Mzantsi Medics

Blood chemistry.

Test	Unit	Reference range
Na	mmol/L	136 -145
K	mmol/L	3.5 – 5.1
Cl	mmol/L	98 – 107
HCO3	mmol/L	22 – 29
Urea	mmol/L	2.1 – 7.1

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Creatinine and eGFR

Test	Unit	Reference range
Creatinine	umol/L	64 – 104 (Males) 49 – 90 (Females)
eGFR	mL/min/1.73 m2	≥ 90

Full Blood Count (FBC) / Complete Blood Count (CBC)

Test	Unit	Reference range
Haemoglobin	g/dL	14.5 – 18.5 males 12.5 – 16.5 females
Erythrocyte count	x 1012/L	4.80 – 6.40
Haematocrit	L/L (%)	0.42 – 0.54 42% – 54%
MCV MCH MCHC	fL pg g/dL	82 – 98 27 – 33 31 – 35
RDW	%	12.1 – 16.3
Platelets	x 109/L	150 – 400
MPV	fL	7.1 – 11.0
Leucocyte count	x 109/L	4.0 – 11.0
Neutrophils Lymphocytes Monocytes Eosinophils Basophils	x 109/L	1.6 – 8.0 1.0 – 4.5 0.2 – 0.8 0.04 – 0.45 0.00 – 0.10

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nomenclature

Councilman bodies	Hepatocytes undergoing apoptosis
Howell-Jolly bodies	Nuclear remnants found in erythrocytes	Asplenia
Toxic granulation	Multiple dark blue granules noted on the cytoplasm of mature neutrophils	Neutrophil activation Acute Bacterial infection Inflammation
Dohle bodies	Pale blue remnants of ribosomes and endoplasmic reticulum noted on neutrophil cytoplasm.	Neutrophil activation Toxic granules Bacterial infection Inflammation Burns Pregnancy
Toxic vacuolation	Stainless vacuoles in cytoplasm of neutrophils	Neutrophil activation Bacterial infection
Howell-Jolly body-like inclusions	Round, dark purple intracytoplasmic inclusions in neutrophils similar to Howell-Jolly bodies.	Immunosuppression therapy Organ transplant HIV Chemotherapy
Left shift	Presence of immature neutrophils.	Neutrophil activation CML
Pelger-Huët cells		CML Pelger-Huët anomaly
Hyper segmented neutrophils	The presence of neutrophils with 6 or more lobes or the presence of more than 3% of neutrophils with at least five lobes.	Megaloblastic (macrocytic) anaemias B12 Deficiency Folate deficiency
Platelet clumping	The EDTA anticoagulant causes platelets to clump and results in pseudothrombocytopenia being reported. An exclusively in vitro phenomenon.	EDTA anticoagulant
Platelet satellitism / rosetting	The EDTA anticoagulant causes platelets to adhere around neutrophils and results in pseudo-thrombocytopenia being reported. An exclusively in vitro phenomenon.	EDTA anticoagulant

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Erythrocyte sedimentation rate (ESR): Westergren method

• Males 0–15 mm/1 hr
• Females 0–25 mm/1 hr.

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C-Reactive protein

Test	Unit	Reference range
CRP	mg/L	<10

International normalised ratio (INR)

Test	Reference range
INR	≤ 1.1 2 – 3 DVT / PE Prophylaxis. 2 – 3.5 Mechanical Heart Valves.

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Liver function tests

Test	Unit	Reference range
Total protein	g/L	60 – 78
Albumin	g/L	35 – 52
Total bilirubin	umol/L	5 – 21
Conjugated bilirubin (DBil)	umol/L	0 – 3
ALT	U/L	10 – 40
AST	U/L	15 – 40
ALP	U/L	53 – 128
GGT	U/L	< 68

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Calcium, magnesium and phosphate

Test	Unit	Reference range
Ca	mmol/L	2.15 – 2.50
Mg	mmol/L	0.63 – 1.05
Pi	mmol/L	0.78 – 1.42

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Fasting lipogram

Test	Unit	Reference range
Total-C	mmol/L	< 4.5
HDL-C	mmol/L	> 1.0 Males > 1.2 Females
LDL-C*	mmol/L	< 1.8
TG	mmol/L	< 1.7

Dyslipidaemia

• Total cholesterol >5.1 mmol/l             OR
• LDL >3 mmol/l                                    OR   
• HDL <1 (men) and <1.2 mmol/l (women).

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HMG CoA Reductase inhibitors (Statins)
Statin	30% LDL-C decrease dose
Fluvastatin	40 – 80 mg
Pravastatin	20 – 40 mg
Atorvastatin	10 mg
Simvastatin	10 – 20 mg
Rosuvastatin	2.5 mg

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Diabetes Mellitus

Test	Unit	Reference range
HbA1C	%	3.8 – 6.4
BHB	mmol/L	< 0.5 (> 3 mmol/L = DKA)

C-Peptide

• 0.78 – 1.89 ng/mL
• 0.26–0.62 nmol/L

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Tumour markers  

Test	Unit	Reference range
PSA	Ug/L	<4.00

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Arterial blood gas (ABG)

Test	Unit	Reference range
pH	–	7.35 – 7.45
PaCO2	mm Hg (kPa)	35 – 45 (4.6 – 6.9)
PaO2	mm Hg (kPa)	80 – 100 (10.5 – 13.1)
HCO3	mmol/L	22 – 26
Std HCO3	mmol/L	20 – 25
BE	mmol/L	-2 to +2
AG	mmol/L	10 – 20: (Na + K)-(CI +HCO3) or 7 – 16: Na-(CI +HCO3)
Lactate	mmol/L	0.5 – 1.0
O2 Saturation	%	95 – 98

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Cardiac markers

Test	Unit	Reference range
Hs TnI	ng/L	< 10 (Abott)
TnI	ng/L	0 – 26.2 (Abott) 0 – 40 (Beckman)
Hs TnT	ng/L	0 – 14
CK total	U/L	20 – 200
CK – MB	ug/L	0.00 – 5.20
Myoglobin	ug/L
NT ProBNP	pg/mL	< 100

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Thyroid function tests

Test	Unit	Reference range
TSH	mIU/L	0.34 – 5.60
Thyroxine (Free T4)	pmol/L	7.6 – 16.1

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Haematinics

Test	Unit	Reference range
Iron	umol/L	9.0 – 30.4
Transferrin	g/L	1.90 – 3.75
% Saturation	%	15 – 50
Ferritin	ug/L	5 – 204
Vitamin B12	pmol/L	138 – 652
Serum folate	nmol/L	7.0 – 46.4

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HIV Monitoring

Test	Unit	Reference range
CD45 +ve leucocytes count	x 109/L	4.00 – 10.00
CD4% of lymphocytes	%	28 – 51
Absolute CD4	Cells/uL	332 – 1642
Viral load	Copies/mL	0 – 40
HIV log	Log	0 – 1.6

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Drugs

Drug	Class	Range
lithium	Mood stabiliser	0.8 – 1.2 mmol/L

General guidelines

• The frequency of the special investigations needed should be kept in mind by the healthcare provider.
• Monitoring of trends rather than a single value is of significant importance.
• The special investigations should be done with a clinical picture always kept in mind.
• Greater value is attained from the special investigations if the lab technicians are aware of the clinical picture being worked up.
• The health care provider should always be mindful of specimen collection techniques which may yield incorrect results.
• When in doubt call for advice.

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OTHERS

ELISA

FISH

Gel Electrophoresis

Polymerase Chain Reaction (PCR)

PCR Realtime

Western Blot

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Disclaimer: This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. Mzantsi Medics disclaims any warranty or liability relating to this information or the use thereof.