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Internal Medicine | Medicine (MD/DO) School Study Aid


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Appendix of Laboratory Values
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Normal Electrolyte Lab Values
Potassium (K+)
3.5 to 5.0 mEq/L
Calcium (Ca2+)
8.5 to 10.5 mg/dL
Phosphate (PO43–)
2.5 to 4.5 mg/dL
Magnesium (Mg2+)
1.5 to 2.5 mEq/L
Sodium (Na+)
135 to 145 mEq/L
Chloride (Cl)
95 to 105 mEq/L
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2 mins
Sodium (Na+) Lab Value
135-145 mEq/L
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24 secs
Hypernatremia
Assessment
> 145 mEq/L Na+
Change in LOC
Extreme Thirst
Orthostatic Hypotension
Dry Flushed Skin
Muscle Twitching
Seizures
Priority Interventions
Prevent Dehydration
Hypotonic Solutions (0.225% or 0.45% NaCl)
Sodium Restriction
Diuretics
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2 mins
Hyponatremia
Assessment
< 135 mEq Na+
Nausea and Vomiting
Decreased LOC
Confusion / Lethargy
Seizures
Priority Interventions
Assess Airway
Reduce Diuretic Dosage
Fluid Excess Hyponatremia
Mannitol (Osmitrol)
Fluid Restriction
Fluid Deficit Hyponatremia
Hypertonic Solution (3% or 5% NaCl)
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2 mins
Potassium (K+) Lab Value
3.5 to 5.0 mEq/L
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20 secs
Hyperkalemia
Assessment
> 5.0 mEq/L K+
Abdominal Cramps
Muscle Weakness
Diarrhea
Arrhythmia
Tall, Peaked T Waves
Interventions
IV Calcium
Infusion of Glucose and Insulin
Loop or Thiazide Diuretics
Kayexalate
Dialysis
Prevention Education
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2 mins
Hypokalemia
Assessment
< 3.5 mEq/L
Muscle Weakness
Arrhythmia
U Wave
Ileus
Hyporeflexia
Interventions
IV K+ Infusion at 5-10 mEq/hr
Give Orally with Food
Nursing Considerations
Monitor Respiratory Status
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3 mins
Calcium (Ca2+) Lab Value
8.5 to 10.5 mg/dL
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25 secs
Hypercalcemia
Assessment
> 10.5 mg/dL Ca2+
Pathologic Fractures
Lethargy
Hypercoagulation
Constipation
ECG Changes
QT Shortening
Interventions
No Calcium Intake
Chelating Drugs
Calcitonin
Bisphosphonates
Loop Diuretics instead of Thiazide Diuretics
Considerations
Increased Risk for Renal Calculi
Increase Fluids
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3 mins
Hypocalcemia
Assessment
< 8.5 mg/dL Ca2+
Decreased Bone Density
Muscle Spasms
Tetany
Chvostek's Sign
Trousseau's Sign
Increased DTR
ECG Changes
QT Prolongation
Considerations
Oral and IV Replacement of Ca2+
Seizure Precautions
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2 mins
Calcium Correction for Hypoalbuminemia
0.8 * (Normal Albumin - Patient Albumin) + Calcium
Steps
Multiply * 0.8
Subtract (Normal Albumin - Patient Albumin)
Add Calcium
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1 min
Magnesium (Mg2+) Lab Value
1.5 to 2.5 mEq/L
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28 secs
Hypermagnesemia
Assessment
Flushing
Lethargy
Muscle Weakness
Decreased Deep Tendon Reflexes (DTRs)
Decreased Respirations
Bradycardia
Hypotension
Interventions
Dialysis
IV Calcium Gluconate
Diuretics
Avoid Antacids and Laxatives containing Mg2+
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2 mins
Hypomagnesemia
Assessment
Confusion
Increased Deep Tendon Reflexes (DTRs)
Neuromuscular Irritability
Seizures
Muscle Cramps
Tremors
Insomnia
Tachycardia
Interventions
Magnesium Sulfate
Foods High in Magnesium
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1 min
Chloride (Cl-) Lab Value
95-105 mEq/L
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27 secs
Phosphate (PO43-) Lab Value
2.5 to 4.5 mg/dL
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29 secs
Liver Enzyme Tests: AST and ALT
AST/ALT Ratio
AST: 10-30 U/L
ALT: 10-40 U/L
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1 min
Total Protein Lab Values
6.4 - 8.3 g/dL
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1 min
Albumin Lab Value
3.5 - 5.0 g/dL
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42 secs
Bilirubin Lab Value
0.2-1.2 mg/dL
Increased Bilirubin Causes Jaundice
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54 secs
Blood Glucose Lab Value
70-100 mg/dL
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25 secs
pH - Blood and Urine Lab Value
Blood
7.35 - 7.45
Urine
4.0 - 8.0
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1 min
Red Blood Cell Count (RBC) Lab Values
Women: 3.5-5.5 million cells/ MuL
Men: 4.3-5.9  million cells/ MuL
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1 min
Hemoglobin
Hemoglobin Has Four Iron Hemes
Lots Of Hemoglobin In Red Blood Cells
High O2 Levels Increase O2 Binding
High Temperature Reduces O2 Binding
High CO2 Levels Reduce O2 Binding
Low pH Reduces O2 Binding
Myoglobin Binds Oxygen in Muscle
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2 mins
Hemoglobin (Hgb) Lab Values
Men: 13 - 17 g/dL
Women: 12 - 16 g/dL
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46 secs
Hemoglobin A1c Lab Value
4-6%
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1 min
Hematocrit (Hct) Lab Values
Women: 36% - 46%
Men: 41% - 53%
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1 min
Platelet Lab Value
150,000-400,000 Micro L
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40 secs
Bleeding Time Lab Values
2-7 Minutes
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40 secs
PT/PTT Lab Values
Prothrombin Time (PT)
10-14 seconds
Activated Partial Thromboplastin Time (PTT or aPTT)
25-35 seconds
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1 min
INR Lab Value
0.8-1.2 Normal Range
Warfarin
2.0-3.0
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1 min
WBC Differential Lab Value
White Blood Cells (WBC)
5-10 (5,000-10,000)
Leukocyte Differential
Neutrophils (50%-70%)
Bands (2%-5%)
Segs (50%-70%)
Lymphocytes (20%-40%)
Monocytes (4%-8%)
Eosinophils (2%-4%)
Basophils (0.5%-1.5%)
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2 mins
BUN (Blood Urea Nitrogen) Lab Values
10-20 mg/dL
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40 secs
Creatinine Lab Values
Measures Renal Function
0.6 - 1.3 mg/dL
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1 min
Urine Specific Gravity Lab Value
1.003-1.030
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1 min
Cardiac Enzyme Evaluation: Myoglobin
Measures
Skeletal or Cardiac Muscle Injury
Time Ranges
Onset: 1 - 4 Hours
Peak: 12 Hours
Return to Normal: 24 Hours
Considerations
Elevation After 24 Hours: Reinfarction
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2 mins
Cardiac Enzyme Evaluation: Troponin
Measures
Cardiac Muscle Injury
Time Ranges
Onset: 1 Hour
Peak: 10 - 24 Hours
Return to Normal: 5 - 14 Days
Considerations
Most Specific for Cardiac Muscle
Treated Aggressively
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2 mins
Troponin Lab Values
Troponin T (cTnT)
< 0.1 ng/mL Normal
Troponin I (cTnI)
< 0.5 ng/mL Normal
> 2.3 ng/mL Myocardial Injury
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2 mins
Cardiac Enzyme Evaluation: Creatine Kinase CK-MB
Measures
Skeletal or Cardiac Muscle Injury
Time Ranges
Onset: 4-8 Hours
Peak: 12-24 Hours
Return to Normal: 2-3 Days
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1 min
Triglycerides Lab Value
< 150 mg/dL
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50 secs
Cholesterol Lab Values
LDL (Low Density Cholesterol)
< 100 mg/dL
HDL (High Density Cholesterol)
> 40 mg/dL Males
> 50 mg/dL Females
Total Cholesterol
< 200 mg/dL
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1 min
CSF Lab Values: Normal
Pressure: < 20 cm H2O
Color/Appearance: Clear or Colorless
Proteins: < 40 mg/dL
Lactate Dehydrogenase: 10% of Serum Level
Cells: 0-5 Small Lymphocytes
Glucose: 40-70 mg/dL
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2 mins
Anticentromere Antibodies
Autoimmune Disorders
CREST Syndrome (Limited Scleroderma)
Diffuse Scleroderma
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49 secs
Antihistone Antibodies
Drug-induced Lupus
SHIPP Acronym
Sulfonamides
Hydralazine
Isoniazid (INH)
Phenytoin
Procainamide
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59 secs
Anti-glomerular Basement Membrane Antibodies
Glomerulonephritis
Goodpasture's Disease
Linear immunofluorescence
Hemoptysis
Hematuria
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1 min
Anti-desmoglein Antibodies
Pemphigus Vulgaris
Flaccid Blisters
Skin and Oral Mucosa
Positive Nikolsky's Sign
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59 secs

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