Monday, February 4, 2008

Typical Lab Values from NBME !!

I prefer the term "Typical" to describe laboratory values. Using the word "Normal" implies that someone falling outside of the given range is "Abnormal" ... and I do not think that is a term that a health care provider should present to their patients.

Typical “Normal” Laboratory Values that appear on the USMLE Step 1 provided by the NBME.

TYPICAL “Normal” LABORATORY VALUES

REFERENCE RANGE SI REFERENCE INTERVALS

BLOOD, PLASMA, SERUM

* Alanine aminotransferase (ALT, GPT at 30 C) 8-20 U/L 8-20 U/L

Amylase, serum 25-125 U/L 25-125 U/L

* Aspartate aminotransferase (AST, GOT at 30 C) 8-20 U/L 8-20 U/ L

Bilirubin, serum (adult) Total // Direct 0.1-1.0 mg/dL // 0.0-0.3 mg/dL 2-17 μmol/L // 0-5 μmol/L

* Calcium, serum (Ca2+) 8.4-10.2 mg/dL 2.1-2.8 mmol/L

* Cholesterol, serum Rec:<200> <5.2>

Cortisol, serum 0800 h: 5-23 μg/dL 138-635 nmol/L

1600 h: 3-15 μg/dL 82-413 nmol/L

2000 h: ≤ 50% of 0800 h Fraction of 0800 h: ≤ 0.50

Creatine kinase, serum Male: 25-90 U/L 25-90 U/L

Female: 10-70 U/L 10-70 U/L

* Creatinine, serum 0.6-1.2 mg/dL 53-106 μmol/L

Electrolytes, serum

Sodium (Na+) 136-145 mEq/L 136-145 mmol/L

Chloride (Cl-) 95-105 mEq/L 95-105 mmol/L

* Potassium (K+) 3.5-5.0 mEq/L 3.5-5.0 mmol/L

Bicarbonate (HCO3-) 22-28 mEq/L 22-28 mmol/L

Magnesium (Mg2+) 1.5-2.0 mEq/L 1.5-2.0 mmol/L

Estriol, total, serum (in pregnancy)

24-28 wks // 32-36 wks 30-170 ng/mL // 60-280 ng/mL 104-590 // 208-970 nmol/L

28-32 wks // 36-40 wks 40-220 ng/mL // 80-350 ng/mL 140-760 // 280-1210 nmol/L

Ferritin, serum Male: 15-200 ng/mL 15-200 μg/L

Female: 12-150 ng/mL 12-150 μg/L

Follicle-stimulating hormone, serum/plasma Male: 4-25 mIU/mL 4-25 U/L

Female: premenopause 4-30 mIU/mL 4-30 U/L

midcycle peak 10-90 mIU/mL 10-90 U/L

postmenopause 40-250 mIU/mL 40-250 U/L

Gases, arterial blood (room air)

pH 7.35-7.45 [H+] 36-44 nmol/L

pCO2 33-45 mm Hg 4.4-5.9 kPa

pO2 75-105 mm Hg 10.0-14.0 kPa

* Glucose, serum Fasting: 70-110 mg/dL 3.8-6.1 mmol/L

2-h postprandial: <> <>

Growth hormone – arginine stimulation Fasting: <> <>

provocative stimuli: > 7 ng/mL > 7 μg/L

Immunoglobulins, serum

IgA 76-390 mg/dL 0.76-3.90 g/L

IgE 0-380 IU/mL 0-380 kIU/L

IgG 650-1500 mg/dL 6.5-15 g/L

IgM 40-345 mg/dL 0.4-3.45 g/L

Iron 50-170 μg/dL 9-30 μmol/L

Lactate dehydrogenase, serum 45-90 U/L 45-90 U/L

Luteinizing hormone, serum/plasma Male: 6-23 mIU/mL 6-23 U/L

Female: follicular phase 5-30 mIU/mL 5-30 U/L

midcycle 75-150 mIU/mL 75-150 U/L

postmenopause 30-200 mIU/mL 30-200 U/L

Osmolality, serum 275-295 mOsmol/kg 275-295 mOsmol/kg

Parathyroid hormone, serum, N-terminal 230-630 pg/mL 230-630 ng/L

* Phosphatase (alkaline), serum (p-NPP at 30 C) 20-70 U/L 20-70 U/L

* Phosphorus (inorganic), serum 3.0-4.5 mg/dL 1.0-1.5 mmol/L

Prolactin, serum (hPRL) <> <>

* Proteins, serum

Total (recumbent) 6.0-7.8 g/dL 60-78 g/L

Albumin 3.5-5.5 g/dL 35-55 g/L

Globulin 2.3-3.5 g/dL 23-35 g/L

Thyroid-stimulating hormone, serum or plasma 0.5-5.0 μU/mL 0.5-5.0 mU/L

Thyroidal iodine (123I) uptake 8-30% of administered dose/24 h 0.08-0.30/24 h

Thyroxine (T4), serum 5-12 μg/dL 64-155 nmol/L

Triglycerides, serum 35-160 mg/dL 0.4-1.81 mmol/L

Triiodothyronine (T3), serum (RIA) 115-190 ng/dL 1.8-2.9 nmol/L

Triiodothyronine (T3), resin uptake 25-35% 0.25-0.35

* Urea nitrogen, serum (BUN) 7-18 mg/dL 1.2-3.0 mmol urea/L

* Uric acid, serum 3.0-8.2 mg/dL 0.18-0.48 mmol/L

CEREBROSPINAL FLUID

Cell count 0-5 cells/mm3 0-5 x 106/L

Chloride 118-132 mEq/L 118-132 mmol/L

Gamma globulin 3-12% total proteins 0.03-0.12

Glucose 40-70 mg/dL 2.2-3.9 mmol/L

Pressure 70-180 mm H2O 70-180 mm H2O

Proteins, total <40> <0.40>

HEMATOLOGIC

Bleeding time (template) 2-7 minutes 2-7 minutes

Erythrocyte count Male: 4.3-5.9 million/mm3 4.3-5.9 x 1012/L

Female: 3.5-5.5 million/mm3 3.5-5.5 x 1012/L

Erythrocyte sedimentation rate (Westergren) Male: 0-15 mm/h 0-15 mm/h

Female: 0-20 mm/h 0-20 mm/h

Hematocrit Male: 41-53% 0.41-0.53

Female: 36-46% 0.36-0.46

Hemoglobin A1c ≤ 6% ≤ 0.06%

Hemoglobin, blood Male: 13.5-17.5 g/dL 2.09-2.71 mmol/L

Female: 12.0-16.0 g/dL 1.86-2.48 mmol/L

Hemoglobin, plasma 1-4 mg/dL 0.16-0.62 mmol/L

Leukocyte count and differential

Leukocyte count 4500-11,000/mm3 4.5-11.0 x 109/L

Segmented neutrophils 54-62% 0.54-0.62

Bands 3-5% 0.03-0.05

Eosinophils 1-3% 0.01-0.03

Basophils 0-0.75% 0-0.0075

Lymphocytes 25-33% 0.25-0.33

Monocytes 3-7% 0.03-0.07

Mean corpuscular hemoglobin 25.4-34.6 pg/cell 0.39-0.54 fmol/cell

Mean corpuscular hemoglobin concentration 31-36 % Hb/cell 4.81-5.58 mmol Hb/L

Mean corpuscular volume 80-100 μm3 80-100 fl

Partial thromboplastin time (activated) 25-40 seconds 25-40 seconds

Platelet count 150,000-400,000/mm3 150-400 x 109/L

Prothrombin time 11-15 seconds 11-15 seconds

Reticulocyte count 0.5-1.5% of red cells 0.005-0.015

Thrombin time <2> <2>

Volume

Plasma Male: 25-43 mL/kg 0.025-0.043 L/kg

Female: 28-45 mL/kg 0.028-0.045 L/kg

Red cell Male: 20-36 mL/kg 0.020-0.036 L/kg

Female: 19-31 mL/kg 0.019-0.031 L/kg

SWEAT

Chloride 0-35 mmol/L 0-35 mmol/L

URINE

Calcium 100-300 mg/24 h 2.5-7.5 mmol/24 h

Chloride Varies with intake Varies with intake

Creatine clearance Male: 97-137 mL/min

Female: 88-128 mL/min

Estriol, total (in pregnancy)

30 wks 6-18 mg/24 h 21-62 μmol/24 h

35 wks 9-28 mg/24 h 31-97 μmol/24 h

40 wks 13-42 mg/24 h 45-146 μmol/24 h

17-Hydroxycorticosteroids Male: 3.0-10.0 mg/24 h 8.2-27.6 μmol/24 h

Female: 2.0-8.0 mg/24 h 5.5-22.0 μmol/24 h

17-Ketosteroids, total Male: 8-20 mg/24 h 28-70 μmol/24 h

Female: 6-15 mg/24 h 21-52 μmol/24 h

Osmolality 50-1400 mOsmol/kg

Oxalate 8-40 μg/mL 90-445 μmol/L

Potassium Varies with diet Varies with diet


Proteins, total <> <>

Sodium Varies with diet Varies with diet

Uric acid Varies with diet Varies with diet

*Included in the Biochemical Profile (SMA-12). By chance alone, at least one false-positive result is expected in almost half the people having 12 tests (SMA-12) and in two thirds of those having 20 tests (SMA-20).

SMA-6 (6 tests) – bicarbonate, chloride, glucose, potassium, sodium, urea nitrogen

SMA-12 (12 tests) – bicarbonate, calcium, chloride, cholesterol, creatinine, glucose, phosphatase (alkaline), potassium, sodium, transaminases (alanine and aspartate), urea nitrogen

SMA-20 (20 tests) – protein (albumin), bicarbonate, bilirubin (direct and total), calcium, chloride, cholesterol, creatinine, gamma-glutamyltransferase, glucose, lactic dehydrogenase, magnesium, phosphatase (alkaline), potassium, protein (total), sodium, transaminases (alanine and aspartate), urea nitrogen, uric acid

Typical “Normal” Laboratory Values that appear on the USMLE Step 1 provided by the NBME .

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