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Appendix 

Appendix
Author(s):

Punit S. Ramrakha

, Kevin P. Moore

, and Amir H. Sam

Page of

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date: 04 August 2020

Reference intervals

Biochemistry (always consult your local laboratory)

(See Table A1.)

Table A1

Substance

Reference interval

ACTH

<80ng/L

ALT

Men <31IU/L

Women <19IU/L

Albumin

35–50g/L

Aldosterone1

100–500pmol/L

ALP

30–300IU/L (adults)

α‎-fetoprotein

<10kU/L

Amylase

0–180 Somogyi U/dL

Angiotensin II1

5–35pmol/L

ADH

0.9–4.6pmol/L

AST

5–35IU/L

Bicarbonate

24–30mmol/L

Bilirubin

3–17micromol/L (0.25–1.5mg/dL)

Calcitonin

<0.1 micrograms/L

Ca2+ (ionized)

1.0–1.25mmol/L

Ca2+ (total)

2.12–2.65mmol/L

Chloride

95–105mmol/L

Total cholesterol

3.9–5.5mmol/L

LDL cholesterol

1.55–4.4mmol/L

HDL cholesterol

0.9–1.93mmol/L

Cortisol (a.m.)

450–700nmol/L

Cortisol (midnight)

80–280nmol/L

CK

Men 25–195IU/L

Women 25–170IU/L

Creatinine

70 to ≤130micromol/L

CRP

0–10

Ferritin

12–200 micrograms/L

Folate

5–6.3nmol/L (2.1–2.8 micrograms/L)

GGT

Men 11–51IU/L

Women 7–33IU/L

Glucose (fasting)

3.5–5.5mmol/L

Glycosylated haemoglobin (HbA1c)

5–8%

GH

<20mU/L

Iron

Men 14–31micromol/L

Women 7–33IU/L

LDH

70–250IU/L

Mg2+

0.75–1.05mmol/L

Osmolality

278–305mOsmol/kg

PTH

<0.8–8.5pmol/L

PO43– (inorganic)

0.8–1.45mmol/L

K+

3.5–5.0mmol/L

Prolactin

Men <450U/L; women <600U/L

PSA

0–4ng/mL

Protein (total)

60–80g/L

Red cell folate

0.36–1.44micromol/L (160–640 micrograms/L)

Renin (erect/recumbent)1

2.8–4.5/1.1–2.7pmol/mL/h

Na+

135–145mmol/L

TSH

0.3–3.8mU/L

Thyroxine (T4)

70–140nmol/L

Thyroxine (free)

10.0–26.0pmol/L

Triglyceride (fasting)

0.55–1.90mmol/L

Tri-iodothyronine (T3)

1.2–3.0nmol/L

Urea

2.5–6.7mmol/L

Urate

Men 0.21–0.48mmol/L

Women 0.15–0.39mmol/L

Vitamin B12

0.13–0.68nmol/L (>150ng/L)

1 The sample requires special handling—contact the lab.

Urine

(See Table A2.)

Table A2

Substance

Reference interval

Adrenaline

0.03–0.10micromol/24h

Cortisol (free)

≤280nmol/24h

Dopamine

0.65–2.70micromol/24h

Hydroxyindole acetic acid (HIAA)

16–73micromol/24h

Hydroxymethylmandelic acid (HMMA, VMA)

16–48micromol/24h

Metanephrines

0.03–0.69micromol/mmol creatinine

Noradrenaline

0.12–0.5micromol/24h

Osmolality

350–1000mOsmol/kg

PO43– (inorganic)

15–50mmol/24h

K+

14–120mmol/24h

Na+

100–250mmol/24h

Cerebrospinal fluid

See Appendix Lumbar puncture 2, p. [link].

Haematology

(See Table A3.)

Table A3

Measurement

Reference interval

WBC

3.2–11.0 × 109/L

RBC

Men 4.5–6.5 × 1012/L

Women 3.9–5.6 × 1012/L

Hb

Men 13.5–18.0g/dL

Women 11.5–16.0g/dL

Haematocrit (Hct) or packed cell volume (PCV)

Men 0.4–0.54L/L

Women 0.37–0.47L/L

MCV

82–98fL

Mean cell haemoglobin (MCH)

26.7–33.0pg

Mean cell haemoglobin concentration (MCHC)

31.4–35.0g/dl

Platelet count

120–400 × 109/L

Neutrophils

40–75%

Abs. no. 1.9–7.7 × 109/L

Monocytes

3.0–11.0%

Abs. no. 0.1–0.9 × 109/L

Eosinophils

0.0–7.0%

Abs. no. 0.0–0.4 × 109/L

Basophils

0.0–1.0%

Abs. no. 0.2–0.8 × 109/L

Lymphocytes

20–45%

Abs. no. 1.3–3.5 × 109/L

Reticulocyte count1

0.8–2.0% (25–100 × 109/L)

ESR

Depends on age (and Appendix in anaemia)

Men (age in years)/2

Women (age in years + 10)/2

PT—factors II, VII, and X

10–14s

APTT—factors VIII, IX, XI, and XII

35–45s

1 Only use percentages if the red cell count is normal; otherwise use absolute values.

Guidelines on oral anticoagulation

(See Table A4.)

Table A4

INR

Clinical condition

2.0–3.0

Treatment of DVT, PE, TIAs; chronic AF

3.0–4.5

Recurrent DVTs and PEs; arterial grafts and arterial disease (including MI); prosthetic cardiac valves

For acid–base nomogram on the interpretation of arterial blood gases, see Fig. A1.

Fig. A1 Acid base nomogram on the interpretation of arterial blood gases.

Fig. A1 Acid base nomogram on the interpretation of arterial blood gases.

Reprinted from The Lancet, 1, Flenley DC, ‘The rationale of oxygen therapy’, 270–3, Copyright 1967, with permission from Elsevier.

For nomogram for body size, see Fig. A2.

Useful contacts

Liver units

Royal Free Hospital, London

0207 794 0500

Addenbrooke’s Hospital, Cambridge

01223 245 151

Freeman Hospital, Newcastle

0191 233 6161

Queen Elizabeth Hospital, Birmingham

0121 472 1311

St James Hospital, Leeds 0

113 243 3144

Edinburgh Royal Infirmary, Edinburgh

0131 536 1000

Kings College Hospital, London

0207 737 4000

Organ donation and transplantation

ODT

0117 975 7575

Poisons units

National Poisons Information Service

0344 892 0111

Drug and chemical exposure in pregnancy

UK Teratology Information Service

0344 892 0909

Tropical and infectious diseases

Hospital for Tropical Diseases, London

020 3456 7890: ask for the tropical medicine registrar (or 24h HTD registrar on-call: 07908 250924)

Northwick Park, London

0208 864 3232 (bleep infectious diseases registrar)

Liverpool

0151 705 3100 during working hours (out of hours: 0151 706 2000 and ask for the tropical medicine physician on-call)

Anti-venom kits for snakebites

For information on identification and management, contact:

Liverpool

0151 705 3100

London

0207 188 0500

Virus reference laboratory

Colindale, London

0208 200 4400