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Clincal Chemistry and Hematology

CLINICAL CHEMISTRY VALUES

SODIUM (m Eq/L): the pricipal cation found in extracellular fluids. Sodium salts are necessary for the preservation of balance between calcium and potassium to maintain normal heart action and body equilibrium. It regulates osmotic pressure in cells and fluids and isotonic balance in tissues. It acts as a buffer in blood and prevents excessive water loss from tissues.

POTASSIUM (m Eq/L): the principle cation in intracellular fulid. Potassium aids regulation of osmotic pressure and acid /base balance. It is necessary for normal excitability of muscle tissue, especially cardiac muscle and conduction of nerve impulses.

CHLORIDE (m Eq/L): found in blood serum principally as sodium chloride. Chloride levels are elevated in nephritis, eclampsia, anemia, and cardiac disease and are decreased in fevers, diabetes and pneumonia.

ANION GAP (dimensionless): a concept used to estimate electrolyte (anin & cation) levels in serum and conditions influencing them, estimated by subtracting the sum of the anions Cl^- + HCO₃^- from the sum Na⁺ and K⁺. The anion gap increases with production of inorganic acids in lactic acidosis, ketoacidosis, dehydration, renal disease, and after ingestion of acids.

CREATININE (mg/dl): one of the ono-protein constituents of blood. Increased quantities are found in advanced stages of renal disease. It is a normal alkaline constituent of urine and blood. Creatinine is derived from the nonenzymatic interconversion of creatine in skeletal muscle. Plasma concentration of creatinine is very stable. Serum creatinine levels are a function of lean body mass and may be higher in males.

BUN-BLOOD UREA NITROGEN (mg/dl): nitrogen in the blood in the form or urea. The level of urea is a rough estimate of kidney function. Increases usually indicate decreased renal function. Increases also occur with high protein diet, tissue breakdown or decreased protein synthesis.

BUN/CREATININE (dimensionless): the ration is elevated whenever urea production is increased by diet or glucocorticoid therapy, with some neoplasm and antibiotics and with excessive protein catabolism as seen in infections and in uncontrolled diabetes mellitus. A low ration is found in pregnancy, over-hydration, sever liver disease and malnutrition.

OSMOLALITY (mOsm/Kg): The concentration of dissolved ionic substances in serum. Changes of osmolality can reflect the presence of toxic substances and ketoacidosis.

GLUCOSE (mg/dl): the amount of dextrose in serum or whole blood. Increased levels indicate hyperendocrine conditions. Decreased levels indicate hypo-endocrine condictions.

URIC ACID (mg/dl): a common constituent of urinary and renal calculi. Uric acid must be excreted and cannot be destroyed by the body. Increases are observed after ingestion of proteins, exercise and in gout, leukemia and acute articular rheumatism. Decreases are observed in nephritis, chlorosis, lead poisoning and protein free diet.

CHOLESTEROL (mg/dl): a sterol widely distributed in animal tissues. It can be synthesized by the liver and is a normal constituent of bile. It is the principle constituent of gall stones and is important in metabolism serving as a precursor of various steriod hormones.

INORGANIC PHOSPHATES (mg/dl): important in maintenance of acid / base balance of blood. Decreases occur when alkaline reserves are high; in nephritis, tetany (hypo-parathyroidism), adrenal cortical deficiency, and bond disease. Increased excretion occurs when alkali reserve is low; in starvation, hyper-parathyroidism, high protein diet and extreme muscular exercise.

CALCIUM (mg/dl): essential to blood coagulation, acid / base balance, bones, teeth, activation of enzymes, muscle and nerve function. Vitamin D must be present fo calcium absorption.

TOTAL PROTEIN (g/dl): protein present in the blood serum including immunoglobulins, albumin, compliment (proteins of antigen - antibody function), coagulation factors and enzymes. All proteins fulfill some physiological or biological function and activities cover a wide range of functions.

IONIZABLE CALCIUM (mg/dl): physiologically active calcium. About 47% of plasma calcium is ionized. The physiological function is control of cell membrane permeability. Calcium homeostasis is maintained by parathyroid hormone.

ALBUMIN (g/dl): a water-soluble protein formed principally in the liver. It is responsible for much of colloidal osmotic pressure of blood, importatnt in regulating exchange of water between plasma and the interstitial compartment. It also functions as a carrier protein for fatty acids, bilirubin, drugs and hormones such as cortisol and thyroxine when their specific binding globulins are saturated. A decrease may indicate severe renal disease. liver disease, or malnutrition; extensive burns may result in a serious decrease in plasma protein.

GLOBULINS (g/dl): insoluble in water and highly concentrated salt solutions. They are soluble in moderately concentrated salt solutions. All plasma proteins are globulins except albumin and pre-albumin. Globulins function as carrier proteins, clotting factors, compliment components and immunoglobulins.

A/G RATIO (dimensionless): the amount of albumin in relation to globulin.

TOTAL BILIRUBIN (mg/dl): ornage bile pigment produced by breakdown of heme and reduction of biliverdin (a green bile pigment formed by the catabolism of hemoglobin.) It mormally circulates in plasma and is taken up by liver cells and conjugated to form bilirubin diglucuronide, the water-soluble pigment which is excreted in bile. Elevated levels indicate liver dysfunction or hemolytic anemia.

ALKALINE PHOSPHATASE (U/L): present in teeth, developing bond, plasma, kidney and intestine. Excreted by the liver. Increases indicated obstructive liver disease and disease of the pancreas, lung, bond some malignancies without metastasis and in pregnancy. In the first month of life it may be six times the normal adult levels.

SGOT (U/L): serum glutimic oxaloacetic transaminase also called AST (aspartate amino transerase). It is present in many tissues and body fluids. Elevated values are observed in myocardial infarction, viral or toxic hepatitis, infectious mononucleosis, obstructive jaundice and some muscle diseases such as progressive muscular dystrophy.

LDH (U/L): lactate dehydrogenase is an enzyme wide spread in tissues and is partiularly abundant in kidney, skeletal muscles, liver and myocardium. It is present in several molecular forms called isoenzymes. Various isoenzymes are present to a greater extent than others therefore the pattern of LDH isoenzymes in serum aids the identification of damaged tissue. Blood obtained from animals via cardiac puncture will yield very high LDH.

GGTP (U/L): gamma glutamyl transpeptidase a tissue enzyme that provides a very sensitive index of alcohol and drug hepatoxicity, of infiltrative lesions of the liver and of biliary tract obstruction.

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