1. COMPLETE BLOOD CELL COUNT (CBC)
HAEMOGLOBIN: Male- 13-18 gm/ dl; Female- 12-16gm/dl (Normal values)
HAEMATOCRIT: Male-45-62%; Female- 37-48%
MEAN CORPUSCULAR VOLUME (MCV): 83-103 fl (femtolitres) or cum m/red cell (Normal); increased in liver disease, alcoholism, sprue, deficiency of folate or B12; decreased in iron deficiency anaemia, pernicious anaemia, thalassemia & chlorosis.
MEAN CORPUSCULAR HAEMOGLOBIN CONCENTRATION (MCHC): 32-36% (Normal); increased in spherocytosis; decreased in iron deficiency, macrocytic anaemia, pyridoxine responsive anaemia & thalassemia.
MEAN CORPUSCULAR HAEMOGLOBIN (MCH): 27- 32 pg/cell (Normal)
PLATLET COUNT: 150000-350000 per cmm (Normal); increase in cancer, chronic leukemia, polycythemia vera, splenectomy, heart disease & rheumatoid arthritis.
WBC COUNT: 4,300-10,800 cells/ µL/ cu mm (Norma)
Leukocytosis: increase of WBC above 10000/ cu mm; increased in any infection, haemorrhage, trauma/ tissue injury, serum sickness, malignancy, leukemia & tissue necrosis; decreased in viral infection, hypersplenism, & bone marrow depression due to drugs.
Eosinophilia: increase more than 5%; increased in allergies, parasitic diseases, lung & bone cancer, chronic skin affections & Hodgkin’s disease; decreased in infectious mononucleosis, hypersplenism, congestive cardiac failure, cushing’s syndrome, aplastic anaemia & use of ACTH.
Basophils: < 1%
Lymphocytes: 20-40% (Normal); increased in upper respiratory tract infections, viral diseases like mumps, bacterial infections like TB, hypothyroidism & lymphocytic leukemia; decreased in hodgkin’s disease, L.E, after ACTH, after burns & trauma & chronic uraemia.
2. RBC: 4. 2- 6. 9 million/ µL/ cu mm (Normal value)
3. ESR : Male: 1-13 mm/hr; Female: 1-20mm/ hr
ESR is raised in
Slow rising ESR: pregnancy (after 4th month), anaemia, acute myocardial infarction, rheumatoid arthritis, carcinomatosis, pulmonary TB, acute gout, burns, acute infections & after fracture & operations.
Rapid rise in ESR: kala azar & multiple myeloma.
4. LIVER FUNCTION TEST
- Normal total 0.3-1.1 mg/100 ml
- Direct 0.1- 0.4 mg/100ml
- Indirect 0.2- 0.7 mg/100ml
- Rise of indirect serum bilurubin In haemolytic diseases, Gilbert’s disease&Acute or chronic hepatitis
- Rise of total bilurubin: Biliary tract obstruction, Cancer of head of pancreas& inGall stones
- Normal 3.5-5.5gm/100ml.
- Increased in Haemoconcentration shock & Dehydration
- Decreased in Malnutrition, Starvation, Glomerulonephritis, Hepatic insufficiency, Leukemia & in Other malignancies
- Normal : 1. 5-3 gm/100 ml.
- Elevated in Hepatic disease, Multiple myeloma, Bacterial & viral infection, Typhus & malaria
- Decreased in Starvation with malnutrition, Lymphatic leukemia& Agammaglobulinemia
SERUM ALKALINE PHOSPHATASE
- Normal : 5-13 KA or 2-5 Bodansky units/100 ml
- Elevated in Severe osteomalacia, Osteogenic sarcoma, Metastasis to bone, Paget’s disease, Myeloid leukemia, Hyperthyroidism & in Pregnancy
- Decreased in Hypothyroidism & Growth retardation
SGPT; SERUM GLUTAMIC PYRUVIC ACID TRANSAMINASE (ALT- ALANINE)
- Normal : 5-35 sigma frankel/ml, 4-24 IU/litre
- Increased in Hepatocellular diseases, Active cirrhosis, Metastatic liver tumour & obstructive liver tumour, Obstructive jaundice, Liver congestion, Pancreatitis& inHepatic injury in myocardial infection
SGOT; SERUM GLUTAMIC OXALOACETIC TRANSAMINASE (AST- ASPARTATE)
- Normal : 5-40 sigma frankel/ml, 0-36 IU/litre
- Increased in MI, Liver diseases, Acute pancreatitis, Acute haemolytic anaemia, Severe burns, Recent brain trauma
- Decreased in Beriberi & Uncontrolled diabetes
PROTHROMBIN TIME: normal- 11-16 seconds; increased in prothrombin deficiency, Vit. K deficiency, haemorrhagic disease, liver disease, biliary obstruction & hypervitaminosis A.
- Normal : < 165 mg/100 ml
- Elevated in Hyperthyroidism, Diabetes mellitus, Biliary obstruction & Primary hyperproteinemias.
- Decreased in Malabsorption, Malnutrition & Primary hypolipoproteinemias.
- Normal 150-250 mg/ 100ml
- Increased in Xanthomatosis, Pregnancy, Alcohol & fatty diet, Myxoedema, Diabetes mellitus, Obesity & Nephritic syndrome.
- Decreased in Hyperthyroidism, Acute infections & Anaemia with malnutrition.
HDL CHOLESTEROL: > 40 mg%
- Normal 44mg/ 100ml in men & 55 mg/dl in women.
- Increased in Chronic liver disorder, increased physical activity & Moderate intake of alcohol.
- Decreased in Smokers & High risk patients of MI.
LDL CHOLESTEROL: < 130 mg%
6. BLOOD UREA
- Normal 10-15 mg/100ml.
- Increased in Impaired renal function, Shock/ dehydration, Diabetes, Acute myocardial infarction, Gout & Excessive protein intake.
- Decreased in Liver failure, Malnutrition, Impaired absorption, In celiac disease,Nephritic syndrome&Over hydration.
7. UREA NITROGEN (BUN): 7-18 mg/dl (Normal value)
8. CREATININE: 0. 6- 1. 2 mg/ dl; BUN/CREATININE RATIO: 5-35
9. CREATININE PHOSPHOKINASE, total
Normal : 20-200 IU/ LITRE.
CREATININE PHOSPHOKINASE, isoenzymes
- MM fraction : 94-95%
- MB fraction : 0-5%
- BB fraction : 0-2%
Heart: 80% MM, 20% MB Brain: 100% BB Skeletal muscles: 95% MM, 2% MB.
10. BLOOD URICACID
- Normal 2.2-8 mg%
- Increased in Gout, Metastatic cancer, Starvation/shock, Alcoholism, Multiple myeloma, Diabetic ketosis & leukemia
- Decreased in Aspirin & Sulfinpyrazone
11. SERUM CALCIUM
- Normal 9.6- 10.9 mg/ 100ml
- Elevated in Hyperparathyroidism (20 mg), Hypervitaminosis D (17 mg), Multiple myeloma & Cushing’s syndrome.
- Decreased in Hyperparathyroidism, Osteomalacia/ rickets & Malabsorption syndrome.
12. SERUM AMYLASE
- Normal : 0. 5- 2 Bodansky units
- Elevated in Acute pancreatitis, Carcinoma of pancreas, perforated peptic ulcer, acute cholecystitis, Cirrhosis liver, Mumps & Renal failure.
- Decreased in Necrotising hepatitis, Severe burns, Toxaemia of pregnancy.
13. SERUM IRON
- Normal : 75 mcg/100 ml.
- Elevated in Haemochromatosis, Aplastic anaemia, Haemosiderosis, Haemolytic anaemias, Pernicious anaemia
- Decreased in Iron deficiency anaemia, Nephrosis, Chronic renal insuffiency, Paroxysmal nocturnal haematuria.
14. LACTIC ACID DEHYDROGENASE
- Normal : 63-155 units
- Increased in Acute MI, Acute leukemia, Hepatic disease, Extensive cancer, Shock & anoxia
- Decreased in: Good response to cancer
15. THYROXINE TOTAL T4
- Normal : 5-12. 5 µg/ dl
- Increased in Hyperthyroidism , Acute thyroiditis, Sub acute thyroiditis, Hepatitis
- Decreased in Cretinism, Myxoedema, Simmond’s disease, Hypothyroidism, Nephrosis.
16. TRIIODOTHYRONINE (T3)
- Normal: 110-230ng/ 100 ml.
- Increased in hyperthyroidism, T3 thyrotoxicosis, acute thyroiditis, idiopathic TBG elevation.
- Decreased in hypothyroidism, starvation, acute illness, idiopathic TBG decrease.
17. BLOOD SUGAR
Fasting blood sugar: normal value- 60-100 mg %. Increased in diabetes, cushing’s disease, acute stress, pheochromocytoma, hyperthyroidism, pancreatitis, chronic liver disease &chronic malnutrition.
Decreased in over dose of insulin, addison’s disease, bacterial sepsis, islet cell carcinoma, hepatic necrosis, hypothyroidism & psychogenic causes.
18. ASO ( ANTI STREPTOLYSIN O) TITRE
- Normal: Below 2oo units.
- Increased: recent infection with streptococci or an exaggerated immune response to an earlier exposure in a hypersensitive person.
Specific gravity: 1. 003- 1. 030; specific gravity increases if excretion of urine decreases.
It is increased in diabetes mellitus or nephrosis & in excessive water loss.
Low specific gravity: diabetes insipidus, glomerulonephritis, pyelonephritis & in severe renal damage.
- Protein: 2-8 mg/ dl (normal value)
- Protienuria due to kidney causes: TB &cancer of kidney, nephritis, polycystic kidney, ascitis & nephrosis.
- Protienuria due to non- renal causes: fever, toxaemia, trauma, severe anaemias & aspirin.
- PH: 4. 6- 8. 0
Colour of urine:
- Colourless urine: large fluid intake, untreated diabetes mellitus, diuretic therapy, alcohol ingestion, nervousness.
- Orange coloured urine: concentrated urine, excessive sweating, restricted fluid intake & fever.
- Red or reddish dark brown: haemoglobinuria, myoglobin & porphyries.
- Slack urine: alkaptonuria
- Brown black: Lysol poisoining, melanin.
- Turbidity: fresh urine is clear. Urine becomes turbid due to UTI.
- Sugar normal values: 100 mg/ 24 hours. Increased in diabetes mellitus, brain injury & MI.
- Red cell cast: acute glomerulonephritis, collagen disease, renal infarction & endocarditis.
- Increased red cells: pyelonephritis, renal stone, trauma to kidney, haemophilia, lupus vulgaris, cystitis, TB & malignancy.
- White blood cells: large number of WBC’S indicates bacterial infection in urinary tract; if infection is in kidney, there may be associated cellular or granular casts, bacteria, epithelial cells & few RBC’S.
- White blood cells & casts: pyelonephritis, acute glomerulonephritis & interstitial inflammation of kidney.
- Epithelial cells & casts: renal epithelial cell casts are formed by cast of tubular cells, hence occasional renal epithelial cells are found. Increased in amyloidosis & poisoining from heavy metals.
Diarrhoea mixed with mucus & blood: typhus, typhoid, cholera, amoebiasis & large bowel cancer.
Diarrhoea mixed with mucus & pus: ulcerative colitis, shigellosis, regional enteritis, salmonellosis, obstruction of common bile duct (putty like appearance), sprue & celiac disease (stool resembles like aluminium) & in cystic fibrosis (greasy butter stool).
Alteration in shape & size: narrow ribbon like stool: spastic bowel, rectal narrowing, decreased elasticity or partial obstruction; excessive hard stool: increased absorption of fluids, constipation; very large caliber stool: dilatation of viscus; small, round, hard stool: habitual moderate constipation.
Colour of feces: yellow to yellow green: during breast fed; green colour: chlorophyll rich vegetables; black colour: iron, charcoal & bismuth; light coloured stool: diets high in milk & low in meat; clay coloured: due to excessive fat; red colour: due to beets.
CSF/ normal values
Bilurubin: 0 Cells: 0-5 / mm3; all lymphocytes Chloride: 110-129 meq/ litre.
Glucose: 48- 86 mg/dl or 60% serum glucose. PH: 7. 34- 7. 43.
Pressure: 7-20 cm water Protein, lumbar CSF: 15- 45 mg/ dl
Albumin: 58% alpha 1: 9% alpha 2: 8% beta: 10% gamma: 10%
Protein, cisternal CSF: 15-25 mg/dl Protein, ventricular CSF: 5-12 mg/ dl.
Volume: 2- 6. 6 ml. Count: >50 million/ ml. Motility: > 75 %
PH: 7. 2- 8 Morphology of sperms: > 60 % normal forms. Liquefaction: complete in 15 minutes. Spermatocrit: 10%
BLOOD SMEAR: Burr cells: Uraemia Spur cells: Cirrhosis
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