Applied and improved

Lab. Panels

Clinical chemistry

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

Zinc: Zn.

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

 

Lipid profile

Tchol: serum total cholesterol

LDL: Low density lipoprotein

HDL: high density lipoprotein

VLDL: very low density lipoprotein

TG: Triglyceride

Other. Components of lipid profile as requested.

 

Liver enzymes:

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

 

Hormones assay:

T4: four iodothyronine

T3: Three iodothyronine

TSH: Thyroid stimulating hormone

Anti Tpo: anti thyroid peroxidase

AntiTg: anti thyroglobulin

PT: Parathyroid Hormone

FERTILITY Hormones

HCG: Human chorionic gonadotropic hormone

Prog: progesterone

Est: Estrogen

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.

 

Tumor markers

PSAT: total prostatic antigen

PSAF: Free PSA

Myocardial assays

Trop: troponin

CKMB: Creatinine kinase MB

LDH: Lactate dehydrogenase

 

Viral assays

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

Protein determination

CSF- chemistry

Sugar determination

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.

Protein- determination

Sugar- determination

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.

 

a-Urine analysis

Macroscopic evaluation

Microscopic examination

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

OB- HB

OA- HA

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

 

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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.

 

Hematology: Panels

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.

 

Clinical Microbiology

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.

 

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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 assays

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)