lewis lab values

Question 1

1. What is the normal qualitative analysis of acetone?

2. What conditions elevate acetone?

Answer 1

• Negative

- it is higher in Diabetic ketoacidosis, high-fat diet, low-carbohydrate diet, starvation

Question 2

1. what is the normal range of Alanine aminotransferase (ALT)
2. What conditions elevate this level?

Answer 2

• 4-36 U/L (same as SI units)

- lover disease, shock

Question 3

1. what is the normal range of albumin?
   - What elevates this level?
   - what lowers this level?

Answer 3

• 35-50 g/L (3.5-5 g/dL)
• dehydration elevates
• lowered by: Burns, chronic liver disease, malabsorption, malnutrition, nephrotic syndrome, pregnancy

Question 4

• what is the normal value of Ammonia?

- what elevates this?

Answer 4

• 6-47 mcmol/L (10-80 mcg/dL)

- elevated by: GI bleeds, hepatic encephalopathy, portal hypertension, severe liver disease

Question 5

-what is the normal range for Amalase

Answer 5

• 30-220 U/L (60-120 Somogyi units/dL)
• elevated: acute/chronic pancreatitis, mumps, perforated ulcers
• lower: acute alcoholism, cirrhosis, pancreatic destruction

Question 6

Ascorbic Acid

Answer 6

-23-85 mcmol/L (0.4-1.5 mg/dL)
-elevated: excessive ingestion of vit C
-lower: Connective tissue disorders, hepatic disease, renal disease, rheumatic
fever, vitamin C deficiency

Question 7

Aspartate aminotransferase (AST)

Answer 7

-0-35 U/L(same as SI units)
-elevated: Acute hepatitis, liver disease, myocardial infarction (MI),
pulmonary infarction

Question 8

Bicarbonate

Answer 8

-21-28 mmol/L (21-28 mEq/L
-elevated: Chronic use of loop diuretics, compensated respiratory acidosis,
metabolic alkalosis
-lower: Acute renal failure, compensated respiratory alkalosis, diarrhea, metabolic acidosis

Question 9

Bilirubin

Answer 9

-Total: 5.1-17 mcmol/L (0.3-1.0 mg/dL) Indirect: 3.4-12 mcmol/L (0.2-0.8 mg/dL) Direct: 1.7-5.1 mcmol/L (0.1-0.3 mg/dL)
-Elevated: Biliary obstruction, hemolytic anemia, impaired liver function,
pernicious anemia, prolonged
fasting

Question 10

Arterial pH

Answer 10

7. 35-7.45 (same as SI units)
   - elevated: alkalosis
   - lower: acidosis

Question 11

PaCO2

Answer 11

• 35-45 mm Hg
• elevated: Compensated metabolic alkalosis, respiratory acidosis -lower: Compensated metabolic acidosis, respiratory alkalosis

Question 12

calcium

Answer 12

-2.25-2.75 mmol/L (9-10.5 mg/dL)
-elevated: Acute osteoporosis, hyperparathyroidism, multiple
myeloma, vitamin D intoxication
-lower: Acute pancreatitis, hypoparathyroidism, liver disease, malabsorption syndrome, renal failure, vitamin D deficiency

Question 13

Chloride

Answer 13

-98-106 mmol/L (98-106 mEq/L)
-elevated: Corticosteroid therapy, dehydration, excessive infusion of normal saline,
metabolic acidosis, respiratory alkalosis, uremia
-lower: Addison’s disease, congestive heart failure, diarrhea, metabolic alkalosis, overhydration, respiratory acidosis, SIADH (syndrome of inappropriate antidiuretic syndrome), vomiting

Question 14

Cholesterol: HDL

Answer 14

• > 1.55 mmol/L (>40 mg/dL)
• elevated: Biliary obstruction, cirrhosis hypothyroidism, hyperlipidemia, idiopathic hypercholesterolemia, renal disease, uncontrolled diabetes
• lower: Corticosteroid therapy, extensive liver disease, hyperthyroidism, malnutrition

Question 15

cholesterol: LDL

Answer 15

<2.59 mmol/L (<100 mg/dL)

• elevated: Biliary obstruction, cirrhosis hypothyroidism, hyperlipidemia, idiopathic hypercholesterolemia, renal disease, uncontrolled diabetes
• lower: Corticosteroid therapy, extensive liver disease, hyperthyroidism, malnutrition

Question 16

Cholesterol total

Answer 16

<5 mmol/L (<200 mg/dL) age dependent

• elevated: Biliary obstruction, cirrhosis hypothyroidism, hyperlipidemia, idiopathic hypercholesterolemia, renal disease, uncontrolled diabetes
• lower: Corticosteroid therapy, extensive liver disease, hyperthyroidism, malnutrition

Question 17

Cholinesterase (RBC)

Answer 17

5-10 U/L (same as SI units)
-elevated: Exercise, sickle cell disease
-lower: Acute infections, insecticide intoxication, liver disease, muscular
dystrophy

Question 18

Cortisol

Answer 18

• 8 A.M.: 138-635 nmol/L (5-23 mcg/dL)
• 8 P.M.: < 83-359 nmol/L (3-13 mcg/dL)
• elevated: adrenal adenoma, Cushing’s syndrome, hyperthyroidism, stress, pancreatitis
• lower: Addison’s disease, adrenal insufficiency, hypopituitary states, hypothyroidism, liver disease

Question 19

creatine

Answer 19

-15.3-76.3 mcmol/L (0.2-1.0 mg/dL)
-elevated: active rheumatoid arthritis, biliary obstruction, hyperthyroidism, renal
disorders, severe muscle disease
-lower: diabetes mellitus

Question 20

Creatine kinase (CK)

Answer 20

Male: 55-170 U/L (same as SI units)
Female: 30-135 U/L (same as SI units)
-elevated: Brain damage, exercise, musculoskeletal injury or disease,
MI, numerous intramuscular
injections, severe myocarditis

Question 21

CK-MB (CK-2)

Answer 21

• Male: 2-6 mcg/L (2-6 ng/mL)
• Female: 2-5 mcg/L (2-5 ng/mL)
• elevated: acute MI

Question 22

creatinine

Answer 22

-Male: 53-106 mcmol/L (0.6-1.2 mg/dL)
-Female: 44-97 mcmol/L (0.5-1.1 mg/dL)
-elevated in renal disease
-lower: Diseases with decreased muscle mass (e.g. muscular dystrophy, myasthenia
gravis)

Question 23

Ferritin (serum)

Answer 23

Male: 12-300 ng/L (12-300 ng/mL)
Female: 10-150 ng/L (10-150 ng/mL)
-elevated: Anemia of chronic disease (infection, inflammation, liverdisease), sideroblastic anemia
-lower: Iron-deficiency anemia, severe protein deficiency

Question 24

Folic acid (folate)

Answer 24

-11-57 mmol/L (5-25 ng/mL)
-elevated: Hypothyroidism, pernicious anemia
-lower: Alcoholism, hemolytic anemia, inadequate diet, malabsorption
syndrome, malnutrition, megaloblastic anemia

Question 25

Glucose, fasting

Answer 25

-4-6 mmol/L (70-110 mg/dL)
-elevated: Acute stress, cerebral lesions, Cushing’s syndrome, diabetes
mellitus, hyperthyroidism, pancreatic insufficiency
-lower: Addison’s disease, hepatic disease, hypothyroidism, insulin overdosage, pancreatic tumour, pituitary hypofunction, postdumping syndrom

Question 26

2-Hr oral glucose tolerance testing (OGTT)

Answer 26

-fasting: 4-6 mmol/L (70-110 mg/dL)
1 hr: <11.1 mmol/L (<200 mg/dL)
2 hr: <7.8 mmol/L (<140 mg/dL

• elevated: diabetes millitus
• lower: Hyperinsulinism