CBC Increased Decreased

(Complete Blood Count)

RBC polycythemia or abnormal loss of erythrocytes

erythrocytosis usually caused bone marrow suppression
by oxygen need (e.g. lung
disease, congenital heart
defects)

Hgb polycythemia blood loss

hemolytic anemia
bone marrow suppression
sickle cell anemia

Hct - % of RBC to Plasma polycythemia blood loss,

dehydration overhydration
burns dietary deficiency
anemia
RBC indices:
Mean corpuscular volume liver disease iron deficiency anemia
(MCV) alcoholism lead poisoning
The average size of the pernicious anemia
individual RBC

Mean corpuscular rarely seen iron deficiency anemia

haemoglobin (MCH) amount
of Hgb present in one cell

Mean Corpuscular Hgb rarely seen iron deficiency anemia

concentration (MCHC)
proportion of each cell
occupied by Hgb
WBC leukocytosis leukopenia
infection autoimmune disease

Differential count:
Neutrophils stress viral diseases
acute infection some drugs (e.g chemotherapy,
antibiotics such as penicillin,
nafcillin and cephalosporins)
radiation therapy

Lyphocytes viral infection adrenal corticosteroids,

mononucleosis immunosuppressive drugs,
tuberculosis autoimmune diseases
chronic bacterial infections severe malnutrition
lymphocytic anemia

Monocytes chronic inflammatory drug therapy: prednisone

disorders
tuberculosis
protozoan infections

Eosinophils allergic reactions corticosteroid therapy

parasitic infections

Basophils leukemia acute allergic reaction

corticosteroids
acute infections

Platelet count malignant tumors viral infections, thrombocytic

polycythemia vera purpura, AIDS, SLE
chemotherapy drugs, some
types of anemias, Idiopathic
 Tests Significance Increased Decreased
Liver Function
Tests:

ALT (alanine marker of hepatic hepatitis; infectious not significant

amino injury; more mononucleosis; acute
transferase) specific of liver pancreatitis; acute
SGPT (serum damage than AST myocardial infarction;
pyruvic heart failure
transaminase)

found in the heart, liver diseases, acute chronic renal dialysis

AST (aspartate liver, and skeletal myocardial infarction, vitamin B6 deficiency
amino muscle. can be anemias, skeletal muscle
transferase) used to indicate diseases
SGOT (serum liver injury.
glutamic
oxaloacetic
transaminase)

Albumin protein produced an increased level chronic liver

by the liver reflects dehydration dysfunction; AIDS,
severe burns,
malnutrition, renal
disease; acute and
chronic infections

Alkaline found in tissues of Liver disease, bone malnutrition, pernicious

phosphatase the liver, bone, disease, anemia and severe
intestine, kidney hyperparathyroidism, anemias,
and intestine. myocardial infarction, hypothyroidism,
chronic renal failure, magnesium and zinc
heart failure deficiency
Ammonia The liver converts liver disease, cirrhosis, renal failure
ammonia, a by- Reye’s syndrome, GI
product of protein hemorrhage
metabolism, into
urea which is
excreted by the
kidneys

Blirubin Results from the Total: hepatitis, not significant

breakdown of Hgb obstruction of the
in the red blood common or hepatic bile
cell; removed ducts, pernicious
from the body by anemia, sickle cell
the liver which anemia
excretes it into Direct: cancer of the
bile head of the pancreas,
choledocholithiasis
Indirect: hemolotic
anemias, drug toxicity,
transfusion reaction

GGT (gamma- found primarily in liver disease, alcohol not significant

glutamyl the liver, kidney, abuse
transferase) prostate, and
spleen, is more
specific for the
hepatobiliary
system

Prothrombin a protein liver disease, damage; thrombophlebitis,

produced by the vitamin K deficiency, malignant tumor
liver for clotting obstruction of common
blood bile duct; deficiency of
 factors II, V, VII or X

Cardiac Markers:

CK (creatinine an enzyme found acute myocardial not significant

kinase) in the heart and infarction, myocarditis,
skeletal muscles. after open heart surgery,
has three acute cerebrovascular
isoenzymes: BB or disease, muscular
CK1, MB or CK2, dystrophy and chronic
and MM or CK3 alcoholism
CK isoenzymes:
MB: myocardial infarct,
myocardialischemia,
angina pectoris

Myoglobin after an MI, serum MI, angina, other muscle rheumatoid arthritis
levels of injury (trauma), renal myasthenia gravis
myoglobin rise in failure, rhabdomyolysis
2-4 hours making
it an early marker
for muscle
damage in MI

Troponin I cardiac troponin is Troponin I: small infarct, not significant

Troponin T highly myocardial injury
concentrated in Troponin T: acute MI,
the heart muscle. unstable angina,
this test is used in myocarditis
the early diagnosis
of MI. after an MI
 Troponin I begins
to increase in 4-6
hrs and remains
elevated for 5-7
days. Troponin T
begins to increase
in 3-4 hrs and
remains elevated
for 10-14 days

BNP (brain hormone heart failure, not significant

natriuretic produced by the symptomatic cardiac
peptide) ventricles of the volume overload,
heart and is a paroxysmal atrial
marker of tachycardia
ventricular systolic
and diastolic
dysfunction. This
test is useful in
diagnosing and
guiding treatment
of heart failure

Lipoprotein
Profile:
Cholesterol important type II familial severe hepatocellular
screening for hypercholesterolemia; disease;
heart disease biliary cirrhosis; chronic hyperthyroidism;
renal failure; poorly malnutrition, chronic
controlled diabetes anemias, severe burns
mellitus; alcoholism; diet
high in cholesterol and
fats
HDL HDL excess, chronic liver familial
good cholesterol disease, long term hypolipoproteinemia,
aerobic or vigorous hypertriglyceridemia
exercises (familial), poorly
controlled diabetes
mellitus, chronic renal
failure

LDL familial type 2 hypolipoproteinemia;

bad cholesterol hyperlipidemia; diet high hyperthyroidism,
in cholesterol and chronic anemias, severe
saturated fat, nephritic hepatocellular disease
syndrome, multiple
myeloma, DM, chronic
renal failure

Triglycerides hyperlipoproteinemia; malnutrition,

this test evaluates liver disease, renal hyperthyroidism, brain
suspected disease, hypothyroidism, infarction, COPD
atherosclerosis pancreatitis, myocardial
and measures the infarction
body’s ability to
metabolize fat
Hemoglobin A1C (HBA1C)

- glycosylated hemoglobin
- measurement of blood glucose that is bound to hemoglobin
HBA1C is a reflection of how well blood glucose levels have been controlled during
the prior 3 – 4 months

Guaiac test

- test for occult blood

- false-positive results can occur if the client has recently ingested (a) red meat (beef,
lamb, liver, and processed meats); (b) raw vegetables or fruits particularly radishes,
turnips, horseradish, and melons or (c) certain medications that can irritate the
gastric mucosa and cause bleeding such as aspirin or other NSAIDS, steroids, iron
preparations, and anticoagulants.
- false-negative results can occur if the client has taken more than 250 mg per day of
vitamin C from all sources up to 3 days before the test

Urine Testing:

Specific gravity

- indicator of urine concentration or the amount of solutes (metabolic wastes and

electrolytes) present in urine
- normal range 1.010 – 1.025
- high sp. gravity may indicate fluid deficit or dehydration
- excess fluid intake or diseases affecting the ability of the kidneys to concentrate urine
can result in low sp. gravity
Urinary pH

- measured to determine urine alkalinity or acidity and assess the client’s acid-base
status
- normally acidic w/ an average pH of 6 (>7 alkaline, <7 acidic)

Glucose

- urine is tested for glucose to screen clients for DM and to assess during pregnancy for
abnormal glucose tolerance

Ketones

- ketone bodies are a product of the breakdown of fatty acids, normally not present in
the urine
- may be found in clients w/ poorly controlled DM
- also used to evaluate ketoacidosis in clients who are alcoholic, fasting, starving, or
consuming high protein diets

Protein

- protein molecules are normally too large to pass through glomerular capillaries into
the filtrate but in cases of glomerulonephritis it becomes leaky and allows the
passage of protein
Occult blood

- normally not present in urine

Osmolality

- measure of solute concentration of urine that is a more exact measurement of urine

concentration than sp. gravity.
- also used to monitor fluid and electrolyte balance
- an increase in urine osmolality indicates fluid volume deficit; a decreased urine
osmolality reflects fluid volume excess