Arterial blood gases – review; Anion gap (review); ANC calculator. |
Albumin |
3.2 – 5 g/dl |
Alkaline phosphatase
(Adults: 25-60) |
33 – 131 IU/L |
Adults > 61 yo: |
51 – 153 IU/L |
Ammonia |
20 – 70 mcg/dl |
Bilirubin, direct |
0 – 0.3 mg/dl |
Bilirubin, total |
0.1 – 1.2 mg/dl |
|
Arterial |
Venous |
pH |
7.35 – 7.45 |
7.32 – 7.42 |
pCO2 |
35 – 45 |
38 – 52 |
pO2 |
70 – 100 |
28 – 48 |
HCO3 |
19 – 25 |
19 – 25 |
O2 Sat % |
90 – 95 |
40 – 70 |
BUN |
7 – 20 mg/dl |
|
Male |
Female |
Hemoglobin (g/dl) |
13.5 – 16.5 |
12.0 – 15.0 |
Hematocrit (%) |
41 – 50 |
36 – 44 |
RBC’s ( x 106 /ml) |
4.5 – 5.5 |
4.0 – 4.9 |
RDW (RBC distribution width) |
< 14.5 |
MCV |
80 – 100 |
MCH |
26 – 34 |
MCHC % |
31 – 37 |
Platelet count |
100,000 to 450,000 |
CK-BB |
0% |
CK-MB (cardiac) |
0 – 3.9% |
CK-MM |
96 – 100% |
Creatine phosphokinase (CPK) |
8 – 150 IU/L |
Creatinine (mg/dl) |
0.5 – 1.4 |
Calcium |
8.8 – 10.3 mg/dL |
Calcium, ionized |
2.24 – 2.46 meq/L |
Chloride |
95 – 107 mEq/L |
Magnesium |
1.6 – 2.4 mEq/L |
Phosphate |
2.5 – 4.5 mg/dL |
Potassium |
3.5 – 5.2 mEq/L |
Sodium |
135 – 147 mEq/L |
Ferritin (ng/ml) |
13 – 300 |
Folate (ng/dl) |
3.6 – 20 |
Glucose, fasting (mg/dl) |
60 – 110 |
Glucose (2 hours postprandial) (mg/dl) |
Up to 140 |
Hemoglobin A1c |
<6% of total Hb
AACE Guidelines (2011)
Hemoglobin A1c, % (as a screening test)
5.4 – Normal
————————-
5.5-6.4 – High risk/prediabetes; requires screening by glucose criteria
————————-
6.5 -Diabetes, confirmed by repeating the test on a different day
=================
In general, therapy should target a A1C level of 6.5% or less for most nonpregnant adults. |
Iron (mcg/dl) |
65 – 150 |
Lactic acid (meq/L) |
0.7 – 2.1 |
LDH (lactic dehydrogenase) |
56 – 194 IU/L |
Cholesterol, total |
< 200 mg/dl |
HDL cholesterol |
35 mg/dL. Negative risk factor: 60 mg/dL |
LDL cholesterol |
65 – 180 mg/dl |
Triglycerides |
Normal: < 150 mg/dL.
Borderline-high: 150 to 199 mg/dL
High: 200 to 499 mg/dL
Very High: >499 mg/dL |
|
|
Osmolality |
289 – 308 mOsm/kg |
SGOT (AST) |
< 35 IU/L (20-48) |
SGPT (ALT) |
<35 IU/L |
Testosterone – total(serum) |
Male: 300 to 1000 ng/dL
Female: < 62 ng/dLALT:
Male:
14-15 yr: 33-585 ng/dL
16-17 yr: 185-886 ng/dL
18-39 yr: 400-1080 ng/dL
40-59 yr: 350-890 ng/dL
> 60 yr: 350-720 ng/dLTanner Stage IV: 165-854 ng/dL
Tanner Stage V: 194-783 ng/dL |
Thyroid Function Testing
Thyroid Function Test |
Measurement |
Normal Range |
Total T4 (TT4) |
bound and free T4 |
4.5 -11.5 ug/dL |
Free T4 (FT4) |
free T4 |
0.8 -2.8 ng/dL |
Free T4 Index (FT4I) |
estimate of free T4
FT4I = TT4 x RT3U |
1.0 -4.3 U |
Total T3 (TT3) |
bound and free T3 |
75 -200 ng/dL |
Resin T3 Uptake (RT3U) |
binding capacity of TBG |
25 -35% |
TRH |
TRH |
5 -25 mIu/mL |
TSH |
TSH |
0.5 – 4.70 µIU/mLAmerican Association of Clinical Endocrinologists guidelines changed their normal range for TSH to
0.3 – 3.04 mIU/L. |
Thyroglobulin |
Thyroglobulin |
5-25 ng/mL |
Radioactive Iodine Uptake (RAIU) |
Distribution of radiolabeled iodine in the thyroid |
5 hr – 5 to 15%
24 hr – 15 to 35% |
Notes:
Free T4 – much more useful then total T4 (e.g. interested in unbound or active form). Total T4 not commonly measured. Greatly affected by TBG.
Free T4 index: indirect measure of free T4. Corrects for high/low values of TBG.
Total T3: not as useful as free T3, however, may be useful in locating problems with TBG, or if looking for problems with peripheral conversion of T4 to T3.
Resin T3 Uptake: if low, then TBG binding capacity is high. Opposite if high.
TSH: best measure to determine thyroid function.
Thyroglobulin: nonspecific test that is elevated when the thyroid gland is inflamed or enlarged. |
Free T3 |
2.3-4.2 pg/ml |
Total iron binding capacity (TIBC) |
250 – 420 mcg/dl |
Transferrin |
> 200 mg/dl |
Uric acid (male) |
2.0 – 8.0 mg/dl |
(female) |
2.0 – 7.5 mg/dl |
WBC (cells/ml) |
4,500 – 10,000 |
Segmented neutrophils |
54 – 62% |
Band forms |
3 – 5% (above 8% indicates left shift) |
Basophils |
0 – 1 (0 – 0.75%) |
Eosinophils |
0 – 3 (1 – 3%) |
lymphocytes |
24 – 44 (25 – 33%) |
Monocytes |
3 – 6 (3 – 7%) |
Equations:
(1) Segs and bands reported as a percentage:
WBC * ((segs / 100) + (bands / 100))(2) Segs and bands reported in total numbers:
WBC * (segs + bands)Neutrophils (aka polymorphonuclear cells, PMNs, granulocytes, segmented neutrophils, or segs) fight against infection and represent a subset of the white blood count. Neutropenia by definition is an ANC below 1800/mm3 (some sources use a lower value).
Absolute neutrophil count (ANC) of 1000-1800:
Most patients will be given chemotherapy in this range.
Risk of infection is considered low.
Mild neutropenia – Absolute neutrophil count (ANC) of 500-1000:
Carries with it a moderate risk of infection.
Absolute neutrophil count (ANC) of less than 500:
Severe neutropenia – high risk of infection. Remember that a reduced WBC is known as leukopenia.
The WBC consists of the following (differential):
Lymphocytes: 20-40%
Neutrophils: 50-60%
Basophils: 0.5-2%
Eosinophils: 1-4%
Monocytes: 2-9% (average: 4%).
ANC = Total WBC x (% “Segs” + % “Bands”)
Equivalent to: WBC x ((Segs/100) + (Bands/100))
The ANC refers to the total number of neutrophil granulocytes present in the blood.
Normal value: 1500 cells/mm3.
Mild neutropenia: 1000 – <1500/mm3.
Moderate neutropenia: 500 – <1000/mm3.
Severe neutropenia: < 500/mm3. |