Reference Ranges Flashcards
1
Q
calcium
A
8.5-10.5 mg/dl
2
Q
calculate corrected calcium if
A
albumin is low
3
Q
increased Ca due to
A
calcium supplementation, thiazide diuretics, vitamin D
4
Q
decreased Ca due to
A
long-term heparin, loop diuretics, bisphosphonates, cinacalcet
5
Q
chloride (Cl)
A
95-106 mEq/L
6
Q
magnesium (Mg)
A
1.3-2.1 mEq/L
7
Q
decrease Mg due to
A
PPIs, diuretics, amphotericin B
8
Q
phosphate (PO4)
A
2.3-4.7 mEq/L
9
Q
increased PO4 due to
A
CKD
10
Q
potassium (K)
A
3.5-5 mEq/L
11
Q
increased K due to
A
ACEi, ARB, aldosterone receptor antagonists (ARAs), aliskiren, canagliflozin, cyclosporine, tacrolimus, potassium supplements, SMX/TMP, drospirenone-containing oral contraceptives
12
Q
decreased K due to
A
beta-2 agonists, diuretics, insulin, sodium polystyrene sulfonate
13
Q
sodium (Na)
A
135-145 mEq/L
14
Q
decreased Na due to
A
hypertonic saline, tolvaptan
15
Q
decreased Na due to
A
carbamazepine, oxcarbazepine, SSRIs, diuretics
16
Q
bicarb (HCO3)
A
venous: 24-30 mEq/L
arterial: 22-26 mEq/L
17
Q
increased bicarb due to
A
loop diuretics, systemic steroids
18
Q
decreased bicarb due to
A
topiramate, zonisamide, salicylate overdose
19
Q
BUN
A
7-20 mg/dl
20
Q
increased BUN due to
A
renal impairment and dehydration
21
Q
SCr
A
0.6-1.3 mg/dl
22
Q
increased SCr due to
A
drugs that impair renal function: aminoglycosides, amphotericin B, cisplatin, colistimethate, cyclosporine, loop diuretics, polymixin, NSAIDs, radiocontrast dye, tacrolimus, vancomycin
23
Q
glucose
A
70-110 mg/dl
24
Q
anion gap (AG)
A
5-12 mEq/L
25
increased AG suggests
metabolic acidosis (increased acidity in the blood)
26
WBCs
4,000-11,000 cells/mm3
27
WBC count can increase due to
systemic steroids
28
WBC count can decrease due to
clozapine, chemotherapy that targets the blood marrow, carbamazepine, immunosuppressants (DMARDs, biologics)
29
neutrophils
45-73%
30
neutrophils are also called
PMNs, polys, segs
31
bands
3-5% (left shift when elevated)
32
what are bands?
immature neutrophils released from the bone marrow to fight infection
33
eosinophils
0-5%
34
basophils
0-1%
35
lymphocytes
20-40%
36
lymphocytes decrease due to
bone marrow suppression, HIV, or due to systemic steroids
37
RBCs in females
4.1-4.9 x10^6 cells/microliters
38
RBCs in males
4.5-5.5 x10^6 cells/microliters
39
average lifespan of RBCs
120 days
40
RBCs increase due to
erythropoiesis-stimulating agents (ESAs)
41
RBCs decrease due to
chemotherapy that targets the bone marrow, low production, blood loss, deficiency anemia (B12, folate), hemolytic anemia, sickle cell anemia
42
Hgb in males
13.5-18 g/dL
43
Hgh in females
12-16 g/dL
44
Hgb increase due to
ESAs
45
Hgb decrease due to
anemias and bleeding (drug-induced causes include anticoagulants, antiplatelets, fibrinolytics)
46
mean corpuscular volume (MCV)
80-100 fL
47
what does the MCV reflect
size and average volume of RBCs
48
increased MCV (macrocytic anemia)
due to B12 or folate deficiency
49
decreased MCV (microcytic anemia)
due to iron deficiency
50
folic acid (folate)
5-25 mcg/L
51
folic acid decrease due to
phenytoin/fosphenytoin, phenobarbital, primidone, methotrexate
52
who should take folate supplements
women of childbearing age and alcohol use disorder
53
reticulocyte count
0.5-2.5%
54
reticulocyte count decrease due to
untreated anemia, bone marrow suppression
55
Coombs Test, Direct (direct antiglobulin test)
negative
56
Coombs Test is used for the diagnosis of
immune-mediated hemolytic anemia
57
which drugs can cause immune-mediated hemolytic anemia
penicillins, cephalosporins, isoniazid, levodopa, methyldopa, quinidine, rifampin, sulfonamides
58
glucose-6-phosphate dehydrogenase (G6PD)
5-14 units/gram
59
when do we look at G6PD?
when determining if hemolytic anemia is due to G6PD deficiency
60
G6PD deficiency causes
RBC destruction with G6PD deficiency is triggered by stress, foods (fava beans), or drugs (dapsone, methylene blue, nitrofurantoin, pegloticase, primaquine, rasburicase, quinidine, quinine, sulfonamides
61
Anti-Xa
used to monitor low molecular weight heparins (LMWH) and unfractionated heparin (UFH)
62
when to obtain anti-Xa level in LMWH therapy
obtain peak anti-Xa level 4 hours after SC LMWH dose of 1.0-2.0 IU/mL
63
when to obtain anti-Xa level in unfractionated heparin therapy
obtain 6 hours after IV infusion starts and every 6 hours until therapeutic (0.3-0.7 IU/mL)
64
Prothrombin Time/International Normalized Ratio (PT/INR)
PT: 10-13 seconds (varies)
INR: <1.2 (if not on warfarin)
65
what is PT/INR used for
to monitor warfarin
66
why would INR increase
without taking warfarin, increased INR is typically due to liver disease
67
false increases in PT/INR can occur with
daptomycin, oritavancin, televancin
68
what is aPTT used for?
used to monitor unfractionated heparin (UFH)
69
false increase in aPTT can occur with
oritavancin, televancin
70
aPTT
22-38 seconds ("control")
71
when to obtain aPTT in UFH therapy
obtain 6 hours after IV infusion starts and every 6 hours until therapeutic
72
what is aPTT goal on UFH therapy
1.5-2.5x control
73
PLTs
150,000-450,000 cells/mm^3
74
what is the avg life span of PLTs?
7-10 days
75
PLTs are required for
clot formation, spontaneous bleeding can occur when PLTs are <20,000 cells/mm^3
76
when would PLTs decrease
heparin, LMWH, fondaparinux, linezolid, valproic acid
77
albumin
3.5-5 g/dL
78
albumin decrease due to
cirrhosis, malnutrition
79
impact of low albumin
serum levels of highly protein-bound drugs (warfarin, calcium, phenytoin)
80
which drugs require correction of low albumin
phenytoin and calcium (a "free" phenytoin or ionized calcium does not require adjustment)
81
AST/ALT
10-40 units/L
82
what is AST and ALT
enzymes released from injured hepatocytes (liver cells)
83
bilirubin
0.1-1.2 mg/dL
84
why do we look at bilirubin?
used along with other liver tests to determine causes of liver damage and detect bile duct blockage
85
ammonia
though not diagnostic, often measured in suspected hepatic encephalopathy (HE)
86
increased ammonia due to
valproic acid, topiramate
87
decreased ammonia due to
lactulose
88
amylase
60-180 units/L
89
lipase
5-160 units/L
90
when would amylase and lipase increase?
increased in pancreatitis which can be caused by didanosine, stavudine, GLP-1 agonists, DPP-4 inhibitors, VPA, hypertriglyceridemia
91
CK or CPK
males: 55-170 IU/L
females: 30-135 IU/L
92
what is CK used for
used to assess muscle inflammation (myositis) or more serious muscle damage, and to diagnose cardiac conditions
93
increased CK can be due to
daptomycin, statins, tenofovir, raltegravir, dolutegravir
94
BNP and NT-proBNP
markers of cardiac stress (higher values indicate a higher likelihood of HF); renal failure is the second most common cause of increased BNP and NT-proBNP
95
LDL
<100 mg/dl is desirable
96
total cholesterol
<200 mg/dL
97
non-HDL
<130 mg/dL is desirable
98
triglycerides
<150 mg/dL
99
TC, HDL, LDL, TG
lipid panel which is ordered to assess the major cholesterol types and determine CV risk
100
C-reactive protein (CRP)
0-0.5 mg/dl
101
increased CRP
indicates inflammation (infection, trauma, malignancy)
102
fasting plasma glucose (FPG) in diabetes
>126 mg/dL (diagnostic)
103
FPG diagnostic for pre-diabetes
100-125 mg/dL
104
hemoglobin A1c
<7% (ADA)
=< 6.5% (AACE)
105
what is A1c?
inc glucose -> inc BG attached to Hgb -> inc A1c
106
ADA goals
FBG: 80-130 mg/dL
PPG: <180 mg/dL
A1c: <7%
107
AACE goals
FBG: <110 mg/dL
PPG: <140 mg/dL
A1c: <6.5%
108
C-peptide
insulin breakdown product; absent or low in T1DM (dysfunctional beta cells)
109
T1DM
-autoimmune
-immune system attack and destroy insulin-producing beta cells in the pancreas
110
T2DM
-insulin resistance
-our body's cells do not respond effectively to insulin
111
urinary albumin excretion (UAE)
<30 mg/24 hours
112
normal albumin excretion
-healthy kidneys have intact glomeruli (filtering units) and tubules that prevent significant protein leakage
-normal albumin excretion in urine is minimal
113
abnormal albumin excretion
when glomeruli is damaged, they become "leaky" allowing albumin to enter the urine
114
TSH
0.3-3 mIU/L
115
increased TSH
hypothyroidism
116
decreased TSH
hyperthyroidism
117
which drugs effect TSH levels
amiodarone, interferons
118
which drugs can cause increased TSH (hypothyroidism)
tyrosine kinase inhibitors, lithium, carbamazepine
119
uric acid in males
3.5-7.2 mg/dl
120
uric acid in females
2-6.5 mg/dl
121
uric acid can increase due to
diuretics, niacin, low doses of aspirin, pyrazinamide, cyclosporine, select pancreatic enzyme products, select chemotherapy (due to TLS)
122
drug induced lupus erythrematous (DILF)
anti-TNF agents, hydralazine, isoniazid, methimazole, methyldopa, minocyclcine, procainamide, propylthiouracil, quinidine, terbinafine
123
CD4 T lymphocyte count
immunocompromised state: <200 cells/mm3
124
pH
7.35-7.45
125
prostate-specific antigen (PSA)
<4 ng/mL
126
lactic acid (lactate)
0.5-2.2 mEq/L
127
