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    Blood test Blood test Document Transcript

    • BLOOD TEST CLINICAL SIGNIFICANCEThe listings below discuss a few of the more common things measured in chemistry andhematology tests and their clinical significance. TESTS CLINICAL NORMAL SIGNIFICANCE RANGEPROFILESLYTES Why get tested? NA: 132-142 mmol/LCentrifuge specimen and refrigerate if To detect a problem with K: 3.6-5.0 mmol/Lpickup time is more than 2 hrs. the body’s electrolyte CL: 101-111 mmol/L balance CO2: 21-31 mmol/L When to get tested? Anion Gap: 6-16 As part of routine health screening, or when your doctor suspects that you have an excess or deficit of one of the electrolytes (usually sodium or potassium), or if your doctor suspects an acid- base imbalanceBASIC METABOLIC PANEL (BMP) The Basic Metabolic Panel GLUC: 60-110 mg/dCentrifuge specimen and refrigerate if (BMP) is a group of 8 tests BUN: 8-24 mg/dLpickup time is more than 2 hrs. (or sometimes 7 tests) that CRET: 0.9-1.6 mg/dL is ordered as a screening CA: 8.4-10.7 mg/dL tool to check for conditions, NA: 132-142 mmol/L such as diabetes and kidney K: 3.6-5.0 mmol/L disease. The BMP uses a CL: 101-111 mmol/L tube of blood collected by CO2: 21-31 mmol/L inserting a needle into a Anion Gap: 6-16 vein in your arm. Fasting for 10 to 12 hours prior to the blood draw may be preferred. The BMP is often ordered in the hospital emergency
    • BASIC METABOLIC PANEL (BMP) room setting because its(CON’T) components give your doctor important information about the current status of your kidneys, electrolyte and acid/base balance, and blood sugar level. Significant changes in these test results can indicate acute problems, such as kidney failure, insulin shock or diabetic coma, respiratory distress, or heart rhythm changes. The BMP is also used to monitor some known conditions, such as hypertension and hypokalemia (low potassium level). If your doctor is interested in following two or more individual BMP components, he may order the entire BMP because it offers more information. Alternatively, he may order an electrolyte panel to monitor your sodium, potassium, chloride, and CO2. If your doctor wants even more information, he may order a complete metabolic panel.COMPREHENSIVE METALBOIC The Comprehensive GLUC: 60-110 mg/dPANEL (CMP) Metabolic Panel (CMP) is a BUN: 8-24 mg/dLCentrifuge specimen and refrigerate if frequently ordered group of CRET: 0.9-1.6 mg/dLpickup time is more than 2 hrs. 14 tests that gives your TBIL: 0.0-1.2 mg/dL doctor important ALKP: 49-142 IU/L information about the SGOT: 16-49 IU/L current status of your SGPT: 10-60 IU/L kidneys, liver, and TP: 6.1-8.0 g/dL electrolyte and acid/base ALB: 3.2-5.5 g/dL balance as well as of your CA: 8.4-10.7 mg/dL
    • COMPREHENSIVE METALBOIC blood sugar and blood NA: 132-142 mmol/LPANEL (CMP) (CON’T) proteins. Abnormal results, K: 3.6-5.0 mmol/L and especially combinations CL: 101-111 mmol/L of abnormal results, can CO2: 21-31 mmol/L indicate a problem that Anion Gap: 6-16 needs to be addressed. The CMP is used as a broad screening tool to check for conditions such as diabetes, liver disease, and kidney disease. It is also used to monitor complications of diseases or side effects of medications used to treat diseases. The CMP is routinely ordered as part of a blood work-up for a medical exam or yearly physical and is collected by inserting a needle into a vein in your arm. Usually fasting for 10 to 12 hours prior to the blood draw is preferred. While the tests are sensitive, they do not usually tell your doctor specifically what is wrong. Abnormal test results or groups of test results are usually followed-up with other specific tests to confirm or rule out a suspected diagnosis. The CMP is also used to monitor some known problems, such as hypertension, and drug therapies, such as cholesterol-lowering drugs. If your doctor is interested in following two or more individual CMP components, s/he may order the entire CMP because it
    • COMPREHENSIVE METALBOIC offers more information.PANEL (CMP) (CON’T)LIPID PANEL The lipid profile is a group TGL: mg/dL of tests that are often Normal= <150 Borderline = 150-199 ordered together to High = 200-499 determine risk of coronary Very High = >500 heart disease. The tests that CHOL: mg/dL make up a lipid profile are Desirable <200 tests that have been shown Borderline 200-239 High > or = 240 to be good indicators of HDL: 40-59 mg/dL whether someone is likely Cal. LDL: mg/dL to have a heart attack or Optimal <100 stroke caused by blockage Near 100-129 of blood vessels (hardening Borderline 130-159 High 160-189 of the arteries). Very High >190LIVER PANEL A liver panel, also known TBIL: 0.0-1.2 mg/dL as liver (hepatic) function DBIL: 0.0-0.2 mg/dL tests or LFT, is used to IBIL: 0.0-0.1 mg/dL detect liver damage or ALKP: 49-142 IU/L disease. It usually includes SGOT: 16-49 IU/L seven tests that are run at SGPT: 10-60 IU/L the same time on a blood ALB: 3.2-5.5 g/dL sample.CHEMISTRYALBUMIN INCREASED absolute 3.2-5.5 g/dL serum albumin content is not seen as a natural condition. Relative increase may occur in hemoconcentration. Absolute increase may occur artificially by infusion of hyperoncotic albumin suspensions. DECREASED serum albumin is seen in states of decreased synthesis (malnutrition, malabsorption, liver disease, and other chronic diseases), increased loss (nephritic syndrome, many GI conditions, thermal burns, etc.), and increased catabolism (thyrotoxicosis,
    • ALBUMIN (CON’T) cancer chemotherapy, Cushing’s disease, familial hypoproteinemia).ALKALINE PHOSPHATASE INCREASED serum 49-142 IU/L alkaline phosphatase is seen in states of increased osteoblastic activity (hyperparathyroidism, osteomalacia, primary and metastatic neoplasms), hepatobiliary diseases characterized by some degree of intra- or extrahepatic cholestasis, and in sepsis, chronic inflammatory bowel disease, and thyrotoxicosis. Isoenzymes determination may help determine the organ/tissue responsible for an alkaline phosphatase elevation. DECREASED serum alkaline phosphatase may not be clinically significant. However, decreased serum levels have been observed in hypothyroidism, scurvy, kwashiorkor, achrondroplastic dwarfism, deposition of radioactive materials in bone, and in the rare genetic condition hypophosphatasia. There are probably more variations in the way in which alkaline phosphatase is assayed than any other enzyme. Therefore, the reporting units vary from place to place. The reference range for the assaying laboraotory must be carefully studied when interpreting any individual result.
    • ALT (SGPT) INCREASE of serum 10-60 IU/L alanine aminotransferase (ALT, formerly called “SGPT”) is seen in any condition involving necrosis of hepatocytes, myocardial cells, erythrocytes, or skeletal muscle cells.AMYLASE Why get tested? 25-125 U/L To diagnose pancreatitis or other pancreatic diseases When to get tested? If you have symptoms of a pancreatic disorder, such as severe abdominal pain, fever, loss of appetite, or nauseaAST (SGOT) INCREASE of aspartate 16-49 IU/L aminotransferase (AST, formerly called “SGOT”) is seen in any condition involving necrosis of hepatocytes, myocardial cells, or skeletal muscle cells. DECREASED serum AST is of no known clinical significance.ASO, TITER Antistreptolysin O (ASO) 0-100 IU/mL titer is a blood test used to help diagnose a current or past infection with Group A strep (Streptococcus pyogenes). It detects antibodies to streptolysin O, one of the many strep antigens. This test is rarely ordered now compared to thirty years ago. For an acute strep throat infection, this test is not performed; the throat culture is used. However, if a doctor is trying to find out if someone had a recent strep
    • ASO, TITER (CON’T) infection that may not have been diagnosed, this test could be helpful. In addition, it may be used to help diagnose rheumatic fever, which occurs weeks after a strep throat infection when the throat culture would no longer be positive.BUN Serum urea nitrogen (BUN) 8-24 mg/dL is INCREASED in acute and chronic intrinsic renal disease, in state characterized by decreased effective circulating blood volume with decreased renal perfusion, in postrenal obstruction of urine flow and in high protein intake states. DECREASED serum urea nitrogen (BUN) is seen in high carbohydrate/low protein diets, states characterized by increased anabolic demand (late pregnancy, infancy, acromegaly), malabsorption states and severe liver damage.TOTAL BILIRUBIN Serum total bilirubin is TBIL: 0.0-1.2 mg/dLDIRECT BILIRUBIN INCREASED in DBIL: 0.0-0.2 mg/dLINDIRECT BILIRUBIN hepatocellular damage IBIL: 0.0-1.1 mg/dL (infectious hepatitis, alcoholic and other toxic hepatopathy, neoplasms), intra- and extrahepatic biliary hemolysis, physiologic neonatal jaundice, Crigler-Najjar syndrome, Gilbert’s disease, Dubin-Johnson syndrome, and fructose intolerance. Disproportionate
    • TOTAL BILIRUBIN ELEVATION of directDIRECT BILIRUBIN (conjugated) bilirubin isINDIRECT BILIRUBIN seen in cholestasis and late(CON’T) in the course of chronic liver disease. Indirect (unconjugated) bilirubin tends to predominate in hemolysis and Gilbert’s disease. DECREASED serum total bilirubin is probably not of clinical significance but has been observed in iron deficiency anemia.BNP Why get tested? 0-100 pg/mL To help diagnose the presence and severity of heart failure When to get tested? If you have symptoms of heart failure, such as shortness of breath and fatigue, or if you are being treated for heart failureCALCIUM HYPERCALCEMIA is 8.4-10.7 mg/dL seen in malignant neoplasms (with or without bone involvement), primary and tertiary hyperparathyroidism, sarcoidosis, Vitamin D intoxication, milk-alkali syndrome, Paget’s disease of bone (with immobilization), thyrotoxicosis, acromegaly, and diuretic phase of renal acute tubular necrosis. For a given total calcium level, acidosis increases the physiologically active ionized form of calcium. Prolonged tourniquet pressure during venipuncture may
    • CALCIUM (CON’T) spuriously increase total calcium. Drugs producing hypercalcemia include alkaline antacids, DES, diuretics (chronic administration), estrogens (including oral contraceptives) and progesterone. HYPOCALCEMIA must be interpreted in relation to serum albumin concentration. True decrease in the physiologically active ionized form of Ca++ occurs in may situations, including hypoparathyroidism, Vitamin D deficiency, chronic renal failure, magnesium deficiency, prolonged anticonvulsant therapy, acute pancreatitis, massive transfusion, alcoholism, etc. Drugs producing hypocalcemia include most diuretics, estrogens, fluorides, glucose, insulin, excessive laxatives, magnesium salts, methicillin and phosphates.CEA Why get tested? Non-Smokers: <2.8 n g/mL To determine whether Smokers: <7.4 ng/mL cancer is present in the body and to monitor cancer treatment When to get tested? When your doctor thinks your symptoms suggest the possibility of cancer and before starting cancer treatment as well as at intervals during and after therapyCHOLESTEROL Total cholesterol has been found to correlate with total
    • CHOLESTEROL (CON’T) found to correlate with total CHOL: mg/dL and cardiovascular Desirable <200 Borderline 200-239 mortality in the 30-50 year High > or = 240 age group. Cardiovascular mortality increases 9% for each 10 mg/dL increase in total cholesterol over the baseline value of 180 mg/dL. Approximately 80% of the adult male population has values greater than this, so the use of median 95% of the population to establish normal range (as is traditional in lab medicine in general) has no utility for this test. Excess mortality has been shown not to correlate with cholesterol levels in the >50 years age group, probably because of the depressive effects on cholesterol levels expressed by various chronic diseases to which older individuals are prone.CK Why get tested? FEMALE: 34-204 IU/L To determine if you have MALE: 41-277 IU/L had a heart attack and if other muscles in your body have been damaged. When to get tested? If you have chest pain or muscle pain and weakness; immediately after a suspected heart attack and every few hours for a total of 3 or 4 testsCREATININE Serum creatinine level and CRET: 0.9-1.6 mg/dLCREATININE CLEARANCE “creatinine clearance” are different ways of determining kidney function. Creatinine is a protein produced by muscle and
    • CREATININE released into the blood.CREATININE CLEARANCE (CON’T) The amount produced is relatively stable in a given person. The creatinine level in the serum is therefore determined by the rate it is being removed, which is roughly a measure of kidney function. If kidney function falls (say a kidney is removed to donate to a relative), the creatinine level will rise. Normal is about 1 for an average adult. Infants that have little muscle will have lower normal levels (0.2). Muscle bound weight lifters may have a higher normal creatinine. Serum creatinine only reflects renal function in a steady state. After removing a kidney, if the donor’s blood is checked right away the serum creatinine will still be 1. In the next day the creatinine will rise to a new steady state (usually about 1.8). If both kidneys were removed (say for cancer) the creatinine would continue to rise daily until dialysis is begun. How fast it rises depends on creatinine production, which is again related to how much muscle one has. Creatinine clearance is technically the amount of blood that is “cleared” of creatinine per time period. It is usually expressed in mL per minute. Normal is 120 mL/min for an adult. It is roughly, inversely related
    • CREATININE to serum creatinine: If theCREATININE CLEARANCE (CON’T) clearance drops to one half of the old level, the serum creatinine doubles (in the steady state). So for an adult, serum creatinine of 2 is roughly a creatinine clearance of 60 mL/min; creatinine 3 is roughly a clearance of 30; creatinine of 4 is roughly a clearance of 15, etc. So why didn’t the creatinine rise to only 2 when a kidney was removed? The answer is that the remaining kidney “hyperfilters” and seems to work harder, therefore kidney function is not quite halved. Usually, an adult will need dialysis because symptoms of kidney failure appear at a clearance of less than 10 mL/min. Creatinine clearance has to be measured by urine collection (usually 12 or 24 hours). It is a more precise estimate of kidney function than serum creatinine since it does not depend on the amount of muscle one has.CRP Why get tested? 0.0-0.99 mg/dL To identify the presence of inflammation and to monitor response to treatment [Note: to test for your risk of heart disease, a more sensitive test (hs- CRP) is used.] When to get tested? When your doctor suspects that you might be suffering from an inflammatory disorder (as with certain
    • CRP (CON’T) types of arthritis and autoimmune disorders or inflammatory bowel disease) or to check for the presence of infection (especially after surgery)HIGH SENSITIVITY CRP Why get tested? mg/dL May be helpful in assessing Lowest Risk <0.06 risk of developing heart Low Risk 0.07-0.11 disease Mod. Risk 0.12-0.19 When to get tested? High Risk 0.20-0.38 No current consensus exists Highest Risk >0.39 on when to get tested; the test is most often done in conjuction with other tests that are ordered to assess risk of heart disease, such as lipid profiles.DLDL To help determine your risk mg/dL of developing heart disease Optimal <100 and to monitor lipid Near Optimal 100-129 lowering lifestyle changes Borderline 130-159 and drug therapies. To High 160-189 accurately determine your Very High >190 low-density lipoprotein (LDL) level when you are nonfasting.FERRITIN The test is done to learn 24-336 ng/mL about your body’s ability to store iron for later use. You should get tested when your doctor suspects you may not have enough iron or too much iron in your systemVITAMIN B12 Why get tested? pg/mL To help diagnose the cause Normal 180-707 of anemia or neuropathy Indeterminate 141-179 (nerve damage), to evaluate Deficient <141 nutritional status in some patients, to monitor effectiveness of treatment for B12 or folate deficiency. When to get tested? When you have large red
    • VITAMIN B12 (CON’T) blood cells, when you have symptoms of anemia and/or of neuropathy. When you are being treated for B12 or folate deficiency.FOLATE Why get tested? ng/mL To help diagnose the cause Normal >3.1 of anemia or neuropathy Indeterminate 2.5-3.1 (nerve damage), to evaluate Deficient <2.5 nutritional status in some patients, to monitor effectiveness of treatment for B12 or folate deficiency. When to get tested? When you have large red blood cells, when you have symptoms of anemia and/or of neuropathy. When you are being treated for B12 or folate deficiency.GLUCOSE Why get tested? 60-110 mg/dL To determine whether or not your blood glucose level is within normal ranges; to screen for, diagnose, and monitor diabetes, pre-diabetes, and hypoglycemia (low blood glucose) When to get tested? As part of a yearly physical and when you have symptoms suggesting hyperglycemia (high blood glucose) or hypoglycemia, or if you are pregnant; if you are diabetic, up to several times a day to monitor glucose levels 3.3-5.6 %HEMOGLOBIN A1C Why get tested?(GLYCOHEMOGLOBIN) To monitor a person’s diabetes and to aid in treatment decisions When to get tested?
    • HEMOGLOBIN A1C When first diagnosed with(GLYCOHEMOGLOBIN) diabetes and then 2 to 4(CON’T) times per yearIRON Iron is needed to help form ug/dL adequate numbers of Male 50-160 normal red blood cells, Female 40-150 which carry oxygen throughout the body. Iron is a critical part of hemoglobin, the protein in red blood cells that binds oxygen in the lungs and releases it as blood travels to other parts of the body. Iron is also needed by other cells, especially muscle (which contains another oxygen binding protein called myoglobin). Low iron levels can lead to anemia, in which the body does not have enough red blood cells. Other conditions can cause you to have too much iron in your blood. Serum Iron level measures the level of iron in the liquid part of your blood.IMMUNOELECTROPHORESIS Why get tested? To help diagnose and monitor multiple myeloma and a variety of other conditions that affect protein absorption, production, and loss as seen in severe organ disease and altered nutritional states When to get tested? If you have an abnormal total protein or albumin level or if your doctor suspects that you have a condition that affects protein concentrations in the blood and/or causes
    • IMMUNOELECTROPHORESIS protein loss through the(CON’T) urineLD Why get tested? IU/L To help identify the cause Male 140-304 and location of tissue Female 142-297 damage in the body, and to monitor its progress; historically, has been used to help diagnose and monitor a heart attack, but troponin has largely replaced LDH in this role. When to get tested? Along with other tests, when your doctor suspects that you have an acute or chronic condition that is causing tissue or cellular destruction and he wants to identify and monitor the problem.LIPASE Why get tested? 22-51 U/L To diagnose pancreatitis or other pancreatic disease When to get tested? If you have symptoms of a pancreatic disorder, such as severe abdominal pain, fever, loss of appetite, or nauseaMAGNESIUM Why get tested? 1.8-2.5 mg/dL To evaluate the level of magnesium in your blood and to help determine the cause of abnormal calcium and/or potassium levels When to get tested? If you have symptoms (such as weakness, irritability, cardiac arrhythmia, nausea, and/or diarrhea) that may be due to too much or too little magnesium or if you have abnormal calcium or potassium levels
    • PHOSPHOROUS Why get tested? 4.0-7.0 mg/dL To evaluate the level of phosphorus in your blood and to aid in the diagnosis of conditions known to cause abnormally high or low levels When to get tested? As a follow-up to an abnormal calcium level, if you have a kidney disorder or uncontrolled diabetes, and if you are taking calcium or phosphate supplementsPOTASSIUM Why get tested? 3.6-5.0 mmol/L To diagnose levels of potassium that are too high (hyperkalemia) or too low (hypokalemia) When to get tested? As part of a routine medical exam or to investigate a serious illness, such as high blood pressure or kidney diseasePROSTATIC SPECIFIC ANTIGEN Why get tested? 0.00-4.00 ng/mL(PSA) To get screened for -- and to monitor -- prostate cancer When to get tested? There is some debate over this (see prostate cancer screening). Generally, for men over 50, as recommended by your physician (may be annually or less frequently); annually starting at age 45 for African-American men and men with a family history of prostate cancer.RHEUMATOID FACTOR Why get tested? IU/mL To help diagnose Negative <20 rheumatoid arthritis (RA) Weak Positive 20-50
    • RHEUMATOID FACTOR (CON’T) and Sjögren’s syndrome Positive >50 When to get tested? If your doctor thinks that you have symptoms of RA or Sjögren’s syndromeTRANSFERRIN Why get tested? mg/dL To learn about your body’s Male 215-365 ability to transport iron Female 250-380 When to get tested? When your doctor suspects you may have too much or too little iron in your body because of a variety of conditions; the test also helps to monitor liver function and nutritionTOTAL PROTEIN Why get tested? 6.1-8.0 g/dL To determine your nutritional status or to screen for certain liver and kidney disorders as well as other diseases When to get tested? If you experience unexpected weight loss or fatigue or if your doctor thinks that you have symptoms of a liver or kidney disorderURIC ACID Why get tested? 3.8-8.9 mg/dL To detect high levels of uric acid, which could be a sign of the condition gout When to get tested? When your doctor thinks that you might have gout or when monitoring certain chemotherapy or radiation therapies for cancerURINE CHEMISTRYMICROALBUMIN Why get tested? To get screened for a possible kidney disorder When to get tested? Annually after a diagnosis of diabetes or hypertension
    • ENDOCRINOLOGYCORTISOL Why get tested? ug/dL To help diagnose Cushing A.M. 8.7-22.4 syndrome or Addison P.M. <10 disease When to get tested? If your doctor suspects damage to the adrenal glandHCG, QUALITATIVE AND Why get tested? NegativeQUANTITATIVE To confirm and monitor pregnancy or to diagnose trophoblastic disease or germ cell tumors When to get tested? As early as 10 days after a missed menstrual period (some methods can detect hCG even earlier, at one week after conception) or if a doctor thinks that your symptoms suggest ectopic pregnancy, a failing pregnancy, trophoblastic disease, or germ cell tumorsFOILICLE STIMULATING Why get tested? 1.24-19.26 mIU/mLHORMONE (FSH) To evaluate your pituitary function, especially in terms of fertility issues When to get tested? If you are having difficulty getting pregnant or are having irregular menstrual periods or if your doctor thinks that you have symptoms of a pituitary or hypothalamic disorderLUTEINIZING HORMONE Why get tested? 1.24-8.62 mIU/mL(LH) To evaluate your pituitary function, especially in terms of fertility issues When to get tested? If you are having difficulty getting pregnant or are having irregular menstrual periods or if your doctor thinks that you have
    • LUTEINIZING HORMONE symptoms of a pituitary or(LH) (CON’T) hypothalamic disorderPROLACTIN Why get tested? 2.64-13.13 ng/mL To determine whether or not your prolactin levels are higher (or occasionally lower) than normal When to get tested? When you have symptoms of an elevated prolactin, such as: galactorrhea and/or visual disturbances and headaches, as part of a workup for female and male infertility, and for follow up of low testosterone in men.TESTOSTERONE, TOTAL Why get tested? 175-781 ng/dL To determine if your testosterone levels are abnormal, which may help to explain difficulty getting an erection (erectile dysfunction), inability of your partner to get pregnant (infertility), or premature or delayed puberty if you are male, or masculine physical features if you are female When to get tested? If you are male and your doctor thinks that you may be infertile or if you are unable to get or maintain an erection; if you are a boy with either early or delayed sexual maturity; if you are a female but have male traits, such as a low voice or excessive body hair, or are infertileTHYROID STIMULATING Why get tested? 0.318-5.90 uIU/mLHORMONE (TSH) To screen for and diagnose thyroid disorders; to monitor treatment of hypothyroidism When to get tested?
    • THYROID STIMULATING For screening: There is noHORMONE (TSH) (CON’T) consensus within the medical community as to at what age adult screening should begin or whether it should even be done; however, newborn screening is widely recommended. For monitoring treatment: as directed by your doctor. Otherwise: as symptoms present.T4 Why get tested? 6.09-12.23 ug/dLDRAW IN A PLAIN RED TOP To diagnoseTUBE. THE GEL IN THE GOLD hypothyroidism or .TOPS CAUSE INTERFERENCE hyperthyroidism in adults; to screen for hypothyroidism in newborns. When to get tested? Usually is ordered in response to an abnormal TSH test result. Commonly performed on newborns.URINALYSISURINALYSIS Why get tested?SPECIMEN GOOD FOR 8 HOURS To screen for metabolic andREFRIGERATED OR 1 HOUR AT kidney disordersROOM TEMP. When to get tested? Regularly on admission to a hospital; in a work-up for a planned surgery; as part of an annual physical exam; or when evaluating a new pregnancy. May be done if you have abdominal pain, back pain, frequent or painful urination, or blood in the urine.HEMATOLOGY/COAGULATION MIX TUBES WELLHEMOGLOBIN/HEMATOCRIT Why get tested? HCT: 38-50 %(H&H) If you have anemia (too few HGB: 13.0-17.0 g/Dl red blood cells) or
    • HEMOGLOBIN/HEMATOCRIT polycythemia (too many red(H&H) (CON’T) blood cells), to assess itsCLOTTED SPECIMENS HAVE TO severity, and to monitorBE REJECTED. response to treatment When to get tested? As part of a complete blood count (CBC), which may be ordered for a variety of reasonsPLATELET COUNT Why get tested? 140-400 THOUSCLOTTED SPECIMENS HAVE TO To diagnose a bleedingBE REJECTED. disorder or a bone marrow disease When to get tested? As part of a regular complete blood count (CBC) or to diagnose/monitor a bone marrow/blood diseaseCOMPLETE BLOOD COUNT Why get tested? WBC: 3.5-11.0 THO/MM3(CBC) To determine general health RBC: 4.2-5.7 MIL/MM3 HGB: 13.0-17.0 g/dLCLOTTED SPECIMENS HAVE TO status and to screen for a HCT: 38-50 %BE REJECTED. variety of disorders, such as MCV: 80-99 Fl anemia and infection, as MCH: 27-34 uug well as nutritional status MCHC: 33-36 g/Dl and exposure to toxic RDW: 11.2-15.2% PLT: 140-400 THOUS substances MPV: 7.3-10.1 When to get tested? As part of a routine medical exam or as determined by your doctorCOMPLETE BLOOD COUNT WITH Why get tested? WBC: 3.5-11.0 THO/MM3DIFFERENTIAL To diagnose an illness RBC: 4.2-5.7 MIL/MM3 HGB: 13.0-17.0 g/dL(CBCD) affecting your immune HCT: 38-50 %CLOTTED SPECIMENS HAVE TO system, such as an infection MCV: 80-99 FlBE REJECTED. When to get tested? MCH: 27-34 uug As part of a complete blood MCHC: 33-36 g/Dl count (CBC), which may be RDW: 11.2-15.2% PLT: 140-400 THOUS ordered for a variety of MPV: 7.3-10.1 reasonsESR (SEDIMENTATION RATE) Why get tested?SPECIMEN CAN BE HELD FOR 12 To detect and monitor the mm/hrHOURS IF REFRIGERATED. activity of inflammation as Male 0-15 an aid in the diagnosis of Female 0-20 the underlying cause When to get tested?
    • ESR (SEDIMENTATION RATE) When your doctor thinks(CON’T) that you might have a condition that causes inflammation and to help diagnose and follow the course of temporal arteritis or polymyalgia rheumaticaPROTHROMBIN TIME (PT) Why get tested? With anticoagulant:PROTHROMBIN TIME IS GOOD To check how well blood- <45 secFOR 24 HOURS REFRIGERATED. thinning medications (anti- Without anticoagulant: coagulants) are working to 10.5-13.8 secTUBE MUST BE FILLED prevent blood clots; to helpCOMPLETELY. detect and diagnose a bleeding disorder When to get tested? If you are taking an anti- coagulant drug or if your doctor suspects that you may have a bleeding disorderPARTIAL THROMBOPLASTIN TIME Why get tested? 22.0-37.0 sec(PTT) As part of an investigationPTT MUST BE RUN WITHIN 4 of a bleeding or thromboticHOURS. episode. To help evaluate your risk of excessiveTUBE MUST BE FILLED bleeding prior to a surgicalCOMPLETELY. procedure. To monitor heparin anticoagulant therapy. When to get tested? When you have unexplained bleeding or blood clotting. When you are on heparin anticoagulant therapy. Sometimes as part of a pre- surgical screen.WHITE BLOOD CELL COUNT Why get tested? 3.5-11.0 THO/MM3(WBC) If your doctor thinks that you might have an infection or allergy and to monitor treatment When to get tested? As part of a complete blood count (CBC), which may be ordered for a variety of
    • reasonsD-DIMER Why get tested? 0-400 ng/mL To help diagnose or rule out thrombotic (blood clot producing) diseases and conditions When to get tested? When you have symptoms of a disease or condition that causes acute and/or chronic inappropriate blood clot formation such as: DVT (Deep Vein Thrombosis), PE (Pulmonary Embolism), or DIC (Disseminated Intravascular Coagulation), and to monitor the progress and treatment of DIC and other thrombotic conditions.SEROLOGYANTI-NUCLEAR ANTIBODY Why get tested? Negative(ANA) To help diagnose systemic lupus erythematosus (SLE) and drug-induced lupus and rule out certain other autoimmune diseases When to get tested? If your doctor thinks that you have symptoms of SLE or drug-induced lupusHIV Why get tested? Negative To determine if you are infected with HIV When to get tested? Three to six months after you think you may have been exposed to the virusH. PYLORI ANTIBODY SCREEN Why get tested? Negative To diagnose an infection with Helicobacter pylori When to get tested? If you have gastrointestinal pain or symptoms of an ulcer
    • MONO SCREEN Why get tested? Negative To get screened for mononucleosis When to get tested? If you have symptoms of mononucleosis, including fever, sore throat, swollen glands, and fatigueFLU A&B Why get tested? Negative To determine whether or not you have the influenza A or B; to help your doctor make rapid treatment decisions; and to help determine whether or not the flu has come to your community. When to get tested? When it is flu season and your doctor wants to determine whether your flu- like symptoms are due to influenza A or B, or to other causes. Within 48 hours of the onset of your symptoms, to help determine treatment options.MICROBIOLOGYURINE CULTURE Why get tested? To diagnose a urinary tract infection (UTI) When to get tested? If you experience symptoms of a UTI, such as pain during urinationAFB CULTURE Why get tested? To help identify a mycobacterial infection, to diagnose tuberculosis (TB), to monitor the effectiveness of treatment When to get tested? When you have symptoms, such as a chronic cough,
    • AFB CULTURE weight loss, fever, chills,(CON’T) and weakness, that may be due to TB or due to another mycobacterial infection. When your doctor suspects that you have active TB. When your doctor wants to monitor the effectiveness of TB treatment.HERPES CULTURE Why get tested? To screen for or diagnose infection with the herpes simplex virus When to get tested? If you have symptoms of an infection with the herpes simplex virus, such as blisters or sores around your mouth or in the genital areaRAPID BETA SCREEN Why get tested? To determine if a sore throat (pharyngitis) is caused by a Group A streptococcal bacteria (“strep throat”) When to get tested? If you have a sore throat and fever and your doctor thinks it may be due to an upper respiratory infectionCHLAMYDIA SCREEN Why get tested? To screen for or diagnose chlamydia infection When to get tested? If you are sexually active, pregnant, have one or more risk factors for developing chlamydia, or have a cervical infection; depending on your risk factors, may be annuallyGC SCREEN Why get tested? To screen for Neisseria gonorrhoeae, which causes the sexually transmitted
    • GC SCREEN (CON’T) disease gonorrhea When to get tested? If you have symptoms of gonorrhea or are pregnantMRSA SCREEN The goal of laboratory testing for staph wound infections is to identify the presence of S. aureus, to determine whether it is a MRSA strain, and to evaluate the staph’s susceptibility to available antibiotics. If an infection is due to MRSA, it should be investigated to determine where it came from and how it was acquired. This is especially important in CA- MRSA to prevent further cases from occurring.VRE SCREEN VRE are specific types of antimicrobial-resistant staph bacteria. While most staph bacteria are susceptible to the antimicrobial agent vancomycin some have developed resistance. VRE cannot be successfully treated with vancomycin because these organisms are no longer susceptibile to vancomycin. However, to date, all VRE isolates have been susceptible to other Food and Drug Administration (FDA) approved drugs.FECAL ANALYSISBLOOD Why get tested? Negative To screen for gastrointestinal bleeding, which may be an indicator of colon cancer When to get tested? As part of a routine
    • BLOOD (CON’T) examination, annually after age 50 (as recommended by the American Cancer Society and other major organizations), and as directed by your doctorC DIFFICILE TOXIN Why get tested? Negative To detect the presence of Clostridium difficile toxin When to get tested? When a patient has acute diarrhea that persists for several days, abdominal pain, fever, and/or nausea following antibiotic therapyGIARDIA SPECIFIC ANTIGEN This test detects protein Negative structures on the giardia parasite. It is more sensitive and specific for this particular parasite than the O&P microscopic exam.WBC’S Stool WBC (white None Seen blood cells) may be present in the stool when there is a bacterial infection.