Bilirubin
(
Hepatitis
)
(
Not
often
on
test
)
:
Bilirubin
is
a
product
of
red
blood
cell
____________________
.
Serum
levels
are
used
to
test
the
severity
and
the
progress
of
jaundice
.
An
increase
in
serum
bilirubin
is
commonly
associated
with
increased
red
blood
cell
____________________
or
by
liver
disease
.
Direct
?
if
the
bilirubin
has
a
chance
to
go
to
the
liver
and
get
conjugated
it
becomes
water
soluble
.
This
is
known
as
?
direct
reacting
bilirubin
?
and
an
increase
usually
indicates
the
presence
of
a
biliary
____________________
.
Indirect
?
When
bilirubin
doesn't
get
to
the
liver
,
it
doesn't
become
water
soluble
,
thus
it
is
unconjugated
or
indirect
.
If
this
type
of
bilirubin
is
elevated
,
one
should
suspect
excess
red
blood
cell
____________________
.
Normals
:
0
.
1
-
1
.
0
mg
/
ml
Increased
In
:
Direct
?
____________________
,
hepatic
duct
obstruction
Indirect
-
____________________
disease
Bun
(
Blood
Urea
Nitrogen
)
:
This
is
the
chief
end
product
of
amino
acid
metabolism
,
formed
by
the
liver
.
It
is
excreted
in
urine
and
comprises
about
½
of
the
urinary
solids
.
Normals
:
8
-
25
mg
/
100ml
Increased
In
:
starvation
,
____________________
disease
,
dehydration
,
hypotension
,
chronic
____________________
,
urinary
tract
____________________
____________________
In
:
hepatic
insufficiency
,
hepatic
failure
,
pregnancy
Calcium
(
Serum
)
:
Calcium
,
as
well
as
phosphorus
,
are
stored
in
the
bone
and
are
constantly
exchanged
with
blood
and
tissue
fluids
.
Vitamin
D
and
parathormone
influence
this
process
.
Vitamin
D
is
needed
for
____________________
absorption
of
calcium
.
Parathormone
increases
the
rate
of
bone
____________________
with
mobilization
of
calcium
and
phosphorus
from
bone
.
Milk
and
milk
by
products
supply
most
of
the
dietary
calcium
.
99%
of
the
calcium
in
the
body
is
found
in
the
bones
and
the
teeth
.
Calcium
is
found
in
the
body
in
both
the
ionized
form
and
the
protein
bound
form
.
The
ionized
form
functions
in
the
activation
of
____________________
in
blood
clotting
,
in
muscle
____________________
and
in
the
transmission
of
nerve
impulses
.
A
____________________
serum
level
of
calcium
causes
tetany
.
Normals
:
9
-
11mg%
Increased
In
:
____________________
,
bone
metastasis
,
hypervitaminosis
,
D
____________________
,
____________________
Decreased
In
:
____________________
,
malabsorption
,
vitamin
D
____________________
,
acute
pancreatitis
,
renal
failure
,
malnutrition
CEA
(
Carcinoembryonic
Antigen
)
:
A
glycoprotein
that
is
normally
present
in
the
GI
tissues
of
the
fetus
and
normally
secreted
into
the
lumen
of
the
GI
tract
in
the
adult
.
These
levels
are
high
in
biliary
tract
obstruction
,
alcoholic
hepatitis
,
heavy
smoking
,
and
____________________
of
the
GO
tract
,
lungs
and
breast
.
When
used
in
conjunction
with
other
methods
the
test
seems
to
be
useful
as
an
indicator
for
the
progress
in
the
treatment
for
many
cancers
.
The
serum
level
seems
to
fall
to
normal
within
one
month
of
treatment
.
Normals
:
5
.
0
mg
/
ml
Coombs
Test
:
This
is
used
to
detect
anti
red
cell
____________________
in
the
body
.
It
is
normally
negative
.
Positive
reactions
are
found
in
____________________
diseases
of
the
newborn
,
autoimmune
hemolytic
anemia
,
etc
.
CPK
(
SGOT
/
AKA
AST
and
LDH
)
:
Creatine
phosphokinase
is
present
almost
exclusively
in
____________________
muscle
,
____________________
muscle
,
and
in
brain
tissue
.
It
enters
the
circulation
quickly
after
atrophy
or
____________________
of
the
cells
.
One
of
the
most
valuable
tests
to
indicate
the
occurrence
of
an
____________________
.
It
increases
50
-
100
times
the
normal
level
4
-
6
hours
after
an
MI
.
It
peaks
30
hours
later
.
It
returns
to
normal
in
2
-
3
days
.
In
muscular
dystrophies
the
values
will
be
____________________
300
-
400
times
normal
.
Isoenzymes
:
CK1
BB
:
brain
tissue
CK2
MB
:
myocardial
tissue
CK3
MM
:
skeletal
muscle
Normals
:
Males
=
5
-
____________________
u
/
ml
:
Females
5
-
____________________
u
/
ml
Creatinine
:
(
Best
test
for
____________________
function
)
An
end
product
of
the
normal
metabolism
of
phosphocreatine
utilized
for
muscle
energy
.
It
is
a
nitrogenous
compound
secreted
in
the
____________________
.
This
level
does
not
vary
with
diet
,
so
it
is
a
very
valuable
indicator
of
____________________
function
.
Normals
:
0
.
7
-
1
.
5
mg
/
____________________
ml
Increased
In
:
chronic
____________________
,
obstructive
uropathy
,
____________________
shock
.
Decreased
In
:
muscular
dystrophies
CRP
:
(
Any
time
there
is
____________________
)
C
-
reactive
protein
is
not
normally
present
in
a
patient's
blood
.
It
appears
in
the
presence
of
inflammation
,
and
is
an
earlier
indicator
of
____________________
than
an
ESR
.
It
is
best
used
to
evaluate
the
course
and
severity
of
____________________
necrosis
.
Present
In
:
It
is
present
in
acute
rheumatic
fever
,
____________________
arthritis
,
malignancy
,
acute
____________________
and
viral
infections
.
ESR
:
The
erythrocyte
sedimentation
rate
refers
to
the
amount
of
red
blood
cells
that
fall
to
the
bottom
of
a
test
tube
in
one
hour
.
____________________
and
necrosis
of
tissue
causes
RBC's
to
aggregate
and
become
heavier
.
The
heavier
the
cell
,
the
faster
it
falls
.
The
cells
are
made
heavier
by
____________________
produced
by
the
body
in
____________________
states
.
Normals
:
Males
=
0
=
15
:
Females
0
-
20
Increased
In
:
____________________
,
inflammatory
disease
,
____________________
,
multiple
myeloma
,
temporal
arteritis
,
and
all
____________________
diseases
FTA
:
The
Fluorescent
Treponema
Antibody
Test
is
sensitive
and
specific
for
____________________
.
It
is
best
used
when
definite
syphilis
symptoms
are
present
,
yet
other
tests
show
negative
results
.
Glucose
(
Blood
)
:
Blood
sugar
is
formed
from
carbohydrates
and
stored
in
the
liver
as
glycogen
.
Slight
elevations
are
said
to
be
of
questionable
significance
.
This
test
is
done
in
the
fasting
state
and
is
diagnostic
of
diabetes
mellitus
if
____________________
consecutive
fasting
blood
sugar
tests
are
over
____________________
mg%
.
Normals
:
80
-
____________________
Increased
In
:
diabetes
mellitus
,
acute
emotional
or
physical
disturbnaces
,
____________________
,
pancreatitis
,
chronic
renal
or
liver
disease
Decreased
In
:
overdose
of
insulin
,
____________________
disease
,
starvation
,
liver
damage
(
alcoholism
)
,
and
pancreatic
islet
cell
carcinoma
Glucose
(
Blood
)
Postprandial
:
This
is
a
blood
sugar
test
taken
____________________
hours
after
eating
a
high
carbohydrate
meal
.
In
normal
people
the
blood
sugar
returns
to
normal
within
2
hours
.
Increased
In
:
Diabetes
Glucose
(
GSF
)
:
The
CSF
glucose
is
usually
____________________
percent
of
blood
glucose
.
Blood
glucose
is
drawn
1
hour
prior
to
a
spinal
tap
.
Changes
in
blood
sugar
are
seen
in
the
CSF
1
-
3
hours
later
.
Normals
:
50
-
____________________
mg
/
dl
Decreased
In
:
acute
pyogenic
infections
,
____________________
GGT
:
Referred
to
as
gamma
-
glutamyl
transferase
or
gamma
-
glutamyl
transpeptidase
.
It
is
an
enzyme
found
mainly
in
the
liver
,
kidney
,
spleen
and
prostate
.
This
enzyme
is
normally
higher
in
males
because
of
large
amounts
found
in
the
prostate
.
The
test
is
used
to
determine
liver
cell
____________________
and
____________________
induced
liver
disease
.
Used
to
screen
for
chronic
alcoholism
,
to
monitor
the
cessation
of
alcohol
consumption
and
all
forms
of
liver
disease
.
This
test
is
more
sensitive
in
detecting
____________________
jaundice
,
cholangitis
and
cholecystitis
than
alkaline
phosphatase
or
transaminase
tests
.
Glucose
Tolerance
Test
(
GTT
)
:
The
patient
is
instructed
to
fast
____________________
hours
before
theis
procedure
.
A
blod
sample
is
drawn
to
determine
the
fasting
blood
glucose
level
.
A
glucose
solution
(
Glucola
)
is
given
orally
,
and
blood
samples
are
drawn
at
½
hour
,
1
hour
and
each
hour
thereafter
for
a
total
of
____________________
hours
.
1
.
Normal
2
.
Mild
Diabetes
3
.
Severe
Diabetes
4
.
Functional
Hypoglycemia
5
.
Organic
or
Endocrine
Hypoglycemia
Note
:
The
GTT
is
potentially
____________________
,
especially
for
uncontrolled
diabetics
,
persons
taking
hormones
,
salicylate
,
diuretics
,
anti
seizure
drugs
,
or
birth
control
pills
.
