CLLS 5260A

Basic Lab Math

How to Calculate

CONTENTS:
Simple Arithmetic ......................................................................................................................... 2
Metric System and Conversions: Volume, Weight, Distance ................................................ 2
Temperature Conversion ............................................................................................................ 3
Inches to cm and Pound to kg.................................................................................................... 3
Rounding ....................................................................................................................................... 3
Percent Solutions ......................................................................................................................... 3
Adult Blood Volume ................................................................................................................. 4
Infant Blood Volume ................................................................................................................ 4
Solutions From Solutions ............................................................................................................ 5
Dilutions ......................................................................................................................................... 5
Basic Statistics.............................................................................................................................. 8
Mean........................................................................................................................................... 8
Median ....................................................................................................................................... 8
Mode........................................................................................................................................... 8
Range ......................................................................................................................................... 8
Coefficient of Variation ............................................................................................................ 8
Standard Deviation .................................................................................................................. 8
Diagnostic Sensitivity and Specificity ........................................................................................ 9
Probability .................................................................................................................................... 10
Screening Antigen-Negative RBC Units ................................................................................. 10
G Force ........................................................................................................................................ 11
Half-Life........................................................................................................................................ 11

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Simple Arithmetic

To add or subtract exponents, the power must be the same. (2.5 x 104) + (3.4 x 103)
= (2.5 x 104) + (0.34 x 104) = 2.84 x 104

(1.4 x 106) - (5.8 x 105)

= (1.4 x 106) - (0.58 x 106) = 0.82 x 106 or
8.2 x 105
When multiplying exponents, the power is added. (3 x 105) x (4 x 103)
= 12 x 108 (or 1.2 x 109)

When dividing exponents, the power of the denominator is (6 x 106) = 3 x 104

subtracted from the power of the numerator (2 x 102)

Perform the math within the parenthesis before moving on to the Correct
calculations outside of the parenthesis C = 5/9 (ºF - 32)
C = 5/9 (98 - 32) = 36.66666 or 37º

Incorrect
5/9 ºF - 32
5/9 * 98 - 32 = 22.4444444 or 22 ºC

When multiplying fractions: multiply the numbers in the 2 x4 = 8

numerator for the new numerator; multiply the numbers in the 3 5 15
denominator for the new denominator.

When dividing fractions: invert the fraction that is used as the 𝑎𝑎

÷
𝑎𝑎
=
𝑎𝑎
x
𝑏𝑏
𝑏𝑏 𝑏𝑏 𝑏𝑏 𝑎𝑎
denominator, and then multiply the numbers in the numerator for
the new numerator; multiply the numbers in the denominator for
= 20/40 =1/2
the new denominator.

Metric System and Conversions: Volume, Weight, Distance

Metric System is the system of measurement used in the healthcare industry. The metric system is a
decimal system (a system based on the number 10), units larger or smaller than the basic units are
arrived at by multiplying or dividing by 10 or powers of 10.

m = meter = measures distance

g = gram = measures weight
L = liter = measures volume

Prefix Multiple Meter gram liter

Kilo- (k) 1,000 (103) km kg kL
Base Unit 100 m g L
Deci- (d) 0.1 (10-1) dm dg dL
Centi- (c) 0.01 (10-2) cm cg cL
Milli- (m) 0.001 (10-3) mm mg mL
Micro- (µ) 0.000001 (10-6) µm µg µL

If we put the above prefixes together with the unit of volume measurement, we have:
1 dL = [1 x 10-1L] and 1 L = [1 x 10¹dL] OR 1 dL = 100 mL = 0.1 L
1 cL = [1 x 10-2 L] and 1 L = [1 x 10²cL]
1 mL = [1 x 10-3 L] and 1 L = [1 x 10³ mL]
1 µL = [1 x 10-6 L] and 1 L = [1 x 106 uL] OR 1 µL = 0.1 mL

Therefore, a dL is the same thing as saying 10-1L.

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An mL is the same as saying 10-3 L. It is just an abbreviation.

Examples:

1 Two deciliters equals how many milliliters? 1 dL = [1.0 x 10-1 L]

1 L = [1.0 x 103 mL]

(2 dL) x (1.0 x 10-1 L) x (1.0 x 10³mL)

dL L
= 2.0 x 10² mL or 200 mL

2 Convert 20 mg/dL to mg/µL. [20 mg] x [10-1 dL] x [10-6 L]

dL 1L 1µL

= 20 x 10¹ x 10-6 mg/µL

= 20 x 10-5 mg/µL
or 2.0 x 10-4 mg/µL

3 Convert 95 mg/dL to µg/mL [95 mg/dL] x [10¨³ g] x [106 µg] x [10¹dL] x [10¨³ L]
mg g L mL

= 95 µg/mL x 10
= 9.5 x 102 µg/mL

Temperature Conversion

Remember, perform the math within the parenthesis before moving on to the calculations outside of the
parenthesis.

F = 9/5 ºC + 32 no parenthesis here

C = 5/9 (ºF - 32) parenthesis here

Let’s look at information that you already know:

0ºC = 32ºF, and room temperature is 72 oF or about 22 oC

Now let's see if the formulas work.

ºF = 9/5 (22) + 32; ºF = 71.6 or 72 ºC

Inches to cm and Pound to kg

Here are some other equivalents that might be helpful in medical conversions.

Distance Inch (in) = 2.54 centimeters (cm)

Centimeter (cm) = 0.4 inches

Weight Pound (lb) = 0.454 kilograms (kg)

Kilogram (kg) = 2.2 pounds
Rounding
Round up to the next number at 0.5 or greater fraction and down at less than 0.5 fraction.

For example, round the following numbers to one significant number:

2.44444 is rounded down to 2
2.544233 is rounded up to 3

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Percent Solutions
There are three types of percent solutions. All are parts of solute per 100 total parts of solution.
Explanation Example

% as weight per weight Percent of weight of solute in the total A 100% (W/W) NaCl solution is
(% W/W) weight of the solution. Percent here is made by weighing 100 g NaCl
the number of grams of solute in 100 made up to 100 g of solution.
grams of solution.
% as volume per Percent of volume of solute in the total A 10% (V/V) ethanol solution is
volume volume of solution %V/V. Percent here is 10 mL of ethanol in 100 mL of
% V/V the number of milliliters of solute in 100 solution; unless otherwise stated,
mL of solution. water is the solvent
% as weight per volume Percent of weight of solution in the total A 4% (W/V) NaCl solution is 4 g
% W/V volume of solution. Percent here is the of NaCl made up to 100 mL of
number of grams of solute in 100 mL of solution.
solution. This is the most common way
of expressing a percent solution. In fact,
any percent solution not stipulated as
W/W, W/V, or V/V is assumed to be %
W/V.

Examples:

Question Answer
1 What is the percent concentration of a 5.85 g = 5.85% W/V solution of NaCl
solution if 5.85 g NaCl is diluted to 100 mL 100 ml
with H20?

2 What is the percent concentration of a 40 g/500 mL = X g/100 mL; X = 8 g

solution if 40 g CaCl2 is diluted to 500 mL 8 g in 100 mL = 8% (W/V) solution
with H20?

3 How would you make 250 mL of an 8.5% 8.5% = 8.5 g

NaCl solution? 100 mL

8.5 g/100 mL = X g/250 mL; X = 21.3 g

Weight out 21.3 g NaCl made up to 250 mL with H2O
4 How much (volume) 0.85% NaCl may be An 0.85% NaCl solution = 0.85 g/100 mL
made from 2.55 g NaCl? Set up a proportion:
0.85 g/100 mL = 2.55 g/X; X = 300 mL

Adult Blood Volume – REMEMBER 2.2 lbs/kg

Blood volume is based on body weight in kilogram.
An adult has 60-70 mL/kg, depending on the reference used.
Technical Manual says 60 mL/kg (female) and 66 mL/kg (male).
Example: an adult male weighing 150 lb is 68.2 kg and has 4.5 L total blood volume.

Infant Blood Volume

It is important to be able to estimate the blood volume of an infant, ICU, removal of 10% of an infant’s
blood volume in a short time can lead to serious consequences.
Full term neonate = 85 mL/kg
Preterm neonate = 105 mL/kg

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Making Solutions from Solutions

Sometimes solutions are made from more concentrated solutions rather than dry chemicals. The formula
for determining how to make these solutions is:
V1C1 = V2C2
Where, V1 is the volume of the more concentrated solution
and C1 is the concentration of the more concentrated solution
and V2 is the volume of the less concentrated solution
and C2 is the concentration of the less concentrated solution

Concentration may be in units of % or other units.

Another way to state the formula is the volume of a concentrated solution times its concentration will
contain the proper amount of chemical to give the volume of a weaker solution times its concentration.

1 How much saline must you add to 5 mL of V1C1 = V2C2

20% solution to make a 5% solution? (5 mL) (20%) = (x) (5%)
x = 20 mL

Add 15 mL of saline to the 5 mL of the more concentrated

solution.

Dilutions

There are several terms used in expressing dilution:

1. Dilution - Dilutions are expressed as the ratio of the quantity of a desired solute (serum, urine,
chemical solution, etc.) contained in a solvent (diluent). A 1:10 dilution of serum was made by adding one
part serum to nine parts diluent to make a total of ten parts. If 1.0 milliliter of serum is added to 9.0
milliliters of H20, a total volume of 10.0 milliliters is obtained. Therefore, the dilution is expressed
according to the following equation.

Volume of serum/volume of solution = 1.0 mL serum .

1.0 mL serum + 9 mL solution

Dilution = 1:10 total. This means that each milliliter of solution contains 1/10 as much serum as each mL
of the original serum. Another way to say this is a serum sample was diluted 1:10 with H20.

One precaution: Some people write ratio meaning the amount of solute in proportion to the amount of
solute. If you are unsure of someone's intent, ask him or her to clarify.

2. Diluted to - This is essentially the same as "dilution." If 1 mL is diluted to 10 mL, enough diluent is
added to the original volume to yield a final, total volume of 10 mL.

For example, if a 1 mL serum is diluted to 10 mL solution, 9 mL H20 is added to the original serum
sample. Using this information, one can see why "diluted to" is the same as "dilution" using the following
equation:

Volume of serum/total volume of solution = 1 mL/10 mL = 1:10

One mL serum was diluted to 10 mL.

3. Added to - This expression is usually a hang-up since it is not the same as "diluted to." "Added to"
refers to the volume of the solute added to a specified volume of solvent.

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For example, if 1 mL serum is added to 10 mL H20, this means 1 mL + 10 mL yields a total volume of 11
mL. If you expressed this using one of the above terms you must say 1 mL was added to 10 mL or 1 mL
was diluted to 11 mL. This means a 1/11 dilution was made since:
volume of serum/total volume of solution = 1 mL serum/[1 mL serum +10 mL H20] = 1:11

4. Serial dilution - This term is frequently used and refers to a "multiple" dilution problem. In other words,
an initial dilution is made and then this dilution is used to make a second dilution, and so on.

For example, a 1:2 serial dilution is made using a 1 mL volume of serum. This expression indicates that 1
mL of serum is added to 1 mL of H20 and then mixed. This initial dilution is 1:2. Then, 1 mL of this dilution
is added to 1 mL of H20 further diluting the sample. This same process is continued.

Dilutions must be used carefully and the calculation of dilution factors must be done accurately, since an
error may seriously affect a test result. Read the following material closely in order to understand the
variety of ways dilutions are used.

Preparation of Dilutions
The first rule in performing dilutions is careful reading of procedural instructions. For example:
"A 1 mL-serum specimen diluted to 50 mL is not the same as: "A 1 mL serum specimen added to 50 mL."

If several dilutions are made in succession of one another, the final dilution can be calculated by simply
multiplying each dilution factor involved. To illustrate, consider the following situations:
A serum specimen was diluted 1:20 and then 2 mL of that was diluted to 10 mL, and 1 mL of that was
added to 4 mL using H20. Exactly 2 mL of this last dilution was discarded, and the remainder was diluted
to 30 mL. What was the final dilution of the serum specimen? Read each portion carefully.

1/20 x 2/10 x 1/5 x 3/30 = 6/30,000 = 1/5,000 or 1:5000

Remember when you multiply fractions, you multiply the numbers in the numerator for the new numerator
and you multiply the numbers in the denominator for the new denominator. Always reduce the final
answer to a fraction with the lowest possible denominator.

In the Immunology or Serology area of the lab, serial dilutions, sometimes referred to as serological
dilutions, are extensively used in the test procedures. Serial dilutions usually refer to dilutions of the same
proportion made repeatedly from the previous dilution. The directions for preparing these serial dilutions
may be written several ways. To illustrate, consider the following two examples:

Example 1:
Eight test tubes are placed in a rack. To the first tube, add 3 mL of saline. To each of the remaining seven
tubes add 2 mL of saline. To the first tube add 1 mL of serum and mix well. Transfer 2 mL of tube # 1 to
tube # 2 and mix well. 2 mL of the contents of tube # 2 is then transferred to tube # 3, and the procedure
is repeated for the remaining tubes, finally discarding 2 mL from the last tube. What is the dilution of
serum in tube # 8?

Dilution 1/4 x 2/4 x 2/4 x 2/4 x 2/4 x 2/4 x 2/4 x 2/4 = 1/512

Example 2:
One mL of serum is added to 3 mL of saline in the first tube of a series of eight. A 1:2 serial dilution is
then made. What is the dilution of serum in the 8th tube?
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1/4 x 2/4 x 2/4 x 2/4 x 2/4 x 2/4 x 2/4 x 2/4 = 1/512

Both example 1 and example 2 illustrate how the same serial dilution problem may be expressed in two
different ways. In the first example, a step-by-step procedural outline is provided. Go back and look at
example 1. In the first tube, 1 mL of serum was added to 3 mL of saline. To calculate the dilution
contained in this tube, apply the following.

Volume serum/total volume of solution = 1mL/l mL serum + 3 mL saline = 1/4

In the second tube, 2 mL of the first dilution was added to 2 mL of saline:

1/4 x 2/4 or 1/4 x 1/2 = 1/8 in 2nd tube

By transferring 2 mL of dilution from one tube to a second tube containing 2 mL of saline, and continuing
to do so, this is actually making a 1:2 serial dilution.

There exists a simplified equation, which can be used in calculating the dilution of a particular tube in a
serial dilution:

Original dilution x (dilution factor)n-1

Where, n = the number of tubes
and n-1 is the exponent or power to which the dilution is raised

To apply this equation the dilution factor in the original tube must first be determined. Secondly, the
dilution factor of subsequent tubes must be determined. Remember back to the two examples given. In
the first tube, a 1:4 dilution is made. The dilution factor of each subsequent tube was 1:2. Therefore,
1/4 (1/2)7 = 1/512

Sometimes you have to set tubes up for a serial dilution and calculate how much solute needs to be
added to solvent to obtain a certain serial dilution. For example, if you wanted to make a 1:2 serial dilution
and have 1 mL of solution remaining in each tube, you do the following.
1) Final volume remaining = solvent volume
2) Set up a proportion: serial dilution = solute volume .
solute volume + solvent volume
In the above problem, the remaining volume of 1 mL is the same as the solvent volume. Plugging that in
the second
1/2 = x/(x + 1 mL)
1 = 2x/(x + 1 mL)
1(x + 1 mL) = 2x
x + 1 mL = 2x
1 mL = 2x – x or 1 mL = 1x

Therefore, the amount of solute is 1 mL added to each tube of 1 mL solvent (1/2 dilution).
Let's try another problem. You want to make a 1/4 dilution with the final volume in each tube of 1.5 mL.
1) The solvent volume is 1.5 mL
2) The solute volume:
1/4 = x/[x + 1.5 mL]
1 = 4x/[ x + 1.5 mL ]
1(x + 1.5 mL) = 4x
x + 1.5 mL = 4x
1.5 mL = 4x -x
1.5 mL = 3x
0.5 mL = x

This means that 0.5 mL of solute will be added to 1.5 mL of solvent (0.5 mL + 1.5 mL = 2.0 mL or 1:4
dilution) mixed and the 0.5 mL is removed (leaving 1.5 mL) and added to the next tube with 1.5 mL
solvent.

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Determining Concentrations of Dilutions
If you want to determine the concentration of a substance in a particular dilution, you multiply the original
concentration times the dilution. To illustrate consider the following:

Example 1: You had a solution with 4 g of glucose per mL (4g/mL). You dilute this original solution by
adding 1 mL of it to 9 mL of water. What is the dilution you prepared?
By adding 1 mL of solution to 9 mL of water, you have prepared a 1:10 dilution. Therefore:
4 g/mL x 1/10 = 4 g/mL/10 = 0.4 g/mL

Example 2: If you had a 100 mg/dL solution of glucose and made a 1:5 dilution, what concentration of
glucose is contained in the dilution?
100 mg/dL x 1/5 = 100 mg/dL/5 = 20 mg/dL

Basic Statistics

For details:
Standard deviation for lab: http://www.qcnet.com/Portals/50/PDFs/QCWorkbook2008_Jun08.pdf
Standard deviation for lab: https://www.westgard.com/lesson34.htm
Practice problems: http://www.mathsisfun.com/mean.html

Mean
The arithmetic average, written as X with a bar on top

Median
The middle value of a body of data

Mode
The most frequently occurring variable in a mass of data

Range
The difference between the highest and lowest values in the sample or population

Coefficient of Variation
Examines the SD as a percentage (s/x) x 100

Standard Deviation
The Square root to the variance and characterizes the dispersion of the variables around the mean. The
symbol for the population SD is σ. The symbol for a sample SD is s:

Where
X = individual value
X bar = mean, the arithmetic average
N = sample size

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Diagnostic Sensitivity and Specificity
Clinical research often investigates the statistical relationship between symptoms (or test results) and the
presence of disease. Chi-square analysis can be applied to the data in the form of a 2 by 2 table in order
to assess the statistical significance of the association between the presence or absence of a symptom
and the presence or absence of the disease under study. When significant associations are found, it is
useful to express the data in ways which are clinically relevant. In order to communicate the results in a
consistent manner, the following definitions have been developed. Note: Analytical sensitivity and
specificity are not the same as diagnostic sensitivity and specificity.

The probability that a symptom is present (or screening test is

Sensitivity a/ (a+c) positive) given that the person has the disease. This is also known
as the true positive rate
The probability that a symptom is not present (or screening test
Specificity d/(b+d) is negative) given that the person does not have the disease.
This is also known as the true negative rate
Predictive value TP/(TP+FP) The probability that a person has the disease given a positive
positive a/(a+b) test result
Predictive value TN/( TN+FN) The probability that a person does not have the disease given a
negative d/(c+d) negative test.

How do you determine the cutoff? This may be lab or test dependent.
In general, specificity should be high (>80%) to rule in the diagnosis of a disease.

Please memorize this formula a, b, c, d

Disease
Diagnostic a = TP (true positive)
Present Absent b = FP (false positive)
Test
c = FN (false negative)
Test + a b a+b
d = TN (true negative)
Test - c d c+d
a+c b+d a+b+c+d

Or you can memorize this formula

Disease
Diagnostic a = TP (true positive)
Present Absent b = FP (false positive)
Test
c = FN (false negative)
Test + TP FP TP+FP
d = TN (true negative)
Test - FN TN FN+TN
TP+FN FP+TN

Example:
PSA assay at medical decision limit; + is above medical limit and 0 is below limit
n = 113
Patients with prostate cancer and + test: 33 = True Positives
Patient with prostate cancer and 0 test: 37 = False Negatives
Control without prostate cancer and + test: 4= False Positives
Control without prostate cancer and 0 test: 39 =True Negatives

Construct 2 x 2 table:
Disease + Disease - Sensitivity = 33/33+37 = 47%
PSA + 33 4 Specificity = 39/4+39 = 91%
PSA - 37 39

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Probability

In the blood bank, probability is the chance that an antibody has been correctly identified, in which the
numbers of positive and negative results are compared with the number of cells that express or lack the
corresponding antigen. The p value is a conditional term when used in antibody identification. A value of
0.05 is generally accepted as a minimum value for a valid interpretation statistically (95% probability). P
value of 0.05 means that there is 5% chance of error.

p = (A+B)! x (C+D)! x (A+C)! x (B+D)!

N! x A! x B! x C! x D! A = # positive tests with Ag + RBCs (true positives)
B = # positive tests with Ag = RBCs (false positives)
C = # negative tests with Ag + RBCs (false negatives)
D = # negative tests with Ag = RBCs (true negatives)
! = the symbol for factorial, the product of all whole #’s
from 1 to the number involved
Example: 6! = 6 x 5 x 4 x 3 x 2 x 1 = 720
Reaction Ag + Ag -
Positive A B A+B
Negative C D C+D
A+C B+D N

Example:
What is the p if a serum reacts positive with 3 S+ RBCs and negative with 3 S- red cells?

p = 3! X 3! X 3! X 3! = 3! X 3! =1 = 0.05
6! X 3! X 0! X 3! X 0! 6! 20

0! Is a null number. It is not zero.

Reaction S+ S- N
Positive 3 0 3
Negative 0 3 3
3 3 6

Resources for the use of Fisher’s Exact Test

Good explanation: http://en.wikipedia.org/wiki/Fisher's_exact_test
This site is a calculator – it does the math for you: http://faculty.vassar.edu/lowry/fisher.html

Screening Antigen-Negative RBC Units

1 – (frequency of antigen 1) = X
1 – (frequency of antigen 2) = Y

# units needed = # units needed to screen

(X x Y)

Example:

How many RBC units should be screened for a patient with anti-K and -Jka?
(Assume antigen frequency: Jka = 79% and K = 9%)

4 units = 21 units
(0.21 x 0.91)

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G Force

If R = radius in inches if R is measured in cm:

RCF (g) = 28.38 x R x (RPM/1000)2 RCF (g) = (0.00001118)( r )(rpm)2

Example:
A Sorvall centrifuge has a radius of 9 inches. If whole blood is centrifuged at 3000 x g for 6 minutes, what
is the RPM?

RPM = √ [RCF/(28.38 x R)] x 1000

RPM = √ [3000/(28.38 x 9)] x 1000

RPM = √ [3000/(255.42)] x 1000

RPM = √ 11.75 x 1000

RPM = 3.43 x 1000

RPM = 3430

Half-Life

Half-life (t½) is the time required for a quantity to fall to half its value as measured at the beginning of the
time period.

Example:
A woman received antepartum RhIG at week 29. Approximately how much RhIG remains at week 40 at
delivery?

One dose of RhIG contains 300 μg of IgG anti-D

Half-life of IgG is 21-25 days, depending on the reference.
Let’s use 25 days for this calculation.

Day 0 = 300 μg
Day 25 = 150 μg
Day 50 = 75 μg
Day 75 = 38 μg
Day 100 = 19 μg

The number of days from week 29 to week 40 is 77 days (11 weeks x 7 days).
Approximately 38 μg of IgG remains.

Rev. DR 08/2023