Interpretation of Clinical Laboratory Tests

Pharmacy Practice for Final Year B.Pharmacy Sem-VII,
As per PCI Syllabus
Interpretation of Clinical Laboratory Tests

1. Prepared By:- Ms.Mali S.M. Asst.Professor Subject :- Pharmacy Practice Sahyadri College of Pharmacy, Methwade Unit - V Topic-21 1

2. Haematological Parameters Urine Analysis What is lab result mean ? What are false-positive and false-negative test results? 2

3. What if your results are different than the reference range? Blood chemistry reference value Liver function test (LFT) Hematologic lab value 3

4. Erythrocytes (RBCs) Leucocytes (WBCs) Thrombocytes(Platelets) Haemoglobin Erythrocytes Sedimentation Rate/E.S.R Clotting Time Of Blood 4

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7. Lab test results may be positive, negative, or inconclusive . Your doctor will discuss what your test results mean for you and your health. 7 A positive test result means that the substance or condition being tested for was found. Positive test results also can mean that the amount of a substance being tested for is higher or lower than normal . A negative test result means that the substance or condition being tested for was not found. Negative results can also mean that the substance being tested for was present in a normal amount. Inconclusive test results are those that are not clearly positive or negative. For example, some tests measure the level of antibodie s to some bacteria or viruses in blood or other bodily fluid to look for an infection. It is not always clear if the level of antibodies is high enough to indicate an infection.

8. 8 A false-positive test result is one that shows a disease or condition is present when it is not present. A false-positive test result may suggest that a person has the disease or condition when he or she does not have it. For example, a false-positive pregnancy test result would appear to detect the substance that confirms pregnancy , when in reality the woman is not pregnant. A false-negative test result is one that does not detect what is being tested for even though it is present. A false-negative test result may suggest that a person does not have a disease or condition being tested for when he or she does have it. For example, a false-negative pregnancy test result would be one that does not detect the substance that confirms pregnancy, when the woman really is pregnant.

9. 9 It is possible to have a result that is different than the reference range even though nothing is wrong with you. Sometimes certain factors can affect your test results, such as: P regnancy medicine you are taking eating right before a test smoking being under stress.

10. 10 Labs may use different types of equipment and tests, and sometimes they set their own reference ranges. Your lab report will contain the reference ranges your lab uses . Do not compare results from different labs.

11. Sodium 135–145 mmol/L usually caused by excess water (e.g., ↑ serum antidiuretic hormone) and is treated with water restriction. ↑ in severe dehydration, diabetes insipidus, significant renal and GI losses. potassium 3.5–5 mmol/L ↑ with renal dysfunction, acidosis,K- sparing diuretics, hemolysis, burn ,crush injuries … ↓ by diuretics, or with alkalosis, severe vomiting and diarrhea . Co2 22–28 mmol/L Sum of HCO3− and dissolved CO2. Reflects acid–base balance and compensatory pulmonary (CO2) and renal (HCO3−).. 11

12. BUN (blood urea nitrogen) 2.8–7.1 mmol/L excreted renaly. ↑ in renal dysfunction, high protein intake, upper GI bleeding , volume contraction. Creatinine (in conventional unit ) 0.6–1.2 mg/dL excretedrenaly. ↑ in renal dysfunction. Glucose (in conventional unit ) 70–99 mg/dL ↑ in diabetes or by adrenal corticosteroids Glycosylated hemoglobin (HB1c) <4%–5.6% U s e d t o a ss e s s a v e r a g e b l oo d glucose during 1–3 months. Helpful for monitoring chronic blood glucose contr ol 12

13. Uric acid <0.42 mmol/L ↑ in gout, neoplastic, and with drug (diuretics, niacin, low- dosesalicylate, cyclosporin). Albumin (in conventional unit ) 3.3–4.8 g/dL ↓ in liver disease ,malnutrition, ascites, hemorrhage, protein-wasting nephropathy. CK (in conventional unit ) <150 units/L ↑ with IM injections, MI, acute psychotic episodes. LDH (in conventional unit ) <200 units/L ↑ in malignancy, extensive burns, PE, renal disease . CRP unit ) (in conventional 0–1.6 mg/dL Non specific indicator of acute inflammation 13

14. AST 0–35 units/L ↑ with MI and liver injury. ALT 0–35 units/L ↑ negligibly unless parenchymal liver disease. More liver specific than AST. ALP 30–120 units/L ↑ in bile duct obstruction, obstructive liver disease GGT 0–70 units/L Sensitive test reflecting hepatocellular injury .. Usually high in chronic alcoholics. Billirubin (total) 0.1–1 mg/dL Breakdown product of hemoglobin, bound to albumin, conjugated in liver. ↑ with hemolysis, cholestasis, liver injury. 14

15. R B C Male 4.3–5.9 x 106/mL Female 3.5–5.0× 106/mL ↓ with anemias,bleeding.. ↑ with chronic hypoxia. H g b Male 14–18 g/dL Female 12–16 g/dL ------------ ------------ MC V 76–100 mm3 for RBC size; ↑ MCV=macrocytic, ↓ MCV= microcytic. W B C 4–11×103/mL P l a t e l e t s 150–450×103/mL ↑ in infection and stress. < 100×103/mL=thrombocytopenia < 20 × 103 / m L = ↑ r i s k f o r s e v e r e bleeding . 15

16. Amylase 35–120 units/L ↑ in pancreatitis or duct obstruction Lipase 0–160 units/L ↑ in acute pancreatitis PSA 0–4 ng/mL ↑ in benign prostatic hypertrophy (BPH) TSH 0.4–5 munits/mL ↑ TSH in primary hypothyroidism LDL 70–160 mg/dL ---------- HDL 40 mg/dL ---------- Cholesterol <200mg/dL ↑ LDL or ↓ HDL are risk factors for cardiovascular disease Triglycerides Or TG (fasting) <150 mg/dL ↑ by alcohol, saturated fats, drugs (propranolol, diuretics, oral contraceptives) 16

17. 17 What are liver function tests? A liver function test is often recommended in the following situations: to check for damage from liver infections, such as hepatitis B and hepatitis C to monitor the side effects of certain medications known to affect the liver. if you already have a liver disease, to monitor the disease and how well a particular treatment is working if you’re experiencing the symptoms of a liver disorder if you have certain medical conditions such as high triglycerides, diabetes, high blood pressure, or  anemia if you drink alcohol heavily if you have gallbladder disease

18. 18 L iver Function T ests

19. Tari Broderick . (2016). Interpretation of Clinical Laboratory Tests . In: Laura Blyton HANDBOOK OF APPLIED THERAPEUTICS . Michigan : S4Carlisle Publishing Services . 5-15. A Text book of Pharmacy Practice by The author Sourabh Kosey. 21.1-21.6 A Text book of Pharmacy Practice by the author Dr. Sachin V. Tembhurne , Dr. Ashwini R. Madgulkar , Dr. Virendra S. Ligade Nirali Prakashan . 21.1-21.8 www.Google.com https://www.healthline.com/health/liver-function-tests 19

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