routine lab tests

1. Routine Lab Tests

2. • Can you mention some of routine Lab tests?
– CBC
– Blood group(esp. for surgical patients)
– U/A
– serum electrolytes , ------

3. CBC
• The complete blood count (CBC) is a common
blood test that evaluates the three major
types of cells in the blood:
• red blood cells,
• white blood cells, and
• platelets.

4. Ctd.
A CBC may be ordered as part of a
• routine checkup, or
• if your child is feeling more tired than usual,
• seems to have an infection,
• or has unexplained bruising or bleeding.

5. Red blood cells
• The CBC's measurements of red blood cell (RBC) count
includes:
• hemoglobin (the oxygen-carrying protein in RBCs),
• Hct:The hematocrit (Ht or HCT) or packed cell volume (PCV)
or erythrocyte volume fraction (EVF) is the proportion of
blood volume that is occupied by red blood cells
• red cell indices
MCV,MCH,MCHC

6. • MCV=HCT/RBC,
NV = 83 to 97 fL

7. • MCHC=HGB/HCT
NV 31 to 34 g/dL

8. • MCH=HGB/RBC,
NV 28 to 32

9. Red blood cells
• provides information about the RBCs, which
carry oxygen from the lungs to the rest of the
body

10. • These measurements are usually done to test
for anemia, a common condition that occurs
when the body has insufficient red blood cells.

11. White blood cells
• The white blood cell (WBC) count measures
the number of WBCs (also called leukocytes)
in the blood.
• The WBC differential test measures the
relative numbers of the different kinds of
WBCs in the blood.

12. • Polymorphs( neutrophils) : react within an
hour of tissue injury and are the hallmark of
acute inflammation
• Lymphocytes: play an important and integral
role in the body's defenses.

13. • Monocytes: part of the human body's
immune system , in response to inflammation
signals, monocytes can move quickly (aprox. 8-12
hours) to sites of infection
• Eosinophils:They also control mechanisms associated
with allergy and asthma
• Basophils: allergies and parasitosis

17. • WBCs, which help the body fight infection, are
bigger than red blood cells and there are far
fewer of them in the bloodstream.

18. An abnormal WBC count may indicate
• an infection,
• inflammation, or
• other stress in the body.
• For example, a bacterial infection can cause
the WBC count to increase, or decrease,
dramatically

19. Platelets
• The smallest blood cells, platelets play an
important role in blood clotting and the
prevention of bleeding.
• When a blood vessel is damaged or cut,
platelets clump together and plug the hole
until the blood clots...

20. • If the platelet count is too low, a person can
be in danger of bleeding in any part of the
body..

22. The CBC can also test for
• loss of blood,
• abnormalities in the production or destruction
of blood cells,
• acute and chronic infections,
• allergies, and
• problems with blood clotting

23. The Procedure
• Not much blood is drawn in a CBC. A health
professional will usually draw the blood from
a vein.
• For an infant, the blood may be obtained by
puncturing the heel with a small needle.

24. • If the blood is being drawn from a vein, the
skin surface is cleaned with antiseptic, and an
elastic band is placed around the upper arm to
apply pressure and cause the vein to swell
with blood.

25. • A needle is inserted into a vein (usually in the
arm inside of the elbow or on the back of the
hand) and blood is withdrawn and collected in
a vial or syringe.

26. • After the procedure, the elastic band is
removed. Once the blood has been collected,
the needle is removed and the area is covered
with cotton or a bandage to stop the bleeding.
The entire test will only take a few minutes.

27. Normal values
• Hgb wbc N L M E p
• At birth 13.7-20 9-30 61 31 6 2 150-450
• 2 wk 13-20 5-20 40 48 9 3
• 1 m 10-14 5-19 35 56 7 3
• 6 m-6 y 10.5-14 6-17 32 61 5 3
• 7-12 y 11-16 5-14 51 42 5 3
• adult
• female 12-16 4-13 57 35 5 3
• male 14-18

28. Blood Chemistries

29. • Blood chemistries refers to an analysis of a
number of chemical substances in the blood,
having clinical significance

30. Cardiac Enzymes
• CPK
• AST
• LDH

31. Liver Function Tests

32. Kidney Function Tests

33. Electrolytes
• Calcium
• Chloride
• Phosphorus
• Magnesium
• Potassium
• Sodium

34. Lipid profiles
• Cholesterol
• Total
• LDL
• HDL
• VLDL
• Triglycerides

35. Coagulation profile
• CBC
• Platelets
• Prothrombin Time(PT)
• Partial thromboplastin time(PTT)
• Bleeding time

36. Hormonal asseys
• Pregnancy test
• T3 and T4
• TSH
• FSH
• LH
• Prolactin
• Estradiol
• DHEAS (Dehydroepiandrosterone sulfate

37. • Glucose
• CO2 Content
• Uric Acid
• CPK
• LDH

38. Liver function tests
•

39. Primary functions of the liver
• Bile production and excreation
• Excreation of bilirubin, cholestrol,hormones
and drugs
• Metabolism of fats, proteins,and
carbohydrates
• Storage of glycogen , vitamins,and minerals
and regulation of glucose levels

40. • Synthesis of plasma proteins,such as albumin
and clotting factors
• Blood detoxification and purification
• Conversion of ammonia into a less toxic form
called urea

41. • A/G Ratio ( normal is 2:1( reversed)
• Albumin
• Alkaline Phosphatase : a marker for poor bile flow
• Transaminases:markers of hepatocyte integrity
-ALT( SGPT: serum glutamic pyruvic (SGPT): more
specific for liver
5-45 IU

42. • AST( SGOT(Serum glutamic-oxaloacetic transaminase ):leakes
from injured liver,heart,skeletal muscle cells or rbcs, rarely
kidneys
5- 55 IU
• Bilirubin :is the yellow breakdown product of normal heme
catabolism. Heme is formed from hemoglobin, a principal
component of red blood cells.
• Total :
• Direct (Conjugated):
• Indirect (Unconjugated)

43. elevated
• Hemolysis
• Hepatocellular disease
• Biliary obstruction

44. • Hepatitis B Surface Antigen
• LDH
• Prothrombin time
• Blood ammonia level
• autoantibodies

45. Functions of the kidney
• Removal of nitrogenous waste products of
metabolism
• Regulation of acid base balance
• Regulation of fluid and electrolyte balance
• Removal of toxins/drugs
• Maintenace of BP
• Production of erytropoietin

46. • BUN: The blood urea nitrogen (BUN) test is a
measure of the amount of nitrogen in the blood in
the form of urea, and a measurement of
renal function. Urea is a substance secreted by the
liver, and removed from the blood by the kidneys.
• Creatinine :Creatinine is a break-down product of
creatine phosphate in muscle, and is usually
produced at a fairly constant rate by the body
(depending on muscle mass)

47. • Creatinine Clearance :Creatinine clearance
rate (CCr) is the volume of blood plasma that
is cleared of creatinine per unit time and is a
useful measure for approximating the GFR.
• GFR:Glomerular filtration rate (GFR)
describes the flow rate of filtered fluid
through the kidney

48. • LDH: It catalyses the interconversion of pyruvate and
lactate with concomitant interconversion of NADH
and NAD
• calcium
• Phosphorus
• Total Protein
• Uric Acid

49. • Urea/creatinine ratio