruction
Response to initiation of Fe therapy
Decreased reticulocyte indications
Fe-deficiency anemia
Chronic infection
Radiation
Aplastic anemia
Increased mean cell volume variations
Macrocytic anemia d/t folic acid or vitamin B12 deficiency
Decreased MCV variations
Microcytic anemia d/t Fe deficiency or thalassemia
Anemia of chronic disease
Lead poisoning
Chemistry panel includes
Na, K, BUN, creatinine, bilirubin, cholesterol, lead
Na values
Newborn/child: 135-145 mEq/L
Increased Na indications
Dehydration
Vomiting or diarrhea
Diabetes insipidus
Cushing syndrome
Decreased Na indications
Vomiting or diarrhea Burns DKA Addison's disease Acute/chronic renal failure Syndrome of inappropriate antidiuretic hormone (SIADH)
K values
Newborn/child: 3.5-3.0 mEq/L
Increased K indications
Acidosis
Renal failure
Decreased K indications
Diarrhea or vomiting
Dehydration
Malabsorption
Use of diuretics or anti-inflammatory drugs
BUN values
5-20 mg/dL
Increased BUN indications
High-protein diet Renal or urinary obstruction or disease GI hemorrhage Malignancies Dehydration Shock
Decreased BUN indications
Hemodilution
Pregnancy
Nephrotic syndrome
Liver failure
Creatinine values (more sensitive indicator of renal function)
0.3-1 mg/dL
Increased creatinine indications
Renal dysfunction
Urinary tract obstruction
Dehydration
Muscle disease
Bilirubin levels
Birth: 1.5 mg/dL
3-4 days postnatal
Breastfed: 7.3
Formula fed: 5.7
Older infant/child
Total < 1.5
Direct (conjugated): 0.2-0.4 (find pathology if high)
Indirect (unconjugated): 0.4-0.8 (>20 mg/dL neurotoxic!)
Cholesterol values (mg/100 mL)
Full-term newborn: 45-167
Infant: 70-190
Child/teen: <170
Lead value
< 10 ug/dL
pH values
Newborn: 5-7
Child: 4.8-7.8
Increased pH indications
Alkaline
UTI
Salicylate intoxication
Decreased pH indications
Acidic
Acidosis
Renal failure
Diarrhea
Dehydration
Specific gravity values
Newborn: 1.001-1.020
Child: 1.001-1.030
Increased specific gravity indications
Dehydration
Nephrosis
Glomerulonephritis
Decreased specific gravity indications
Diabetes insipidus
Glucose should be negative in UA
Presence of sugar –> diabetes mellitus, metabolic disorder, liver disease, renal tubular disorders
Protein should be negative in UA
Presence of protein –> renal disease, exercise, SLE, orthostatic proteinuria, asymptomatic proteinuria
Ketones should be negative in UA
Presence of ketones –> fever, dehydration, anorexia, diarrhea, fasting, prolonged vomiting or anorexia
Nitrites should be negative in UA
Presence of nitrites –> UTI (strong predictor)
WBC range in UA & increase indications
0-4 WBCs/HPF
Increased WBC: UTI, fever, pyelonephritis, TB, nephrosis
RBC range in UA & increased indications
1-2 RBCs/HPF
Increased RBC: UTI, pyelonephritis, SLE, renal stones, trauma, TB, hemophilia, polyarteritis nodosa, malignant HTN
Bacteria should be negative in UA
confirmed UTI –> 100,000 colonies/mL or more of single pathogen on urine culture by clean-catch
repeat urine culture must be obtained if result of 10,000-100,000 colonies/mL for febrile kids 2-24 mo (both pyuria & < 50,000 colonies/mL)
CSF pressure
70-180 mm H2O
Increased CSF pressure –> increased ICP r/t tumor, cerebral hemorrhage, meningitis, obstructed shunt
CSF appearance
Clear
Bloody: traumatic tap, cerebral hemorrhage
Yellow: hyperbilirubinemia, metastatic melanoma
Cloudy: increased WBCs (bacterial meningitis)
Glucose in CSF
60-80 mg/dL
Increased: diabetes
Decreased: bacterial meningitis, TB, hypoglycemia, leukemia with mets
Protein in CSF
15-45 mg/dL
Increased: encephalitis, bacterial meningitis, TB, acoustic neuroma
CSF cell count in infants and kids/teens
Infant: 0-20 WBCs/mm3
Kid/teen: 0-10 WBCs/mm3
Increased: bacterial meningitis, early viral meningitis, cerebral abscess
