Biochemistry Tests

Acid phosphatase

The prostate is the richest source of this enzyme

Indication: cancer of the prostate, bone disease

Normal Range: Male-2.5-11.7U/L,

Female-0.3-9.2U/L

Interpretation: Elevated levels are seen in cancer of the bone and prostrate

Adrenocorticotrophic hormone

Under the conditions of stress ACTH produced by the pituitary gland stimulates adrenal cortex to release cortisol. Both cortisol and ACTH levels are to be determined. Hydrocortisone is the major steroid hormone synthesised.

Indication: Adrenal and pituitary gland disorders

Normal Range: ACTH – Morning-25-50pg/ml, evening-0-50pg/ml

Interpretation Increased levels indicate cushings syndrome characterized by hyperglycemia, hypertension, weight gain, impotency and physiological disorders Dexamethasone suppression indicate Addisons disease characterized by low blood pressure, hypoglycemia and depression

Alanine transaminase

It is a mostly liver enzyme, formerly known as serum glutamate oxaloactetate transaminase.

Indication: It is present in red blood cells, heart and liver. Formerly known as serum glutamate pyruvate transaminase.

Normal Range: 0-35U/L

Interpretation: Hepatitis, cirrhosis, ischemia, tumor of liver, ischemia interoperates high levels of enzyme. Higher levels also indicate viral hepatitis.

Alkaline phosphatase

It is present in all tissues especially in bile ducts, placenta, liver and bone

Indication: Elevated in conditions of hepatitis and acute liver damage

Normal Range: 44-77IU/l

Interpretation:                 Higher values indicate biliary obstruction, hepatitis, anemia and fracture.

Alpha1-proteinase inhibitor

It is a glycoprotein also known as alpha 1-antitrypsin. It serves as inhibitor of several protien cleaving enzymes like elastase, trypsin and chymotrypisn. It is synthesised in the liver.

Indication:                          Pulmonary emphysema liver cirrhosis

Normal Range: 150-250mg/100ml

Interpretation:                 Decreased levels may be taken for liver damage and jaundice.

Ammonia

Ammonia arises from the hydrolysis of amino acid glutamine in kidney

Indication: Impaired buffering action of kidney

Normal Range: 30-50millimoles/day

Interpretation:                 Increased levels indicate diabetic ketoacidosis and starvation. Decreased levels indicate carbohydrate rich diet

Amylase

This enzyme digests starch and is present in pancreas and salivary glands

Indication Acute pancreatitis

Normal Range: Male-60-180Su/Dl,

Female-95-290U/L

Interpretation:                 Elevated levels are seen after the pancreatitis, conditions of salivary gland damages like mumps and swelling of parotid glands

Ascorbic acid test

It plays an important role in connective tissue formation.

Indication: Scurvy

Interpretation: Deficiency is characterized by inability to form intercellular substances in tissues leading to swollen and tender joints.

Aspartate transaminase

Indication:                          Elevated in conditions of cirrhosis, hepatitis, and jaundice.

Normal Range:                  17-59U/L

Interpretation:                 High levels – Liver damage, hepatitis, necrosis, kidney or lung changes.

Low levels – Vitamin B6 deficiency. AST to ALT ratio is directly proportional to alcohol dependence.

Biotin

It plays an important role in carboxylation reactions

Indication:                          Dermatitis

Normal Range: 200-350pgs/Ml

Interpretation: Deficiency leads to anorexia, nausea, vomiting, depression and glossitis.

Blood urea nitrogen

It is the catabolic product of proteins and the excess is execrated in kidneys.

Indication:                          Kidney damage

Normal Range: 7-25mgs/dl

Interpretation: Increased levels indicate heart and kidney damage. Decreased levels indicate mal absorption and low protein intake

Carr-price test

Vitamin-A plays an important role in vision, growth and reproduction.

Indication:                          Vision impairment

Normal Range: 0.91-1.71micrograms/dL

Interpretation: Deficiency leads to keratomalacia characterized by degenerative changes in retina leading to blindness, dry skin and roughness increased levels leads to nausea, vomiting, headache, dizziness, and hepatomegaly.

Catecholamines in urine

This is secreted by adrenal medulla and in case of tumors it secretes more. 24 hours urine sample is required.

Indication:                          Hypertension, hyperglycemia, weight loss, glycosuria.

Normal Range: 50micrograms in 24 hours urine sample

Interpretation: Elevated levels are seen in pheochromocytoma characterized by cancer of adrenal medullary glands. Increased levels also indicate functional paraganglioma characterized by cancer of symphatetic paragnalian cells.

Ceruloplasmin

Indication: Liver and eye degenerations

Normal Range: 0.2-0.55 absorbance units/0.1ml serum

Interpretation: Increased levels indicate degeneration of eye, accumulation in liver and neurological disorders.

Chloride

Indication: Cushing syndrome, chronic nephritis, Addison disease

Normal Range:                  Normal values-170-250millimoles of chloride

Interpretation:                 Lower levels indicates vomiting and diarrhoea. Decreased activity of tubular reabsorption

Creatinine kinase

Test: Creatinine kinase

Indication: Myocardial infarction,skeletal muscle disorders

Normal Range: Male-15-160U/L,female-15-130U/L

Interpretation: Higher values are due to myocardial breakdown and central nervous system shock

Folic acid

Test: Folic acid

Indication Anemia

Physiology It plays an important role in nucleic acid and aminoacid biosyntheis

Normal Range 3-20nanograms/Ml

Interpretation Deficiency is due to poor absorption and insufficient dietary intake.

Follicle stimulating hormone test

Test Follicle stimulating hormone test

Indication Reproductive organ disorders

Normal Range Male 4-25U/L, female 4-30U/L

Interpretation Higher values indicate hypopitutarism,genetic disorders like Turner and Knilfielters syndrome.Low levels indicate disorders of pituatiry and hypothalamus

Gamma glutamyl transpeptidase

Test Gamma glutamyl transpeptidase

Indication Elevated in biliary obstruction, rickets, osteomalacia, osteosarcoms diseases.

Physiology It is found in blood stream and is especially of hepatic origin

Normal Range 0-51IU/l

Interpretation Higher values indicate bile duct obstruction cancer and necrosis of liver.

Glycosylated haemoglobin

Test Glycosylated haemoglobin

Indication persistence of hyperglycemia

4-hydroxy3-methoxymandelic acid in urine

Test 4-hydroxy3-methoxymandelic acid in urine

Indication hypertension

Normal Range Daily excreation-2-6mgs/day.

Interpretation Increased levels are seen in pheochromocytoma. Decreased levels are due to consumption of lipid lowering drugs.

5-Hydroxyindole 3-acetic acid in urine

Test 5-Hydroxyindole 3-acetic acid in urine

Indication Gastrointestinal tract tumors

Normal Range Daily excreation-2-9mgs/day.

Interpretation Increased levels are seen in carcinoid syndrome characterised by cancer of digestive tract.

Hematuria

Test hematuria

Indication Presence of red blood cells in urine

Interpretation An increase of RBC”s in urine indicates hemoglobinuria, Internal burns, poisoning and improper blood transfusion

High density lipoproteins

Test High density lipoproteins

Indication Chronic heart disease

Normal Range 35-135mgs/dl

Interpretation Lower levels indicate risks of heart disease

Iron and iron binding capacity in serum

Test Iron and iron binding capacity in serum

Indication Anemia and polycythemia

Normal Range Iron-70-180micrograms/100ml. Iron binding capacity – 250-430 micrograms/100 ml.

Interpretation Lower values indicate pernicious anemia

Lactate dehydrogenase

Test Lactate dehydrogenase

Indication To diagonise heart atttack, anemia, liver disease, tissue changes.

Normal Range 45-90U/L.

Interpretation High values may be due to myocardial infarction, infectious mononucleosis, cell damage, trauma, muscle injury.

Lipase

Test Lipase

Indication Acute pancreatitis

Low density lipoproteins

Test Low density lipoproteins

Indication Arteriosclerosis

Physiology It is a lipid transport vehicle

Normal Range 62-130mgs/dl

Interpretation Heart disease

Niacin

Test Niacin

Indication Pellagra

Physiology It plays an important role in metabolic reactions.

Normal Range 2.4-6.1mgs/Dl

Interpretation Deficiency leads to dermatitis, dementia, diarrhea, psychosis and carcinoid syndrome.

5 prime nucleotidase

Test 5 prime nucleotidase

Indication Bile duct obstruction

Normal Range 0-15U/L

Interpretation Increased level indicates liver and bone disease

Protein

Test Protein

Indication Proteinuria, preeclampsia, glomerularnephritis and diabetic nephropathy

Normal Range Mild proteinurial – less than 0.5 g/day, moderate proteinuria-0.5-3.0g/day. Marked proteinuria-3-15g/day

Interpretation Mild proteinuria – stress and fever. Moderate proteinuria – congestive heart failure and multiple myeloma. Marked proteinuria – glomerularnephritis, diabetic nephropathy

Prothrombin time tests

Test Prothrombin time tests

Indication Blood clotting disorders

Normal Range 11-15seconds

Interpretation A prolonged prothrombin time indicates deficiency of vitamin k due to liver disease, deficiency of factors V, X, XII, fibronogen and thrombin

Schilling test

Test Schilling test

Indication Perinicious anemia. Neurological disorders

Normal Range 250-835pgs/mL

Interpretation Deficiency leads to loss of sensation, weakness, paralysis.

Serum calcium

Test serum calcium

Indication Hyperparathyroidism, rickets, osteomalacia, hypervitaminosis, nephrosis, pancreatitis, tetany.

Normal Range 12-20mgs/100ml

Interpretation Higher levels are seen in hyperparathyrodism and hypervitaminosis and defective kidney function to excrete decreased levels are seen in rickets and osteomalacia.

Sex hormone test

Test Sex hormone test

Indication Menstural problems, fertility problems, pregnancy delayed problems

Normal Range Estrogen-24-149pg/ml, testosterone-300-1200ng/dL, progesterone-menopausal women-150ng/Dl-2000ng/dL, Premenopausal-1500-2000ng/dL

Interpretation Increased levels of estrogen indicate early onset of puberty, male having female characters. Low levels of estrogen indicates pregnancy failure. Increased levels of progesterone indicates cancer of ovary and cysts formation in ovary. Decreased levels are found in abortion. Higher levels of testosterone are seen in tumor of testes and encephilitis. decreased levels are seen in genetical disorders like Down and Knilfilter syndrome

Thyroid function test

Test Thyroid function test

Indication Hyperparathyroidism and hypothyroidism

Normal Range T4-60-140nmol/L, T3-1.2-1.8nmol/L, TSH-0.1-6IU/L

Interpretation Total T4-Increased levels are seen in graves disease, cancer of thyroid as symptoms of hyperthyroidism. Low levels are seen in hypothyroidism whose symptoms are myoxyedema hashmito disease and pituatry disorders. T 3 -Increased levels are seen in hyperthyroidism and decreased levels are seen in hypothyroidsm. TSH-High in hypothyroidism and low in hyperthyroidism

Total acidity

Test Total acidity

Indication Achlorhydria,hypochlorhydria,hyperchlorhydria

Normal Range Free acidity-0-30 clinical units/100ml,Total acidity-20-50 units/100ml

Interpretation Lower secreations indicate achlorhydria characterised by low secreation of HCl, if pepsin levels are also low then it is known as achyllia gastrica. Anemia, gastritis and carcinoma also lowers the secreation level.Higher values indicate hyperchlorhydria characterised by gastric ulcer and duedonal ulcer.

Total bilirubin

Test Total bilirubin

Indication Cholecystitis, jaundice, cirrohosis, hemolytic anemia.

Normal Range Total bilirubin-0.3-1.0mgs/dl. Direct bilirubin-0.1-0.3mgs/dl. Indirect bilirubin-0.2-0.7mgs/dl

Interpretation Increased levels are seen in conditions of damaged gall bladder due to gall stones, where there is a maximum reabsorption of bilirubin, excessive breakdown of red blood cells, use of more of medications such as antibiotics.

Triglycerides

Test Triglycerides

Indication Artheroscelorosis

Physiology Nearly 95% of dietary fat are stored as triglycerides and it is stored in adipose tissue

Normal Range 0-200mgs/dl

Interpretation Increased levels indicate myocardial infarction, liver disease. Decreased levels indicate poor nutrition and poor absorption

Urea

Test Urea

Indication Glomerular nephritis, acute and chronic renal failure, urinary tract obstruction

Urine analysis physical characteristics

Test Urine analysis physical characteristics

Indication Polyuria, oliguria, anuria, acute nephritis, colour of urine is smoky brown yellow, milky diabetes insipidus

Interpretation An increase in urinary out indicates polyuria characterised by diabetes. A low output symbolises oliguria due to nephritis,fever and vomitting and anuria is due to poisoning by heavy metals. Pus, bilirubin and blood output changes the color of urine

Vitamin – B2

Test Vitamin – B2

Indication Dermatitis photophobia

Normal Range 4-24micrograms/Dl.

Interpretation Deficiency leads to sore throat edema, hyperemia and glossitis. Other symptoms include seborrhic dermatitis and normocytic anemia.

Vitamin-B 6

Test Vitamin-B 6

Indication Dermatitis hypochromic anemia

Normal Range 5-30nanograms/Ml

Interpretation Deficiency leads to epileptiform convulsions and hematological manifestations.

Vitamin-B1

Test Vitamin-B1

Indication Beri beri

Normal Range 150-200U/L

Interpretation Deficiency may be due to chronic alkalosis megaloblastic anemia

Vitamin-D test

Test Vitamin-D test

Indication Bone disorders

Normal Range 16-65pgs/mL.

Interpretation Deficiency leads to Rickets in children and osteolmalacia in adults. Increased levels are due to renal failure, hyperparathyroidism.

Vitamin-E

Test Vitamin-E

Indication Anemia

Normal Range 12-42micromoles/L

Interpretation Deficiency leads to edema, hemolytic anemia.

Vitamin-K

Test Vitamin-K

Indication Impaired blood clotting

Physiology Il promoted blood clotting.

Normal Range 0.8-.64mgs/L.

Interpretation Deficiency leads to hemolytic disease

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