Labs Values

Question 1

ALT

Answer 1

alanine aminotransferase aka SGPT
4 - 36 U/L
*labs may vary per reference

Question 2

AST

Answer 2

aspartate aminotransferase aka SGOT
0 - 35 U/L
*labs may vary per reference

Question 3

ALP

Answer 3

alkaline phosphatase

44 - 147 U/L

Question 4

Elevated ALP

Answer 4

Elevated ALP levels may indicate:

• Biliary obstruction
• Conditions of the bone
• Osteomalacia
• Osteoblastic bone tumors
• Liver disease
• Hepatitis
• Hyperparathyroidism
• Leukemia
• Lymphoma
• Rickets
• Sarcoidosis

Question 5

AST

Answer 5

Aspartate aminotransferase, or AST, is an enzyme normally found in the red blood cells, liver, heart, muscle tissue, pancreas, and kidneys.

The AST test is performed to determine the level of this enzyme in the blood. This test is performed along with other blood tests, such as ALT, ALP, and bilirubin to confirm and monitor liver disease.

Question 6

Elevated AST

Answer 6

An increased AST level is usually a sign of liver disease, but this would have to be confirmed with other blood tests mentioned above. An increased level may be a result of:

• Cirrhosis (scarring of the liver)
• Death of liver tissue
• Heart attack
• Hemochromotosis (too much iron in the body)
• Hepatitis
• Liver ischemia (poor blood flow to the liver)
• Tumor or cancer to the liver
• Pancreatitis
• Muscle disease or trauma
• The use of drugs

Question 7

Chlorine (Cl)

Answer 7

96 mEq/L to 106 mEq/L

Chloride is an electrolyte that works with other electrolytes, such as sodium and potassium to maintain normal acid-base balance in the body.

Question 8

Elevated Cl Levels

Answer 8

Elevated chloride levels may be due to:

• Diarrhea
• Metabolic acidosis
• Respiratory alkalosis
• Renal tubular acidosis

Question 9

Low Cl Levels

Answer 9

Low levels of chloride may be related to:

• Addison’s disease
• Burns
• Congestive heart failure
• Dehydration
• Excessive sweating
• Metabolic alkalosis
• Respiratory acidosis
• Vomiting

Question 10

Potassium (K)

Answer 10

Potassium is an electrolyte that helps to maintain the body’s acid-base balance. Potassium is also responsible for communication between nerves and muscles, including the heart. It assists with moving nutrients to the inside of cells and waste products out.

The normal reference range for potassium is 3.5 mEq/L to 5 mEq/L.

Question 11

Hyperkalemia (High K Levels)

Answer 11

Hyperkalemia, or high potassium levels, may be a result of:

• Kidney failure
• Blood transfusions
• Metabolic or respiratory acidosis
• Red blood cell destruction
• Some medications
• Diet high in potassium

Question 12

Hypokalemia (Low K Levels)

Answer 12

Hypokalemia, or low blood potassium, may be due to:

• Chronic diarrhea
• Diuretics
• Hyperaldosteronism
• Diet low in potassium
• Vomiting

Question 13

ALT

Answer 13

Alanine aminotransferase (ALT) is an enzyme found mainly in the liver, but also in the kidneys, heart, muscles, and pancreas in smaller amounts.

The normal reference range for ALT is:

• Men: 10 IU/L to 40 IU/L
• Women: 7 IU/L to 35 IU/L

Question 14

Elevated ALT Levels

Answer 14

An increase in the ALT level is usually a sign of liver disease. Liver disease can be confirmed when other liver blood tests are performed, such as:

• Albumin
• Alkaline phosphatase (ALP)
• Aspartate aminotransferase (AST)
• Prothrombin time (PT)
• Serum bilirubin
• Urine bilirubin

An increased ALT level may be a result of:

• Cirrhosis (scarring of the liver)
• Death of liver tissue
• Hepatitis (swollen and inflamed liver)
• Hemochromatosis (too much iron in the body)
• Fatty liver
• Liver ischemia (poor blood flow to the liver)
• Tumor or cancer of the liver
• Pancreatitis
• The use of drugs

Question 15

Hematocrit (Hct)

Answer 15

The hematocrit test (also referred to as HCT, Ht, or PCV [packed cell volume]) is a measure of the amount of space, or volume, the red blood cells take up in the blood. The value is expressed as a percentage of red blood cells in a given volume of blood.

The normal reference ranges are as follows:

• Men: 40% to 50%
• Women: 36% to 44%

Question 16

BUN

Answer 16

6 mg/dL to 20 mg/dL.

Blood urea nitrogen, or BUN, is a test for the levels of urea nitrogen in the blood. Urea nitrogen is the end result after protein is broken down.

Question 17

High BUN Levels

Answer 17

High levels of BUN may be related to:

• Congestive heart failure
• Dehydration
• Excessive protein intakes
• Gastrointestinal bleeding
• Heart attack
• Kidney disease or failure
• Shock
• Urinary tract obstruction

Question 18

Low BUN Levels

Answer 18

Low BUN levels may correlate with:

• Liver failure
• Low protein diet
• Malnutrition
• Over-hydration

Question 19

Calcium (Ca)

Answer 19

8.5 mg/dL to 10.2 mg/dL.

A calcium blood test measures the amount of calcium in the blood. All cells in the body need calcium to work appropriately, such as heart function, muscle contractions, nerve transmissions, blood clotting, and strengthening bones and teeth. The test may be performed when investigating:

• Bone diseases
• Cancers of the breast, lung, neck, and kidney
• Chronic kidney disease
• Chronic liver disease
• Parathyroid gland disorders
• Thyroid gland functionality
• Low vitamin D levels

Question 20

Hypercalcemia (High Ca Levels)

Answer 20

Elevated calcium levels may be due to:

• Diet high in calcium or vitamin D
• Hyperparathyroidism
• Detection of cancer
• Overactive thyroid gland
• Paget disease
• Tumors producing parathyroid hormone-like substances

Question 21

Hypocalcemia (Low Ca Levels)

Answer 21

Low calcium levels may correlate with:

• Intestinal malabsorption
• Hypoparathyroidism
• Kidney failure
• Low serum albumin (A reduction in total serum calcium can result from a decrease in albumin secondary to liver disease, nephrotic syndrome, or malnutrition. Hypocalcemia causes neuromuscular irritability and tetany)
• Liver disease
• Magnesium deficiency
• Pancreatitis
• Vitamin D deficiency

Question 22

Creatinine (Crea)

Answer 22

The normal reference range for creatinine is:

• Men: 0.7 mg/dL to 1.3 mg/dL
• Women: 0.6 mg/dL to 1.1 mg/dL

Creatinine is a chemical waste product in the blood that passes through the kidneys to be filtered and eliminated in urine. The chemical waste is a by-product of normal muscle function. The more muscle a person has, the more creatinine they produce. Levels of creatinine in the blood reflect both the amount of muscle a person has and their amount of kidney function.

Question 23

Elevated Creatinine Levels

Answer 23

Elevated creatinine levels may be due to:

• Blocked urinary tract
• Kidney damage, failure, or infection (renal disease)
• Poor blood flow to the kidneys
• Dehydration
• Various muscle diseases (gigantism, acromegaly, muscular dystrophy)
• Congestive heart failure
• Shock
• Hyperthyroidism

Question 24

Low Creatinine Levels

Answer 24

Low levels of creatinine may be a result of:
*  Decreased muscle mass
*  Malnutrition
(protein-energy malnutrition or PEM)
* Small stature
* Advanced or severe liver disease
* During pregnancy

Question 25

Sodium

Answer 25

135 mEq/L to 145 mEq/L Sodium is an electrolyte that assists with maintaining the body's acid-base balance.

Question 26

Hypernatremia (High Na Levels)

Answer 26

Hypernatremia, or high blood sodium levels, may be due to: * Increased fluid loss as a result of excessive sweating, diarrhea, burns, or the use of diuretics * Problems with the adrenal glands, such as Cushing syndrome or hyperaldosteronism * Diabetes insipidus (kidneys unable to conserve water) * Diet high in salt * Use of laxatives or other medications

Question 27

Hyponatremia (Low Na Levels)

Answer 27

Hyponatremia, or low blood sodium levels, may correlate with: * Use of diuretics * Fluid losses from vomiting or diarrhea * Heart failure, kidney diseases, or cirrhosis, which may cause an increase in total body water, hence diluting blood sodium * Addison's disease * Ketonuria (buildup of ketones in the urine)

Question 28

Albumin (Alb)

Answer 28

3.5 g/dL to 5.0 g/dL Albumin is a protein made by the liver and is an indicator of the body's protein stores. Albumin is a very common protein found in the blood with a variety of functions. It also is produced only in the liver, and if its levels are lower than normal it can be suggestive of chronic liver disease or liver cirrhosis.

Question 29

Low Albumin Levels

Answer 29

Low levels of albumin may indicate kidney diseases or liver disease, such as hepatitis or cirrhosis. Low levels can also occur with: * Following surgery * Crohn's disease * Diet low in protein * Celiac disease * Whipple disease

Question 30

High Albumin Levels

Answer 30

Increased albumin levels may be a result of DEHYDRATION or from a diet high in protein. **DEHYDRATION can occur d/t inadequate water intake or fluid loss d/t severe vomiting or diarrhea; more albumin in the capillaries/blood vessels than fluid to maintain homeostasis Thus, serum albumin levels could be elevated in individuals affected by diseases that cause dehydration Although dehydration does not actually increase protein levels, the loss of water causes the blood to thicken, which can causes the blood components to concentrate.

Question 31

Hemoglobin (Hgb)

Answer 31

Hemoglobin, or Hgb for short, is a protein in red blood cells that carries oxygen to cells of the body. Hemoglobin is responsible for giving the cell a red color. The hemoglobin test measures the amount of hemoglobin in the blood. This test is a good indicator of the blood's ability to carry oxygen throughout the body. The normal reference ranges for hemoglobin are as follows: * Men: 14 g/dL to 18 g/dL * Women: 12 g/dL to 16 g/dL

Question 32

Phosphate (Phos)

Answer 32

2.5 and 4.5 mg/dL Hypophosphatemia is common in patients receiving parenteral nutrition. In critically ill patients, the prevalence of hypophosphatemia is greater. When large doses of glucose are administered through PN solutions, this can stimulate the release of endogenous insulin, which can then result in the redistribution of phosphorus to the intracellular space. Also, when there is aggressive refeeding with an excessive amount of IV glucose, this may result in a glucose-induced osmotic diuresis and increased losses of phosphorus.

Question 33

A patient's labs show the following: low albumin, transferrin within normal limits, and high sodium. What do you suspect?

Answer 33

**Edema due to acute sodium toxicity A patient with a diagnosis of dehydration can have a high blood sodium level.  However, we need to look at the whole picture of the patient’s labs.  This patient also has a low albumin level, which could indicate low body protein stores.  However, the transferrin levels are within normal limits.  If transferrin levels were also decreased, this could indicate possible protein deficiency.   A dehydrated patient would show increased albumin levels due to a decrease in plasma water.  Since albumin levels are low, and transferrin is within normal limits, we can rule out dehydration. Sodium overload in the body can cause edema and result in hypoalbuminemia. Acute sodium toxicity can be a cause of this patient's edema.

Question 34

The initial lab work of a patient who just underwent an extensive surgical procedure shows a very low prealbumin level of 9.1 mg/dL. Which other lab value would you expect to be significantly elevated?

Answer 34

The initial lab values of a very LOW prealbumin (normal range >= 20 mg/dL) and very HIGH C-reactive protein (normal range 0.0 to 0.4 mg/dL) would be consistent with an acute phase response of trauma and surgery. C-reactive protein is a protein sythesized by the liver as part of the acute phase response and is normally elevated under these conditions. A low prealbumin level is a good indicator of poor nutritional status. However, when prealbumin and C-reactive protein are both assessed, malnutrition may be ruled out if C-reactive protein is elevated.

Question 35

Prealbumin

Answer 35

normal range ≥ 20 mg/dL

Question 36

C-reactive Protein

Answer 36

normal range 0.0 to 0.4 mg/dL