Author Archives: د.حسام أبو فرسخ

:Normal range

Hb               : 13-15 mg/dl

pH               : 7.35-7.45

pCO2           : 35-45 mm Hg

pO2             : 90-95 mm Hg

HCO3           : 20-24 mm/L

TCO2            : 21-25 mm/L

ABE              : -2.0 – +2.0 mm/L

SBE               : -2.0 – +2.0 mm/L

SBC               : -2.0 – +2.0 mm/L

O2SAT           : 95-97%

%.O2CT              : 14-18 Vol

Comment: Blood gas and pH testing are done to evaluate oxygen and carbon dioxide gas exchange, respiratory function including hypoxia and acid-base status. They are clinically indicated in a wide variety of medical and surgical situations involving cardiorespiratory, metabolic, and central nervous disturbances. Raffin has pointed out that few studies are available to indicated and that a complete list of clinical settings involving ill patients in whom blood gas studies might be indicated would include much of the tables of contents of general medicine texts

Sample: Heparinized arterial blood

:Normal range

Blood, umol/L*

Newborn: 40-80

Infants: 50-100

Children: 40-95

Adults: 44-80

Urine, umol/L*

Infants: < 80

Children: < 106

Adults: 88-300

Comment: Look amino acid in plasma & urine

Sample: 24hr urine, spot urine, plasma, (lithium heparin) separate immediately

:Normal range

Blood, umol/L*

Newborn: 23-37

Infants: 33-67

Children: 22-44

Adults: < 30

Urine, umol/L*

Infants: < 45

Children: < 65

Adults: 155-390

Comment: Look amino acid in plasma & urine

Sample: 24hr urine, spot urine, plasma, (lithium heparin) separate immediately

:Normal range

Up to 1.0 mg/dl up to 17.1 mmol/L

:Comment

:Causes of high bilirubin

Hepatobiliary disease: hepatitis, cholangitis, cholecystitis, even without common duct calculi; cirrhosis, other types of liver disease including primary or secondary neoplasia

alcoholism (usually with high AST (Sgot), GGT, MCV, or some combination of these findings); cholestasis (intrahepatic or extrahepatic); infectious mononucleosis (look also for increased LD (LDH), lymphocytosis); Dubin-Johnson syndrome; Gilbert disease (familial hyper bilirubinemia). If > 80% of total bilirubin is indirect and total bilirubin is < 6.0 mg/dL hemolysis or Gilbert syndrome is suggested

Malnutrition, anorexia, or prolonged fasting: 36 hours or more may cause moderate rise

Pernicious anemia, hemolytic anemia, erythroblastosis fetalis, other neonatal jaundice, hematoma and following a blood transfusion, especially if several units are given in a short time or with delayed hemolytic transfusion reaction. The major source of bilirubin is hemoglobin catabolism from lysis of red blood cells

Pulmonary embolism/ infract

Congestive heart failure

Drugs: A large number of drugs can cause jaundice by in vivo action. Drugs which may cause cholestasis and/or hepatocellular damage include acetaminophen, aminosalicylic acid, anabolic steroids, azathioprine, chlorpromazine, Clindamycin, erythromycin, esterified estrogens, gentamicin, indinavir, indomethacin, isoniazid, MAO inhibitors, methyldopa, nortriptyline, oleandomycin oral contraceptives, penicillin, phenothiazines, procainamide, progesterone, pyrazinamides, sulfonamides, valproic acid, warfarin, drugs of abuse (eg, 3.4 methylenedioxymethamphetamine –MDMA), and many other agents. A few drugs can cause analytical decreases (eg, Amikacin, high doses of ascorbic acid, theophyline) and a large number of drugs can cause analytic, physiologic, or pathologic increases

Sample: Serum, protect from light

Normal range: Negative

Comment: Serologic evaluation has a very limited role in evaluation of possible Lyme disease; investigate arthritis, rash, encephalopathy, polyneuropathy, and carditis. The use of these serologic tests is to support the clinical diagnosis of Lyme disease. Negative serologic results should never be used as a reason to with hold antibiotic treatment when Lyme disease is suspected

Sample: serum

Normal range: 7-21 mg/dl

Comment: Blood urea increase with age. Raised levels in renal dysfunction, dehydration, high protein catabolism. Low levels in pregnancy, starvation and hepatocellular failure

Sample: serum

Normal range: To evaluate white and red cell morphology and platelet count

Comment: A blood film or peripheral blood smear is examined if the hematology results are abnormal or if the client specifically requests that a blood film is examined

Sample: EDTA, whole blood

Normal range: 1-3 minutes

Comment: Prolonged in thrombocytopenic states, disorders with defective vascular and platelet function and after aspirin ingestion. Usually prolonged in von Willebrand’s disease. A normal result in this condition should warrant a repeat test about one month later. Aspirin ingestion must be avoided for at least 7 days prior to the test

Sample: from forearm

Normal range: Negative

Comment: In the conjugated state bilirubin can pass in the urine and is found in conditions such as obstructive jaundice and toxic damage to liver. It may appear in cases of hepatitis before jaundice and is also useful in following the course of infective hepatitis. Increased in conditions that have an elevated serum conjugated bilirubin

Sample: Spot urine, protect from light

:Normal range

Newborn up to 24 hours: 10.0 mg/dl

24hrs-1 month: up to 18 mg/dl

Comment: Most often used in cases of neonatal hyperbilirubinemia. Neonatal serum is measured to monitor hemolytic disease of the newborn (HDN) (erythroblastosis fetalis). HDN and hydrops fetalis. Other etiologies of neonatal jaundice physiologic jaundice, hematoma/hemorrhage, hypothyroidism, increased bilirubin load because of increased RBC volume or decreased RBC survival, glucose –6- phosphate deficiency, Pyruvate kinase deficiency, sepsis, glactosemia, deficiency of glucuronyl transferase (Crigler-Najjar syndrome), Gilbert syndrome, spherocytosis, ellipocytosis, congenital erythropoietic porphyria and cholestasis (eg, biliary atresia). Other risk factors include streptomycin, chloramphenicol, benzyl alcohol, and sulfisoxazole. Dark urine or light stools are among indications for measurement of serum bilirubin

Sample: Serum, protect from light