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Module 4/Diagnostic Tests and Procedures/Laboratory Tests


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DIFFERENTIAL (di-fer-EN-she-l):
(ALK PHOS) or ALP Test
*to screen/monitor treatment for liver or bone disorder.
**part of routine lab testing profile; part of routine liver panel.
Measures the amount of alkaline phosphatase (an enzyme found on cell membranes) in serum.
ELEVATED LEVELS in liver diseases (such as hepatitis and hepatoma), and in bone disease and bone cancer.
ALBUMIN (al-BU-min):
*to screen for a liver disorder or kidney disease--effective marker of general nutrition.
Measures albumin (protein) in both serum and in urine.
DECREASE of albumin in serum indicates disease of the kidneys, malnutrition, or liver disease or may occur in extensive loss of protein in the gut or from the skin, as in a burn.
PRESENCE of albumin in the urine (albuminuria) indicates malfunction of the kidney.
(PAP) Measures the amount of an enzyme called acid phosphatase in serum. Enzyme levels are elevated in metastatic prostate cancer. Moderate elevations of this enzyme occur in diseases of bone and when breast cancer cells invade bone tissue.
ALPHA-FETOPROTEIN (al-fa-fe-to-PRO-ten):
(AFP)also known as: AFP Maternal test, msAFP, Triple Screen or Triple test.
*AFP is used to detect tumors that mark cancers of the liver, testes and ovaries. Once diagnosed, patients undergo periodic testing for AFP to monitor their response to therapy.
*also used to assess the risk of carrying a fetus with Down's Syndrome (AFP levels are LOW).
Test for the presence of a protein called alpha-globulin in serum. The protein is normally present in the serum of the fetus, infant, and pregnant women. In fetuses with abnormalities of the brain and spinal cord, the protein leaks into the amniotic fluid surrounding the fetus and is an indicator of spinal tube defect (spina bifida) or anencephaly (absent brain development).
HIGH LEVELS are found in patients with cancer of the liver and other malignancies (testicular and ovarian cancers).
ELEVATED LEVELS are also seen in benign liver disease such as cirrhosis and viral hepatitis.
ANTINUCLEAR ANTIBODY TEST (an-tih-NU-kle-ar AN-tih-bod-e test):
*to diagnose systemic lupus erythematosus and rule out certain autoimmune diseases.
A sample of plasma is tested for the presence of antibodies that are found in patients with systemic lupus erythematosus.
*test for multiple myeloma (bone marrow cancer)
Measures the presence of the Bence Jones protein in serum or urine. Bence Jones protein is a fragment of a normal serum protein, an immunoglobulin, produced by cancerous bone marrow cells (myeloma cells). Normally it is not found in either blood or urine, but in multiple myeloma (a malignant condition of bone marrow) high levels of Bence Jones protein are detected in urine and serum.
BILIRUBIN (bil-eh-RU-bin):
*to screen for and monitor liver disorders and diseases.
Measures the amount of bilirubin, an orange-brown pigment, in serum and urine. Bilirubin is derived from hemoglobin, the oxygen-carrying protein in red blood cells.
ITS PRESENCE IN HIGH CONCENTRATION in serum and urine causes jaundice (yellow coloration of the skin) and may indicate disease of the liver, obstruction of bile ducts, or a type of anemia that leads to excessive destruction of red blood cells.
*general screening tool and performed as part of a complete physical exam by many internists; includes 12-25 analyses
*also used preoperative.
This comprehensive blood test provides information regarding the function of several body systems. Tests include calcium (bones), phosphorus (bones), urea (kidney), creatinine (kidney), bilirubin (liver), SGOT (liver and heart muscle) and SGPT (liver), alkaline phosphatase (liver and bone), globulin (liver and immune disorders), and albumin (liver and kidney).
*to test for systemic infection;to check for signs or symptoms of a bacterial infection; to detect and identify bateria and yeast in the blood.
To test for infection in the bloodstream;
1) a sample of blood is added to a special medium (food in culture bottles) that promotes the growth of microorganisms.
2)The medium is then examined by a medical technologist for evidence of bacteria or other microbes.
BLOOD UREA NITROGEN (Blud u-RE-ah NI-tro-jen):
*to evaluate kidney function and monitor effectiveness of dialysis.
Measures the amount of urea (nitrogen-containing waste material) in serum.
HIGH LEVEL of serum urea indicates poor kidney function, since it is the kidney's job to remove urea from the bloodstream and filter it into urine.
CALCIUM (KAL-se-um):
*to determine if levels of calcium in the blood is at normal levels.
**routine metabolic panel in persons with kidney,bone or nerve disease or symptoms of abnormal calcium present.
Measures the amount of calcium in serum, plasma, or whole blood.
LOW LEVELS associated with abnormal functioning of nerves and muscles.
HIGH LEVELS indicate loss of calcium from bones, excessive intake of calcium, disease of the parathyroid glands, or cancer.
CARBON DIOXIDE (KAR-bon di-OK-side):
This gas, produced in tissues and eliminated by the lungs, is measured in the blood.
ABNORMAL LEVELS may reflect lung disorders.
CARCINOEMBRYONIC ANTIGEN (kar-sih-no-em-bree-ON-ik AN-ti-jen):
*to determine whether cancer is present in the body and to monitor cancer treatment (can not indicate which kind of cancer is present).
A plasma test for a protein normally found in the blood of human fetuses and produced in healthy adults only in a very small amount, if at all.
*CEA is a protein that is normally not able to be detected in the blood of a healthy person.
HIGH LEVELS of this antigen may be a sign of a variety of cancers, in particular colon or pancreatic cancer.
CEREBROSPINAL FLUID (seh-re-bro-SPI-nal FLU-id):
(CSF)also known as: Lumbar Puncture or Spinal Tap
*to diagnose disorders of the central nervous system
Chemical tests are performed on specimens of cerebrospinal fluid removed by lumbar puncture. The fluid is tested for protein, sugar and blood cells. It is also cultured to detect microorganisms.
ABNORMAL CONDITIONS such as meningitis, brain tumor and encephalitis are detected using this test.
CHOLESTEROL (ko-LES-ter-ol):
also known as: Blood Cholesterol or Total Cholesterol
*to screen for risk of developing heart disease; measures all cholesterol,good and bad that is carried in blood by lipoproteins.
Measures the amount of cholesterol (substance found in animal fats and oils, egg yolks and milk) in serum or plasma. Normal values vary for age and diet;
LEVELS ABOVE 200 mg/dI indicate a need for further testing and efforts to reduce cholesterol level, since high levels are associated with hardening of arteries and heart disease. Blood is also tested for the presence of a lipoprotein substance that is a combination of cholesterol and protein.

HIGH LEVELS OF HDL (high-density lipoprotein)**GOOD** cholesterol in the blood are beneficial, since HDL cholesterol promotes the removal and excretion of excess cholesterol from the body
HIGH LEVELS OF of low-density lipoprotein (LDL)**BAD** are dangerous.
*is useful in diagnosing anemia, infection and blood cell disorders such as leukemia.
*usually ordered as part of a routine medical exam.
Numbers of leukocytes (white blood cells), erythrocytes (red blood cells), and platelets (clotting cells) are determined.
CK Test; also known as: CPK, Total CK or CK
*To determine if you have had a heart attack and if other muscles in your body have been damaged.
Serum test to detect levels of creatine kinase, a blood enzyme. Creatine kinase is normally found in heart muscle, brain tissue, and skeletal muscle.
PRESENCE of one form (isoenzyme) of creatine kinase (either CK-MB or CK2) in the blood is strongly indicative of recent myocardial infarction (heart attack), since the enzyme is released from heart muscle when the muscle is damaged or dying.
*to diagnose kidney malfunction,
Measures the rate at which creatinine is cleared (filtered) by the kidneys from the blood.
IF CREATINE CLEARENCE IS LOW it indicates that the kidneys are not functioning effectively to clear creatinine from the bloodstream and filter it into urine.
CREATININE (kre-AT-tih-nin):
also known as: Creat
*to determine if your kidneys are functioning normally and to monitor treatment for kidney disease
*the most reliable test for kidney function.
Measures the amount of creatinine, a nitrogen containing waste material, in serum or plasma. Since creatinine is normally produced as a protein breakdown product in muscle and excreted by the kidney in urine, an ELEVATION IN THE creatinine level in the blood indicates a disturbance of kidney function.
ELEVATIONS ARE ALSO SEEN in high protein diets and dehydration.
This test identifies microorganisms in a special laboratory medium (fluid, solid, or semisolid material). In sensitivity tests, culture plates containing a specific microorganism are prepared, and antibiotic containing disks are applied to the culture surface. Following overnight incubation, the area surrounding the disk (where growth was inhibited) is measured to determine if the antibiotic is effective against the specific organism.
ELECTROLYTES (e-LEK-tro-litz):
also known as: Lytes
*to evaluate vomiting, diarrhea and cardiac symptoms.
Tests on serum or whole blood to determine the concentration of electrolytes (chemical substances which are capable of conducting an electric current). When dissolved in water, electrolytes break apart into charged particles (ions). Positively charged electrolytes are sodium (Na.) potassium (K.), calcium (Ca), and magnesium (Mg.). Negatively charged electrolytes are chloride (Cl) and bicarbonate (HC03). These charged particles should be present at all times for proper functioning of cells. AN ELECTROLYTE IMBALANCE OCCURS WHEN SERUM CONCENTRATION IS EITHER TOO HIGH OR TOO LOW.
CALCIUM BALANCE can affect the bones, kidneys, gastrointestinal tract and neuromuscular activity,
SODIUM affects blood pressure, nerve functioning and fluid levels surrounding cells.
POTASSIUM affects heart and muscular activity.
ELISA (eh-LI-zah):
Enzyme Linked Immunosorbent Assay
*1st screening test for antibodies to the HIV virus (to detect HIV/AIDS)
A laboratory assay (test) for the presence of antibodies to the AIDS virus. If a patient tests positive, it is likely that his/her blood contains the AIDS virus (HIV or human immunodeficiency virus). The presence of the virus stimulates white blood cells to make antibodies that are detected by the ELISA assay. This is the first test done to detect AIDS infection and is followed by a Western blot test to confirm the results, ELISA is an acronym for enzyme linked immunosorbent assay.
ERYTHROCYTE SEDIMENTATION RATE (eh-RITH-ro-sit sed-ih-men-TA-shun rat):
(ESR) or Sed Rate
*to detect and monitor the activity of inflammation.
Measures the rate at which red blood cells (erythrocytes) in well-mixed venous blood settle to the bottom (sediment) of a test tube. If the rate of sedimentation is markedly slow (ELEVATED SED RATE), it may indicate inflammatory conditions, such as rheumatoid arthritis, or conditions that produce excessive proteins in the blood.
ESTRADIOL (es-tra-DI-ol):
*to measure or monitor estrogen levels in women who have unexplained abnormal menstrual cycles, abnormal bleeding, menopause or hormone problems.
A test for the concentration of estradiol, which is a form of estrogen (female hormone) in serum, plasma, or urine.
*performed at the time of biopsy on tissue which has been rapidly frozen after removed, them examined and determined to be cancerous.
*the purpose of this test is to determine whether or not the tumor will be sensitive to hormone treatments as opposed to or in addition to chemo, radiation therapy or surgery.
This test, determines if a sample of tumor contains an estrogen receptor protein. The protein, if present on breast cancer cells, combines with estrogen, allowing estrogen to promote the growth of the tumor. Thus,
IF AN ESTROGEN RECEPTOR ASSAY TEST WERE POSITIVE (THE PROTEIN IS PRESENT) then treatment with an anti-estrogen drug would retard tumor growth.
IF THE ASSAY WERE NEGATUVE (THE PROTEIN IS NOT PRESENT) then the tumor would not be affected by anti-estrogen drug treatment.
Measured in serum, globulins are proteins that bind to and destroy foreign substances (antigens). Globulins are made by cells of the immune system. Gamma globulin is one type of globulin that contains antibodies to fight disease.
DECREASED LEVELS = problems with antibodies, immunodeficiency virus, infectious disease
INCREASED LEVELS = stress, dehydration, blood cancer, allergies, liver and heart disease
(GLU)also known as: Blood Glucose, Blood Sugar
*to screen for,diagnose and monitor diabetes, pre-diabetes and hypoglycemia.
Measures the amount of glucose (sugar) in serum and plasma.
HIGH LEVELS of glucose (hyperglycemia) indicate diseases such as diabetes mellitus and hyperthyroidism.
HEMOCCULT TEST (he-mo-o-KULT test):
(FOBT)also known as: Stool Occult blood
*to screen for gastrointestinal bleeding, which may be an indicator of colon cancer
1)A small sample of stool is tested for otherwise inapparent (occult means "hidden") traces of blood.
2)The sample is placed on the surface of a collection kit and reacts with a chemical (e.g., guaiac).
A POSITIVE RESULT INDICATES bleeding from a polyp, ulcer, or malignant tumor.
HEMATOCRIT (he-MAT-o-krit):
(Hct) also known as: Crit or PCV
*test to evaluate for anemia, polycythemia or dehydration
Measures the percentage of red blood cells in the blood. The normal range is 40 - 50% in males and 37 - 47% in females.
*to determine how well your body absorbs and uses glucose
1)fast 12 hours prior to test
2)before test heparin lock to allow repeated blood samples to be drawn.
3)blood urine samples taken
4)glucose drink given to patient
5)1/2 hour after the glucose is taken , blood and urine samples are obtained.
6)blood and urine collected every hour for 4-5 hours
The test DETERMINES HOW TH BODY USES GLUCOSE and CAN INDICATE ABNORMAL CONDITIONS SUCH AS diabetes mellitus, hypoglycemia and liver or adrenal gland dysfunction.
HEMOGLOBIN ASSAY (HE-mo-glo-bin AS-a):
(Hgb)or Hb
*to assess severity,monitor responce to treatment of anemia or polycythemia
*part of a CBC test
Measures the concentration of hemoglobin in blood. The normal blood hemoglobin ranges are 13.5 to 18.0 gm/100 ml in adult males and 12.0 to 16.0 gm/100 ml in adult females.
HUMAN CHORIONIC GONADOTROPIN (HU-man kor-e-ON-ik go-nad-o-TRO-pin):
*pregnancy test,performed 10 days after a missed menstrual period
Measures the concentration of human chorionic gonadotropin (a hormone secreted by cells of the fetal placenta) in urine. It is detected in urine within days after fertilization of egg and sperm cells and provides the basis of the most commonly used pregnancy test.
IMMUNOASSAY (im-u-no-AS-a):
*screening urine for drug abuse,and therapeutic drug monitoring.
A method of testing blood and urine for the concentration of various chemicals, such as hormones, drugs, or proteins. The technique makes use of the immunological reaction between antigens and antibodies. An assay is a determination of the amount of any particular substance in a mixture.
*screening for mental retardation of a newborn baby
This test determines if the urine of a newborn baby contains substances called phenyl ketones. If so, the condition is called phenylketonuria (PKU). Phenylketonuria occurs in infants born lacking a specific enzyme.
IF THE ENZYME IS MISSING, HIGH LEVELS OF phenylalanine (an amino acid) accumulate in the blood, affecting the infant's brain and causing mental retardation. This situation is prevented by placing the infant on a special diet that prevents accumulation of phenylalanine in the bloodstream.
also known as: Thrombocyte count
*to diagnose a bleeding disorder or bonemarrow disease (leukemia)
*standard of CBC test
Determines the number of clotting cells (platelets) in a sample of blood
*to diagnose levels of potassium that are too high (hyperkalemia) or too low (hypokalemia)
*as part of routine medical exam or to investigate illness such as high blood pressure or kidney disease.
Measures the concentration of potassium in serum. Potassium combines with other minerals (such as calcium) and is an important chemical for proper functioning of muscles, especially the heart muscle.
*test performed at the time of biopsy on tissue which has veen rapidly frozen after removed, examined and the determined to be cancerous.
*to determine whether breast cancer tumor is positive for progesterone receptors, which helps to guide treatment and determine prognosis.
*if diagnosed with breast cancer, foctor can determin whether the tumors growth is influenced by the hormones estrogen, progesterone, or both.
Determines if a sample of tumor contains a progesterone receptor protein.
IF POSITIVE,it identifies a tumor that would be responsive to antiprogesterone hormone therapy.
(PSA) also known as: Total PSA
*to screen for and monitor prostate cancer.
This blood test measures the amount of an antigen that is elevated in all men with prostatic cancer and in some with an inflamed prostate gland.
(PT) also known as: Pro Time
*to check how well blood thinning meds are working to prevent blood clots.
Measures the activity of factors in the blood that participate in clotting.
DEFICIENCY of any of these factors can lead to a prolonged prothrombin time and difficulty in blood clotting. The test is important as a monitor for patients who are taking anticoagulants, substances that block the activity of blood clotting factors, and increase the risk of bleeding.
(RBC) or RBC Count
*to evaluate any change in the number of red blood cells in your body.
*as part of a CBC
This test counts the number of erythrocytes in a sample of blood.
A LOW RED BLOOD CELL COUNT may indicate anemia.
A HIGH RBC can indicate polycythemia vera.
Detects an abnormal protein (rheumatoid factor) present in the serum of patients with rheumatoid arthritis.
SERUM GLUTAMIC-OXALOACETIC TRANSAMINASE (SE-rum glu-TAM-ik oks-al-ah-SE-tik trans-AM-in-as):
*to detect liver damage.
Measures the amount of the enzyme glutamate-oxaloacetate transaminase (aspartate transaminase) in serum. The enzyme is normally present, but when there is damage to heart (heart attack) or liver cells, it is released by the damaged tissue and accumulates in the blood.
*to screen for liver damage; detects liver injury, helps determine which form of liver disease is present.
Measures the amount of the enzyme glutamate-pyruvic transaminase (alanine transaminase) in serum. The enzyme is normally in the blood but ACCUMULATES IN ABNORMALLY HIGH AMOUNTS when there is acute damage to liver cells as in hepatitis, infectious mononucleosis, and obstructive jaundice.
SERUM PROTEIN ELECTROPHORESIS (SE-rum PRO-ten e-ek-tro-for-E-sis):
This procedure separates proteins using an electric current. The material tested, such as serum, containing various proteins, is placed on paper or gel or in liquid and, under the influence of an electric current, the proteins separate (-phoresis means separation) so that they can be identified and measured. The procedure is also known as protein electrophoresis.
DECREASED PROTEIN = malnutrition
INCREASED PROTEIN = Infectious disease
In these tests, substances are applied to the skin or injected under the skin, and the reaction of immune cells in the skin is observed. These tests detect a person's sensitivity to substances such as dust or pollen. They can also indicate if a person has been exposed to the bacteria that cause tuberculosis or diphtheria.
SPUTUM TEST (SPU-tum test):
Examines mucus that is coughed up from the lungs. The sputum is examined microscopically and chemically and cultured for the presence of microorganisms.
These tests measure the levels of thyroid hormones, such as thyroxine (T 4) and triiodothyronine (T 3) in serum. Thyroid-stimulating hormone (TSH), which is produced by the pituitary gland and stimulates the release of T 4 and T 3 from the thyroid gland, can also be measured in serum. These tests aid in the diagnosis of hypo and hyperthyroidism and are helpful in monitoring response to thyroid treatment.
(TG) or TRIG
*assess the risk or heart disease
*as part of a lipid profile during regular exam or if being treated for high triglycerides
Determines the amount of triglycerides (fats) in the serum.
ELEVATED triglycerides are considered an important risk factor for the development of heart disease.
URIC ACID (UR-ik AS-id):
*to detect high levels of uric acid, which could be a sign of gout
Measures the amount of uric acid (a nitrogen-containing waste material) in the serum and urine.
HIGH SERUM LEVELS indicate a type of arthritis called gout. In gout, uric acid accumulates as crystals in joints and in tissues.
HIGH LEVELS OF URIC ACID may also cause kidney stones.
URINALYSIS u-rih-NAL-ih-sis):
*to screen for metabolic and kidney disorders
Examination of urine as an aid in the diagnosis of disease. Routine urinalysis involves
1)observation of unusual color or odor;
2)determining specific gravity (amount of materials dissolved in urine);
3)chemical tests (for protein, sugar, acetone);
4)and microscopic examination for bacteria, blood cells, and sediment. Urinalysis is used to detect abnormal functioning of the kidneys and bladder, infections, abnormal growths, and diabetes mellitus.
WESTERN BLOT (WES-tern blot):
*2nd HIV test , if ELISA is positive, must be confirmed with Western Blot Test.
This test is more specific than the ELISA to detect infection by HIV (AIDS virus). A patient's serum is mixed with purified proteins from HIV and the reaction is examined. If the patient has made antibodies to HIV, those antibodies will react with the purified HIV proteins, and the test will be positive.
(WBC)or White Count
*if your doctor thinks you might have an infection or allergy and to monitor treatment.
Determines the number of leukocytes in the blood.
HIGHER THEN NORMAL COUNTS can indicate the presence of infection or leukemia.
DIFFERENTIAL (di-fer-EN-she-l)
White Blood Cell Differential Count
also known as:WBC Differential,or DIFF
*the WBC Differential assesses the ability of the body to respond to and elimanate infection
*run as part of CBC
A differential is the percentages of different types of white blood cells (neutrophils, eosinophils, basophils, lymphocytes, monocytes)in a sample of blood.
I gives more specific information about leukocytes and aids in the diagnosis of allergic diseases, disorders of the immune system, and various forms of leukemia.

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