Disease Correlation
Accurate lab testing, and the ability to correlate the results to a patient’s symptoms, greatly assists in accurate diagnosis and treatment
Liver Diseases
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Cirrhosis
- Laboratory Findings:
- Chemistry
- Hypoalbuminemia (low albumin): Decreased liver synthesis
- Elevated Total Bilirubin: Impaired bilirubin metabolism and excretion
- Elevated Liver Enzymes (AST, ALT, ALP, GGT): Variable, may be normal or decreased in advanced stages
- Hematology
- Prolonged Prothrombin Time (PT): Decreased synthesis of clotting factors
- Chemistry
- Disease State Correlation: Chronic liver damage leads to impaired protein synthesis, bilirubin metabolism, and clotting factor production
- Clinical Significance: Reflects the severity of liver dysfunction
- Laboratory Findings:
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Hepatitis (Viral, Alcoholic, Drug-Induced)
- Laboratory Findings:
- Elevated Liver Enzymes (ALT and AST): Indicators of liver inflammation and damage
- Elevated Total Bilirubin: Impaired bilirubin metabolism
- Elevated Direct (Conjugated) Bilirubin: Indicates cholestasis (impaired bile flow)
- Disease State Correlation: Liver inflammation causes cell damage, leading to elevated liver enzymes and impaired bilirubin metabolism
- Clinical Significance: Provides insights into the extent of liver damage
- Specific causes such as alcoholic hepatitis will show elevated GGT (gamma-glutamyl transferase)
- Laboratory Findings:
-
Hepatic Encephalopathy
- Laboratory Findings:
- Elevated Ammonia: Impaired urea cycle function
- Disease State Correlation: Liver failure leads to impaired ammonia detoxification, resulting in neurological dysfunction
- Clinical Significance: Requires quick treatment to help prevent permanent brain damage
- Laboratory Findings:
Kidney Diseases
-
Nephrotic Syndrome
- Laboratory Findings:
- Proteinuria: Excretion of > 3.5 g of protein per day in urine
- Hypoalbuminemia: Decreased protein intake
- Disease State Correlation: Damage to the glomeruli leads to increased protein loss in urine, decreased serum albumin, and edema
- Clinical Significance: Indicates glomerular damage
- Laboratory Findings:
-
Chronic Kidney Disease (CKD)
- Laboratory Findings:
- Elevated Serum Creatinine and Blood Urea Nitrogen (BUN): Decreased renal excretion
- Proteinuria: Kidney damage leads to increased protein excretion
- Disease State Correlation: Gradual loss of kidney function leads to decreased excretion of waste products and increased protein excretion
- Clinical Significance: Indicates impaired kidney function
- Laboratory Findings:
Nutritional Disorders
-
Protein-Energy Malnutrition (PEM)
- Laboratory Findings:
- Hypoalbuminemia: Due to decreased protein synthesis
- Low Prealbumin (Transthyretin): Indicates recent protein loss
- Disease State Correlation: Inadequate intake of protein and energy leads to depletion of body protein stores and impaired organ function
- Clinical Significance: Used to measure nutritional deficiency
- Laboratory Findings:
Cancer
-
Multiple Myeloma
- Laboratory Findings:
- Monoclonal Gammopathy: A single, abnormally elevated immunoglobulin peak on serum protein electrophoresis
- Bence Jones Protein: Monoclonal light chains in urine
- Disease State Correlation: A proliferation of plasma cells produces large amounts of a single immunoglobulin or light chain, which can be detected in serum and urine
- Clinical Significance: Helpful in diagnosing cancer
- Laboratory Findings:
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Tumor Markers (Prostate Cancer, Hepatocellular Carcinoma, Ovarian Cancer)
- Prostate-Specific Antigen (PSA) - Prostate Cancer
- Alpha-Fetoprotein (AFP) - Hepatocellular Carcinoma, Germ Cell Tumors
- Cancer Antigen 125 (CA-125) - Ovarian Cancer
- Carcinoembryonic Antigen (CEA) - Colorectal, Lung Cancer
- Laboratory Findings: Elevated levels of the specific tumor marker
- Disease State Correlation: Tumor cells produce specific tumor markers that can be detected in the blood
- Clinical Significance: Monitoring, assessing, and helping determine the stage of the cancer
Other Conditions
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Gout
- Laboratory Findings:
- Hyperuricemia (Elevated Serum Uric Acid)
- Disease State Correlation: Increased uric acid production or decreased excretion leads to urate crystal deposition in joints
- Clinical Significance: Confirmation of gout is possible through detection of uric acid crystals within synovial fluid of joints
- Laboratory Findings:
Key Terms
- Hyperproteinemia: Elevated total protein levels in blood
- Hypoalbuminemia: Abnormally low levels of albumin in the blood
- Proteinuria: Presence of excess protein in urine
- Hypoalbuminemia: Abnormally low levels of albumin in the blood
- AST: Aspartate Aminotransferase
- ALT: Alanine Aminotransferase
- GGT: Gamma-Glutamyl Transferase
- ALP: Alkaline Phosphatase
- PT: Prothrombin Time
- CKD: Chronic Kidney Disease
- PSA: Prostate-Specific Antigen
- AFP: Alpha-Fetoprotein
- CEA: Carcinoembryonic Antigen
- CA-125: Cancer Antigen 125
- Bence Jones Protein: An abnormal protein found in the urine of patients with multiple myeloma or other B cell neoplasms. Bence Jones proteins are monoclonal globulin light chains