Laboratory Compendium

ABCDEFGHIJKLMNOPQRSTUVWXYZ
Lab
Normal
Comments

Acetominophen
<200 ug/ml @ 4 hrsUsed to check for Tylenol overdose
Acetone
Negative in all dilutionsOrdered to help determine if patient in suspected DKA is experiencing lactic vs ketoacidosis. Note that negative screen does not rule out DKA (there are ketoacids that are not measured).
AFB
No mycobacteria isolatedUsed to check for mycobacteria - specify if order is for blood, urine, feces, respiratory/sputum, or miscellaneous (with or without smear)
AFP
??Alpha-Fetoprotein. Part of triple marker. Also used as a tumor marker for hepatocellular carcinoma, and is used as a screening test for Hep B and C patients.
Albumin
3.0-5.5 g/dl(see LFT page) Usually used as a marker of hepatic synthetic capacity or as a nutrition marker
Alcohol screen
None detectedTests for ethanol, methanol, and isopropanol. Usually part of tox screening
Aldosterone (serum)
1.0-21.0 if >11 yo(send-out to Mayo) Used in checking for HTN, renal function, adrenal function
Alkaline Phosphatase
38-126 u/L(see LFT page) Used to check for hepatic damage. Also elevated in cholestasis, bone CA.
ALA
1.5-7.5 mg/24 if >6 yo(send-out to Mayo) Aminolevulonic Acid. Urine test. A heme breakdown product that increases in porphyria.
ALT (SGPT)
15-75 u/L(see LFT page) Elevated levels indicate hepatic damage
Ammonia
9-33 umol/LUsed in liver patients to help diagnose hepatic encephalopathy, which is seen in patients with cirrhosis or portal shunts.
Amphetamine Screen
Negative ScreenScreen only. Confirmation sent out to Mayo.
Amylase
30-110 u/LElevated in pancreatic damage (sensitive but not specific marker for pancreatitis), pancreatic duct blockage
Anaerobe Culture
No growthSpecify if order is for bone marrow, fluid, respiratory, tissue, or other. Use special collection tubes, deliver immediately. Reported when positive, negative is final at 48 hrs
Anti-DNA
Negative(send-out to Mayo) This test is a variant on the anti-nuclear antibody screens. Can order either single or double stranded - double is more specific for SLE. Can also send out for Quantitative if this is positive
Anti-Gliaden Antibodies (IgG, IgA)
Varies with age and Ig (Send-out to Mayo) Used to screen for gluten-sensitive enteropathy
Anti Glomerular Basement Membrane Antibody
NegativeTwo tests - one at FAHC, one at Mayo. Used to test for Goodpasture's or Anti GBM Disease.
Anti Neutrophil Cytoplasmic Antibody (ANCA)
NegativeElevated in the "pauci-immune vasculidities."
C-ANCA associated with Wegener's
P-ANCA associated with polyarteritis
Anti Nuclear Antibody (ANA)
<40 dilsElevated in lupus, other autoimmune coditions
Antibody Screen
negativeaka "Coomb's Test (indirect). Used in working up hemolytic anemia.
Arginine Vasopressin
??(Send-out to Mayo) Used to check serum ADH (Vasopressin) levels, in SIADH or DI
AST (SGOT)
8-50 u/L(see LFT page) Elevated levels indicate hepatic damage

ABCDEFGHIJKLMNOPQRSTUVWXYZ
Lab
Normal
Comments

Bacterial Culture
No growthSpecify if order is for blood, bone marrow, feces (with or without smear), genital, object, respiratory/sputum, tissue, urine, or other.
Barbiturate Screen
Negative screenScreen only. Confirmation sent out to Mayo.
Basic Metabolic Panel (BMP)
see individual testssee electrolytes and blood pages. Includes BUN, Calcium, Chloride, CO2, Creatinine, Glucose, Potassium, Sodium
Benzodiazepine Screen
Negative screenScreen only. Confirmation sent out to Mayo.
Bilirubin
Unconj: 0.0-1.1 / Conj: 0.0-0.3 mg/dl(see LFT page) Unconjugated increased with hepatic damage or increased heme breakdown. Conjugated increases with cholestasis or hepatocellular damage. Note that unconj + conj does NOT equal total - there are other fractions (delta, etc.)
Bleeding Time
3-10 minutesCoag study. High operator variability.
Blood Gas
see ABGsee ABG page. Helpful for analyzing respiratory, renal function; acid-base status.
Blood Gas with Whole Blood Electrolytes
see individual testsIncludes pH, pCO2, pO2, Chloride, Potassium, Sodium
BUN
10-26 mg/dlsee electrolytes page. Decreased in malnutrition, liver disease. Increases in GI bleeds or any decreased GFR (such as renal failure), and in catabolic states. Ratio of BUN/Creat is often analyzed: if the ratio is >20:1, then volume depletion &/or hypoperfusion is probably present.

ABCDEFGHIJKLMNOPQRSTUVWXYZ
Lab
Normal
Comments

C-Reactive Protein
< or = 1.0 mg/dlNon-specific measure of inflammatory activity.
C. Dificile Toxin
NegativeFecal study to detect C. diff (pseudomembranous) colitis, which is common in patients on ABX.
C3 Complement
79-152 mg/dlAutoimmune response- will measure as decreased if reaction present, as complement is consumed. Measured as part of workup for renal failure  - immune complexes will clog tubules.
C4 Complement
16-38 mg/dlAutoimmune response- will measure as decreased if reaction present, as complement is consumed. Measured as part of workup for renal failure  - immune complexes will clog tubules.
CA 125
<35 u/mlTumor marker for ovarian CA.
Calcium
8.5-10.5 mg/dlIncreased in malignancy, hyperparathyroid. Decreased in hypoalbuminemia, renal insufficiency, vit D deficiency. Can also order Ionized serum or Ionized whole blood, or urine Ca.
Cannabinoid Screen
Negative screenScreen only for marijuana products. Confirmation sent out to Mayo.
Carbamezapine
4-10 ug/mlCarbamezapine = Tegretol, an anticonvulsant. Too much leads to lethargy, hepatic and renal damage. Too little does not control seizures. Reference range may not be accurate for specific patients.
Carbon Dioxide (CO2)
24-30 mEqProxy for bicarbonate - useful for assessing acid-base status. see ABG and electrolytes pages.
Carboxyhemoglobin
<1.5% (non-smoker)
1.5-5.0% (smoker)
Used to test for CO (carbon monoxide) poisoning. Tends to be normally elevated in smokers.
CBC
see individual testsaka Hemagram. see blood page. Includes WBC, RBC, Hgb, Hct, MCV, MCH, MCHC, RDW, Platelets
CD4 / CD8
see individual testssee HIV page. CD4 count is used as a marker in HIV progression.
CEA
<3.0 ng/ml in non-smokersA tumor marker that is used for monitoring recurrence in patients with known CEA-producing tumors. These can be any adenocarcinomas, although typically used for colon CA. Note that this is used for progression or recurrence - NOT as a screening tool, an application for which this test is not particularly useful. 
Chloride
96-110 mEq/Lsee electrolytes page. Increased in dehydration, CF, hyperparathyroid. Decreased in dilution, SIADH, DKA.
Cholesterol
<200 mg/dlTotal chol - needs breakdown to be clinically useful (HDL, LDL, TG). 200-239 = Borderline. >240 = High Risk.
CK-MB
0-5 ng/mlUsed to rule out MI. Starts to rise 4-6 hours after a cardiac event, and peaks at 12-24 hours. Returns to normal by 1-3 days. Remains negative in patients with angina, even if high-risk and unstable - specific for infarction of cardiac muscle. Can be falsely elevated in skeletal muscle damage or with renal failure.
CK-MB with Total CK
see individual testsUsing both values allows you to calculate the CK Index. The Index is calculated as CK-MB/Total CK. If the index is elevated, then the increase in CK-MB is probably due to cardiac damage, whereas if it's low (<1%), then the cause is probably skeletal muscle.
Cocaine Metabolites
Negative screenScreen only. Confirmation sent out to Mayo.
Cold Agglutinins
Negative screenAre a cause of normocytic anemia.
Comprehensive Metabolic Panel (CMP)
see individual testsIncludes Albumin, Alk Phos, ALT, AST, Bili (conj & unconj), BUN, Calcium, Chloride, CO2, Creatinine, Glucose, Potassium, Sodium, Total Protein
Coomb's - Direct
negativeaka "Direct Antiglobulin" - part of workup for hemolytic anemia. This test looks specifically for antibodies attached to RBC's, and will be positive in autoimmune hemolytic anemias (HA) and transfusion reactions, but negative in non-autoimmune HA.
Coomb's - Indirect
negativeaka "Antibody Screen" - part of workup for hemolytic anemia. This test looks for RBC antibodies in serum. If a person has received a blood transfusion in the past and has developed antibodies to an RBC antigen, then this test will be positive.
Cortisol
7-9am: 4.3-22.4 ug/dl
3-5pm:3.1-16.7 ug/dl
Can help to diagnose Cushing's, Addison's. Dexamethasone, given at night, should suppres AM peak of cortisol - if it doesn't, susupect Cushing's ("Dexamethasone Suppression Test").
Creatinine
0.7-1.5 mg/dlsee electrolytes page. Increases in renal insufficiency (decreased GFR). Decreases in states of increased GFR (such as pregnancy), decreased muscle mass/use. Ratio of BUN/Creat is often analyzed: if the ratio is >20:1, then volume depletion &/or hypoperfusion is probably present.
Creatinine Clearance
: 107-139 ml/min
: 87-107 ml/min
Proxy measurement for GFR, renal function. In the kidney, creatinine is filtered but not reabsorbed.
Cryoglobulins
Negative screen at 72 hourssee anemia page - same as cold agglutinin, which clogs vessels when <98o and thereby causes vasculitis. Seen in renal failure, and associated with liver disease (particularly Hep C), as well as being caused by mycoplasma and EBV.

ABCDEFGHIJKLMNOPQRSTUVWXYZ
Lab
Normal
Comments

D-Dimer
<50 ug/mlFibrinogen breakdown product. Extremely non-specific acute phase reactant. Reliably elevated in PE, DVT, DIC.
Depakote
50-100 ug/mlaka Valproic Acid
Dexamethasone Suppression Test
50-100 ug/mlBaseline level, then three post-test samples are drawn. Used to diagnose Cushing's - if 1o, dexamethasone will NOT suppress cortisol.
Digoxin
0.5-2.0 ng/mlDig levels need to be monitored to ensure therapeutic range, although values within reference range may not be therapeutic for individual patients. Dig toxicity can occur at any level and can be fatal.
Dilantin
??aka Phenytoin
Direct Antiglobulin
Negativeaka Coomb's Test (direct) - used for working up hemolytic anemia.
Drug Screen 6
Negative ScreenIncludes Amphetamines, Barbiturates, Benzodiazepines, Cocaine, Cannabinoids, and Opiates.
Drug Screen - Agitated
Negative ScreenIncludes Cocaine and Amphetamines
Drug Screen - Sedated
Negative ScreenIncludes Barbiturates, Benzodiazepines, and Opiates
Drug Screen - Comprehensive
Negative Screen(send-out to Mayo) - takes 2-3 days. Can specify blood, urine, or both.

ABCDEFGHIJKLMNOPQRSTUVWXYZ
Lab
Normal
Comments

Electrolytes
see individual testsIncludes Chloride, CO2, Potassium, Sodium
Electrophoresis, Hemoglobin
No abnormal hemoglobins identifiedUseful for diagnosing hemoglobinopathies, such as thalassemias.
Electrophoresis, Serum
Albumin: 49-61%
Alpha 1: 2.4-4.9%
Alpha 2: 10-19%
Beta: 9-14%
Gamma: 11-21%
Total Protein: 6.0-8.5 g/dl
Individual bands are stronger in myeloma
Erythropoeitin
4-24 mU/mL(send-out to Mayo) Created in kidneys, stimulates red blood cell production. Occasionally tested when other causes of anemia are ruled out.
Estradiol
??Elevated in polycystic ovarian disease, but not as useful a marker as the LH/FSH ratio. Used as part of a fertility workup to assess the menstrual cycle, and to time in vitro fertilization. Can be used to confirm menopause, but is not as good as FSH for this purpose.
Ethanol, Blood
<10 mg/dlBlood alcohol
Ethylene Glycol
None detectedAntifreeze

ABCDEFGHIJKLMNOPQRSTUVWXYZ
Lab
Normal
Comments

Factor __ Assay
60-140% of normalAssays available for Factors: 2, 5, 7, 8, 9, 10, 11, 12. Tested to rule out various specific hereditary coagulopathies. An antigen test is also available for Factor 8.
Factor V Leiden
Negative(send-out to Mayo) Part of hypercoagulability workup. Factor V Leiden is a hereditary deficiency in the clotting cascade.
Fecal Occult Blood
NegativeNon-specific, non-sensitive test for GI bleeding.
Ferritin
: 42-313 ng/ml
: 8-151 ng/ml
see anemia page. Ferritin is storage form of iron. Low in iron-deficiency states, increased (particularly >70%) indicates hemochromatosis. Is also an acute phase reactant (meaning that it rises non-specifically in many inflammatory conditions).
Fetal Lung Maturity
>55 mg/g<39 = immature
40-54 = borderline
Blood, meconium and bilirubin (and other contaminants) may give false readings.
Fibrinogen
144-399 mg/dlIncreases in coagulopathies or any inflammatory process (it's an "acute phase reactant"). It drops in DIC.
Folate
2.8-18.0 ng/mlsee anemia page. Common cause of macrocytic anemia. Often low in alcoholics or with celiac sprue (and other intestinal conditions)
Free Thyroxine Index
1.3-4.1Includes T3 uptake, T4, and T7 calculation
FSH
: 1-18 mIU/ml
follicular phase: 2-11 mIU/ml
midcycle: 3.4-35 mIU/ml
luteal phase: 1-9 mIU/ml
>menopause: 25-120 mIU/ml
Part of amenorrhea workup, and a common test to confirm menopause. Also, used in conjunction with LH to diagnose POD (polycystic ovarian disease) - in this condition, the LH/FSH ratio is >2.
Fungus Culture
No fungus isolated/seenCan order for Blood, Fluid, Genital, Nails, Oral, Respiratory/Sputum, Skin, Spinal Fluid, Tissue, Urine, or Other

ABCDEFGHIJKLMNOPQRSTUVWXYZ
Lab
Normal
Comments

Gabapentin
2.0-12.0 ug/ml(send-out to Mayo) aka Neurontin. Loss of efficacy when serum concentrations below reference range.
GC Screen Culture
No Neisseria Gonorrhea isolatedGonorrhea test - reported when positive, negative final at 48 hours.
GGT
: 15-73 U/L
: 12-43 U/L
Gamma Glutyl Transerfase. see LFT page. A more specific LFT than AST or ALT - more directly indicates hepatic (as opposed to another source) damage.
Glucose 1 Hr Screen
<135 mg/dlGestational diabetes screen. If elevated, need to perform 3 hour tolerance test.
Glucose 2 Hr Screen
<200 mg/dlGeneral diabetes screen. If elevated, meets criteria for DM. see diabetes page.
Glucose 3 Hr Screen
??Gestational diabetes screen.
Glucose
??see diabetes page for all diagnostic criteria - >200 on more than one occasion = diabetes.
Glucose-6-Phosphate
8.6-18.6 u/g of HgbIf a patient has this deficiency, the use of sulfa (or some other) drugs can cause hemolytic crisis.
Glucose, CSF
60-80% of plasma glucoseDecreased with CSF bacteria (who eat sugar)
Glucose, Serum or Plasma (Fasting)
<50yo: 70-115 mg/dl
>50yo: 85-125 mg/dl
>125 needed on two occasions for diagnosis of DM. see diabetes page.
Glucose, Urine
0.003-0.025 g/dlRule of thumb is that blood glucose should be >250 before glucose spills into urine.
GNRH
??(send-out to Mayo) Gonadotropin Releasing Hormone. If pan-hypopituitary, this (and TSH and ACTH) will be decreased.
Growth Hormone
: < or = 5 ng/ml
: < or = 10 ng/ml
(send-out to Mayo) Increased in acromegaly. Decreased in some short-stature conditions.

ABCDEFGHIJKLMNOPQRSTUVWXYZ
Lab
Normal
Comments

Haloperidol
5-16 ng/mlaka Haldol. Low dose therapeutic = 2-5 ng/ml. High dose therapeutic = 10-40 ng/ml. Different ranges are therapeutic for individuals. Overdose can lead to extrapyramidal symptoms and tardive dyskinesia.
Ham's Test
No hemolysisaka "sugar water test," used to diagnose paroxysmal nocturnal hemoglobinuria (a cause of anemia, which also leads to false positive urine dipsticks for blood). The test looks for fragile red blood cells, and has a reputation for not being reliable.
Haptoglobin
36-195 mg/dlA test for intravascular hemolysis (seen in DIC, TTP, heart valve shearing). Haptoblogin binds to free hemoglobin, so it is consumed (and therefore decreases) in intravascular hemolysis, when lots of hemoglobin is freed.
HCG
<4 mIU/mlHuman Chorionic Gonadotropin. Used as pregnancy test. If 4-10 mIU/ml, must repeat - not diagnostic. This is serum test - there is also a urine test, see Pregnancy test, urine
HDL
>35 mg/dlHigh-Density Lipoprotein. Must be taken fasting. Increases with exercise.
Heavy Metal Panel
Arsenic: <0.07 ug/ml
Cadmium: <5.0 ng/ml
Lead, Adult: <20 ug/dl
Lead, Peds: <10 ug/dl
Mercury: <10 ng/ml
(send-out to Mayo) Test for Arsenic, Cadmium, Lead, Mercury. Not that toxic ranges include:
Lead, Adult: >30 ug/dl
Lead, Peds: >20 ug/dl
Mercury: >50 ng/ml
Hemagram
see individual testsaka CBC. Includes WBC, RBC, Hgb, HCT, MCV, MCH, MCHC, RDW, and Platelets. see blood page for details
Hemagram & Diff
see individual testsHemagram with 5-part differential (neutrophils, lymphocytes, basophils, monocytes, eosinophils). see blood page for details
Hematocrit (HCT)
: 39-49%
: 33-43%
Decreased in blood loss, anemia. Increased in polycythemia, smokers.
Hemoglobin (Hgb)
: 13-17
: 12-15
Decreased in blood loss, anemia. Increased in hemoconcentration, polycythemia.
Hemoglobin A1C
<6% (non-diabetic)Used to measure effectiveness of maintaining blood glucose over an extended period - the test is said to summarize glucose control over the 6 months prior to the blood draw. Glucose Control Index (for diabetics:)
>= 10%: Poor
9-10%: Fair
8-9%: Good
7-8%: Excellent
6-7%: Near-Normal
<=6%: Normal
Heparin Platelet Antibody
NegativeUsed to look for Heparin-induced, antibody-meidated platelet aggregation, seen in Heparin-induced thrombocytopenia (potentially fatal if untreated)
Hep A Antibody
Negativesee hepatitis page. Positive indicates prior exposure - in which case the lab checks for IgM, which would indicate acute infection.
Hep B
Negativesee hepatitis page. Surface antigen indicates acute infection, surface antibody indicates cleared infection. Core antibody indicates current or prior exposure.
Hep C Antibody
Negativesee hepatitis page. 10% false positive, otherwise indicates prior infection with or without currently active viremia - confirm viremia with PCR.
Hep C Genotype
variablesee hepatitis page. (send-out to Mayo) Used to distinguish between various strains of Hep C, which have different susceptibilities to various medications.
Hep C RNA PCR
Negativesee hepatitis page. (send-out to Mayo) Used to confirm active Hep C.
Hep D Antibody
Negativesee hepatitis page. (send-out to Mayo) Indicates current or prior exposure to Hep D.
Herpes IgG Antibody
<=0.90Herpes test. Note that 0.91-1.09 is equivocal (non-diagnostic) - >1.10 is positive.
Herpes Culture (HSV)
No herpes simplex recoveredUsed for swab of vesicular fluid
HIV Antibody
Non-reactivesee HIV page. HIV Test. If reactive, sent to Mayo for confirmation. Lab will not report results to patients - only to physicians. Sensitivity is currently >50 copies. Also, see viral load on this page
HIV Confirmation
Negativesee HIV page. (send-out to Mayo) Used to confirm HIV. Done by Western blot, and positives are reported as either HIV1 or HIV2 positive. Actually a serotype (not a genotype, as often called), since it characterizes the antibody to HIV, not the HIV virus itself.
HLA B27
Detected or Not DetectedIncreased in patients who are predisposed to seronegative spondylarthropathies, such as Reiter's, ankylosing spondylitis, Crohn's. Part of workup for patients with monoarticular arthridities.
Homocysteine
4.5-12.5 umol/LElevated in homocysteinuria, or other genetic defects. Recent studies show that an increase in homocysteine is correlated with an increased risk of cardiovascular disease.
HPV
Negative(send-out to Mayo) Human Papilloma Virus - predisposes to cervical CA. If positive, will determine which groups are present.
HVA Urine
<8 mg/24 hrs (adult)(send-out to Mayo) Homovanillic Acid - used to confirm pheochromocytoma, along with MVA

ABCDEFGHIJKLMNOPQRSTUVWXYZ
Lab
Normal
Comments

Imipramine
150-250 ng/mlTherapeutic range, but different patients may respond to different levels
Immunodeficiency Panel
CD3: 67-84%
CD4: 40-65%
CD8: 10-38%
Absolute CD4: 702-1791/ul
Can also be ordered with B and NK Cell markers:
CD19: 7-22%
CD16/56: 2-22%
Immunofixation, serum
NegativeLooks for monoclonal immunoglobulins, as seen in myeloma
Immunofixation, urine
NegativeLooks for monoclonal immunoglobulins, as seen in myeloma. Called Bence-Jones proteins when found in urine.
Influenza
Negative(send-out to state lab) Can order Influenza A Antibody, Influenza B Antibody, or Influenza B Vaccine Response. Can also order Influenza Culture.
INR
0.8-1.2International Normalized Ratio. Standardized lab used in place of PT to follow Warfarin (Coumadin) effectiveness.
Insulin
Fasting: 0-22 ug/mlCan be used to check for insulinoma (pancreatic cell tumor)
Insulin Antibodies
<3%Can be used to confirm this specific variant of DM2
Iron
: 70-180 ug/dl
: 60-180 ug/dl
see anemia page. Decreased in iron-deficiency anemia or anemia of chronic disease.
Iron Binding Capacity (IBC or TIBC)
250-450 ug/dlsee anemia page. Decreases in malnutrition, anemia of chronic disease or iron deficiency, or hemochromatosis.
Iron Saturation
0.2-0.55A calculated value from Iron and IBC. Iron sat = Iron/IBC.
Saturation >50% with Fe+: Hemochromatosis.
Saturation normal with Fe+: Chronic disease.
Saturation with Fe+: Iron deficiency (in this case, the lower the sat the more specific - <10% is >90% specific.).

ABCDEFGHIJKLMNOPQRSTUVWXYZ
Lab
Normal
Comments

Kidney Stone Analysis
reportIf not calcium-carbonate, unlikely to show up on x-ray.
Lactose Tolerance
??Used to confirm suspected lactose intolerance.
LDH
313-618 u/LLactose dehydrogenase Non-specific. Rises in hemolysis and PCP (penumonia).
LDL
<130 mg/dlsee lipids page. Low-Density Lipoprotein. This value is generally calculated on the lipid panel - the only reason to order this test is if TG are high (>400), making calculation innacurate (and direct measurement needed). 130-160 = Borderline. >160 = High Risk.
Lead
Child: 0-9 ug/dl
Adult: 0-20 ug/dl
also part of Heavy Metal Screen
Leukemia Panel
reportCan be ordered for Bone Marrow or Peripheral Blood
LH
20-70 yo: 2-9 mIU/ml
<70 yo: 3-34 mIU/ml
follicular phase: 1-18 mIU/ml
midcycle: 15-80 mIU/ml
luteal phase: 0.5-18 mIU/ml
>menopause: 12-55 mIU/ml
Used as part of workup for amennorrhea / oligomennorrhea, or as test for menopause or ovarian failure. Also, used in conjunction with FSH to diagnose POD (polycystic ovarian disease) - in this condition, the LH/FSH ratio is >2.
Lipase
0-210 u/LElevated in pancreatic damage (sensitive but not specific marker for pancreatitis), pancreatic duct blockage
Lipid Panel
see individual testssee lipids page. Should be fasting x 8 hours. Includes Cholesterol, Triglycerides, HDL, LDL (LDL is calculated using the formula LDL = total chol - HDL - TG/5), and Chol/LDL ratio.
Lithium
0.6-1.2 mmol/LTherapeutic range. Toxic = >2.5 mmol/L, although toxicity can occur at any level.
Liver Panel (LFT)
see individual testsIncludes Albumin, Alk Phos, ALT, AST, Bili-Conj, Bili-Unconj, Bili-Total, and Total Protein. see LFT page.
Lupus Anticoagulant Workup
see individual testsIncludes PTT, 50/50 Mix, Dilute Russell Viper Venom Time. Will confirm if positive.
Lyme Antibody
NegativeA screening test - cannot distinguish between IgG and IgM, although it will detect both. Confirm with Lyme Antibody by Western Blot (a send-out to Mayo).

ABCDEFGHIJKLMNOPQRSTUVWXYZ
Lab
Normal
Comments

Magnesium
1.4-2.3 mEq/LDecreased in malnutrition. Should check mag when K+ or Ca+ are decreased - they often coincide. Low mag leads to tetany. Elevated in renal failure. Bartlett's can lead to increased mag loss by kidneys.
Methanol
NegativePart of Alcohol Screen
Methemoglobin
0.004-0.015A breakdown product of hemoglobin. Increased in CO poisoning. Biochemically, methemoglobin has had its iron changed from ferrous (2+) to ferric (3+) by oxidation - this is caused by a variety of chemicals, including primaquin, sulfonamides, Dapsone, and others.
Microalbumin
<1.9 mg/dl Microalbumin
<20 mg/g Creatinine
Urine test. Increases in renal failure.
Monoclonal Protein, Quantitative
interpretationUrine test - a follow-up to positive electophoresis indicating myeloma
Monospot
NegativeBlood test for mononucleosis
Myoglobin
0.00-0.09 ug/ml(send-out to Mayo) A urine test. Increased in rhabdomyolysis (muscle breakdown). Buildup in kidneys can cause renal failure (ATN).

ABCDEFGHIJKLMNOPQRSTUVWXYZ
Lab
Normal
Comments

Newborn Screen
see individual tests(send-out to state lab) Includes PKU, T4, Galactose screen.
Niacin
??(send-out to Mayo) Decrease leads to dermatitis, diarrhea, dementia. Seen in alcoholics
Nortriptyline
50-150 ng/mlTricyclic antidepressant. Can use to check for therapeutic range or overdose
Opiate Screen
Negative screenScreen only. Confirmation send out to Mayo.
Osmolality
Serum: 280-300 mOsm/Kg
Serum: 275-295 mOsm/Kg
Urine: 392-1090 mOsm/Kg
Urine: 301-1090 mOsm/Kg
Can also order for CSF, but no reference range. Use to check for hemoconcentration / hemodilution, and for concentration of urine (particularly in working up suspected SIADH/DI)
Osmotic Fragility
Hemolysis less than or equal to controlUsed to help diagnose paroxysmal nocturnal hemoglobinuria (PNH).
Oxygen Saturation (O2 Sat)
0.95-0.99Arterial sample. Decreased in V/Q problems, multiple pulmonary or cardiac causes.

ABCDEFGHIJKLMNOPQRSTUVWXYZ
Lab
Normal
Comments

Parathyroid Hormone
10-65 pg/dlReference range assumes normal calcium. The hormone leads to increased absorption and release of Ca into the bloodstream (at the expense of bone)
pH
7.38-7.42See ABG page. Low means acidosis, high means alkalosis.
Phenobarbital
15-40 ug/mlBarbiturate used as anticonvulsant. Too low leads to seizures, too high leads to respiratory depression, hepatic dysfunction, megaloblastic anemia
Phenylalanine
0.4-3.7 mg/dlNewborn screen used to test for an inborn error of metabolism - PKU, or phenylketonuria.
Borderline: 3.8-10.0 mg/dl
Elevated: >10.0 mg/dl
Phenytoin
10.0-20.0 ug/mlaka Dilantin, an anticonvulsant. High levels can lead to arrythmia, multi-organ damage
Phosphorous
2.5-4.5 mg/dlDecreased in malnutrition. Tends to trend with Mag and Ca+. Decreased in PKA, refeeding syndrome (both K+ and phos will be decreased). Decreased phos leads to hemolytic anemia and heart failure. Elevated in renal failure - can cause calciphylaxis (CaPO4 deposits throughout the body).
Platelet Aggregation
See path reportOrdered when unexplained coagulopathy present
Porphobilinogen Screen
Negative screenIncreased in porphyrias.
Porphyrins
many individual tests(send out to Mayo) Used when porphyria screen positive for further analysis. Includes Uroporphyrins, Heptacarboxylporphyrins, Hexacarboxylporphyrins, Pentacarboxlporphyrins, Coproporphyrins, Porphobilinogen
Porphyrin Screen
Negative screenUsed when porphyria suspected - if positive, order porphyrins.
Potassium (K)
3.5-5.0 mEq/Lsee electrolytes page. Decreased in dilution, alkalosis, diuretic use. Increased in acidemia, renal insufficiency
Prealbumin
18-38 mg/dlNutrition lab - low prealbumin indicates poor nutritional status
Preformed Antibody Screen
>5%Looks for specific antibodies, the presence of which you've determined with an indirect Coomb's test. For example, the if the anti-D preformed antibody test is positive, the patient has an antibody to the D antigen on RBCs, so must get only Rh- blood.
Pregnancy Test
Negative or PositiveLooks for elevated HCG. This test is equivalent to home pregnancy test. Serum test is more sensitive
Profile Arthritis
see individual testsIncludes ANA and Rheumatoid Factor
Profile Hepatitis A/B/C
see individual testsIncludes Hep A Antibody, Hep B Surface Ab and Ag, Hep B Core Ab, Hep C Ab.
Profile Hepatitis B
see individual testsIncludes Surface Ab, Surface Ag, Core Ab
Profile Prenatal
see individual testsIncludes Antibody Screen, ABO/Rh, Hep B Surface Ag, Syphilis Serology, Rubella IgG Ab, Hemagram. Can also be ordered without Rubella
Profile Thyroid
see individual testsIncludes Free T4 and TSH
Progesterone
see next column: 0.3-1.2 ng/ml
Non-pregnant, Follicular Phase: 0.2-1.4 ng/ml
Non-pregnant, Luteal Phase: 3.3-25.6 ng/ml
Non-pregnant, Mid-Luteal Phase: 4.4-28.0 ng/ml
Postmenopausal: <0.7 ng/ml
Pregnant, First Trimester: 11.2-90.0 ng/ml
Pregnant, Second Trimester: 25.6-89.4 ng/ml
Pregnant, Third Trimester: 484.4-422.5 ng/ml
Prolactin
see next column: 2.1-17.1 ng/ml
Non-pregnant: 2.8-29.2 ng/ml
Pregnant: 9.7-208.5 ng/ml
Postmenopausal: 1.8-20.3 ng/ml
Prostate Specific Antigen (PSA)
<50yo: 0-2.5 ng/ml
50-59yo: 0-3.5 ng/ml
60-69yo: 0-4.5 ng/ml
>70yo: 0-6.5 ng/ml
Screening test for prostate CA. Confirm with biopsy
Protein
6.0-8.5 g/dlLow in malnutrition or protein wasting states (enteropathy or nephropathy, for example). Can be followed daily - any decrease of ~1 g/dl is considered dramatic and evidence of protein wasting, as seen in exudative diarrhea. Protein elevated in gammopathies. Protein:Albumin ratio is increased in myeloma, autoimmune hepatitis.
Protein, CSF
15-60 mg/dlElevated when any organism in CSF, or when leaky BBB. Also, if CSF protein is elevated but no CSF bugs are grown, consider Guillian-Barre syndrome. 
Protein, Urine
<150 mg/24 hrIncreased in renal failure
Prothrombin Time (PT)
12.3-13.9 secondsINR is more widely used indicator. Affected by Warfarin (Coumadin)
Prothrombin Time 50/50 Mix
Requires interpretationMix is used when the question remains whether the coagulopathy is caused by a deficiency of a clotting factor or an antibody to that factor. The patient's blood is mixed with normal - if the problem is deficiency, the mixture will correct the coagulopathy - if it is an antibody, the coagulopathy will remain.
PTT
21-30 secondsAffected by Heparin
PTT 50/50 Mix
Requires interpretationMix is used when the question remains whether the coagulopathy is caused by a deficiency of a clotting factor or an antibody to that factor. The patient's blood is mixed with normal - if the problem is deficiency, the mixture will correct the coagulopathy - if it is an antibody, the coagulopathy will remain.

ABCDEFGHIJKLMNOPQRSTUVWXYZ
Lab
Normal
Comments

Rabies Antibody
??(send-out to Mayo) Rabies test
Renal Transplant Panel
CD3: 67-84%??
Renin
0.5-2.5 ng/ml/hrPart of a workup for renal vascular disease - if renal artery stenosis, would be increased. Not used by itself - also get aldosterone level
Reticulocyte Count
0.01-0.029+/- 100% inter-operator variability! Increased whenever increased red cell production.
Rheumatoid Factor
<20 IU/mlElevated in rheumatoid arthritis
RPR
see Syphilis serology. This is the newer syphilis test, more sensitive with fewer false positives.

ABCDEFGHIJKLMNOPQRSTUVWXYZ
Lab
Normal
Comments

Salicylate
Negative: <2 mg/dl
Therapeutic: <20 mg/dl
Toxic: >30 mg/dl
Lethal: >60 mg/dl
Sed. Rate
: <15 mm
: <20 mm
Non-specific indicator for inflammation
Sickle Cell
NegativeFairly definitive test for sickle-cell disease
Sjogren's Antibodies
NegativeTest for Sjogren's, an autoimmune disease with anti-SS DNA antibodies
Sodium
136-145 mEq/Lsee electrolytes page. Decreased in hemodilution, SIADH, renal failure. Increased in vomiting, diarrhea, DI.
Sperm Antibody
<20%Percentage of sperm bound to antibody must be weighed against total sperm count for meaningful interpretation. Test is used in cases of difficulty conceiving.
Sputum Cytology
variesThree consecutive morning samples should be ordered.
Strep Screen
None isolatedCan be ordered for Group A or Group B. Reported when positive, negative is final at 48 hours.
Sweat Test
Chloride: <30 mEq/L
Sodium: <60 mEq/L
Used to diagnose cystic fibrosis - one of the findings in CF is elevated Cl- production.
Equivocal: 40-60 mEq/L
Abnormal: >60 mEq/L
Spyhilis Serology
NegativeRPR or VRDL ??

ABCDEFGHIJKLMNOPQRSTUVWXYZ
Lab
Normal
Comments

T3 Uptake
28-36%An indirect measure of thyroid-binding globulin. T3 Uptake, when multiplied by total T4, is equivalent to the "free thyroxine index," or FTI. The FTI is also known as T7, or a "calculated free T4."
T3, Free
2.3-4.2 pg/ml(send-out to Mayo) see thyroid page. Elevated in hyperthyroid, decreased in hypothyroid. The free test is more accurate than the total, as it is not affected by changes in binding proteins.
T3, Total
60-181 ng/dlsee thyroid page. Elevated in hyperthyroid, decreased in hypothyroid
T4
4.5-10.9 ug/dlsee thyroid page. Elevated in hyperthyroid, decreased in hypothyroid
T4, Free
0.8-1.8 ng/dlsee thyroid page. Elevated in hyperthyroid, decreased in hypothyroid. The free test is more accurate than the total, as it is not affected by changes in binding proteins.
Testosterone
: 241-827 ng/dl
: 14-76 ng/dl
Tested in multiple conditions, including prostate conditions, sperm production problems, female hirsutism, suspected androgen-insensitivity, etc. Can send-out to Mayo for Total & Free studies
Thiamine (B1)
??(send-out to Mayo) Deficiency is common in alcoholics, and leads to Wernicke's Encephalopathy &/or Korsakoff's Dementia. Giving glucose without giving thiamine can cause Wernicke's - always give thiamine with glucose
Thyroid Cascade
see individual testssee thyroid page for complete algorithm. (TSH +/- => Free T4 +/- => Total T3)
TORCH Screen
see individual testsIncludes Toxoplasmosis IgG Ab, Rubella IgG Ab, CMV, Herpes. Commonly transmitted diseases during childbirth
Transferrin
202-336 mg/dlsee anemia page. Transporter for iron in serum. Increases during iron deficiency
TRH Stimulation
reportTSH levels are drawn at baseline, 30, and 60 minutes after admin of TRH. Can help to distinguish between secondary (pituitary) and tertiary (hypotahalamic) causes of thyroid dysfunction
Tricyclic Screen
:<500 ng/mlPotentially toxic > 500, although different levels are appropriate for different patients. Helpful in assessing possible OD
Triglyceride
35-160 mg/dlsee lipids page. Part of lipid profile. &gt;1000 can cause pancreatitis. High TG is an independent (although not widely cited) risk factor for CAD. Hypertriglyceridemia is often familial, and is also often seen in insulin resistance.
Triple Markers
reportIncludes AFP, HCG, and Unconjugated Estriol
Troponin I
<0.15 ng/mlUsed to help rule out MI, along with CK-MB. Troponin I rises 4-8 hours after an event, peaks 12-24 hours after the event, and stays elevated for 7-10 days, as compared to CK-MB, which only stays elevated for 1-3 days. Troponin I is specific for cardiac damage, but not for MI - it is useful as a marker of generalized myocardial injury, including high-risk unstable angina.
Indeterminate: 0.15-1.50 ng/ml
Positive: >1.50 ng/dl
TSH
0.35-5.50 uIU/mlsee thyroid page. Elevated in primary hypothyroid, decreased in primary hyperthyroid. Elevated in secondary hyperthyroid, decreased in secondary hypothyroid
Tzank Smear
NegativeHerpes test

ABCDEFGHIJKLMNOPQRSTUVWXYZ
Lab
Normal
Comments

Uric Acid (Urate)
: 3.9-9.0 mg/dl
: 2.2-7.7 mg/dl
Elevated in renal insufficiency &/or gout.
Urinalysis
see individual testssee urinalysis page
Urine Cytology
reportBe certain to include any history of CA, radiation, chemo in order
Valproic Acid
50-100 ug/dlaka Depakote, for seizure disorder or bipolar disorder. OD can lead to hepatic failure, bone marrow suppression
VDRL
??see Syphilis Serology. Can send CSF to state lab. This test has been replaced by RPR (which is more sensitive and specific for syphilis), but is still available by specific request.
Viral Load
negativesee HIV page. An HIV test, done by PCR. Used to follow the progress of therapy and to help plan for prophylaxis. Also is used to diagnose HIV seroconversion syndrome - the mono-like syndrome that occurs during first exposure to HIV. When first infected, patients' HIV screens will be negative, but viral load will be positive.
Vitamin __
variesCan order Vitamins A, B1, B6, B12, C, D,125-Dihydroxy, D,25-Hydroxy, E, K1
VMA
2-10 mg/24 hrsVanillylmandelic acid - 24 hour urine test used to diagnose pheochromocytoma, along with HVA

ABCDEFGHIJKLMNOPQRSTUVWXYZ
Lab
Normal
Comments

WBC
3.2-9.8see blood page. Increased in infection, inflammation, leukemias. Decreased in autoimmune disease, bone marrow dysfunction.
Zinc
0.66-1.10 ug/mlElevated zinc most likely from over ingestion, can cause copper deficiency &/or leukopenia.

ABCDEFGHIJKLMNOPQRSTUVWXYZ