Understanding Blood Test

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NAME GGT (Gamma glutamyltransferase ) ROLE The purpose of this blood serum chemistry test is to provide information about hepatobiliary diseases, to assess liver function, and to detect alcohol ingestion. Another purpose is to distinguish between skeletal disease and hepatic disease when serum alkaline phosphatase is elevated. MCV = Hct/Hgb NORMAL Normal results in females under age 45, range from 5 to 27 U/L; in females over age 45 and in males, levels range from 6 to 37 U/L. DIFF A normal
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    NAMEROLENORMALDIFFGGT (Gammaglutamyltransferase) The purpose of thisblood serumchemistry test is toprovide informationabout hepatobiliarydiseases, to assessliver function, andto detect alcoholingestion. Anotherpurpose is todistinguish betweenskeletal disease andhepatic diseasewhen serumalkalinephosphatase iselevated.Normal results infemales under age45, range from 5to 27 U/L; infemales over age45 and in males,levels range from 6to 37 U/L.A normal GGT level suggests such elevstems from skeletal disease. Serum GGvary with the assay method used (coloror kinetic). The sharpest increases in Glevels indicate obstructive jaundice andmetastasis. Elevations may indicate anhepatic disease, acute pancreatitis, rendisease, alcohol ingestion, postoperativstatus, and prostatic metastasis. This tnonspecific, providing little data about tof hepatic disease. GGT is particularly sto the effects of alcohol in the liver, andmay be elevated after moderate alcoholand in chronic alcoholism, even withoutevidence of hepatic injury. MCV (meancorpuscular volume) MCV = Hct/Hgb Normal values:MCV: 80 to 95femtoliter MCH: 27to 31picograms/cellMCHC: 32 to 36grams/deciliterThese RBC indices are useful in the diff diagnosis of types of anemia. Anemiasclassified on the basis of cell size (MCV)cell color (MCHC). MCV less than lowernormal: microcytic MCV within normal rnormocytic MCV greater than upper limnormal: macrocytic MCHC less than lowof normal: hypochromic MCHC with norrange: normochromic MCHC greater thlimit of normal: hyperchromic   Anemias have been classified as followsnormocytic/normochromic (NC/NC) aneacute blood loss aplastic anemia (for exdue to chloramphenicol toxicity) prosthheart valves sepsis tumormicrocytic/hypochromic anemia: iron dlead poisoning thalassemiamicrocytic/normochromic anemia:erythropoietin deficiency secondary to rfailure macrocytic/normochromic anemichemotherapy folate deficiency vitamindeficiency Uric Acid   4.1 to 8.8 mg/dlGreater-than-normal levels of uric acid(hyperuricemia) may indicate: acidosis gout leukemalcoholismhypoparathyroidismnephroldiabetesmellituslead poisoningpolycytverarenalfailuretoxemia ofpregnancypurine-diet  severeexercise Lower-than-normal levels of uric acid mindicate:  Fanconi's syndromeWilson's disease Slow purine diet Additional conditions under which the tbe performed: chronic gouty arthritis inthe kidney and ureter Cholesterol   140 to 310 mg/dloptimal values:140-220 mg/dlNote: mg/dl =milligrams perdeciliteratherosclerosis biliary cirrhosis familialhyperlipidemias high-cholesterol diethypothyroidism myocardial infarction nsyndrome uncontrolled diabetes Triglycerides   Normal values: 10to 190 mg/dl Note:mg/dl = milligramsper decilitercirrhosis familial hyperlipoproteinemia (hypothyroidism low protein in diet andcarbohydrates poorly controlled diabetenephrotic syndrome pancreatitis  Alanine Aminotransferase(ALT, SGPT, GPT) Intracellular enzymeinvolved in amino acidand carbohydratemetabolism. Present inlarge concentrations inliver, kidney; smaller amounts in skeletalmuscle and heart.Released with tissuedamage.Normal Range:Laboratory-specificU/LIncreased in:Acute viral hepatitis (ALT>AST),tract obstruction (cholangitis, choledocholithiaalcoholic hepatitis and cirrhosis (AST>ALT), liabscess, metastatic or primary liver cancer; rifailure, ischemia or hypoxia, injury to liver ( shliver ), extensive trauma. Drugs causing choleand other hepatotoxic drugs. Additional: ALT screening of donor blood usedbanks to exclude non-A, non-B hepatitis.    Albumin Major component of plasma proteins,influenced bynutritional state,hepatic function, renalfunction, variousdiseases.Normal Range: 3.4-4.7 g/dLincreased in: Dehydration, shock, hemoconceDecreased in: Decreased hepatic synthesis (cliver disease, malnutrition, malabsorption, malicongenital analbuminemia [rare]). Increased l(nephrotic syndrome, burns, trauma, hemorrhfluid replacement, fistulae, enteropathy, acutechronic glomerulonephritis). Hemodilution (preCHF). Drugs (eg, estrogens). Additional: Serum albumin gives an indicationseverity in chronic liver disease. Useful in nutriassessment if no impairment in production or iloss.    Alkaline Phosphatase  Alkaline phosphatasesare found in liver, bone,intestine, placenta.Normal Range:Method and agedependentincreased in: Obstructive hepatobiliary diseashepatotoxic drugs, bone disease (physiologicgrowth, Paget's disease, osteomalacia, osteosarcoma, bone metastases), hyperparathyroidrickets. Benign familial hyperphosphatasemia,  pregnancy (3rd trimester), GI disease (perforaor infarct).Decreased in: Hypophosphatasia. Additional: Normal in osteoporosis. Alkalinephosphatase isoenzyme separation by electroor differential heat inactivation is unreliable. Uglutamyl transpeptidase (GGT), which increashepatobiliary disease, to infer srcin of increasalkaline phosphatase (ie, liver or bone).    ANA (Antinuclear  Antibodies) Heterogeneousantibodies to nuclear antigens (DNA andRNA, histone andnonhistone proteins). Antinuclear antibody ismeasured in patient'sserum by layeringserum over humanepithelial cells anddetecting the antibodywith fluorescein-conjugated polyvalentanti-humanimmunoglobulin.Normal Range: <1:20Elevated in: 1/3-3/4 of patients over age 65 (ulow titers), systemic lupus erythematosus (98induced lupus (100%), Sj?gren's (80%), rheuarthritis (30-50%), scleroderma (60%), mixedconnective tissue disease (100%), Felty's synmononucleosis, hepatic or biliary cirrhosis, heleukemia, myasthenia gravis, dermatomyositipolymyositis, chronic renal failure. Additional: A negative ANA test does not comrule out SLE, but alternative diagnoses shouldconsidered. Pattern of staining of ANA may giclues to diagnoses, but since the pattern alsowith serum dilution, it is not routinely reported.rim (peripheral) pattern is highly specific (for Suseful as a screening test. Should be used onlthere is clinical evidence of a connective tissu  ANCA (antineutrophil   cytoplasmic antibodies),   P-ANCA (perinuclear)   C-ANCA (cytoplasmic) Tests are on the bloodserum. C-ANCA ismost seen inWegener'sgranulomatosus. C- ANCA suggests asystemic vasculitisdisease, and is rarelyseen in patients withlupus. P-ANCA is mostseen in necrotizing,crescenticglomerulonephritis andpolyarteritis nodosa. P- ANCA is found in somelupus patients.Normal Range: nonepresent  Anti-Cardiolipin   (Anti-Phospholipid)  Anticardiolipinantibodies are a subsetof a group of antibodieswhich react withnegatively chargedphospholipids. Antibodies tocardiolipin have beenassociated with anNormal Range for anti-IgG: 0 - 20 GPL   Normal Range for anti-IgM: 0 - 10 MPL.increased in: SLE, some connective tissue disand in Antiphospholipid Syndrome.    Additional: Patients with acute and chronic inf (including syphilis, HIV, Lyme disease) may alincreased anti-cardiolipin antibodies    incresased incidence of vascular thrombosis,thrombocytopenia andrecurrent fetal loss inpatients with SLE.  Anti-DNA   IgG or IgM antibodiesdirected against hostdouble-stranded DNA.Normal Range: < 1:10titer increased in: Systemic lupus erythematosus (specificity 95%). Anti-ds-DNA antibody is not f drug-induced lupus. Additional: High titers are seen only in SLE. Tianti-ds-DNA correlate well with disease activitwith occurrence of glomerulonephritis.    Antinerythrocyte   antibodies (anti-RBC)also known as Coombstest The direct Coombs testmeasures the presenceof antibodies that arebound to the surface of circulating RBCs.Indirect Coombsmeasures *free* anti-RBC antibodies. Thesensitivity of this test isin question--but itremains the standardfor detection of autoimmune anemia.Normal Range: nonepresent  Antineurofilamentantibodies Limited studies havebeen done with thistest. Antibodies againstneurofilaments in bloodserum. 60% of diffuseNP lupus patients haveshown this antibody.Normal Range: nonpresent  Anti-Cardiolipin   (Anti-Phospholipid) MPLAnticardiolipinantibodies are a subsetof a group of antibodieswhich react withnegatively chargedphospholipids. Antibodies tocardiolipin have beenassociated with anincresased incidence of vascular thrombosis,thrombocytopenia andrecurrent fetal loss inpatients with SLE.Normal Range for anti-IgG: 0 - 20 GPL   Normal Range for anti-IgM: 0 - 10increased in: SLE, some connective tissue disand in Antiphospholipid Syndrome.    Additional: Patients with acute and chronic inf (including syphilis, HIV, Lyme disease) may alincreased anti-cardiolipin antibodies.    Antinerythrocyte   antibodies (anti-RBC)also known as Coombstest The direct Coombs testmeasures the presenceof antibodies that arebound to the surface of circulating RBCs.Indirect Coombsmeasures *free* anti-RBC antibodies. Thesensitivity of this test isNormal Range: nonepresent
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