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How to Interpret Your Lab Results

How to Interpret Your Lab Results. Presenting. CBC: Complete Blood Count Serum Chemistries Liver Function Tests Lipids/Glucose T cell subsets Viral load. Elements of the CBC. RBC’s: Red Blood Cells WBC’s: White Blood Cells Platelets Serum Plasma. Stem Cells.

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How to Interpret Your Lab Results

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  1. How to Interpret Your Lab Results

  2. Presenting • CBC: Complete Blood Count • Serum Chemistries • Liver Function Tests • Lipids/Glucose • T cell subsets • Viral load

  3. Elements of the CBC • RBC’s: Red Blood Cells • WBC’s: White Blood Cells • Platelets • Serum Plasma

  4. Stem Cells • Stem cells are young cells • All blood cells start as stem cells • They get “drafted” as RBCs, WBCs or platelets depending on the body’s needs

  5. Not all blood cells are the same….

  6. Red Blood Cell Tests • Erythrocytes “cytes” = cells • Shaped like a bagel with hole covered • Red Blood Cell count: total number of red blood cells • Hemoglobin (HGB): protein in RBC’s that actually carries 02

  7. Red Blood Cell Tests • Hematocrit (HCT): measures the % of blood volume taken up by RBC’s • Mean Corpuscular Volume (MCV): average volume (size) of RBC’s • Mean Corpuscular Hemoglobin (MCH): amt/concentration of hgb in average cell • Platelets: help stop bleeding by forming clots. Low plt count: thrombocytopenia

  8. Normal RBC values • RBC for males: 4.5-5.5 • RBC for females: 4.0-4.9 • Hgb (males): 13.5-16.5 • Hgb (females): 12-15 • Hct (males): 41-50 • Hct (females): 36-44

  9. Normal RBC Values • MCV: 80-100 • MCH: 26-34 • Plt: 100,000- 450, 000

  10. White Blood Cells • WBC’s are fighter cells • Some make antibodies • Some fight directly • Divided into types by how they look and what they do

  11. WBC Differential (Different Types of WBC’s) • 5 types of white blood cells • neutrophils fight bacterial infections; low count=neutropenia (HIV, some meds can cause neutropenia) • lymphocytes: 2 types: T cells attack + Kill germs/regulate immune system need to know lymphocyte count to calculate T cells B cells make antibodies

  12. More Types of WBC’s • Monocytes or Macrophages fight infections by eating germs;high count usually signifies infection • Eosinophils involved with allergies and reaction to parasites • Basophils Seem to be involved in long term allergic response; not well understood

  13. Normal WBC values • WBC: 4,500- 10, 000 • Neutrophils: 54-62% • Lymphocytes: 24-44 • Monocytes: 3-6 • Eosinophils: 0-3 • Basophils: 0-1

  14. ***Neutrophils • Neutrophils make up majority of WBCs. They are your “soldiers”. Neutrophils have “polys” and “bands.” • “Polys” are mature neutrophils • “bands” are immature neutrophils

  15. Blood Chemistry Tests • Electrolytes: related to fluid balance • Sodium • Potassium • Chloride • Calcium

  16. Normal Electrolytes values • Sodium: 135-145 • Potassium: 3.5-5.2 • Chloride: 95-107 • Calcium: 8.8-10.3

  17. Kidney Function Tests • Blood Urea Nitrogen (BUN) nitrogen in blood waste that is normally removed by kidneys • Creatinine waste product; most direct sign of kidney function

  18. Kidney Normal Values • BUN: 7-20 • Creatinine: 0.5-1.4

  19. Liver Function Tests • High enzymes can signal liver damage (meds, hepatitis, alcohol, drugs) • ALT (SGPT) • AST (SGOT) • Bilirubin yellow fluid produced when RBC’s break down (liver disease; indinavir and atazanavir can elevate bili) • Alkaline Phosphatase • LDH

  20. Liver Normal Values • Bilirubin: 0.1-1.2 • Alkaline phosphatase: 33-131 • LDH: 56-194

  21. Other Tests • Albumin: major protein in blood maintains balance in cells;carries nutrients;can affect other lab tests • Erythrocte Sedimentation Rate: how quickly RBC’s settle in a tube of blood; high sed rate=inflammation

  22. Normal Values • Albumin: 3.2-5

  23. Fat in Blood: Lipids • Fat is a source of energy • Carries some vitamins • Helps make hormones • Helps make cell membranes • Lubricates some body parts • Fats are carried wrapped in lipoproteins • Triglycerides most common, then cholesterol

  24. So what’s the problem? • Small lipoproteins (LDL or VLDL) carry fat from liver to rest of body • Too much of these cause fat build-up on walls of arteries

  25. Lipids • Cholesterol : <200 • HDL (good cholesterol) : 30-70 • LDL (badcholesterol) : 65-180 • Triglycerides : <160

  26. Blood Sugar • Glucose provides energy • High blood sugar could signal diabetes • Insulin is produced in pancreas and helps glucose move from blood to cells • Some protease inhibitors can cause elevation of blood sugar by inhibiting insulin

  27. Types of glucose tests • Random Blood sugar (not fasting) • Fasting Blood sugar (nothing to eat or drink except H2O for 8 hrs) • Glucose Tolerance Test (Starts fasting, then given sweet drink and measured over time) • Hemoglobin A1c (Measures glucose control over 3 month)

  28. Normal Glucose • Glucose: up to 140 • Glucose (Fasting): 60-110 • Hemoglobin A1C: 6-8

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