This test is to monitor for overdose of acetaminophen (Ex: "Tylenol")
Usually collected in a red-top tube; Allow 30-60 min. to clot first before centrifugation
ADH: Antidiuretic Hormone
This test aids in the diagnosis of pituitary function, diabetes insipidus, and the individual should fast for 12 hours prior to the test and limit physical activity before collection
Will be elevated in SIADH (syndrome of inappropriate antidiuretic hormone), nephrogenic diabetes insipidus, porphyria, pulmonary disease, or Guillain-Barre' syndrome
Will be decreased in nephrotic syndrome or pituitary diabetes (diabetes insipidus)
ALB: Albumin
Albumin is a protein made by liver cells and the most common protein found in the plasma/serum
Albumin helps to prevent the leakage of fluid from blood vessels into extracellular fluid and tissues and it helps maintain osmotic pressure
As part of a liver function test, it can aid in the identification of liver damage, disease or disorders
Levels tend to drop in individuals with viral Hepatitis C or cirrhosis of the liver
Very low levels of albumin result in edema, or fluid buildup/retention in the tissues such as the legs, face, or stomach (ascites fluid)
Low levels of albumin may also indicate renal (kidney) disease or dysfunction, illness, or malnutrition
Levels may be elevated if an individual is dehydrated, has severe vomiting and/or diarrhea, or is on heparin, insulin, or anabolic steroids
ALK-P: Alkaline Phosphatase (liver enzyme)
Tests for an enzyme that is made by the liver and bones and placenta of pregnant women and may indicate a liver or bone disorder, disease or condition, biliary obstruction, or vitamin D deficiency and rickets, vitamin D malabsorption, or bone demineralization
May be part of a liver panel test
Decreased in Mg or protein deficiency
Increased in skeletal disease, biliary obstruction, cirrhosis, mononucleosis, hepatitis, osteomalacia, vitamin D deficiency and rickets, or biliary fibrosis in Paget's disease
Individuals should fast for 8 hours prior to collection
Ranges from about 30-85 IU/mL
ALT: Alanine Aminotransferase (liver enzyme), also called alanine transaminase
Part of a liver panel/function test
Tests for a liver enzyme, a protein that liver cells make, which is found in plasma, serum, and tissues of the body, mainly in the liver
It catalyzes (kicks off) two reactions of the alanine cycle
Requires the help of the coenzyme pyridoxal phosphate
One of the most important liver function tests (more so than the AST)
Serum levels are clinical biomarkers for the health of the liver
When liver cells are damaged, they can release ALT into the bloodstream, causing the blood levels of the enzyme to be elevated, therefore a high level may indicate some liver damage
Usually elevated in viral hepatitis, diabetes, fatty liver, congestive heart failure, damage to the liver, problems with the bile duct, gallstones, infectious mononucleosis, myopathy, choline deficiency, some types of drugs and antibiotics
Individuals with viral Hepatitis C (acute or chronic), liver damage due to toxicity or drugs, ischemia, or cirrhosis of the liver may or may not have elevated ALT levels
AMY: Amylase
This test is important in the diagnosis of acute pancreatitis or pancreatic injury
Individuals must avoid alcohol prior to the collection
Decreased in chronic pancreatitis, pancreatic cancer, cirrhosis or hepatitis
Increased in acute pancreatitis, biliary duct obstruction, peptic ulcer resulting in pancreatic injury, pancreatic cancer, renal disease, and in some drug usage
Amylase is the enzyme secreted by the pancreas and salivary glands, which breaks down starch into sugars and is naturally present in the saliva of humans and it begins the process of digestion
Anion Gap:
This is a measurement designed to determine types of metabolic acidosis, to monitor renal function and total parenteral nutrition
Normal range is 8-14 mEq/L
Decreased in hyponatremia, multiple myeloma, use of diuretics, ACTH, cortisone, excess use of antacids or black licorice, excess IV infusion of sodium chloride, iodine absorption, and use of some drugs
Increased in ketoacidosis, lactic acidosis, fasting, starvation and eating disorders, salicylates or ingestion of antifreeze, corticosteroid use, drugs to lower blood pressure, diuretics
aPTT: Activated Partial Thrombin Time
In an individual who is NOT on an anticoagulant, 107 seconds +/- 13 seconds is normal
During cardiac bypass surgery, it should be 400-600 seconds
During oxygenation it should be 220-260 seconds
If drawn from a line, the first 5-10 mL drawn should be discarded prior to drawing the sample to be sent to the lab for testing
This is used to monitor the effect of heparin or of protamine sulfate in heparin neutralization
This is used to identify severe deficiencies in blood clotting factors (other than factor VII)
AST: Aspartate Aminotransferase
Part of a liver panel/function test
Tests for a liver enzyme, a protein that liver cells make
High ALT: When the liver is damaged, AST leaks out of the liver cells and into the bloodstream, making the levels higher in the blood, as in acute viral hepatitis, drug-induced liver damage, severe skeletal muscle trauma, liver congestion, or major surgery, severe MI, cirrhosis, mononucleosis, chronic hepatitis, MD, hemolytic anemia, liver tumors, embolisms, fatty liver, acute pancreatitis or other conditions
Found also in the heart, kidneys, muscles and brain, so elevated levels in the blood might mean that any of these organs may be damaged
High AST/Normal ALT: damage may be coming from someplace other than the liver
Alternating levels of high and low or even normal AST: May indicate viral Hepatitis C
BILI: Bilirubin
Part of a liver panel/function test designed to assess hepatic function and aid in the diagnosis of jaundice and monitoring of these conditions, as well as aid in the diagnosis of biliary obstruction and hemolytic anemia
Bilirubin is the breakdown product of hemoglobin from RBCs and is a yellowish pigment and passes through the liver
The liver excretes bile, which contains bilirubin, and this is affected by a damaged liver, and this may cause levels to be elevated
Individuals with viral Hepatitis C may have fluctuating levels of bilirubin in their bloodstream
Chronic levels of elevated blood bilirubin indicate severe liver damage or cirrhosis and can cause dark urine, light colored stools and jaundice (yellowing of the skin and/or whites of the eyes)
Direct Bilirubin
Indirect Bilirubin
Total Bilirubin (Direct + Indirect)
If >15 mg/dL in a neonate, this indicates a need for an exchange transfusion
Elevated in hepatic damage, severe hemolytic anemia, biliary obstruction, Gilbert syndrome
Includes the following tests: Sodium (Na+), Potassium (K+), Chloride (Cl-), CO2, Glucose, BUN, Creatinine, Calcium (Ca+), Glomerular Filtration Rate (GFR), BUN/Creatinine Ratio
GHGB: Hemoglobin A1C
Tests for glucose levels and insulin in the bloodstream to aid in the diagnosis and monitoring of diabetes mellitus type 2
H & H: Hemoglobin and Hematocrit
Aids in the diagnosis and monitoring of red blood cell health, such as anemia, hemorrhages, need for blood component administration, packed red blood cells, polycythemia, and other diseases and disorders of the red blood cells
BNP: B-Type Natriuretic Peptide
Aids in diagnosis of acute heart failure (800 pglml), myocardial infarcation (100-400), pulmonary embolism (150-500), aortic stenosis (100-500) or left ventricular dysfunction
Normal is <100 pg/mL
Increased in renal disease in the absence of heart failure
Run on an EDTA lavender-top Vacutainer tube, spun (serum)
If an individual has had an infusion of nesiritide, collection should wait until 2 hours post-infusion to avoid contamination of the sample
BNP is a hormone that is secreted by cardiomyocytes (cells) found in the heart ventricles, which respond to stretching when ventricular blood volume is increased
Ca++: Calcium
Aids in diagnosis and monitoring of thyroid and parathyroid problems, Cushing's disease, renal failure, pancreatitis, peritonitis, malnutrition, increased or decreased albumin, tumors/cancer, increased antacid use
PCT: Procalcitonin
This test will be decreased with estrogen use
This test will be increased in renal failure, pancreatitis, thyroid problems, cirrhosis of the liver, cancer, or pernicious anemia
ICA: Ionized Calcium
Increased in bone cancer
Decreased in diarrhea, malabsorption, alcohol poisoning, renal failure, pancreatitis, certain medication use, heparin use, laxative use, use of magnesium-based products such as some antacids
Cl-: Chloride
An electrolyte
Aids in diagnosis of dehydration, renal failure, acidosis, certain medication use, IV of sodium excess, vomiting, excess use of antacids
CK/CKMB: Creatine Kinase
CKMB specifically tests isoenzymes in blood
CK tests isoenzymes in heart and muscle cells
CKBB tests isoenzymes in the brain and smooth muscle
CKMM tests isoenzymes in the heart and muscle cells
This is part of the cardiac markers tests, which aids in the diagnosis of myocardial infarction, myocarditis, muscular dystrophy, Reyes syndrome, traumatic brain injury, hypothermia, ischemia, renal failure, and carbon dioxide poisoning
Creatinine:
Tests for renal (kidney) disease
D-Dimer:
Coagulation test and aids in diagnosis and monitoring of disseminated intravascular coagulation, pulmonary embolism, blood clots, AV thrombosis, neoplasms, fibrinolysis, meningitis and pregnancy
DRSU: Drug Screen on Urine
ESR: Sedimentation rate
Tests to see how long it takes the RBCs to settle
Decreased in polycythemia, sickle cell crisis, hyperviscosity (thick blood), and fibrinolysis
Increased in pregnancy, anemia, inflammation, TB, multiple myeloma, Waldenstrom's macroglobulinemia, rheumatory arthritis, and RF
T4: TT4 and FT4 (Thyroxine)
Monitors thyroid disorders and heparin usage
Circulates in the blood as an equal mix of free and serum protein bound hormone
Total T4 monitors bound T4 (bound to protein) and free T4 monitors free (unbound) hormone
T4 is bound to thyroxine binding globulin (TBG) 75%, albumin 10%, and prealbumin 15%, estimated
FT4 elevated in thyroid goiter and toxic levels of hormone therapy
Only about 0.03% circulates as free, unbound hormone, which is the biologically active hormone
T3: TT3 and FT3
Monitors thyroid disorders and dysfunctions (most useful test), heparin usage and 3rd trimester pregnancy
Circulates in the blood as an equal mix of free and serum protein bound hormone
Total T3 monitors bound T3 (bound to protein) and free T3 monitors free (unbound) hormone
FT3: quantitative for free triiodothyronine in serum and plasma
Free portion is the biologically active thyroid hormone
Elevated in Graves' Disease
TT3: Bound to thyroxine binding globulin (TBG) (38-80%), prealbumin (9-27%), and albumin (11-35%), estimated
Hb: Hemoglobin
Aids in diagnosis of polycythemia, dehydration, anemias, hemorrhages, and fluid retention
INR:
This is a coagulation study test that monitors Warfarin therapy, DIC, cirrhosis, heparin therapy, vitamin K deficiency, salicylic acid intoxication (aspirin), and blood transfusions
Part of a liver function test
LA: Lactic Acid
This test is used to aid in the diagnosis of acidosis, cardiac failure, pulmonary failure, hemorrhage, diabetes mellitus type 2, hepatic diseases, and shock
Collected in a gray-top tube and placed in an ice slushy, protected from light
Lactic acidosis is a type of metabolic acidosis and is the result of an acute or chronic condition, toxicity or poisoning, or the use of some types of medication
Type A: decreased blood flow or decreased tissue oxygenation (this is called hypoxia or ischemia) and is more serious
Type B: B1 (underlying disease), B2 (medication, toxicity, poisoning, intoxication), B3 ( inborn error of metabolism, such as a mitochondrial disease, glucose-6-phosphatase deficiency, other enzyme deficiencies)
When lactate builds up in the body, it lowers the pH (anything <7.35-7.45 is considered "acidic")
Some diseases that cause this include underlying heart disease, lung disease, infection with sepsis, inflammation, severe trauma, severe dehydration, shock, cancer, cellulitis, bowel ischemia (twisted bowel, alcoholism and intoxication), blood poisoning
Signs and symptoms: nausea, vomiting, weakness, hyperventilation, tachycardia (rapid heartbeat)
Diabetic ketoacidosis is a type of metabolic acidosis in patients with uncontrolled diabetes mellitus
Lipase:
This test is used to aid in the diagnosis of acute pancreatitis, pancreatic duct obstruction, gallstones, peptic ulcer, obstruction of the intestines, pancreatic cancer, and renal failure
Mg++: magnesium:
This electrolyte test is used to aid in the diagnosis and monitoring of dehydration, renal failure, lithium levels for those on lithium salts for Bipolar disorder, Addison's disease, alcoholism, MA, diarrhea, pancreatitis, burns, parathyroidism, malnutrition, muscle, nerve and enzyme function
Osmolality:
This test aids in the diagnosis and monitoring of kidney diseases
It will be altered in ADH secretion, hyponatremia, H2O intoxication, dehydration, azotemia, diabetic ketoacidosis, diabetes insipidus, hypernatremia, and hypercalcemia
PTT: Partial Thrombin Time
Coagulation test used to monitor clotting factors, heparin, FSP, fibrinogen, and anticoagulant therapy
Phosphate:
This test is useful in the diagnosis and monitoring of skeletal diseases, healing fractures, thyroid disorders, DKA, intestinal obstruction, lactic acidosis, renal failure, malnutrition, MA or acidosis
PT: Prothrombin
This coagulation test aids in the monitoring of fibrinogen, prothrombin, factors V, VII, X or K, and monitors anticoagulant therapy
Part of a liver function test
CMP: Comprehensive Metabolic Panel
16 tests that monitor the health of the kidney and liver, electrolytes, metabolism, state of hydration, acid/base balance, blood glucose and blood proteins
Includes: Alkaline phosphatase (ALK-P), Albumin (ALB), BUN, Calcium (Ca+), Chloride (Cl-), Creatinine, Potassium (K+), Total Protein, Glucose, Total Bilirubin (BIL-T), AST, ALT, Na+, CO2, GFR
CPK: Creatine Kinase
Aids in diagnosis of myocardial infarction, heart attack, and muscle damage
Tpn: Troponin:
One of the cardiac marker tests, this test also aids in detecting small infarcts, transient ischemic attacks, acute myocardial infarctions, necrosis and muscle damage, unstable angina, myocarditis, chronic renal failure, congestive heart failure, muscle trauma and rhabdomyolysis
HAPT: Haptoglobin
Haptoglobin is a protein that is synthesized by the liver
It binds with the globin chains of hemoglobin
It conserves iron and prevents hemoglobin loss
This test aids in the diagnosis of anemia, hemolytic disease of the newborn, and transfusion reactions (low levels)
Liver diseases, mechanical heart valves, and vigorous exercise can also cause levels to be consistently low
Elevations of haptoglobin are associated with infections of tissue, trauma, necrosis, or surgery, biliary obstruction, or ongoing corticosteroid therapy