tag:blogger.com,1999:blog-69988060018833946912024-03-14T01:49:21.967+05:30Lab TestsEverything about lab tests in childrenVipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.comBlogger49125tag:blogger.com,1999:blog-6998806001883394691.post-27394609256398894352010-10-13T18:32:00.001+05:302010-10-13T19:47:34.369+05:30(SGPT) Serum Glutamic Pyruvic Transaminase / Alkaline Aminotransferase (ALT)<div class="MsoBodyTextIndent2" style="mso-list: l5 level1 lfo7; text-indent: -.25in;"><b>1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></b><b>Alkaline Aminotransferase (ALT) Serum Glutamic Pyruvic Transaminase (SGPT)</b></div><div class="MsoBodyTextIndent2"><b>Introduction</b></div><div class="MsoBodyTextIndent2"><a href="http://labtests.pediaindia.net/2010/10/serum-glutamic-oxaloacetic-transaminase.html">See AST</a></div><div class="MsoBodyTextIndent2"><br />
</div><table border="1" cellpadding="0" cellspacing="0" style="border-collapse: collapse; border: none; margin-left: 41.4pt; mso-border-alt: solid windowtext .5pt; mso-padding-alt: 0in 5.4pt 0in 5.4pt;"><tbody>
<tr style="height: 29.65pt;"> <td colspan="3" style="border: solid windowtext .5pt; height: 29.65pt; padding: 0in 5.4pt 0in 5.4pt; width: 297.0pt;" valign="top" width="396"><div align="center" class="MsoBodyTextIndent2" style="margin-left: 0in; tab-stops: .5in; text-align: center;">Normal Range</div></td> </tr>
<tr style="height: 26.5pt;"> <td style="border-top: none; border: solid windowtext .5pt; height: 26.5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 99.0pt;" valign="top" width="132"><div class="MsoBodyTextIndent2" style="margin-left: 0in; tab-stops: .5in;"> Males</div></td> <td style="border-bottom: solid windowtext .5pt; border-left: none; border-right: solid windowtext .5pt; border-top: none; height: 26.5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 117.0pt;" valign="top" width="156"><div class="MsoBodyTextIndent2" style="margin-left: 0in; tab-stops: .5in;"> Females</div></td> <td style="border-bottom: solid windowtext .5pt; border-left: none; border-right: solid windowtext .5pt; border-top: none; height: 26.5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 81.0pt;" valign="top" width="108"><div class="MsoBodyTextIndent2" style="margin-left: 0in; tab-stops: .5in;"> 1-3 years</div></td> </tr>
<tr style="height: 28.75pt;"> <td style="border-top: none; border: solid windowtext .5pt; height: 28.75pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 99.0pt;" valign="top" width="132"><div class="MsoBodyTextIndent2" style="margin-left: 0in; tab-stops: .5in;"> 10 – 40 U/L</div></td> <td style="border-bottom: solid windowtext .5pt; border-left: none; border-right: solid windowtext .5pt; border-top: none; height: 28.75pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 117.0pt;" valign="top" width="156"><div class="MsoBodyTextIndent2" style="margin-left: 0in; tab-stops: .5in;"> 9 - 25 U/L</div></td> <td style="border-bottom: solid windowtext .5pt; border-left: none; border-right: solid windowtext .5pt; border-top: none; height: 28.75pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 81.0pt;" valign="top" width="108"><div class="MsoBodyTextIndent2" style="margin-left: 0in; tab-stops: .5in;"> 5 – 45 U/L</div></td> </tr>
</tbody></table><div class="MsoBodyTextIndent2"><br />
</div><div class="MsoBodyTextIndent2"><b>Increased in</b></div><div class="MsoBodyTextIndent2"><a href="http://labtests.pediaindia.net/2010/10/serum-glutamic-oxaloacetic-transaminase.html">See AST</a></div><span style="font-family: 'Times New Roman'; font-size: 12pt;">Other causes are: obesity (not AST); Severe preeclampsia (both); Rapidly progressing acute lymphoblastic leukemia (both), levels in females approximately 75% of those in males</span>Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com1tag:blogger.com,1999:blog-6998806001883394691.post-44921704835822477142010-10-13T18:30:00.001+05:302010-10-13T18:30:24.036+05:30serum Glutamic – Oxaloacetic Transaminase [SGOT] / Aspartate Aminotransferase [AST]<p class="MsoBodyTextIndent2" style="text-indent:-.25in;mso-list:l5 level1 lfo7"><b>1.<span style="font:7.0pt "Times New Roman""> </span></b><b>Aspartate Aminotransferase [AST]/ serum Glutamic – Oxaloacetic Transaminase<span style="mso-spacerun: yes"> </span>[SGOT]</b></p> <p class="MsoBodyTextIndent2"><b>Introduction</b></p> <p class="MsoBodyTextIndent2">Aminotransferases like ALT and AST that are concentrated in liver used as indicators of hepatocellular damage. Both parallel to each other but in alcohol related disease ALT is lower than AST.</p> <p class="MsoBodyTextIndent2" style="margin-left:0in"><span style="mso-spacerun: yes"> </span></p> <p class="MsoBodyTextIndent2"><span style="mso-spacerun: yes"> </span><b>Indications</b></p> <p class="MsoBodyTextIndent2">Differential diagnosis of disease of hepatobiliary system and pancreas; repeat testing to establish chronicity of viral hepatitis; to check hepatotoxicity of a drug. </p> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><span style="mso-spacerun: yes"> </span></p> <table border="1" cellspacing="0" cellpadding="0" style="margin-left:41.4pt; border-collapse:collapse;border:none;mso-border-alt:solid windowtext .5pt; mso-padding-alt:0in 5.4pt 0in 5.4pt"> <tbody><tr style="height:29.65pt"> <td width="396" colspan="3" valign="top" style="width:297.0pt;border:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:29.65pt"> <p class="MsoBodyTextIndent2" align="center" style="margin-left:0in;text-align: center;tab-stops:.5in">Normal levels</p> </td> </tr> <tr style="height:26.5pt"> <td width="132" valign="top" style="width:99.0pt;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><span style="mso-spacerun: yes"> </span>Men</p> </td> <td width="156" valign="top" style="width:117.0pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><span style="mso-spacerun: yes"> </span>Women</p> </td> <td width="108" valign="top" style="width:81.0pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><span style="mso-spacerun: yes"> </span>0-3 years</p> </td> </tr> <tr style="height:28.75pt"> <td width="132" valign="top" style="width:99.0pt;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:28.75pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><span style="mso-spacerun: yes"> </span>10 – 40 U/L</p> </td> <td width="156" valign="top" style="width:117.0pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:28.75pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><span style="mso-spacerun: yes"> </span>9 - 25 U/L</p> </td> <td width="108" valign="top" style="width:81.0pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:28.75pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><span style="mso-spacerun: yes"> </span>20 – 60 U/L</p> </td> </tr> </tbody></table> <p class="MsoBodyTextIndent2"><b> </b></p> <p class="MsoBodyTextIndent2"><b>Increased in</b></p> <span style="font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family: "Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US; mso-bidi-language:AR-SA">Liver disease: Acute viral infections e.g. viral hepatitis A, B, C (value is increased up to 50 times the normal, peak levels up to 400 – 4000 U or more are reached during the icteric phase and gradually decline, during recovery phase); hepatotoxic drugs and chemicals (e.g. antifungals, narcotics and barbiturates, acetaminophen, salicylates); musculoskeletal disorders (myoglobinuria); acute myocardial infarction; acute pancreatitis; all common fevers (value raised up to 40 – 100 U) e.g. malaria, typhoid, extra pulmonary tuberculosis, dengue fever. </span> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-67178151103746724952010-10-13T18:27:00.001+05:302010-10-13T18:27:52.582+05:30Serum Globin<p class="MsoBodyTextIndent2" style="text-indent:-.25in;mso-list:l5 level1 lfo7"><b>1.<span style="font:7.0pt "Times New Roman""> </span></b><b>Serum Globin</b></p> <p class="MsoBodyTextIndent2"><b>Introduction</b></p> <p class="MsoBodyTextIndent2">Globulins are produced by variety of tissue including liver. Serum globulins include alpha and beta globulins as well as serum immunoglobulins.</p> <table border="1" cellspacing="0" cellpadding="0" style="margin-left:.7in;border-collapse: collapse;border:none;mso-border-alt:solid windowtext .5pt;mso-padding-alt: 0in 5.4pt 0in 5.4pt"> <tbody><tr style="height:23.35pt"> <td width="384" colspan="2" valign="top" style="width:4.0in;border:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:23.35pt"> <p class="MsoBodyTextIndent2" align="center" style="margin-left:0in;text-align: center">Normal range</p> </td> </tr> <tr style="height:26.5pt"> <td width="204" valign="top" style="width:153.0pt;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in"><span style="mso-spacerun: yes"> </span>Adults: 1.9 – 3.5 gm/Dl</p> </td> <td width="180" valign="top" style="width:135.0pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in"><span style="mso-spacerun: yes"> </span>Fetal: 0.4 – 3.7gm/dL</p> </td> </tr> </tbody></table> <p class="MsoBodyTextIndent2" style="margin-left:0in"> </p> <p class="MsoBodyTextIndent2"><span style="mso-spacerun: yes"> </span><b>Indications</b></p> <p class="MsoBodyTextIndent2">To evaluate chronic liver diseases and cirrhosis (increases to varying degrees).</p> <p class="MsoBodyTextIndent2"><b> </b></p> <p class="MsoBodyTextIndent2"><b>Increased in</b></p> <p class="MsoBodyTextIndent2">Chronic liver diseases and cirrhosis; increase may be present in non- hepatic disorders or may reflect increased stimulation of peripheral reticuloendothelial compartment due to shunting of antigens past the liver and impaired clearance by kuffer cells.<span style="mso-spacerun: yes"> </span></p> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-29098158010695622402010-10-13T18:24:00.001+05:302010-10-13T18:24:45.738+05:30Serum Albumin<p class="MsoBodyTextIndent2" style="text-indent:-.25in;mso-list:l5 level1 lfo7"><b>1.<span style="font:7.0pt "Times New Roman""> </span></b><b>Serum Albumin</b></p> <p class="MsoBodyTextIndent2"><b>Introduction</b></p> <p class="MsoBodyTextIndent2">Albumin is quantitatively the most important serum protein synthesized by liver.</p> <p class="MsoBodyTextIndent2"> </p> <p class="MsoBodyTextIndent2"><span style="mso-spacerun: yes"> </span><b>Indications</b></p> <p class="MsoBodyTextIndent2">Marker of disorders of protein metabolism (e.g. nutritional, decreased synthesis increased loss).</p> <p class="MsoBodyTextIndent2"> </p> <p class="MsoBodyTextIndent2"><b>Normal range</b></p> <p class="MsoBodyTextIndent2">3.5 – 5.0 mg/dL</p> <p class="MsoBodyTextIndent2"> </p> <p class="MsoBodyTextIndent2"><b>Increased in</b></p> <p class="MsoBodyTextIndent2">Dehydration (relative increase); LV albumin infusion</p> <p class="MsoBodyTextIndent2"> </p> <p class="MsoBodyTextIndent2"><b>Decreased in</b></p> <span style="font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family: "Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US; mso-bidi-language:AR-SA">Same as for total serum proteins.</span> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-7976128164302388942010-10-13T18:23:00.000+05:302010-10-13T18:24:02.176+05:30Total Serum Proteins<p class="MsoBodyTextIndent2" style="text-indent:-.25in;mso-list:l5 level1 lfo7"><b>1.<span style="font:7.0pt "Times New Roman""> </span></b><b>Total Serum Proteins</b></p> <p class="MsoBodyTextIndent2"><b>Introductions</b></p> <p class="MsoBodyTextIndent2">Extensive liver injury may lead to decreased blood levels of albumin, prothrombin, fibrinogen and other proteins synthesized exclusively by hepatocytes. Serum protein levels are neither early nor sensitive indicators of liver disease.</p> <p class="MsoBodyTextIndent2"><b>Normal range</b></p> <p class="MsoBodyTextIndent2">5.5- 8.5 mg/dL</p> <p class="MsoBodyTextIndent2"><b>Indications</b></p> <p class="MsoBodyTextIndent2">Screening for nutritional deficiencies and gammopathies. <b></b></p> <p class="MsoBodyTextIndent2"><b>Increased in</b></p> <p class="MsoBodyTextIndent2">Hypergammaglobulinemias, hypovolemic states.<b></b></p> <p class="MsoBodyTextIndent2"><b>Decreased in</b></p> <span style="font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family: "Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US; mso-bidi-language:AR-SA">Nutritional deficiency (e.g. malabsorption, Kwashiorkor, marasmus); decreased ineffective protein synthesis (e.g. severe liver disease, agammaglobulinemia increased loss (e.g. renal nephrotic syndrome); Gl disease (e.g. Protein losing enteropathies, surgical resection); severe skin disease (e.g. burns, eczema); plasmapheresis, increased catabolism (e.g. fever, inflammation, hyperthyroidism malignancy); dilutional (e.g. IV fluids administration, SIADH water intoxication). </span> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-91554393270730168432010-08-21T11:05:00.000+05:302010-08-21T11:06:01.089+05:30Serum Bilirubin<p class="MsoBodyTextIndent2" style="text-indent:-.25in;mso-list:l5 level1 lfo7"><b>Serum Bilirubin</b></p> <p class="MsoBodyTextIndent2"><b>Introduction</b></p> <p class="MsoBodyTextIndent2" style="text-indent:-.25in"><b><span style="mso-tab-count:1"> </span></b>Spectrophotometric determinations of serum bilirubin in clinical laboratory measures two pigment fractions: (1) The water soluble conjugated fraction that gives a direct reaction with diazo reagent and consist largely of conjugated bilirubin. (2) The lipid soluble indirect – reaction fraction that represents primarily unconjugated bilirubin. </p> <p class="MsoBodyTextIndent2" style="text-indent:-.25in"><b>Indications</b></p> <p class="MsoBodyTextIndent2" style="text-indent:-.25in">Differential diagnosis of disease of hepatobiliary system and pancreas and other </p> <p class="MsoBodyTextIndent2" style="text-indent:-.25in">Causes of jaundice.</p> <p class="MsoBodyTextIndent2" style="text-indent:-.25in"> </p> <table border="1" cellspacing="0" cellpadding="0" style="margin-left:23.4pt; border-collapse:collapse;border:none;mso-border-alt:solid windowtext .5pt; mso-padding-alt:0in 5.4pt 0in 5.4pt"> <tbody><tr style="height:29.65pt"> <td width="312" colspan="2" valign="top" style="width:3.25in;border:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:29.65pt"> <p class="MsoBodyTextIndent2" align="center" style="margin-left:0in;text-align: center;tab-stops:.5in">Normal levels</p> </td> </tr> <tr style="height:26.5pt"> <td width="156" valign="top" style="width:117.0pt;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in">Total bilirubin</p> </td> <td width="156" valign="top" style="width:117.0pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in">Direct bilirubin</p> </td> </tr> <tr style="height:28.75pt"> <td width="156" valign="top" style="width:117.0pt;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:28.75pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><span style="mso-spacerun: yes"> </span>0.1 – 1.2 mg/dL</p> </td> <td width="156" valign="top" style="width:117.0pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:28.75pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><span style="mso-spacerun: yes"> </span>0.03 – 0.5 mg/dL</p> </td> </tr> </tbody></table> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"><span style="mso-spacerun: yes"> </span></p> <p class="MsoBodyTextIndent2" style="margin-left:.25in"><b>Increased in</b></p> <p class="MsoBodyTextIndent2" style="margin-left:.25in"><b>Direct (conjugated) Bilirubin in</b></p> <p class="MsoBodyTextIndent2" style="margin-left:.25in">20 -40% of total: more suggestive of hepatic than posthepatic jaundice, 40 -60% of total: occur in either hepatic or posthepatic; > 50% of total: more suggestive of posthepatic than hepatic jaundice; total serum bilirubin > 40mg/dl indicates hepatocellular rather than extrahepatic obstruction. </p> <p class="MsoBodyTextIndent2" style="margin-left:.25in"><b>Conditions</b></p> <p class="MsoBodyTextIndent2" style="text-indent:-.25in;mso-list:l5 level2 lfo7; tab-stops:list .5in"><span style="font-family:Symbol">·<span style="font:7.0pt "Times New Roman""> </span></span>Hereditary disorders (e.g. Dubin Johnson syndrome, Rotor's syndrome)</p> <p class="MsoBodyTextIndent2" style="text-indent:-.25in;mso-list:l5 level2 lfo7; tab-stops:list .5in"><span style="font-family:Symbol">·<span style="font:7.0pt "Times New Roman""> </span></span>Biliary duct obstruction (extra and intrahepatic)</p> <p class="MsoBodyTextIndent2" style="text-indent:-.25in;mso-list:l5 level2 lfo7; tab-stops:list .5in"><span style="font-family:Symbol">·<span style="font:7.0pt "Times New Roman""> </span></span><span style="mso-spacerun: yes"> </span>Hepatic cellular damage (viral, toxic, alcohol/ drug related)</p> <p class="MsoBodyTextIndent2" style="text-indent:-.25in;mso-list:l5 level2 lfo7; tab-stops:list .5in"><span style="font-family:Symbol">·<span style="font:7.0pt "Times New Roman""> </span></span>Infiltration, space – occupying lesions (e.g. metastatic tumor, abscess, granulomas)</p> <p class="MsoBodyTextIndent2" style="margin-left:.25in"><span style="mso-spacerun: yes"> </span><b>Increased unconjugated (indirect) bilirubin in </b></p> <span style="font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family: "Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US; mso-bidi-language:AR-SA">Increased bilirubin production; hemolytic diseases (e.g. hemoglobinopathies, RBC enzyme deficiencies, disseminated intravascular coagulation (DIC), autoimmune hemolysis); ineffective erythropoiesis; blood transfusions; hematomas; hereditary disorders (e.g. Gilbert's disease, Crigler – Najjar syndrome); drugs causing hemolysis<b>.</b></span> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-38332426470360980192010-08-17T11:07:00.003+05:302010-08-17T11:07:54.436+05:30Uric Acid<p class="MsoBodyTextIndent2" style="text-indent:-.25in;mso-list:l4 level2 lfo5; tab-stops:list .5in left 181.5pt"><b>1.<span style="font:7.0pt "Times New Roman""> </span></b><b>Uric Acid</b></p> <p class="MsoBodyTextIndent2" style="margin-left:.25in;tab-stops:181.5pt"><b> </b></p> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt"><b>Introduction</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt">Uric acid levels are very labile and show day to day and seasonal variation in same person, also increased by emotional stress, total fasting, increased body weight, uric acid levels that do not correlate with the severity of kidney damage; urea and Creatinine are better.</p> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt"><b>Indications</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt">Monitor chemotherapeutic treatment of neoplasms to avoid renal urate deposition with possible renal failure; monitor treatment of gout.<span style="mso-spacerun: yes"> </span></p> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt"><b> </b></p> <table border="1" cellspacing="0" cellpadding="0" style="margin-left:41.4pt; border-collapse:collapse;border:none;mso-border-alt:solid windowtext .5pt; mso-padding-alt:0in 5.4pt 0in 5.4pt"> <tbody><tr style="height:26.5pt"> <td width="504" colspan="3" valign="top" style="width:5.25in;border:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:26.5pt"> <p class="MsoBodyTextIndent2" align="center" style="margin-left:0in;text-align: center;tab-stops:181.5pt">Normal Levels</p> </td> </tr> <tr style="height:26.5pt"> <td width="174" valign="top" style="width:130.2pt;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:181.5pt"><span style="mso-spacerun: yes"> </span>Males</p> </td> <td width="181" valign="top" style="width:135.6pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:181.5pt"><span style="mso-spacerun: yes"> </span>Females</p> </td> <td width="150" valign="top" style="width:112.2pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:181.5pt"><span style="mso-spacerun: yes"> </span>1 –3 years</p> </td> </tr> <tr style="height:31.9pt"> <td width="174" valign="top" style="width:130.2pt;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:31.9pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:181.5pt"><b><span style="mso-spacerun: yes"> </span></b>4.0 – 8.6 mg/dL</p> </td> <td width="181" valign="top" style="width:135.6pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:31.9pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:181.5pt"><span style="mso-spacerun: yes"> </span>3 – 5.9 mg/dL</p> </td> <td width="150" valign="top" style="width:112.2pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:31.9pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:181.5pt"><span style="mso-spacerun: yes"> </span>1. 8 -5</p> </td> </tr> </tbody></table> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt"><b>Increased in</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt">Renal failure; gout and also in 25% of relatives of patients of gout; asymptomatic hyperuricemia; leukemia, multiple myeloma, malignancies, lymphoma and other disseminated neoplasm and cancer chemotherapy; hemolytic and sickle cell anemia; toxemia of pregnancy; psoriasis (1/3 cases); drug use (barbiturates, methyl alcohol, salicylates, thiazides, furosemide, mitomycin, levodopa, phenytoin sodium); metabolic acidosis; diet (high protein, weight reduced diet).<span style="mso-spacerun: yes"> </span></p> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt"><span style="mso-spacerun: yes"> </span></p> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt">Others von Gierke's disease, lead poisoning, Down's syndrome, polycystic kidney disease, atherosclerosis and hypertension (serum uric acid is increased in 80% of patients with elevated serum triglycerides).</p> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt"><b>Decreased in</b></p> <span style="font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family: "Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US; mso-bidi-language:AR-SA">Drugs (adrenocorticotropic hormone [ ACTH], high dose salicylates, probenecid, cortisone); Wilson's disease, Fanconi's syndrome, celiac disease, xanthuria</span> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-70181752145402247822010-08-17T11:07:00.001+05:302010-08-17T11:07:11.688+05:30Creatinine<p class="MsoBodyTextIndent2" style="tab-stops:.5in 39.0pt"><b>Creatinine </b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in 39.0pt"><b><span style="mso-tab-count:1"> </span>Introduction</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:39.0pt"><b><span style="mso-tab-count: 1"> </span></b>Serum Creatinine is the most specific and sensitive indicator of renal disease. Use of BUN and Creatinine levels together is more informative in renal disorders.</p> <p class="MsoBodyTextIndent2" style="margin-left:.25in;tab-stops:39.0pt"><b><span style="mso-tab-count:1"> </span></b></p> <table border="1" cellspacing="0" cellpadding="0" style="margin-left:41.4pt; border-collapse:collapse;border:none;mso-border-alt:solid windowtext .5pt; mso-padding-alt:0in 5.4pt 0in 5.4pt"> <tbody><tr style="height:28.75pt"> <td width="516" colspan="4" valign="top" style="width:387.0pt;border:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:28.75pt"> <p class="MsoBodyTextIndent2" align="center" style="margin-left:0in;text-align: center;tab-stops:109.5pt">Normal Range</p> </td> </tr> <tr style="height:32.35pt"> <td width="120" valign="top" style="width:1.25in;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:32.35pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:39.0pt"><span style="mso-spacerun: yes"> </span>Male</p> </td> <td width="132" valign="top" style="width:99.0pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:32.35pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:39.0pt"><b><span style="mso-spacerun: yes"> </span></b>Female</p> </td> <td width="142" valign="top" style="width:106.2pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:32.35pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:39.0pt"><span style="mso-spacerun: yes"> </span>Fetal </p> </td> <td width="122" valign="top" style="width:91.8pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:32.35pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:39.0pt"><b><span style="mso-spacerun: yes"> </span></b>Pregnancy</p> </td> </tr> <tr style="height:36.4pt"> <td width="120" valign="top" style="width:1.25in;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:36.4pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:39.0pt"><b><span style="mso-spacerun: yes"> </span></b>0.7 - 1.4 mg/dL</p> </td> <td width="132" valign="top" style="width:99.0pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:36.4pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:39.0pt"><span style="mso-spacerun: yes"> </span>0.6 – 1.1 mg/dL</p> </td> <td width="142" valign="top" style="width:106.2pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:36.4pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:39.0pt"><span style="mso-spacerun: yes"> </span>0.4 – 0.9 mg/dL<b></b></p> </td> <td width="122" valign="top" style="width:91.8pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:36.4pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:39.0pt">0.4 – 0.6 mg/dL<b></b></p> </td> </tr> </tbody></table> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:39.0pt"><b> </b></p> <p class="MsoBodyTextIndent2" style="tab-stops:39.0pt"><b><span style="mso-tab-count: 1"> </span>Indications</b></p> <p class="MsoBodyTextIndent2" style="margin-left:.25in;tab-stops:39.0pt"><b><span style="mso-tab-count:1"> </span></b>Diagnosis of renal insufficiency</p> <p class="MsoBodyTextIndent2" style="margin-left:.25in;tab-stops:39.0pt"> </p> <p class="MsoBodyTextIndent2" style="tab-stops:39.0pt"><b><span style="mso-tab-count: 1"> </span>Increased in</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:39.0pt"><span style="mso-tab-count: 1"> </span>Diet [ingestion of Creatinine (roast meat); prerenal azotemia; postrenal azotemia; impaired kidney function, 50% of renal function is needed to increase serum Creatinine from 1.0 – 2.0mg/dl. Therefore, not sensitive to mild – to moderate renal injury.</p> <p class="MsoBodyTextIndent2" style="tab-stops:39.0pt"><b>Decreased in</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:39.0pt">Pregnancy – normal value is 0.4 – 0.6 mg/dL. > 0.8mg/Dl is abnormal and should alert clinician to further diagnostic evaluation.</p> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-74900759163767422192010-08-17T11:06:00.001+05:302010-08-17T11:06:45.871+05:30Blood Urea Nitrogen (BUN)<p class="MsoBodyTextIndent2" style="text-indent:-.25in;mso-list:l4 level2 lfo5; tab-stops:list .5in left 181.5pt"><b>1.<span style="font:7.0pt "Times New Roman""> </span></b><b>Blood Urea Nitrogen (BUN)</b></p> <p class="MsoBodyTextIndent2" style="margin-left:.25in;tab-stops:181.5pt"><b> </b></p> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt"><b>Introduction </b></p> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt"><b> </b></p> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt">BUN correlates with uremic symptoms better than serum creatinine.</p> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt"> </p> <table border="1" cellspacing="0" cellpadding="0" style="margin-left:41.4pt; border-collapse:collapse;border:none;mso-border-alt:solid windowtext .5pt; mso-padding-alt:0in 5.4pt 0in 5.4pt"> <tbody><tr style="height:20.0pt"> <td width="360" valign="top" style="width:3.75in;border:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:20.0pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in 181.5pt">Normal Range</p> </td> </tr> <tr style="height:25.15pt"> <td width="360" valign="top" style="width:3.75in;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:25.15pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in 181.5pt">Adults: 7 –20mg/dL</p> </td> </tr> <tr style="height:25.15pt"> <td width="360" valign="top" style="width:3.75in;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:25.15pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in 181.5pt">Neonate: 5 –18 mg/dL</p> </td> </tr> <tr style="height:25.15pt"> <td width="360" valign="top" style="width:3.75in;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:25.15pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in 181.5pt">6 –8 mg/dL: associated with over hydration states</p> </td> </tr> <tr style="height:23.85pt"> <td width="360" valign="top" style="width:3.75in;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:23.85pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in 181.5pt">50 – 150mg/dL: implies serious impairment of renal function </p> </td> </tr> <tr style="height:15.75pt"> <td width="360" valign="top" style="width:3.75in;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:15.75pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:181.5pt">150 –250mg/DL: is conclusive evidence of severely impaired glomerular function.</p> <p class="MsoBodyTextIndent2" style="margin-left:-.25in;tab-stops:list .5in left 181.5pt"> <b></b></p> </td> </tr> </tbody></table> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt"><b>Indications</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt">Differential diagnosis of various renal disorders; evidence of hemorrhage in Gl tract; assessment of patients requiring nutritional support in excess of catabolism (e.g. burns, cancer).<b></b></p> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt"><b>Increased in</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt">Impaired kidney function; prerenal azotemia – ant case of reduced renal blood flow; congestive heart failure; salt and water depletion (vomiting, diarrhea, sweating); shock; postrenal azotemia – any obstruction of urinary tract (increased blood urea nitrogen [BUN] / Creatinine ratio); hemorrhage into Gl tract; AMI; stress. </p> <p class="MsoBodyTextIndent2" style="tab-stops:181.5pt"><b>Decreased in</b></p> <span style="font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family: "Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US; mso-bidi-language:AR-SA">Diuresis (e.g. with overhydration, often associated with low protein catabolism); severe liver damage (drug poisoning, hepatitis, other); increased utilization of protein for synthesis (late pregnancy, infancy, acromegaly, malnutrition ); diet (low protein and high carbohydrate, impaired absorption, malnutrition); nephritic syndrome; syndrome of inappropriate antidiuretic hormone secretion ( SIADH). </span> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-37385311185853316232010-08-17T11:05:00.003+05:302010-08-17T11:05:55.649+05:30Triglycerides (80% in VLDL 15% in LDL)<p class="MsoBodyTextIndent2" style="text-indent:-.25in;mso-list:l4 level1 lfo5; tab-stops:list .5in"><b>1.<span style="font:7.0pt "Times New Roman""> </span></b><b>Triglycerides (80% in VLDL 15% in LDL)</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"><b>Introduction</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in">Triglyceride levels are not strong predictors of atherosclerosis or CAD and may not be an independent risk factor. Triglyceride levels are inversely related to HDL cholesterol levels.</p> <table border="1" cellspacing="0" cellpadding="0" style="margin-left:.5in;border-collapse: collapse;border:none;mso-border-alt:solid windowtext .5pt;mso-padding-alt: 0in 5.4pt 0in 5.4pt"> <tbody><tr style="height:22.0pt"> <td width="511" colspan="4" valign="top" style="width:383.4pt;border:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:22.0pt"> <p class="MsoBodyTextIndent2" align="center" style="margin-left:0in;text-align: center;tab-stops:.5in">Normal Range</p> </td> </tr> <tr style="height:26.5pt"> <td width="511" colspan="4" valign="top" style="width:383.4pt;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:145.5pt"><b><span style="mso-tab-count:1"> </span></b>20 –170mg/dL</p> </td> </tr> <tr style="height:26.5pt"> <td width="136" valign="top" style="width:101.7pt;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><b>Classification</b></p> </td> <td width="136" valign="top" style="width:101.7pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"> <b></b></p> </td> <td width="136" valign="top" style="width:101.7pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"> <b></b></p> </td> <td width="104" valign="top" style="width:78.3pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"> <b></b></p> </td> </tr> <tr style="height:26.5pt"> <td width="136" valign="top" style="width:101.7pt;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in">Normal Range</p> </td> <td width="136" valign="top" style="width:101.7pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><b><span style="mso-spacerun: yes"> </span></b>Borderline</p> </td> <td width="136" valign="top" style="width:101.7pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><span style="mso-spacerun: yes"> </span>High</p> </td> <td width="104" valign="top" style="width:78.3pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><b><span style="mso-spacerun: yes"> </span></b>Very high</p> </td> </tr> <tr style="height:26.5pt"> <td width="136" valign="top" style="width:101.7pt;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in">< 150mg/dL</p> </td> <td width="136" valign="top" style="width:101.7pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><b><span style="mso-spacerun: yes"> </span></b>150 – 199mg/dL</p> </td> <td width="136" valign="top" style="width:101.7pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><b><span style="mso-spacerun: yes"> </span></b>200 – 499mg/dL</p> </td> <td width="104" valign="top" style="width:78.3pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in">> 500mg/dL</p> </td> </tr> </tbody></table> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:57.75pt"><b> </b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"><b>Increased in</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in">Genetic hyperlipidemias (e.g. Lipoprotein lipase deficiency, apo C..II deficiency, familial Triglyceridemia, dysbetalipoproteinemia); secondary hyperlipidemias (gout, pancreatitis, acute illness (e.g. in AMI rises to peak in 3 weeks and increase may persist for 1 year); drug use (e.g. thiazides, steroids, amiodarone, interferon).</p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"><b>Decreased in </b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in">Abetalipoproteinemia; malnutrition; vigorous exercise; drugs (e.g. ascorbic acid, clofibrate, phenformin, metformin, progestins).<span style="mso-spacerun: yes"> </span></p> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-37038752809853944122010-08-17T11:05:00.001+05:302010-08-17T11:05:13.169+05:30LDL (Low Density Lipoprotein) cholesterol (Lipid Profile)<p class="MsoBodyTextIndent2" style="text-indent:-.25in;mso-list:l4 level1 lfo5; tab-stops:list .5in"><b>1.<span style="font:7.0pt "Times New Roman""> </span></b><b>LDL (Low Density Lipoprotein) cholesterol</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"><b>Introduction</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in">LDL levels are directly related to risk fill CAD</p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"><b> </b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"><b>Indication</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in">Assess risk and decide treatment for CAD</p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"> </p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"><b>Normal Levels</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"><b> </b></p> <p class="MsoBodyTextIndent2" style="margin-left:.25in;tab-stops:.5in"><b><span style="mso-tab-count:1"> </span></b>No coronary heart disease (CHD) and < 2 risk factors < 160mg/dL</p> <p class="MsoBodyTextIndent2" style="margin-left:.25in;tab-stops:.5in"> </p> <p class="MsoBodyTextIndent2" style="margin-left:.25in;text-indent:.25in; tab-stops:.5in">No CHD but > 2 risk factors < 130mg/dL</p> <p class="MsoBodyTextIndent2" style="margin-left:.25in;text-indent:.25in; tab-stops:.5in"> </p> <p class="MsoBodyTextIndent2" style="margin-left:.25in;text-indent:.25in; tab-stops:.5in">Presence of CHD < 100mg/dL</p> <p class="MsoBodyTextIndent2" style="margin-left:.25in;text-indent:.25in; tab-stops:.5in"><b>Increased in </b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in">Familial hypercholesterolemia and combined hyperlipidemia; diabetes mellitus (DM) and hypothyroidism; chronic renal failure; diet high in cholesterol and total and saturated fat;</p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in">Pregnancy; cholesteryl ester storage disease; drug use (e.g. anabolic, steroids, beta – blockers, progestins, carbamazepine). </p> <p class="MsoBodyTextIndent2" style="margin-left:.25in;text-indent:.25in; tab-stops:.5in"><b>Decreased in</b></p> <span style="font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family: "Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US; mso-bidi-language:AR-SA">Severe illness; abetalipoproteinemia; some laboratories also various ratios; total cholestero/HDL ratio – low risk: 3.3 – 4.4, average risk: 4.4 – 7.1, moderate risk: 7.1 – 11.0, high risk > 11.0.</span> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-74454994423099777022010-08-17T11:04:00.001+05:302010-08-17T11:04:24.470+05:30High Density Lipoprotein (HDL) Cholesterol (Lipid Profile)<p class="MsoBodyTextIndent2" style="text-indent:-.25in;mso-list:l4 level1 lfo5; tab-stops:list .5in"><b>1.<span style="font:7.0pt "Times New Roman""> </span></b><b>High Density Lipoprotein (HDL) Cholesterol</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"><b>Introduction</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in">Levels of HDL are inversely related to risk of CAD. For every mg/dL decreased in HDL, risk of CAD increase by 2 -3%</p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"> </p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"><b>Indications</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in">Assessment of risk of CAD</p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"> </p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in">Diagnosis of various lipoproteinemia</p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"> </p> <table border="1" cellspacing="0" cellpadding="0" style="margin-left:41.4pt; border-collapse:collapse;border:none;mso-border-alt:solid windowtext .5pt; mso-padding-alt:0in 5.4pt 0in 5.4pt"> <tbody><tr style="height:29.65pt"> <td width="312" colspan="2" valign="top" style="width:3.25in;border:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:29.65pt"> <p class="MsoBodyTextIndent2" align="center" style="margin-left:0in;text-align: center;tab-stops:.5in">Normal Levels</p> </td> </tr> <tr style="height:26.5pt"> <td width="156" valign="top" style="width:117.0pt;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><span style="mso-spacerun: yes"> </span>Men</p> </td> <td width="156" valign="top" style="width:117.0pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:26.5pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><span style="mso-spacerun: yes"> </span>Women</p> </td> </tr> <tr style="height:28.75pt"> <td width="156" valign="top" style="width:117.0pt;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:28.75pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><span style="mso-spacerun: yes"> </span>> 40mg/dL</p> </td> <td width="156" valign="top" style="width:117.0pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:28.75pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in"><span style="mso-spacerun: yes"> </span>> 50mg/dL</p> </td> </tr> </tbody></table> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"><span style="mso-spacerun: yes"> </span></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"><b>Increased in (60mg/Dl is negative risk factor for CAD)</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"><b> </b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in">Vigorous exercise; moderate consumption of alcohol; Increased clearance of triglyceride (VLDL), Familial lipid disorders with protection against atherosclerosis (illustrates importance of measuring HDL to evaluate hypercholesterolemia); 1 in 20 adults with mild increased total cholesterol levels (240 – 300mg/dL) secondary to increased HDL ( > 70mg/dL); Hypobetalipoproteinemia.</p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"> </p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"><b>Decreased in (< 32mg/dL in men, < 38mg/dL in women)</b></p> <span style="font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family: "Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US; mso-bidi-language:AR-SA">Stress and recent illness (e.g. acute myocardial infarction [AMI], stroke, surgery, trauma); starvation, non fasting sample; obesity and lack of exercise; cigarette smoking; DM, hypo – and hyper – thyroidism; acute and chronic liver disease; genetic disorders; familial hypoalphalipoproteinemia.</span> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-22955133291631775012010-08-17T11:03:00.001+05:302010-08-17T11:03:41.988+05:30Total Serum Cholesterol (Lipid Profile)<p class="MsoBodyTextIndent2" style="text-align: center;text-indent: -0.25in; "><b>ToTotal Serum Cholesterol</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"><b>Indications</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in">Monitoring for increased risk factor for coronary artery disease(CAD); Screening for primary and secondary hyperlipidemias; Monitoring of treatment for hyperlipidemias.</p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"> </p> <table border="1" cellspacing="0" cellpadding="0" style="margin-left:41.4pt; border-collapse:collapse;border:none;mso-border-alt:solid windowtext .5pt; mso-padding-alt:0in 5.4pt 0in 5.4pt"> <tbody><tr style="height:22.0pt"> <td width="336" colspan="2" valign="top" style="width:3.5in;border:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:22.0pt"> <p class="MsoBodyTextIndent2" align="center" style="margin-left:0in;text-align: center;tab-stops:.5in">Normal range</p> </td> </tr> <tr style="height:25.6pt"> <td width="180" valign="top" style="width:135.0pt;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:25.6pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in">Adults: 130 –20mg/dL</p> </td> <td width="156" valign="top" style="width:117.0pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:25.6pt"> <p class="MsoBodyTextIndent2" style="margin-left:0in;tab-stops:.5in">Fetal: 32 – 76mg/dL</p> </td> </tr> </tbody></table> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"><b>Increased in</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in">Hyperlipoproteinemias; cholesteryl<span style="mso-spacerun: yes"> </span>ester storage disease; biliary obstruction (stone, carcinoma, cirrhosis); von Gierke's disease; hypothyroidism; nephrosis (due to chronic nephritis, amyloidosis, renal vein thrombosis, systemic lupus erythematosus [ SLE]; Pancreatic disease, diabetes mellitus.</p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in"><b>Decreased in</b> </p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in">Severe liver cell damage (due to chemicals, drugs, hepatitis); hyperthyroidism; malnutrition; infection and inflammation; drugs.</p> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-81420390028861360332010-08-17T11:00:00.001+05:302010-08-17T11:00:48.605+05:30Oral Glucose Tolerance Test (OGTT)<p class="MsoNormal" align="center" style="margin-left:.25in;text-align:center; tab-stops:.25in"><b>Oral Glucose Tolerance Test (OGTT)</b></p> <h2><span style="mso-tab-count:1"> </span>Introduction</h2> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.25in">OGTT is done after overnight fasting for 10 –16 hrs. Certain drugs should be stopped several weeks before the test (e.g. oral diuretics, 0.Cs phenytoin). Loading dose of glucose [adults = 75gms, for children 1.75gm/kg (of ideal body weight in obese children but never > 75gms). Pregnancy = 100gms] is consumed in 5 mins. Blood sample drawn at fasting, 30, 60, 90, 120 mins.</p> <h4 style="tab-stops:.25in">Indications</h4> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.25in">OGTT should be reserved principally for patients with '' borderline'' fasting plasma glucose levels ( i.e. fasting range 110 – 140 mg/dL).</p> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.25in">All pregnant women should be tested for gestational diabetes with a 50gms dose at 24 – 28 weeks of pregnancy; if result abnormal, OGTT should be performed after pregnancy.</p> <h4 style="tab-stops:.25in">Increased tolerance in<span style="mso-spacerun: yes"> </span></h4> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.25in">Pancreatic is let cell hyperplasia or tumor, poor absorption from gastrointestinal (Gl) tract in intestinal disease (e.g. steatorrhea, sprue, colic disease), hypothyroidism Addison's disease, liver disease, hypopituitarism. </p> <h4 style="tab-stops:.25in"><span style="mso-spacerun: yes"> </span>Decreased tolerance in<span style="mso-spacerun: yes"> </span></h4> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.25in">Diabetes mellitus- For diagnosis of diabetes in nonpregnant adults, at least two values of OGTT should be increased (or fasting serum glucose > 140mg/dL on more than one occasion and other causes of transient glucose intolerance must be ruled out. </p> <p class="MsoNormal" style="margin-left:.25in;tab-stops:.25in"><span style="mso-tab-count:2"> </span>Other causes of decreased tolerance are hyperthyroidism, hyperlipidemia, steroid effect, Cushing's effect, administration of adrenocorticotropic hormone (ACTH) or steroids, pregnancy.</p> <span style="font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family: "Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US; mso-bidi-language:AR-SA">Drugs like indomethacin, various neuroactive drugs (phenothiazines, tricyclics, lithium, haloperidol), heparin.</span> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-47865152002355441722010-08-17T10:59:00.003+05:302010-08-17T10:59:57.693+05:30Blood Glucose<p class="MsoBodyTextIndent2" align="center" style="text-align:center;tab-stops: .5in 155.25pt 208.5pt"><b><u>Blood Glucose</u></b></p> <h4 style="tab-stops:.25in">Indications</h4> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.25in">Diagnosis of diabetes mellitus [defined by World Health Organization (WHO) as unequivocal increase of fasting serum (or plasma) glucose > 126 mg/dl on more than one occasion or any glucose level<span style="mso-spacerun: yes"> </span>> 200mg/dL]; Control of Diabetes Mellitus; Diagnosis of hyperglycemia.<span style="mso-spacerun: yes"> </span></p> <p class="MsoNormal" style="margin-left:.25in;tab-stops:.25in"><span style="mso-tab-count:1"> </span></p> <table border="1" cellspacing="0" cellpadding="0" style="margin-left:41.4pt; border-collapse:collapse;mso-table-layout-alt:fixed;border:none;mso-border-alt: solid windowtext .5pt;mso-padding-alt:0in 5.4pt 0in 5.4pt"> <tbody><tr style="height:18.4pt"> <td width="348" colspan="2" valign="top" style="width:261.0pt;border:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:18.4pt"> <p class="MsoNormal" align="center" style="text-align:center;tab-stops:.25in">Normal Range </p> </td> </tr> <tr style="height:18.85pt"> <td width="158" valign="top" style="width:118.2pt;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:18.85pt"> <p class="MsoNormal" style="tab-stops:.25in"><span style="mso-spacerun: yes"> </span>Fasting</p> </td> <td width="190" valign="top" style="width:142.8pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:18.85pt"> <p class="MsoNormal" style="tab-stops:.25in"><span style="mso-spacerun: yes"> </span>Post prandial (2hrs)</p> <p class="MsoNormal" style="tab-stops:.25in"><span style="mso-spacerun: yes"> </span></p> </td> </tr> <tr style="height:27.4pt"> <td width="158" valign="top" style="width:118.2pt;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:27.4pt"> <p class="MsoNormal" style="tab-stops:.25in"><span style="mso-spacerun: yes"> </span>60 – 100mg/dL</p> </td> <td width="190" valign="top" style="width:142.8pt;border-top:none;border-left: none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:27.4pt"> <p class="MsoNormal" style="tab-stops:.25in"><span style="mso-spacerun: yes"> </span>< 140 mg/dL</p> </td> </tr> </tbody></table> <p class="MsoNormal" style="margin-left:.25in;tab-stops:.25in"><span style="mso-tab-count:1"> </span><b></b></p> <p class="MsoNormal" style="margin-left:.25in;tab-stops:.25in"><b><span style="mso-tab-count:1"> </span>Higher levels seen in</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.25in">Diabetes Mellitus including: hemochromatosis, Cushing's syndrome; acromegaly and gigantism, Increased circulating epinephrine due to – adrenaline injection, pheochromocytoma, stress, acute and chronic pancreatitis, effect of drugs like (corticosteroids, estrogens, alcohol, phenytoin, thiazides.)</p> <blockquote class="webkit-indent-blockquote" style="margin: 0 0 0 40px; border: none; padding: 0px;"><h4 style="tab-stops:.25in">Lower levels seen in </h4></blockquote> <span style="font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family: "Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US; mso-bidi-language:AR-SA">Pancreatic disorders (e.g. Islet cell tumor, Pancreatitis, glucagons deficiency); extrapancreatic tumors (e.g. carcinoma of adrenal gland and stomach, fibrosarcoma); hepatic disease (e.g. hepatitis, poisoning, cirrhosis, primary or metastatic tumor); endocrine disorders (hypopituitarism, Addison's disease, hypothyroidism); functional disturbances (e.g. postgastrectomy, gastroenterostomy, autonomic nervous system disorders); pediatric anomalies (e.g. prematurity, infant of diabetic mother); enzyme disease (e.g. von Gierke's disease, galactosemia, fructose intolerance others like malnutrition, alcoholism, exogenous, insulin or oral hypoglycemics).<span style="mso-spacerun: yes"> </span></span> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com3tag:blogger.com,1999:blog-6998806001883394691.post-78899194928139427442010-08-17T10:59:00.001+05:302010-08-17T10:59:24.145+05:30Activated Partial Thromboplastin Time(aPTT)<p class="MsoNormal" align="center" style="margin-left:.5in;text-align:center; tab-stops:.25in 185.25pt"><b><u>Activated Partial Thromboplastin Time(aPTT)</u></b></p> <p class="MsoNormal" align="center" style="margin-left:.5in;text-align:center; tab-stops:.25in 185.25pt"><b> </b></p> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.25in 185.25pt"><b>Introduction </b></p> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.25in 185.25pt">aPTT is the best screening test for disorders of coagulation; it is abnormal in 90% of patients with coagulation disorders. Screens for all coagulation factors that contribute to thrombin except factor VII and XII. The test may not detect mild clotting defects which seldom cause significant bleeding.</p> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.25in 185.25pt"> </p> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.25in"><b>Normal range</b></p> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.25in">25 – 38 seconds</p> <blockquote class="webkit-indent-blockquote" style="margin: 0 0 0 40px; border: none; padding: 0px;"><h4 style="tab-stops:.25in">Indications and Interpretation</h4></blockquote> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.25in">Monitor heparin therapy; Screen for hemophilia A and B,</p> <blockquote class="webkit-indent-blockquote" style="margin: 0 0 0 40px; border: none; padding: 0px;"><h4 style="tab-stops:.25in">Prolonged by</h4></blockquote> <p class="MsoBodyTextIndent2" style="tab-stops:.25in">Defect in following factors: I, II, V, VIII, IX, X, XI, XII; Presence of specific inhibitors of clotting factors (most frequently antibody against factor VIII, in 15% of patients with hemophilia); heparin, warfarin and lupus anticoagulant.</p> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.25in"><b>Normal in </b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in 155.25pt 208.5pt"><span style="mso-spacerun: yes"> </span>Thrombocytopenia, Platelet dysfunction, Von Willebrand's disease, isolated defects of factor VII.</p> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-82476651528801125612010-08-17T10:58:00.003+05:302010-08-17T10:58:38.854+05:30Prothrombin Time(PT)<p class="MsoNormal" align="center" style="margin-left:.5in;text-align:center; tab-stops:.5in 155.25pt 208.5pt"><b><u>Prothrombin Time(PT) </u></b></p> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.5in 155.25pt 208.5pt"><b>Normal range</b><u></u></p> <p class="MsoNormal" style="margin-left:.25in;tab-stops:.25in"><span style="mso-tab-count:1"> </span>11 –16 seconds</p> <p class="MsoNormal" style="margin-left:.25in;tab-stops:.25in"><span style="mso-tab-count:1"> </span><b>Indication</b></p> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.25in">Control of long – term oral anticoagulant therapy with coumarins and indanedione derivatives; evaluation of liver functions( PT is the most useful test of impaired liver synthesis of prothrombin complex factors[ factor II, VII, IX, Protein C & S]; evaluation of coagulation disorders- screen for abnormality of factors involved in extrinsic pathway (factor V, VII, IX, Prothrombin, fibrinogen). Should be used with a PTT.</p> <h4 style="tab-stops:.25in">Prolonged by defect in </h4> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.25in">Factor I, II, V, VII and X</p> <h4 style="tab-stops:.25in">Prolonged in <span style="font-weight:normal"></span></h4> <p class="MsoNormal" style="margin-left:.5in">In adequate vitamin K in diet, premature infants, newborns of vitamin K deficient mothers, poor fat absorption (obstructive jaundice, colitis, steatorrhea), severe liver damage (hepatitis, poisoning), anticoagulant drugs, familial hypoprothrombinemia. </p> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-31329883530895056932010-08-17T10:58:00.001+05:302010-08-17T10:58:14.371+05:30Coagulation Time/ Clotting Time (CT)<p class="MsoBodyTextIndent2" align="center" style="text-align:center"><b>Coagulation Time/ Clotting Time (CT)</b></p> <p class="MsoBodyTextIndent2"><b>Normal range</b></p> <p class="MsoBodyTextIndent2"><span style="mso-spacerun: yes"> </span>6 –17 minutes (glass tube), <b></b></p> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.5in 155.25pt 208.5pt"><b>Indications and Interpretations<span style="mso-tab-count:1"> </span></b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in 155.25pt 208.5pt">Former routine method for control of heparin therapy but now replaced by a partial thromboplastin time(PTT) as it is not a reliable screening test for bleeding conditions because it is not sensitive enough to detect mild conditions but only detects severe ones; normal coagulation time does not rule out a coagulation defect; routine preoperative bleeding and coagulation time are of<span style="mso-spacerun: yes"> </span>little value for preoperative screening.</p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in 155.25pt 208.5pt"><b>Prolonged in </b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in 155.25pt 208.5pt">Severe deficiency (< 6%) or any known plasma clotting factors except factor XII and factor VII, afibrinogenemia and presence of circulating anticoagulant (including heparin).</p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in 155.25pt 208.5pt"><b>Normal in</b></p> <p class="MsoBodyTextIndent2" style="tab-stops:.5in 155.25pt 208.5pt">Thrombocytopenia, deficiency of factor VII, von Willebrand's disease, and mild coagulation defects due to any causes.</p> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-15688865499722152032010-08-17T10:57:00.001+05:302010-08-17T10:57:48.237+05:30Bleeding Time (BT)<p class="MsoNormal" style="text-align: center;margin-left: 0.25in; "><b>Bleeding Time (BT)</b></p> <p class="MsoNormal" style="margin-left:.25in;tab-stops:.25in 155.25pt"><b><span style="mso-spacerun: yes"> </span></b></p> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.5in 155.25pt"><b>Normal Range</b></p> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.5in 155.25pt">3 – 9.5 minutes</p> <h4 style="tab-stops:.5in 155.25pt 208.5pt">Indications and Interpretations<span style="mso-tab-count:1"> </span></h4> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l2 level2 lfo2; tab-stops:.25in .5in list 81.0pt"><span style="font-family: Symbol">·<span style="font:7.0pt "Times New Roman""> </span></span>BT is functional test of primary hemostasis</p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l2 level2 lfo2; tab-stops:.25in .5in list 81.0pt"><span style="font-family: Symbol">·<span style="font:7.0pt "Times New Roman""> </span></span>BT is single screening test for platelet functional or structural disorders, acquired (e.g. uremia) or congenital</p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l2 level2 lfo2; tab-stops:.25in .5in list 81.0pt"><span style="font-family: Symbol">·<span style="font:7.0pt "Times New Roman""> </span></span>Normal BT without suggestive history usually excludes platelet dysfunction. However, a normal BT does not rule out significant defect; with clinical suspicion platelet aggregation should be performed</p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l2 level2 lfo2; tab-stops:.25in .5in list 81.0pt"><span style="font-family: Symbol">·<span style="font:7.0pt "Times New Roman""> </span></span>To work up for coagulation disorders in patients, having history of excess bleeding even with normal platelet count.</p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l2 level2 lfo2; tab-stops:.25in .5in list 81.0pt"><span style="font-family: Symbol">·<span style="font:7.0pt "Times New Roman""> </span></span>Normal in all other disorders of coagulation except von Willebrand's disease deficiency and some cases of very low plasma fibrinogen.</p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l2 level2 lfo2; tab-stops:.25in .5in list 81.0pt"><span style="font-family: Symbol">·<span style="font:7.0pt "Times New Roman""> </span></span>May be useful to monitor treatment of active hemorrhage in patients with prolonged BT due to uremia, Von Willebrand's disease, congenital platelet function abnormalities or severe anemia.</p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l2 level2 lfo2; tab-stops:.25in .5in list 81.0pt"><span style="font-family: Symbol">·<span style="font:7.0pt "Times New Roman""> </span></span>No value in performing BT if platelet count < 100,000/cumm as BT is usually prolonged. Prolonged BT with platelet count > 100, 000/cumm usually indicates impaired platelet function (e.g. due to aspirin) or von Willebrand's disease.<span style="mso-spacerun: yes"> </span></p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l2 level2 lfo2; tab-stops:.25in .5in list 81.0pt"><span style="font-family: Symbol">·<span style="font:7.0pt "Times New Roman""> </span></span>Even with a prolonged BT, blood loss does not exceed that of patients with normal BT. Prolonged BT does not necessarily cause increased bleeding.</p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l2 level2 lfo2; tab-stops:.25in .5in list 81.0pt"><span style="font-family: Symbol">·<span style="font:7.0pt "Times New Roman""> </span></span>BT increased out of proportion to platelet count suggests von Willebrand's disease or qualitative platelet defect.</p> <h4 style="tab-stops:.5in">Usually prolonged in<span style="mso-tab-count:1"> </span></h4> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.5in"><b>Thrombocytopenia:</b> Platelet count < 100,00/cumm and usually < 80,000/cumm before BT becomes abnormal and < 40,000/cumm before abnormality becomes pronounced.</p> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.5in"><b><br></b></p><p class="MsoNormal" style="margin-left:.5in;tab-stops:.5in"><b>Platelet function disorders</b></p><p class="MsoNormal" style="margin-left:.5in;tab-stops:.5in"><b></b>Hereditary: Von Willebrand's disease, deficient release of platelet glycoproteins, gray platelet syndrome, hereditary hemorrhagic telangiectasia</p> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.5in">Acquired: Drugs (aspirin, non- steroidal anti-inflammatory drugs [ NSAIDs], antimicrobials, anticoagulants, anesthetic, calcium channel blockers, β – blockers, phenothiazine, antidepressants), uremia, fibrin degradation products (e.g. disseminated intravascular coagulation [DIC], liver disease, fibrinolytic therapy, immune thrombocytopenias, myeloproliferative disease, vascular disorders, amyloidosis, viral infections, scurvy.</p> <h4 style="tab-stops:.5in">Usually normal in</h4> <p class="MsoBodyTextIndent2">Hemophilia, severe hereditary hypoprothrombinemia or hypofibrinogenemia.</p> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-27704119018198717822010-08-17T10:56:00.003+05:302010-08-17T10:56:42.210+05:30Erythrocyte Sedimentation Rate (ESR)<p class="MsoNormal" align="center" style="margin-left:.5in;text-align:center"><b>Erythrocyte Sedimentation Rate (ESR)</b></p> <h4 style="tab-stops:.5in">Introduction </h4> <p class="MsoNormal" style="margin-left:.5in">ESR is the rate at which RBC's settle down when blood, to which anticoagulant is added, is allowed to stand in a narrow tube for one hour expressed in millimeters of clear plasma at the end of 1st hour. Sedimentation rate depends on various factors like; rouleaux formation (Rouleaux formation is directly proportional to concentration of fibrinogen and globulin in plasma. It is retarded by albumin); viscosity of plasma (ESR decreases if viscosity increases); ratio of cells to plasma (decreased ratio leads to increase Rouleaux formation); nature of anticoagulant used.</p> <p class="MsoNormal"> </p> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.25in 134.25pt"> </p> <table border="1" cellspacing="0" cellpadding="0" style="margin-left:41.4pt; border-collapse:collapse;mso-table-layout-alt:fixed;border:none;mso-border-alt: solid windowtext .5pt;mso-padding-alt:0in 5.4pt 0in 5.4pt"> <tbody><tr style="height:25.6pt"> <td width="468" colspan="6" valign="top" style="width:351.0pt;border:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:25.6pt"> <p class="MsoNormal" style="tab-stops:114.0pt"><span style="mso-tab-count:1"> </span>Normal Range (mm in 1 hr)</p> </td> </tr> <tr style="height:17.5pt"> <td width="156" colspan="2" valign="top" style="width:117.0pt;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:17.5pt"> <p class="MsoNormal" style="tab-stops:.25in"><span style="mso-spacerun: yes"> </span>Westergren</p> </td> <td width="312" colspan="4" valign="top" style="width:3.25in;border-top:none; border-left:none;border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:17.5pt"> <p class="MsoNormal" style="tab-stops:.25in"><span style="mso-spacerun: yes"> </span>Wintrobe's<span style="mso-spacerun: yes"> </span></p> </td> </tr> <tr style="height:21.1pt"> <td width="72" valign="top" style="width:.75in;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:21.1pt"> <p class="MsoNormal" style="tab-stops:.25in"><span style="mso-spacerun: yes"> </span>Males</p> </td> <td width="84" valign="top" style="width:63.0pt;border-top:none;border-left:none; border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:21.1pt"> <p class="MsoNormal" style="tab-stops:.25in"><span style="mso-spacerun: yes"> </span>Females</p> </td> <td width="72" valign="top" style="width:.75in;border-top:none;border-left:none; border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:21.1pt"> <p class="MsoNormal" style="tab-stops:.25in"><span style="mso-spacerun: yes"> </span>Males </p> </td> <td width="72" valign="top" style="width:.75in;border-top:none;border-left:none; border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:21.1pt"> <p class="MsoNormal" style="tab-stops:.25in">Females</p> </td> <td width="84" valign="top" style="width:63.0pt;border-top:none;border-left:none; border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:21.1pt"> <p class="MsoNormal" style="tab-stops:.25in"><span style="mso-spacerun: yes"> </span>Children </p> </td> <td width="84" valign="top" style="width:63.0pt;border-top:none;border-left:none; border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:21.1pt"> <p class="MsoNormal" style="tab-stops:.25in">Newborns</p> </td> </tr> <tr style="height:25.15pt"> <td width="72" valign="top" style="width:.75in;border:solid windowtext .5pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt; height:25.15pt"> <p class="MsoNormal" style="tab-stops:.25in"><span style="mso-spacerun: yes"> </span>0 –13</p> </td> <td width="84" valign="top" style="width:63.0pt;border-top:none;border-left:none; border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:25.15pt"> <p class="MsoNormal" style="tab-stops:.25in"><span style="mso-spacerun: yes"> </span>0 –20</p> </td> <td width="72" valign="top" style="width:.75in;border-top:none;border-left:none; border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:25.15pt"> <p class="MsoNormal" style="tab-stops:.25in"><span style="mso-spacerun: yes"> </span>0 –10</p> </td> <td width="72" valign="top" style="width:.75in;border-top:none;border-left:none; border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:25.15pt"> <p class="MsoNormal" style="tab-stops:.25in"><span style="mso-spacerun: yes"> </span>0 -15</p> </td> <td width="84" valign="top" style="width:63.0pt;border-top:none;border-left:none; border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:25.15pt"> <p class="MsoNormal" style="tab-stops:.25in"><span style="mso-spacerun: yes"> </span>0 – 13</p> </td> <td width="84" valign="top" style="width:63.0pt;border-top:none;border-left:none; border-bottom:solid windowtext .5pt;border-right:solid windowtext .5pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt;height:25.15pt"> <p class="MsoNormal" style="tab-stops:.25in">0 -2</p> </td> </tr> </tbody></table> <p class="MsoNormal" style="margin-left:.25in;tab-stops:.25in"> </p> <h2 style="margin-left:.5in;tab-stops:.5in">Increased in </h2> <p class="MsoNormal" style="margin-left:.5in">Tissue damage or inflammation, anemia, any toxic or infective condition (acut or chronic), malignancies, nephrosis, physiological increase in females, pregnancy increase in temperature.</p> <p class="MsoNormal"><span style="mso-tab-count:1"> </span><b>Decreased in </b></p> <span style="font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family: "Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US; mso-bidi-language:AR-SA">Polycythemia, leukemia, hypofibrinogenemia, pernicious anemia, congestive heart failure (CHF), Protein shock (e.g. burns, severe allergic reactions), physiological decrease in newborns, decrease in temperature.</span> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-10731059020256746452010-08-17T10:56:00.001+05:302010-08-17T10:56:02.512+05:30Reticulocyte Count (RC)<p class="MsoNormal" align="center" style="margin-left:.5in;text-align:center; tab-stops:.25in 134.25pt"><b><u>Reticulocyte Count (RC)</u></b></p> <h4>Introduction</h4> <p class="MsoBodyTextIndent2" style="tab-stops:.25in 134.25pt">The reticulocyte count is a fairly accurate reflection of erythropoietic activity therefore their number increases whenever red blood cells (RBCs) are being rapidly manufactured.</p> <p class="MsoBodyTextIndent2" style="tab-stops:.25in 134.25pt"><b>Normal Range</b> </p> <p class="MsoBodyTextIndent2" style="tab-stops:.25in 134.25pt"><b>Adults:</b> 0.5 – 1.85 % of erythrocytes, absolute count – 29,000 – 87, 000/<a href="http://cu.mm">cu.mm</a>.</p> <p class="MsoBodyTextIndent2" style="tab-stops:.25in 134.25pt"><b>Newborn:</b> 2.5 – 6.5 %, falls to adult range by second week of life.</p> <p class="MsoBodyTextIndent2" style="tab-stops:.25in 134.25pt"><b>Indications</b></p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l2 level2 lfo2; tab-stops:.25in .5in list 81.0pt"><span style="font-family: Symbol">·<span style="font:7.0pt "Times New Roman""> </span></span>Diagnosis of inffective erythropoiesis or decreased RBC formation </p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l2 level2 lfo2; tab-stops:.25in .5in list 81.0pt"><span style="font-family: Symbol">·<span style="font:7.0pt "Times New Roman""> </span></span>Increase indicates effective RBC production used as: Index of therapeutic response to iron, folate or vitamin B12 therapy and blood loss; monitor treatment response after bone marrow suppression and transplantation; monitor response to erythropoietin therapy.</p> <h4 style="tab-stops:.25in .5in">Increased in</h4> <h4 style="tab-stops:.25in .5in"><span style="font-weight:normal"><span style="mso-spacerun: yes"> </span>After blood loss or increased RBC destruction, after iron therapy, after specific therapy for megaloblastic anemia and other hematologic conditions like polycythemia, metastatic carcinoma in bone marrow.</span></h4> <h4 style="tab-stops:.25in .5in"><span style="font-weight:normal"><span style="mso-spacerun: yes"> </span></span>Decreased in<span style="mso-spacerun: yes"> </span></h4> <p class="MsoBodyTextIndent2" style="tab-stops:.5in">Ineffective erythropoiesis or decreased RBC formation (severe autoimmune type<span style="mso-spacerun: yes"> </span>of hemolytic disease, megaloblastic disorders), alcoholism, myxedema.</p> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-16282859139523723252010-08-11T17:33:00.001+05:302010-08-11T17:35:51.337+05:30Abnormally shaped RBCs Spiculated<b><span style="font-size:12.0pt;font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman";mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"><div>Abnormally shaped RBCs</div><div><br></div>Spiculated –</span></b><span style="font-size: 12.0pt;font-family:"Times New Roman";mso-fareast-font-family:"Times New Roman"; mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:AR-SA"> Acanthocytes (abetalipoproteinemia, post – splenectomy, fulminating liver disease); Burr cells (stomach cancer, GI bleeding, uremia); Bite cells (hemolysis due to drugs); RBC fragmentation (cytotoxic chemotherapy, autoimmune hemolytic anemia, deficiency anemias, acute leukemia, inherited structural abnormality of RBC membrane protein spectrin).</span> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-25213290777343895792010-08-11T17:31:00.001+05:302010-08-11T17:35:51.338+05:30Abnormally shaped RBCs Elongated<b><span style="font-size:12.0pt;font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman";mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"><div>Abnormally shaped RBCs</div>Elongated – </span></b><span style="font-size: 12.0pt;font-family:"Times New Roman";mso-fareast-font-family:"Times New Roman"; mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:AR-SA">Elliptocytes (hereditary, microcytic anemia); ovalocytes (megaloblastic anemia); teardrop cells (spent polycythemia. myelofibrosis. Thalassemia); Sickle cells (sickle cell disorders); HbC crystalloids (HbC trait or disease). Acute alcoholism); Target cells (HbC disease or trait, HbD, HbE, HbS, thalassemia, iron deficiency anemia, liver disease, post – splenectomy).</span> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-80604782028534503812010-08-11T17:30:00.001+05:302010-08-11T17:35:51.338+05:30Abnormally shaped RBCs Round<h4>Abnormally shaped RBCs</h4> <b><span style="font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family: "Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US; mso-bidi-language:AR-SA">Round</span></b><span style="font-size:12.0pt; font-family:"Times New Roman";mso-fareast-font-family:"Times New Roman"; mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:AR-SA"> – Macrocytes (increased erythropoiesis); round macrocytes (liver disease, hypothyroidism, alcoholism); macro – ovalocytes (megaloblastic anemia, cancer chemotherapy, myelodysplastic syndromes); microcytes (hypochromic anemias), spherocytes (hereditary spherocytosis, recent blood transfusion); stomatocytes (hereditary stomatocytosis, acute alcoholism); target cells (HBC disease or trait, HbD, HbE, HbS, thalassemia, iron deficiency anemia, liver disease, post splenectomy).</span> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0tag:blogger.com,1999:blog-6998806001883394691.post-22036486213985548582010-08-11T17:27:00.001+05:302010-08-11T17:35:51.339+05:30Peripheral Blood Smear (PS)<p class="MsoBodyTextIndent2" align="center" style="text-align:center;tab-stops: .25in 134.25pt"><b><u>Peripheral Blood Smear(PS) - RBCs</u></b></p> <h4>Indications</h4> <p class="MsoBodyTextIndent2" style="tab-stops:.25in 134.25pt">Peripheral smear is done for typing anemia, to confirm red blood cells (RBC) indices or indicate leukemia or other conditions,</p><p class="MsoBodyTextIndent2" style="tab-stops:.25in 134.25pt"><br></p> <h4>RBC inclusions</h4><h4></h4> <p class="MsoNormal" style="margin-left:.5in;tab-stops:.25in 134.25pt">Basophilic or polychromatophilic macrocytes ( <b>< </b>15 in<b> </b>healthy persons, increased in erythropoiesis due to hemorrhage or hemolysis); microcytes with stippling (thalassemia, lead poisoning); Cabot's rings (severe hemolytic anemias, pernicious anemia [ PA]); Howell – Jolly bodies(megaloblastic anemia, thalassemia, hyposplenism, splenectomy); Pappenheimer bodies (Sideroblastic anemia, thalassemia, lead poisoning, pyridoxine unresponsive or responsive anemias); Heinz bodies (congenital G – 6 PD deficiency, drug induced hemolytic anemias); Plasmodium trophozoites(malaria); reticulocyte.</p> Vipul Jainhttp://www.blogger.com/profile/10431475049109465105noreply@blogger.com0