pemeriksaan lab (campur sari)

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Daftar isi 1. pemeriksaan lab Hb : 11g/dl, halaman : 3 MCV : 80fl, halaman : 8 MCH : 30pg, halaman : 8 ureum : 35 mg/dl, halaman : 11 creatine 1.0 mg/dl, halaman : 16 asam urat : 5 mg/dl, halaman : 20 BSS : 270 mg/dl, halaman : 24 HbA1c : 7,8%, halaman : 29 total kolestrol : 130 mg/dl, halaman : 33 HDL : 50 mg/dl, halaman : 33

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Page 1: Pemeriksaan Lab (Campur Sari)

Daftar isi

1. pemeriksaan lab

Hb : 11g/dl, halaman : 3

MCV : 80fl, halaman : 8

MCH : 30pg, halaman : 8

ureum : 35 mg/dl, halaman : 11

creatine 1.0 mg/dl, halaman : 16

asam urat : 5 mg/dl, halaman : 20

BSS : 270 mg/dl, halaman : 24

HbA1c : 7,8%, halaman : 29

total kolestrol : 130 mg/dl, halaman : 33

HDL : 50 mg/dl, halaman : 33

LDL : 100mg/dl, halaman : 34

Na : 120 mEq/L, halaman : 35

Page 2: Pemeriksaan Lab (Campur Sari)

K : 2,8 mEq/L halaman : 36

Page 3: Pemeriksaan Lab (Campur Sari)

Hb : 11g/dl,

http://www.su rgeryencyclopedia.com/Fi-La/Hemoglobin-Test.html

Hemoglobin is a protein inside red blood cells that carries oxygen. A hemoglobin

test reveals how much hemoglobin is in a person's blood. This information can be

used to help physician's diagnose and monitor anemia (a low hemoglobin level)

and polycythemia vera (a high hemoglobin level).

Purpose

A hemoglobin test is performed to determine the amount of hemoglobin in a

person's red blood cells (RBCs). This is important because the amount of oxygen

available to tissues depends upon how much oxygen is in the RBCs, and local

perfusion of the tissues. Without sufficient hemoglobin, the tissues lack oxygen

and the heart and lungs must work harder to compensate.

A low hemoglobin measurement usually means the person has anemia. Anemia

results from a decrease in the number, size, or function of RBCs. Common

causes include excessive bleeding, a deficiency of iron, vitamin B 12 , or folic acid,

destruction of red cells by antibodies or mechanical trauma, and structurally

abnormal hemoglobin. Hemoglobin levels are also decreased due to cancer,

kidney diseases, other chronic diseases, and excessive IV fluids. An elevated

hemoglobin may be caused by dehydration (decreased water), hypoxia

(decreased oxygen), or polycythemia vera. Hypoxia may result from high

altitudes, smoking, chronic obstructive lung diseases (such as emphysema), and

congestive heart failure. Hemoglobin levels are also used to determine if a

Page 4: Pemeriksaan Lab (Campur Sari)

person needs a blood transfusion   . Usually a person's hemoglobin must be

below 7–8 g/dL before a transfusion is considered, or higher if the person has

heart or lung disease. The hemoglobin concentration is also used to determine

how many units of packed red blood cells should be transfused. A common rule

of thumb is that each unit of red cells should increase the hemoglobin by

approximately 1.0–1.5 g/dL.

Precautions

Fluid volume in the blood affects hemoglobin values. Accordingly, the blood

sample should not be taken from an arm receiving IV fluid. It should also be

noted that pregnant women and people with cirrhosis, a type of permanent liver

disease, have extra fluid, which dilutes the blood, decreasing the hemoglobin.

Dehydration, a decreased amount of water in the body, concentrates the blood,

which may cause an increased hemoglobin result.

Certain drugs such as antibiotics   , aspirin   , antineo-plastic drugs, doxapram,

indomethacin, sulfonamides   , primaquine, rifampin, and trimethadione, may also

decrease the hemoglobin level.

A nurse or phlebotomist usually collects the sample by inserting a needle into a

vein, or venipuncture, after cleaning the skin, which helps prevent infections.

Description

Hemoglobin is a complex protein composed of four subunits. Each subunit

consists of a protein, or polypeptide chain, that enfolds a heme group. Each

Page 5: Pemeriksaan Lab (Campur Sari)

heme contains iron (Fe 2+ ) that can bind a molecule of oxygen. The iron gives

blood its red color. After the first year of life, 95-97% of the hemoglobin

molecules contain two pairs of polypeptide chains designated alpha and beta.

This form of hemoglobin is called hemoglobin A.

Hemoglobin is most commonly measured in whole blood. Hemoglobin

measurement is most often performed as part of a complete blood

count   (CBC), a test that includes counts of the red blood cells, white blood cells,

and platelets (thrombocytes).

Some people inherit hemoglobin with an abnormal structure. The abnormal

hemoglobin results from a point mutation in one or both genes that code for the

alpha or beta polypeptide chains. Examples of hemoglobin abnormalities

resulting from a single amino acid substitution in the beta chain are sickle cell

and hemoglobin C disease. Most abnormal hemoglobin molecules can be

detected by hemoglobin electrophoresis, which separates hemoglobin molecules

that have different electrical charges.

Preparation

No special preparation is required other than cleaning and disinfecting the skin at

the puncture site. Blood is collected in a tube by venipuncture. The tube has an

anticoagulant in it so that the blood does not clot in the tube, and so that the

blood will remain a liquid.

Aftercare

Page 6: Pemeriksaan Lab (Campur Sari)

Discomfort or bruising may occur at the puncture site. Pressure to the puncture

site until the bleeding stops reduces bruising; warm packs relieve discomfort.

Some people feel dizzy or faint after blood has been drawn, and lying down and

relaxing for awhile is helpful for these people.

Risks

Other than potential bruising at the puncture site, and/or dizziness, there are

usually no complications associated with this test.

Normal results

Normal values vary with age and sex, with women generally having lower

hemoglobin values than men. Normal results for men range from 13–18 g/dL. For

women the normal range is 12–16 g/dL. Critical limits (panic values) for both

males and females are below 5.0 g/dL or above 20.0 g/dL.

A low hemoglobin value usually indicates the person has anemia. Different tests

are done to discover the cause and type of anemia. Dangerously low hemoglobin

levels put a person at risk of a heart attack, congestive heart failure, or stroke. A

high hemoglobin value indicates the body may be making too many red blood

cells. Other tests are performed to differentiate the cause of the abnormal

hemoblogin level. Laboratory scientists perform hemoglobin tests using

automated laboratory equipment. Critically high or low levels should be

immediately called to the attention of the patient's doctor.

Resources

Page 7: Pemeriksaan Lab (Campur Sari)

BOOKS

Chernecky, Cynthia C. and Barbara J. Berger. Laboratory Tests and Diagnostic

Procedures. 3rd ed. Philadelphia: W. B. Saunders Company, 2001.

Kee, Joyce LeFever. Handbook of Laboratory and Diagnostic Tests. 4th ed.

Upper Saddle River, NJ: Prentice Hall, 2001.

Kjeldsberg, Carl R. Practical Diagnosis of Hematologic Disorders. 3rd ed.

Chicago: ASCP Press, 2000.

ORGANIZATIONS

American Association of Blood Banks. 8101 Glenbrook Road, Bethesda,

Maryland 20814. (301) 907-6977. Fax: (301) 907-6895. http://www.aabb.org   .

OTHER

Uthman, Ed. Blood Cells and the CBC. 2000 [cited February 17,

2003]. http://web2.iadfw.net/uthman/blood_cells.html   .

Victoria E. DeMoranville 

Mark A. Best, M.D.

Read more: Hemoglobin Test - blood, tube, complications, heart, cells, risk,

cancer, Definition, Purpose, Precautions, Description, Preparation, Aftercare,

Risks, Normal results http://www.surgeryencyclopedia.com/Fi-La/Hemoglobin-

Test.html#ixzz1JrfwurGq

Page 8: Pemeriksaan Lab (Campur Sari)

MCV : 80fl,

MCH : 30pg,

http://www.nlm.nih.gov/medlineplus/ency/article/003648.htm

RBC indices

Red blood cell (RBC) indices are part of the complete blood count (CBC)

test. They are used to help diagnose the cause of anemia, a condition in

which there are too few red blood cells.

The indices include:

Average red blood cell size (MCV)

Hemoglobin  amount per red blood cell (MCH)

The amount of hemoglobin relative to the size of the cell

(hemoglobin concentration) per red blood cell (MCHC)

See also: RBC count

How the Test is Performed

Blood is typically drawn from a vein, usually from the inside of the elbow or

the back of the hand. The site is cleaned with germ-killing medicine

(antiseptic). The health care provider wraps an elastic band around the

upper arm to apply pressure to the area and make the vein swell with

blood.

Next, the health care provider gently inserts a needle into the vein. The

blood collects into an airtight vial or tube attached to the needle. The

elastic band is removed from your arm.

Once the blood has been collected, the needle is removed, and the

puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to

puncture the skin and make it bleed. The blood collects into a small glass

Page 9: Pemeriksaan Lab (Campur Sari)

tube called a pipette, or onto a slide or test strip. A bandage may be placed

over the area if there is any bleeding.

The values for MCHC, and MCH are calculated from the hemoglobin

(Hgb), hematocrit (Hct), and RBC count:

MCHC = Hgb/Hct

MCH = Hgb/RBC count

The MCV is measured directly by a machine.

How to Prepare for the Test

No special preparation is necessary.

How the Test Will Feel

When the needle is inserted to draw blood, some people feel moderate

pain. Others feel only a prick or stinging sensation. Afterward, there may

be some throbbing.

Why the Test is Performed

RBCs transport hemoglobin which, in turn, transports oxygen. The amount

of oxygen tissues receive depends on the amount and function of RBCs

and hemoglobin.

The MCV reflects the size of red blood cells. The MCH and MCHC reflect

the hemoglobin content of red blood cells. These RBC measures are used

to diagnose types of anemia.

Anemias are defined based on cell size (MCV) and amount of Hgb (MCH).

MCV less than lower limit of normal: microcytic anemia

MCV within normal range: normocytic anemia

MCV greater than upper limit of normal: macrocytic anemia

MCH less than lower limit of normal: hypochromic anemia

MCH within normal range: normochromic anemia

Page 10: Pemeriksaan Lab (Campur Sari)

MCH greater than upper limit of normal: hyperchromic anemia

Normal Results

MCV: 80 to 100 femtoliter

MCH: 27 to 31 picograms/cell

MCHC: 32 to 36 grams/deciliter

Note: Normal value ranges may vary slightly among different laboratories.

Talk to your doctor about the meaning of your specific test results.

What Abnormal Results Mean

This test is used to diagnose the cause of anemia. The following are the

types of anemia and their causes:

Normocytic/normochromic (NC/NC) anemia is caused by sudden

blood loss, prosthetic heart valves,sepsis, tumor, long-term disease

or aplastic anemia.

Microcytic/hypochromic anemia is caused by iron deficiency, lead

poisoning, or thalassemia.

Microcytic/normochromic anemia results from a deficiency of the

hormone erythropoietin from kidney failure.

Macrocytic/normochromic anemia results from chemotherapy, folate

deficiency, or vitamin B-12 deficiency.

Risks

Veins and arteries vary in size from one patient to another and from one

side of the body to the other. Obtaining a blood sample from some people

may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

Excessive bleeding

Fainting or feeling light-headed

Page 11: Pemeriksaan Lab (Campur Sari)

Hematoma (blood accumulating under the skin)

Infection (a slight risk any time the skin is broken)

Alternative Names

Erythrocyte indices; Blood indices; Mean corpuscular hemoglobin (MCH);

Mean corpuscular hemoglobin concentration (MCHC); Mean corpuscular

volume (MCV); Red blood cell indices

References

Zuckerman K. Approach to the anemias. In: Goldman L, Ausiello D,

eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;

2007:chap 162.

Update Date: 2/9/2010

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of

General Medicine, Department of Medicine, University of Washington

School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical

Director, A.D.A.M., Inc.

ureum : 35 mg/dl

http://surgery.about.com/od/beforesurgery/qt/BloodChemistry.htm

Blood Urea Nitrogen (BUN)

BUN is a measure of kidney function. A high level may indicate that the kidneys are functioning less than normal.

Normal Values: 8-25mg/100ml (USA)2.9-8.9 mmol/L (International)

http://www.nlm.nih.gov/medlineplus/ency/article/003474.htm

BUN

Page 12: Pemeriksaan Lab (Campur Sari)

BUN stands for blood urea nitrogen. Urea nitrogen is what forms when

protein breaks down.

A test can be done to measure the amount of urea nitrogen in the blood.

How the Test is Performed

Blood is typically drawn from a vein, usually from the inside of the elbow or

the back of the hand. The site is cleaned with germ-killing medicine

(antiseptic). The health care provider wraps an elastic band around the

upper arm to apply pressure to the area and make the vein swell with

blood.

Next, the health care provider gently inserts a needle into the vein. The

blood collects into an airtight vial or tube attached to the needle. The

elastic band is removed from your arm.

Once the blood has been collected, the needle is removed, and the

puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to

puncture the skin and make it bleed. The blood collects into a small glass

tube called a pipette, or onto a slide or test strip. A bandage may be placed

over the area if there is any bleeding.

How to Prepare for the Test

Many drugs affect BUN levels. Before having this test, make sure the

health care provider knows which medications you are taking.

Drugs that can increase BUN measurements include:

Allopurinol

Aminoglycosides

Amphotericin B

Aspirin (high doses)

Bacitracin

Page 13: Pemeriksaan Lab (Campur Sari)

Carbamazepine

Cephalosporins

Chloral hydrate

Cisplatin

Colistin

Furosemide

Gentamicin

Guanethidine

Indomethacin

Methicillin

Methotrexate

Methyldopa

Neomycin

Penicillamine

Polymyxin B

Probenecid

Propranolol

Rifampin

Spironolactone

Tetracyclines

Thiazide diuretics

Triamterene

Page 14: Pemeriksaan Lab (Campur Sari)

Vancomycin

Drugs that can decrease BUN measurements include:

Chloramphenicol

Streptomycin

How the Test Will Feel

When the needle is inserted to draw blood, some people feel moderate

pain, while others feel only a prick or stinging sensation. Afterward, there

may be some throbbing.

Why the Test is Performed

The BUN test is often done to check kidney function.

Normal Results

7 - 20 mg/dL. Note that normal values may vary among different

laboratories.

What Abnormal Results Mean

Higher-than-normal levels may be due to:

Congestive heart failure

Excessive protein levels in the gastrointestinal tract

Gastrointestinal bleeding

Hypovolemia

Heart attack

Kidney disease, including glomerulonephritis, pyelonephritis,

and acute tubular necrosis

Kidney failure

Shock

Urinary tract obstruction

Page 15: Pemeriksaan Lab (Campur Sari)

Lower-than-normal levels may be due to:

Liver failure

Low protein diet

Malnutrition

Over-hydration

Additional conditions under which the test may be done include:

Acute nephritic syndrome

Alport syndrome

Atheroembolic kidney disease

Dementia due to metabolic causes

Diabetic nephropathy/sclerosis

Digitalis toxicity

Epilepsy

Generalized tonic-clonic seizure

Goodpasture syndrome

Hemolytic-uremic syndrome (HUS)

Hepatokidney syndrome

Interstitial nephritis

Lupus nephritis

Malignant hypertension (arteriolar nephrosclerosis)

Medullary cystic kidney disease

Membranoproliferative GN I

Membranoproliferative GN II

Page 16: Pemeriksaan Lab (Campur Sari)

Type 2 diabetes

Prerenal azotemia

Primary amyloidosis

Secondary systemic amyloidosis

Wilms' tumor

Risks

Veins and arteries vary in size from one patient to another and from one

side of the body to the other. Obtaining a blood sample from some people

may be more difficult than from others.

Other risks are slight but may include:

Excessive bleeding

Fainting or feeling light-headed

Hematoma (blood accumulating under the skin)

Infection (a slight risk any time the skin is broken)

Considerations

For people with liver disease, the BUN level may be low even if the

kidneys are normal.

Alternative Names

Blood urea nitrogen

References

Molitoris BA. Acute kidney injury. In: Goldman L, Ausiello D, eds. Cecil

Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 121.

Update Date: 5/13/2009

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of

General Medicine, Department of Medicine, University of Washington

Page 17: Pemeriksaan Lab (Campur Sari)

School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in

Medicine, Harvard Medical School, Assistant in Medicine, Division of

Infectious Disease, Department of Medicine, Massachusetts General

Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director,

A.D.A.M., Inc.

, creatine 1.0 mg/dl,

http://surgery.about.com/od/beforesurgery/qt/BloodChemistry.htm

Creatinine

Creatinine is produced by the body during the process of normal muscle breakdown. High levels may indicate kidney impairment, low blood pressure, high blood pressure or another condition. Some medications can also cause a higher than normal level of blood creatinine. Low levels may be caused by late stage muscular dystrophy, myasthenia gravis and over hydration.

Normal Values:

Men: 0.2-0.5 mg/dl (USA) 15-40 umol/L (International)

Women: 0.3-0.9mg/dl (USA) 25-70 umol/L (International)

http://www.nlm.nih.gov/medlineplus/ency/article/003475.htm

Creatinine - blood

Creatinine is a breakdown product of creatine, which is an important part of

muscle. This article discusses the laboratory test to measure the amount of

creatinine in the blood.

Creatinine can also be measured with a urine test. See: Creatinine - urine

How the Test is Performed

Page 18: Pemeriksaan Lab (Campur Sari)

Blood is drawn from a vein, usually from the inside of the elbow or the back

of the hand. The site is cleaned with germ-killing medicine (antiseptic). The

health care provider wraps an elastic band around the upper arm to apply

pressure to the area and make the vein swell with blood.

Next, the health care provider gently inserts a needle into the vein. The

blood collects into an airtight vial or tube attached to the needle. The

elastic band is removed from your arm.

Once the blood has been collected, the needle is removed, and the

puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to

puncture the skin and make it bleed. The blood collects into a small glass

tube called a pipette, or onto a slide or test strip. A bandage may be placed

over the area if there is any bleeding.

How to Prepare for the Test

The health care provider may tell you to stop taking certain drugs that may

affect the test. Such drugs include:

Aminoglycosides (for example, gentamicin)

Cimetidine

Heavy metal chemotherapy drugs (for example, Cisplatin)

Kidney damaging drugs such as cephalosporins (for example,

cefoxitin)

Trimethoprim

How the Test Will Feel

When the needle is inserted to draw blood, some people feel moderate

pain, while others feel only a prick or stinging sensation. Afterward, there

may be some throbbing.

Why the Test is Performed

Page 19: Pemeriksaan Lab (Campur Sari)

The test is done to evaluate kidney function. Creatinine is removed from

the body entirely by the kidneys. If kidney function is abnormal, creatinine

levels will increase in the blood (because less creatinine is released

through your urine).

Creatinine levels also vary according to a person's size and muscle mass.

Normal Results

A normal value is 0.8 to 1.4 mg/dL.

Females usually have a lower creatinine than males, because they usually

have less muscle mass.

Note: Normal value ranges may vary slightly among different laboratories.

Talk to your doctor about the meaning of your specific test results.

What Abnormal Results Mean

Higher-than-normal levels may indicate:

Acute tubular necrosis

Dehydration

Diabetic nephropathy

Eclampsia  (a condition of pregnancy that includes seizures)

Glomerulonephritis

Kidney failure

Muscular dystrophy

Preeclampsia  (pregnancy-induced hypertension)

Pyelonephritis

Reduced kidney blood flow (shock, congestive heart failure)

Rhabdomyolysis

Page 20: Pemeriksaan Lab (Campur Sari)

Urinary tract obstruction

Lower-than-normal levels may indicate:

Muscular dystrophy (late stage)

Myasthenia gravis

Additional conditions under which the test may be performed:

Alport syndrome

Atheroembolic kidney disease

Chronic kidney disease

Cushing syndrome

Dementia due to metabolic causes

Dermatomyositis

Diabetes

Digitalis toxicity

Ectopic Cushing syndrome

Generalized tonic-clonic seizure

Goodpasture syndrome

Hemolytic-uremic syndrome (HUS)

Hepatorenal syndrome

Interstitial nephritis

Lupus nephritis

Malignant hypertension (arteriolar nephrosclerosis)

Medullary cystic kidney disease

Page 21: Pemeriksaan Lab (Campur Sari)

Membranoproliferative GN I  and GN II

Type 2 diabetes

Polymyositis (adult)

Prerenal azotemia

Primary amyloidosis

Secondary systemic amyloid

Thrombotic thrombocytopenic purpura

Wilms' tumor

Risks

Excessive bleeding

Fainting or feeling light-headed

Hematoma (blood accumulating under the skin)

Infection (a slight risk any time the skin is broken)

Multiple punctures to locate veins

Alternative Names

Serum creatinine

References

Bazari H. Approach to the patient with renal disease. In: Goldman L,

Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders

Elsevier; 2007:chap 115.

Update Date: 8/7/2009

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of

General Medicine, Department of Medicine, University of Washington

School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical

Director, A.D.A.M., Inc.

Page 22: Pemeriksaan Lab (Campur Sari)

asam urat : 5 mg/dl,

http://www.chemocare.com/managing/hyperuricemia-high-uric-acid.asp

Normal Uric acid levels are 2.4-6.0 mg/dL (female) and 3.4-7.0 mg/dL

(male).  Normal values will vary from laboratory to laboratory.

http://www.nlm.nih.gov/medlineplus/ency/article/003476.htm

Uric acid - blood

Uric acid is a chemical created when the body breaks down substances

called purines. Purines are found in some foods and drinks, such as liver,

anchovies, mackerel, dried beans and peas, beer, and wine.

Most uric acid dissolves in blood and travels to the kidneys, where it

passes out in urine. If your body produces too much uric acid or doesn't

remove enough if it, you can get sick. High levels of uric acid in the body is

called hyperuricemia.

This test checks to see how much uric acid you have in your blood.

See also: Uric acid - urine

How the Test is Performed

Blood is typically drawn from a vein, usually from the inside of the elbow or

the back of the hand. The site is cleaned with germ-killing medicine

(antiseptic). The health care provider wraps an elastic band around the

upper arm to apply pressure to the area and make the vein swell with

blood.

Next, the health care provider gently inserts a needle into the vein. The

blood collects into an airtight vial or tube attached to the needle. The

elastic band is removed from your arm.

Page 23: Pemeriksaan Lab (Campur Sari)

Once the blood has been collected, the needle is removed, and the

puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to

puncture the skin and make it bleed. The blood collects into a small glass

tube called a pipette, or onto a slide or test strip. A bandage may be placed

over the area if there is any bleeding.

A laboratory specialist checks the blood sample for uric acid.

How to Prepare for the Test

You should not eat or drink anything for 4 hours before the test unless told

otherwise. Your doctor may also tell you to stop taking any drugs that may

affect the test results. NEVER stop taking any medicine without talking to

your doctor.

Drugs that can increase the level of uric acid in your body include:

Alcohol

Ascorbic acid

Aspirin

Caffeine

Cisplatin

Diazoxide

Diuretics

Epinephrine

Ethambutol

Levodopa

Methyldopa

Nicotinic acid

Page 24: Pemeriksaan Lab (Campur Sari)

Phenothiazines

Theophylline

Drugs that can decrease the level of uric acid in your body include:

Allopurinol

Azathioprine

Clofibrate

Corticosteroids

Estrogen

Glucose

Guaifenesin

Mannitol

Probenecid

Warfarin

Why the Test is Performed

This test is done to see if you have high levels of uric acid in your blood.

High levels of uric acid can cause goutor kidney disease.

Your doctor may also order this test if you have had or are about to have

certain types of chemotherapy. Rapid weight loss, which may occur with

such treatments, can increase the amount of uric acid in your blood.

Normal Results

Normal values fall between 3.0 and 7.0 mg/dL.

Note: Normal values may vary slightly from laboratory to laboratory.

What Abnormal Results Mean

Greater-than-normal levels of uric acid (hyperuricemia) may be due to:

Page 26: Pemeriksaan Lab (Campur Sari)

Terkeltaub R. Crystal deposition diseases. In: Goldman L, Ausiello D,

eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;

2007:chap 294.

Update Date: 5/7/2009

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of

General Medicine, Department of Medicine, University of Washington

School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical

Director, A.D.A.M., Inc.

BSS : 270 mg/dl,

http://ezinearticles.com/?What-Are-Normal-Blood-Glucose-And-Blood-Sugar-Levels?

&id=720997

Fasting Blood Sugar Test:

Measures the gulucose level after 8 hours fast or overnight. Normal fasting glucose is

less than 100mg/dl. If your fasting glucose is from 100mg/dl to 125mg/dl then you

will have impaired blood glucose also known as Pre-Diabetes. If your sugar level is

above 125mg/dl then your doctor will diagnose as a patient of diabetes.

Random Blood Glucose Test:

Random blood sugar test gives your blood sugar at any time in a day. Normal random

blood sugar level should be less than 200mg/dl. If your random blood sugar is

between 140mg/dl to 200mg/dl then you will have pre-diabetes.

Oral glucose tolerance test

This test measures your response to sugar. First we measure fasting glucose, and

then glucose solution is given, after that we measure blood glucose after 1 hour and

2hours. A normal blood glucose level after an oral glucose tolerance test is less than

140 mg/dL. Level between 140 mg/dL to 199 mg/dL suggests pre-diabetes. A glucose

Page 27: Pemeriksaan Lab (Campur Sari)

level of 200 mg/dL or higher two hours after you drink the glucose solution may

suggest that you have diabetes mellitus.

Article Source: http://EzineArticles.com/720997

Article Source: http://EzineArticles.com/720997

Article Source: http://EzineArticles.com/720997

http://surgery.about.com/od/beforesurgery/qt/BloodChemistry.htm

Glucose

This test shows the level of glucose in the blood. High levels of glucose can indicate the presence of diabetes or another endocrine disorder. Keep in mind that some medications and the timing of the test in relation to meals can radically alter the results. Do not assume that your results indicate a problem until you have consulted with your physician.

Normal Values: 70-110 mg/ml (USA) 3.9-5.6 mmol/L (International) *tapi ini bkan nilai gula darah sewaktu, melainkan gula darah puasa

http://www.diabetes-blood-sugar-solutions.com/guidelinesbloodsugarlevels.html

Normal Range Blood Sugar Levels

Normal - US

(mg/dl)

Normal - Canada

(mmol/L)

Fasting Glucose < 100 * < 6.1*

Page 28: Pemeriksaan Lab (Campur Sari)

Normal - US

(mg/dl)

Normal - Canada

(mmol/L)

2 hr after eating < 140 < 7.8

A1c (glycosylated hemoglobin)

< 6% (0.060) < 6% (0.060)

*Note that in the U.S., the value for normal fasting glucose is less than that in Canada. 100 mg/dl converts to 5.6 mmol/L.

Normal range blood sugar levels have been harder to define over the recent years. Research keeps revealing that even slight elevations in blood glucose are associated with eye damage and increased risk of heart attack and stroke even before people get diabetes.

Of course, the slightly higher glucose levels put these same people at increased risk for getting diabetes. These slight elevations are now termed as "pre-diabetes".

In Canada, if you have a fasting glucose of 5.7-6.9 mmol/L the guidelines suggest you have a 75 g oral glucose tolerance test (OGTT) to screen for diabetes. This test requires you drink a sweet liquid and have your blood glucose tested every 1/2 hour for 2 hours. A signficant number of people can have normal or near normal fasting glucose levels but test positive for diabetes when they have the 2 hr OGTT done. If you already have diabetes, you do not need this test. (I've had numerous diabetic patients over the years ask to have this test done. Once you are diagnosed with diabetes, this test is unnecessary).

You will notice in the above guidelines blood sugar levels that the fasting values do not convert equally. Canada allows for a higher acceptable fasting value than does the United States. This is because research can be interepreted differently and of course, guidelines are time sensitive. With each new release of guidelines

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blood sugar levels there is a change (of late, anyway). Notably, the numbers to diagnose diabetes or pre-diabetes drop.

U.S. Glucose Levels to Diagnose Diabetes & Pre-diabetes

ADA Guidelines Blood Sugar Levels

for Diagnosing Diabetes & Pre-diabetes

Fasting Glucose

(mg/dl)

2 hr after eating or

75-gram OGTT (mg/dl)

Pre-diabetes: IFG 100 – 125 and < 140

Pre-diabetes: IGT < 100 and 140 – 199

Pre-diabetes:

IFG & IGT100 – 125 and 140 – 199

Diabetes ≥ 126* or≥ 200*

(or random sugar)

*A confirmatory test of either a fasting blood sugar, OGTT or random blood sugar with symptoms must be made on another day (except in the case of unequivocal hyperglycemia with metabolic decompensation).

ADA= American Diabetes Association

IFG = Impaired fasting glucose

IGT = Impaired glucose tolerance

OGTT = Oral glucose tolerance test

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Canadian Glucose Levels to Diagnose Diabetes & Pre-diabetes

Fasting Glucose

(mmol/L)

2 hr after eating or

75-gram OGTT

(mmol/L)

Pre-diabetes: IFG 6.1 – 6.9 and < 7.8

Pre-diabetes: IGT < 6.1 and 7.8 – 11.0

Pre-diabetes:

IFG & IGT6.1 – 6.9 and 7.8 – 11.0

Diabetes ≥ 7* or ≥ 11.1*

*A confirmatory test must be made on another day (except in the case of unequivocal hyperglycemia with metabolic decompensation).

IFG = Impaired fasting glucose

IGT = Impaired glucose tolerance

OGTT = Oral glucose tolerance test

The guidelines blood sugar levels for diagnosing diabetes have changed over the years. They're lower now. And we now have a classification called "pre-diabetes". And this year, the American

Diabetes Association (ADA) dropped the level at which you can be classified as having "pre-diabetes". Why? Because at these new

"pre-diabetes" glucose levels they are finding damage to the eyes and cardiovascular system.

If you have slightly elevated glucose levels (pre-diabetes) , know this amazing tidbit:

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The Diabetes Prevention Study shows that losing 5-7 % of your weight, exercising for 1/2 hr per day and following a healthy diet can reduce your risk of getting diabetes by up to 58%!.

Glucose Guidelines (targets) for Diabetes

ADA

(mg/dl)

AACE

(mg/dl)

CDA

(mmol/L)

Fasting Glucose

70-130 < 1104 – 7

(4 - 6 if safe is no longer a general guideline)

2 hr after eating < 180 as peak blood sugar after eating

regardless of time

< 1405 – 10

(5-8 if unable to achieve A1c < 7% and not at risk for

hypoglycemia)

A1c

(glycosylated hemoglobin)

< 7%

(< 6% if safe)

< 6.5%

(< 0.065)

<7% (< 0.070)

(<6.5% if need to lower risk nephropathy and weighed

against risk for hypoglycemia)

ADA = American Diabetes Association

AACE = American Assoc. Clinical Endocrinologists

CDA = Canadian Diabetes Association

HbA1c : 7,8%, http://www.nlm.nih.gov/medlineplus/ency/article/003640.htm

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HbA1c is a test that measures the amount of glycated hemoglobin in your

blood. Your doctor may order this test if you have diabetes.

How the Test is Performed

Blood is drawn from a vein, usually from the inside of the elbow or the back

of the hand. The puncture site is cleaned with germ-killing medicine

(antiseptic). The health care provider wraps an elastic band around the

upper arm. This puts pressure on the area and makes the vein swell with

blood.

Next, the health care provider gently inserts a needle into the vein. The

blood collects into an airtight vial or tube attached to the needle. The

elastic band is removed from your arm. Once the blood has been

collected, the needle is removed. Then the puncture site is covered to stop

any bleeding.

In infants or young children, a sharp tool called a lancet may be used to

puncture the skin and make it bleed. The blood collects into a small glass

tube called a pipette, or onto a slide or test strip. A bandage may be placed

over the area if there is any bleeding.

How to Prepare for the Test

No special preparation is needed.

How the Test Will Feel

When the needle is inserted, you may feel a slight pinch or some stinging.

Afterward, there may be some throbbing.

Why the Test is Performed

Your doctor may order this test if you have diabetes. It is used to measure

your blood sugar control over several months. It can give a good estimate

of how well you have managed your diabetes over the last 2 or 3 months.

The test may also be used to screen for diabetes.

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You have more glycated hemoglobin if you have had high levels of glucose

in your blood. In general, the higher your HbA1c, the higher the risk that

you will develop problems such as:

Eye disease

Heart disease

Kidney disease

Nerve damage

Stroke

This is especially true if your HbA1c remains high for a long period of time.

The closer your HbA1c is to normal, the less risk you have for these

complications.

Normal Results

An HbA1c of 6% or less is normal.

If your HbA1c is above 6.5% you may be diagnosed with diabetes.

If you have diabetes, try to keep your HbA1c level at or below 7%.

However, you and your health care provider must decide what a normal

HbA1c level is for you.

Talk with your doctor about the meaning of your test results.

What Abnormal Results Mean

Abnormal results mean that your blood glucose levels have been above

normal over a period of weeks to months.

If your HbA1c is above 7%, it means that your diabetes control may not be

as good as it should be.

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High values mean you are at greater risk of diabetes complications. If you

can bring your level down, you decrease your chances of long-term

complications.

Ask your doctor how often you should have your HbA1c tested. Usually,

doctors recommend testing every 3 or 6 months.

Risks

Getting a blood sample from some people may be more difficult than from

others.

Other risks linked with having blood drawn are slight, but may include:

Excessive bleeding

Fainting or feeling light-headed

Hematoma (blood accumulating under the skin)

Infection (a slight risk any time the skin is broken)

Alternative Names

Glycated hemoglobin; Glycosylated hemoglobin; Hemoglobin -

glycosylated; A1C; GHb; Glycohemoglobin; Diabetic control index

References

International Expert Committee Report on the Role of the A1C Assay in the

Diagnosis of Diabetes. Diabetes Care. July 2009 32:1344-1345.

American Diabetes Association. Standards of medical care in diabetes--

2010. Diabetes Care. 2010 Jan;33 Suppl 1:S11-61.

total kolestrol : 130 mg/dlhttp://www.heart.org/HEARTORG/Conditions/What-Your-Cholesterol-Levels-

Mean_UCM_305562_Article.jsp

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Total Cholesterol Level Category

Less than 200 mg/dL Desirable level that puts you at lower risk for coronary heart disease. A cholesterol level of 200 mg/dL or higher raises your risk.

200 to 239 mg/dL Borderline high

240 mg/dL and above High blood cholesterol. A person with this level has more than twice the risk of coronary heart disease as someone whose cholesterol is below 200 mg/dL.

, HDL : 50 mg/dl,

http://www.heart.org/HEARTORG/Conditions/What-Your-Cholesterol-Levels-

Mean_UCM_305562_Article.jsp

HDL Cholesterol Level Category

Less than 40 mg/dL(for men)Less than 50 mg/dL(for women)

Low HDL cholesterol. A major risk factor for heart disease.

60 mg/dL and above High HDL cholesterol. An HDL of 60 mg/dL and above is considered protective against heart disease.

With HDL (good) cholesterol, higher levels are better. Low HDL cholesterol (less than 40 mg/dL for men, less than 50 mg/dL for women) puts you at higher risk for heart disease. In the average man, HDL cholesterol levels range from 40 to 50 mg/dL. In the average woman, they range from 50 to 60 mg/dL. An HDL cholesterol of 60 mg/dL or higher gives some protection against heart disease. The mean level of HDL cholesterol for American adults age 20 and older is 54.3 mg/dL.

Smoking, being overweight and being sedentary can all result in lower HDL cholesterol. To raise your HDL level, avoid tobacco smoke, maintain a healthy weight and get at least 30-60 minutes of physical activity more days than not.

People with high blood triglycerides usually also have lower HDL cholesterol and a higher risk of heart attack and stroke. Progesterone, anabolic steroids and

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male sex hormones (testosterone) also lower HDL cholesterol levels. Female sex hormones raise HDL cholesterol levels.

LDL : 100mg/dl,

http://www.heart.org/HEARTORG/Conditions/What-Your-Cholesterol-Levels-

Mean_UCM_305562_Article.jsp

The lower your LDL cholesterol, the lower your risk of heart attack and stroke. In

fact, it's a better gauge of risk than total blood cholesterol. In general, LDL levels

fall into these categories:

LDL Cholesterol Level Category

Less than 100 mg/dL Optimal

100 to 129 mg/dL Near or above optimal

130 to 159 mg/dL Borderline high

160 to 189 mg/dL High

190 mg/dL and above Very high

Your other risk factors for heart disease and stroke help determine what your LDL level should be, as well as the appropriate treatment for you. A healthy level for you may not be healthy for your friend or neighbor. Discuss your levels and your treatment options with your doctor to get the plan that works for you. The mean level of LDL cholesterol for American adults age 20 and older is 115.0 mg/dL.

The Cholesterol Heart Profilers is a great starting point for learning about prevention and treatment options for your specific cholesterol levels. This free, confidential online service creates a printable report with the key information you need to fully understand your cholesterol levels, health risks and treatment options. You'll get a personalized cardiovascular disease risk profile, along with a summary of treatment options, potential side effects, success rates and a list of relevant medical journal articles and research studies, all summarized in plain English.

Page 37: Pemeriksaan Lab (Campur Sari)

Na : 120 mEq/L,

http://surgery.about.com/od/beforesurgery/qt/BloodChemistry.htm

Serum Sodium (Na)

This portion of the test shows the amount of sodium present in the blood. The kidneys work to excrete any excess sodium that is ingested in food and beverages. Sodium levels fluctuate with dehydration or over-hydration, the food and beverages consumed, diarrhea, endocrine disorders, water retention (various causes), trauma and bleeding.

Normal Values: 135-145 mEq/L (USA) 3.5-5 mmol/L

http://www.medicinenet.com/electrolytes/article.htm

Increased sodium (hypernatremia) in the blood occurs whenever there is excess sodium in relation to water. There are numerous causes of hypernatremia; these may include kidney disease, too little water intake, and loss of water due to diarrhea and/or vomiting.

A decreased concentration of sodium (hyponatremia) occurs whenever there is a relative increase in the amount of body water relative to sodium. This happens with some diseases of the liver and kidney, in patients withcongestive heart failure, in burn victims, and in numerous other conditions.

A Normal blood sodium level is 135 - 145 milliEquivalents/liter (mEq/L), or in international units, 135 - 145 millimoles/liter (mmol/L).

K : 2,8 mEq/L

http://surgery.about.com/od/beforesurgery/qt/BloodChemistry.htm

Serum Potassium (K)

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This test shows the level of potassium in the blood. Potassium plays an important role in muscle contractions and cell function. Both high and low levels of potassium can cause problems with the rhythm of the heart so it is important to monitor the level of potassium after surgery. Patients who are taking diuretics regularly may require regular blood tests to monitor potassium levels, as some diuretics cause the kidneys to excrete too much potassium.

Normal Values: 3.5-5 mEq/L (USA) 3.5-5 mmol/L (International)

http://www.medicinenet.com/electrolytes/article.htm

Increased potassium is known as hyperkalemia. Potassium is normally excreted by the kidneys, so disorders that decrease the function of the kidneys can result in hyperkalemia. Certain medications may also predispose an individual to hyperkalemia. 

Hypokalemia, or decreased potassium, can arise due to kidney diseases; excessive loss due to heavy sweating, vomiting, or diarrhea, eating disorders, certain medications, or other causes.

The normal blood potassium level is 3.5 - 5.0 milliEquivalents/liter (mEq/L), or in international units, 3.5 - 5.0 millimoles/liter (mmol/L).