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Clinical Analysis Areas & Tests

CLINICAL ANALYSIS AREAS: Hematology, Coagulation, Chemistry, Serology/Immunology, Urinalysis, Microbiology, Blood Bank/Immunohematology, Cytogenetic/Flow Cytometry.
HEMATOLOGY Dept performs lab tests to identify disease associated w/blood and blood forming tissues. Most commonly ordered is CBC (complete blood count).
CBC Complete Blood Count: Usually performed on a (Beckman Coulter Counter - electronically counts cells and calculates results.) CBC is a multipart assay reported on a form called a hemogram.
Coagulation Study of ability of blood to form and dissolve clots. Used to discover, identify & monitor defects in blood-clotting mechanism.
Anticoagulants Medications to thin the blood.
Common Coagulation tests
INR (International Normalized Ratio) *The PT & the calculated standardized unit for the PT (INR) are measures of the Extrinsic pathway of coagulation). Used in conjunction w/ activated aPTT, which measures the Intrinsic Pathway.
CHEMISTRY (Clinical Analysis Area) Dept. performs most lab tests. May have subsections: toxicology, therapeutic drug monitoring, molecular diagnostics. Highly computerized like COBAS 6000 instrument, performs metabolic panels on multiple testing aspects & risk panels per testing.
Risk Panels for Cardioyascular Assessment includes tests such as: Apolipoprotein B (ApoB); the primary component of LDL. 9p21: genomic marker for CAD. N-terminal prohormone of BNP (Brain Natriuretic Peptide or NT-proBNP). High-sensitivity C-reactive protein (hsCRP)
cont. Homocysteine: elevated levels increase risk for heart/blood vessel disease. Fibrinogen: biomarker assoc. w/ cardiovascular disease.
PM (Personalized Medicine) Customized health assessment, treatment and care.
Common Coagulation Tests:
Activated Partial Thromboplastin Time (aPTT) Prolonged times may indicate stage 1 defects; values reflect adequacy of heparin therapy.
D-dimer Evaluates thrombin & plasmin activity. Useful for testing for disseminated intravascular coagulation (DIC); used to monitor thrombolytic therapy.
Fibrin Split Products (FSP) High levels result in FDP fragments that interfere with platelet function & clotting.
Fibrinogen Fibrinogen deficiency suggests hemorrhagic disorders. Used mostly in obstetrics.
PT (Prothrombin Time) or (INR) International Normalized Ration Prolonged times may indicate stage 2 & 3 coagulation defects. Values are used to monitor warfarin therapy and evaluate liver diseases & Vitamin K deficiency.
TT (Thrombin Time)
Most common chemistry specimens: Serum & Plasma. Other types of specimens tested: whole blood, urine, various body fluids.
Disease/Organ Specific CHEMISTRY PANELS (CMS approved)
Panel Grouping & Diagnostic Tests
Panel Group: BMP (Basic Metabolic Panel) Glucose, Blood Urea Nitrogen (BUN), Creatinine, Sodium (NA2+), Potassium (K+), Chloride (Cl-), Carbon Dioxide (CO2), Calcium (CA2+)
Panel Group: CMP (Comprehensive Metabolic Panel) Albumin, glucose, BUN, Creatinine, Sodium, Potassium, Chloride, CO2, aspartate amino-transferase (AST), Alanine Aminotransferase (ALT), alkaline phosphatase, total protein, total bilirubin, calcium.
Panel Group: Electrolyte Panel Sodium, Potassium, Chloride, CO2.
Panel Group: Hepatic Function Panel A AST, ALT, Alkaline, phosphatase, total protein, albumin, total bilirubin, direct bilirubin.
Panel Group: Lipid Panel Cholesterol, lipoprotein, high-density cholesterol (HDL) triglycerides.
Panel Group: Renal Function Panel Glucose, BUN, creatinine, sodium, potassium, chloride, CO2, calcium, albumin, phosphorus.
Hct HEMATOCRIT Values correspond to the red cell count & hemoglobin level; when decreased: indicates anemic conditions.
Hgb HEMOGLOBIN Decreased values: indicate anemic conditions. Values differ per age, sex, altitude and hydration.
RBC Count RED BLOOD CELL COUNT Measure of erythropoietic activity. Decrease in numbers are related to anemic conditions.
WBC Count WHITE BLOOD CELL COUNT Abnormal leukocyte response indicative of various conditions (infection, malignancies). When accompanied by low WBCs, differential test becomes more specific.
Diff DIFFERENTIAL WHITE COUNT Changes in appearance or # of specific cell types signify specific disease conditions. Values also monitor chemotherapy or radiation Tx.
Indices Changes in RBC size, weight & Hgb content indicate certain anemias.
MCH Mean Corpuscular Hemoglobin Reveals the weight of the Hgb in the cell, regardless of size. Decreased content: indicates iron deficiency anemia. Increased content: found in macrocytic anemia.
MCV Mean Corpuscular Volume Reveals size of the cell. Decreased MCV: associated w/ thalassemia iron-deficiency anemia. Increased MCV: suggests folic acid or vitamin B12 deficiency & chronic emphysema
MCHC Mean Corpuscular Concentration Reveals the Hgb concentration per unit vol. of RBCs. Below Normal range: RBCs are deficient in Hgb (as in thalassemia, over hydration or iron-deficiency anemia. Above normal range is seen in severe burns, prolonged dehydration & hereditary spherocytosis.
RDW RED BLOOD CELL DISTRIBUTION WIDTH Reveals size of differences of the RBCs. Early predictor of anemia before other signs and symptoms appear.
Created by: MCasler



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