Thursday, November 26, 2009

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Basics of Laboratory Tests

Basic Info about Labs and Transcribing Values, etc.

(Book of Style) Do not put a comma in laboratory values, as in white blood cell count, of less than 10,000. The white blood cell count should be transcribed as 7000 not 7,000. D-dimer should be transcribed as 5000 not 5,000, for example.
DO use the comma when the value is 10,000 or more (5 digits).

BLOOD: CBC (complete blood count) includes: white blood cell count (WBCs), red blood cell count (RBCs), hemoglobin and hematocrit (H&H), platelet count. A CBC (complete blood count) with differential may contain these values dictated: segmented neutrophils, lymphocytes, monocytes, eosinophils, and basophils.

RENAL PROFILE: (kidney) SMA-7: Includes electrolytes (sodium, potassium, chloride, and CO2 - or they may say HCO3 or bicarbonate), because those measure the same thing in the blood.
Also includes BUN (blood urea nitrogen), creatinine, and glucose.

Electrolytes: May be a separate panel, which includes:
sodium, potassium, chloride, bicarbonate (may be CO2, which is carbon dioxide, or HCO3) - they measure the same thing in the blood) & glucose.

SMA-12 will include all that is in the SMA-7 and will also include other values, such as calcium, phosphorus, magnesium, and others (this may vary in different laboratories).

LIPID PROFILE:
Lipoproteins and triglycerides
Cholesterol, total
HDL cholesterol (high density lipoprotein)
LDL cholesterol (low density lipoprotein)
Triglycerides

LIVER FUNCTION TESTS: (LFTs)
AST (or SGOT)
ALT (or SGPT)
GGT (gamma glutamyl transferase)
direct bilirubin
indirect bilirubin
total bilirubin
LDH (lactic dehydrogenase)
albumin
total protein
5'-nucleotidase

Note: (some laboratories have not done the revision yet, but...)
Formerly known as SGOT (serum glutamic oxaloacetic transaminase) is now commonly called AST (aspartate aminotransferase).

Formerly known as SGPT (serum glutamic pyruvic transaminase) is now commonly called ALT (alanine aminotransferase).

BLOOD GASES:
pH
pCO2
pO2
HCO3
O2 Saturation %

URINE:
In determining infection, the laboratory test looks for NITRITES. And it is "leukocyte esterase" in the urine.
URINE: Specific Gravity normal ranges 1.010-1.030 0 WBCs, 0 RBCs, glucose 80, total protein 30, chloride 120. (normal ranges at some labs)

Of Note: It is nitrItes in the urine, and nitrAtes for the heart. I for urine, A for heart - is an easy way to remember! :)

BNP (which stands for B-type natriuretic peptide). This is a test for cardiology.

A BMP is basic metabolic profile which will have more than one value listed. Also known as: Basic Metabolic Panel, Chem 7, SMA 7.

Also tricky is CNP (cardiac natriuretic peptide) which can sound like CMP (comprehensive metabolic profile) which will also have more than one value.

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