1 of ... QID: 3197.18 Block 1 of 4

A 46-year-old woman is brought to the emergency department because of a 2-day history of dry cough, difficulty breathing, nausea, and vomiting. She is on immunosuppressive therapy following a kidney transplant she received 2 months ago. Temperature is 39.4Β°C (103Β°F), pulse is 88/min, respirations are 26/min, blood pressure is 100/74 mm Hg, and oxygen saturation is 92% on room air. An x-ray of the chest shows bilateral, symmetrical lower lobe peribronchovascular and alveolar infiltrates. Bronchoalveolar lavage is performed and the results are shown.

Histopathology
Lab Values
Serum Reference Range SI Reference
Alanine aminotransferase (ALT) 10–40 U/L 10–40 U/L
Aspartate aminotransferase (AST) 12–38 U/L 12–38 U/L
Alkaline phosphatase 25–100 U/L 25–100 U/L
Amylase 25–125 U/L 25–125 U/L
Bilirubin, total // direct 0.1–1.0 mg/dL // 0.0–0.3 mg/dL 2–17 Β΅mol/L // 0–5 Β΅mol/L
Calcium 8.4–10.2 mg/dL 2.1–2.6 mmol/L
Cholesterol
 Total Normal: <200 mg/dL // High: >240 mg/dL <5.2 mmol/L // >6.2 mmol/L
 HDL 40–60 mg/dL 1.0–1.6 mmol/L
 LDL <160 mg/dL <4.2 mmol/L
Triglycerides Normal: <150 mg/dL // Borderline: 151–199 mg/dL <1.70 mmol/L // 1.71–2.25 mmol/L
Cortisol 0800 h: 5–23 Β΅g/dL // 1600 h: 3–15 Β΅g/dL 138–635 nmol/L // 82–413 nmol/L
2000 h: <50% of 0800 h Fraction of 0800 h: <0.50
Creatine kinase Male: 25–90 U/L 25–90 U/L
Female: 10–70 U/L 10–70 U/L
Creatinine 0.6–1.2 mg/dL 53–106 Β΅mol/L
Urea nitrogen 7–18 mg/dL 2.5–6.4 mmol/L
Creatinine clearance Male: 97–137 mL/min 97–137 mL/min
Female: 88–128 mL/min 88–128 mL/min
Electrolytes, serum
 Sodium (Na+) 136–146 mEq/L 136–146 mmol/L
 Potassium (K+) 3.5–5.0 mEq/L 3.5–5.0 mmol/L
 Chloride (Clβˆ’) 95–105 mEq/L 95–105 mmol/L
 Bicarbonate (HCO3βˆ’) 22–28 mEq/L 22–28 mmol/L
 Magnesium (Mg2+) 1.5–2.0 mg/dL 0.75–1.0 mmol/L
Ferritin Male: 20–250 ng/mL 20–250 Β΅g/L
Female: 10–120 ng/mL 10–120 Β΅g/L
Follicle-stimulating hormone Male: 4–25 mIU/mL 4–25 U/L
Female: premenopause 4–30 mIU/mL 4–30 U/L
 midcycle peak 10–90 mIU/mL 10–90 U/L
 postmenopause 40–250 mIU/mL 40–250 U/L
Glucose Fasting: 70–100 mg/dL 3.8–5.6 mmol/L
Random, non-fasting: <140 mg/dL <7.77 mmol/L
Growth hormone - arginine stimulation Fasting: <5 ng/mL <5 Β΅g/L
Provocative stimuli: >7 ng/mL >7 Β΅g/L
Iron Male: 65–175 Β΅g/dL 11.6–31.3 Β΅mol/L
Female: 50–170 Β΅g/dL 9.0–30.4 Β΅mol/L
Total iron-binding capacity 250–400 Β΅g/dL 44.8–71.6 Β΅mol/L
Transferrin 200–360 mg/dL 2.0–3.6 g/L
Lactate dehydrogenase 45–200 U/L 45–200 U/L
Lipase 13–60 U/L 13–60 U/L
Luteinizing hormone Male: 6–23 mIU/mL 6–23 U/L
Female: follicular phase 5–30 mIU/mL 5–30 IU/L
 midcycle 75–150 mIU/mL 75–150 IU/L
 postmenopause 30–200 mIU/mL 30–200 IU/L
Osmolality 275–295 mOsmol/kg H2O 275–295 mOsmol/kg H2O
Intact parathyroid hormone (PTH) 10–60 pg/mL 10–60 ng/L
Phosphorus (inorganic) 3.0–4.5 mg/dL 1.0–1.5 mmol/L
Prolactin (hPRL) Male: <17 ng/mL <17 Β΅g/L
Female: <25 ng/mL <25 Β΅g/L
Proteins
 Total 6.0–7.8 g/dL 60–78 g/L
 Albumin 3.5–5.5 g/dL 35–55 g/L
 Globulin 2.3–3.5 g/dL 23–35 g/L
Troponin I ≀0.04 ng/mL ≀0.04 Β΅g/L
TSH 0.4–4.0 ΞΌU/mL 0.4–4.0 mIU/L
Thyroidal iodine (123I) uptake 8%–30% of administered dose/24 h 0.08–0.30/24 h
Thyroxine (T4) 5–12 Β΅g/dL 64–155 nmol/L
Free T4 0.9–1.7 ng/dL 12.0–21.9 pmol/L
Triiodothyronine (T3) (RIA) 100–200 ng/dL 1.5–3.1 nmol/L
Triiodothyronine (T3) resin uptake 25%–35% 0.25–0.35
Uric acid 3.0–8.2 mg/dL 0.18–0.48 mmol/L
Immunoglobulins
IgA 76–390 mg/dL 0.76–3.90 g/L
IgE 0–380 IU/mL 0–380 kIU/L
IgG 650–1500 mg/dL 6.5–15.0 g/L
IgM 50–300 mg/dL 0.5–3.0 g/L
Gases, arterial blood (room air)
pH 7.35–7.45 [H+] 36–44 nmol/L
Pco2 33–45 mm Hg 4.4–5.9 kPa
Po2 75–105 mm Hg 10.0–14.0 kPa
Cerebrospinal Fluid Reference Range SI Reference
Cell count 0–5/mm3 0–5 x 106/L
Chloride 118–132 mEq/L 118–132 mmol/L
Gamma globulin 3%–12% total proteins 0.03–0.12
Glucose 40–70 mg/dL 2.2–3.9 mmol/L
Pressure 70–180 mm H2O 70–180 mm H2O
Proteins, total <40 mg/dL <0.40 g/L
Hematologic Reference Range SI Reference
Erythrocyte count (RBC) Male: 4.3–5.9 million/mm3 4.3–5.9 x 1012/L
Female: 3.5–5.5 million/mm3 3.5–5.5 x 1012/L
Erythrocyte sedimentation rate (Westergren) Male: 0–15 mm/h 0–15 mm/h
Female: 0–20 mm/h 0–20 mm/h
Hematocrit Male: 41%–53% 0.41–0.53
Female: 36%–46% 0.36–0.46
Hemoglobin, blood Male: 13.5–17.5 g/dL 135–175 g/L
Female: 12.0–16.0 g/dL 120–160 g/L
Hemoglobin A1c ≀6% ≀42 mmol/mol
Leukocyte count (WBC) 4500–11,000/mm3 4.5–11.0 x 109/L
Neutrophils, segmented 54%–62% 0.54–0.62
Neutrophils, bands 3%–5% 0.03–0.05
Eosinophils 1%–3% 0.01–0.03
Basophils 0%–0.75% 0.00–0.0075
Lymphocytes 25%–33% 0.25–0.33
Monocytes 3%–7% 0.03–0.07
CD4+ T-lymphocyte count β‰₯500/mm3 β‰₯0.5 x 109/L
Platelet count 150,000–400,000/mm3 150–400 x 109/L
Reticulocyte count 0.5%–1.5% 0.005–0.015
D-Dimer ≀250 ng/mL ≀1.4 nmol/L
Partial thromboplastin time (aPTT) (activated) 25–40 seconds 25–40 seconds
Prothrombin time (PT) 11–15 seconds 11–15 seconds
Mean corpuscular hemoglobin (MCH) 25–35 pg/cell 0.39–0.54 fmol/cell
Mean corpuscular hemoglobin concentration (MCHC) 31%–36% Hb/cell 4.8–5.6 mmol Hb/L
Mean corpuscular volume (MCV) 80–100 Β΅m3 80–100 fL
Volume
Plasma Male: 25–43 mL/kg 0.025–0.043 L/kg
Female: 28–45 mL/kg 0.028–0.045 L/kg
Red cell Male: 20–36 mL/kg 0.020–0.036 L/kg
Female: 19–31 mL/kg 0.019–0.031 L/kg

Urine
Reference Range
SI Reference
Calcium 100–300 mg/24 h 2.5–7.5 mmol/24 h
Osmolality 50–1200 mOsmol/kg H2O 50–1200 mOsmol/kg H2O
Oxalate 8–40 Β΅g/mL 90–445 Β΅mol/L
Proteins, total <150 mg/24 h <0.15 g/24 h
17-Hydroxycorticosteroids Male: 3.0–10.0 mg/24 h 8.2–27.6 Β΅mol/24 h
Female: 2.0–8.0 mg/24 h 5.5–22.0 Β΅mol/24 h
17-Ketosteroids, total Male: 8–20 mg/24 h 28–70 Β΅mol/24 h
Female: 6–15 mg/24 h 21–52 Β΅mol/24 h

Body Mass Index (BMI)
Adult: 19–25 kg/m2
Notes