Anatomical Pathology Blood Tests

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1 Always refer to the laboratory report for appropriate reference ranges at the time of analysis. This document lists the test reference ranges that were established for the analysis methodologies used only by Nova Scotia Health Authority s Central Zone (Central Zone) Department of Pathology and Laboratory Medicine facilities. Anatomical Pathology Blood Tests Name of Test Specimen Type Units Low High Critical Anti-Cardiac Muscle Antibody Serum (SST) Qualitative N/A N/A N/A Anti-Skeletal Muscle Antibody Serum (SST) Qualitative N/A N/A N/A Anti-Pemphigoid Antibody Serum (SST) Qualitative N/A N/A N/A Anti-Pancreatic Islet Cell Antibody Serum (SST) Qualitative N/A N/A N/A Anti-Smooth Muscle Antibody Serum (SST) Qualitative N/A N/A N/A Anti-Liver Kidney Microsomal Antibody Serum (SST) Qualitative N/A N/A N/A Clinical Chemistry Blood Tests Name of Test Gender Age Units Low High Critical Acetaminophen M/F >1yr µmol/l Therapeutic 66 Therapeutic 199 Refer to Rumack Matthew nomogram Adrenocorticotropic hormone (ACTH) Acetaminophen results can be falsely low for patients undergoing treatment of N-acetylcysteine (NAC). M/F >0min pmol/l Albumin M/F <1yr g/l M/F >1yr g/l Alcohol M/F >1yr mmol/l None seen >40 Alkaline Phosphatase (ALP) Alanine Aminotransferase (ALT) The method is intended for clinical purposes only. Medical-legal specimens should be analyzed by gas chromatographic method for confirmation of results. M/F >18yr U/L For children s ranges, register and sign in: No gender 0-1yr U/L 0 32 difference No gender 1-19yr U/L 0 24 difference M >19yr U/L 0 54 F >19yr U/L 0 44 Alpha-1-Antitrypsin M/F >0 min g/l Alpha Fetoprotein (AFP) M/F 0min - 3mth µg/l Not established 3mth mth 6mth - 1yr Page 1 of 32

2 Clinical Chemistry Blood Tests Name of Test Gender Age Units Low High Critical 1-3yr 3 21 >3yr 1 8 Ammonia M/F >1yr µmol/l Amylase M/F 1-19yr U/L M/F >19yr U/L Amylase is less sensitive and specific in acute pancreatitis than lipase. Amylase results may be elevated in patients with macroamylase. The most common amylase is complexed with an immunoglobulin. This elevated amylase is not diagnostic for pancreatitis. By utilizing plasma lipase, macroamylase may be determined. Androstenedione M >0min nmol/l F Angiotensin Converting Enzyme (ACE) Note: Stated reference range is for adults. M/F >0min U/L 8 52 Reference values are for adults. The reference intervals for pediatric patients may be up to 50% higher than that of adults. Plasma Angiotensin Converting Enzyme (ACE) is significantly reduced in patients on ACE inhibitors (eg. Vasotec and Captopril). Anion Gap M/F >1yr 5 15 Anti-Thyroid Peroxidase Antibody (Anti-TPO) Apolipoprotein B (APO B) Aspartate Aminotransferase (AST) Beta 2 Microglobulin M/F >0min IU/mL <6 M 0-1yr g/l >1-12yr >12-60yr >60yr F 0-1yr >1-12yr >12-60yr >60yr M/F >1yr U/L 5 45 For <1 yr range register and sign in: M >0min nmol/l <194.0 F <201.0 Expected values 95 th percentile. If required the conversion factor from International System of Measurement (SI) to Conventional Units: nmol/l divided by =ng/mL ng/ml divided by 1000 =mg/l Bicarbonate M/F >18yr mmol/l <10 or >40 For children s ranges, register and sign in: Bilirubin, direct M/F 0-14d µmol/l >14d Bilirubin, indirect M/F <18yr µmol/l Not established >18yr Bilirubin, total M/F Newborn µmol/l Age of Full-term Newborn Newborn Premature < 24 hours < < < 48 < < Page 2 of 32

3 Clinical Chemistry Blood Tests Name of Test Gender Age Units Low High Critical hours 2-5 days < < days < < d Not established 15d yr >18yr C-peptide M/F 0min- 1wk pmol/l Not established >1wk Calcium M/F >18yr mmol/l <1.50 or >3.25 Reference range based on samples from ambulatory patients. Recumbent: 0.10 mmol/l lower. For children s ranges, register and sign in: Calcium, ionized M/F mmol/l <0.75 or >1.60 Calcium, Total Corrected M/F >18yr mmol/l This Corrected Total Calcium value can be compared to the normal range for patients with a normal Albumin of 40 g/l. Calcitonin M >0min pg/ml <11 F <7 Carbamazepine M/F <16yr µmol/l Not established >40 Carboxyhemoglobin (COHB) >16yr Therapeutic 17 Therapeutic 51 >75 Routine determination of the Carbamazepine-10, 11-epoxide, an active metabolite, is not clinically indicated in most patients. However, if its level is considered imperative to clinical decision making, the test should be specifically ordered. M/F >18yr % >20.0 <1.5 (non-smokers) <10.0 (smokers) >20.0 (Toxic) >50.0 (Lethal) CA 125 M/F >0min U/mL CA 15-3 M/F >0min U/mL Ca 15-3 test is not sufficiently sensitive or specific to be used for cancer screening. It may be useful for follow up of known breast cancer. CA 19-9 M/F >18yr U/mL Ca19-9 test is not sufficiently sensitive or specific to be used for cancer screening; modest elevations can be seen in some benign conditions. It may be useful for follow-up of known cancers. However, individuals who are Lewis A/B negative are nonsecretors of Ca19-9. If monitoring with Ca19-9, a change in value may be considered to be significant if it is >30% of the baseline. Carcinoembryonic Antigen (CEA) M/F >0min µg/l Non Smokers: less than or equal to 5.0 µg/l This test is not sufficiently sensitive or specific for cancer screening. Ceruloplasmin M/F >0min mg/l Chloride M/F >1yr mmol/l <70 or >130 Cholesterol M/F >1yr mmol/l Page 3 of 32

4 Clinical Chemistry Blood Tests Name of Test Gender Age Units Low High Critical For interpretation of levels or ranges, please see: Cholinesterase No gender 0 15d U/L difference No gender 15d-1yr difference No gender 1-18yr difference M >18yr F Cortisol M/F >0min nmol/l Until 9:30 am: nmol/l pm: nmol/l If Addison s disease is clinically suspected, an AM cortisol result of <240nmol/L cannot exclude this. Cortisol (DST) M/F >0min nmol/l Not established Note: This result was following a Dexamethasone Suppression Test. Creatine Kinase (CK) M >0min U/L F Exercise can significantly increase plasma Creatine Kinase (CK) activity. CK activity in the black population is approximately 2 times that of the white/asian population. Statin treatment can cause elevation of CK activity. Reference ranges are for adults. Reference ranges have not been established for children. Creatinine M >18yr µmol/l >400 F For children s ranges, register and sign in: C-Reactive Protein CRP M/F >1yr mg/l >8mg/L is consistent with acute phase response to inflammation Cardiovascular Risk Assessment: Low Risk: <1 mg/l Average Risk: 1-3 mg/l High Risk: >3 mg/l Digoxin M/F >1yr nmol/l Therapeutic 1.00 Dehydroepiandrosterone sulfate (DHEAS) Therapeutic 2.60 Toxic >3.00 Levels >5.10 nmol/l may be potentially life-threatening. Toxicity is enhanced by hypokalemia, hypomagnesemia, hypocalcemia or renal dysfunction. Digoxin results will be affected for patients undergoing treatment with digibind (antibody fragment therapy) No gender difference 0min- µmol/l 1wk wk- 1mth mth 1yr yr yr M 11-15yr yr yr yr >55yr F 11-15yr Page 4 of 32

5 Clinical Chemistry Blood Tests Name of Test Gender Age Units Low High Critical 15-35yr yr yr >55yr Ages 5 14 years: Reference range is based on children who are pre-pubertal. If the child has achieved puberty, values may be higher by at least twice the upper limit stated on this report. Ages > 14 years: Reference range is based on the assumption that the individual has achieved puberty. Erythropoietin M/F >0min IU/L If the patient is receiving recombinant erythropoietin, analysis may not be valid and reference ranges are not applicable Note: High circulating biotin levels may reduce results by more than 10% of the true value. Estimated Glomerular Filtration Rate (egfr) Patients must discontinue any biotin supplement at least 3 days prior to testing. M/F >=18yr Stage of Kidney Disease egfr Description 1 >=90 Normal or High Mildly Decreased 3a Mildly to Moderately Decreased 3b Moderately to Severely Decreased Severely Decreased 5 <15 Kidney Failure *Multiply the adult (>= 18 years) egfr results by if patient of African descent. CAUTION: egfr should not be used when plasma creatinine is changing rapidly, in pregnancy, for drug dosing, and should be interpreted with caution in extremes of body habitus. egfr <60 ml/min/1.73me2 and/or Albumin to Creatinine Ratio (ACR) >= 3 mg/mmol for >3 months are diagnostic criterion for Chronic Kidney Disease (CKD). For more information on CKD identification, management and referral: Estradiol M >0min pmol/l (E2) F Post-Menopausal: not on HR: < on HR: < Follicular: Midcycle: Luteal: Reference Ranges based on post-puberty Ferritin No gender <4d µg/l Not established difference 4d-15d d mth 6mth-1yr yr yr M 14-16yr yr >19yr F 14-19yr >19yr Ferritin is an acute phase reactant, hence mild/moderate elevations may be seen in inflammatory conditions Folate, RBC M/F >0min nmol/l >285 Page 5 of 32

6 Clinical Chemistry Blood Tests Name of Test Gender Age Units Low High Critical Folate, Serum M/F <5d nmol/l Not established 5d-1yr > yr > yr > yr > yr > yr > yr >18.0 Follicle-stimulating hormone (FSH) Gamma-Glutamyl Transferase (GGT) >19yr M >0min IU/L F >0min Follicular: Midcycle: Luteal: Postmenopausal: Reference Ranges based on post-puberty M/F 0d-15d U/L d-1yr yr yr 7 21 >19yr 0 49 GGT is inducible by drugs such as phenytoin and phenobarbital, and therefore elevations should not be considered indicative of liver disease until drug use is ruled out. Elevations are also seen after ingestion of alcoholic beverages. Gastrin M/F >0min ng/l Reference range for FASTING samples only Note: High circulating biotin levels may reduce results by more than 10% of the true value. Patients must discontinue any biotin supplement at least 3 days prior to testing. Gentamycin M/F >1yr mg/l Toxic Pre: 3.00 Post: Random: 3.00 Divided Daily Dose: PRE Level: <2 mg/l POST Level: 5-8 mg/l (3-5 for UTI or when used for synergy for gram positive organisms) Once Daily Therapy: 6 hour PRE: <1mg/L Glucose, AC M/F >1yr mmol/l <2.2 or >25.0 see the Canadian Journal of Diabetes 2013; Glucose, PC M/F >1yr mmol/l <2.2 or There is no established range for Glucose, PC >25.0 Glucose, Random M/F >1yr mmol/l <2.2 or >25.0 Growth Hormone (GH) M >0min µg/l <3.00 F <8.00 Note: The secretion of Growth Hormone is episodic and pulsatile. The stated reference range is for adults and must be interpreted with caution since levels may be significantly affected by many factors such as food, exercise, sleep and stress. HDL Cholesterol M/F mmol/l see Page 6 of 32

7 Clinical Chemistry Blood Tests Name of Test Gender Age Units Low High Critical Human M/F IU/L Chorionic Gonadotropin, Reference ranges: Beta Men and Pre-Menopausal Non-Pregnant Women: <5 IU/L (quantitative) Post-Menopausal Women: <8 IU/L Note: Suggest repeat testing in 72 hours for borderline high (5-25 IU/L) beta-human Chorionic Gonadotropin (beta hcg) results. IgE M/F 0min-6yr IU/mL yr >15yr In ADULTS only; the likelihood of predicting allergy in susceptible individuals is high when IgE level is above 200 IU/mL Insulin M/F <1wk pmol/l Not established >1wk <120 Expected range for FASTING samples only Insulin-Like Growth Factor-1 (IGF-1) (also known as Somatomedin-C) M 0min-4yr µg/l yr yr yr yr yr yr yr yr yr yr yr yr yr yr yr yr yr yr yr >90yr Not established F 0min-4yr µg/l yr yr yr yr yr yr yr yr yr yr yr yr yr yr yr Page 7 of 32

8 Clinical Chemistry Blood Tests Name of Test Gender Age Units Low High Critical 60-65yr yr yr yr >90yr Not established Iron M >18yr µmol/l F The circulated iron level can show a 30% diurnal variation, with a peak early in the morning. Patient is not fasting or on iron supplements, this may lead to an erroneously high iron result hence incorrect TIBC and % Saturation. For children s ranges, register and sign in: Ketones M/F >18yr Negative Lactate M/F >18yr mmol/l >4.0 Lactate Dehydrogenase (LD) M/F >18yr U/L LDH should only be used for follow up of known hematological malignancies or for the investigation of suspected hemolytic anemia. For children s ranges, register and sign in: LDL Cholesterol M/F >18yr mmol/l see Lipase M/F >18yr U/L 8 78 For children s ranges, register and sign in: Lithium M/F >1yr mmol/l Therapeutic 0.60 Luteinizing Hormone (LH) Therapeutic 1.20 M >0min IU/L F Follicular: Midcycle: Luteal: Postmenopausal (No HR): Reference Ranges based on post-puberty Toxic >1.50 Magnesium M/F >18yr mmol/l For children s ranges, register and sign in: Methemoglobin M/F >18yr % >30.0 Methotrexate (MTX) Non-HDL Cholesterol NT-proBNP (currently available to select study group only) M/F >1yr µmol/l Therapeutic Protocol dependent Toxic After 24 hours: >10.00 After 48 hours: >1.00 After 72 hours: >0.10 Specimens from patients who have received glucarpidase (carboxypeptidase G2) as a high dose methotrexate rescue therapy should not be tested for the Methotrexate level. Methotrexate should be tested after the patient stops the glucarpidase therapy for at least five to seven days. M/F >0min mmol/l Optimal: <2.60 M/F >18yr pg/ml Reference ranges: <300 pg/ml: Acute Congestive Heart Failure unlikely Page 8 of 32

9 Clinical Chemistry Blood Tests Name of Test Gender Age Units Low High Critical pg/ml: Consider age-stratified cutpoints Patient age NT-proBNP values in pg/ml =============== ============== ========= <50 years > years >900 >75 years >1800 ================ ============= ======= Interpretation: Acute CHF less likely, Acute CHF likely, alternative causes consider confounding must be considered factors CHF = Congestive Heart Failure Osmolality M/F >18yr mmol/kg >325 Parathyroid Hormone, Intact (ipth) M/F <6d pmol/l Not established 6d-1yr yr-9yr yr yr >19yr It is recommended to measure ipth on a morning fasting sample Phenobarbital M/F µmol/l >250 Therapeutic concentration: Infants and children: umol/l Adults: umol/l Toxic concentration: >= 259 umol/l Phenytoin M/F >1yr µmol/l >125 Therapeutic response: umol/l Toxic: >119 umol/l Reference range presupposes a normal plasma albumin. For abnormal albumin, the phenytoin result should be adjusted when comparing to the reference range as follows: Corrected Phenytoin = measured Phenytoin/(0.9(Albumin/40)+0.1) The calculation does not pertain to all patients' conditions. Albumin testing should be required with phenytoin by physicians if the calculation needs to be done. Phosphorus M/F >18yr mmol/l Phosphorus has a very strong biphasic circadian rhythm. Values are lowest in the morning, peak first in the late afternoon and peak again in the late evening. The second peak is quite elevated and results may be outside the reference range. Potassium M/F >0min mmol/l <2.8 or >6.2 Reference values have not been established for patients that are less than 1 year of age. Note: Potassium (K+) reference ranges have been adjusted to accommodate for the possibility of slight leakage of K+ from red blood cells prior to sample separation. Prealbumin M 0-15d mg/l M 15d-1yr M 1-13yr M 13-19yr M >19yr F 0-15d Page 9 of 32

10 Clinical Chemistry Blood Tests Name of Test Gender Age Units Low High Critical F 15d-1yr F 1-13yr F 13-19yr F >19yr Prealbumin is only used for monitoring the response to nutritional support in the acutely ill patient. Progesterone M/F nmol/l Reference Ranges based on post-puberty Male: nmol/l Female: Follicular: nmol/l Luteal: nmol/l Postmenopausal: nmol/l First trimester: nmol/l Second trimester: nmol/l Third trimester: nmol/l Day 21 of cycle: minimal level consistent with ovulation = 20.0 nmol/l : level >30.0 nmol/l indicates ovulation is very likely Prolactin M <4d µg/l Not established 4d-30d d-1yr yr >19yr F <4d Not established 4d-30d d-1yr yr >19yr Female reference range is for non-pregnant Prostatic Specific Antigen (PSA) Prostatic Specific Antigen, Free (FPSA) M/F µg/l Reference Ranges: years: < 2.5 ug/l years: < 3.5 ug/l years: < 4.5 ug/l years: < 6.5 ug/l Oesterling et al JAMA 270: , 1993 Serum PSA concentrations, regardless of value, should not be interpreted as evidence for the presence or absence of malignant disease. Other clinically acceptable tests and procedures must be considered in the diagnosis of the disease and good patient management. M/F µg/l Free PSA is not informative when PSA is <4 µg/l (indicating that prostate cancer is unlikely) or when PSA is >20 µg/l (indicating that prostate cancer is likely). Also see interpretation of the fpsa/psa ratio. PSA Free Ratio M/F prostate cancer can be excluded with reasonable (90%) confidence when the PSA is >4 and <20 µg/l and the Free PSA/PSA ratio is > 0.20 Protein, Total M/F >1yr g/l <30 Values may be slightly lower in recumbent patients Salicylate M/F >1yr mmol/l >2.2 Analgesia: mmol/l Anti-inflammatory: mmol/l Toxic (adult): >3.6 mmol/l Page 10 of 32

11 Clinical Chemistry Blood Tests Name of Test Gender Age Units Low High Critical Toxic (children): >2.2 mmol/l Saturation (Iron) M/F >1yr % In hereditary hemochromatosis, plasma iron is usually >30.00 µmol/l and %Saturation is >60%. In advanced iron overload states, the %Saturation often is >90%. Measurement of iron, total iron binding capacity (TIBC), and %Saturation is often unreliable for iron deficiency. Ferritin is recommended for this purpose. Sex Hormone M 18yr nmol/l Binding Globulin (SHBG) F 18yr Sodium M/F >0min mmol/l <120 or >160 Reference values have not been established for patients less than 1 year of age. Pseudohyponatremia may be caused by specimens with high proteins or lipid concentrations. T3, Free M <4d pmol/l Not established 4d-1yr yr yr yr >19yr F <4d Not established 4d-1yr yr yr yr >19yr T4, Free M/F <5d pmol/l Not established 5-15d d d-1yr yr >19yr Testosterone M >0min nmol/l F Male reference range applies to post-puberty and is based on a morning sample, since levels tend to decline through the day Testosterone, Bioavailable M >0min nmol/l F Theophylline M/F >1yr µmol/l >160 Therapeutic: Children and adults: umol/l Neonatal apnea: umol/l Toxic concentration: >= 111 umol/l Thyroglobulin M/F >0min ug/l Warning! Antithyroglobulin antibodies affect thyroglobulin clearance in vivo and directly interfere with thyroglobulin assays (may be falsely high or low). Please note change in reporting units for Thyroglobulin starting July 8, 2016 Reference ranges: Intact thyroid : <56.0 µg/l Page 11 of 32

12 Clinical Chemistry Blood Tests Name of Test Gender Age Units Low High Critical Athyrotic: <0.2 µg/l Note: High circulating biotin levels may reduce results by more than 10% of the true value. Patients must discontinue any biotin supplement at least 3 days prior to testing. Thyroglobulin M/F >0min IU/L <40 Antibody Thyroid Stimulating M/F <4d miu/l Not established Hormone 4d-6mth mth yr 14-19yr >19yr Female years: Thyroid Stimulating Hormone (TSH) reference range during pregnancy may be lower by up to 0.20 miu/l of the lower limit and 1.00 miu/l of the upper limit of stated reference range, particularly during the first trimester. Refer to American Thyroid Association (ATA) guidelines for more information. Tobramycin M/F >18yr mg/l Pre: 3.00 Post: >12.00 Random: >3.00 Expected Values: Divided Daily Dose: PRE Level: <2 mg/l POST Level: 5-8 mg/l (4-6 UTI) Once Daily Therapy 6 hour PRE: <1 mg/l Total Iron M/F >1yr µmol/l Binding Capacity Triglyceride M/F >1yr mmol/l Fasting sample reference ranges: Normal: <1.70 Borderline High: High: Very High; >5.65 Trig >15 can lead to abdominal pain and may be life-threatening due to chylomicron-induced pancreatitis. Troponin T (High Sensitivity) M/F >18yr ng/l High Sensitivity Troponin T Normal Values Suggested Time Intervals for Serial Testing 14 ng/l 0, 3, 6 hours Rule-in Rule-out Acute Myocardial Infarction Acute Myocardial Infarction Result >50 ng/l Two (2) results with a difference of <15 ng/l Or at least six (6) hours apart >= 20 ng/l change in results during serial sampling plus signs of ischemia Unsaturated Iron Binding Capacity M >1yr µmol/l F Page 12 of 32

13 Clinical Chemistry Blood Tests Name of Test Gender Age Units Low High Critical Urea M/F >18yr mmol/l For children s ranges, register and sign in: Uric Acid M >18yr µmol/l M F High normal uric acid level does not rule out gout, especially if sample taken during an acute attack. If on treatment for chronic gout, recommended levels are <360. Note that falsely lower results may be seen in patients on Rasburicase. For children s ranges, register and sign in: Valproic Acid M/F >1yr µmol/l Therapeutic Toxic > Vancomycin M/F >1yr mg/l Pre: Post: Random: The optimal predose vancomycin level depends on the organism and type of infection being treated: 5-10 mg/l - Mild to moderate infections involving coagulase negative staphylococci or enterococci mg/l - Staphylococcus aureus NOT MRSA mg/l - Severe Staphylococcus aureus infections including osteomyelitis, pneumonia, meningitis and endocarditis or infection with MRSA Organisms with an MIC 2 mg/l have a high failure rate; consider an ID consult Vitamin B12 M/F >0min pmol/l Consider B12 replacement for symptomatic patients with B12 levels between 138 and 220 pmol/l and hematological or neurological abnormalities Vitamin D M/F >18yr nmol/l Toxicity: >200.0 Interpretive Data Reference ranges for adults only: <25.0 nmol/l: severe vitamin D deficiency nmol/l: vitamin D deficiency possible nmol/l: likely vitamin D replete >200.0 nmol/l: vitamin D toxicity possible For children s ranges, register and sign in: Routine Hematopathology Blood Tests Test Name Gender Age Range Critical WBC x 10 9 /L M 0-15 days <1.5 & >30.0 F 0-15 days <1.5 & >30.0 M 15 days 1 month <1.5 & >30.0 F 15 days 1 month <1.5 & >30.0 M 1 2 months <1.5 & >30.0 F 1 2 months <1.5 & >30.0 Page 13 of 32

14 Hematopathology Blood Tests Test Name Gender Age Range Critical M 2 6 months <1.5 & >30.0 F 2 6 months <1.5 & >30.0 M 6 months 2 years <1.5 & >30.0 F 6 months 2 years <1.5 & >30.0 M 2 6 years <1.5 & >30.0 F 2 6 years <1.5 & >30.0 M 6 12 years <1.5 & >30.0 F 6 12 years <1.5 & >30.0 M years <1.5 & >30.0 F years <1.5 & >30.0 M years <1.5 & >30.0 F years <1.5 & >30.0 RBC x /L M 0-15 days F 0-15 days M 15 days 1 month F 15 days 1 month M 1 2 months F 1 2 months M 2 6 months F 2 6 months M 6 months 2 years F 6 months 2 years M 2 6 years F 2 6 years M 6 12 years F 6 12 years M years F years M years F years HGB g/l M 0-15 days <70 F 0-15 days <70 M 15 days 1 month <70 F 15 days 1 month <70 M 1 2 months <70 F 1 2 months <70 M 2 6 months <70 F 2 6 months <70 M 6 months 2 years <70 F 6 months 2 years <70 M 2 6 years <70 F 2 6 years <70 M 6 12 years <70 F 6 12 years <70 M years <70 F years <70 M years <70 F years <70 HCT M 0-15 days F 0-15 days M 15 days 1 month F 15 days 1 month M 1 2 months F 1 2 months Page 14 of 32

15 Hematopathology Blood Tests Test Name Gender Age Range Critical M 2 6 months F 2 6 months M 6 months 2 years F 6 months 2 years M 2 6 years F 2 6 years M 6 12 years F 6 12 years M years F years M years F years MCV fl M 0-15 days F 0-15 days M 15 days 1 month F 15 days 1 month M 1 2 months F 1 2 months M 2 6 months F 2 6 months M 6 months 2 years F 6 months 2 years M 2 6 years F 2 6 years M 6 12 years F 6 12 years M years F years M years F years MCH pg M 0-15 days F 0-15 days M 15 days 1 month F 15 days 1 month M 1 2 months F 1 2 months M 2 6 months F 2 6 months M 6 months 2 years F 6 months 2 years M 2 6 years F 2 6 years M 6 12 years F 6 12 years M years F years M years F years MCHC g/l M 0-15 days F 0-15 days M 15 days 1 month F 15 days 1 month M 1 2 months F 1 2 months Page 15 of 32

16 Hematopathology Blood Tests Test Name Gender Age Range Critical M 2 6 months F 2 6 months M 6 months 2 years F 6 months 2 years M 2 6 years F 2 6 years M 6 12 years F 6 12 years M years F years M years F years RDW % M 0-15 days F 0-15 days M 15 days 1 month F 15 days 1 month M 1 2 months F 1 2 months M 2 6 months F 2 6 months M 6 months 2 years F 6 months 2 years M 2 6 years F 2 6 years M 6 12 years F 6 12 years M years F years M years F years PLT x 10 9 /L M 0-15 days <75 F 0-15 days <75 M 15 days 1 month <75 F 15 days 1 month <75 M 1 2 months <75 F 1 2 months <75 M 2 6 months <75 F 2 6 months <75 M 6 months 2 years <75 F 6 months 2 years <75 M 2 6 years <75 F 2 6 years <75 M 6 12 years <75 F 6 12 years <75 M years <75 F years <75 M years <30 F years <30 MPV fl M 0-15 days F 0-15 days M 15 days 1 month F 15 days 1 month M 1 2 months F 1 2 months Page 16 of 32

17 Hematopathology Blood Tests Test Name Gender Age Range Critical M 2 6 months F 2 6 months M 6 months 2 years F 6 months 2 years M 2 6 years F 2 6 years M 6 12 years F 6 12 years M years F years M years F years LYMPH % M 0-15 days F 0-15 days M 15 days 1 month F 15 days 1 month M 1 2 months F 1 2 months M 2 6 months F 2 6 months M 6 months 2 years F 6 months 2 years M 2 6 years F 2 6 years M 6 12 years F 6 12 years M years F years M years F years MONO % M 0-15 days F 0-15 days M 15 days 1 month F 15 days 1 month M 1 2 months F 1 2 months M 2 6 months F 2 6 months M 6 months 2 years F 6 months 2 years M 2 6 years F 2 6 years M 6 12 years F 6 12 years M years F years M years F years NEUT % M 0-15 days F 0-15 days M 15 days 1 month F 15 days 1 month M 1 2 months F 1 2 months Page 17 of 32

18 Hematopathology Blood Tests Test Name Gender Age Range Critical M 2 6 months F 2 6 months M 6 months 2 years F 6 months 2 years M 2 6 years F 2 6 years M 6 12 years F 6 12 years M years F years M years F years EOS % M 0-15 days F 0-15 days M 15 days 1 month F 15 days 1 month M 1 2 months F 1 2 months M 2 6 months F 2 6 months M 6 months 2 years F 6 months 2 years M 2 6 years F 2 6 years M 6 12 years F 6 12 years M years F years M years F years BASO % M 0-15 days F 0-15 days M 15 days 2 months F 15 days 2 months M 2 months - 6 years F 2 months - 6 years M 6 18 years F 6 18 years M years F years IG % M years 0 5 F years 0 5 LYMPH Absolute x10 9 /L M 0-15 days F 0-15 days M 15 days 1 month F 15 days 1 month M 1 2 months F 1 2 months M 2 6 months F 2 6 months M 6 months 2 years F 6 months 2 years M 2 6 years F 2 6 years Page 18 of 32

19 Hematopathology Blood Tests Test Name Gender Age Range Critical M 6 12 years F 6 12 years M years F years M years F years MONO Absolute x10 9 /L M 0-15 days F 0-15 days M 15 days 1 month F 15 days 1 month M 1 2 months F 1 2 months M 2 6 months F 2 6 months M 6 months 2 years F 6 months 2 years M 2 6 years F 2 6 years M 6 12 years F 6 12 years M years F years M years F years NEUT Absolute x10 9 /L M 0-15 days <0.5 x10 9 /L F 0-15 days M 15 days 1 month F 15 days 1 month M 1 2 months F 1 2 months M 2 6 months F 2 6 months M 6 months 2 years F 6 months 2 years M 2 6 years F 2 6 years M 6 12 years F 6 12 years M years F years M years F years EOS Absolute x10 9 /L M 0-15 days F 0-15 days M 15 days 1 month F 15 days 1 month M 1 2 months F 1 2 months M 2 6 months F 2 6 months M 6 months 2 years F 6 months 2 years M 2 6 years Page 19 of 32

20 Hematopathology Blood Tests Test Name Gender Age Range Critical F 2 6 years M 6 12 years F 6 12 years M years F years M years F years BASO Absolute x10 9 /L M 0-15 days F 0-15 days M 15 days 1 month F 15 days 1 month M 1 2 months F 1 2 months M 2 6 months F 2 6 months M 6 months 6 years F 6 months 6 years M 6 12 years F 6 12 years M years F years IG Absolute x10 9 /L M 0-2 days F 0-2 days M 2 days 14 days F 2 days 14 days M 14 days 1 month F 14 days 1 month M 1 3 months F 1 3 months M 3 6 months F 3 6 months M 6 months 2 years F 6 months 2 years M 2 6 years F 2 6 years M 6 12 years F 6 12 years M years F years M years F years Retic % M 0-4 days F 0-4 days M 4 days 1 month F 4 days 1 month M 1 2 months F 1 2 months M 2 6 months F 2 6 months M 6 months 2 years F 6 months 2 years M 2 6 years F 2 6 years M 6 12 years Page 20 of 32

21 Hematopathology Blood Tests Test Name Gender Age Range Critical F 6 12 years M years F years M years F years Retic Absolute x 10 9 /L M 0-4 days F 0-4 days M 4 days 1 month F 4 days 1 month M 1 2 months F 1 2 months M 2 6 months F 2 6 months M 6 months 2 years F 6 months 2 years M 2 6 years F 2 6 years M 6 12 years F 6 12 years M years F years M years F years ESR (Male) ESR (Female) Haptoglobin M/F >0min g/l Plasma Hemoglobin years 0 30 mg/dl Transferrin M/F >0min g/l Coagulation INR >5.0 PTT sec >80 (not on heparin) Thrombin Time sec Dade PTT sec D-Dimer <200 ng/ml Fibrinogen g/l Manual INR Manual PTT sec Manual TT sec FII 0-89 days U/mL 89 days 1 year U/mL 1 6 years U/mL 6 11 years U/mL years U/mL U/mL FV 0-89 days U/mL 89 days 1 year U/mL 1 6 years U/mL 6 11 years U/mL years U/mL U/mL FVII U/mL FVIII U/mL FIX 0-89 days U/mL Page 21 of 32

22 Hematopathology Blood Tests Test Name Gender Age Range Critical 89 days 1 year U/mL 1 6 years U/mL 6 11 years U/mL years U/mL U/mL FX 0-89 days U/mL 89 days 1 year U/mL 1 6 years U/mL 6 11 years U/mL years U/mL U/mL FXI 0-89 days U/mL 89 days 1 year U/mL 1 6 years U/mL 6 11 years U/mL years U/mL U/mL FXII 0-89 days U/mL 89 days 1 year U/mL 1 6 years U/mL 6 11 years U/mL years U/mL U/mL vwf Antigen (U/mL) Blood Group: O A, B, AB vwf Activity U/mL vwf Ristocetin Cofactor M/F U/mL Protein C 0-89 days U/mL 89 days - 1 year U/mL 1 6 years U/mL 6 11 years U/mL U/mL Protein S 0-89 days U/mL 89 days - 1 year U/mL 1 6 years U/mL 6 11 years U/mL M U/mL F U/mL AT 0-89 days U/mL 89 days 1 year U/mL 1 6 years U/mL 6 11 years U/mL years U/mL U/mL APC Resistance Ratio >2.1 Lupus Anticoagulant Ratio PFA 100 >37 weeks up to 2.5 COL/EPI sec years COL/ADP sec 2.5 years 17 years COL/EPI sec COL/ADP sec Adult (18+ years) COL/EPI sec COL/ADP sec Page 22 of 32

23 Hematopathology Blood Tests Test Name Gender Age Range Critical Anti-Xa * no therapeutic range. Ballpark range is U/mL Immunology A1C (%) yrs ASOT M/F >0min IU/mL C3 M/F >0min g/l C4 M/F >0min g/l CRP (mg/l) yrs IgA (g/l) M/F 0 2 mos mos mos mos mos mos mos mos 1yr yrs yrs yrs yrs yrs yrs yrs IgG (g/l) M/F 0 2 mos mos mos mos mos mos mos mos 1yr yrs yrs yrs yrs yrs yrs yrs IgM (g/l) M/F 0 2 mos mos mos mos mos mos mos mos 1yr yrs yrs yrs yrs yrs yrs yrs Page 23 of 32

24 Hematopathology Blood Tests Test Name Gender Age Range Critical Free Kappa (mg/l) yrs Free Lambda (mg/l) yrs Free Kappa/Free Lambda yrs Rheumatoid Factor M/F >0min IU/L SPE - Albumin yrs g/l SPE Alpha yrs g/l SPE Alpha yrs g/l SPE Beta yrs g/l SPE Beta yrs g/l SPE Gamma yrs g/l UPE No reference range UIFE No reference range M Protein Scan No reference range Microbiology Blood Tests Name of Test Specimen Units Low High Critical Type C6 Lyme Disease Antibody Screen Serum (SST) Qualitative N/A N/A N/A Lyme Disease Antibody Screen Serum (SST) Qualitative N/A N/A N/A Anti EBNA Serology Serum (SST) Qualitative N/A N/A N/A EBV IgM Serology Serum (SST) Qualitative N/A N/A N/A Helicobacter pylori Serology Serum (SST) Qualitative N/A N/A N/A HTLV 1 and 2 Serum (SST) Qualitative N/A N/A N/A Measles Antibody IgG Serum (SST) Qualitative N/A N/A N/A Measles Antibody IgM Serum (SST) Qualitative N/A N/A N/A Treponema Pallidum Pa Serum (SST) Qualitative N/A N/A N/A Acute Mononucleosis Screen Serum (SST) Qualitative N/A N/A N/A Mumps Antibody IgG Serum (SST) Qualitative N/A N/A N/A Mumps Antibody IgM Serum (SST) Qualitative N/A N/A N/A Parvovirus B19 IgG Serum (SST) Qualitative N/A N/A N/A Parvovirus B19 IgM Serum (SST) Qualitative N/A N/A N/A Rapid Plasma Reagin Titre Serum (SST) Titer N/A N/A N/A Varicella zoster Immune status Serum (SST) Qualitative N/A N/A N/A Cytomegalovirus Antibody IgM Serum (SST) Qualitative N/A N/A N/A CMV Antibody IgG Serum (SST) Qualitative N/A N/A N/A HIV 1 and 2 Screening Test Serum (SST) Qualitative N/A N/A N/A HIV Western Blot Confirmatory Serum (SST) Qualitative N/A N/A N/A Hepatitis B Core Antibody Serum (SST) Qualitative N/A N/A N/A Hepatitis B Surface Antibody Serum (SST) Qualitative N/A N/A N/A Hepatitis B Surface Antigen Serum (SST) Qualitative N/A N/A N/A Hepatitis C Antibody Serum (SST) Qualitative N/A N/A N/A Hepatitis C Antibody RIBA Confirmation Serum (SST) Qualitative N/A N/A N/A Hepatitis C Genotyping Serum (SST) Qualitative N/A N/A N/A Hepatitis A Antibody IgM Serum (SST) Qualitative N/A N/A N/A Hepatitis A Antibody IgG Serum (SST) Qualitative N/A N/A N/A Rubella Antibody IgG Serum (SST) Qualitative N/A N/A N/A Rubella Antibody IgM Serum (SST) Qualitative N/A N/A N/A Syphilis Screening EIA Serum (SST) Qualitative N/A N/A N/A Toxoplasma Antibody IgG Serum (SST) Qualitative N/A N/A N/A Toxoplasma Antibody IgM Serum (SST) Qualitative N/A N/A N/A ANA Serum (SST) Qualitative N/A N/A N/A Anti-Cardiolipin IgG Serum (SST) GPL unit/ml N/A N/A N/A Anti-Cyclic Citrullinated Peptide Serum (SST) U/mL N/A N/A N/A Page 24 of 32

25 Microbiology Blood Tests Name of Test Specimen Units Low High Critical Type Anti-Mitochondrial 2 Serum (SST) Qualitative N/A N/A N/A Anti-Tissue Transglutaminase IgA Serum (SST) U/mL N/A N/A N/A Vasculitis Panel Serum (SST) AI N/A N/A N/A Hepatitis C Viral Load Serum (SST) log IU/ml N/A N/A N/A HIV Viral Load Plasma (EDTA) Copies/mL N/A N/A N/A Cytomegalovirus Quantitative PCR Plasma (EDTA) IU/mL N/A N/A N/A Name of Test ph Clinical Chemistry Arterial Blood Gas Tests Specimen Type Arterial Blood (Heparinized syringe) Units Low High Interpretive Data Critical ph, PCO2 and PO2 results reflect the GEM4000 device default temperature of 37.0 ºC. <7.20 or >7.60 PCO2 mmhg <20 or >70 PO2 mmhg <60 ph (cor) ph (cor), pco2 (cor) & po2 (cor) are reflecting the patient's actual body temperature. <7.20 or >7.60 pco2 (cor) mmhg <20 or >70 po2 (cor) mmhg <60 HCO3 mmol/l <10 or >40 Base Excess mmol/l O2 Content ml/dl 16.3 M 15.6 F 23.6 M 21.0 F O2 Saturation (SO2) % Hemoglobin oxygen saturation Fractional Oxyhemoglobin (O2Hb) % Fractional oxyhemoglobin Total Hemoglobin g/l 140 M 180 M < F 160 F Carboxyhemoglobin (COHgb) >20.0 % <1.5 (non-smokers) <10.0 (smokers) >20.0 (Toxic) >50.0 (Lethal) Methemoglobin % 1.5 >30.0 (METHgb) Sodium mmol/l <120 or >160 Potassium mmol/l <2.8 or >6.2 Ionized Calcium mmol/l <0.75 or >1.60 Lactate mmol/l >4.0 Page 25 of 32

26 Name of Test ph Clinical Chemistry Venous Blood Gas Tests Specimen Type Venous Blood (Heparinized syringe) Units Low High Interpretive Data Critical ph, PCO2 and PO2 results reflect the GEM4000 device default temperature of 37.0 ºC. PCO2 mmhg PO2 mmhg Reference ranges are not established for venous blood ph (cor) ph (cor), pco2 (cor) & po2 (cor) are reflecting the patient's actual body temperature. pco2 (cor) mmhg po2 (cor) mmhg Reference ranges are not established for venous blood HCO3 mmol/l <10 or >40 Base Excess mmol/l Reference ranges are not established for venous blood O2 Content ml/dl 13.1 M 17.6 M O2 Saturation (SO2) 11.6 F 15.6 F % Hemoglobin oxygen saturation Reference ranges are not established for venous blood Fractional Oxyhemoglobin (O2Hb) % Fractional oxyhemoglobin Reference ranges are not established for venous blood Total Hemoglobin g/l 140 M 180 M <70 Carboxyhemoglobin (COHgb) 120 F 160 F % <1.5 (non-smokers) <10.0 (smokers) >20.0 (Toxic) >50.0 (Lethal) Methemoglobin % 1.5 >30.0 (METHgb) Sodium mmol/l <120 or >160 Potassium mmol/l <2.8 or >6.2 Ionized Calcium mmol/l <0.75 or >1.60 Lactate mmol/l >4.0 >20.0 Page 26 of 32

27 Name of Test Central Zone Point Of Care (POC) Arterial Blood Gas Tests Specimen Type Units Low High Interpretive Data (Chartable) Critical POC ph Arterial ph, pco2, & po2 <7.20 or >7.60 POC pco2 Blood mmhg results reflect the <20 or >70 (Heparinized GEM4000 device POC po2 Syringe) mmhg default temperature <60 of C. POC ph (cor) ph (cor), pco2 (cor) <7.20 or >7.60 POC pco2 (cor) mmhg & po2 (cor) are <20 or >70 reflecting the POC po2 (cor) mmhg patient's actual body <60 temperature. POC HCO3 mmol/l <10 or >40 POC Base Excess mmol/l POC O2 Saturation % Hemoglobin oxygen saturation POC O2Hb % Fractional oxyhemoglobin POC Total Hemoglobin g/l 140 M 180 M < F 160 F POC COHgb % <1.5 (non-smokers) >20.0 <10.0 (smokers) >20.0 (Toxic) >50.0 (Lethal) POC METHgb % 1.5 >30.0 POC Sodium mmol/l <120 or >160 POC Potassium mmol/l <2.8 or >6.2 POC Chloride mmol/l POC Ionized Calcium mmol/l <0.75 or >1.60 POC Lactate mmol/l >4.0 POC Glucose mmol/l <2.2 or >25.0 Page 27 of 32

28 Name of Test Central Zone Point of Care (POC) Venous Blood Gas Tests Specimen Type Units Low High Interpretive Data (Chartable) Critical POC ph Venous ph, pco2, & po2 results POC pco2 Blood mmhg reflect the GEM4000 (Heparinized device default POC po2 Syringe) mmhg temperature of C. Reference ranges are not established for venous blood. POC ph (cor) ph (cor), pco2 (cor) & POC pco2 (cor) mmhg po2 (cor) are reflecting the patient's actual body POC po2 (cor) mmhg temperature. Reference ranges are not established for venous blood. POC HCO3 mmol/l <10 or >40 POC Base Excess mmol/l Reference ranges are not established for venous blood. POC O2 Saturation % Hemoglobin oxygen saturation. Reference ranges are not established for venous blood. POC O2Hb % Fractional oxyhemoglobin. Reference ranges are not established for venous blood. POC Total Hemoglobin g/l 140 M 180 M < F 160 F POC COHgb % <1.5 (non-smokers) >20.0 <10.0 (smokers) >20.0 (Toxic) >50.0 (Lethal) POC METHgb % 1.5 >30.0 POC Sodium mmol/l <120 or >160 POC Potassium mmol/l <2.8 or >6.2 POC Chloride mmol/l POC Ionized Calcium mmol/l <0.75 or >1.60 POC Lactate mmol/l >4.0 POC Glucose mmol/l <2.2 or >25.0 Page 28 of 32

29 Clinical Chemistry Urine Tests Name of Test Specimen Gender Units Low High Critical Type Alb/Creat Ratio Random M/F mg/mmol <3.0 mg/mmol URINE ALBUMIN/CREATININE RATIO = ALB/CREAT RATIO = (U ACR) (Previously referred to as microalbuminuria) Normal-mildly increased: <3.0 mg/mmol Moderately increased: mg/mmol Severely increased: >30.0 mg/mmol For more information on Chronic Kidney Disease (CKD) identification, management and referral: Amylase 24 Hr & M/F U/Hr U/TV 0 none 16 none timed Reference Values are for adults; reference ranges have not been established for children. Calcium 24 Hr M mmol/tv F Reference ranges are based on individuals consuming an average daily intake of 600 to 800 mg of calcium per day. Catecholamines: Epinephrine Catecholamines: Norepinephrine Catecholamines: Dopamine Chloride Reference ranges are for adults; reference ranges have not been established for children. 24 Hr M/F nmol/tv >18yr Random M/F µmol/mol 0-11mth: urine 1-4 yrs: creatinine 4-10 yrs: yrs: >18 yrs: Hr M/F nmol/tv >18yr Random M/F µmol/mol urine creatinine 24 Hr M/F >18yr Random M/F >18yr 24 Hr & random 0-11mth: yrs: yrs: yrs: >18 yrs: nmol/tv µmol/mol urine creatinine 0-11mth: yrs: yrs: yrs: >18 yrs: M/F mmol/tv Reference Values are for adults; reference ranges have not been established for children. Citrate 24 Hr M/F mmol/tv 1.7 Reference Values are for adults; reference ranges have not been established for children. Cortisol 24 hr M/F nmol/tv Reference ranges are for adults; reference ranges have not been established for children. Page 29 of 32

30 Name of Test Cortisol/Creatinine ratio Creatinine Creatinine Clearance Glucose Human Chorionic Gonadotropin (qualitative) Magnesium Clinical Chemistry Urine Tests Specimen Type Gender Units Low High Critical calculation M/F ratio Not established 24 Hr & timed 24 Hr & timed 24 Hr & random M mmol/tv F Reference Values are for adults; reference ranges have not been established for children. M/F ml/s Reference ranges are for adults; reference ranges have not been established for children. M/F mmol/tv <2 Reference Values are for adults; reference ranges have not been established for children. urine M/F IU/L The detectable level of HCG concentration of Stanbio QuPID test is as low as 20 IU/L. The following are possible limitations of this assay: 1) Positive, but very low levels of hcg can be present shortly after implantation. 2) If the level of hcg at the time of collection is below the sensitivity of the test (20 IU/L), a false negative or slightly positive is possible. 3) False positive results are possible due to conditions other than pregnancy and interference by human anti-mouse antibodies (HAMA). Any questionable result should be confirmed with a 48-hour repeat or a quantitative serum hcg. Reference values are for adults; reference ranges have not been established for children. 24 Hr & random M/F mmol/tv Reference Values are for adults; reference ranges have not been established for children. Osmolality 24 Hr & M/F mm/kg 0-15 yrs: yrs: 600 random 16 yrs: yrs: 1400 Oxalate 24 Hr M µmol/tv F Reference Values are for adults; reference ranges have not been established for children. Very high ascorbic acid (Vitamin C) can interfere at levels over 16 umol/tv. Patients should refrain from taking excessive amounts of Vitamin C or Vitamin C rich food for at least 48 hours prior to urine collection. ph 24 Hr & random M/F Not established Phosphorus 24 Hr M/F mmol/tv Reference Values are for adults; reference ranges have not been established for children. Potassium 24 Hr & random M/F mmol/tv <2 or >200 Reference Values are for adults; reference ranges have not been established for children. Pro/Creat Ratio Random M/F g/mmol <0.024 URINE PROTEIN/CREATININE RATIO = PRO/CREAT RATIO = (U PCR) (Previously referred to as proteinuria) Protein 24 Hr & random M/F g/l Reference values are for adults; reference ranges have not been established for children. 24 hour at rest: g/tv 24 hour excretion: <0.30 g/tv Page 30 of 32

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