Test and procedures in Clinical Areas

• Hematology - blood and blood-forming tissues

  (1) Hematocrit (Hct) – hemoglobin level and RBC count

  (2) Hemoglobin (Hgb) – values that rule out anemia

  (3) Red Blood Cell (RBC) Count – erythropoietic activity

  (4) White Blood Cell (WBC) Count – leukocyte response

  (5) Platelet Count – chemotherapy and radiation conditions

  (6) Differential White Blood Cell Count – changes in the appearance or quantity of specific cell types
• Hematology

  (1)    Indices – show the changes in RBC size, weight, and Hgb content

  (2)    Mean Corpuscular Hemoglobin (MCH) – weight of the hemoglobin in the cell

  (3)    Mean Corpuscular Volume (MCV) – size of RBCs

  (4)    Mean Corpuscular Hemoglobin Concentration (MCHC) – concentration of the hemoglobin per unit volume of RBCs

  (5)    Red Blood Cell Distribution Width (RDW) – size differences of the RBCs
• Coagulation – the ability of blood to form and dissolve clots

  (1)    Activated Partial Thromboplastin Time (APTT) – adequacy of heparin therapy

  (2)    D-dimer – thrombin and plasmin activity

  (3)    Fibrin Split Products – amount of fibrin degradation products (FDPs) in the blood

  (4)    Fibrinogen Test – fibrinogen levels in the blood

  (5)    Prothrombin Time (PT) or International Normalized Ratio (INR) – liver diseases or deficiency in Vitamin K
• Chemistry – amounts of certain chemicals in a blood sample

  (1)    Alanine Aminotransferase Test (ALT) – liver damage

  (2)    Alpha-fetoprotein (AFP) – alpha-fetoprotein levels in pregnant women during the second trimester of pregnancy

  (3)    Alkaline Phosphatase (AP) Test – amount of alkaline phosphates enzyme in the bloodstream

  (4)    Ammonia – measures the level that could indicate cirrhosis and hepatitis

  (5)    Amylase – checks the enzyme level that could indicate liver disease, cholecystitis, etc.
• Chemistry

  (1)    Aspartate Aminotransferase Test (AST) – levels of aspartate aminotransferase enzyme that may indicate liver damage

  (2)    Bilirubin Test – amount of bilirubin levels in the bloodstream that could indicate RBC destruction

  (3)    Arterial Blood Gases (ABG) – acid-base balance by measuring the pH, partial pressure of CO2 and O2

  (4)    Blood Urea Nitrogen (BUN) – amount of urea nitrogen found in the blood that could determine impaired renal function

  (5)    B-type Natriuretic Peptide (BNP) Test – levels of the BNP hormone in the blood which could indicate congestive heart failure
• Chemistry

  (1)    C-reactive Protein High Sensitivity (hs-CRP) – level of CRP

  (2)    Carcinoembryonic Antigen (CEA) Test – CEA protein levels in the blood that may help diagnose and manage certain types of cancers

  (3)    Blood Calcium – total amount of calcium in the blood that could help determine or monitor the effects of renal failure

  (4)    Total Cholesterol – indicates risk of cardiovascular diseases

  (5)    Cortisol – shows adrenal hypofunction and hyperfunction

  (6)    Creatine Kinase (CK) – used to check muscle damage
• Chemistry

  (1)    Creatinine – checks for cases that indicate renal impairment or muscular dystrophy

  (2)    Drug Analysis – monitors therapeutic range to avoid toxic levels of drugs

  (3)    Electrolytes (sodium, potassium, chloride, CO2) – show the sodium values that determine disorder of the kidney and adrenals

  (4)    Glucose – used to check diabetes, liver disease, or malnutrition

  (5)    Gamma-Glutamyl Transferase (GGT) – used for diagnosis of liver, specifically hepatobiliary problems

  (6)    Hemoglobin A1C – determines glycosylated hemoglobin level
• Chemistry

  (1)    Lactate dehydrogenase – checks lung, kidney, and liver dysfunction

  (2)    Lipase – shows the level that could lead to either pancreatitis or pancreatic carcinoma

  (3)    Prostate Specific Antigen (PSA) – test that screens patients for the presence of prostate cancer

  (4)    Total Protein – used to check liver and kidney disorders

  (5)    Triglycerides – serve as an index in the evaluation of atherosclerosis and lipid metabolism disorder
• Chemistry

  (1)    Troponin I – used for early diagnosis of small myocardial infarcts

  (2)    Uric Acid Test – used to check levels that indicate gout and renal problems

  (3)    Vitamin B12 and Folate Tests – used to check for anemia and diseases of the small intestine
• Serology/Immunology – serum and autoimmune reactions in the blood

  A.Bacterial Studies

  (1)    Antinuclear Antibody (ANA) – shows autoimmune disorders such as systemic lupus erythematosus

  (2)    Antistreptolysin-O (ASO) Titer – indicates streptococcal infection

  (3)    Cold Agglutinins – checks case of atypical pneumonia

  (4)    Febrile Agglutination Test – shows the presence of antibodies to specific organisms
• Serology/Immunology

  A.Bacterial Studies

  (1)    FTA-ABS (Fluorescent Treponemal Antibody-Absorption) – confirms syphilis

  (2)    Rapid Plasma Reagin (RPR) – when positive, it is indicative of syphilis but it still needs confirmation(3) Rheumatoid Factor (RF) – indicates rheumatoid arthritis
• Serology/Immunology

  B. Viral Studies

  (1)    Anti-HIV – screens human immunodeficiency virus (HIV)

  (2)    Cytomegalovirus Antibody (CMV) – a confirmatory test for CMV antibody

  (3)    Epstein-Barr Virus (EBV) – checks for the presence of heterophil antibody which indicates infectious mononucleosis

  (4)    Hepatitis B Surface Antigen (HBsAg) – checks for the presence of hepatitis antigen on the surface of RBCs
• Serology/Immunology

  C. General Studies

  (1)    C-reactive protein (CRP) – indicates inflammation when levels are increased

  (2) Human Chorionic Gonadotropin (HCG) Test – the hormone is present when a patient is pregnant
• Urinalysis - tests urine specimen

  A.Physical evaluation

  1.       Color indicates the presence of bilirubin or urobilin in the urine specimen

  2.       Clarity/transparency shows the presence of fat, chyle, or bacteria which affect the turbidity

  3.       Specific gravity suggests renal tubular involvement or ADH (antidiuretic hormone) deficiency
• Urinalysis

  B.Chemical Evaluation

  1.       Blood – hematuria could be due to hemorrhage, infection, or trauma

  2.       Bilirubin – helps differentiate between obstructive jaundice and hemolytic jaundice

  3.       Glucose – glucosuria may be a result of diabetes mellitus or renal impairments

  4.       Ketones – uncontrolled diabetes mellitus or starvation

  5.       Leukocyte – indicates urinary tract infection (UTI) if there is a lot of neutrophils
• Urinalysis

  B.Chemical Evaluation

  1.       pH – indicates the acid-base balance

  2.       Protein – proteinuria is an indicator of renal dysfunction or disorder

  3.       Nitrite – positive results could mean bacterial infection

  4.       Urobilinogen – increases in amount when the patient suffers from hepatitic issues
• Urinalysis

  C.Microscopic Evaluation - shows the status of the urinary tract, hematuria, pyuria, etc.
• Microbiology – microorganisms in body fluids or tissues

  1.       Acid-Fast Bacilli (AFB) – used to monitor the treatment for tuberculosis (TB)

  2.       Blood Culture – checks for the presence of bacteria indicative of bacteremia or septicemia

  3.       Campylobacter-like Organism (CLO) Test – shows the presence of Helicobacter pylori

  4.       Culture and Sensitivity (C&S) – indicates infection if there is growth in the pathogenic microorganism
• Microbiology

  1.       Fungus Culture and Identification – used to determine the type of fungi if present

  2.       Gram Stain – it is done to allow antimicrobial therapy while waiting for culture results

  3.       Occult Blood – checks for blood in the stool which could result from gastrointestinal bleeding

  4.       Ova and Parasites (O&P) Exam – solves “etiology unknown” intestinal disorders
• Blood Bank/Immunohematology – blood for transfusion

  1.       Antibody (Ab) Screen – agglutination means the presence of abnormal antibodies in the blood

  2.       Direct Antihuman-globulin Test (DAT) – determines transfusion incompatibility

  3.       ABO and Rh Type – shows the ABO and RH blood groups

  4.       Type and Crossmatch – shows the blood group and screens for antibodies in the recipient’s blood

  5.       Compatibility Testing – detects antibodies and antigens in both recipient’s and donor’s blood
• Stat laboratory - located near the emergency room of some tertiary care facilities.