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How to Interpret Your Lab Results. Presented by Pat Hogan, ARNP, AAHIVS Group Health Cooperative. Presenting. CBC: Complete Blood Count Serum Chemistries Liver Function Tests Lipids/Glucose T cell subsets Viral load. Elements of the CBC. RBC’s: Red Blood Cells

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how to interpret your lab results

How to Interpret Your Lab Results

Presented by

Pat Hogan, ARNP, AAHIVS

Group Health Cooperative

presenting
Presenting
  • CBC: Complete Blood Count
  • Serum Chemistries
  • Liver Function Tests
  • Lipids/Glucose
  • T cell subsets
  • Viral load
elements of the cbc
Elements of the CBC
  • RBC’s: Red Blood Cells
  • WBC’s: White Blood Cells
  • Platelets
  • Serum Plasma
slide4

Stem Cells

  • Stem cells are young cells
  • All blood cells start as stem cells
  • They get “drafted” as RBCs, WBCs or platelets depending on the body’s needs
red blood cell tests
Red Blood Cell Tests
  • Erythrocytes

“cytes” = cells

  • Shaped like a bagel with hole covered
  • Red Blood Cell count: total number of red blood cells
  • Hemoglobin (HGB): protein in RBC’s that actually carries 02
red blood cell tests7
Red Blood Cell Tests
  • Hematocrit (HCT): measures the % of blood volume taken up by RBC’s
  • Mean Corpuscular Volume (MCV): average volume (size) of RBC’s
  • Mean Corpuscular Hemoglobin (MCH):

amt/concentration of hgb in average cell

  • Platelets: help stop bleeding by forming clots. Low plt count: thrombocytopenia
white blood cells
White Blood Cells
  • WBC’s are fighter cells
  • Some make antibodies
  • Some fight directly
  • Divided into types by how they look and what they do
wbc differential different types of wbc s
WBC Differential (Different Types of WBC’s)
  • 5 types of white blood cells
  • neutrophils or polymorphonuclear cells

fight bacterial infections; low count=neutropenia (HIV,some meds can cause neutropenia)

  • lymphocytes: 2 types:

T cells attack + Kill germs/regulate immune system

need to know lymphocyte count to calculate T cells

B cells make antibodies

more types of wbc s
More Types of WBC’s
  • Monocytes or Macrophages

fight infections by eating germs;high count usually signifies infection

  • Eosinophils

involved with allergies and reaction to parasites

  • Basophils

Seem to be involved in long term allergic response; not well understood

blood chemistry tests
Blood Chemistry Tests
  • Electrolytes: related to fluid balance
  • Sodium
  • Potassium
  • Chloride
  • Bicarb
kidney function tests
Kidney Function Tests
  • Blood Urea Nitrogen

(BUN)

nitrogen in blood

waste that is normally removed by kidneys

  • Creatinine

waste product; most direct sign of kidney function

liver function tests
Liver Function Tests
  • High enzymes can signal liver damage

(meds, hepatitis, alcohol, drugs)

  • ALT (SGPT)
  • AST (SGOT)
  • Bilirubin yellow fluid produced when RBC’s break down

(liver disease; indinavir and atazanavir can elevate bili)

  • Alkaline Phosphatase
  • LDH
other tests
Other Tests
  • Albumin:

major protein in blood

maintains balance in cells;carries nutrients;can affect other lab tests

  • Erythrocte Sedimentation Rate:

how quickly RBC’s settle in a tube of blood; high sed rate=inflammation

fat in blood lipids
Fat in Blood: Lipids
  • Fat is a source of energy
  • Carries some vitamins
  • Helps make hormones
  • Helps make cell membranes
  • Lubricates some body parts
  • Fats are carried wrapped in lipoproteins
  • Triglycerides most common, then cholesterol
so what s the problem
So what’s the problem?
  • Small lipoproteins (LDL or VLDL) carry fat from liver to rest of body
  • Too much of these cause fat build-up on walls of arteries
lipids
Lipids
  • Cholesterol
  • HDL (good cholesterol)
  • Ratio
  • LDL (badcholesterol)
  • Triglycerides
blood sugar
Blood Sugar
  • Glucose provides energy
  • High blood sugar could signal diabetes
  • Insulin is produced in pancreas and helps glucose move from blood to cells
  • Some protease inhibitors can cause elevation of blood sugar by inhibiting insulin
types of glucose tests
Types of glucose tests
  • Random Blood sugar

(not fasting)

  • Fasting Blood sugar

(nothing to eat or drink except H2O for 8 hrs)

  • Glucose Tolerance Test

(Starts fasting, then given sweet drink and measured over time)

  • Hemoglobin A1c

(Measures glucose control over 3 month)

t cell subsets it s a war out there
T cell subsets: It’s a war out there!
  • CD4

(cells that HIV targets and kills)

  • CD4%

(% of total lymphocytes)

  • CD8

(fight HIV)

viral load tests
Viral Load Tests
  • Different types of tests and results may be different
  • PCR
  • bDNA (branched DNA)
  • Viral load testing measures only that which is in your blood
  • Valuable for managing therapy: goal is undetectable
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