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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

Presented by

Pat Hogan, ARNP, AAHIVS

Group Health Cooperative


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Presenting

  • CBC: Complete Blood Count

  • Serum Chemistries

  • Liver Function Tests

  • Lipids/Glucose

  • T cell subsets

  • Viral load


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Elements of the CBC

  • RBC’s: Red Blood Cells

  • WBC’s: White Blood Cells

  • Platelets

  • Serum Plasma


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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


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Not all blood cells are the same….


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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


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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


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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


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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


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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


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Blood Chemistry Tests

  • Electrolytes: related to fluid balance

  • Sodium

  • Potassium

  • Chloride

  • Bicarb


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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


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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


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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


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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


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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


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Lipids

  • Cholesterol

  • HDL (good cholesterol)

  • Ratio

  • LDL (badcholesterol)

  • Triglycerides


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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


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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)


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T cell subsets: It’s a war out there!

  • CD4

    (cells that HIV targets and kills)

  • CD4%

    (% of total lymphocytes)

  • CD8

    (fight HIV)


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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