1. Results and
Result Reporting
Skill 304
Dr.
Mohammad Marie
Lecture \ 6

2. Learning objectives To know guidelines in result reporting.
To recognize how to interpret CBC result.
To recognize how to interpret CHEMISTRY result.
To understand the meaning of <critical values>.

3. Results reporting Laboratory result consisting of the following
patient identification data
name of lab section
name of test performed
specimen type
lab number
Result may be presented as either of the following:
numerical value
qualitative value
interpretative comments

4. Results reporting
Reference values should be mentioned in the result report .
Reference range : it is the interval between and including two reference limits ( upper & lower ) for the specific test .
The test should be repeated if the results are out of range

5. Results reporting
If the sample is rejected, the reasons must be written
Samples may be rejected due to:
Q.N.S sample. (Quantity of specimen not sufficient)
Clotted sample.
Hemolysis sample.
Sample collected in wrong tube.
Teset N/A ( not available )
Specimen not labeled.
Iincomplete request's information.

6. Results interpreting
CBC

7. General information
Test result
Test parameters
interpretation
Reference range

8. Results interpreting
1- WBC : white blood cell 2- NEU : neutrophil cell 3- LYM : lymphocyte cell 4- MONO : monocyte cell 5- EOS : eosnophil cell 6- BASO : basophil cell 7- RBC : red blood cell cell 8- HGB : hemoglobin 9- HCT : hematocrit 10-MCV : Mean corpuscular volume

9. Results interpreting
11- MCH: mean corpuscular hemoglobin 12- MCHC :mean corpuscular hemoglobin conc. 13- RDW : red blood cell distribution width 14- PLT : platelets 15- MPV : Mean platelet volume

10. Normal ranges SI Unit Conventional Unit Analyte 4.5-11.0 x10⁹/L
WBC
54-62 %
x10⁹/L
/ µL
NEU
1-3 %
x10⁹/L
0-450/ µL
EOS %
x10⁹/L
0-200/ µL
BAS
25-33 %
x10⁹/L
/ µL
LYMPH
3-7 %
x10⁹/L
0-800/ µL
MONO
x10¹²/L
x10⁶/ µL
RBC MALE
x10¹²/L
x10⁶/ µL
RBC FEMALE
g/l
g/dl
HGB MALE
g/l
g/dl
HGB FEMALE
x10⁹/L
x10³/ µL
PLT

11. Result interpretation
Increased
Type of Cell
Primary & secondary polycythemia
polycythemia
RBC
leukocytosis
WBC
bacterial infection & acute inflammation
neutrophilia
NEU
 Allergic disorders & Parasitic infections
eosinophilia
EOS
myeloproliferative disorders
basophilia
BAS
acute viral infections , chronic intracellular bacterial infections (TB) & some protozoal infections (TOXO)
lymphocytosis
LYMPH
 chronic inflammation.
monocytosis
MONO
Inflammation , Surgery  , Anemia or hemorrhage
thrombocytosis
PLT

12. INTERPRET
decreased
Type of Cell
Decreased production in the bone marrow , Increased destruction & Medications
erythroblastopenia
RBC
leukopenia
WBC
neutropenia
NEU
Leukocytosis with eosinopenia can be a predictor of bacterial infection
eosinopenia
EOS
basopenia
BAS
a recent infection
lymphocytopenia
LYMPH
monocytopenia
MONO
Vitamin B12 or folic acid deficiency & Decreased production of thrombopoietin
thrombocytopenia
PLT
Aplastic anemia , Leukemia , Severe Folate or vitamin B12 deficiency , HIV , Pernicious anemia & Medication
pancytopenia
ALL CELL

13. Results interpreting
Chemistry

15. Results interpreting
1- GLU : glucose 2- UREA OR BUN : Blood urea nitrogen 3- CR-S OR CREA : creatinine 4- URIC : uric acid 5- NA : sodium 6- K : potassium 7- CL : chloride 8- CALC OR Ca : calcium 9- PHS : phosphorus 10- MG : magnesium

16. Results interpreting
11- FE : ferrous 12- IBCT : total iron binding capacity 13- AST (GOT) : aspartate aminotransferase 14- ALT (GPT) : alanine transaminase 15- ALP : alkaline phosphatase 16- TBIL : total bilirubin 17- DBIL : direct bilirubin 18- GGT: Gamma-glutamyltransferase 19- TP : total protein 20- ALB : albumin

17. Results interpreting
21- LIP : lipase 22- AMY : amylase 23- LD : lactate dehydrogenase 24- CK : creatine kinase 25- CK-MB (MBI) : creatine kinase ( M:muscle, B:brain ) 26- CPK : creatine phosphokinase 27- CHOL : cholesterol 28- TG : triglyceride 29- HDL : High-density lipoprotein cholesterol 30- A/G RATIO : albumin/globulin ratio 31- LDL : low-density lipoprotein cholesterol

18. abbreviations SE test ( serum electrolyte ) include : NA + K + CL
U/E test include :
Urea+electrolyte and mainly include glucose+ creatinine
LFT test ( liver function tests ) include :
ALT + AST + ALP + SBR + TP + ALB
RFT or KFT test ( kidney function tests ) include :
UREA + CREA

19. abbreviations SBR test ( serum bilirubin ) include : TBIL + DBIL
LIPIDE PROFILE test include :
CHOL + TG + LDL + HDL
CE test ( cardiac enzyme tests ) include :
CK + CKMB + LDH + AST
FULL CHEMISTRY test include :
ALL TEST ABOVE

20. Result interpretation
SI Unit
Conventional Unit
Analyte
Increased in diabetes and severe illness; decreased in insulin overdose or hypoglycemia
mmol/l
mg/dl
GLU
Increased in renal disease and dehydration decreased in liver damage and malnutrition
mmol/l
8-23 mg/dl
BUN
Produced at a constant rate and excreted by the kidney; increased in kidney disease
µmol/l
mg/dl
CREA
Produced by breakdown of ingested purines in food and nucleic acids; elevated in kidney disease, gout, and leukemia
µmol/l
4-8 mg/dl
URIC

21. Result interpretation
SI Unit
Conventional Unit
Analyte
Increased in dehydration and diabetes insipidus; decreased in overload of IV fluids, burns,diarrhea, or vomiting
mmol/l
mEq/l NA
Increased in renal failure, extensive cell damage, and acidosis; decreased in vomiting, diarrhea, and excess administration of diuretics or IV fluids
mmol/l
8-23 mg/dl K
Increased in dehydration, hyperventilation, and congestive heart failure; decreased in vomiting,diarrhea, and fever
µmol/l
mg/dl CL

22. Result interpretation
SI Unit
Conventional Unit
Analyte
Increased in excess parathyroid hormone production and in cancer; decreased in alkalosis, elevated phosphate in renal failure, and excess IV fluids
mmol/l
mg/dl Ca
Evaluated in response to calcium; main store is in bone: elevated in kidney disease; decreased in excess parathyroid hormone
mmol/l
mg/dl
PHS
Vital in neuromuscular function; decreased levels may occur in malnutrition, alcoholism, pancreatitis, diarrhea
mmol/l
mEq/l Mg

23. Result interpretation
SI Unit
Conventional Unit
Analyte
Decreased in iron deficiency and anemia; increased in hemolytic conditions
µmol/l
µg/dl FE
Enzyme present in tissues with high metabolic activity; increased in myocardial infarction and liver disease
µKat/l
10-30 U/L
AST
Used to diagnose and monitor treatment of liver disease and to monitor the effects of drugs on the liver; increased in liver disease .
µKat/l
10-40 U/L
ALT

24. Result interpretation
SI Unit
Conventional Unit
Analyte
Enzyme of bone metabolism; increased in liver disease and metastatic bone disease
µKat/l
U/L
ALP
Breakdown product of hemoglobin from red blood cells; increased when excessive red blood cells are being destroyed or in liver disease
µmol/l
mg/dl
TBIL
Used to diagnose liver disease and to test for chronic alcoholism
µKat/l
2-30 U/L
GGT

25. Result interpretation
SI Unit
Conventional Unit
Analyte
Increased in dehydration, multiple myeloma ; decreased in kidney disease, liver disease, poor nutrition, severe burns, excessive bleeding
60-80 g/l
6-8 g/dl TP
Albumin holds water in blood; decreased in liver disease and kidney disease
35-50 g/l
g/dl
ALB
Enzyme used to diagnose pancreatitis
µKat/l
U/L
LIP

26. Result interpretation
SI Unit
Conventional Unit
Analyte
Used to diagnose and monitor treatment of acute pancreatitis and to detect inflammation of the salivary glands
µKat/l
U/L
AMY
Enzyme released in many kinds of tissue damage, including myocardial infarction, pulmonary infarction, and liver disease
µKat/l
U/L LD
(LDH)
Elevated enzyme level indicates myocardial infarction or damage to skeletal muscle.
µKat/l
U/L CK

27. Result interpretation
SI Unit
Conventional Unit
Analyte
Screening test used to evaluate risk of heart disease; levels of 200 mg/dL or above indicate increased risk of heart disease and warrant further investigation
< 5.18 mmol/l
< 200 mg/dl
CHOL
An indication of ability to metabolize fats; increased triglycerides and cholesterol indicate high risk of atherosclerosis
1.8 mmol/l
< 160 mg/dl TG
Both are Used to evaluate the risk of heart disease
< 1.03 mmol/l
< 40 mg/dl
HDL
(low level)
4.14 mmol/l
LDL
(high level)

28. Critical values
Critical Results : a Pathophysiological state at such variances with normal as to be life-threatening unless something is done promptly and for which some corrective action could be taken.

29. Critical values PROCEDURE :
1- A critical value result should be confirmed by repeating the test for a second time.
2- If the result is similar to the previous one, the comment code or footnote: CPR (Consistent with the Previous Result) is written by the lab technician.
3- If the result is critical and no history of pervious critical value for this test, the result is confirmed, and the doctor is called.

30. Some Critical values Remark SI Unit Conventional Unit Analyte High Low
>26.9 mmol/L
<2.6 mmol/L
>500 mg/dL
<40 or 45mg/dL
Glucose
>156 mmol/L
<121 mmol/L
>160 mEq/L
<120 mEq/L NA
>6.4mmol/L
<2.8mmol/L
>6.0 mEq/L
<2.5 mEq/L K

31. Some Critical values Remark SI Unit Conventional Unit Analyte High Low
3.22 mmol/L
1.65 mmol/L
>13.0 mg/dL
<7.0 mg/dL Ca
222 µmol/L
------
>=12.0 mg/dL
Not
applicable
Serum Bilirubin,
Newborn (under 30
days old)
2.6 mmol/L
2.1 mmol/L
CSF GLUCOSE
2.02 mmol/L
318 mmol/kg
CSF PROTEIN

32. Some Critical values Remark SI Unit Conventional Unit Analyte High Low
≥ 30 x 109/L
≤ 2.0 x 109/L
WBC
> 60%
< 20%
HCT
> 1,000 x 10-9/L
< 20 x 10-9/L
PLT
≥ 5 (on therapy)
≥ 3 (not on treatment)
INR
≥ 60 second (pre op)
≥ 160 second (on heparin)
APTT
> 200 g/L
≤ 80 g/L
HGB

33. Some of Critical values
Positive blood culture
Positive CSF (gram stain, culture)
Positive AFB smear (new patient)
Positive smear for P. Falciparum
Positive Meningococcus (smear or culture)
Positive new MRSA
Positive salmonella or shigella and campylobacter
Positive Clostredium perfringens
Positive HIV, HEP B , HEP C , CMV
Positive Respiratory Virus (RSV, Adeno, Inf…)

34. Thank you