| kaka | بەروار: Thursday, 2013-09-05, 0:44 AM |بەشداری # 1 |
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Private
گروپ: Administrators
بەشداری: 15
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A-type Natriuretic Peptide (ANP)
22–77 pg/mL; SI units: 22–77 ng/L
. Lavender-top tube. Immediately send to lab on ice. Specimen
may need to be fasting; check with lab.
■ Secreted by atrial myocardium; exerts an antihypertensive
effect by increasing the renal excretion of sodium and water.
■ Secreted from the atria in response to atrial wall stretch.
■ Less useful than B-type natriuretic.
Acid-fast Bacillus Stain (AFB).
Negative for acid-fast organisms
. Sputum specimen sent in a sterile collection cup. Gastric
washings/aspirates, urine, cerebral spinal fluid (CSF), other body
fluids, or tissue samples may also be tested.
■ Sputum samples should be induced in the early morning to
obtain the best specimen.
■ Collect specimens for 3 days.
■ Tests for Mycobacterium tuberculosis, atypical mycobacteria,
or other acid-fast bacteria. See Tuberculosis Culture.
Acid Phosphatase (ACP, Prostatic Acid Phosphatase, PAP)
2.6 ng/mL or 0.5 IU/L; SI units: 2.2 – 10.5 U/L
. Red-top tube.
■Assess prostate cancer metastasis, treatment effectiveness.
■ Infrequently done; usual test is PSA, prostate-specific antigen.
ACTH (Adrenocorticotropic Hormone)
AM: 80 pg/mL; SI units: 18 pmol/L
PM: 50 pg/mL; SI units: 11 pmol/L
. Green-top tube.
■ Assess signs and symptoms of adrenocortical dysfunction.
■ Sample must be iced and sent to lab immediately.
ACTH Stimulation Test (Cosyntropin Stimulation Test)
7 g/dL over baseline in rapid screening test
40 g/dL over baseline in 1- or 3-day test
. Green-top tube.
■ Differentiate between pituitary-induced adrenal dysfunction
and adrenal insufficiency.
■ Test involves obtaining a baseline ACTH level, administering
cosyntropin (a synthetic ACTH-like drug) over a prescribed
period, and drawing repeat ACTH levels.
Activated Partial Thromboplastin Time (aPTT)
See Partial Thromboplastin time (PTT).
Antithrombin III (AT-III)
21–30 mg/dL; SI units: 210–300 mg/L
. Blue- or red-top tube.
■ Assess patients with thromboses.
■ Patients with low levels are resistant to heparin therapy.
Alanine aminotransferase (ALT)
10–35 U/L; SI units: 0–0.58 mkat/L
. Red-top tube.
■ Enzyme found in liver cells.
■ Used in diagnosis of liver, biliary, and pancreatic disease.
Albumin
Adult: 3.5–5 g/dL; SI units: 35–50 g/L
Child: 3.8–5.4 g/dL; SI units: 38–54 g/L
. Red-top tube.
■ Main plasma protein; helps maintain osmotic pressure.
Decreased albumin causes fluid shifts and resultant edema.
■ Levels decrease in renal or hepatic disease, acute infection,
malnutrition, malignancy, diabetes, and many other chronic
and acute conditions.
Albumin Cobalt Binding Test (ACB Test) (Ischemia-modified
Albumin [IMA])
85 U/mL
. Red-top tube.
■A new cardiac marker test. The binding properties of albumin
change when it comes into contact with ischemic heart tissue
(ischemia-modified albumin [IMA]) making it less able to bind
with cobalt. When a cobalt solution is added to the serum,
cobalt binds to the normal albumin but not to IMA. More free,
or unbound, cobalt indicates the presence of abnormal
albumin.
■ Level rises within a few minutes of the onset of cardiac
ischemia. Allows a greater window of time for therapeutic
intervention as other markers only detect cardiac muscle
necrosis, not ischemia.
■ Used in conjunction with ECG and troponin levels to evaluate
etiology of chest pain.
Albumin/Globulin Ratio (A/G Ratio)
1
. Calculated from total protein and albumin levels.
■ Total protein – albumin globulins. Albumin ÷ globulins A/G
ratio.
■ Serum protein electrophoresis has replaced the A/G ratio.
Aldosterone, Serum
7–30 ng/dL; SI units: 190–832 pmol/L (drawn in upright position)
3–16 ng/dL; SI units: 80–440 pmol/L (drawn in supine position)
. Red-or green-top tube.
■ Aldosterone is a potent mineralocorticoid that regulates sodium,
potassium, and water balance.
■ Used with plasma rennin levels to distinguish between primary or
secondary (more common) hyperthyroidism.
Aldosterone, Urine
2–26 g/24 hr; SI units: 6–72 nmol/24 hr
. 24-hr urine collection.
■ Aldosterone is a potent mineralocorticoid that regulates sodium,
potassium, and water balance.
■ Used to diagnose primary or secondary hyperaldosteronism.
Alkaline Phosphatase (ALP)
Adult: 42–136 U/L
Child: 50–230 U/L
. Red-top tube.
■ Enzyme found predominately in the liver, biliary tract, and bone.
■ Useful in assessing liver and bone disease.
■ ALP isoenzymes distinguish between liver and bone disease. ALP1 is
hepatic; ALP2 is from bone.
Alpha-Fetoprotein (AFP, a-Fetoprotein
Men, Nonpregnant Females: 16 ng/mL; SI Units: 16 mL
Pregnant Females at 15–18 Weeks’ Gestation: 10–150 ng/mL; SI units:
10–150 mL
. Red-top tube.
■ In men and nonpregnant females as a tumor marker to aid in
diagnosis of hepatocellular carcinoma, testicular tumor, ovarian
cancer. May be elevated in alcoholic cirrhosis.
■ In pregnancy to detect fetal neural tube defect, multiple pregnancy,
fetal distress, fetal death.
Ammonia
Adult: 15–45 g/dL; SI units: 11–35 mol/L
Child: 29–70 g/dL; SI units: 29–70 mol/L
. Green-top tube.
■ Ammonia forms when protein is broken down by bacteria in the
intestinal tract. It is then converted to urea by the liver and excreted
by the kidneys.
■ Elevated in liver failure. Elevations manifest as encephalopathy
(lethargy, confusion, tremors, coma).
Amylase, Serum
Adult: 60–160 Somogyi U/dL; SI units: 30–70 U/L
. Red-top tube.
■ Secreted by the pancreas and elevated in pancreatic disorders.
■ Damaged or obstructed pancreatic cells cause amylase to spill into
lymph ducts and the peritoneum where excess amylase is picked up
by by the blood.
Anion Gap (AG)
8–16 mEq/L
. Calculated from electrolyte values.
■ Anion gap equals the difference between the cations (sodium and
potassium) and the anions (chloride and bicarbonate).
■ (Na K) – (Cl- HCO3
-) AG
■ Elevated AG (17 mEq/L) is associated with metabolic acidosis.
■ Decreased AG (8 mEq/L) is associated with metabolic alkalosis
(see ABG section in this Tab).
Antibodies, Auto
◆ Anticentomere antibody
◆ Anti-DNA antibody
◆ Antiglomerular basement membrane antibody
◆ Antimicrosomal antibody
◆ Antimitochondrial antibody
◆ Antimyocardial antibody
◆ Antineutrophil cytoplasmic antibody (ANCA)
◆ Antinuclear antibody (ANA)
◆ Antiparietal cell antibody
◆ Antiscleroderma antibody (SCL 70)
◆ Antismooth muscle antibody
◆ Sjögren syndrome antibody (SS-A)
Negative. Reference ranges and measurement units for
individual tests vary as does the amount of detectable antibody
that constitutes a positive result. Results may be reported as the
amount of antibody detected and if the values are considered
negative, positive, or equivocal.
. Red-top tube.
■ Autoantibodies are proteins created by the immune system
that attack the body’s own tissues or organs.
■ Autoantibodies represent a failure by the immune system
to distinguish between foreign proteins and the body’s own
tissues.
■ Elevated autoantibody levels are found in people with
autoimmune disorders such systemic lupus erythematosus
(SLE).
■ Autoimmune disorders may be organ specific as in Graves’
disease, or systemic, as in vasculitis.
Antidiuretic Hormone (ADH); ADH Suppression Test
ADH: 1–5 pg/mL; SI units: 1.5 ng/L
ADH suppression test: 80% of waterload excreted in 5 hr; Urine
osmolality ≥100 mmol/kg; Urine to serum osmolality ratio 100;
Urine specific gravity 1.003.
. Red-top tube, plastic.
■ ADH controls the amount of water resorbed by the kidney.
■ Inadequate ADH secretion results in diabetes insipidus (DI).
■ Excess secretion of ADH related to various cancers (lung,
pancreas, urinary tract, blood) results in syndrome of
inappropriate ADH (SIADH).
Antistreptolysin O/Antistreptococcal O Titer (ASO)
Adult and preschool age child: 100 IU/mL
Child (school age) : 200 IU/mL
. Red-top tube
■ Streptolysin is an enzyme secreted by beta-hemolytic streptococci.
It causes an antibody response that begins to rise 1
week after streptococcal infection and peaks in 2–3 weeks.
■ High serum ASO levels are seen with acute rheumatic fever,
poststreptococcal glomerulonephritis, and collagen
diseases.
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| kaka | بەروار: Thursday, 2013-09-05, 0:44 AM |بەشداری # 2 |
|
Private
گروپ: Administrators
بەشداری: 15
|
A-type Natriuretic Peptide (ANP)
22–77 pg/mL; SI units: 22–77 ng/L
. Lavender-top tube. Immediately send to lab on ice. Specimen
may need to be fasting; check with lab.
■ Secreted by atrial myocardium; exerts an antihypertensive
effect by increasing the renal excretion of sodium and water.
■ Secreted from the atria in response to atrial wall stretch.
■ Less useful than B-type natriuretic.
Acid-fast Bacillus Stain (AFB).
Negative for acid-fast organisms
. Sputum specimen sent in a sterile collection cup. Gastric
washings/aspirates, urine, cerebral spinal fluid (CSF), other body
fluids, or tissue samples may also be tested.
■ Sputum samples should be induced in the early morning to
obtain the best specimen.
■ Collect specimens for 3 days.
■ Tests for Mycobacterium tuberculosis, atypical mycobacteria,
or other acid-fast bacteria. See Tuberculosis Culture.
Acid Phosphatase (ACP, Prostatic Acid Phosphatase, PAP)
2.6 ng/mL or 0.5 IU/L; SI units: 2.2 – 10.5 U/L
. Red-top tube.
■Assess prostate cancer metastasis, treatment effectiveness.
■ Infrequently done; usual test is PSA, prostate-specific antigen.
ACTH (Adrenocorticotropic Hormone)
AM: 80 pg/mL; SI units: 18 pmol/L
PM: 50 pg/mL; SI units: 11 pmol/L
. Green-top tube.
■ Assess signs and symptoms of adrenocortical dysfunction.
■ Sample must be iced and sent to lab immediately.
ACTH Stimulation Test (Cosyntropin Stimulation Test)
7 g/dL over baseline in rapid screening test
40 g/dL over baseline in 1- or 3-day test
. Green-top tube.
■ Differentiate between pituitary-induced adrenal dysfunction
and adrenal insufficiency.
■ Test involves obtaining a baseline ACTH level, administering
cosyntropin (a synthetic ACTH-like drug) over a prescribed
period, and drawing repeat ACTH levels.
Activated Partial Thromboplastin Time (aPTT)
See Partial Thromboplastin time (PTT).
Antithrombin III (AT-III)
21–30 mg/dL; SI units: 210–300 mg/L
. Blue- or red-top tube.
■ Assess patients with thromboses.
■ Patients with low levels are resistant to heparin therapy.
Alanine aminotransferase (ALT)
10–35 U/L; SI units: 0–0.58 mkat/L
. Red-top tube.
■ Enzyme found in liver cells.
■ Used in diagnosis of liver, biliary, and pancreatic disease.
Albumin
Adult: 3.5–5 g/dL; SI units: 35–50 g/L
Child: 3.8–5.4 g/dL; SI units: 38–54 g/L
. Red-top tube.
■ Main plasma protein; helps maintain osmotic pressure.
Decreased albumin causes fluid shifts and resultant edema.
■ Levels decrease in renal or hepatic disease, acute infection,
malnutrition, malignancy, diabetes, and many other chronic
and acute conditions.
Albumin Cobalt Binding Test (ACB Test) (Ischemia-modified
Albumin [IMA])
85 U/mL
. Red-top tube.
■A new cardiac marker test. The binding properties of albumin
change when it comes into contact with ischemic heart tissue
(ischemia-modified albumin [IMA]) making it less able to bind
with cobalt. When a cobalt solution is added to the serum,
cobalt binds to the normal albumin but not to IMA. More free,
or unbound, cobalt indicates the presence of abnormal
albumin.
■ Level rises within a few minutes of the onset of cardiac
ischemia. Allows a greater window of time for therapeutic
intervention as other markers only detect cardiac muscle
necrosis, not ischemia.
■ Used in conjunction with ECG and troponin levels to evaluate
etiology of chest pain.
Albumin/Globulin Ratio (A/G Ratio)
1
. Calculated from total protein and albumin levels.
■ Total protein – albumin globulins. Albumin ÷ globulins A/G
ratio.
■ Serum protein electrophoresis has replaced the A/G ratio.
Aldosterone, Serum
7–30 ng/dL; SI units: 190–832 pmol/L (drawn in upright position)
3–16 ng/dL; SI units: 80–440 pmol/L (drawn in supine position)
. Red-or green-top tube.
■ Aldosterone is a potent mineralocorticoid that regulates sodium,
potassium, and water balance.
■ Used with plasma rennin levels to distinguish between primary or
secondary (more common) hyperthyroidism.
Aldosterone, Urine
2–26 g/24 hr; SI units: 6–72 nmol/24 hr
. 24-hr urine collection.
■ Aldosterone is a potent mineralocorticoid that regulates sodium,
potassium, and water balance.
■ Used to diagnose primary or secondary hyperaldosteronism.
Alkaline Phosphatase (ALP)
Adult: 42–136 U/L
Child: 50–230 U/L
. Red-top tube.
■ Enzyme found predominately in the liver, biliary tract, and bone.
■ Useful in assessing liver and bone disease.
■ ALP isoenzymes distinguish between liver and bone disease. ALP1 is
hepatic; ALP2 is from bone.
Alpha-Fetoprotein (AFP, a-Fetoprotein
Men, Nonpregnant Females: 16 ng/mL; SI Units: 16 mL
Pregnant Females at 15–18 Weeks’ Gestation: 10–150 ng/mL; SI units:
10–150 mL
. Red-top tube.
■ In men and nonpregnant females as a tumor marker to aid in
diagnosis of hepatocellular carcinoma, testicular tumor, ovarian
cancer. May be elevated in alcoholic cirrhosis.
■ In pregnancy to detect fetal neural tube defect, multiple pregnancy,
fetal distress, fetal death.
Ammonia
Adult: 15–45 g/dL; SI units: 11–35 mol/L
Child: 29–70 g/dL; SI units: 29–70 mol/L
. Green-top tube.
■ Ammonia forms when protein is broken down by bacteria in the
intestinal tract. It is then converted to urea by the liver and excreted
by the kidneys.
■ Elevated in liver failure. Elevations manifest as encephalopathy
(lethargy, confusion, tremors, coma).
Amylase, Serum
Adult: 60–160 Somogyi U/dL; SI units: 30–70 U/L
. Red-top tube.
■ Secreted by the pancreas and elevated in pancreatic disorders.
■ Damaged or obstructed pancreatic cells cause amylase to spill into
lymph ducts and the peritoneum where excess amylase is picked up
by by the blood.
Anion Gap (AG)
8–16 mEq/L
. Calculated from electrolyte values.
■ Anion gap equals the difference between the cations (sodium and
potassium) and the anions (chloride and bicarbonate).
■ (Na K) – (Cl- HCO3
-) AG
■ Elevated AG (17 mEq/L) is associated with metabolic acidosis.
■ Decreased AG (8 mEq/L) is associated with metabolic alkalosis
(see ABG section in this Tab).
Antibodies, Auto
◆ Anticentomere antibody
◆ Anti-DNA antibody
◆ Antiglomerular basement membrane antibody
◆ Antimicrosomal antibody
◆ Antimitochondrial antibody
◆ Antimyocardial antibody
◆ Antineutrophil cytoplasmic antibody (ANCA)
◆ Antinuclear antibody (ANA)
◆ Antiparietal cell antibody
◆ Antiscleroderma antibody (SCL 70)
◆ Antismooth muscle antibody
◆ Sjögren syndrome antibody (SS-A)
Negative. Reference ranges and measurement units for
individual tests vary as does the amount of detectable antibody
that constitutes a positive result. Results may be reported as the
amount of antibody detected and if the values are considered
negative, positive, or equivocal.
. Red-top tube.
■ Autoantibodies are proteins created by the immune system
that attack the body’s own tissues or organs.
■ Autoantibodies represent a failure by the immune system
to distinguish between foreign proteins and the body’s own
tissues.
■ Elevated autoantibody levels are found in people with
autoimmune disorders such systemic lupus erythematosus
(SLE).
■ Autoimmune disorders may be organ specific as in Graves’
disease, or systemic, as in vasculitis.
Antidiuretic Hormone (ADH); ADH Suppression Test
ADH: 1–5 pg/mL; SI units: 1.5 ng/L
ADH suppression test: 80% of waterload excreted in 5 hr; Urine
osmolality ≥100 mmol/kg; Urine to serum osmolality ratio 100;
Urine specific gravity 1.003.
. Red-top tube, plastic.
■ ADH controls the amount of water resorbed by the kidney.
■ Inadequate ADH secretion results in diabetes insipidus (DI).
■ Excess secretion of ADH related to various cancers (lung,
pancreas, urinary tract, blood) results in syndrome of
inappropriate ADH (SIADH).
Antistreptolysin O/Antistreptococcal O Titer (ASO)
Adult and preschool age child: 100 IU/mL
Child (school age) : 200 IU/mL
. Red-top tube
■ Streptolysin is an enzyme secreted by beta-hemolytic streptococci.
It causes an antibody response that begins to rise 1
week after streptococcal infection and peaks in 2–3 weeks.
■ High serum ASO levels are seen with acute rheumatic fever,
poststreptococcal glomerulonephritis, and collagen
diseases.
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