Biochemistry Test
Acid phosphatase
Test Acid phosphatase
Indication cancer of the prostate, boned disease
Physiology The prostate is the richest source
Normal Range Male-2.5-11.7U/L,Female-0.3-9.2U/L
Interpretation Elevated levels are seen in cancer of the bone and prostrate
Adrenocorticotrophic hormone
Test Adrenocorticotrophic hormone
Indication Adrenal and pitutary gland disorders
Physiology Under the conditions of stress ACTH produced by the
pituatry gland stimulates adrenal cortex to release cortisol. Both cortisol and
ACTH levels are to be determined. Hydrocortisone is the major steroid hormone synthesized.
Normal Range ACTH - Morning-25-50pg/ml, evening-0-50pg/ml
Interpretation increased levels indicate cushings syndrome characterized
by hyperglycemia, hypertension, weight gain, impotency and physcological
disorders Dexamethasone supression indicate Addisons disease characterised by low blood pressure, hypoglycemia and depression
Alanine transaminase
Test Alanine transaminase
Indication It is present in red blood cells, heart and liver. Formerly known as serum glutamate pyruvate transminase.
Physiology It is a mostly liver enzyme, formely known as serum glutamate oxaloactetate transaminase.
Normal Range 0-35U/L
Interpretation hepatitis, cirrohosis, ischemia, tumor of liver, ischemia
interpretates high levels of enzyme. Higher levels also indicate viral hepatitis. Alkaline phosphatase
Test Alkaline phosphatase
Indication Elevated in conditions of hepatitis and acute liver damage
Physiology It is present in all tissues especially in bile ducts, placenta, liver and bone
Normal Range 44-77IU/l
Interpretation higher values indicate biliary obstruction, hepatitis, anemia and fracture.
Alpha1-proteinase inhibitor
Test Alpha1-proteinase inhibitor
Indication Pulmonary emphysema liver cirrohosis
Physiology It is a glycoprotein also known as alpha 1-antitrypsin. It
serves as inhibitor of several protien cleaving enzymes like elastase, trypsin and chymotrypisn. It is synthesized in the liver.
Normal Range 150-250mg/100ml
Interpretation Decreased levels may be taken for liver damage and jaundice
Amylase
Test Amylase
Indication Acute pancreatitis
Physiology This enzyme digests starch and is present in pancreas and salivary glands
Normal Range Male-60-180Su/Dl, Female-95-290U/L
Interpretation Elevated levels are seen after the pancreatitis, conditions of salivary gland damages like mumps and swelling of paratoid glands Ammonia
Test Ammonia
Indication Impaired buffering action of kidney
Physiology Ammonia arises from the hydrolysis of amino acid glutamine in kidney
Normal Range 30-50millimoles/day
Interpretation Increased levels indicate diabetic ketoacidosis and starvation. Decreased levels indicate carbohydrate rich diet
Ascorbic acid test
Test Ascorbic acid test
Indication Scurvy
Physiology It plays an important role in connective tissue formation.
Interpretation Deficiency is characterized by inability to form intercellular substances in tissues leading to swollen and tender joints.
Aspartate transaminase
Test Aspartate transaminase
Indication Elevated in conditions of cirrhosis, hepatitis, and jaundice.
Normal Range 17-59U/L
Interpretation High levels-Liver damage, hepatitis, necrosis, kidney or
lung changes. Low levels - Vitamin B6 deficiency. AST to ALT ratio is directly proportional to alcohol dependence.
Test Biotin
Indication Dermatitis
Physiology It plays an important role in carboxylation reactions
Normal Range 200-350pgs/Ml
Interpretation Deficiency leads to anorexia, nausea, vomiting, depression
and glossitis.
Test Blood urea nitrogen
Indication kidney damage
Physiology It is the catabolic product of proteins and the excess is
excreated in kidneys.
Normal Range 7-25mgs/dl
Interpretation Increased levels indicate heart and kidney damage. Decreased
levels indicate mal absorption and low protein intake
Test Carr-price test
Indication Vison impairment
Physiology Vitamin-A plays an important role in vision, growth and
reproduction.
Normal Range 0.91-1.71micrograms/dL
Interpretation Deficiency leads to keratomalacia characterized by
degenerative changes in retina leading to blindness, dry skin and roughness
increased levels leads to nausea, vomiting, headache, dizziness, and
hepatomegaly.
Test Catecholamines in urine
Indication hypertension, hyperglycemia, weight loss, glycosuria.
Physiology This is secreated by adrenal medulla and in case of tumors
it secreates more. 24 hours urine sample is required.
Normal Range 50micrograms in 24 hours urine sample
Interpretation Elevated levels are seen in pheochromocytoma characterized
by cancer of adrenal medullary glands. Increased levels also indicate
functional paraganglioma characterized by cancer of symphatetic paragnalian
cells.
Test
Ceruloplasmin
Indication
liver and eye degenerations
Physiology
It is a trace element present in smaller quantities.
Normal
Range 0.2-0.55 absorbance units/0.1ml serum
Interpretation
Increased levels indicate degeneration of eye, accumulation in liver and
neurological disorders.
Chloride
Test chloride
Indication Cushing syndrome, chronic nephritis, Addison disease
Physiology Normally chloride is excreated in urine along with sodium
as sodium chloride. In pathological conditions diminished amount of chloride is
excreated.
Normal Range Normal values-170-250millimoles of chloride
Interpretation Lower level indicates vomiting and diarrhea. Decreased
activity of tubular reabsorption.
Test Creatinine kinase
Indication Myocardial infarction, skeletal muscle disorders
Physiology Widely distributed in tissues with highest activity in
skeletal muscles, heart muscles and brain tissues
Normal Range Male-15-160U/L, female-15-130U/L
Interpretation Higher values are due to myocardial breakdown and central
nervous system shock
Diabetes
Mellitus
Test Diabetes Mellitus
Indication Hyperglycemia, obesity, impaired fasting blood glucose, impaired
glucose tolerance
Physiology It exists in 4 forms as type 1 or IDDM, type 2 or NIDDM, other
specific type of diabetes and gestational diabetes mellitus. Type 1 is
characterized by self destruction of pancreatic cells resulting in absolute
deficiency of insulin. Type 2 is characterized by individuals’ resistance to
insulin and it is the majority
Test Folic acid
Indication Anemia
Physiology It plays an important role in nucleic acid and amino acid biosynthesis
Normal Range 3-20nanograms/Ml
Interpretation Deficiency is due to poor absorption and insufficient
dietary intake.
Test Follicle stimulating hormone test
Indication Reproductive organ disorders
Physiology It regulates the growth and development of gametes
Normal Range male 4-25U/L, female 4-30U/L
Interpretation Higher values indicate hypopitutarism, genetic disorders
like Turner and Knilfielters syndrome. Low levels indicate disorders of
pituatiry and hypothalamus
Test gamma glutamyl transpeptidase
Indication Elevated in biliary obstruction, rickets, osteomalacia,
osteosarcoms diseases. Physiology It
is found in blood stream and is especially of hepatic origin
Normal Range 0-51IU/l
Interpretation higher values indicate bile duct obstruction cancer and
necrosis of liver.
Test Glycosylated haemoglobin
Indication persistence of hyperglycemia
Physiology Glucose combines with hemoglobin to form glycated
hemoglobin. The levels indicate at any point of time the average blood glucose
level for the past 3 or 4 months
Test 4-hydroxy3-methoxymandelic acid in urine
Indication hypertension
Physiology Also known as vanillyl mandelic acid and it is estimated in
24 hours urine sample. It is a catabolic product of catecholamines.
Normal Range Daily excreation-2-6mgs/day.
Interpretation Increased levels are seen in pheochromocytoma. Decreased
levels are due to consumption of lipid lowering drugs.
Test 5-Hydroxyindole 3-acetic acid in urine
Indication gastrointestinal tract tumors
Physiology It is synthesized from serotonin which is present only in blood
platelets and excreated in urine.
Normal Range Daily excreation-2-9mgs/day.
Interpretation Increased levels are seen in carcinoid syndrome characterized
by cancer of digestive tract.
Test
hematuria
Indication
Presence of red blood cells in urine
Physiology
A benezidine test is performed
Interpretation
An increase of RBC"s in urine indicates hemoglobinuria, internal burns, poisoning
and improper blood transfusion
High density
lipoproteins
Test High density lipoproteins
Indication chronic heart disease
Physiology It carries cholesterol from peripheral tissues and carries
it to liver
Normal Range 35-135mgs/dl
Interpretation Lower levels indicate risks of heart disease
Test Iron and iron binding capacity in serum
Indication Anemia and polycythemia
Physiology Iron is bound to transferrin and is transported in plasma.
Iron binding capacity is the amount of iron required to combine which can
combine with transferrin
Normal Range Iron-70-180micrograms/100ml. Iron binding capacity -
250-430 micrograms/100 ml.
Interpretation lower values indicate pernicious anemia
Test Niacin
Indication Pellagra
Physiology It plays an important role in metabolic reactions.
Normal Range 2.4-6.1mgs/Dl
Interpretation Deficiency leads to dermatitis, dementia, diarrhoea,
psychosis and carcinoid syndrome.
Test 5 prime nucleotidase
Indication Bileduct obstruction
Physiology Widely distributed in tissues. It catalyses the breakdown
of nucleotides from the 5 prime end
Normal Range 0-15U/L
Interpretation Increased level indicates liver and bone disease
Test Protein Indication
proteinuria, preeclampsia, glomerularnephritis and diabetic nephropathy
Physiology Normally protein is present in only in trace levels in
urine collected. Abnormal levels are seen in pathological conditions
Normal Range mild proteinurial-less than 0.5 g/day, moderate
proteinuria-0.5-3.0g/day. Marked proteinuria-3-15g/day
Interpretation mild proteinuria-stress and fever. Moderate
proteinuria-congestive heart failure and multiple myeloma. Marked
proteinuria-glomerularnephritis, diabetic nephropathy
Test Prothrombin time tests
Indication Blood clotting disorders
Physiology It measures the time taken for the blood to clot. It
involves a lot of clotting factors from factor I to factor XIII.
Normal Range 11-15seconds
Interpretation A prolonged prothrombin time indicates deficiency of
vitamin k due to liver disease, deficiency of factors V, X, XII, fibronogen and
thrombin
Test Schilling test
Indication Perinicious anemia. Neurological disorders
Physiology Also called as cyanocobalamin. Urine samples are required.
Normal Range 250-835pgs/mL
Interpretation Deficiency leads to loss of sensation, weakness, and
paralysis.
Test serum calcium
Indication Hyperparathyroidism, rickets, osteomalacia,
hypervitaminosis, nephrosis, pancreatitis, tetany.
Physiology Plays an important role in muscle relaxation and contraction.
Present in higher amounts in bones along with phosphorous.
Normal Range 12-20mgs/100ml
Interpretation Higher levels are seen in hyperparathyrodism and
hypervitaminosis and defective kidney function to excrete decreased levels are
seen in rickets and osteomalacia.
Test serum phosphate
Indication Fanconi syndrome, hyper and hypo parathyrodism.
Physiology Present in larger amount in bones along with calcium
Normal Range 2.5-4.5 mg/100ml
Interpretation Decreased levels are seen in rickets characterized by lower
amounts of vitamin D, hyperparathyroidism, increased amounts are seen in
hypervitaminosis D and renal failure.
Test Sex hormone test
Indication Menstrual problems, fertility problems, pregnancy delayed
problems
Physiology The hormones include estrogen, testosterone, and
progesterone. Estrogen stimulates sexual maturity, female sterility. Progesterone
stimulates pregnancy maintenance. Androgen stimulates male fertility and
secondary sexual characters
Normal Range Estrogen-24-149pg/ml, testosterone-300-1200ng/dL,
progesterone-menopausal women-150ng/Dl-2000ng/dL, Premenopausal-1500-2000ng/dL
Interpretation increased levels of estrogen indicate early onset of
puberty, male having female characters. A low level of estrogen indicates
pregnancy failure. Increased levels of progesterone indicate cancer of ovary
and cysts formation in ovary. Decreased levels are found in abortion .Higher
levels of testosterone are seen in tumor of testes and encephalitis. Decreased
levels are seen in genetical disorders like Down and Knilfilter syndrome
Test Thyroid function test
Indication Hyperparathyroidism and hypothyroidism
Physiology A butterfly like gland with two lobes extending around
trachea and produces thyroxine. It exists as total T4, T3, free T4 and TSH. It
affects cellular growth and metabolism
Normal
Range T4-60-140nmol/L, T3-1.2-1.8nmol/L, TSH-0.1-6IU/L
Interpretation Total T4-Increased levels are seen in graves disease, cancer
of thyroid as symptoms of hyperthyroidism. Low levels are seen in
hypothyroidism whose symptoms are myoxyedema hashmito disease and pituatry
disorders .T 3 -Increased levels are seen in hyperthyroidism and decreased
levels are seen in hypothyroidsm. TSH-High in hypothyroidism and low in
hyperthyroidism
Test Total acidity
Indication Achlorhydria, hypochlorhydria, hyperchlorhydria
Physiology Gastric juice contains two types of acidity namely free
acidity and total acidity. The sum of these is the total acidity. The major
products of the gastric juice are mucins, HCl and pepsin. Combined acidity is
the difference between total acidity and free acidity
Normal Range Free acidity-0-30 clinical units/100ml, Total acidity-20-50
units/100ml
Interpretation Lower secreations indicate achlorhydria characterized by
low secreation of HCl, if pepsin levels are also low then it is known as
achyllia gastrica. Anemia, gastritis and carcinoma also lower the secreation
level. Higher values indicate hyperchlorhydria characterized by gastric ulcer
and duodenal ulcer.
Test Total bilirubin
Indication Cholecystitis, jaundice, cirrhosis, hemolytic anemia.
Physiology A break down product of biliverdin present in bile and
excreated in feaces giving brownish appearance of feaces. Exists as total
bilirubin, indirect bilirubin and direct bilirubin
Normal Range Total bilirubin-0.3-1.0mgs/dl. Direct
bilirubin-0.1-0.3mgs/dl. Indirect bilirubin-0.2-0.7mgs/dl
Interpretation Increased levels are seen in conditions of damaged gall
bladder due to gall stones, where there is a maximum reabsorption of bilirubin,
excessive breakdown of red blood cells, and use of more of medications such as
antibiotics.
Test Triglycerides
Indication Artheroscelorosis
Physiology Nearly 95% of dietary fat are stored as triglycerides and
it is stored in adipose tissue Normal Range
0-200mgs/dl
Interpretation Increased levels indicate myocardial infarction, liver
disease. Decreased levels indicate poor nutrition and poor absorption
Test Urea
Indication Glomerular nephritis, acute and chronic renal failure, urinary
tract obstruction Physiology it is synthesized
in the liver, carried in the blood to kidney. It contains 45% of total non
protein nitrogen in plasma
Test Urine analysis physical characteristics
Indication polyuria, oliguria, anuria, acute nephritis, colour of
urine is smoky brown yellow, milky diabetes insipidus
Physiology There are lot of constituents present in urine which are
increased during pathological conditions.early morning sample is generally
preferred for analysis
Interpretation An increse in urinary out indicates polyuria characterized
by diabetes. A low output symbolises oliguria due to nephritis, fever and vomiting
and anuria is due to poisoning by heavy metals. Pus, bilirubin and blood output
changes the color of urine
Test
Vitamin - B2
Indication
Dermatitis photophobia
Physiology
It plays an important role in oxidation and reduction reactions.
Normal
Range 4-24micrograms/Dl.
Interpretation
Deficiency leads to sore throat edema, hyperemia and glossitis. Other symptoms
include seborrhic dermatitis and normocytic anemia.
Vitamin-B 6
Test Vitamin-B 6
Indication Dermatitis hypochromic anemia
Physiology It plays an important role in glycogen metabolism.
Normal Range 5-30nanograms/Ml
Interpretation Deficiency leads to epileptiform convulsions and
hematological manifestations.
Test Vitamin-B1
Indication Beri beri
Physiology Vitamin B1 plays an important role in carbohydrate
metabolism and nervous functions.
Normal Range 150-200U/L
Interpretation Deficiency may be due to chronic alkalosis megaloblastic
anemia
Test Vitamin-D test
Indication bone disorders
Physiology Serum sample is required. Test done by RIA, HPLC. Vitamin D
plays an important role in calcium metabolism and calcification of bone and
teeth.
Normal Range 16-65pgs/mL.
Interpretation Deficiency leads to Rickets in children and osteolmalacia
in adults. Increased levels are due to renal failure, hyperparathyroidism.
Test Vitamin-E
Indication Anemia
Physiology It is an antioxidant for unsaturated lipids
Normal Range 12-42micromoles/L
Interpretation Deficiency leads to edema, hemolytic anemia.
Test Vitamin-K
Indication Impaired blood clotting
Physiology Il promoted blood clotting.
Normal Range 0.8-.64mgs/L.
Interpretation Deficiency leads to hemolytic disease
Aspartate transaminase (AST), also called aspartate aminotransferase is commonly known as sgot (AspAT/ASAT/AAT) or serum glutamic oxaloacetic transaminase (SGOT), is a pyridoxal phosphate (PLP)-dependent transaminase enzyme (EC2.6.1.1). aspartate transaminase
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