THE PACKAGE of your BLOOD TEST
In a normal sheet analysis is this table.
RBC the red blood cell count
HGB the absolute value of hemoglobin
HCT hematocrit
MCV volume mean corpuscular red cell
MCH the average content of hemoglobin per red blood cell
the MCHC mean corpuscular hemoglobin concentration
RDW index of red cell volume distribution
HDW index distribution of the concentration of HB
PLT the platelet count
MPV Mean platelet volume
PT prothrombin time PTT
partial prothrombin time
WBC the total count of white blood cells or leukocytes
NEUT neutrophil counts
LYMPH lymphocyte count
MONO counts monocytes
EOS eosinophil counts
BASO counts of basophils
the ESR ESR
side Remia
ferritinemia
transferrinemia
GLICEMIA
COLESTEROLO TOTAL
TRIGLICERIDI
HDL
LDL
URICEMIA
azotemia
CREATININE
GOT or ALT
GPT and AST
GAMMA GT
ALKALINE PHOSPHATASE
TOTAL BILIRUBIN
DIRECT BILIRUBIN
INDIRECT BILIRUBIN
AMYLASE
CPK or CK
TSH
FT4
FT3
FOOTBALL
POTASSIUM
SODIUM
CHLORINE
blood
Blood or blood stream through the arteries and veins reaches every tissue in our body can be separated into two
corpuscular components (red and white blood cells, platelets)
liquid also known as plasma plasma
subtracting some of its components responsible for blood clotting (coagulation factors) we obtain the serum.
what is the blood
The main functions of blood are:
the transport of oxygen, nutrients, drugs, waste products, salts, hormones and carbon dioxide to and from all the cells of 'body.
defense against pathogens by the white cells and the proteins they secreted
thermoregulation
repair of damaged vessels
information of organ function (level of salts, glucose, hormones, and venous blood pressure, temperature etc)
blood counts
In any given answer sheet of the first laboratory dedicated all'emocromo page is complete, ie the analysis of corpuscular components of blood that by convention is divided into:
red series: erythrocytes (red, R red initials), the hemoglobin contained therein (the initials of hemoglobin H) and platelets (the platelet P of acronyms). This series aims to highlight the features of the transport of oxygen through the correct composition of red blood cells, both in shape and volume both in the content of hemoglobin. The functionality of clotting is first analyzed by the number and shape of platelets
white series: granulocytes (themselves divided into neutrophils, eosinophils, basophils), monocytes, lymphocytes. Through analysis of this series, shows the capability of defense and response body still in emergency situations.
1. the red series
a) The red blood cell count (RBC) or erythrocytes (GR) or red blood cells
Every adult has around 30 trillion and are responsible for transporting oxygen for cellular respiration. Are formed in the bone marrow and for their production are needed to substances such as the vit.B12, folic acid and iron. The duration of the GR is about 120 days, then they are segregated in the spleen and throughout the reticuloendothelial system and decomposed. Their raw material is largely reused for the new GR.
Normal values \u200b\u200bof the absolute amount of circulating GR is expressed under the symbol RBC
normal values \u200b\u200bof RBC
Men 4.5 - 6.1 million / ml
Women 3.9 - 5.4 million / ml
What does this mean a reduction of red blood cells (RBC) ?
The reduction in RBC is said to anemia and can occur as a result of
loss through internal bleeding obvious or hidden or eg. faeces or urine
incomplete or defective structure of the same GR (vit.B12 deficiency, folic acid and iron)
decay too fast or abnormal destruction of RBCs (bad form, a disease of the reticuloendothelial system)
What is an I increase of erythrocytes (RBC )?
The increase in red blood cells may be due to
less oxygen from the outside (long stay at high altitude)
a low internal concentration of oxygen (chronic heart or lung disease)
a disease of the bone marrow to produce excessive RBC
The evaluation of blood picture is never based on a single laboratory value, but requires a comparison with other parameters, eg number of red blood cells, hemoglobin and hematocrit.
b) hematocrit (HCT)
Through a process of centrifugation, the blood is broken down into liquid and corpuscular part, describing the amount of RBC percentage compared to whole blood. The hematocrit is thus another parameter to determine the actual amount of red blood cells for carrying oxygen to tissues and to exclude anemia. Normal hematocrit values \u200b\u200b
Men Women 36-45% 42-50%
Children: Infants 45-75% 30-55%
1 month 6 months 34-46%
1 to 4 years 33-44% 36-43% 10 years
What does this mean a reduction of hematocrit?
A reduction in hematocrit or mean corpuscular part of blood is decreased (also would have lowered the number of red blood cells and hemoglobin), or the liquid (eg for hyperhidrosis-tion of the body) is increased.
What does an increase hematocrit?
An increase in hematocrit can mean either an increase in the corpuscular part of blood (polyglobulia) or a decrease in the fluid part (dehydration very serious body that ispissatio sanguinis).
C) The absolute value of hemoglobin (HGB)
E 'defined as the pigment of red blood cells capable of carrying oxygen to tissues. When the HB, within the lungs through the breathing process, is bound to oxygen is called oxyhemoglobin, a compound that gives blood its characteristic red color. Hemoglobin is a large molecule that is formed in the bone marrow from two components: heme iron atoms and with a protein to form a double chain (alpha and beta) globin, which is mainly the training shall Vit . B12 and folic acid. The oxygen-rich blood flowing through arteries, the veins which is poor. Often based on the color of blood as possible to tell whether bleeding is arterial or venous.
normal values \u200b\u200bHGB
Men 20-40 years 13-18 g / dl
> 40 years 14-17 g / dl
Women 20-40 years 12-16 g / dl
> 40 years from 12 to 17.5 g / dl
Infants Children 17-27 g / dl 1 month
12-22 g / d
6 months 10-15 g / dI
1 year from 9.5 to 14.5 g / dI
4-10 years 10-16g/dI
What does this mean a reduction of hemoglobin?
Normally, hemoglobin is directly related to the number of red blood cells, and their lack of a generally well-say a shortage of hemoglobin. An ab-lowering of hemoglobin is therefore a symptom of anemia.
What does an increase hemoglobin?
Even in the event of an increase in hemoglobin can be pre-see an increase in red blood cells (polyglobulia), possible causes are therefore the same as the increase in the num-ber of red cells.
When the two chains (alpha and beta) globin are disproportionate in their relationship, it is called thalassemia or Mediterranean anemia. Beta thalassemia or alpha thalassemia, depending on the deficit. In this case there is a marked destruction (hemolytic anemia) of red blood cells.
d) The other cell parameters for the evaluation of anemia: MCV
MCH MCHC RDW
HDW
The study of anemia is a complex phenomenon, but often appear in the routine examination of the values \u200b\u200bthat must be known. When
erythropoiesis, namely the formation of red blood cells in the bone marrow is of normal quality, hematocrit and red blood cell count per ml of blood are closely related to each other and undergo consensual changes. When, on the contrary erythropoiesis becomes qualitatively altered (as in some congenital or acquired anemias), these relationships can change. They then investigated other parameters such as:
MCV mean corpuscular volume of red blood cells (obtained by dividing the hematocrit the number of red blood cells)
MCH the average content of hemoglobin per red blood cell (obtained by dividing the HB in g / dl for the number of red blood cells in the same volume)
concentration MCHC mean corpuscular Hemoglobin is the ratio between the amount of hemoglobin in g / dl and the volume of red blood cells expressed nell'ematocrito.
anemic In some situations, such as the lack of iron for anemia (iron deficiency anemia) the number of red cells may be normal or even increased by reduction of the MCV (microcytosis) and MCH (hypochromia). In the case of marked destruction of red blood cells (hemolytic anemia) is a decrease of RBC, but the anemia is normocytic and normochromic for normality of MCV and MCH.
In other situations the anemic red blood cell count has actually dropped more than they are reduced hematocrit and hemoglobin. It is then to be an increase of MCV and MCH (macrocytosis). This phenomenon is characteristic of pernicious anemia, due to the lack of Vit.B12 and folic acid (essential to the formation of globin) but also of other anemias of lack of structure formation of red blood cell.
In other cases it may be increased but not MCH MCV (microcytosis and normochromic) as the deficiency anemia, that is when they fail Vit.B12 that both the iron and folic acid. Even then you have a large but low red blood cell MCHC, ie decrease in the concentration of hemoglobin in the blood cell. A second feature of the deficit, it is called in megaloblasts and megalocitosi deficiency and macrocytosis in macroblastosi vitB12 and folic acid deficiency.
For a better evaluation of anemia in the laboratory now apply the so-called distribution parameters
RDW index of red cell volume distribution vn.11-16.5%
HDW index distribution of the concentration of HB vn . 2.2-3.2 g / dl
All the cells that the analyzer counts, in this case are presented in a Cartesian graph, where the vertical axis shows the volume of red blood cells while the horizontal axis describes the content of hemoglobin. In the normal patient all of the red blood cells comes at a quadrant of the central plot, while the small volume of red blood cells (microcytosis) and low hemoglobin (hypochromia) are distributed in low and left.
e) serum iron. The ferritin levels. The transferrinemia.
For the evaluation of anemia, namely the reduction of oxygen to tissues for cellular energy, we also evaluate the elements essential to the formation of hemoglobin and then the red cell. Globin, of course, joins the atoms forming the heme iron. The iron storage and transport is therefore a key parameter to diagnose, prevent and treat anemia.
More than half of the body iron is contained in red blood cells and makes himself available for the formation of new blood cells from the destruction of old blood cells from the spleen and the entire reticuloendothelial system. So it's a closed system and only a small percentage depends on intestinal absorption. However iron is also distributed in other storage protein in circulation (serum iron) and transport (transferrinemia). In some disorders, or bleeding events, reducing not only the hematocrit and hemoglobin but also the parameters of storage, transport and the balance of iron in the tissues (ferritin). In states of hemolytic anemia (destruction of enhanced GR) and in pernicious anemia may be some increase in serum ferritin. A big one has instead incremeneto in iron overload (hemochromatosis). Normal serum iron values \u200b\u200b
man 60-160mcg/dl
women 40-140 mcg / dl
man Ferritin 30-400 ng / ml
fertile woman 15-150 ng / ml
menopausal 30-400 ng / ml
Transferrinemia 200-300 mg / dl
2.la white series
White blood cells (leukocytes)
WBC White blood cells ( leukocytes) are also called "guardians of the blood" which play a fundamental role in defense against foreign agents or pathogens. When the body is put on the alert for the appearance of "enemies" such as bacteria, fungi, foreign bodies or even obesity and excessive stress, leukocytes are mobilized and begin, if necessary, their struggle against "intruders".
normal values \u200b\u200bof white blood cell (WBC)
4000-l0000/micronl
Adult Children: Infants 9400-34000 / 5000-20000 micronl
1 month / 1 year micronl
6000-17000 / micronl
4 years 5000-5500 / micronl
10 years 4500-L3000 / micronl
What does an increase in white blood cells?
The most common cause of a moderate increase in white blood cells are the body's exposure to inflammation is not caused by pathogens. It can also cause an increase in white blood cells also all forms of excessive stress and every state of shock ..
A strong increase (but combined with organic and other symptoms, however, evaluation is always the doctor) the number of leukocytes is present in the most serious diseases of the blood system, leukemias. Leukemias arise due to uncontrolled neoplastic proliferation of white blood cells in the bone marrow mature "complete" or immature "incomplete." These invade the body, replacing the other elements of the blood and inhibit irreversible and incurable defense system, the coagulation system of blood and oxygen transport. Depending on the type of white blood cells moltiplicatisi and the degree of increase, a distinction is made between acute and chronic leukemia. Depending on the type of leukemia you can have a dramatic course of the disease that leads to death in a short time without treatment options, or a development which for years has no major problems. The therapeutic approach varies depending on the extent of the disease and ranges from "simple observation" to the use of chemotherapy, radiotherapy and bone marrow transplants.
What is a leukocyte reduction?
A drop of white blood cells can be found in pictures of very serious infection, were symptomatic of the exhaustion of the defense system, damage to bone marrow (for example due to drugs, radiation or chemicals), and in many virus infections and in some diseases of the blood system.
DIFFERENTIAL BACKGROUND In many of the white series
disease or blood disorders, differentiate between different types of white blood cells is a valuable source of information for the diagnosis .. The analyst can be achieved through separation of white blood cells as well as through the microscope a precise determination of red blood cells and platelets. White blood cells (leukocytes) can be divided into different groups, the most important being: granulocytes, lymphocytes, monocytes
1) Granulocytes are distinguished into: *
neutrophils (Neut) vn. 45-70%
are the first responders in the inflammatory processes activating the complex system of phagocytosis and the secretion of humoral factors of defense
What does an increase in neutrophils
The increase in neutrophils may occur by physical exertion, stress, pregnancy, menstruation, bacterial infection, burns, bleeding, metabolic disorders such as diabetes, cortisone drugs, etc leucocemie
What does a decrease in neutrophil
The decrease in neutrophils may occur by bacterial, viral infections, parasites or insufficient production of the elements by the bone; to increase the activity of destruction by the spleen for autoimmune diseases, etc. *
eosinophils (EOS) vn. 1-3%
particles are delegated to the contrast of some processes in allergy and parasitic
What does it mean an increase of eosinophils (eosinophilia)
Eosinophils increase in allergic conditions of any kind, and in parasitic infections and autoimmune phenomena etc.
What does a decrease in eosinophils (eosinopenia)
Eosinophils decrease in cases of severe bacterial infections.
* basophils (baso) vn are the 0-0.5%
particles which produces immunoglobulin
What does it mean an increase of basophils (basophilia)
's increase of basophils occurs in some autoimmune diseases, Hodgkin's disease to increased production of immunoglobulins
What does a decrease in basophil basophil
The decrease is true for increased destruction by the spleen and severe immunodeficiencies.
2) lymphocytes (lymph) vn.20
-40% of the circulating cells are delegated to specialized defense against foreign agents and their first major split them apart in B lymphocytes (in presence of the or foreign antigen is multiplied and transformed into plasma cells secreting immunoglobulins or antibodies) for the immediate defense or humoral and T lymphocytes to defend delayed or cell mediated primarily through phagocytosis.
What does an increase in lymphocytes (lymphocytosis)
's increase in lymphocytes occurs in bacterial and viral infections, allergic processes, lymphoid leukemia, in certain endocrine diseases such as hyperthyroidism.
What does the presence of plasma cells in the blood (plasmacytosis)
In normal plasma cells are not present in the blood is observed in multiple myeloma, in infectious mononucleosis, measles, rubella and chickenpox.
What does a decrease in lymphocytes (lymphopenia)
A small decrease can be charged to acquired immune deficiency with chronic infections. In the case of immunodeficiency after infection or after chemotherapy or autoimmune diseases (kidney, thyroid, etc.) or to decrease the leukemia has to be very important.
3) Monocytes (mono) vn. 3-7%
circulating cells are large members to cell-mediated immune defense especially through the so-called process of phagocytosis. The outside agency is literally eaten and metabolized inside.
What does an increase in the monoliths (Monocytosis)
The increase of monocytes occurs in some diseases (like tuberculosis, malaria, etc.) or other disease processes (autoimmune diseases) as a defense response that is called into question mainly mediated by the immune system cells (T lymphocytes and monocytes). Myeloid leukemia and lymphoma, or simply the overproduction of these tumor cells.
THE SPEED 'erythrocyte sedimentation rate (ESR)
The measurement of the speed with which the cells are deposited in a vertical tube at a given time, is referred to as erythrocyte sedimentation rate. It 's the most widely used and well-known procedure for the assessment of inflammation body. Routine is performed in almost all the blood test: a small amount of blood collected (1.6 mi) is mixed with citric acid (to prevent clotting), then the blood is drawn into a pipette, 200 mm long. After about two hours it detects how many mm of red blood cells are deposited on the bottom of the tube.
normal values \u200b\u200bof ESR
Men 4-10 mm.
Women 10-20 mm per hour. hour.
What does an increase in ESR?
Increased ESR primarily indicates acute or chronic inflammation in the body. The place or type of inflammation may not yet be established by simple examination of the ESR. Elevated erythrocyte sedimentation rate are also found in the presence of lesions of the liver tumors, kidney disease, anemia and pregnancy. It will be the framework and other findings or useful to differentiate.
What does this mean a reduction in ESR?
A decrease in ESR is always present when the corpuscular part del.sangue increased compared to the liquid. This results in certain haematological disorders (abnormal viability, defective blood cells), but also as a side effect of some drugs.
blood clotting
During surgery, the operator must ensure not only that there is a sufficient portion of blood but it works perfectly or nearly so, the coagulation system or curtain. When a blood vessel is injured, however, there is a leakage of blood all the more significant the larger is the size of the wound. Without countermeasures by the body, the risk of bleeding is always present. A preservation of blood loss, the body has thus a perfect security system, known as the coagulation system. This consists of three main components:
The ability of blood vessels to heal after injury
Platelets (thrombocytes) immediately after injury are grouped along the edges of the vessel, forming a buffer
coagulation factors that initiate the clotting process by producing the definitive clot by setting the repair of the damage.
An examination of information on the coagulation system is ordered in the case of routine surgery. The tests are performed as a rule include:
- determining the number of platelets
- Quick
the time - the partial thromboplastin time
* Platelets (thrombocytes, platelets) PLT
are one of the most important components of blood with their help in fact, the wounds of the vessels provided they are not too large, rirnarginate are typically within three minutes. When a vessel suffers an injury, platelets are deposited on the edges of the wound, forming a plug (thrombus) that should prevent further loss of blood. Platelets also give some "substances" that initiate clotting by attracting more precisely the cells that repair the damage.
normal values \u200b\u200b
Adults l50.000-400.000/ml
What does an increase in platelets? Up transient platelet
are found for example in the aftermath of major infectious diseases, after acu-te loss of blood or injury or removal of the spleen (organ function as storage of platelets). A sharp rise in values \u200b\u200bof platelets leads to an increased risk of thrombosis.
What does this mean a reduction of platelets?
due to the reduced number of platelets can be found in noise production in the bone marrow, for example due to damage from radiation or drugs, but also to a chronic deficiency of vitamin B12 and folic acid. In addition, some malignant diseases of the bone marrow (leukemia for example) may reduce or hinder the production of platelets. A marked reduction in the number of platelets leads to the failure of the mechanism of coagulation-tion with the risk of bleeding.
Today is also used to assess the MPV
platelet volume average (vn 7-11 fL)
the purpose of considering the shape of platelets in the coagulation defect situations.
* Quick Time (thromboplastin time, prothrombin time) PT vn 70-120%. Quick
time gives information about the integrity of a clear set of fundamental factors of coagulation. With a sample of blood clotting time is measured and compared with normal values. The Quick Time is used as a control in anticoagulant therapy, such as in cases of thrombosis or myocardial infarction.
* The partial thromboplastin time (PTT) vn 33-55 seconds.
The determination of the PTT gives an overview of the functioning of a whole series of coagulation factors. Always with a blood sample and by the addition of a specific factor, the clotting time is measured.
examinations in specialist coagulation defects
In all cases where the tests described research-tively give approximate indications of the existence of disturbances of the coagulation system, it is necessary to require some further analysis in order to explain exactly if the clotting factor is responsible for altered or not a given disorder. These surveys assume special significance in cases of suspected hereditary diseases of blood (hemophilia), which are precisely the defects of clotting factors.
coagulation factors
the last stage of the real coagulation, taking part in more than thirty different proteins, called clotting factors present in blood plasma, platelets and blood vessel walls, in a sort of reaction chain, known as the clotting cascade, it acts in-room affair. The lack of any of these components leads to a sharp slowdown or even an arrest bleeding wounds, so there's minimal to take dangerous to life itself. An examination of coagulation factors is so specialized and are asked only if the physician has important to propose a diagnosis of hemophilia.
blood glucose
go to carbohydrate metabolism
The determination of blood glucose is obtained or venous blood sample, for example by drawing blood from the crook of his arm, or more simply and quickly by drawing from fingertip or ear lobe. With this sampling technique is analyzed oxygenated blood (capillary) of which the sugar content can be determined within a few seconds with a simple electronic device for measuring blood glucose, also suitable for self-monitoring of diabetes mellitus.
Fasting 60-110 mg. / dl
A full stomach> 140 mg/100 ml
What does an increase in blood sugar?
In principle, high blood glucose values \u200b\u200bindicate the presence of hyperglycemia or frank diabetes mellitus, so we need to pay atten-tion to an individual rise in blood glucose as pos-sible signal the presence of diabetes. Particularly im-portant to know which is time interval between the last food intake and blood glucose. After
diet extremely rich in carbohydrates is possible by analyzing blood glucose, find-crease up to 220 mg / dl, without this there is a diabetes. What
consequences for an increased blood glucose?
The first conclusion to be drawn from the determination of an increased rate of glucose, is the need for repeated checking of values, possibly at different times of day, in order to obtain a profile of daily or weekly blood glucose values. Equally important is the research of sugar in the urine glycosuria said that under normal conditions is equal to zero) that can be performed quickly and easily graces in strips. If
values \u200b\u200bincreased only slightly, it is possible with the help of the glucose load test, known in medicine oral glucose tolerance test, review function and responsiveness of insulin-producing cells of the pancreas.
A further laboratory test makes it possible to evaluate the state of the sugar metabolism in order to indicate if the blood sugar during the last three to four weeks is essentially normal or higher glycosylated hemoglobin (HbAlc). This value depends on the concentration of glucose inside the red blood cells and increases sharply in diabetics. It 'an important element for assessing the risk of vascular complications.
glycosylated hemoglobin vn.7% normal hemoglobin
course after finding the value of sugar, should be consideration of any other disease or discomfort that could have caused such changes in the laboratory, for example, taking certain medications, diseases of the adrenal glands and thyroid, liver and pancreas. A
can also lower blood sugar? The most frequent cause
certainly the appearance of a lowering of blood glucose is an overdose of drugs that are administered for hyperglycemia (blood glucose lowering). They can cause a drop in blood sugar also food shortages, excessive physical fatigue, alcoholism, or more rarely diseases of the pancreas and liver.
lipid metabolism
go to the metabolism Lipid
Total cholesterol Cholesterol is found exclusively in humans and animals (it is not present in plants). It 'an important component of the cell membrane, and the basic structure for the production of some hormones and vitamin D. Cholesterol is also an irreplaceable raw material for the bile acid.
normal values \u200b\u200bof total cholesterol from 100 to 220 mg / dl
Triglycerides Triglycerides, also known as neutral lipids, are treated mainly with food and only a small proportion are produced by the body itself. With regard to calcification vessels, they are of equal importance to that of cholesterol, but often high rates of triglyceride are associated with other metabolic diseases (like diabetes, obesity, gout, hypertension) and in women after menopause, with a high risk of myocardial infarction.
Since triglycerides are the main part of the normal dietary fat and are also produced in the body through a diet rich in carbohydrates, you can quickly adjust the rate through proper nutrition.
triglycerides normal values \u200b\u200bfrom 50 to 175 mg / dl
Lipoproteins
Fats are not soluble either in water or in blood. However, they may be transported with-out problems in different parts of the body. In this regard, the agency uses a gimmick: as soon as the fat-junction Gono into the bloodstream, they are almost "taken back" by certain proteins and transported to their destination.
These combinations of lipids and proteins are denominated lipoproteins and can be further divided into different categories. In relation to their content of cholesterol and triglycerides, depending on the density of their molecules and according to their size, lipoproteins are divided into 4 main classes:
- chylomicrons
- Lipoproteins VLDL
type - type of lipoprotein LDL
- HDL-type lipoprotein
In common laboratory diagnostics, are particular importance in two main classes of lipoproteins because their percentage of fat in the blood is of considerable significance in the genesis-dell'arterioselerosi. Today, the value of cholesterol is so divided, almost routine in its HDL and LDL components, in order to assess the risk factors that are described.
The high density lipoprotein HDL lipoproteins are considered "good", they seem to protect the arteries artery-sclerosis. The higher the value, the greater the risk protection:
Male Action Protective high>> 55
poor protective action>> Female 35-55
protective action of high>> 65
poor protective action>> 45-65
The low-density lipoprotein LDL , in contrast, are classified as lipoproteins " bad "because they promote the adhesion of fat on artery walls, increasing the likelihood-ity of the formation of atherosclerosis: risk
Males Females average 150-190
high risk>> 190
v the metabolism of the page
hyperuricemia and purine metabolism
Each protein consists of a set of amino acid, whose species composition is determined by esattez-tion in the gene. The code of this information is found in every cell in the form of nucleic acid, specifically of deoxyribonucleic acid (DNA) and ribonucleic acid (RNA).
Similar to protein metabolism in which there is a continuous basal parts of the protein, the body also composes and decomposes nucleic acids stable. Items that can not be used in this way, but must be further broken down and eliminated. The purine bases of DNA and RNA are converted into uric acid, a substance that in subjects healthy is excreted by the kidneys. An adult
eliminate 400 to 800 mg / day of uric acid in the urine (2 / 3 the amount) and evacuation (1 / 3 the amount). This uric acid is derived mostly from purine metabolism and your body to a lesser extent from foods high in purines (primarily from animal flesh). Men
normal values \u200b\u200bfrom 3.5 to 7.0 mg / dl
Women 2.5 to 5.7 mg /
of
What does an increase in uric acid?
The most frequent cause of increased uric acid (hyperuricemia) is a hereditary disorder of metabolism that increases the concentration of uric acid in blood and tissues. This gives rise to the risk that uric acid crystallizes in the form of salts (urates), settle, especially in the joints and kidneys and lead to clinical gout. In people with this disorder may occur in the form of gouty attacks, which consist of sudden, violent and painful inflammation of the individual joints (the most frequently affected is the joint of the big toe). Gout is virtually incurable, and after a long time not only leads to a dysfunction of the joints, but also to deposit in the kidneys of crystals of uric acid, kidney stones and with repeated injury to the kidneys themselves. The subjects in which is found un'iperuricemia, groped must first eliminate all factors risk of an increase of uric acid as the excess weight, arterial hypertension, the ipercolesterolernía, diabetes.
What does this mean a reduction of uric acid?
Reduced values \u200b\u200bof uric acid can be found relatively often as minor side effects of specific drugs. More rarely, the decline is its cause serious liver disease or intoxication by heavy metals.
FUNCTIONALITY 'RENAL
go to urinary
The urinary system (kidneys, ureter, bladder, urethra) meet with the production and elimination of urine to the vital task of eliminating products metabolism, the so-called toxic substances, the total of which, otherwise, would be to lead-poisoning organism. The central organs of the urinary system are the kidneys, which are bilateral ally located near the spine, below the diaphragm. They filter the blood in their at-conducted through the renal arteries and the urine produced, passing through the ureter-so, it reaches the bladder. The latter serves as a collection basin and ensure the elimination of urine.
Through blood tests and urine is as possible to ascertain disease and renal dysfunction is often an initial-god, especially when it has not yet manifested any symptoms of illness. The most important values \u200b\u200bof laboratory, which relate to renal function are serum creatinine and blood urea nitrogen or urea.
creatinine Creatinine is the end product of muscle metabolism, and is derived from an enzyme called creatine, which is transferred to the blood and excreted through the kidneys. When the kidneys reduce their filtering function, increases in blood stream by the creatinine value: The latter is then used as a reference for the correct or impaired renal function
Men
normal values \u200b\u200bfrom 0.7 to 1.4 mg / dl
Women 0.6 to 1.2 mg / dl.
What does an increase in creatinine values?
An increase in creatinine values \u200b\u200bmay be caused by: •
acute or chronic renal failure • muscle injury (eg bruises).
What does a reduction in blood creatinine?
Reduced values \u200b\u200bdo not usually have any pathological significance, can be detected in case of: • poor muscle
• pregnancy
With the help of additional laboratory tests (that is not routinely performed) (creatinine clearance) can more quickly diagnose any disorders of renal function.
BUN
In the body proteins are continuously made but broken. Amino acids produced by decomposition are then used for the construction of new proteins or be disposed of. In the liver, the ammonia is converted into non-toxic urea and excreted in the urine. In the laboratory values \u200b\u200bin the presence of blood breakdown products of proteins are measured or as urea or urea, ie urea nitrogen.
normal values \u200b\u200bof urea 10.0 - 50.0 mg / dl
normal values \u200b\u200bof blood urea nitrogen 5.0 - 23.0 mg / dl
What does an increase in urea or urea?
The most important cause is a disturbance of kidney function. Another cause is an increased protein intake (food too rich in meat) or amino acid supplements or a severe loss of proteins in diseases with tissue destruction.
FUNCTION 'OF THE LIVER AND BILE
go to the digestive organ
vital for the body, the liver also has an extraordinary capacity for regeneration and reserve capacity that allows him, in loss of 2 / 3 of its mass, yet be able to perform all its duties. Conditions harmful to the liver are primarily the "chronic poisoning" (eg excessive consumption of alcohol or drug abuse) and liver inflammation (hepatitis), more rarely, primary tumors and metastasis from other organs. As a result of many liver diseases is primarily an increase in the size of the liver, which undergoes constant over the years further injury until you get to cirrhosis (destruction of most liver cells are replaced by nodules of "scar tissue" ). It can detect a malfunction of the liver, with a series of blood tests, long before that occurs. some physical ailment. Mainly used for the assessment of liver enzymes, which can be used, including quantitative information for liver damage. Here are the most important liver enzymes that can be determined routinely.
GOT (Glutamate-oxaloacetate transaminase or ALT
GPT (glutamate pyruvate-transaminase) or AST
Both enzymes GOT and GPT, often referred to simply as transaminases together, play an important role in the decomposition of the main parts of the protein (amino acids) of 'body. They are not only in the liver, but also, for example in the muscle (heart and skeletal muscle), brain and kidneys. Higher values \u200b\u200btherefore always requires a more precise investigation and possibly the completion of further analysis as
the markers of hepatitis B
normal values \u200b\u200b
GOT GPT
Men under 19 U / 1 in 23 U / 1
Women under 15 U / 1 in 18 U / I.
What does an increase in transaminases?
most common cause of an increase in transaminases are
- a simple overload of the hepatic metabolism
- infectious hepatitis (eg, viral hepatitis, but the diagnosis must be confirmed and sustained by the hepatitis markers)
- cirrhosis
liver - cancer and liver metastases
- biliary tract diseases, diseases of other organs, for example, myocardial infarction, pulmonary embolism.
A more precise diagnosis on the significance of the increase in transaminases (eg, A determination about the extent of damage found in liver cells) is possible by determining the ratio GOT / GPT as well as through the establishment of an additional laboratory parameter.
GAMMA GT (GammaGIutamilTransferasi gamma GT)
The GammaGT is an important enzyme in the metabolic protein that reacts very sensitive organism in a number of diseases of liver and bile ducts. Men
normal values \u200b\u200bbelow 28 U / I
Women under 18 U / I.
What does an increase in values \u200b\u200bgammaGT?
main causes of increased values \u200b\u200bof Gamma-GT:
• alcohol abuse • •
hepatitis side effects of drugs
• biliary and pancreatic diseases.
less common causes are cancer of the liver (secondary or metastasis of the liver), of myocardial infarction, kidney and others (GammaGT are not only in the liver but can be detected in other organs, although in smaller quantities). An isolated increase in the value of GammaGT not necessarily indicate the presence of disease, a diagnosis is only possible through further laboratory tests such as MARKERS OF HEPATITIS B
alkaline phosphatase (ALP) Alkaline phosphatase derived
from the bones, the liver, the bile ducts, the small intestine and some components of blood. An increase in value so always needs a more thorough investigation and careful comparison with other laboratory values.
normal values \u200b\u200bfor children up to 15 years to 300 U / 1
Boys 15 to 18 years to 400 U / 1
Adults under 170 U / I.
What does an increase in alkaline phosphatase values?
E 'possible to detect an increase in alkaline phosphatase values, especially in liver and bile ducts, as in bone disease. In order to determine precisely which entity is to be attributed to the cause, it is possible to measure various subunits (isozymes) phosphatase alkalinity, thereby achieving a isoenzirna liver, a pancreatic enzyme, a isoenzirna marrow, and intestine. Must be the doctor to know if it is necessary and useful to determine these values, also consideration of other laboratory tests.
Bilirubin Bile is formed, together with water and electrolytes, bilirubin, bile acids, cholesterol and other fat-soluble substances. Bilirubin is derived largely from degradation-tion of red blood cells (erythrocytes), which are imperfect or older when they are "segregated" in the spleen, bone marrow, liver, and "broken" into their constituent parts. Part red blood cells, heme, designed for the transport of oxygen, is broken down first in the yellowish bilirubin, which can only be transported to the liver by binding with protein molecules in the blood. This first form of bilirubin is determined by the laboratory as free bilirubin or indirect. It is separated from the protein in the liver and then tied to a specific acid, glucuronic acid. Now become more soluble and referred to as direct or conjugated bilirubin, can be eliminated through the bile into the intestine and possibly in the urine. E 'can then be determined in the laboratory the different fractions of bilirubin and identify the organism in which area you find the cause of a possible corruption of values.
Total bilirubin normal values \u200b\u200b
Adults up to 1.1 mg / dl
Children up to 1.0 mg / dl
Babies maxima at 5 / 6 days old up to 13.5 mg / dl
Bilirubin direct
is not normally present in blood, values \u200b\u200bup to 0.30 mg / dl, however, may be obtained artificially by the common methods of measurement and are therefore considered as normal. Indirect bilirubin
(It is calculated by subtracting direct bilirubin from total bilirubin)
Adults up 1.1 mg / dl.
What does an increase in total bilirubin values?
Higher values \u200b\u200bof total bilirubin
should always lead to additional laboratory investigations
fractions by determining direct and indirect.
An increase in the values \u200b\u200bof indirect bilirubin can be caused by: •
diseases that cause increased destruction of circulating erythrocytes (the If the daily loss exceeds 5%, 0.8% instead of the normal and the liver is unable to metabolize the degradation products). •
babies of 2 or 3 days of life with physiologic "neonatal jaundice" (the liver is initially im too mature for his work) •
babies, have a Rh (Rhesus) incompatible with the maternal blood
• subject metabolic disorders with benign probable hereditary origin (jaundice family, etc.).
An increase in the values \u200b\u200bof direct bilirubin may be caused by: *
acute inflammation of the liver (hepatitis A, B, C) go to MARKERS OF HEPATITIS B *
liver cirrhosis and liver cancer fatty liver
* *
bile outflow disorders (eg * biliary obstruction due to stones or tumors
* side effects caused by 'taking certain medications.
amylase (alpha-amylase)
Amylase is an enzyme produced by the pancreas and the parotid gland. It causes the transformation of starch into a monosaccharide (glucose).
normal 40-250U / l
What does an increase in amylase values?
High values \u200b\u200bcan be found in the presence of:
acute inflammation of the pancreas (acute pancreatitis)
chronic inflammation of the pancreas (chronic pancreatitis)
inflammation of the parotid gland (parotid, for example, with mumps)
kidney tumors (rare).
creatine kinase (CK or CPK)
CK is an enzyme found only in muscle tissue where it plays a crucial task of turning chemical energy into mechanical energy, then in physical strength. CK is present in high concentrations in skeletal muscle, in lower concentration in the tissue of the heart muscle and concentration even lower in smooth muscle (eg, intestinal muscle). With the help of the definition of a subgroup of CK, ie CKMB, which is found almost exclusively in heart muscle, you can determine whether an increase in CK was caused by an injury to the heart as a heart attack (and not, for example by injury to skeletal muscle or smooth muscle). In the emergency room is often decisive in order to affirm the presence of myocardial infarction, where an electrocardiogram was negative.
normal range 40 -175 U / l
THE THYROID
Go to thyroid
GENERAL
The thyroid gland is located in the region of the neck, in front of the trachea, immediately below the larynx, and gland is a hormone vital for our organism. Thyroid hormones, namely thyroxine (T4) and tri-i-dotironina (T3) have a role in basal metabolic rate, ie the speed with which the cells of the body at rest produce and consume energy. An excess of thyroxine then leads to higher consumption of energy, a deficiency of thyroxine results in a reduction of basal metabolism.
control the production of thyroxine is through a variety of mechanisms, which act as pituitary and hypothalamus from higher plants. These are continuously informed about needs and available quantity of thyroxine and intervene in case of an increase or a decrease in the production of it. That's why the value of pituitary thyroid stimulating hormone TSH has great value. The most important raw material for the production of thyroxine and iodine. The alteration that occurs most frequently borne is his enlargement of the thyroid. It is called goiter (struma) and its appearance should always pre-qualify as a valid reason for the control of thyroid functions. Routine should first be determined by the values \u200b\u200bof thyroxine (T4) and tri-iodotiro-nina (T3). Today, we prefer to determine the free fraction of the two hormones.
TSH, thyroxine (FT4) AND TRI-iodothyronine (FT3)
normal values \u200b\u200b(dependent upon the method of determining the laboratory)
adults TSH 0.2-0.4 mU / ml FT4
Adults 5-12 mg / dl
FT3 Adults 80-180 mg / dl.
Even in the presence of a goiter can be detected normal values \u200b\u200bof thyroid hormones, the cause of an enlarged thyroid gland is often a lack of iodine-nell'alimentazio it.
What does an increase in the values \u200b\u200bof the thyroid?
Higher values \u200b\u200bindicate a thyroid hyperthyroidism. In this respect, are often found in subjects with the tasks, the following symptoms:
• agitation, nervousness, weight loss, diarrhea, trembling hands
• • • flushing
tachycardia, heart rhythm disturbances.
What does a reduction in blood thyroid?
A reduction in blood indicates a ipofun thyroid thyroid-tion.
In this respect, are often found in subjects with the tasks, the following symptoms: •
weight gain, constipation
• changes in hair, skin swelling
• fatigue, depression.
the minerals
Together with an adequate intake water of calories and vitamins, are essential to the functionality of organs including the minerals, especially sodium, potassium, chlorine and calcium. We find them in the body in a concentration of grams and are treated in such amounts with food. The salts are subjected to elimination mechanisms able to prevent their excessive concentration.
the FOOTBALL help build bones and teeth, is in the coagulation process, the behavior of the nervous system, muscle function and the immune system. Main sources are milk and dairy products, fruits, vegetables, oats and walnuts.
normal range 8.10 - 10.40mg/dl
POTASSIUM the acid-base balance contributes to water retention and intraccellulare; to nerve transmission, muscle activity and effectiveness of the function of many enzymes. Main sources are fruits such as bananas, vegetables, nuts, potatoes, rice, milk.
normal range 3.5 - 5.5 mEq / l sodium
the intracellular water contributes to the balance, nerve transmission, muscle contraction to. Main sources are meat, salt.
normal 135 to 145 mEq / l CHLORINE
the intracellular water contributes to the balance. Major sources are meat broth, salt.
normal 100 to 112 mEq / l
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