Blood Test Case Collection
Learn to interpret blood tests systematically with our collection of clinical cases written by experienced clinicians.
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Cases
Learn to develop a systematic approach to interpreting blood test results. See some examples of our explanations here.
Example
Learn to recognise key blood test abnormalities
A 21 year old woman presents to her GP feeling tired all the time and with intermittent abdominal pains. She has a past medical history of irritable bowel syndrome, for which she takes Buscopan (hyoscine butylbromide).
On examination, her abdomen is soft but with generalised tenderness. She has a vesicular, erythematous eruption on her knees bilaterally. Her vital signs are all within normal limits.
Interpret the patient's blood tests using a structured approach. This will be followed by a discussion on the clinical reasoning behind the case.
Full blood count (FBC)
| Test | Result | Reference range |
|---|---|---|
| Haemoglobin (Hb) | 110 | ♂ 130 – 180 g/L ♀ 115 – 165 g/L |
| White cell count (WCC) | 7 | 3.6 – 11.0 x 109/L |
| Neutrophils | 4.5 | 1.8 – 7.5 x 109/L |
| Lymphocytes | 1.6 | 1.0 – 4.0 x 109/L |
| Monocytes | 0.5 | 0.2 – 0.8 x 109/L |
| Eosinophils | 0.3 | 0.1 – 0.4 x 109/L |
| Basophils | 0.1 | 0.02 – 0.10 x 109/L |
| Platelet count | 145 | 140 – 400 x 109/L |
| Mean cell volume (MCV) | 76 | 80 – 100 fL |
Urea & electrolytes (U&Es)
| Test | Result | Reference range |
|---|---|---|
| Sodium (Na+) | 135 | 133 – 146 mmol/L |
| Potassium (K+) | 4.5 | 3.5 – 5.3 mmol/L |
| Urea | 4.0 | 2.5 – 7.8 mmol/L |
| Creatinine | 50 | ♂ 59 – 104 μmol/L ♀ 45 – 84 μmol/L |
| eGFR | >90 | 90ml/min/1.73m2 |
CRP
| Test | Result | Reference range |
|---|---|---|
| C-reactive protein (CRP) | 7 | <5 mg/L |
Haematinics
| Test | Result | Reference range |
|---|---|---|
| Serum ferritin | 7 | 41 – 400 ug/L |
Coeliac serology
| Test | Result | Reference range |
|---|---|---|
| Total IgA | >0.2 | >0.2g/L |
| IgA anti-tTg | Positive | - |
| IgA anti-endomysial antibodies | Positive | - |
Example
Each panel of blood tests is analysed using a step-by-step approach
A 57 year old man presents to the emergency department with a two day history of fever and abdominal pain. He has a past medical history of hypertension on ramipril. On examination he appears jaundiced and has a tender right upper quadrant. His temperature is 38.5oC, heart rate 101 bpm and blood pressure 110/80 mmHg.
Interpret the patient's blood tests using a structured approach. This will be followed by a discussion on the clinical reasoning behind the case.
Full blood count (FBC)
| Test | Result | Reference range |
|---|---|---|
| Haemoglobin (Hb) | 135 | ♂ 130 – 180 g/L ♀ 115 – 165 g/L |
| White cell count (WCC) | 19.78 | 3.6 – 11.0 x 109/L |
| Neutrophils | 15.8 | 1.8 – 7.5 x 109/L |
| Lymphocytes | 3.0 | 1.0 – 4.0 x 109/L |
| Monocytes | 0.6 | 0.2 – 0.8 x 109/L |
| Eosinophils | 0.3 | 0.1 – 0.4 x 109/L |
| Basophils | 0.08 | 0.02 – 0.10 x 109/L |
| Platelet count | 430 | 140 – 400 x109/L |
| Mean cell volume (MCV) | 92.1 | 80 – 100 fL |
Urea & electrolytes (U&Es)
| Test | Result | Reference range |
|---|---|---|
| Sodium (Na+) | 137 | 133 – 146 mmol/L |
| Potassium (K+) | 4.9 | 3.5 – 5.3 mmol/L |
| Urea | 10.2 | 2.5 – 7.8 mmol/L |
| Creatinine | 175 | ♂ 59 – 104 μmol/L ♀ 45 – 84 μmol/L |
| eGFR | 42 | >90ml/min/1.73m2 |
Liver function tests (LFTs)
| Test | Result | Reference range |
|---|---|---|
| Alkaline phosphatase (ALP) | 320 | 30 – 130 U/L |
| Alanine aminotransferase (ALT) | 37 | ♂ <41 U/L ♀ <33 U/L |
| Aspartate aminotransferase (AST) | 52 | 1 – 45 U/L |
| Bilirubin | 72 | <21 μmol/L |
| Gamma-glutamyl transferase (GGT) | 160 | ♂ <60 U/L ♀ <40 U/L |
| Albumin | 37 | 35 – 50 g/L |
Amylase
| Test | Result | Reference range |
|---|---|---|
| Amylase | 140 | 28–100 U/L |
CRP
| Test | Result | Reference range |
|---|---|---|
| C-reactive protein (CRP) | 210 | <5 mg/L |
Bone profile
| Test | Result | Reference range |
|---|---|---|
| Corrected calcium | 2.5 | 2.2 – 2.6 mmol/L |
| Phosphate | 1.2 | 0.8 – 1.5 mmol/L |
| Alkaline phosphatase (ALP) | 320 | 30 – 130 U/L |
Coagulation screen
| Test | Result | Reference range |
|---|---|---|
| PT | 12 | 10 – 14 seconds |
| APTT | 32 | 24 – 47 seconds |
| Fibrinogen | 3.1 | 1.5 – 4.5 g/l |
