Lab Reference

Normal · critical · interpretation

Haematology

  • Haemoglobin

    ♂ 130–170 g/L · ♀ 120–155 g/L

    Critical: <70 or >200 g/L

    Oxygen-carrying capacity. Low = anaemia; high = polycythaemia.

    ↑ Causes

    • • Polycythaemia vera
    • • Chronic hypoxia (COPD, OSA, altitude)
    • • Dehydration

    ↓ Causes

    • • Iron / B12 / folate deficiency
    • • Chronic disease
    • • Bleeding, haemolysis
    • • Marrow failure
  • WCC (total)

    4–11 × 10⁹/L

    Critical: <1 or >30

    Total leucocytes; check differential.

    ↑ Causes

    • • Infection
    • • Inflammation
    • • Steroids
    • • Leukaemia

    ↓ Causes

    • • Viral
    • • Sepsis (severe)
    • • Chemo
    • • Marrow failure
  • Platelets

    150–400 × 10⁹/L

    Critical: <20 or >1000

    Low → bleeding risk; high → thrombosis.

    ↑ Causes

    • • Reactive (infection, iron def)
    • • MPN (ET, PV)

    ↓ Causes

    • • ITP
    • • DIC
    • • TTP/HUS
    • • Drugs (heparin → HIT)
    • • Marrow failure

Coagulation

  • INR

    0.8–1.2 (target 2–3 on warfarin)

    Critical: >5 (with bleed)

    Extrinsic pathway. Used to monitor warfarin.

    ↑ Causes

    • • Warfarin
    • • Liver disease
    • • Vit K deficiency
    • • DIC
    • • DOAC interference
  • APTT

    26–38 s

    Intrinsic pathway. Monitors heparin.

    ↑ Causes

    • • Heparin
    • • Haemophilia
    • • vWD
    • • Antiphospholipid (paradoxical)
    • • DIC
  • D-dimer

    <500 ng/mL (age-adjusted)

    Use only with low/intermediate pre-test probability for VTE rule-out.

    ↑ Causes

    • • VTE
    • • DIC
    • • Pregnancy
    • • Malignancy
    • • Infection
    • • Recent surgery

Electrolytes

  • Sodium

    135–145 mmol/L

    Critical: <125 or >155

    Assess with volume status before treating.

    ↑ Causes

    • • Dehydration
    • • DI
    • • Hypertonic saline

    ↓ Causes

    • • SIADH
    • • Diuretics
    • • HF / cirrhosis
    • • Adrenal insufficiency
  • Potassium

    3.5–5.0 mmol/L

    Critical: <2.5 or >6.5

    ECG changes guide urgency.

    ↑ Causes

    • • AKI/CKD
    • • ACEi/ARB/spironolactone
    • • Tissue breakdown
    • • Adrenal insufficiency

    ↓ Causes

    • • Diuretics
    • • Vomiting/diarrhoea
    • • Insulin / β-agonist
    • • Cushing's

Renal

  • Urea

    2.5–7.8 mmol/L

    Rises in dehydration, UGIB, AKI, high-protein diet.

    ↑ Causes

    • • AKI/CKD
    • • Dehydration
    • • UGIB
    • • Catabolic state

    ↓ Causes

    • • Liver failure
    • • Pregnancy
    • • Low protein
  • Creatinine

    ♂ 60–110 · ♀ 45–90 µmol/L

    Use to estimate GFR (CKD-EPI). Trends matter more than absolute value.

    ↑ Causes

    • • AKI/CKD
    • • Muscle injury
    • • Drugs (NSAID, ACEi)

    ↓ Causes

    • • Low muscle mass
    • • Pregnancy

Bone

  • Calcium (corrected)

    2.20–2.60 mmol/L

    Critical: <1.8 or >3.5

    Adjust for albumin: Ca + 0.02 × (40 − albumin).

    ↑ Causes

    • • Primary hyperparathyroidism
    • • Malignancy (PTHrP, bone mets)
    • • Vitamin D toxicity

    ↓ Causes

    • • Hypoparathyroidism
    • • CKD
    • • Vit D deficiency
    • • Pancreatitis
  • Magnesium

    0.7–1.0 mmol/L

    Low Mg → resistant hypokalaemia/hypocalcaemia + arrhythmia.

    ↑ Causes

    • • Renal failure
    • • Mg supplementation

    ↓ Causes

    • • Diuretics
    • • PPI
    • • Diarrhoea
    • • Alcohol
  • Phosphate

    0.8–1.5 mmol/L

    Low → muscle weakness, respiratory failure.

    ↑ Causes

    • • CKD
    • • Hypoparathyroidism
    • • Tumour lysis

    ↓ Causes

    • • Refeeding
    • • DKA recovery
    • • Phosphate binders

Liver

  • ALT

    <40 U/L

    Hepatocellular pattern when >2× ALP rise.

    ↑ Causes

    • • Viral hepatitis
    • • Drug-induced (paracetamol)
    • • Ischaemic hepatitis
    • • NAFLD/NASH
  • ALP

    30–130 U/L

    Cholestatic / bone source. Check GGT to confirm liver origin.

    ↑ Causes

    • • Biliary obstruction
    • • Bone disease (Paget's, mets)
    • • Pregnancy
    • • Drugs
  • Bilirubin

    <21 µmol/L

    Split into conjugated vs unconjugated for differential.

    ↑ Causes

    • • Haemolysis (unconj)
    • • Gilbert's
    • • Hepatitis
    • • Obstruction (conj)
  • Albumin

    35–50 g/L

    Marker of synthetic function + nutrition; falls in inflammation.

    ↓ Causes

    • • Liver failure
    • • Nephrotic syndrome
    • • Malnutrition
    • • Sepsis / inflammation

Inflammatory

  • CRP

    <5 mg/L

    Acute phase reactant; >100 suggests bacterial infection.

    ↑ Causes

    • • Infection
    • • Inflammation
    • • Malignancy
    • • Trauma

Cardiac

  • Troponin (hs)

    Assay-specific, often <14 ng/L

    Rise + fall + symptoms = MI. Many non-ischaemic causes.

    ↑ Causes

    • • ACS
    • • PE
    • • Sepsis
    • • Heart failure
    • • Renal failure
    • • Myocarditis

Metabolic

  • Lactate

    <2 mmol/L

    Critical: >4 mmol/L

    Marker of tissue hypoperfusion or impaired clearance.

    ↑ Causes

    • • Sepsis / shock
    • • Ischaemia
    • • Metformin
    • • Liver failure
  • Glucose (fasting)

    3.9–5.5 mmol/L

    Critical: <3.0 or >25

    Diabetes if fasting ≥7.0 or random ≥11.1 with symptoms.

    ↑ Causes

    • • Diabetes
    • • Stress
    • • Steroids

    ↓ Causes

    • • Insulin / sulphonylurea
    • • Sepsis
    • • Adrenal insufficiency
    • • Insulinoma
  • HbA1c

    <42 mmol/mol (<6.0%)

    Diabetes ≥48 mmol/mol; pre-diabetes 42–47.

    ↑ Causes

    • • Diabetes

    ↓ Causes

    • • Haemolysis
    • • Recent transfusion
    • • Pregnancy
    • • Iron deficiency (falsely high)

Endocrine

  • TSH

    0.4–4.5 mU/L

    Most sensitive marker of thyroid status (except secondary).

    ↑ Causes

    • • Primary hypothyroidism
    • • Recovery from non-thyroidal illness

    ↓ Causes

    • • Thyrotoxicosis
    • • Pituitary disease
    • • Steroids / dopamine

ABG

  • pH

    7.35–7.45

    Critical: <7.20 or >7.60

    Acidaemia vs alkalaemia.

  • PaCO₂

    4.7–6.0 kPa (35–45 mmHg)

    Respiratory component. High = respiratory acidosis.

  • HCO₃⁻

    22–26 mmol/L

    Metabolic component. Low = metabolic acidosis.

  • PaO₂

    >10.6 kPa (80 mmHg) on air

    Critical: <8 kPa

    Hypoxaemia threshold = <8 kPa.

  • Base excess

    −2 to +2 mmol/L

    Metabolic acid–base derangement; <−2 acidosis, >+2 alkalosis.

  • Anion gap

    8–16 mmol/L

    Raised AG: MUDPILES (methanol, uraemia, DKA, paraldehyde, INH/iron, lactate, ethylene glycol, salicylates).

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Clinical Decisions in Seconds