Applied and improved
FPG: Fasting plasma glucose
FBS: Fasting blood sugar
2hpp: 2 hours post prandial sugar
GCT: Glucose challenge test
GTT: Glucose tolerance test
Hb A1C: Glycated Hemoglobin A1C
RBS: Random blood sugar
BUN: Blood urea nitrogen
Urea: Blood urea- Serum urea
Cr: Blood Creatinine Serum Creatinine
Na+: Natriumt. Serum Sodium.
K+: Kallium. Serum Potassium.
CL-: Chlorine- serum chl
LI+: Serum Lithium
Ca++: Serum- Calcium
Ph: Serum Phosphor
Fe+2: Serum Iron (sfe)
TIBC: Total iron binding capacity
Mg++: Serum magnesium
Amy: serum alpha amylase
Lip: serum- Lipase
CPK: Creatinine Phospho Kinase
LDH: Lactate de hydrogenase
Tpro: Serum total protein
Alb: Serum albumin
Ferri: Serum ferritin
Tchol: serum total cholesterol
LDL: Low density lipoprotein
HDL: high density lipoprotein
VLDL: very low density lipoprotein
Other. Components of lipid profile as requested.
ALT- PT: Alanine amino transferase
AST- OT: aspartate amino transferase
Bili- T: Total bilirubin
Bili- D: Direct bilirubin
Alkp: Alkaline phosphatase
GGT: Gamma glutamine Transferase
T4: four iodothyronine
T3: Three iodothyronine
TSH: Thyroid stimulating hormone
Anti Tpo: anti thyroid peroxidase
AntiTg: anti thyroglobulin
PT: Parathyroid Hormone
HCG: Human chorionic gonadotropic hormone
LH: Luteinizing Hormone
AMH: Anti mullerian Hormone
PRL: Prolactin Hormone
Test: Testosterone Hormone
DHEA: Dehydroepiandrosterone (s)
GH: Growth Hormone
GHRH: growth hormone releasing hormone
Cortisol: Cortisol Hormone
Others, As requested.
PSAT: total prostatic antigen
PSAF: Free PSA
CKMB: Creatinine kinase MB
LDH: Lactate dehydrogenase
HCVAb: Hepatitis C virus antibody
HBSAg: Hepatitis B virus antigen
HIV: Human immune deficiency virus- Ag: Ab
Procalcitonin. Infection marker.
Body fluid analysis
Cerebrospinal fluid (CSF)
Cell. Count, differential
Gram- staining: Bacterial meningitis (acute)
AFB staining- in Cases suspicious to TB.
Indian ink- and Gram- staining in cases- suspicious to Cryptococcus neo formans infection
Culturing, and identification for probable germs.
Abdominal fluid in cases of peritonitis, and/ or Ascites.
Culturing- aerobic/ and as requested Anaerobic culture.
Gram- staining- and AFB staining other fluids, also in small amount.
Joint fluid, analysis, pericardial fluid etc ...
Urine- The major body fluid which is voided several times a day (2/3 or more)
Urine is the ulterafilterate of plasma and its analysis reveal important information
Urine is also a part of acid- base balance of Hemostasis.
Kidney and bladder stone analysis
24 hours urine collection for protein
Urine- micro albumin (random)
Urine- protein- random
Urine culturing- and sensitivity testing
Urine sediment staining for Acid fast bacilli
Urine sediment cytology smear
Immune serologic tests
Immune serologic tests comprise of many applied test which are using in rapid, and accurate diagnosis of many diseases. Latex agglutination, immune flour scent and many others are based on Antigen- Antibody reactions. The results can be seen by naked eyes and or read by Elisa, and immune fluorescents/ systems.
CRP: C-reactive protein increased level can be seen in inflammation, infections Traumas, burns, heart attack- etc...
RF: Rheumatoid factor: increased level can be seen in many rheumatologic diseases especially in Rheumatoid arthritis degenerative joint. disease (Djd) and to some extent in systemic lupus Erythematous.
ANA: antinuclear antibody: increased level can be seen in SLE
dsdNese: increase in lupus erythematous and some autoimmune disease.
Anti CCP: anticyclical citrullinated antibody increment of this help in diagnosis of Rheumatoid arteritis especially when RF is Negative
Also it can differentiate between rheumatoid arthritis and other connective tissue diseases and. SLE.
ALPA: antiphospholipid antibody
This antibody seen in patient with autoimmune disorders- These Ab attacks phospholipids and cause blood cloths in vein and arteries
ANCA: Anti neutrophilic antibody and can be seen in 2 forms, P- ANCa and C-ANCa.
These antibodies are autoimmune antibody directed against neutrophilic granulocyte cytoplasmic Antigen and usually are increased in Cases of vasculitis: and Wagner’s granuloma.
Other- Serologic tests
-Widal: Widals are group of serologic test which are done in diagnosis of some infectious diseases such as salmonellosis- and typhoid fever.
OD- HD: Designate somatic Antigen
H. designate flagella antigen
Wright test: This test detect antibodies against Bacteria Causing brucellosis in Human of them Brucella melitensis from goat and Brucella abortous from cow
Wright: test detect IgM antibody in acute and IgG, and IgA in chronic and chronic active . ME test is done, which can break down the IgM and any IgG, are detected
Coomb’s Wright: A kind of wright test which detect blocking antibodies- usually IgA and lesser- extent IgG
SAT: standard agglutination test (tube dilution) is the method of choice.
ELISA method have high sensitivity- specificity for detection of brucellosis
Mono test: in infectious mononucleosis which is a viral infection, and the causative agent is Epstein barre- virus (EBV)
(Heterophil) Antibodies are produced which can agglutinate sheep RBC.
Previous name: Paul, Bunuel test
The result: are prepared within one hours
ASO: Anti streptolysin O: These are antibodies produced against streptolysin enzymes of Beta: Hemolytic- streptococci group A and when you search for rheumatic fever and or glemeronephritis post strep pyogen infection . this test is regarded as positive when the titer more than 200 Todd unit.
Glemeronephritis may occur post skin infection with strep group A.
CBC: Complete blood count which comprise white blood cells (WBC) Red blood cells (RBC), platelets( Plt s) and cell indices. Hemoglobin, hematocrit. Nowadays all component of CBC are done with automatic Hematology analyzer.
PBS: Peripheral blood smear- is a part of CBC panel and usually a slides are stained with wright and/ or Giemsa- staining. In PBS you can search for abnormal WBC/ RBC/ with different and shape Anisocytosis . Target cells and WBC abnormalities .
Blood bank: In blood bank of a hospital .blood group (Type) and compatibility testing (cross- match) are done.
Coomb’s test: Direct and Indirect coomb’s tests are also done in blood bank.
Blood grouping: usually done by cell type- Back type and A/ B/ O and Rh± (D) ± are detected.
Cold and warm antibody: detection are also done in Blood banks.
Bacteriology: Bacteria are unicellular organism majority of them are normal microbiota of Human and animal bodies. Some them are primarily invaders, means that when entrance the body can cause a cute (pyogenic) and chronic (not pyogenic) infectious diseases. Examples, shigella bacilli which can cause shigellosis (dysentery and diarrhea. mycobacterium tuberclosis complex which can cause tuberclosis . Majority of bacteria can be gowned in artificial media and they can be diagnosed by different colony characters and a battery of biochemical test . These statements are the essence of clinical microbiology.
Culture: Put the specimen on special media and observe colonies, and identification.
According to their colony morphology, enzymes, and microbial byproducts.
Aerobic culture: Diagnose majority of aerobic and facultative microbes such as Neisseria gonorrhea etc...
Anaerobic culture: detect and diagnose anaerobic bacteria such as clostridium, bacteroides: etc...
Microaerophilic culture: detect and diagnose microaerophilic bacteria such as helicobacter pylori, campylobacter etc...
The second important step in a medical bacteriology is Antimicrobial sensitivity testing .
In our lab (Shahryar- hospital- lab). Both quantitative MIC determination (E test) and qualitative antibi grams done:
Staining in microbiology:
Simple staining (Methylene blue stain) can detect microbial morphology shape well.
Gram- stain: Can differentiate bacteria as gram positive (violet) and gram negative (pink)- under the microscope Also you can detect bacterial morphology as cocci, bacilli, coccobacilli.
Acid fast staining: Mtb and other acid fast bacteria, Lepera . Can be detected by light microscopy when stained by fusion.
Wet- KOH prep for fungus. 10% KOH
Fungi- culture, and identify cation done in our Lab.
Parasites can be also detected in human excreta (stool -feces) urine, sputum
As a clinical laboratory we try to do the best as we can and hope to be beneficial
Coagulation test, are ordered
When there is easy bruising
Nose bleeds, spontaneous gingival bleeding, when there is an artery or vein thrombi , in DIC when there is a chance of dead fetus .high risk surgery , in which bleeding is not predictable
Inpatients with hematologic disease (leukemias..)
D- Dimer: is a product of Fibrin when is disintegrated (FDP)- and is usually ordered in Deep vein in thrombosis (DVTs) and thromboembolism (Lungs)
PTT: Partial thrombi plastic time and aPTT.
PTT check for factors I, VIII XIII X, XI IX V II
Fibrinogen (I). Prothrombin (II) etc…
This test done in a test tube under controlled condition and measures factor deficiency, in activity and imbalance: Especially in patients using Heparin, etc…
Normal range differ from a laboratory to other, but range from 25- 32 seconds.
F: Fibrinogen test: a single test which measures the function & Fibrinogen.
Von will brand factor, it is ordered to VWF.
Determine von will brand disease and when PTT is abnormally prolonged
Coagulation and fibrinolysis are the cornerstones of Hemostasis.
In coagulation Fibrinogen (FI) is converted to Fibrin and clot is formed and the process terminate.
In fibrinolysis plasminogen- converted to plasmin and acts on clot and melted it.
In coagulation two cascades (pathway) act simultaneously, Extrinsic Pathway which evaluate vita k (liver) FII FI FX FVII and FV (PT) and intrinsic pathway which check for all factors except VII and XIII (PTT).
These two come to each other in common pathway and finally fibrinogen (FI) converted to fibrin clot.
For evaluation of Hemostasis several other tests are checked such as:
BT: bleeding time- which detect platelet number and function
CT: clothing time which measure the time for clot formation outside
T.T: thrombin time which measure the time for a clot to be formed in plasma.
PT: prothrombin time: which measures the function of FI FII FX FVII and Fr- in a test tube. In conventional method is 12-14 second. In other method may varies 15-20 second
INR: international randomized ratio is calculated value (patient PT/ Control PT) Which state the effective ness of warfarin in during treatment. And normally range between 0.8 (02)