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Anion gap can be classified as either high, normal or, in rare cases, low. Laboratory errors need to be ruled out whenever anion gap calculations lead to results that do not fit the clinical picture. Methods used to determine the concentrations of some of the ions used to calculate the anion gap may be susceptible to very specific errors.
Albumin is an acute negative phase respondent and not a reliable indicator of nutrition status. [10] Low albumin levels can also indicate chronic malnutrition from protein losing enteropathy. [3] This is often caused or exacerbated by ulcerative colitis, [11] but can also be seen in cardiac disease and systemic lupus erythematosus. [3]
References range may vary with age, sex, race, pregnancy, [10] diet, use of prescribed or herbal drugs and stress. Reference ranges often depend on the analytical method used, for reasons such as inaccuracy, lack of standardisation, lack of certified reference material and differing antibody reactivity. [11]
In alcoholic liver disease, the mean ratio is 1.45, and mean ratio is 1.33 in post necrotic liver cirrhosis. Ratio is greater than 1.17 in viral cirrhosis, greater than 2.0 in alcoholic hepatitis, and 0.9 in non-alcoholic hepatitis. Ratio is greater than 4.5 in Wilson disease or hyperthyroidism. [6]
The reference range for total protein is typically 60-80g/L. (It is also sometimes reported as "6.0-8.0g/dl"), [2] but this may vary depending on the method of analysis. Concentrations below the reference range usually reflect low albumin concentration, for instance in liver disease or acute infection.
Result 1: if there is a normal anion gap acidosis, the (AG – 12) part of the equation will be close to zero, the delta ratio will be close to zero and there is no mixed acid–base disorder. Your calculations can stop here. A normal anion gap acidosis (NAGMA) has more to do with a change in [Cl −] or [HCO − 3] concentrations.
The product, proalbumin, is in turn cleaved in the Golgi apparatus to produce the secreted albumin. The reference range for albumin concentrations in serum is approximately 35–50 g/L (3.5–5.0 g/dL). [5] It has a serum half-life of approximately 21 days. [6] It has a molecular mass of 66.5 kDa.
The comprehensive metabolic panel, or chemical screen (CMP; CPT code 80053), is a panel of 14 blood tests that serves as an initial broad medical screening tool. The CMP provides a rough check of kidney function, liver function, diabetic and parathyroid status, and electrolyte and fluid balance, but this type of screening has its limitations.