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Table of Contents

  • Blood Tests and Their Explanation
  • Blood Tests and Their Explanation

Blood Tests and Their Explanation

Blood Tests and Their Explanation

Blood tests are mainly used to investigate various diseases.

The most common tests are described, and their indications are given.

Tests (Laboratory test) Normal values Clinical Importance
Biochemical parameters
Glucose fasting
  • 65 to 99 mg/dL
It can evaluate

  1. Diabetes mellitus
  2. Metabolic syndrome
Uric acid
  1. Men = 3.7 to8.6 mg/dL
  2. Women = 2.5 to 7.1 mg/dL
Used for:

  1. Gout
  2. Pain in the joints
  3. Recurrent renal calculi
Creatinine
  1. Men = 0.76 to 1.27 mg/dL
  2. Women = 0.57 to 1.0 mg/dL
  1. Used for renal function tests
  2. Follow-up of the renal diseases
Blood urea nitrogen (BUN)
  • 5 to 26 mg/dL
  1. It assesses the renal function
  2. It evaluates the liver function
BUN/Creatinine ratio
  • 8:1 to 27:1
  1. It evaluates renal functions
  2. It is used on renal dialysis
Sodium (Na)
  • 135 to 144 meq/L
  1. It is part of electrolytes imbalance
  2. It is part of electrolytes therapy
Potassium (K)
  • 3.5 to 5.2 meq/L
  1. It is part of electrolytes imbalance
  2. It is a test for cardiac patients
Chloride (Cl)
  • 97 to 108 mmol/L
  1. It is part of electrolytes
  2. It assesses hydration and acid-base balance
Calcium (Ca++)
  1. 18 to 59 years = 8.7 to 10.2 mg/dL
  2. >59 years = 8.6 to 10.2 mg/dL
  1. It evaluates the parathyroid function
  2. It assesses calcium metabolism
Phosphorus (P)
  • 12 to 60 years = 2.5 to 4.5 mg/dL
  1. This is part of various conditions
  2. It is used to measure phosphorus
Total proteins
  • 6.0 to 8.5 g/dL
  1. Advised in various diseases which will affect protein synthesis
  2. It is advised for the liver functions
Albumin
  • 3.5 to 5.5 g/dL
  1. It is advised in renal diseases
  2. It is advised to assess the liver function
Globulins
  • 1.5 to 4.5 g/dL
  1. It is advised to assess the liver function
Albumin/globulin ratio
  • 1.1: to 1 – 2.5: 1
  1. It is used for renal diseases
  2. It is used for chronic diseases
Bilirubin Total
  • 0.1 to 1.2 mg/dL
  1. It evaluates the liver function
  2. It is advised for hemolytic anemia
SGOT (AST)
  • 0 to 40 IU/L
  1. It advised for liver function
  2. It is advised in coronary heart disease
SGPT (ALT)
  1. Men =0 to 55 IU/L
  2. Women = 0 to 40 IU/L
  1. It is specific for liver cell injury
  2. It differentiates  jaundice from hemolysis or liver
Alkaline phosphatase
  • 25 to 150 IU/L
  1. It is raised in obstructive jaundice
  2. It evaluates bone diseases
Lactate dehydrogenase  (LDH)
  • 100 to 250 IU/L
  1. It is a nonspecific test, raised in the cell injuries
  2. It may be raised in cancers
Iron
  1. Women = 35 to 155 µg/dL
  2. Men = 40 to 155 µg/dL
  1. It is advised in iron-deficiency anemia
  2. It is advised in hemochromatosis
Beta-carotene
  • 10 to 85 µg/dL
  1. It is advised in steatorrhea
  2. It is advised for fat malabsorption
Cholesterol
  1. 100 to 199 mg/dL
  2. Optimal range = 100 to 180 mg/dL
  1. It is advised for coronary artery disease
  2. It evaluates hyperlipidemia
Triglycerides
  1. 0 to 149 mg/dL
  2. Optimal range = <80 mg/dL
  3. Pre-existing CV disease = <60 mg/dL
  1. It is advised for the risk of developing coronary disease
  2. Advised in fat metabolism disorder
HDL-cholesterol
  1. 40 to 50 mg/dL
  2. Optimal range = >50 mg/dL
  • It is advised to predict cardiac disease
LDL-cholesterol
  1. 0 to 99 mg/dL
  2. Optimal range = <100 mg/dL
  • It is advised to predict heart disease
Reticulocytes count Normal = <1%
  1. It is advised to evaluate bone marrow activity
  2. It is advised in antianemic therapy
Hematology
Hemoglobin
  1. Men = 12.5 to 17.0 g/dL
  2. Women = 11.5 to 15.0 g/dL
  • Advised to assess the degree of anemia
Red Blood cells
  1. Men = 4.1 to 5.6/cmm
  2. Women = 3.8 to 5.10/cmm
  • It is advised to assess the anemia
Hematocrit (Hct)
  1. Men = 34% to 50%
  2. Women = 34% to 44%
  • It also helps to evaluate the anemia
Mean corpuscular volume (MCV)
  • 80 to 98 fl
  1. Low levels indicate thalassemia
  2. Also, low levels seen in chronic diseases
Mean corpuscular hemoglobin (MCH)
  • 27 to 34 pg
  • It is advised to classify the anemia
Mean corpuscular hemoglobin concentration (MCHC)
  • 32 to 36 g/dL
  • It is advised to classify the anemia
Red blood cell distribution of width (RDW)
  • 11.7 to 15.0%
  1. It is normal in chronic diseases
  2. It is raised in iron deficiency anemia
White blood cells
  •  4.0 to 10.5/cmm
  • It helps to differentiate between acute and chronic infection.
Platelets count 140,000 to 415,000/cmm
  1. Platelets are advised in the case of bleeding
  2. <20,000/cmm count is an alarming sign of bleeding
Ferritin
  1. Men = 22 to 322 ng/mL
  2. Women = 10 to 291 ng/mL
  1. It is advised to evaluate iron reserve in the body
  2. It is advised in iron deficiency anemia or in iron overload
 Hormones
Cortisol
  1. A.M = 6.2 to 19.4 µg/dL
  2. P.M = 2.3 to 11.9 µg/dL

 

  1. It measures the adrenal functions
  2. It diagnoses Cushing’s syndrome
  3. It detects malfunction of the hypothalamus
Estradiol
  1. Men = 7.6 to 42.6 pg/mL
  2. Women
    1. Follicular phase = 12.5 to 166.0 pg/mL
    2. Ovulation = 85.5 to 498.0 pg/mL
    3. Luteal phase = 43.5 to 211.0 pg/mL
    4. Postmenopausal = <6.0 to 54.7 pg/mL
  1. It detects hypothalamus and pituitary glands functions
  2. It also detects sexual maturity
  3. In males, it evaluates gynecomastia or feminizing syndrome
Estriol Men and non-pregnant women = <2.0 mg/dL
  1. It is advised to assess the placental function
  2. To assess the fetal maturity
  3. This is the major estrogen in pregnant ladies
Estrone
  1. Men = 12 to 72 pg/mL
  2. Women
    1. Follicular phase = 37 to 138 pg/mL
    2. Midcycle peak = 60 to 229 pg/mL
    3. Luteal phase = 50 to 115 pg/mL
  1. It is advised to evaluate postmenopausal bleeding
  2. Increased estrone level may be associated with an increased level of androgens
Total estrogen
  1. Men = 40 to 115 pg/mL
  2. Women
    1. Day 1 to 10 = 61 to 394 pg/mL
    2. Day 11 to 20 = 122 to 437 pg/mL
    3. Day 21 to 30 = 156 to 350 pg/mL
    4. Postmenopausal = <40 pg/mL
  1. It is advised to see sexual maturity
  2. It is advised to assess the menstrual and infertility issues
  3. In pregnant ladies are advised for the fetal-placental health
  4. In males, advised for gynecomastia or feminizing syndrome
  5. It can also be used as a tumor marker
Follicle-stimulating hormone (FSH)
  1. Men >15 years = 1.4 to 18.1 mIU/mL
  2. Women
    1. Follicular phase = 2.5 to 10.2 mIU/mL
    2. Ovulatory peak = 3.4 to 33.4 mIU/mL
    3. Luteal phase = 1.5 to 9.1 mIU/L
    4. Postmenopausal = 23.0 to 116.3 mIU/mL

 

  1. It is advised to assess the menopause
  2. It is advised for the gonadal failure
Dehydroepiandrosterone sulfate (DHEA)
  1. Men =
    1. 15 to 19 years = 70.2 to 492.0 µg/dL
    2. 20 to 24 years = 211.0 to 492.0 µg/dL
    3. 45 to 54 years = 44.3 to 331.0 µg/dL
    4. 65 to 74 years = 33.6 to 249.0 µg/dL
    5. >74 years = 16.2 to 123.0 µg/dL
  2. Women
    1. 15 to 19 years = 65.1 to 368.0 µg/dL
    2. 20 to 24 years = 148.0 to 368.0 µg/dL
    3. 45 to 54 years = 35.0 to 256.0 µg/dL
    4. 65 to 74 years = 9.4 to 246.0 µg/dL
    5. >74 years = 12.0 to154.0 µg/dL

 

 

  1. It is advised to assess the female infertility
  2. It is advised to assess amenorrhea and hirsutism
  3. It is advised to evaluate excess of androgens/adrenocortical disease
  4. It is advised to assess congenital adrenal hyperplasia and adrenal tumors
Prolactin
  1. Men = 2.1 to 17.7 ng/mL
  2. Women
    1. Nonpregnant = 2.8 to 29.2 ng/mL
    2. Pregnant = 9.7 to 208.5 ng/mL
    3. Postmenopausal = 1.8 to 20.3 ng/mL
  1. It is advised in lactation problems
  2. It is also advised in prolactin-secreting tumors
  3. Raised level of prolactin is associated with anovulation and amenorrhea
Pregnenolone
  1. Men = 10 to 200 ng/dL
  2. Women  = 10 to 230 ng/dL

 

  1. It is advised for ovarian failure
  2. It is advised for hirsutism
  3. It is advised for adrenal carcinoma
  4. It is advised for Cushing’s syndrome
Progesterone
  1. Men = 0.2 to 1.4 ng/mL
  2. Women
    1. Follicular phase = 0.2 to 1,5 ng/mL
    2. Luteal phase = 1.7 to 27.0 ng/mL
    3. Ovulation phase = 0.8 to 3.0 ng/mL
    4. Menopausal phase = 0.1 to 0.8 ng/mL
    5. During menstrual phase = 18 to 27 ng/mL
    6. Menopause = 2 to 6 ng/mL
  1. It is advised to confirm the presence of corpus luteum
  2. It evaluates the functional state of the corpus luteum in infertile ladies
  3. It assesses the functional state of the placenta during pregnancy
  4. It is advised to assess the ovarian function
Testosterone Free testosterone

  1. Men
    1.  20 to 29 years = 9.3 to 26.5 pg/mL
    2. 50 to 59 years = 7.2 to 24 pg/mL
    3. >60 years = 6.6 to 18.1 pg/mL
  2. Women
    1. 20 to 59 years = 0.0 to 2.2 pg/mL
    2. >60 years = 0.0 to 1.8 pg/mL

Total testosterone

  1. Men = 348 to 1197 ng/dL
  2. Women
    1. 20 to 49 years = 8 to 48 ng/dL
    2. >49 years = 3 to 41 ng/dL
  1. It is advised to assess the gonadal function
  2. It is also advised to assess the adrenal function or tumor activity
  3. It helps in the diagnosis of hypogonadism, hypopituitarism, and impotence
  4. It helps to diagnose Klinefelter syndrome
  5. In ladies, it is advised to assess the hirsutism, anovulatory cycle, amenorrhea, and virilization.
  6. It helps to diagnose masculinizing tumors of the ovary, tumor of adrenal cortices, and congenital adrenal hyperplasia.

Human chorionic gonadotropin (HCG)

β-subunit

β-subunit of HCG

  1. Negative = <10 mIU/L
  2. Borderline = 10 to 20 mIU/L
  3. Positive = >20 mIU/L
  1. It is a specific and sensitive test for early pregnancy
  2. It is advised in threatened abortion, ectopic pregnancy
  3. It is also tumor markers
Parathyroid hormone, intact (PTH)
  1. Normal = 12 to 65 pg/mL ( calcium = 8.5 to 10.6 mg/dL)
  2. >65 pg/mL (Ca = >10.6 mg/dL) = Primary hyperparathyroidism
  3. >65 pg/ml (Ca = <10.6 mg/dL) = Secondary hyperparathyroidism
  4. <65 pg/mL (Ca = >10.6 mg/dL) = Nonparathyroid hypercalcemia
  5. <12 pg/mL (Ca = <8.5 mg/dL) = Hypoparathyroidism
  6. 12 to 65 pg/mL (Ca = <8.5 mg/dL) = Nonparathyroid hypocalcemia
  1. It is advised to diagnose parathyroid diseases
  2. It monitors the calcium homeostasis
  3. It is advised in patients with renal dialysis
Thyroid-stimulating hormone (TSH)
  • 0 to 40 IU/mL
  1. It is advised in thyroid diseases
  2. It differentiates primary and secondary hypothyroidism
Thyroxine Total (T4)
  • 4.5 to 12.0 µg/dL
  1. It is used to diagnose thyroid function
  2. It is used to monitor the therapy
Thyroxine-Free (T4)
  • 0.82 to 1.77 ng/dL
  1. It is advised in patients where there are protein abnormalities
  2. it is advised to monitor the replacement and suppressive therapy
Triiodothyronine (T3) Total
  • 85 to 205 ng/dL
  1. It is advised for thyroid function
  2. It helps in thyrotoxicosis and hyperthyroidism
Triiodothyronine (T3) Free
  • 2.0 to 4.4 pg/mL
  1. It is advised to evaluate thyroid function
Tumor markers
Cancer antigen CA-15-3
  • 0.0 to 32.4 U/mL
  1. It is advised in the breast cancer
  2. It helps to monitor the therapy
  3. If raised, it indicates recurrence
Cancer antigen CA-27.29
  • 0 to 38.6 U/mL
  1. It is advised to monitor metastatic breast carcinoma
  2. It is advised for monitoring and response to therapy
Cancer antigen CA-125
  • 0 to 32 U/mL
  1. It is advised to monitor ovarian cancer
  2. It detects recurrence or progression of ovarian cancer
Carbohydrate antigen CA-19-9
  • 0 to 37 U/mL
It advised monitoring the GIT, pancreatic, liver, and colorectal cancers
Carcinoembryonic antigen CEA
  1. Nonsmoker = <2.5 ng/mL
  2. Smoker = <5.0 ng/mL
  1. It is advised to assess the extent of the disease and the prognosis of cancers
  2. It is advised in GIT or breast cancer for monitoring and treatment
Prostatic-specific antigen (PSA)
  • 0 to 4.0 ng/mL
  1. It is a sensitive tumor marker for prostatic cancer
  2. It is advised for the therapy prognosis of prostatic cancer
Tumor necrosis factor-alpha (TNF-α)
  • <8.1 pg/mL
  1. It is advised in tumor necrosis
  2. It may be raised in sepsis, AIDS, HCV, and transplantation rejection
Cardiac markers
Troponin I
  • <1.0 ng.mL ( <0.06 ng/mL)
  1. It is the marker for the heart muscle injury
  2. It predicts mortality for unstable angina
Troponin T
  • 0 to 0.1 µg//L
  1. It is advised in the diagnosis of myocardial infarction
  2. It also differentiates unstable angina
Creatinine isoenzyme CK-MB
  • <0% to 5% of the total CK
  • Ck-MB = <6 ng/mL
  1. It is specific to cardiac muscle damage
  2. It comes to normal before Troponins
Myoglobin
  1. Male =20 to 100 ng/mL
  2. Female = 20 to 60 ng/mL
  1. It is an early marker for AMI
  2. It is also raised in muscle injury

This topic is continued.

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