CLINIPATH PATHOLOGY SPECIMEN COLLECTION GUIDE

Transcription

CLINIPATH PATHOLOGY
SPECIMEN COLLECTION
GUIDE
Clinipath Pathology
310 Selby Street North
Osborne Park 6017
Tel:
08 9371 4200
Fax:
08 9371 4444
Web Site:
www.clinipathpathology.com.au
All rights reserved.
No part of this manual may be reproduced, stored in
a retrieval system, or transmitted in any form or any means without the
written permission of Clinipath Pathology
This handbook has been compiled by Clinipath Pathology.
Every care has
been taken to ensure that the information is correct at the time of
printing.
November 2014
Version: CLI-QU-MAN-0026.00
Specimen Collection Guide
10-Nov-2014 Page 1 of 122
CLINIPATH PATHOLOGY
Introduction
SPECIMEN COLLECTION GUIDE
HOW TO USE THIS MANUAL
This book provides comprehensive listings of tests and activities undertaken by Clinipath
Pathology. For ease of use, the entries within this book are in alphabetical order. This
includes diseases, drugs, pathogens, test names, specimen types, analytes, procedures or
clinical topics. Tests which are commonly known by multiple names are cross-referenced and
the detailed test information given under the full test name.
Headings used throughout the manual include:
Test Name:
Test names highlighted in black either have to be collected at the
main laboratory only or have special collection requirements. It is
advisable to contact the Duty Manager on 08 9371 4440 before
collection.
Specimen Required:
This will list the type of specimen i.e. Swab, Serum (1xSST), Mid
Stream Urine (MSU).
Department:
The department which will perform the test and who to contact if you
have any queries about the test. In the case of referred tests you
should contact the Duty Manager in Perth or the Laboratory Manager
in Bunbury.
Reference Range:
Reference ranges are provided in this book for common tests and
analytes. For other tests, the reference ranges may be provided on
the report. From time to time, the reference ranges for a given test
may change due to new methods being introduced. Standard S.I.
units are used throughout this manual.
Interpretation:
Tests may have interpretative comments suggesting the reasons for
a HIGH/LOW result. These are intended as a guide only and
additional queries should be directed to the appropriate pathologist.
Note:
These will contain any special collection requirements such as “Must
be collected at main laboratory for immediate processing.”
No Rebate:
Test marked "No rebate" are not eligible for a medicare rebate. Patients need to be
informed that they will receive a private account. Current costs are available from
Duty Manager or Account department.
Up Front Fee:
Tests marked with "Up front fee" require the patient to pay for the collection and
processing costs of the test before collection. As of Nov 2014 this cost is $80.00
but is subject to change
Specific Requirment:
Tests marked "Specific requirements" mean that the patient must meet certain
requirements to be eligible for a medicare rebate
Comment:
These will include indications and/or limitations of the test and also
may indicate additional information that is required to perform the
test.
ASSAYS NOT LISTED
As a result of continued development, new assays and improved methods are constantly being
introduced. If you require tests not currently listed, please contact the laboratory.
10-Nov-2014 Page 2 of 122
CLINIPATH PATHOLOGY
A
Appendix I
1, 25–OH CHOLECALCIFEROL
Specimen required:
Department:
1 x dedicated small SST
Referred test
3 - METHOXY- 4 - HYDROXYMANDELIC ACID
See ADRENALINE / NORADRENALINE
5HIAA
See HYDROXYINDOLACETIC ACID
17-OH PREGNELONONE
SEE PREGNELONONE
17– OH PROGESTERONE
Specimen required:
Department:
Reference range:
Interpretation:
Serum (1 x SST)
Referred test
Gender specific as stated on report.
HIGH – Congenital adrenal hyperplasia
21 HYDROLASE ANITBODIES
Specimen required:
Department:
1 x SST
Referred test
25–VIT D
See Vitamin D
25 - OH CHOLECALCIFEROL
See VITAMIN D
α 1AT
See ALPHA 1 ANTITRYPSIN
α N ACETYLGALACTOSAMINIDASE
See ALPHA N Acetylgalactosaminidase
10-Nov-2014 Page 3 of 122
CLINIPATH PATHOLOGY
A
A
A1AT
See ALPHA 1 ANTITRYPSIN
AA SCREEN
See AMINO ACID SCREEN
ABSCESS
See WOUND ASPIRATE
ACANTHAMOEBA
Specimen required: Eye swab or Corneal scrapping
Department:
Referred test
Comment:
Notify Duty Manager if requested. May be requested by ophthalmologist in patients who wear
contact lenses and have eye ulceration. Limited material is usually available for all tests.
See also:
Eye Swab
ACA
See ANTI CARDIOLIPIN ANTIBODIES
ACE
See ANGIOTENSIN CONVERTING ENZYME
ACETOMINOPHEN
See PARACETAMOL
ACETYLCHOLINE RECEPTOR ANTIBODIES ( ACRA )
See ANTI ACETYLCHOLINE RECEPTOR ANTIBODY
ACETYLSALICYLIC ACID ( ASPIRIN )
See SALICYLATES
ACID FAST BACILLI ( AFB )
See TUBERCULOSIS
ACH
ACLA
ACPA
See ANTI CYCLIC CITRULLINATED PEPTIDE
ACR
See ALBUMIN/CREATINE RATIO
ACRA
10-Nov-2014 Page 4 of 122
CLINIPATH PATHOLOGY
A
ACTH ( ADRENOCORTICOTROPHIC HORMONE )
Please refer patient to Main Laboratory ONLY.
Specimen required: 1 x PPT - Must be full tube. Tubes must be pre-chilled and collected on ice.
Department:
Biochemistry
Reference range:
0 - 10 pmol/L (Diurnal Variation)
Interpretation:
LOW - Pituitary insufficiency, extrapituitary Cushing’s disease
HIGH - Cushing’s disease of pituitary origin, adrenal insufficiency, ectopic ACTH
Note:
Ideally collected between 8am & 9am, Mon-Fri. Specimen to be spun and frozen immediately.
Afternoon collection (4-5pm) available only when specially requested. (No Add ons)
ACTIVE B12 (Holotranscobalamin)
Specimen required:
Department:
1 x SST
Biochemistry
M
ACTIVATED PROTEIN C RESISTANCE ( APC RESISTANCE )
Specimen required:
Department:
Reference range:
1 x EDTA for molecular study for Factor V Leiden gene mutation
1 x)
Haematology
Norm
ACUTE PHASE REACTANTS
See ESR, FERRITIN, C-REACTIVE PROTEIN
Comment:
If acute phase reactant not specified do an ESR and C-Reactive protein.
ADENOVIRUS SEROLOGY
Specimen required:
Department:
Comment:
ADENOVIRUS PCR
Specimen required:
Department:
Comment:
1 x SST
Referred test
May occasionally cause respiratory infection, rash, meningitis
Dry swab from eye(s) for PCR or stool sample for gastroenteritis. Dry nasal swab and
throat swab if for diagnosis of respiratory infection.
Referred test
Can cause acute conjunctivitis + strains 40/41 cause gastroenteritis
ADRENALINE / NORADRENALINE – Urine ( CATECHOLAMINES )
Specimen required:
Department:
Reference range:
Interpretation:
Note:
Adult - 24 hour urine collection.
Child(<16yrs) – Random urine is preferred specimen
Referred test
Adrenaline
<120 nmol/day
Noradrenaline
<600 nmol/day
HIGH - Phaeochromocytoma, Neuroblastoma (children), severe stress or exercise.
Preservative: 20 mls of 50% Hydrochloric Acid.
Patient should be informed of the need for care with the preservative.
ADH (ANTI DIURETIC HORMONE OR VASOPRESSIN)
See Anti Diuretic Hormone
ADIPONECTIN
Specimen required: 1 x SST separate and freeze ASAP
Demartment:
Referred test
10-Nov-2014 Page 5 of 122
CLINIPATH PATHOLOGY
A
ADRENALINE / NORADRENALINE – Blood
Comment:
Specimen required:
Department:
Note:
Due to special collection requirements this test can only be performed at the Main
Laboratory.
See Metanephrines-Plasma
Referred test
Blood testing will only be performed if Urine Adrenaline/Noradrenaline is elevated and
consultation with pathologist has occurred.
ADRENOCORTICOTROPHIC HORMONE ( ACTH )
See ACTH
AFB CULTURE
See TUBERCULOSIS
AFB SMEAR
See TUBERCULOSIS
Department:
Referred test
Comment:
Can be performed at Clinipath Pathology for urgent cases.
AH50
See CH50
AHS
See Australian Health Survey
AIDS
See HIV SEROLOGY
ALANINE TRANSAMINASE ( ALT OR SGPT )
Specimen required: Serum (1 x SST)
Department:
Biochemistry
Reference range:
0 - 40 U/L
Interpretation:
HIGH - Liver cell damage.
- In viral conditions such as Hepatitis C, the elevation of ALT is typically greater than AST.
Comment:
This Laboratory routinely performs this test as part of Liver Function Tests.
ALBUMIN ( ALB )
Specimen required:
Department:
Reference range:
Interpretation:
Comment:
Serum (1 x SST)
Biochemistry
35-50 g/L
HIGH - Shock, dehydration
LOW - Malnutrition, malabsorption, cirrhosis, heart failure, nephrotic syndrome,
acute phase response
ALBUMIN CREATINE RATIO
Specimen required:
Department:
Reference range:
Spot urine
Biochemistry
As stated on report
10-Nov-2014 Page 6 of 122
CLINIPATH PATHOLOGY
A
ALCOHOL (ETHANOL) – LEGAL (C2H5OH)
Specimen:
Specimen will have already been collected and will be provided in a legal container
Prepayment required $250.00 (June 2012.)
Mark specimen “for legal use only” do not disturb the seal refer to Healthscope Functional
Pathology.
ALCOHOL (ETHANOL) – NON-LEGAL
Specimen required:
Department:
Note:
See also:
ALDOSTERONE
Comment:
Specimen required:
Department:
Note:
Clinipath Pathology Serum (1 x SST )
Bunbury Pathology 1 x Lith Hep, no alcohol wipes
Spot urine samples may be used.
Biochemistry
Clinipath Pathology can perform NON-LEGAL ALCOHOLS ONLY.
DRUGS of ABUSE
If this test is requested with RENIN, please refer the patient to the MAIN LABORATORY .
1 x PPT - Must be full tube (Bunbury Pathology –collect main lab only)
Referred test
Please note medications on request form, this is a non-fasting test
When supine and erect levels are requested, samples should be taken following 20 minutes in
each position. (Not available as an Added Test)
ALDOSTERONE/RENIN
Comment:
Specimen required:
Department:
Note:
Please refer the patient to the MAIN LABORATORY 8.00-9.00am.
1 x PPT - Must be full tube (Bunbury Pathology –collect main lab only)
Referred test
Please note medications on request form, this is a non-fasting test
When supine and erect levels are requested, samples should be taken following 20 minutes in
each position. (Not available as an Added Test)
ALK PHOS ISOENZYMES
See below ALKALINE PHOSPHATASE ELECTROPHORESIS
ALKALINE PHOSPHATASE ( ALP )
Specimen required:
Department:
Reference range:
Interpretation:
Comment:
Serum (1 x SST) (Not available as an Added Test)
Biochemistry
30 - 140 U/L Adult
36 - 550 U/L Child
May be higher during rapid bone growth phases.
HIGH - Bone disease, liver disease (especially obstructive), pregnancy
ALKALINE PHOSPHATASE ISOENZYMES
See below ALKALINE PHOSPHATASE ELECTROPHORESIS
ALKALINE PHOSPHATASE ELECTROPHORESIS
Specimen required:
Department:
Comment:
1 x Red Tube no gel dedicated tube is required
Referred test
This test has replaced Alkaline Phosphatase Isoenzymes. A comment is issued indicating the
proportions of liver, bone and other (e.g. intestinal) isoforms detected in the serum or plasma.
ALPHA – 1 ANTITRYPSIN
Specimen required:
Department:
Reference range:
Interpretation:
Serum (1 x SST)
Biochemistry
0.9-2.0 g/L
HIGH - Acute phase response.
LOW - Congenital Deficiency (Phenotyping and family studies recommended.)
10-Nov-2014 Page 7 of 122
CLINIPATH PATHOLOGY
A
ALPHA – 1 ANTITRYPSIN GENOTYPE
Specimen required:
Department:
Note:
Clinipath Pathology - 1 x EDTA
Bunbury Pathology - 1 x EDTA
Referred test
Send whole blood
ALPHA - FETO PROTEIN ( AFP )
Specimen required:
Department:
Reference range:
Interpretation:
See also:
Specimen required:
Department:
Reference range:
Interpretation:
Serum (1 x SST)
Biochemistry (For tumour marker AFP only, pregnant AFP must be referred to SCI)
Male and Non-Pregnant Female – < 8 kU/L
HIGH
Non–Pregnant: Hepatic carcinoma, hepatitis, cirrhosis, embryonal carcinoma and yolk sac
tumour.
Pregnant: Neural tube defects, Twins, Exomphalos, Wrong Dates.
SECOND TRIMESTER SCREENING
Amniotic Fluid
Referred test
These are gestation specific, and are provided on the report. Ranges for 15 – 21 weeks
gestation are provided.
HIGH - Elevated in 85 - 95% of open neural tube defects.
ALPHA N ACETYLGALACTOSAMINIDASE (Up front fee + No rebate)
Specimen:2 x EDTA collect Monday-Thursday only
Department:
Refered Test
Note:
Patient must pay $80.00 upfront collection and shipping fee and will receive a private nonrebatable account of $110.00 (July 2012)
ALPHA SUB UNIT
Specimen required:
Department:
ALUMINIUM
Specimen required:
Department:
Serum (1 x SST)
Referred test
2 x Trace Element (Royal blue top K2EDTA), can be spot urine
Referred test
AMH
See Anti Mullerian Hormone
AMIKACIN
See GENTAMICIN / AMINOGLYCOSIDE MONITORING
AMINO ACID SCREEN (AA SCREEN) (Partial Medicare rebate)
Specimen required:
Department:
Note:
Comment:
FASTING Lithium Heparin - Collect at Main Laboratory ONLY.
Referred test
Specimen must be separated and frozen within the hour.
This is a Referred test. Please check for current COST TO PATIENT.
Clinipath Pathology requires postage and handling fee. The patient will receive an invoice for
the test. After payment a receipt is issued which can be used to claim some Medicare benefit,
but ONLY if the request was from a registered Medical Practitioner.
AMINOGLYCOSIDE MONITORING
See GENTAMICIN / AMINOGLYCOSIDE MONITORING
10-Nov-2014 Page 8 of 122
CLINIPATH PATHOLOGY
A
AMINOPHYLLINE
See THEOPHYLLINE
AMIODARONE
Specimen required:
Department:
Reference range:
Note:
AMITRIPTYLINE
Specimen required:
Department:
Reference range:
Comment:
AMMONIA
Specimen required:
Department:
1 x Heparin NO GEL . Collect PRE-DOSE sample (Trough)
Referred test
Not reported.
Levels greater than 3 mg/L (of Amiodarone and metabolite Diethyl Amiodarone) may be
associated with an increased incidence of adverse effects.
Please record time of last dose and collection.
1 x Heparin NO GEL. Collect PRE-DOSE sample (Trough)
Referred test
50 - 200 ug/L (Amitriptyline and metabolite Nortriptyline combined).
PEAK LEVEL:
4-8 hours after oral administration.
HALF LIFE:
17-40 hours.
If dose changes, please wait two weeks before re-assay.
Direct patient to main lab as blood must be spun and frozen immediately
Clinipath Pathology - Lithium Heparin, spin and freeze immediately
Bunbury Pathology – 1 x 4.5 EDTA spin and freeze immediately
Referred test
AMOEBA
see ENTAMOEBA HISTOLYTICA
AMPHETAMINES
see DRUGS of ABUSE
AMYLASE
Specimen required:
Department:
Reference range:
Interpretation:
Serum (1 x SST)
Biochemistry
< 100 U/L
VERY HIGH - Acute pancreatitis.
HIGH - Cholecystitis, perforated peptic ulcer, intestinal obstruction, abdominal trauma, ruptured
ectopic pregnancy.
ANA
See ANTI NUCLEAR ANTIBODY (ANA)
ANCA
See ANTI NEUTROPHIL CYTOPLASMIC ANTIBODY)
ANDROGENS
Specimen required:
Department:
See also:
Clinipath Pathology - Serum (1 x SST)
Bunbury Pathology – 2 x Serum (2 x SST)
Biochemistry
Individual Androgens - TESTOSTERONE, D H E A S, ANDROSTENEDIONE, SEX HORMONE
BINDING GLOBULIN
10-Nov-2014 Page 9 of 122
CLINIPATH PATHOLOGY
A
ANDROSTENEDIONE
Specimen required:
Department:
Reference range:
Interpretation:
Note:
Serum (1 x SST)
Biochemistry
Males 2.1-10.8 nmol/L
Female 1.0-11.5 nmol/L
HIGH - Virilising tumours and congenital adrenal hyperplasia.
- Polycystic ovary disease.
The specimen should ideally be collected in the 1st half of the menstrual cycle.
ANTINUCLEAR FACTOR (ANF)
See Anti nuclear antibody
ANGIOTENSIN CONVERTING ENZYME ( ACE )
Specimen required:
Department:
Reference range:
Serum (1 x SST)
Referred test
As stated on report .
ANION GAP
Reference range:
10 – 20 mmol/L
Comment:
This is a calculation performed with routine ELECTROLYTE estimations.
ANTENATAL BASIC SCREENING TESTS (REPLACES PREGNANCY PATHOLOGY ASSESSMENT)
Specimen required:
Department:
Comment:
Serum (1 x SST), 1 x EDTA, MSU, FVU
Serology / Haematology / Microbiology / Biochemistry
Includes a selection of Medicare items which must be specified e.g.
FBC (Full Blood Count)
ABO & Rh GROUP. (Blood Group)
ANTIBODY SCREEN (Maternal Antibody Screen)
RUBELLA IgG ANTIBODIES (Rubella Immunity)
HEPATITIS B SURFACE ANTIGEN
RPR, TPHA (Syphilis Serology)
HCV, HIV, etc
MSU for mc&s
FVU for Chlamydia
Additional serology needs to be specified e.g.
VARICELLA
CMV
TOXOPLASMOSIS
HERPES SIMPLEX I & II
HEPATITIS A
ANTI ACETYLCHOLINE RECEPTOR ANTIBODIES
Specimen required:
Department:
Serum (1 x SST)
Referred test
ANTIBODY REGISTRATION & IDENTIFICATION
Specimen required:
Department:
Comment:
2 x Clotted blood (NO GEL SERUM ) and 1 x EDTA
Referred test
Referred to Red Cross Blood Transfusion Centre.
ANTIBODY SCREENING ( MATERNAL )
Specimen required:
Department:
1 x EDTA
Haematology
10-Nov-2014 Page 10 of 122
CLINIPATH PATHOLOGY
A
ANTIBODIES (NON-MATERNAL)
See FULL ANTIBODIES LIST AT END OF ‘ A’ SECTION
Not to be confused with Blood Group Antibodies
ANTICARDIOLIPIN ANTIBODY IGM & IGG (ACA / ACLA)
Specimen required:
Department:
Indications:
Reference range:
Comment:
Serum (1 x SST)
Referred test
Anticardiolipin antibodies are a characteristic finding in the anti-phospholipid syndrome, which is
sometimes associated with SLE or another autoimmune disease. Typical clinical features
include venous and arterial thromboses, recurrent spontaneous abortion and
thrombocytopaenia.
As stated on report
Was previously called Cardiolipin Antibodies
ANTI CCP
ANTI CENTROMERE Specimen required: 1 x SST
ANTI CYCLIC CITRULLINATED PEPTIDE
Specimen required:
Department:
Reference range:
Comment:
Serum (1 x SST)
Immunology
<5 U/mL
Anti cyclic citrullinated peptide (Anti CCP) antibodies are autoantibodies detected in the serum
of some patients with rheumatoid arthritis (RA). A combination of Anti CCP and rheumatoid
factor has a very high diagnostic specificity (>99%) and is of value in the early diagnosis of RA.
ANTI DIURETIC HORMONE (ADH OR VASOPRESSIN) (No rebate)
Specimen required:
Department:
2x EDTA, kept cold. Must be full draw. Label process immediately
Referred , Patient to sign consent form agreeing to payment
ANTI DNA - ANTI DOUBLE STRANDED DNA ANTIBODIES (DS-DNA)
Specimen required:
Department:
Reference range:
Serum (1 x SST)
Referred test
Negative anti-ds DNA < 6 kIU/L
ANTI DNASE B TITRE
Specimen required:
Department:
Reference range:
Comment:
See also:
Serum (1 x SST)
Referred test
As stated on report.
Positive in 85-90% of patients with rheumatic fever, glomerulonephritis and pyoderma.
This is complementary to ANTI STREPTOLYSIN TITRE.
Not to be confused with double stranded anti DNA.
It is advisable to choose 2 anti streptococcal Ab tests to improve specificity e.g. ASOT + Anti
Dnase B. Antibodies appear 1-2 months after onset of infection. Response is longer lasting than
ASOT.
Streptococcal serology
ANTI ENDOMYSIAL IGA ANTIBODIES
TEST NO LONGER PERFORMED. REPLACED BY TISSUE TRANSGLUTAMINASE ANTIBODIES (TTG)
ANTI
ENA - AUTO ANTIBODIES TO EXTRACTABLE NUCLEAR ANTIGENS (ENA)
Specimen required:
Department:
Comment:
Serum (1 x SST)
Immunology
The ENA which are tested are: SS-A/Ro, SS-B/La, RNP,Sm,Jo-1 and Scl-70. For other
antigens, testing can be discussed with immunology.
10-Nov-2014 Page 11 of 122
CLINIPATH PATHOLOGY
A
ANTI FACTOR Xa
Specimen required:
Department:
Reference range:
2 x Sodium Citrate tubes.
Referred test
ANTI FILAGGRIN ANTIBODIES
TEST NO LONGER PERFORMED. REPLACED BY ANTI CYCLIC CITRULLINATED PEPTIDE
ANTI GAD (GLUTAMIC ACID DECARBOXYLASE) ANTIBODIES
Specimen required:
Department:
Reference range:
Serum (1 x SST)
Referred test
ANTIGEN DETECTION - DIRECT
See HSV, FLU, RSV etc
ANTI GLIADIN ANTIBODIES
TEST NO LONGER PERFORMED - REPLACED BY TISSUE TRANSGLUTAMINASE ANTIBODIES (TTG)
ANTI INTRINSIC FACTOR ANTIBODIES
See INTRINSIC FACTOR ANTIBODIES
ANTI KERATIN ANTIBODIES
TEST NO LONGER PERFORMED. REPLACED BY ANTI CYCLIC CITRULLINATED PEPTIDE
ANTI LIVER/KIDNEY MICROSOMAL ANTIBODIES
Specimen required:
Department:
See also:
Serum (1 x SST)
Immunology
AUTOANTIBODIES
ANTI LYMPHOCYTE ANTIBODIES
Specimen required:
Department:
ANTIMONY
Specimen required:
2 x ACD and 1 x SST
Referred
2 x EDTA
Note: not trace metal tube
ANTI MULLERIAN HORMONE (no rebate)
Specimen required:
Department:
Note:
1 x SST dedicated tube is required
Referred
This is a non-medicare rebatable test. Patients will receive an account.
ANTI MITOCHONDRIAL ANTIBODIES
Specimen required:
Department:
See also:
Serum (1 x SST)
Immunology
AUTOANTIBODIES
ANTI NEUTROPHIL ANTIBODIES
Specimen required:
Department:
Serum (1 x SST) and 1xEDTA
Referred test
10-Nov-2014 Page 12 of 122
CLINIPATH PATHOLOGY
A
ANTI NEUTROPHIL CYTOPLASM ANTIBODIES ( ANCA / MPO / PR3 )
Specimen required:
Department:
Reference range:
Comment:
Serum (1 x SST)
Referred test
Positive results are expressed with titres and interpretative comments.
Indicated in vasculitis syndromes, especially Wegener's granulomatosis and glomerular
nephritis. Also may be positive in some connective tissue disorders, inflammatory bowel disease
and autoimmune hepatitis.
ANTI NUCLEAR ANTIBODIES ( ANA )
Specimen required:
Department:
Results:
Note:
Comment:
Serum (1 x SST)
Immunology
Positive ANA findings are titrated and reported as the pattern of fluorescence and titre strength.
If required Anti ENA and Anti DNA must be requested as separate tests.
Examination by indirect immunofluorescence (ANA)
ANTI PARIETAL CELL ANTIBODIES
Specimen required:
Department:
See also:
Serum (1 x SST)
Immunology
AUTOANTIBODIES
ANTI PLATELET ANTIBODIES
Note:
Specimen required:
Department:
Reference range:
Collect sample at Main Laboratory only, Monday – Friday ONLY before 11.00am. Must
arrive at RPH before 1pm.
Serum (1 x SST) and 2 x Sodium Citrate - DO NOT refrigerate or centrifuge sample
Referred test
Negative
ANTI SMOOTH MUSCLE ANTIBODIES
Specimen required:
Department:
See also:
Serum (1 x SST)
Immunology
AUTOANTIBODIES
ANTI STAPHYLOLYSIN TITRE
Test no longer available
ANTI STREPTOLYSIN O TITRE ( ASOT )
Specimen required:
Department:
Reference range:
Comment:
Note:
See also:
Serum (1 x SST)
Referred test
Adults < 200 iu/mL
Children up to 12 years < 150 iu/mL
Positive in 85-90% of patients with rheumatic fever and 50-60% with glomerulonephritis
Antibodies appear rapidly 1-2 weeks after onset of infection
To increase specificity, it is recommended to perform both ASOT and Anti DNASE b
ANTI DNASE B TITRE
ANTI THROMBIN III ( AT3 )
Specimen required:
Department:
Reference range:
Clinipath Pathology - 1 x Sodium Citrate tube.
Bunbury Pathology 3 x Sodium Citrate
Haematology
APC RESISTANCE
See ACTIVATED PROTEIN C RESISTANCE
AQP4 (specific requirements for M/C rebate)
Specimen required:
1 x serum (SST)
10-Nov-2014 Page 13 of 122
CLINIPATH PATHOLOGY
A
APOLIPOPROTEINS A1 & B
Specimen required:
Department:
Reference range:
Serum (1 x SST) - Fasting
Referred Test
APO-E GENOTYPING (no rebate)
Specimen required:
Department:
Note:
APTT
1 x EDTA
Referred Test
This is a non-medicare rebateable test, please contact main laboratory for current cost.
See PARTIAL THROMBOPLASTIN TIME
ARBOVIRUS SEROLOGY
Specimen required:
Department:
Note:
Serum (1 x SST)
Clinipath Pathology / Referred test
See also Ross River, Barmah Forest etc
Includes Ross River Virus, Barmah Forest Virus and
Dengue Fever serology (Referred test)
Other Arboviruses including should be requested separately
- Murray Valley Encephalitis
- Japanese Encephalitis
ARR (ALDOSTERONE RENIN RATIO)
See Aldosterone or Renin
ARSENIC
Specimen required:
Department:
Reference range:
Note:
Spot Urine / 24 hr urine (no preservative)
Referred test
As stated on report
The preferred specimen for toxicity and occupational monitoring is the urine method which
measures total arsenic. Patients should avoid seafood 5 days prior to testing to exclude
non toxic organo-arsenic compounds.
ASCORBIC ACID
See VITAMIN C
ASCA (ANTIBODY AGAINST SACCHROMYCES CEREVISIAE)
Department:
Referred test
Comment:
May be a marker for inflammatory bowel disease e.g. Crohns
Also see:
Sacchromyces cerevisiae
ASPARTATE AMINOTRANSFERASE (AST or SGOT)
Specimen required:
Department:
Reference range:
Interpretation:
Note:
Serum (1 x SST)
Biochemistry
Female: < 37 U/L
Male:
< 45 U/L
HIGH – Myocardial infarction, liver disease (especially hepatocellular), myopathy, exercise,
haemolytic anaemia.
FALSE HIGH – Haemolysis and delayed separation of specimen.
Routinely performed by this laboratory as part of LFT’s
ASPERGILLIS SEROLOGY
Specimen required:
Department:
Serum (1 x SST)
Referred test
10-Nov-2014 Page 14 of 122
CLINIPATH PATHOLOGY
ASOT
Specimen required:
Department:
See also:
A
Serum (1 x SST)
Referred test
ANTI STREPTOLYSIN O TITRE (ASOT)
ATHLETES FOOT
See Nail Clippings for Dermatophytes
ATYPICAL PNEUMONIA SEROLOGY
Specimen required:
Department:
Note:
Serum (1 x SST)
Referred test
If tests are not specified refer to microbiologist.
Tests include: Mycoplasma pneumoniae, Legionella,
AUSTRALIAN ENCEPHALITIS SEROLOGY
See Arboviruses “Murray Valley” etc regarded as Urgent Test
AUSTRALIAN HEALTH SURVEY
Specimen required:
Department:
Note:
AUTO ANTIBODIES
Specimen required:
Department:
Reference range:
Methodology:
Note:
Interpretation:
Comment:
Serum (2 x SST), 1 x EDTA, 1x 1 x Fluoride Oxalate.1 x Urine
Referred test (sent to DMH)
It is preferable for pt to be fasting but do not turn them away on this basis. Always record
fasting status and time of last meal. Ensure patient had answered all questions on request form.
This survey will run until mid 2012
Serum (1 x small SST) (haemolysed or lipaemic serum is unsuitable)
Immunology
Negative
Qualitative and Quantitative Testing is carried out by Immunofluorescence for the following:
Anti Smooth Muscle Antibodies
Anti Parietal Cell Antibodies
Anti Mitochondrial Antibodies
Anti Nuclear Antibodies
Each test may be requested separately
Anti Liver/Kidney Microsomal Antibodies (LKM), ENA, double stranded DNA must be requested
separately
As reported
A small percentage of the normal population produce positive results in low titre. Any low
positive patients should be retested in approximately one (1) month as some drugs and
illnesses can give a positive result.
ANTIBODY TESTS
Specimen required: Generally, all tests beginning with Auto / or Anti require Serum (1 x SST) with the exception of
those listed in bold at the bottom of the next page
Anti Acetylcholine Receptor Abs – AchR, ACH
Anti Basement Membrane Zone Abs – BMZ – see Skin
Anti Beta-2-Glycoprotein I Abs
Anti Campylobacter jejuni - Guillain-Barré
Anti AntiCardiolipin Abs – ACLA or ACA
Anti Cyclic Citrullinated Peptide Abs-CCP, ACPA
Anti DNA Abs – DNA or DS-DNA
Anti Dnase B – see Streptococcal serology
Anti Endomysial Abs – EMA (see TTG)
Anti Extractable Nuclear Antigens – ENA inc. SSA(Ro), SSB(La), RNP, Sm, Jo-1, Scl-70.
Anti Filaggrin Abs – discontinued see CCP
Anti Ganglioside Abs – GM1
Anti Gliadin Abs (see TTG)
10-Nov-2014 Page 15 of 122
CLINIPATH PATHOLOGY
A
Anti Glomerular Basement Membrane - GBM
Anti Glutamic Acid Decarboxylase – GAD
Anti Gluten Abs - see TTG
Anti Intrinsic Factor Abs
Anti Islet Cell Abs
Anti Keratin Abs – discontinued
Anti Microsomal Abs – replaced by TPO Abs
Anti Mitochondrial Abs
Anti Musk Abs
Anti Myeloperoxidase Abs – MPO see ANCA
Anti Myocardial Abs
Anti Neuronal Nuclear Abs – see Purkinjie Cell Abs
Anti Neutrophil Cytoplasmic Abs – ANCA
Anti Nerve Abs
Anti Nuclear Abs – ANA
Anti Nuclear Factor – ANF – see ANA
Anti Ovarian Abs
Anti Parietal Cell Abs – APC
Anti Phospholipid Abs – see Cardiolipin Abs
Anti Proteinase 3 – PR3 see ANCA
Anti Purkinjie Cell Abs –Hu or Ri or Yo
Anti Reticulin Abs
Anti Ribosomal Abs
Anti Saccaroyces cerevisiae
Anti Skin Abs
Anti Smooth Muscle Abs - SMA
Anti Staphylolysin Abs no longer performed
Anti Streptolysin O Abs – ASOT
Anti Thyroid Abs – TPO Abs & TG Abs
Anti Thyroid Peroxidase Abs – TPO Abs see Thyroid ABs
Anti Thyroglobulin Abs – TG Abs see Thyroid Abs
Anti Tissue Transglutaminase Abs (TTG)
Anti Trypsin – see Alpha 1 Anti Trypsin
Anti TSH Receptor Abs
EXCEPT FOR THE FOLLOWING ANTIBODIES REQUIRING DIFFERENT SAMPLE TYPES:
Anti Factor Xa Activity
Anti Lymphocyte Antibodies
Anti Platelet Antibodies
Anti Sperm Antibodies -ASAB
Anti Thrombin III - ATIII
Maternal Antibodies
Sample Required:
Sample Required:
Sample Required:
Sample Required:
Sample Required:
Sample Required:
Citrate
Serum NO GEL (whole sample) + 2xACD
Citrate x 2, & Serum NO GEL
Can be Serum (1 x SST) OR Semen
Citrate
EDTA x1
10-Nov-2014 Page 16 of 122
CLINIPATH PATHOLOGY
B
B
B1, B2, B3, B6 & B12
See VITAMINS
BARBITURATES
See DRUGS of ABUSE
BARMAH FOREST VIRUS ANTIBODY (BFV) IGG + IGM
Specimen required:
Department:
Indications:
Results:
Serum (1 x SMALL SST )
Serology
May include fever, rash, acute arthritis/arthralgia, myalgia and fatigue.
Reported as Detected / Not Detected with appropriate interpretative comments.
BARTONELLA ANTIBODIES
See CAT SCRATCH
BARTONELLA PCR
Specimen required: 2 x EDTA
B-CELLS
See IMMUNOPHENOTYPING
BCR – ABL
Specimen required:
Department:
Comment:
4 x 4ml EDTA or Bone Marrow
Referred test TRANSPORT WITHIN 24 HOURS TO RPH (store at room temperature), and
before 3.00pm on Fridays. No weekend specimens accepted.
Positive in Chronic Myeloid Leukaemia
BENCE JONES PROTEIN ( BJP )
See URINE ELECTROPHORESIS
BENZODIAZEPINES
See DRUGS of ABUSE
BETA CAROTENE
See CAROTENE
BETA HCG & QUANTITATIVE BETA HCG
See Human Chorionic Gonadotrophin
BETA-2 GLYCOPROTEIN 1 ANTIBODIES
Specimen required:
Department:
Comment:
Serum (1 x SST)
Referred test
Additional test when the ACLA titre is high.
BETA-2 MICROGLOBULIN
Specimen required:
Department:
Reference range:
Interpretation:
Comment:
r
Serum (1 x SST) or spot urine if specifically requested
Biochemistry
0.60 - 2.37 mg/L
HIGH - Renal failure, liver disease, malignant disease, immune disorders.
Can be used to monitor glomerular filtration in renal disease.In lymphoma and myeloma, levels are
related to tumour load and disease activity
10-Nov-2014 Page 17 of 122
CLINIPATH PATHOLOGY
B
BETA THALASSAEMIA
See HAEMAGLOBINOPATHY STUDIES
BFV SEROLOGY IGG & IGM
See BARMAH FOREST VIRUS SEROLOGY
BICARBONATE ( HCO 3 )
Specimen required:
Department:
Reference range:
Interpretation:
Serum (1 x SST)
Biochemistry
21 – 32 mmol/L
HIGH - Respiratory acidosis,
LOW
- Respiratory alkalosis,
Metabolic alkalosis.
Metabolic acidosis.
BILE ACIDS
See BILE SALTS
BILE SALTS
Specimen required:
Department:
BILHARZIA
Specimen required:
Department:
Serum (1 x SST) Patient may be fasting or post prandial
Referred
For egg detection
Terminal stream urine between 10.00am-2.00pm at least 4-8 weeks after estimated exposure
(S.haematobium)
Microbiology
Faecal specimen x2 for ova, cysts and parasites at least 3 months after estimated
exposure (S. mansoni, S. japonicum)
BILHARZIA (SEROLOGY)
Specimen required:
Department:
Comment:
See also:
Serum (1 x SST)
Referred test
May need repeat test at least 3 months after estimated exposure.
SCHISTOSOMIASIS
For ACUTE SCHISTOSOMIASIS see KATAYAMA FEVER
BILIRUBIN – DIRECT ( Conjugated )
Specimen required:
Department:
Reference range:
Interpretation:
Serum (1 x SST)
Biochemistry
Less than 9 umol/L
HIGH - Hepatitis, bile duct blockage, toxins, drugs.
LOW - (Total Bilirubin HIGH)
- Haemolysis, physiological jaundice of the newborn, Crigler-Najjar syndrome, Gilbert’s
disease.
BILIRUBIN – TOTAL ( BILI )
Specimen required:
Department:
Reference range:
In neonates:
Interpretation:
Comment:
Serum (1 x SST)
Biochemistry
Less than 20 umol/L. Adults.
0 - 24 hours
: < 85 umol/L.
24 - 48 hours
: <150 umol/L.
3 - 5 days
: <200 umol/L.
> 1 month
: < 17 umol/L.
HIGH - Hepatitis, bile duct blockage, toxic reactions, Gilbert’s disease, malignancy, cirrhosis.
Neonatal bilirubins may be done from a “heel-prick”, collecting the blood into a Minicollect
Tube. Keep protected from light and transport to Laboratory immediately.
This laboratory routinely performs this test as part of LFT’s
10-Nov-2014 Page 18 of 122
CLINIPATH PATHOLOGY
B
BIRD FLU
See INFLUENZA
BK VIRUS
Specimen required:
Department:
Comment:
Urine for cytology (see cytology)
PCR (urine)
Cytology/ Referred test
One of the polyoma viruses, can cause ureteric pain and obstruction. May be seen in urine
cytology specimens especially from renal transplant patients.
BLEEDING TIME
TEST NO LONGER PERFORMED. REPLACED BY PLATELET FUNCTION TEST
BLOOD CULTURES
Specimen required:
Department:
Note:
Comment:
BLOOD GROUPING
Specimen required:
Department:
Results:
Note:
10 mL of blood inoculated aseptically into each of one aerobic and one anaerobic Bactec
blood culture bottle. Note: the level of fluid in the bottle and ensure that no more than 10ml of
blood is drawn into the bottle.
It is preferable that at least three blood culture sets be collected on separate occasions
preferably during the fever spikes. Two at initial presentation taken from different arms, ten
minutes apart, and a third at ½ hour to 1 hour later or arrange for domiciliary collection at home.
Please indicate on label which arm the blood was collected from. These need to be sent to the
Laboratory immediately. Collection is preferable prior to any antibiotic treatment.
DO NOT Refrigerate and ALWAYS treat as URGENT
Microbiology
Blood culture sets are available from the Laboratory on request and must be stored at room
temperature. Special blood culture bottles are available for AFB/TB from Microbiology.
Positive results are reported immediately growth is detected. Negative reports are issued after
2 days incubation.
1 x EDTA Dedicated Tube
Haematology
Blood samples are grouped for ABO and Rh(D) antigens routinely.
Specimen must be labelled with FULL NAME and Date of Birth and initialled by collector.
Declaration on form must be completed and signed by collector, declaration stickers are available from the
laboratory if Clinipath Pathology request forms are not used.
BLOOD SUGAR LEVEL ( BSL )
See GLUCOSE and/or GLUCOSE TOLERANCE TEST
BNP
See Brain Natriuretic Peptide
BONE MARROW / BONE TREPHINE
Specimen Required: By arrangement with Haematologist.
Department:
Haematology
Note:
Bone marrow for AFB/TB see Tuberculosis
BORDETELLA CULTURE / PCR (WHOOPING COUGH)
See POST NASAL ASPIRATE
BORDETELLA PERTUSSIS SEROLOGY (WHOOPING COUGH)
Specimen required:
Department:
Comment:
(1) Serum (1 x SST) IgA
(2) PNA IgA, only if enough specimen >1ml
Referred test
For acute symptomatic Pertussis, culture/PCR via PNA is optimal and nasal IgA via PMH
For chronic symptomatic Pertussis, blood serology may be preferred. Also see postnasal
aspirate
10-Nov-2014 Page 19 of 122
CLINIPATH PATHOLOGY
B
BORRELIA BURGDORFERI SEROLOGY (LYME DISEASE SEROLOGY)
Specimen required:
Department:
Indications:
Comment:
BOTULISM
Specimen required:
Department:
Note:
Comment:
Serum (1 x SST). Please record any overseas travel history for the past six months.
Referred test
May include distinctive skin lesions (Erythema chronicum migrans), headache, neck stiffness,
myalgia, arthralgia, malaise and fatigue. Consider also RRV, BFV and EBV.
There is no evidence that Lyme disease is present in Australia.
Lyme disease is endemic in parts of USA and Europe and requests for Lyme serology may
suggest recent travel to these areas. Supplementary test is immunoblot; follow up tests may be
needed.
Stool sample
Microbiology
PCR and Toxin assays available as referred tests. Please discuss with Clinical Microbiologist
before requesting.
Toxin from Clostriduim Botulinum causing paralysis (Same toxin used in Botox injections)
BOWEL / COLON / RECTUM TUMOUR MARKERS
See CA19-9, CARCINO EMBRYONIC ANTIGEN (CEA)
BRAIN NATRIURETIC PEPTIDE (no rebate)
Specimen required:
Department:
Reference Range:
Serum (1 x SST)
Referred
As stated on report
BRCA 1&2 (BREAST CANCER GENE STUDIES)
Referring doctors must discuss this test with a Geneticist at KEMH(ph 9340 1525) before proceeding. Cannot
be collected without specific approval from PMH geneticist
Specimen required: 1 x EDTA and 1 x Hep No Gel
Also see:
Genetic Disorders
BREAST TUMOUR MARKERS
See CA15-3 and CARCINO EMBRYONIC ANTIGEN (CEA)
BREATH TEST
See HELICOBACTER BREATH TEST
BRUCELLA SEROLOGY
Specimen required:
Department:
Symptoms:
Note:
Serum (1 x SST)
Referred test
Septicaemia and/or localised infections of bone, tissue or organ systems. It is associated with
exposure to animals or animal products. Can occur in travellers who may have been exposed
to unpasteurised food products.
Blood cultures could be considered in acute brucellosis and the Laboratory should be
notified of this possible diagnosis to avoid laboratory staff acquiring brucellosis
infection.
BURKHOLDERIA PSEUDOMALLEI SEROLOGY (MELIOIDOSIS)
Specimen required:
Department:
Note:
Comment:
Serum (1 x SST)
Referred test
Acute infection requires blood cultures x3
Endemic in Australian top end and in travelers to SE Asia
10-Nov-2014 Page 20 of 122
CLINIPATH PATHOLOGY
C
C
C1 ESTERASE INHIBITOR
Specimen required:
Department:
Reference range:
Comment:
Serum (1 x SST)
Biochemistry/ Referred test
0.15 - 0.35 g/L
Used in the investigation of angioedema.
Serum C1 esterase inhibitor levels may be normal in patients with a functional defect of the
protein. If this is suspected, a functional C1 esterase inhibitor assay should be requested and
serum collected as for a CH50.
C1q
See Complement C1q
CA 15-3
Specimen required:
Department:
Reference range:
Comment:
CA 19-9
Specimen required:
Department:
Reference range:
Comment:
CA 72-4
Specimen required:
Department:
Reference range:
Comment:
CA 125 ANTIGEN
Specimen required:
Department:
Reference range:
Comment:
Serum (1 x SST)
Biochemistry
0 - 25 kU/L
Mammary cancer marker. Rarely elevated in localised disease.
Serum (1 x SST)
Biochemistry
0 - 37 kU/L
Pancreatic cancer marker. May also be raised in gastric, hepatocellular and sometimes colonic
cancer.
Serum (1 x SST)
Referred Test
as stated on report
Gastric cancer marker.
Serum (1 x SST)
Biochemistry
0 - 35 kU/L
Ovarian cancer marker. May also be raised in other gynaecological neoplasmic disease. Mild
increases may be associated with early and ectopic pregnancy, endometriosis, pelvic
inflammatory disease, peritonitis and renal failure.
CA 549 ANTIGEN
TEST NO LONGER PERFORMED - REPLACED BY CA 15-3. See above
CADMIUM
Specimen required:
Department:
Reference range:
2 x Trace Element (Royal blue top K2EDTA) / 24 hour Urine (no preservative), or random
urine
Referred test
As stated on report
10-Nov-2014 Page 21 of 122
CLINIPATH PATHOLOGY
CAERULOPLASMIN
Specimen required:
Department:
Reference range:
Interpretation:
Note:
C
Serum (1 x SST)
Referred test
0.20 - 0.45 g/L.
LOW - Wilson’s disease, chronic hepatitis.
Usually performed in conjunction with Copper assay.
CALCITONIN
Specimen required:
Department:
Reference range:
Serum (1 x SST). Separate ASAP and send sample frozen
Referred test
CALCIUM (CORRECTED)
See Calcium (Serum)
CALCIUM EXCRETION
Specimen Required:
Department:
Tests Performed:
Reference range:
Spot fasting urine and Serum (1 x SST)
Biochemistry
Urine creatinine and calcium; Serum creatinine
Males:
40 – 120 mmol/L GF
Females:
30 – 100 mmol/L GF
CALCIUM (FREE)
See Calcium (Ionised)
CALCIUM (IONISED)
Specimen required:
Department:
Reference range:
Interpretation:
CALCIUM ( SERUM )
Specimen required:
Department:
Reference range:
Interpretation:
1 x SST Spin but do not open. Attach a Process Immediately sticker
Bunbury Pathology – Dedicated Tube 1 x SST (Not available as an Added Test)
Biochemistry
1.12 - 1.32 mmol/L (pH adjusted to 7.40)
As for Calcium (corrected)
Serum (1 x SST)
Biochemistry
2.15 - 2.55 mmol/L (Corrected Calcium)
HIGH - Carcinoma with osteolytic bone metastases, hyperparathyroidism, hypervitaminosis D,
Paget’s disease,
LOW - Hypoparathyroidism, Vitamin D deficiency, acute pancreatitis.
CALCIUM ( URINARY RANDOM/24 HOURS )
Specimen required:
Department:
Reference range:
Interpretation:
Comment:
Random – Spot urine
24 hour - collection bottle with 20 ml 50% HCl. (Warn patient of acid danger)
Biochemistry
2.0 - 7.5 mmol/day
HIGH - Hyperparathyroidism, high serum calcium, osteoporosis.
LOW - Renal failure, nephrotic syndrome.
Strongly affected by diet.
CALCIUM, SPOT URINE (CALCIUM/CREATININE RATIO)
Specimen required:
Department:
CALCIUM STUDIES
Specimen required:
Department:
Spot urine no preservative
Biochemistry
2 x SST (Serum)
Biochemistry
10-Nov-2014 Page 22 of 122
CLINIPATH PATHOLOGY
C
CALCULUS ANALYSIS
See Renal Stones
CALPROTECTIN (no rebate)
Specimen required:
Department:
Faeces
Referred
CAMPYLOBACTER JEJUNI / COLI
Specimen required:
Department:
Notes:
Faeces for culture
Microbiology
Campylobacter may be requested in Guillain-Barre syndrome. Check with Microbiologist.
CAMPYLOBACTER SEROLOGY
Specimen required:
Department:
Notes:
Comment:
Serum (1 x SST)
Referred test
Is available and may be useful in a setting of Guillain-Barre syndrome. Check with
Microbiologist.
Campylobacter serology may be requested in Guillain-Barre syndrome. Not to be confused with
Helicobacter Serology.
CANCER ASSOCIATED SERUM ANTIGEN ( CASA )
TEST NO LONGER PERFORMED - REPLACED BY CA19-9 AND CA125
CANDIDA CULTURE
See SWABS
CANDIDA SEROLOGY
Specimen required:
Department:
Serum (1 x SST)
Referred test
CANNABINOIDS ( THC )
See DRUGS of ABUSE
CARBAMAZEPINE ( TEGRETOL )
Specimen required:
Department:
Results:
Comment:
1 x Serum (1xSST)- Taken immediately prior to next dose.
Bunbury Pathology Serum 1 x SST (trough)
Biochemistry
Therapeutic Range:
4 - 10 mg/L
Peak level:
6 - 12 hours after oral administration.
Half Life:
10 - 30 hours.
1. This drug induces its own metabolism.
2. Tolerance may develop to the anti-epileptic effect.
CARBOHYDRATE DEFICIENT TRANSFERRIN (CDT) (no rebate)
Specimen required:
Department:
Note:
Serum (1 x SST). Separate and freeze as soon as possible.
Referred Test
Not medicare rebatable $90.00 as at July 1 2012
CARBON MONOXIDE
SEE CARBOXY HAEMOGLOBIN ( BELOW)
10-Nov-2014 Page 23 of 122
CLINIPATH PATHOLOGY
C
CARBOXY HAEMOGLOBIN
Specimen Required: As Carboxy Haemoglobin is very labile – Perth patients should be referred directly to Mount
Hospital laboratory for specimen collection. Bunbury patients should have 1 x lith Heparin collected
Department:
Referred test
Comment:
Test performed at Mount Hospital Laboratory. Sample collection should immediately follow
any possible CO poisoning.
CARCINO-EMBRYONIC ANTIGEN (CEA)
Specimen required:
Department:
Reference range:
Interpretation:
CARCINOID
Tests required:
Specimen required:
Department:
Serum (1 x SST)
Biochemistry
< 5.0 ug/L
HIGH - Colorectal and other GI carcinomas, thyroid carcinoma, lung carcinoma, heavy smokers
Urininary 5 HIAA and Platlet serotonin
See instructions for individual tests
Referred
CARDIAC ENZYMES ( CE )
TEST SUPERSEDED BY TROPONIN T, however if requested collect Serum (1 x SST) Always Urgent
CARDIAC MUSCLE ANTIBODY
Specimen required:
Department:
Note:
Serum (1 x SST)
Referred test
History please
CARDIOLIPIN ANTIBODY IGM & IGG (ACA / ACLA)
See ANTI CARDIOLIPIN ANTIBODY (NEW NAME)
CARNITINE
Specimen required:
Department:
Note:
CAROTENE
Specimen required:
Note:
Department:
Reference range:
Interpretation:
Serum (1 x SST)
Referred test
Centrifuge within 4 hours of collection. Test run infrequently at PMH
Serum (1 x SST) – Protect from light by wrapping with aluminium foil
Attach process immediately sticker
Referred test
As stated on the report
HIGH – Carotenemia.
LOW
– Malabsorption.
CATECHOLAMINES
See ADRENALINE/ NORADRENALINE
CAT SCRATCH FEVER SEROLOGY (BARTONELLA HENSELAE)
Specimen required:
Department:
Serum (1 x SST).
Referred test
If Cat Scratch PCR requested 2 x EDTA required.
CCP
CD4 / CD8 RATIO
CD4 Count
See Immunophenotyping
10-Nov-2014 Page 24 of 122
CLINIPATH PATHOLOGY
C
CD57 AND/OR CD58
Specimen:
Department:
Comment:
2 x EDTA
Referred Test
Samples must reach DHM with 48 hours of collection. Must not be collected after midday Thursday
or on Fridays or Saturdays
CD MARKERS
CDT
C
CEA
See Carbohydrate Deficient Transferrin
S
See Carcino-Embryonic Antigen
CELL FLOW CYTOMETRY
CERULOPLASMIN
See Caeuloplasmin
CERVICAL SMEAR
See CYTOLOGY SPECIMENS
CERVICAL SWAB
See GENITAL SPECIMENS
CF GENE
See GENETIC DISORDERS
CH50
Note:
Specimen required
Department:
Collect at Main Laboratory ONLY, sample requires separating and freezing on
collection.
Serum (1 x SST)
Referred test
CHAGAS DISEASE
See TRYPANOSOMIASIS
CHICKEN POX TESTS
See VARICELLA
CHIKUNGUNYA SEROLOGY
Specimen required
Department:
Serum (1 x SST)
Referred test
10-Nov-2014 Page 25 of 122
CLINIPATH PATHOLOGY
C
CHLAMYDIA DNA DETECTION (BY POLYMERASE CHAIN REACTION-PCR)
Specimen collection: Men: First void urine (FVU) (preferably the first of the morning) is as sensitive as a swab.
Women: Endocervical canal swab (dry) for PCR is the most sensitive test. If not feasible, then
first void urine is acceptable. Thin prep testing is also acceptable and is more sensitive than
urine. A self collected low vaginal swab (SOLVS) may be more sensitive than a first void urine
in women.
Department:
Microbiology
Results:
Results are expressed as Detected or Not Detected.
Note:
Timing of Tests: If recent exposure suspected repeat PCR tests 3-6 weeks after estimated
exposure. For individuals who are partners of proven Chlamydia infection initial PCR test may
be negative. These individuals will benefit from prophylaxis regardless of the Laboratory result
i.e. give Azithromycin 1g stat po
Comment:
Chlamydia DNA testing can detect both viable and non-viable organisms, hence should be
performed at least three weeks after treatment of chlamydia infection for proof of cure testing, if
needed.
CHLAMYDOPHILA (PREV CHLAMYDIA) PNEUMONIAE SEROLOGY (IGG ANTIBODIES)
Specimen required:
Department:
Comment:
Serum (SST)
Referred test
Adults will often have antibody from past infection. To prove recent infection, 2 sera collected at
10 days apart are required, except for children under 5 years of age. Can be performed as part
of atypical respiratory serology but must be specifically requested.
CHLAMYDOPHILA (prev CHLAMYDIA) PSITTACI SEROLOGY
See PSITTACOSIS SEROLOGY
CHLAMYDIA TRACHOMATIS SEROLOGY
Test no longer performed. PCR is the test of choice because it is much more sensitive.
Contact Laboratory for further information.
CHLAMYDIA SEROLOGY ( IGA & IGG ANTIBODIES )
see LYMPHOGRANULOMA VENEREUM TESTS.
CHLORIDE ( CL )
Specimen required:
Department:
Reference range:
Interpretation:
Serum (1 x SST)
Biochemistry
95 - 108 mmol/L
HIGH - Hypernatraemia, metabolic acidosis (normal anion gap), respiratory alkalosis.
LOW - Hyponatraemia, metabolic alkalosis, respiratory acidosis, vomiting, diarrhoea.
CHOLECALCIFEROL
See Vitamin D
CHOLESTEROL – TOTAL
Specimen required:
Department:
Health Range:
Interpretation:
Comment:
Serum (1 x SST) - Fasting preferred.
Biochemistry
< 5.5 mmol/L
HIGH - Primary (familial)
- Secondary e.g.: hypothyroidism nephrotic syndrome.
Non-fasting cholesterol specimen may increase total cholesterol result by up to 0.5 mmol/L.
10-Nov-2014 Page 26 of 122
CLINIPATH PATHOLOGY
C
CHOLESTEROL – HDL
Serum (1 x SST) - Fasting preferred.
Biochemistry
1.1 - 3.5 mmol/L
LOW - Increased risk of atherosclerosis and coronary artery disease.
HIGH - Lower risk of atherosclerosis.
(i) The ratio of total cholesterol to HDL cholesterol (coronary risk ratio or CRR) is the best
prognostic marker.
(ii) Desirable risk ratio is 3.5. The higher the ratio, the poorer the prognosis.
(iii) According to Medicare Australia, a request for LIPID PROFILE should be interpreted
as cholesterol and triglycerides ONLY. A specific written request for HDL must be
made e.g. Lipids + HDL.
(iv) Please ask the patient if they are on lipid lowering drugs, and note down the name of the
medication
Specimen required:
Department:
Reference range:
Interpretation:
Comment:
CHOLINESTERASE (PLASMA OR RED CELL OR GENOTYPE)
1 x Heparin NO GEL Note: Collect 2 x Li Hep in Bunbury. Genotype requires 1 x EDTA
Referred test
As stated on report
RED CELL CHOLINESTERASE (TRUE CHOLINESTERASE)
Useful in organic phosphorus poisonings.
SERUM CHOLINESTERASE (PSEUDOCHOLINESTERASE)
LOW
Poisoning with organophosphorus compounds. Patients with scoline sensitivity usually
have low levels, (% inhibition with fluoride and dibucaine numbers necessary for
phenotyping).
Liver damage.
Specimen required:
Department:
Reference range:
Interpretation:
CHROMATOGRAPHY (AMINO ACID)
See AMINO ACID SCREEN
CHROMIUM
Specimen required:
Department:
Reference range:
2 x Trace Element (Royal blue top K2EDTA)
Referred test
As stated on report
CHROMOGRANIN A (No Rebate)
Specimen required:
Department:
Serum (1 x SST). Must be Fasting
Note: do not spin or refrigerate. Send specimen to laboratory marked process
immediately. Laboratory must spin and separate serum and freeze immediately.
This test is not Medicare rebatable and incurs a cost of $65.00 (June 2012)
Referred test
CHROMOSOME STUDIES
See CYTOGENETICS
CHROMOSOME MICROARRAY ANALYSIS (CMA)
Specimen required:
Department:
1x EDTA, 1x Lithium Heparin
Referred test
CHORIONIC GONADOTROPIN
See HUMAN CHORIONIC GONADOTROPHIN
CITRATE
Specimen required:
Department:
24hr urine with 20mL 50% HCL (Warn patients of the acid danger)
Referred test
10-Nov-2014 Page 27 of 122
CLINIPATH PATHOLOGY
CK
C
See CREATINE KINASE
CKMB ISOENZYMES
Specimen required:
Department:
CLOBAZAM
Specimen required:
Department:
Reference range:
CLOMIPRAMINE
Specimen required:
Department:
Therapeutic Range:
Interpretation:
CLONAZEPAM
Specimen required:
Department:
Therapeutic Range:
Interpretation:
Serum (1xSST) Treat as Urgent
Referred test
1 x Heparin NO GEL Collect PRE-DOSE sample (Trough).
Referred test
As stated on report
1 x Lithium Heparin Collect PRE-DOSE sample (Trough).
Referred.
As stated on report
Tricyclic antidepressant.
1 x Heparin NO GEL
Referred
As stated on report
Benzodiazepine
CLOSTRIDIUM DIFFICILE ( CULTURE & TOXIN )
Specimen required:
Department:
CLOZAPINE
Specimen required:
Department:
Therapeutic Range:
Comment:
Faeces sample
Please refrigerate sample if delay in transport.
Referred test
1 x Heparin NO GEL . Collect PRE-DOSE sample (Trough).
Referred
As stated on report
Often collected in parallel with FBC to check white cell count (WCC). The WCC may be
reduced as a side effect of this drug and if requested should be marked as URGENT.
Results >1000 µg/L correlate to increased seizures.
CMA
SEE Chromosome Microarray Analysis
CMI SKIN TESTS (CELL MEDIATED IMMUNITY)
TEST NO LONGER PERFORMED
CMP (CALCIUM MAGNESIUM PHOSPHATE)
Specimen required:
Department:
1 x SST (Serum)
Biochemistry
CMV (CYTOMEGALOVIRUS)
See CYTOMEGALOVIRUS
Coagulation Factors - see Factor Assays
10-Nov-2014 Page 28 of 122
CLINIPATH PATHOLOGY
C
COAGULATION SCREENING PROFILE (Coagulation Studies)
Specimens Required: Clinipath Pathology 1 x Na Citrate tube and 1 x EDTA
Bunbury Pathology Collect 3 x Na Citrate and 1 x EDTA
Department:
Haematology
Profile consists of:
PROTHROMBIN TIME
(PT)
PARTIAL THROMBOPLASTIN TIME (APTT)
THROMBIN CLOTTING TIME
(TCT)
PLATELET COUNT
(PT)
FIBRINOGEN
(FIB)
NOTE:
Medicare Australia does NOT consider Platelet Function as part of the Coagulation Profile so
the test must be specifically requested. If Platelet Function is also requested, collect an extra Na
Citrate tube, and do not spin.
COBALT
Specimen required:
Department:
Reference range:
Referred test
As stated on report
COCAINE METABOLITES
See DRUGS of ABUSE
COELIAC DISEASE SEROLOGY (COELIAC SCREEN)
See TISSUE TRANSGLUTAMINASE (TTG IGA) ANTIBODIES
CO-ENZYME Q10 (Up front collection and transport fee)
Specimen Required: 1 x HNG Spin separate and freeze in foil
Department:
Referred
Comment:
This is a non-rebatable test and patients will receive a private account
COELIAC DISEASE GENOTYPING
See HLA DQ2/8
COLD ANTIBODY TITRE ( COLD AGGLUTININS )
Specimen Required: 2 x EDTA MUST be spun at 37 degrees then refrigerate
Department:
Haematology & Australian Red Cross Blood Service
Interpretation:
High titres in cold antibody diseases (e.g. mycoplasma or EBV infection, lymphoma)
COLLAGEN BINDING ASSAY
See Platlet aggregation studies – referred test
COLON / RECTUM / BOWEL TUMOUR MARKERS
See CA19-9 CEA
CONJUNCTIVAL SWAB
Specimen:
Department:
Gel swab for bacteria
Dry swab for viral PCR e.g. Adenovirus, HSV, Varicella (Referred test)
Dry swab for Chlamydia
Microbiology
10-Nov-2014 Page 29 of 122
CLINIPATH PATHOLOGY
C
COMPLEMENT LEVELS ( C3 , C4 )
Serum (1 x SST)
Immunology
C3: 0.55 - 1.20 g/L
C4: 0.15 - 0.40 g/L
Serum levels may be low in SLE and some other connective tissue diseases, some types of
glomerulonephritis and cryoglobulinaemia.. Useful in following progress of SLE.
Specimen required:
Department:
Reference range:
Interpretation:
COMPLEMENT C1q
Specimen Required: 1 x SST
Department:
Referred
Note:
Separate and freeze ASAP
COOMBS TEST ( DIRECT ANTI-HUMAN GLOBULIN OR DAT )
Specimen Required: 1 x EDTA
Department:
Haematology
Interpretation:
Positive in isoantibody and autoimmune haemolytic anaemia (HA) and drug induced HA.
COOMBS TEST ( INDIRECT )
Specimen Required: 1x EDTA
Department:
Haematology
Interpretation:
Not in common usage: Tested as part of a cross match or maternal antibodies. Refer enquiries
to Haematology.
COPPER ( Cu )
Referred
11 - 23 µmol/L.
HIGH - Inflammation
LOW - Wilson’s disease
If urinary copper is requested please provide patient with a 24hr collection bottle – no additive
Specimen required:
Department:
Reference range:
Interpretation:
Note:
COPROPORPHYRIN
See PORPHYRINS SCREEN
CORONA VIRUS
See SARS virus
CORTISOL ( BLOOD )
Specimen required:
Department:
Reference range:
Interpretation:
Note:
Comment:
Serum (1 x SST)
Biochemistry
AM (0800 - 0900): 171 - 536nmol/L
PM (1500 - 1600): 64 - 327 nmol/L
HIGH (Trend) - Cushing’s syndrome, stress, fever, severe pain.
LOW (Trend) - Addison’s disease, secondary to pituitary failure.
Spot cortisol - a single AM or PM cortisol estimation can be requested. Morning and
afternoon blood collection is only required when a doctor specifically asks for both AM and PM
cortisol levels. Outside am or pm hours label Random Cortisol
Cortisol is a stress hormone - one off high values should be treated with caution.
CORTISOL ( SALIVARY ) (Upfront collection and transport fee)
Specimen required:
Department:
Note:
Saliva, preferred volume 2ml in yellow capped centrifuge tube
Referred
Patient will receive a private account for this test
10-Nov-2014 Page 30 of 122
CLINIPATH PATHOLOGY
C
CORTISOL ( URINARY FREE )
Specimen required:
Department:
Reference range:
Interpretation:
COTININE
Specimen required:
Department:
Reference range:
Interpretation:
24 hour urine - collection in a plain bottle (NO preservative).
Referred
As stated on report
HIGH - Cushing’s syndrome, hormone therapy.
Serum (1 x SST) - urine can also be tested, but serum is the preferred specimen
Biochemistry
< 25 µg/L (non-smokers)
Cotinine is a very specific marker for tobacco smoke.
NORMAL - Non-smokers.
HIGH
- High in smokers.
COXSACKIE VIRUS (ONE OF THE ENTEROVIRUSES)
Specimen required:
Department:
Indications:
Note:
Throat swabs (dry orange top swab) and faeces samples for PCR
Referred test
May include lethargy, fatigue, malaise, fever, rash, pharyngitis, pneumonia, meningitis,
myopericarditis and conjunctivitis.
Consider also other enteroviruses and respiratory viruses including rhinovirus, coronavirus,
influenza and para-influenzae virus, adenovirus and RSV.
See also Hand, Foot, and Mouth disease, viral myocarditis and encephalitis. Diagnosis is by
PCR from clinical specimens. Serum antibody test NOT available in WA and is not generally
recommended. Please discuss with the clinical microbiologist if required.
COXIELLA BURNETII
see Q FEVER
C-PEPTIDE
Specimen required:
Department:
Reference range:
Comment:
Serum (1 x SST) Patient must be Fasting (Not available as and Added test)
Biochemistry
0.4 - 1.5 nmol/L.
Indirect measurement of insulin secretion.
CREATINE KINASE ( CPK , CK ) TOTAL
Specimen required:
Department:
Reference range:
Interpretation:
CREATININE
Specimen required:
Department:
Reference range:
Interpretation:
CREATININE (URINE)
Specimen required:
Department:
Reference range:
Serum (1 x SST)
Biochemistry
Female: Less than 170 U/L
Male:
Less than 195 U/L
HIGH - Myocardial Infarction, myopathy, exercise, Rhabdomyolysis.
Serum (1 x SST)
Biochemistry
Male:
62 - 115 umol/L
Female: 53 - 97 umol/L
HIGH - Acute or chronic renal insufficiency, high meat intake.
LOW - Small muscle mass e.g. muscular dystrophy.
Spot Urine- unless 24 hour urine requested by Doctor
Biochemistry
Male:
7.1 - 17.7 mmol/day
Female: 5.3 - 15.9 mmol/L
10-Nov-2014 Page 31 of 122
CLINIPATH PATHOLOGY
C
CREATININE CLEARANCE
Specimen required:
Department:
Reference range:
Interpretation:
Comment:
Serum (1 x SST) plus a 24 hour Urine (No preservative.)
The blood specimen needs to be collected as close as possible to the urine collection.
Biochemistry
70 - 150 mL/minute
LOW - Renal insufficiency.
Creatinine clearance performed on children below the age of 15 years must be accompanied by
the child’s HEIGHT, AGE and WEIGHT, in order to correct for body surface area.
CRR (CORONARY RISK RATIO)
See Lipid profile
CROSSMATCHING BLOOD FOR TRANSFUSION
Specimen required:
Department:
Note:
Refer to APPHLE-075 for Full procedure. Please check with Haematology Department on 93714270
before accepting X match forany site other than Osborne Park. Ask the patient which hospital they
are going to and when. Ring heamatology and they will instruct you whether to take the blood or
direct the patient to the hospital they are having their operation in.
1 x EDTA. (2 x EDTA for BUNBURY)
1 x Clotted blood (NO GEL SERUM)
(2 x Clotted if more than 4 units required).
Haematology
Blood will NOT be accepted for grouping and crossmatching unless sample and request form
are correctly labelled as per ANZBTS requirements – Phlebotomists must sign request form OR
a signed X-match sticker MUST be attached to the original request form. Specimen tubes for Xmatch MUST be labelled with patient’s full name and DOB and be signed by the phlebotomist.
At least 48 hours notice of crossmatch would be appreciated to ensure that compatible blood is
available.
CRP, HIGH SENSITIVITY (hsCRP)
Specimen required:
Department:
Reference range:
Comment:
Serum (1 x SST)
Biochemistry
As stated on report
Should only be measured when clinically well; used to assess risk of coronary artery disease
C- REACTIVE PROTEIN ( CRP )
Specimen required:
Department:
Reference range:
Interpretation:
Comment:
CRYOGLOBULINS
Specimen required:
Reference range:
Interpretation:
Serum (1 x SST)
Biochemistry
< 5.0 mg/L
HIGH > 100 mg/L : Bacterial infection, vasculitis
20 – 100 mg/L : RA, viral illness, malignancy and other inflammatory processes.
< 10 mg/L : Atherosclerosis, degenerative joint disease.
Non-specific test, but usually indicates organic disease. ESR may be more useful in monitoring
SLE and ulcerative colitis response to treatment.
Collection at the MAIN LABORATORY ONLY.
Serum (1 x SST) and 1 x Heparin NO GEL.
Sample requires special processing, tubes
o
must be pre-warmed and kept at 37 C
Not detected.
Cryoglobulins are either monoclonal immunoglobulins (type 1 cryoglobulinaemia) or immune
complexes (type 2 and 3 cryoglobulinaemia). Type 2 or 3 cryoglobulins are usually associated
with SLE or another connective tissue disease, or with chronic infections, particularly hepatitis C
virus infection.
10-Nov-2014 Page 32 of 122
CLINIPATH PATHOLOGY
C
CRYPTOCOCCAL ANTIGEN
Specimen required:
Department:
CSF EXAMINATION
Specimen required:
Department:
Note:
CYANIDE
Specimen required:
Department:
Reference range:
Comments:
CYCLOSPORIN - A
Specimen required:
Department:
Reference range:
Note:
Serum (1 x SST) or CSF
Referred test
Sterile CSF sample. Urgent-Microbiologist to be notified ASAP
Should ideally have three bottles
Microbiology for cell count and culture (two samples marked #1 #2)
Biochemistry for glucose and protein estimation (Fluoride oxalate bottle)
Additional tests may be needed e.g. Herpes, entrovirus. Menigococcal PCR
1 x Lithium Heparin or Urine (preferred)
Referred test
Patient will receive a private account for this test
1 x EDTA Do not spin.
Referred test
Sample 12 hours post dose, preferably in morning. Do not collect on Fridays or Saturdays
CYCLOSPORIN – A, C2
Specimen required:
Department:
Reference range:
Note:
1 x EDTA
Referred test
Sample must be taken exactly 2hrs post dose.
CYSTICERCOSIS
See TAENIA SEROLOGY (TAPEWORM)
CYSTIC FIBROSIS GENE (No Rebate)
CYTOGENETIC AND FISH TESTING (Karyotyping/Chromosomes)
Do not collect on day proceeding long weekend
Specimen Required:
1. Peripheral blood chromosome study
A minimum of 4ml of Lithium heparinized whole blood is required for adults, 2-4ml is sufficient for
infants/young children (tubes available from Clinipath Pathology). Transport to the Laboratory as soon as
possible at room temperature or cool but NOT FROZEN. NOTE: Due to special processing
requirements, cytogenetic samples cannot be collected the day before a long weekend.
2. Amniotic fluid chromosome study
Ideally 2 to 3 sterile tubes (10mL size) containing a total of 20-25mL of fluid, but may be collected into any
sterile container (available from Clinipath Pathology). Transport to the Laboratory as soon as possible at
room temperature or cool but NOT FROZEN.
3. Chorionic villus biopsy chromosome study
Ideally 20-30mg of chorionic villus tissue is collected into a sterile container containing (bone marrow and
tissue) transport medium or another sterile salt solution (available from Clinipath Pathology). Transport to
the Laboratory as soon as possible (same day) at room temperature or cool but NOT FROZEN.
4. Foetal blood chromosome study
Ideally 1ml of foetal blood collected into a sterile lithium heparinized tube (green top) is required (tube
available from Clinipath Pathology). Transport to the Laboratory as soon as possible at room temperature or
cool but NOT FROZEN.
Version CM-A-Z 7.0.C
10-Nov-2014 Page 33 of 122
CLINIPATH PATHOLOGY
5.
6.
7.
8.
9.
C
Foetal tissue / Products of conception chromosome study
Collect into a sterile container. Keep specimen wet in a sterile isotonic solution, for example bone marrow
transport media, sterile saline, or viral transport media (available from Clinipath Pathology). Transport to the
Laboratory as soon as possible at room temperature or cool NOT FROZEN. SPECIMEN MUST NOT BE
PUT IN FORMALIN. For intrauterine foetal death and stillbirth specimens, collect placental tissue (preferably
chorionic villi), umbilical cord and foetal skin where possible.
Bone marrow chromosome study
Approximately 1ml of bone marrow aspirate is collected into a bone marrow transport medium tube
(available from Clinipath Pathology). Transport to the Laboratory as soon as possible at room temperature
or cool but NOT FROZEN.
Malignant tissue chromosome study
A portion of the tissue of interest is dissected off as aseptically as possible. Ideally, this should be pea sized
or larger. The specimen is placed in a bone marrow transport medium tube (available from Clinipath
Pathology) which has been completely thawed to room temperature, and it is then to be transported to the
Laboratory at room temperature or cool but NOT FROZEN. Please note: The nature of the specimen and
suspected diagnosis must be clearly stated on the request form.
Skin fibroblast chromosome study
A skin biopsy is taken by excision or punch biopsy, and placed into bone marrow and tissue transport
medium (available from Clinipath Pathology). It is then transported to the Laboratory at room temperature or
cool but NOT FROZEN.
Fluorescent in-Situ Hybridization Studies (FISH tests)
Prenatal interphase FISH tests –
As for the amniotic fluid chromosome study except collect an extra 5ml if possible.
As for chorionic villus biopsy chromosome study.
Constitutional FISH tests – Depending upon the clinical context, please submit samples as per the
cytogenetic specimen protocol.
Oncology FISH tests – Samples depend upon the tumour type - peripheral blood, bone marrow or tumour.
Please submit samples as per the cytogenetic specimen protocol. Paraffin section studies are also now
available.
For more information CONTACT CLINIPATH PATHOLOGY 9371 4440 or BUNBURY PATHOLOGY 08 9780 0333
Department:
Cytogenetics SNP (Result Enquiries phone 9371 4340)
Note:
DO NOT PUT ANY SPECIMENS IN FORMALIN or FREEZE Samples
Turnaround Times:
Prenatal Cord Blood
Chorionic Villi
Blood/Amniotic Fluid/Bone Marrow
Tissue biopsies/POC/Tumour
- 48 hours (preliminary), 4 days final report
- 10-15 days
- 10-15 days
- approx 2-3 weeks
Not available as an added test
10-Nov-2014 Page 34 of 122
CLINIPATH PATHOLOGY
C
Cytogenetic and FISH Test List
Cytogenetic Tests
Oncology FISH tests
Amniotic fluid chromosome study
Acute lymphocytic leukaemia t(12;21)
Chorionic villus biopsy chromosome study
Acute non-lymphocytic leukaemia t(8;21)
Foetal blood chromosome study
Acute non-lymphocytic leukaemia M4- Inv(16)
Foetal tissue / Products of conception chromosome study
Acute promyelocytic leukaemia – t(15;17)
Bone marrow chromosome study
C-MYC amplification
Peripheral blood chromosome study
Chronic lymphocytic leukaemia (CLL) panel
Malignant tissue chromosome study
Chronic myeloid leukaemia t(9;22) bcr/abl fusion
Skin fibroblast chromosome study
Chronic myeloid leukaemia (9q34) bcr/abl fusion with 9q
deletion
Prenatal FISH tests
Deletion 7q
IVF single cell preimplantation genetic diagnosis (PGD)
Deletion 20q
Prenatal interphase FISH
EGFR 7p12
Constitutional FISH tests
HER-2/neu amplification
1p36 microdeletion
Lymphoma panel
Deletion 5q
Ewings sarcoma t(11,22)
Cri Du Chat syndrome
Lymphoma (Burkitt, t(8;14))
Di George / Shprintzen / Velocardiofacial syndrome
Lymphoma t(14;18)
Kallmann syndrome
Lymphoma MALT1 18q21 rearrangement
Miller-Dieker syndrome
Mantle cell lymphoma t(11;14)
Prader-Willi syndrome
M-FISH
Smith-Magenis syndrome
Myxoid liposarcoma 12q13 rearrangement
SRY locus
MLL 11q23 rearrangement
Subtelomere FISH
Multiple myeloma panel
Urgent neonate (eg sex chromosome determination and
aneuploidy confirmation)
N-MYC amplification
Whole chromosome paints
Oligodendroglioma – 1p,19q
Williams syndrome
Oligodendroglioma-PTEN 10q23 deletion
Wolf-Hirschhorn syndrome
Sex Mismatch bone marrow transplant
XY sex chromosomes
Synovial sarcoma t(X;18)
Trisomy 8
10-Nov-2014 Page 35 of 122
CLINIPATH PATHOLOGY
C
CYTOLOGY ( Gynaecological & Non-Gynaecological )
Specimens Required: See listings below for Cervical Smears, Sputum, Urine, FNA, Nipple discharge, Other
Body Fluids.
Department:
Cytology
See also:
THIN PREP, HPV DNA Testing
CONVENTIONAL CERVICAL SMEARS
Specimens Required: Fix cervical sample smeared on a glass slide.
Label the glass slide with the patient’s surname and first name and date of
birth with pencil. (ink washes off during processing.)
The Pap smear is a screening test to aid in the detection of abnormal cells in the cervix. It is a
requirement that the glass slides containing the cervical sample are labeled with the patient’s
full name and date of birth. To enable the meaningful reporting of gynaecological cytology, full
information including Clinical history such as parity, menstrual dates and hormonal status is
desirable as well as previous gynaecological history and results. Patients should be advised not
to have smears taken during active menstruation.
For more detailed collection procedures please phone the Cytology Department and speak with
a cytotechnologist/or Pathologist in the Main Laboratory. Medical Liaison can also be contacted
for additional written information.
Collection
Conventional Pap smear slides should be prepared first, prior to preparing the ThinPrep
specimen. When taking the smear, lubricants, other than water should be avoided.
Extended tip spatulas, e.g. Aylesbury in conjunction with an endocervical brush (cytobrush),
give satisfactory samples. Material obtained using these two devices can be mixed on one slide
and submitted to the Laboratory. The broom type devices such as the Cervex brush are also
suitable and should preferentially be used for collecting ThinPrep specimens.
Pap kits made to the physician’s requirements are available from the Laboratory.
Once the sample has been placed on the slide, fix the slide with cytofix immediately. Hold the
cytofix 10-15cm away from the glass slide and give 2 short sprays.
Close the carrier; ensuring the slide is secured by fastening all the clips on the carrier. Place
the slide carrier in a biohazard bag (available from the Laboratory) with the request form.
Request Pap, Pap + ThinPrep, Vault, Vault + ThinPrep on the request form.
Indicate if the patient does not want her results sent to the W.A. Cervical Cancer Registry.
Unless indicated NOT FOR PAP REGISTRY all results from this Laboratory are automatically
downloaded to the CCR. This information is protected by PGP encryption.
THINPREP SPECIMENS
Specimen required:
Cervical sample in ThinPrep collection vial (ThinPrep vials available on request from
Laboratory). Please ensure expiry dates are checked on these vials before use. Label the
glass slide and the ThinPrep vial with the patient’s surname, first name and date of birth
Note:
Currently the split sampling technique is employed within this Laboratory, which involves the
analysis of both the conventional smear and the ThinPrep specimen. The ThinPrep specimen is
not routinely processed without a conventional slide.
Collection:
Collect the sample using a Cervex brush, available from the Laboratory
Transfer the sample to the glass slide by smearing down the glass slide with one side of the
brush, and then the other. Fix the slide immediately with a spray fixative.
Rinse the cervex brush in the ThinPrep vial of preservative fluid and discard.
Note: The end of the Cervex brush should not be left in the vial once rinsed.
. Send prepared slide and ThinPrep vial to the Laboratory for analysis.
Results
Negative results are available within 48 hours. Abnormal results are available in 48-72 hours. If
the cervical cytology result is required urgently please mark this on the request form along with
the date and time the result is required by. Urgent tests will be processed immediately and the
results will be available within 4 working hours of the receipt of the specimen in the Laboratory.
(Please allow additional time if specimen received after hours or on the weekend) Urgent
results can be phoned, faxed or electronically downloaded as required.
10-Nov-2014 Page 36 of 122
CLINIPATH PATHOLOGY
C
SPUTUM
Specimens required: 3 x early morning specimen of sputum in yellow top jar (Preservative free)
Lesions within the respiratory tract cause irritation, which can result in excess sputum
production and haemoptysis (blood in the sputum). The cells lining the respiratory tract are
constantly shed into the sputum. Deep coughing by the patient can expectorate the sputum
containing these cells. If there is a lesion within the respiratory tract, analysis of these cells can
detect it. The method of collection is most important for meaningful results. Three consecutive
early morning deep cough specimens are required, preferably before food. Yellow-topped 50ml
plastic containers are available from the Laboratory to collect specimens. A list of instructions
for the patient can also be provided.
Collection:
Before breakfast, the patient should rinse their mouth with water, cough lightly and spit out any
saliva.
The patient should then take a deep breath and cough as vigorously as possible, spitting the
sputum into the container.
The container should be labelled with the patient’s full name, date of birth, date and time of
collection and placed in a fridge until it is taken to the collection centre.
A separate container should be used each day and each container taken to the collection centre
each day. As each container arrives at the collection centre it should be labeled with a
laboratory ID number. All three specimens should have the same laboratory ID number.
Results:
Results are available within 24 hours. If the Cytology result is required urgently please mark this
on the request form along with the time the results are required. Urgent tests will be processed
immediately and the results will be available within 4 hours of the receipt of the specimen in the
Laboratory. (Please allow additional time if specimen received after hours or on the weekend)
Urgent results can be phoned, faxed or electronically downloaded as required.
URINE CYTOLOGY
Specimens Required: 3 x early morning urine samples. Special containers are available from the
Laboratory.
Note:
Lesions within the urinary tract cause irritation that can result in frequency of urination and
haematuria (blood in the urine). The cells lining the urinary tract are constantly shed into the
urine stored in the bladder and voided from the body. If there is a lesion within the urinary tract,
analysis of these cells can detect it.
Collection:
Specimen is required to be collected in a 200ml white screw top wide mouthed jar - labelled
Urine for Cytology. It is preferable to collect the specimens on three consecutive mornings.
Collect the second specimen of the day. The first specimen of the morning should not be
collected because there will be cell autolysis. Collect half the jar or at least 50mL of
specimen.
After collection the specimen must be refrigerated and sent to the Laboratory as a PRIORITY
specimen. Delay may affect the specimen quality.
The container should be labelled with the patient’s name, date of birth, referring doctor, the date
and the time collected.
Specimen 1, 2 or 3 should be selected on the label.
This should be performed on three consecutive mornings and the specimen brought to the
collection centre each morning.
Results:
on the request form along with the date and time the result is required. Urgent tests will be
processed immediately and the results will be available within 4 hours of the receipt of the
specimen in the Laboratory. (Please allow additional time if specimen received after hours or on
the weekend) Urgent results can be phoned, faxed or electronically downloaded as required.
10-Nov-2014 Page 37 of 122
CLINIPATH PATHOLOGY
C
FNA – ASPIRATION CYTOLOGY (BREAST, THYROID, ETC)
Specimen required:
Prepared slides, any additional material obtained (e.g. needle washings) can be rinsed in saline,
placed in a yellow topped jar and sent to the laboratory to be made into extra slides or cell
blocks. Specimens that are fluid in nature should be placed in a yellow topped jar and sent to
the Laboratory as soon as possible.
Collection:
Label the slides with the patient’s full name (First and surname) and date of birth in pencil.
A full clinical history on the request form will aid in a meaningful diagnosis. A full description of
the aspirated lesion, including the site should be written on the request form.
Note:
If you regularly perform Fine Needle Aspirates, a more detailed protocol is available from the
Cytology Department.
An aspiration service is conducted on Thursday afternoons and appointments can be made by
phoning the MAIN LABORATORY. Same day referral may be available for urgent patients. A
report is usually available four (4) hours after the procedure is completed.
Results:
For submitted FNA’s, results are available within 24 hours. If the Cytology result is required
urgently please mark this on the request form along with the date and time the result is required.
Urgent tests will be processed immediately and the results will be available within 4 hours of the
receipt of the specimen in the Laboratory. (Please allow additional time if specimen received
after hours or on the weekend) Urgent results can be phoned, faxed or electronically
downloaded as required.
NIPPLE DISCHARGE
Specimen required:
Prepared slides (air dried and/or fixed)
Lesions occurring within the breast tissue can sometimes result in a nipple discharge; sampling
of this discharge can yield cells diagnostic of the existing condition.
Collection:
Where possible the discharge should be expressed directly on to a glass slide.
An air-dried and fixed slide is appreciated where possible. The fixed slide should be sprayed
with cytofix immediately upon collection. Label the slide with the patient’s surname and first
name, date of birth and L or R breast. A full clinical history on the request form will aid in a
meaningful diagnosis.
Results:
BODY FLUIDS
Specimen required:
Collect any fluid in a yellow top 50ml container (preservative free), or a larger container if
necessary. These include Peritoneal, Pleural & Pericardial fluid, Ovarian Cyst fluid, Synovial
Fluid, Pouch of Douglas etc. Label the container with the patient’s surname and first name,
date of birth and type of fluid collected. A full clinical history on the request form will aid in a
meaningful diagnosis.
Transport as soon as possible to the Laboratory. If delay occurs, specimen should be
REFRIGERATED.
Results:
10-Nov-2014 Page 38 of 122
CLINIPATH PATHOLOGY
C
Throat Smear
Specimen required:
Fixed Smear
Collection:
Collect the sample with a spatula/ tongue depressor and place onto a glass slide. Fix with
cytofix immediately. Label the slide with the patient’s surname and first name, date of birth in
pencil.
Results:
CYTOMEGALOVIRUS (CMV)
CMV SEROLOGY ( CYTOMEGALOVIRUS SEROLOGY ) IGG & IGM
Specimen required:
Department:
Results:
Symptoms:
Serum (1 x SMALL SST DEDICATED TUBE)
Serology
Reported as Detected/ Not Detected with appropriate interpretative comments.
May include fever, lethargy, and atypical lymphocytosis and is an important cause of congenital
infection. Can cause severe infection in the immunosuppressed patient.
Consider also EBV or Toxoplasmosis.
CMV AVIDITY TESTS
Specimen:
Department:
Comment:
CMV PCR
Specimen:
Department:
Serum (1 x SST)
Referred test
Specialised test for pregnant women with CMV IgM+
Urine, throat swab or sputum or whole blood
2 x EDTA, dedicated tubes.
Referred test
CMV VIRAL LOAD
Specimen:
Department:
2 x EDTA, dedicated tubes.
Referred test
10-Nov-2014 Page 39 of 122
CLINIPATH PATHOLOGY
D
D
DAT
SEE COOMBS TEST
DAZ Gene
Specimen required: 1 x EDTA
D - DIMERS
Specimen required:
Department:
Reference range:
Interpretation:
1 x Sodium citrate. Always treat as Urgent (Not available as an Add on test)
Attach Urgent sticker
Haematology
Negative
May be positive in DVT, PE and DIC
DENGUE FEVER SEROLOGY
Specimen required:
Department:
Results:
Serum (1 x SST)
Referred test
Reported as Detected / Not detected with appropriate interpretive comments.
See also ARBOVIRUS Screen
DEOXYPYRIDINOLINE - Test superceded by N Telopeptide (NTX)
TEST SUPERCEDED
BY N Telopeptide (NTX)
DEXAMETHASONE
SUPPRESSION
TEST
Dose given:
Specimen required:
Department:
Reference range:
Interpretation:
1 mg dexamethasone is given orally at bedtime (11 pm).
Contact the Laboratory to arrange for the drug dose.
A serum (1 x SST) cortisol sample is taken next morning at 8 - 9 am. Must be taken at this
time with patient rested. Please note all medications on the request form.
Biochemistry
As stated on report
Normal suppression response excludes Cushing’s syndrome.
DHEA-S ( DEHYDROEPIANDROSTERONE SULPHATE )
Specimen required:
Department:
Reference range:
Interpretation:
Serum (1 x SST)
Biochemistry
HIGH - Polycystic ovary syndrome, adrenal hyperplasia / tumour.
DHT- see Di Hydroxy Testosterone
DIELDRIN
Specimen required:
Department:
Reference range:
1 x Heparin NO GEL
Referred test
DIFFERENTIAL LEUCOCYTE COUNT
See FULL BLOOD EXAMINATION (FBC)
10-Nov-2014 Page 40 of 122
CLINIPATH PATHOLOGY
DIGOXIN ( DIG )
Specimen required:
Department:
Results:
Comment:
D
Serum (1 x SST) Specimen should be collected at least eight (8) but preferably more than
12 hours after last dose. Please note down time of last dose and time of collection.
Biochemistry
Therapeutic Range:
0.5 – 0.8 ug/L
Peak Level:
Steady state peak 1 - 5 hours after oral administration; however
serum levels may spike 60 - 90 minutes after dose.
Half Life:
20 - 50 hours.
1. Quinidine potentiates the effects of Digoxin.
2. Digoxin is excreted unchanged via the kidney; hence rate of excretion is related to
glomerular filtration rate.
3. Toxicity is exacerbated by low potassium.
DI-HYDROXY TESTOSTERONE (DHT)
Specimen required:
Department:
Comment:
1 X SST (SERUM)
Referred test
Spin and freeze serum ASAP
DILANTIN
See PHENYTOIN
DIRECT ANTIGLOBULIN TEST (DAT)
See COOMBS TEST
DIURETIC SCREEN
Specimen required:
Department:
Classes tested:
Spot Urine
Referred test
Phenylphalene, Coloxyl, Rheine, Bisacodyl, Danthral.
DNA ANTIBODIES (DOUBLE STRANDED DNA ANTIBODIES)
See ANTI DNA ANTIBODIES
Note:
Not to be confused with anti DNAase B, an anti Streptococcal Ab usually tested with ASOT.
DNA PATERNITY TESTING
Specimen Required: Samples will be collected by appointment only at Clinipath Pathology Laboratory in Osborne Pk
or at the Bunbury Laboratory
Department:
Referred test
Note
Please phone Clinic Nurse in Charge on 9371 4530 (Osborne Pk) or Bunbury on
9780 0300 for all information and appointments. Pt to ring Sonic 1800 010 447 for case No
DNA DOSE (Up front fee)
Specimen required:
2 x EDTA referred Test
DOTHIEPIN ( PROTHIADIN )
Specimen required:
Department:
Therapeutic Range:
Interpretation:
1 x Heparin no gel. Collect PRE-DOSE sample (Trough).
Referred
As stated on report
Tricyclic Antidepressant.
DOWNS SYNDROME
See FIRST TRIMESTER SCREENING
DOXEPIN
Specimen required:
Department:
Therapeutic Range:
Interpretation:
1 x Heparin no gel Collect PRE-DOSE sample (Trough).
Referred
As stated on report
Tricyclic antidepressant.
10-Nov-2014 Page 41 of 122
CLINIPATH PATHOLOGY
D
DRUGS OF ABUSE / ADDICTION, DRUG SCREEN
Specimen required:
Department:
Note:
Note:
Spot Urine. If urgent refer patient to Main Laboratory
Biochemistry
Please give adequate history as to type of suspected abuse, e.g. routine screen, preemployment, attempted overdose etc, times of overdose if known. We routinely assay urine
alcohol, amphetamines, cannabinoids, cocaine metabolite, opiates, Benzodiazepines, and
methadone. If other drugs are requested on the form there will be an additional charge, please
check with Duty Manager or Toxicology if unsure.
Please list ANY prescribed drugs and over-the-counter medications taken in the previous few
days.
CHAIN OF CUSTODY FORM SHOULD BE FILLED OUT FOR ALL DRUG SCREEN
SAMPLES COLLECTED.
If Blood required collect 2x Fluoride Oxolate, Up front fee $250.00, referred test
ALCOHOL
Cutoff Level
Detectable for:
40.0 mg/dL
2 - 14 hours post intake
AMPHETAMINES
Cutoff Level
Detectable for:
300 ug/L
48 - 72 hours post intake
CANNABINOIDS (THC)
Cutoff Level
50 ug/L
Detectable for:
Moderate smoker (4 times a week) 15 days post intake
Heavy smoker (smoking daily) 30 days post intake
Chronic smokers - may be up to 2 months post intake
COCAINE METABOLITE
Cutoff Level
300 ug/L
Detectable for:
2 - 4 days post intake
OPIATES
Cutoff Level
Detectable for:
300 ug/L
2 - 3 days post intake
BENZODIAZEPINES
Cutoff Level
200 ug/L
Detectable for:
3 days post intake if therapeutic dose ingested
Up to 4 - 6 weeks after extended dosage
METHADONE
Cutoff Level
Detectable for:
100 ug/L as EDDP metabolite
3 days post intake
Note: Interpretation of retention time must take into account, variability of urine specimens, drug metabolism and halflife, patient’s physical condition, fluid intake, and method and frequency of ingestion. The above detection times serve
as a guideline only.
DRVVT
See LUPUS ANTICOAGULANT
DYSMORPHIC RBC
Specimen required:
MSU
10-Nov-2014 Page 42 of 122
CLINIPATH PATHOLOGY - BUNBURY PATHOLOGY
E
E
EAR SWAB
Specimen required:
Department:
Gel swab for bacteria and fungi
Microbiology
ECS ( ENDOCERVICAL SWAB )
EBV SEROLOGY
See EPSTEIN BARR VIRUS SEROLOGY
ECHOVIRUS (A TYPE OF ENTEROVIRUS)
Specimen:
Department:
EFA
Dry Throat swab and Faeces
Referred
See ESSENTIAL FATTY ACIDS
EFEXOR See Venlafaxine
eGFR (ESTIMATED GFR)
Specimen required:
Department:
Reference interval:
Note:
See Creatinine
Biochemistry
> 60ml/min/1.73m2
Calculated from serum creatinine, age, sex. Considered to be a more reliable index of renal
function than serum Creatinine
ELASTASE -see FAECAL ELASTASE
ELECTROLYTES
Specimen required:
Department:
Note:
Serum (1 x SST)
Biochemistry
We routinely perform Na+, K+, HCO 3 -,Cl- and Anion Gap
ELECTROPHORESIS
See Protein Electrophoresis
ENA ( EXTRACTABLE NUCLEAR ANTIGENS )
See ANTI ENA ANTIBODIES
ENDOCERVICAL SWAB
ENDOMYSIAL IGA ANTIBODIES (EMA)
TEST NO LONGER PERFORMED - REPLACED BY TISSUE TRANSGLUTAMINASE ANTIBODIES (TTG IGA)
ENTAMOEBA HISTOLYTICA (AMOEBIC DYSENTERY)
Specimen required:
Department:
Note:
Stool specimen, must be fresh if trophozoites are to be observed. Patient may have to come
to Main Laboratory.
Special containers are available on request from the Laboratory containing fixative if patient
cannot come to Main Laboratory.
Microbiology
EIA for invasive Eh from stool referred to Pathwest after microbiology.
10-Nov-2014 Page 43 of 122
E
ENTAMOEBA HISTOLYTICA (AMOEBIC DYSENTERY) SEROLOGY
Specimen required:
Department:
Note:
Serum (1xSST) 1-2ml of serum required for Entamoeba Histolytica serology.
Referred test
Following invasive E. Histolytica bowel infection, (amoebic dysentery), patients may present
with distinct abscesses months to years later e.g. liver abscesses. Serology is highly useful for
diagnosis of E. Histolytica abscess.
ENTERIC FEVER
See SALMONELLA TYPHI
ENTEROVIRUS (HAND/FOOT/MOUTH DISEASE)
Specimen required:
Departme
Comments
(1) Throat swabs - Dry swab for PCR NO TRANSPORT MEDIUM
(2) Faeces- for PCR - NO TRANSPORT MEDIUM
(3) Blister lesion fluid/swab- Dry swab for PCR - NO TRANSPORT MEDIUM
(4) Serology - 1 x SST
Referred test
Hand/foot/mouth disease –Other Enterovirus related diseases include rash;
meningitis/encephalitis; myocanditis; rarely conjunctivitis
EOSINOPHIL CATIONIC PROTEIN (ECP)
Specimen required:
Department:
Reference range:
Note:
Serum (1 x SST)
Biochemistry
Children:
< 20 µg/L
Adults:
< 15 µg/L
ECP correlates with airway inflammation in asthma patients. Increased levels may indicate
increased risk of asthma exacerbation.
EPILIM
See VALPROIC ACID
EPO
See ERYTHROPOETIN
EPSTEIN BARR VIRUS (EBV) SEROLOGY IGG & IGM
Specimen required:
Department:
Comment:
Indications:
Comments:
Serum (1 x SMALL SST TUBE)
For PCR 2 x EDTA referred to Pathwest
Serology
Reported as Detected / Not Detected with appropriate interpretive comments.
Full Blood Count and IM Test are important adjuncts to Laboratory diagnosis.
May include fever, pharyngitis, cervical lymphadenopathy and atypical lymphocytosis (is the
causative agent of Infectious Mononucleosis).
Consider also CMV or Toxoplasmosis.
Occasionally referred for specialized EBV serology, e.g. EBNA tests.
ERYTHROPOETIN (EPO)
Note:
Please refer patient to the Main Laboratory for sample collection.
Specimen Required: Serum (1 x SST) – FROZEN
Department:
Referred test
ESSENTIAL FATTY ACIDS ( EFA )
Specimen required:
Department:
Note:
1 x Heparin NO GEL
Referred test
The test is transported to a reference laboratory. Please contact the Laboratory for current
COST TO PATIENT. Handling fee payment to Clinipath Pathology is required at collection. The
patient will be invoiced directly for the test.
10-Nov-2014 Page 44 of 122
E
ESR ( ERYTHROCYTE SEDIMENTATION RATE ) (Not available as an Add on test)
Department:
Haematology
Reference range:
Male:
Female:
0 - 15 mm/hour.
0 - 20 mm/hour.
ESTRADIOL ( E2 )
See OESTRADIOL
ETHANOL ( ETOH )
See ALCOHOL
ETHOSUXIMIDE
Specimen required:
Department:
Reference range:
EVEROLIMUS
Specimen required:
Department:
Reference range:
Clinipath Pathology Serum (1 x SST).
Bunbury Pathology collect 2 x Lithium Heparin do not spin
Collect PRE-DOSE sample (Trough).
Referred
As stated on report
1 x EDTA
Collect PRE-DOSE sample (Trough).
Referred
As stated on report
EXTRACTABLE NUCLEAR ANTIGENS ( ENA )
See ANTI ENA AUTO ANTIBODIES TO EXTRACTABLE NUCLEAR ANTIGENS
EYE SWAB
See specific listing for required test e.g. SWABS FOR BACTERIAL CULTURE
FUNGAL CULTURE
VIRAL DETECTION
ACANTHAMOEBA
NOTE:
Corneal scrapes – Please contact the senior scientist in microbiology as
plates may need to be delivered to the ophthalmologist.
10-Nov-2014 Page 45 of 122
F
F
FACTOR ASSAYS / STUDIES
Specimen Required: 2 x Sodium citrate tubes. Bunbury to collect 3 x Sodium Citrate
Department:
Referred test
Reference range:
FACTOR V LEIDEN
Specimen Required: 1 x Sodium citrate tube (Not available as add on test)
1 x EDTA
Department:
Referred test
Note:
Patient must have written history of DVT or pulmonary embolism for the gene mutation
analysis to be done under Medicare.
See also:
Thrombophilia Screening
FACTOR VIII
Specimen Required: 2 x Sodium citrate tubes. Bunbury to collect 3 x Na Citrate
Department:
Haematology
Reference range:
FAD (VITAMIN B2)
See Vitamin B 2
FAECAL ELASTASE
Specimen required:
Department:
Faeces, specimen should be sent in a brown screw topped faeces container.
Referred test. Freeze and send on dry ice
FAECAL FATS
TEST NO LONGER PERFORMED: SUPERCEDED BY FAECAL ELASTASE
FAECES
Department:
Microbiology
(A) FOR CULTURE
Specimen required: The specimen should be taken if possible from a portion of the stool showing blood or mucus, if
present. The quantity of specimen should be about the size of a walnut and should be sent in a
brown screw topped faeces container. The specimen should be as fresh as possible.
Comment:
The Medicare Benefits Schedule allows for the culture of ONLY ONE FAECES SPECIMEN IN
A SEVEN-DAY PERIOD. (See also section B below).
Routine culture of faeces includes investigation for Salmonella, Shigella and Campylobacter. If
other pathogens are suspected from the history or clinical setting (e.g. Clostridium difficile
yersinia, vibrio.), this needs to be requested specifically and clinical details provided, eg.
Antibiotic therapy, overseas travel etc.
(B) FOR PARASITES AND HELMINTHS
Specimen required: As for culture.
Comment:
The Medicare Benefits Schedule allows for concentration of faeces for ova, cyst and parasite
microscopy on ONLY TWO SPECIMENS IN A SEVEN-DAY PERIOD. One of these specimens
may also be tested by special techniques for Giardia and Cryptosporidium. One of these
specimens may also be cultured, as described in section A above.
Note:
If pinworm is suspected, the cellotape method should be used for collecting the specimen. A
short length of clear cellotape is pressed several times onto the perianal skin and then stuck
down onto a glass slide. A specimen collected first thing in the morning is best.
If Dientamoeba fragilis is suspected, use special containers with a fixative available from the
Microbiology Department.
10-Nov-2014 Page 46 of 122
F
(C) VIRAL STUDIES
Specimen required: As for culture.
Rotovirus and adenovirus 40/41 are tested in the Microbiology Department, Norovirus is
performed at Pathwest by PCR.
Comment:
Faeces testing for enteric viruses is not included in the examinations described above and
must be requested specifically, eg. “viral studies”, “rotavirus” ± “adenovirus” and “norovirus”.
Rotavirus and adenovirus are common causes of diarrhoea in the paediatric age group and
should be suspected in adults parenting infected children. Norovirus is a common cause of
diarrhoea in debilitated and elderly patients. Norovirus was previously know as Norwalk, calici
and small round virus.
In order to help the Laboratory to optimise the detection of gastrointestinal specimens
and comply with the Medicare Benefits Schedule, doctors are asked to request faeces
examination in the following way:
Specimen 1:
M,C&S; O,C&P
Specimen 2:
O,C&P
and add viral studies as indicated.
(D) FOR OCCULT BLOOD
Two type of test are performed for Faecal occult blood detection, a chemical test and an
immunological test
Specimen required: Ideally, fresh stool samples should be collected on three (3) separate days and submitted to
the Laboratory on each day. Please note: To comply with Medicare requirements we can only
process multiple specimens (eg FOBx3) if they are written on the request form. If the doctor
only writes FOB we can only process one specimen. There are no dietary restrictions, as
interference is not caused by Vitamin C, iron tablets etc. Interference can occur with the
chemical test but not usually with immunological test.
Comment:
An immunological test method is used which is more sensitive and specific than chemical
methods, however false results may still be obtained, both false positive and false negative.
The test detects human haemoglobin and is very sensitive at detecting bleeding from the lower
gastro-intestinal tract. Please note that the presence of frank blood may interfere with the test
result.
(E) REDUCING SUBSTANCES
Specimen required: A fresh dedicated faeces sample is required. This sample must be kept refrigerated, see
requirements below:

If time from collection to testing is <2hr - refrigerate at 4 degrees C transport in esky

If time from collection to testing is 2-6 hr - refrigerate at 4 degrees C transport in esky
taped to an ice brick.

If time from collection to testing is >6hr - sample must be frozen. If MC&S is
requested on same request form and sample is to be frozen, two samples will
need to be collected with one being frozen and labelled 'RS'.
FAI
See FREE ANDROGEN INDEX
FAMILIAL MEDITERRANEAN FEVER (No Rebate)
Specimen required:
Department:
1 x EDTA
Referred
FASTING METABOLIC BONE STUDY
See METABOLIC BONE STUDY
FBC OR FBP OR FBE
See FULL BLOOD COUNT
FBS (FASTING BLOOD SUGAR)
See GLUCOSE
FEMALE HORMONE PROFILE
Specimen required: 1 x SST
10-Nov-2014 Page 47 of 122
F
FERRITIN
Specimen required:
Department:
Interpretation:
Serum (1 x SST)
Biochemistry
HIGH - Iron overload, (Haemosiderosis, Haemochromatosis) liver damage, infection,
inflammation, neoplasia.
LOW - Iron deficiency.
FHP- see Female Hormone Profile
FI (FASTING INSULIN)
See INSULIN
FIBRINOGEN
Specimen required:
Reference range:
Department:
Interpretation:
1 x Sodium citrate. (not available as add on test)
2.0 - 4.5 g/L
Haematology
HIGH - Acute phase response.
LOW - Liver failure, haemorrhage, dysfibrinogenaemia, disseminated intravascular coagulation
(DIC).
FIBRIN / FIBRINOGEN DEGRADATION PRODUCTS ( FDP )
See D-DIMERs.
FILARIA SEROLOGY / DETECTION
Department:
Referred test
Note:
May detect various worms, including Wucheria and Onchcerea.
Some microfilaria worms may also be detected in blood films made in Haematology
FINE NEEDLE ASPIRATION CYTOLOGY
See CYTOLOGY.
FIRST TRIMESTER SCREENING (PAPP-A, FREE BETA HCG)
Specimen required:
Department:
Note:
Serum (1 x SMALL SST DEDICATED TUBE) - Blood must be spun and frozen within 6
hours of collection
Attach Process Immediately sticker
Collect BETWEEN 9 & 13 weeks 6 days gestation. Double check gestation/EDD before blood
is collected.
PLEASE COMPLETE CHECK LIST PROVIDED FOR THIS TEST AS RESULTS CANNOT
BE PROCESSED WITHOUT THIS INFORMATION.
Biochemistry
Always performed in conjunction with an ultrasound. Test can be performed anytime
within the required gestation dates of 9 weeks and 13 weeks 6 days. The blood is no longer
required to be taken a certain number of days before/after the ultrasound. Results are issued
direct to the Ultrasonographer. Ultrasound practitioner will calculate the Risk of Downs using
biochemical markers and Nuchal Translucency Measurement from ultrasound. Please ensure
patient is give a First Trimester screening card with the collection details on it.
Under no circumstances discourage a woman who presents for this test for the sake of a
timeframe - the process is flexible – provided the blood is taken between 9 and 14 weeks.
FISH Testing - see Cytogenetics and FISH testing
FK506 ( TACROMILUS LEVEL )
Specimen required:
Department:
Reference range:
Note:
1 x EDTA – refrigerate sample after collection.
Referred test
Sample preferably in the morning at least 12 hours post dose or just prior to next dose.
10-Nov-2014 Page 48 of 122
FLECAINIDE
Specimen required:
Department:
Reference range:
1 x Lithium Heparin. Collect pre dose (Trough)
Referred test
As stated on report
Specimen required:
Department:
Also see:
1 x ACD + 1 xEDTA
Haematology
Immunophenotyping
FLOW CYTOMETRY
F
FLUORESCENT IN SITU HYBRIDIZATION STUDIES (FISH TESTS)
See CYTOGENETICS
FLUORIDE (No Rebate)
Specimen required:
Department:
Note:
FLUOXETINE
Specimen required:
Department:
Reference range:
FNA
Serum (1 x SST), Spot Urine
Referred test
If testing for occupational exposure, spot urine is the specimen of choice.
Patient will be invoiced directly. Refer to Main Laboratory for current charging.
1 x Heparin NO GEL. Collect PRE-DOSE sample (Trough).
Referred test
Fluoxetine
50 - 450 ug/L
Norfluoxetine
50 - 450 ug/L
(at an oral dose of 20 - 60 mg/day.)
See CYTOLOGY.
FODMAPS
See Hydrogen Breath Test
FOLATE /FOLIC ACID ( RED CELL FOLATE )
Specimen required:
Department:
Reference range:
Note:
1 x EDTA
Biochemistry
267-1023 ug/L
Red cell folate not performed routinely Serum Folate will be assayedLQVWHDGLIIRODWHUHTXHVWHG.
Only performed if Red cell folate requested specifically
FOL$7()2/,& ACID ( SERUM FOLATE )
Specimen required:
Department:
Reference range:
Note:
Serum (1 x SST
Biochemistry
NORMAL
4.6 - 20 ug/L
DEFICIENT
< 2.32 ug/L
Serum folate reflects folate absorption in the past week.
.
FOLLICLE STIMULATING HORMONE ( FSH )
Specimen required:
Department:
Reference range:
Serum (1 x SST)
Biochemistry
Female:
Follicular phase
1 - 10 U/L
Mid-cycle peak
6 - 17 U/L
Luteal phase
1 - 9 U/L
Post menopausal 19 - 100 U/L
Male:
1 - 15 U/L
FMBS
See METABOLIC BONE STUDIES
10-Nov-2014 Page 49 of 122
F
FRAGILE X
FREE ANDROGEN INDEX ( FAI )
Specimen required:
Department:
Reference range:
Request includes:
Interpretation
Serum (1 x SST)
Biochemistry
Female 0.51 - 6.5 %
TESTOSTERONE & SEX HORMONE BINDING GLOBULIN.
HIGH - Polycystic Ovary Disease
-Virilisation
FREE LIGHT CHAINS
Specimen required: Serum (1x SST)
Department:
Referred test
Reported as:
Kappa Free Light Chains in mg/L (NR <19.4)
Lambda Free Light Chains in mg/L (NR <26.3) and Kappa/Lambda ratio (NR 0.3-1.7)
FREE PSA
See PROSTATE SPECIFIC ANTIGEN – FREE must have PSA result first
FREE T4
See THYROXINE FREE T4 –must have TSH result first
FREE TESTOSTERONE (CALCULATED FREE TESTOSTERONE)
Supercedes FAI, especially in men
Department:
Biochemistry
Reference range:
0.204 -0.637 in males
0.004 – 0.039 in females
Note:
Calculated from SHBG and Testosterone
Interpretation:
Best calculated index of free (active) testosterone
FRUCTOSAMINE
Specimen required:
Department:
Reference range:
Note:
FSH
Serum (1 x SST)
Referred test
The result is indicative of the circulating levels of glucose over the previous 17 days (which is
the half-life of Albumin). The report will include an estimation of the mean blood glucose level in
the patient over that period.
See Follicle Stimulating Hormone
FRUCTOSE BREATH TEST
See Hydrogen Breath Test. Phone main lab for appointment 08 9371 4530
10-Nov-2014 Page 50 of 122
FULL BLOOD EXAMINATION ( FBC )
F
(No add on test available)
Specimen Required: Adult:
1 x EDTA
Children:
1 x EDTA
Neonates: EDTA heel prick at Main Laboratory.
Department:
Haematology
Reference range:
ADULT
Haemoglobin:
Male:
130 - 180 g/L
Female:
115 - 160 g/L
(if pregnant 104 - 165 g/L)
White Cells (WCC):
4.0 - 11.0 x 109/L
Platelets:
150 - 400 x 109/L
Haematocrit:
Male:
0.40 - 0.54
Female:
0.37 - 0.47
Mean Cell Volume (MCV):
80 - 100 fL
Mean Cell Hb (MCH):
28 - 34 pg
Mean Cell Hb Conc.(MCHC): 31.0 - 36.0 g/dL
Neutrophils:
2.0- 7.5 x 109/L
Lymphocytes:
1.2- 3.5 x 109/L
Monocytes:
< 0.8
x 109/L
Eosinophils:
< 0.5
x 109/L
Basophils:
< 0.1
x 109/L
Paediatric and Child Reference ranges are available.
FUNGAL CULTURE
See specific samples including SKIN SCRAPING
FUNGAL SEROLOGY
Specimen required:
Department:
Serum (1 x SST)
Referred test
10-Nov-2014 Page 51 of 122
G
G
G6PD
See GLUCOSE-6 PHOSPHATE DEHYDROGENASE
GABAPENTIN
Specimen required:
Department:
Therapeutic range:
GAD
1 x Heparin NO GEL - Sample just prior to next dose.
Referred test
Therapeutic benefit is evident at plasma levels > 2 mg/L.
See ANTI GAD ANTIBODIES
GAMMA GLUTAMYL TRANSFERASE (GGT)
Specimen required:
Department:
Reference range:
Interpretation:
Comment:
Serum (1 x SST)
Biochemistry
Male: < 50 IU/L
Female: < 32 IU/L
HIGH - Liver disease (especially obstructive), induction by ethanol and various drugs, and
pancreatitis.
GBM AUTO
See GLOMERULAR BASEMENT MEMBRANE
GASTRIN
Specimen required:
Department:
Reference range:
Interpretation:
Serum (1 x SST) - Fasting.
Referred test
As stated on report
HIGH - Gastrinoma, and peptic ulcer.
GENE RE-ARRANGEMENT STUDIES (TCR AND IGH RE-ARRANGEMENT)
Specimen required:
Department:
Note:
2 x EDTA
Referred test
Tests for clonality. i.e. Band T-Cell lymphomas
GENETIC DISORDERS
Specimen required:
Department:
Note:
2 x EDTA – Dedicated tubes, i.e. not to be shared with any other tests.
Referred test
Genertic Services at DHM performs several tests for genetic disorders including Cystic
Fibrosis, Fragile-X.
For non-routine genetic testing please contact Duty Manager
.
10-Nov-2014 Page 52 of 122
G
GENITAL & OTHER SPECIMENS FOR INVESTIGATION OF INFECTION (INCLUDING STD'S)
Department:
Microbiology
Specimen required:
Gel swabs (Transport media with blue top) are for culture (MC&S)
Dry swabs (orange / white top no transport media) are for PCR
Note: testing on Genital samples for MC&S CANNOT be perfomed on dry swabs
Comment:
The reason for the investigation should be marked on the request form. Organisms such as
anaerobes or coliforms are part of the normal vaginal flora, and their isolation in culture from
the endocervix or vagina does not reliably predict the cause of Pelvic Inflammatory Disease.
However, Post Operative specimens have Anaerobic cultures performed.
If Ureaplasma / mycoplasma are requested, the specimen (dry swab) is referred for PCR. An
additional dry swab should be collected for this test.
MYCOPLASMA
The Laboratory will supply swabs on request.
See also:
Note:
FEMALE:
Endocervical swabs – for Gonorrhoea, and Chlamydia.
(i)
Direct smear for Gram stain (roll, rather than rub a swab from the endocervix onto a clean glass slide, and
allow to air dry). Differentiate clearly from a Pap Smear slide if this is also submitted.
(ii)
Plain swab into Transport Medium, for N.gonorrhoea culture - swab to be kept at room temperature. (Note
that while PCR detection is more sensitive, only culture will provide antibiotic susceptibility information.)
(iii)
Orange capped wire swab for N.gonorrhoea and Chlamydia PCR. Replace swab in dry sheath for transport.
See also Urethral Swabs below and separate entry on URINE FOR MICRO CULTURE AND SENSITIVITY.
Endocervical swabs – for investigations other than STD's.
(i)
Direct smear for microscopy using plain swab.
(ii)
Plain swab into Transport Medium.
High Vaginal Swabs – for Trichomonas, Candida and Bacterial vaginosis
(i)
(ii)
High Vaginal swabs – for investigations other than STD's.
(i)
(ii)
Female Urethral swabs – for Gonorrhoea and Chlamydia.
(i)
Direct smear for Gram stain (roll, rather than rub a swab from the urethra onto a clean glass slide, and
allow to air dry).
(ii)
Plain swab into Transport Medium, for N.gonorrhoeae culture - swab to be kept at room temperature. (Note
(iii)
Orange capped wire swab for N.gonorrhoeae and Chlamydia PCR. Replace swab in dry sheath for
transport.
See also Endocervical Swabs above and separate entry on URINE FOR MICRO CULTURE AND
SENSITIVITY.
Female Mouth/Rectal swabs – as indicated by the history.
(i)
Direct smear for Gram stain (roll, rather than rub a swab from the site onto a clean glass slide, and allow to
air dry).
(ii)
Plain swab into Transport Medium, for N.gonorrhoeae culture. Keep swab at room temperature.
(iii)
transport.
Vulval lesions/vesicles
(i)
Herpes simplex virus PCR: Vesicle fluid or firm swabbing of ulcer base using orange capped wire swab.
Replace swab in dry sheath for transport.
(ii)
A rapid screening test for HSV is also available by immunofluorescence. Special kits are available on
request from the Laboratory
(iii)
Syphilis 1. Syphilis/ Treponema pallidum
Specimen: Dry swab of ulcer/lesion for PCR
2. Chancroid (Haemophilus ducreyi)
Specimen: Swab in gel transport medium for culture
and Dry swab for PCR
Vulval swabs – for investigations other than STD's.
(i)
(ii)
Thinprep vials
(i)
ThinPrep vials can be used for Chlamydia, gonorrhoea PCR, HPV DNA , UREAPLAMSA / MYCOPLASMA
and HSV. PCR can also be performed on brushes including the Cervex Brush.
SOLVS
Self obtained lower vaginal swab for Strep B
10-Nov-2014 Page 53 of 122
MALE:
G
Male Urethral swabs – for Gonorrhoea, Chlamydia.
(i)
Direct smear for Gram stain (roll, rather than rub a swab from the urethra onto a clean glass slide, and
allow to air dry).
(ii)
Plain swab into Transport Medium, for N.gonorrhoeae culture - swab to be kept at room temperature. (Note
(iii)
transport. (See also Urethral Swabs and First Void Urine).
Penile/Urethral swabs – for investigations other than STD's.
(i)
(ii)
Male Mouth/Rectal swabs – as indicated by the history.
(i)
Direct smear for Gram stain (roll, rather than rub a swab from the site onto a clean glass slide, and allow to
air dry).
(ii)
Plain swab in Transport Medium for N.gonorrhoeae culture. Keep swab at room temperature.
(iii)
Male Vesicles or Ulcers.
(i)
Herpes simplex virus PCR: Vesicle fluid or firm swabbing of ulcer base using orange capped wire swab.
Replace swab in dry sheath for transport.
(ii)
Herpes simplex virus culture is also available. Plain wooden shafted swab into Viral Transport Medium.
(iii)
A rapid screening test for HSV is also available by immunofluorescence. Special kits are available on
request from the Laboratory
(iv)
Syphilis 1. Syphilis/ Treponema pallidum
Specimen: Dry swab of ulcer/lesion for PCR
2. Chancroid (Haemophilus ducreyi)
Specimen: Swab in gel transport medium for culture
Dry swab for PCR
GENTAMICIN ASSAY / AMINOGLYCOSIDE MONITORING
Specimen required:
Department:
Comment:
NOTE:
Serum (1 x SST)
Referred test
Aminoglycosides (gentamicin, tobramycin) may be administered 8 hourly, or as a once daily
intravenous dose. It is now recommended that gentamicin and tobramycin are administered as
a once daily intravenous dose, in order to maximise efficacy and minimise toxicity. The patient
information required for dosage calculation is:
- age
- weight (kg)
- height (cm)
- current serum creatinine
- Dose and time of last dose
- Time of blood collection if drug has already been started.
It is essential that the above information is collected so that valid measurements and/or
adjustments can be made.
It is important that serum levels of aminoglycoside are monitored closely in order to avoid renal
toxicity. This should be done after the FIRST DOSE and perhaps several times a week
thereafter. Serum creatinine should also be monitored during a course of aminoglycoside.
AMINOGLYCOSIDE MONITORING AFTER ONCE DAILY IV DOSING:
For patients with essentially normal renal function on once daily IV administration, serum for aminoglycoside
monitoring should be collected BETWEEN 6 AND 14 HOURS after the dose, and the resulting level is compared to
levels on the graph indicated. If the patient’s level falls between the upper and lower line, no dosage adjustment is
necessary. If outside the lines, recalculate the next dose according to the following formula:
Next dose = (target concentration / actual concentration) x initial dose.
AMINOGLYCOSIDE MONITORING AFTER 8 HOURLY IMI or IV DOSING:
Trough levels should be monitored in order to avoid toxicity. Peak levels reflect adequacy of dose.
Trough sample: Collect serum prior to next dose.
Acceptable trough level: < 1 mg/L
Peak sample IV: Collect serum 30 minutes after end of infusion.
IMI: Collect serum 60 minutes after dose.
Acceptable peak level: > 10 mg/L
10-Nov-2014 Page 54 of 122
G
SERUM AMINOGLYCOSIDE
CONCENTRATION (mg/L)
8
7
6
TARGET
5
MAXIMUM
4
3
MINIMUM
2
1
0
6
7
8
9
10
11
12
TIME AFTER END OF INFUSION (Hours)
13
14
GESTATIONAL DIABETES SCREENS
See Glucose Challenge under GTT
GFR/EGFR
See eGFR
GHRELIN - collect 1 x SST Referred Test
GILBERTS GENOTYPING
Specimen required:
Department:
1 x ACD & 1 x 4.5ml EDTA
Referred test
GLIADIN ANTIBODIES ( IGG & IGA )
TEST NO LONGER ROUTINELY PERFORMED replaced by TISSUE TRANSGLUTAMINASE ANTIBODIES (TTG IGA)
GLOMERULAR BASEMENT MEMBRANE
Specimen required:
Department:
GLUCAGON
Note:
Specimen required:
Department:
1 x SERUM (SST).
Referred test
Collect at main laboratory only. Patients must fast overnight. Store tube in refrigerator
before collection
2 x EDTA containing 0.2mL Aprotinin
Referred
GLUCOSE – BLOOD (GLUC OR BSL)
Specimen required:
Department:
Reference range:
Comment:
1 x Fluoride Oxalate.
Biochemistry
Fasting: 3.5 – 5.4 mmol/L
Random: 3.5 – 5.4 mmol/L
Diabetes Australia recommends that persons aged over 35 years with risk factors, fasting or
random levels above 5.4 mmol/L should be investigated further before DM is excluded.
10-Nov-2014 Page 55 of 122
G
GLUCOSE – CSF
Specimen required:
Department:
Reference range:
Interpretation:
CSF.
Biochemistry
2.1 - 4.0 mmol/L
LOW - Bacterial Meningitis, Cryptococcal Meningitis, Malignancy involving the meninges.
HIGH - Sarcoidosis, Hyperglycaemia.
GLUCOSE / INSULIN RATIO
Specimen required:
Department:
Reference range:
Patient must be fasting
Serum (1 x SST) & Glucose tube (Oxalate)
Biochemistry
Glucose / Insulin Ratio > 10
GLUCOSE TOLERANCE TEST (GTT)
May also be requested as an OGGT
COLLECTION STAFF
GTT Check Sheet (Form PIBI-002) must be completed before and during collection. Please contact the Duty Manager
or Senior Biochemistry staff to discuss correct protocol if unsure.
MODIFIED GLUCOSE TOLERANCE TEST (World Health Organisation 2 Hour Protocol)
Specimen Required: 1. Collect a fasting glucose sample (1 x Fluoride oxalate).
2. Give the patient 75 g load of glucose (one whole bottle of glucose drink).
(If pregnant give 75g glucose, unless the doctor specifies differently. Gestational diabetes has
different cutoffs to the ones below.)
3. Begin timing when the drink finished.
4. Collect a one hour and two hour blood sample.
5. Ensure times are written on all samples and ideally mark tubes as F, 1, 2 to help identify
tubes correctly
Note:
Department:
Results:
Glucose load for children = 1.75 g/Kg. Please contact Laboratory first.
Biochemistry
(in mmol/L)
Fasting
2 Hour Post Glucose Load
Normal
≤ 6.0
≤ 7.7
Impaired Fasting Glycemia 6.1 - 6.9
≤ 7.7
Impaired Tolerance
7.8 - 11.0
Diabetes Mellitus
≥ 7.0
≥ 11.1
CONT. OVER PAGE
Comment
For extended or modified GTT’s the tests are done in accordance with requesting
practitioner’s wishes.
PREGNANCY GLUCOSE CHALLENGE ( 1 HOUR SCREENING TEST) OR OGC(T)
a 50 gram load followed by a 1 hour specimen, unless otherwise stipulated. Patient can be
fasting or non-fasting for this 1 hour screening test. Test done at 24 - 28 weeks.
GLUCOSE TOLERANCE TEST WITH INSULIN
Specimen required:
Department:
Note:
3 x SST (Serum) and 3 x Fluoride oxalate
Biochemistry
(1) Same collection procedure as GTT above with the addition of (2) below.
(2) Please ensure a serum sample (1 x SST) and 1 x Fluoride oxalate sample is collected at
each point of the test (Fasting, 1 hour and 2 hour samples). Insulin cannot be performed using
the Fluoride Oxalate tube.
GLUCOSE - 6 PHOSPHATE DEHYDROGENASE ( G6PD )
Specimen required:
Department:
Reference range:
Comment:
1 x EDTA or 1 x Heparin NO GEL
Haematology
Specimen must be at the Laboratory within 24 hours of the bleed.
10-Nov-2014 Page 56 of 122
GLUTAMINE
Specimen required:
Department:
Reference range:
G
1 x Heparin No GEL – Separate promptly and transport frozen.
Referred test
GLUTEN ANTIBODIES ( IGG & IGA )
TEST NO LONGER PERFORMED ROUTINELY - REPLACED BY TISSUE TRANSGLUTAMINASE ANTIBODIES
(TTG IGA) PLEASE CONTACT LABORATORY IF TESTING REQUESTED
GLYCOPROTIEN B II
See BETA GLYCOPROTIEN
GLYCOSYLATED HAEMOGLOBIN
See HAEMOGLOBIN A1C
GNRH
Test not available. FSH/LH ratio performed instead
GONNORRHOEA
See GENITAL & OTHER SPECIMENS FOR INVESTIGATION OF INFECTION (including STD's)
GROUP AND HOLD/SAVE
SEE Cross Matching
GROWTH HORMONE ( GH ) (No add on test available)
Specimen required:
Department:
Reference range:
Interpretation:
Note:
Serum (1 x SST) - Fasting, Resting ~30 min.
Biochemistry
Men 0-1 ug/L
Women 0-10 ug/L
LOW - Dwarfism
HIGH - Gigantism, acromegaly, stress
24 hour Urinary (No preservative) test for Growth Hormone is available and referred to an
external Laboratory with a cost to the patient.
10-Nov-2014 Page 57 of 122
H
H
H Pylori (Titre)
Please see HELICOBACTER SEROLOGY
5HIAA
Please see HYDROXYINDOLACETIC ACID (5HIAA)
21 HYDROLASE ANTIBODIES
Specimen required:
Department:
1 x SST (Serum)
Referred
HAEMOCHROMATOSIS GENE STUDIES (HLA-H) (Must meet specific requirements for rebate)
Specimen required:
Note:
Department:
Reference range:
Comment:
1 X EDTA – DO NOT REFRIGERATE
A single unshared dedicated EDTA tube is required for this test. If other biochemical tests
are required please collect additional tubes.
Referred test
As stated on report
Haemochromatosis gene mutation test identifies the C282Y major and H63D minor mutations.
HAEMOGLOBIN A1C ( HbA1c )
Specimen required:
Department:
Reference range:
Note:
1 x EDTA
Haematology
Non diabetic level
< 6%
Target
< 7%
Poorly controlled range
> 8%
Levels of HbA1c are indicative of the circulating levels of glucose over the previous 60 days
(which is the half-life of haemoglobin). The report will include an estimate of the mean blood
glucose level over this period. Medicare Australia will only allow a rebate if the patient is a
proven diabetic.
HAEMOGLOBINOPATHY STUDIES / HAEMOGLOBIN ELECTROPHORESIS
Specimen required:
Department:
1 x EDTA and 1 x SST
Haematology
This request includes:
(i)
(i)
(ii)
(iii)
(iv)
HbA2
HbF
HbH
Haemoglobin Electrophoresis for abnormal Hb bands
Hbf (by flow cytometry analysis in Feto-maternal haemorrhage)
HAEMOPHILIA GENE STUDIES
Specimen required:
Department:
Note:
1 x EDTA
Referred test
Molecular test which may be requested for carrier diagnosis.
HAEMOPHILUS INFLUENZAE
Specimen required:
Department:
Note:
Sputum, Eye swabs or Ear swab (ruptured drum)
Microbiology
Rarely isolated from genital sites or urine and can be invasive.
10-Nov-2014 Page 58 of 122
H
HAEMOPHILUS DUCREYI
Specimen required:
Department:
Comment:
HAEMOSIDERIN
Specimen required:
Department:
Reference range:
Gel swabs (Blue) for culture - Microbiology
Dry swab (orange/white) for PCR
Microbiology
Cause of ulcerating genital disease (SEA etc)
Spot urine.
Histopathology
Not detected.
HALASCA SCREEN
See THROMBOPHILIA SCREEN
HAMS TEST
TEST NO LONGER PERFORMED - REPLACE WITH FLOW CYTOMETRY FOR CD55, CD59.
SEE IMMUNOPHENOTYPING
Comment:
These neutrophil and red cell antigens (CD55 and CD59) are decreased in Paroxysmal
Nocturnal Haemoglobinuria (PNH)
HAND/FOOT/MOUTH DISEASE / ENTEROVIRUS
Specimen required:
Department:
Note:
Comment:
HAPTOGLOBIN
Specimen required:
Department:
Reference range:
Interpretation:
Throat swab (Dry orange/white) swab for PCR, or Faeces samples, vesicle swab for PCR.
Referred test
Serology testing is not available for Enteroviruses in WA, PCR is the preferred test.
Rash appearing in children. Vesicles/lesions appearing on hands and feet and mouth. Caused
by Coxsackie or other enterovirus.
Serum (1 x SST)
Biochemistry
0.3 - 2.0 g/L
HIGH - Acute phase response, Oestrogen or Steroid therapy
LOW - Intravascular haemolysis, megaloblastic anaemia, massive tissue haemorrhage
Hb1AC
See Haemaglobin A1C
HB ELECTROPHORESIS / HB DNA
See HAEMOGLOBINOPATHY STUDIES
HCG
See HUMAN CHORIONIC GONADOTROPHIN
HEAVY METAL SCREEN
Specimen required:
Department:
Reference range
Note:
4x Trace Element (Royal blue top K 2 EDTA) and Spot Urine
Referred
See individual metals.
Please specify heavy metals required e.g. Lead, Mercury, Cadmium and Arsenic.
Heavy metal screen routinely includes Aluminium (AL), Arsenic (AS), Cadmium (CD), Cobalt
(CO), Lead (BP), and Mercury (HG).
10-Nov-2014 Page 59 of 122
HEINZ BODIES
Specimen required:
Department:
Reference range:
Interpretation:
H
Please refer patient to Clinipath Pathology Main Laboratory.
1 x EDTA - Sample dispatched immediately after collection.
Referred test
Negative.
Positive in certain drug induced haemolytic anaemias.
HELICOBACTER ANTIGEN
Specimen required:
Faeces
Department:
Referred Test
HELICOBACTER BREATH TEST
Specimen required:
Department:
Reference range:
Note:
Comment:
Breath Sample (Collected into special foil balloon)
Please ensure patient is FASTING for minimum 4 hours including water
Can brush teeth. but do not swallow water. Follow instructions on the Kit box
Can ONLY be performed at Collection Centres
Serology
< 50 DPM
Patient should have avoided the medications below but only after consultation with their doctor
i. Antibiotics for 4 weeks before test
ii. Sucralfate for at least 2 weeks before test
iii. Proton-pump inhibitors such as Losec, Somac or Zoton for at least 1 week before test
iv. H2 receptor antagonists and antacids during test and fasting period.
All Helicobacter breath tests are now eligible for a Medicare rebate. Results are reported
Mon-Fri, all tests performed on Fri/Sat/Sun will be reported by 12.00noon Monday morning.
HELICOBACTER SEROLOGY
Specimen required:
Department:
Reference values:
Indications:
Comment:
HEPARIN CONTROL
Specimen required:
Department:
Note:
Serology
< 6.25 U : Negative
6.25 - 7.00 U: Equivocal
> 7.00 U : Positive
Helicobacter pylori is accepted as a causative agent of type B gastritis and peptic ulcer
disease, and is strongly associated with dyspepsia and several other upper gastrointestinal
diseases.
The preferred test to assess successful eradication of Helicobacter pylori is Urea (C14) Breath
test: 4-6 weeks after treatment is completed, see Helicobacter Breath Testing
1 x Sodium citrate tube.
Haematology
See PARTIAL THROMBOPLASTIN TIME.
HEPASCORE (No rebate)
Specimen required:
Department:
1 x dedicated (Serum no gel). Red Top
Referred
10-Nov-2014 Page 60 of 122
H
HEPATITIS SEROLOGY ( HEP A, B & C )
Specimen required:
Department:
Tests performed:
Serology
HEPATITIS A – Total
HEPATITIS A – IgM
HEPATITIS B – SURFACE ANTIGEN
HEPATITIS B – SURFACE ANTIBODY
HEPATITIS B – CORE ANTIBODY (Total)
HEPATITIS B – CORE IgM ANTIBODY
HEPATITIS B – e ANTIGEN
HEPATITIS C – ANTIBODY
HAV-Total
HAV-IgM
HBsAg
Anti HBs (HbsAb)
Anti HBc
Anti HBc IgM
HB e Ag (only if HBsAg are positive)
HCV
Recommended screening tests:
(a)
Initial screen for acute hepatitis with elevated transaminase levels:
Hepatitis A IgM Antibody (HAV-IgM)
Hepatitis B Surface Antigen (HBsAg)
Hepatitis B Core Antibody (Anti HBc)
Hepatitis B Core IgM Antibody (Anti HBc IgM) if indicated
Hepatitis C Antibody (Hep C)
(b)
STD screen or post sexual exposure
(c)
Post-immunisation Screening:
Hepatitis B Surface Antibody (Anti HBs)
Hepatitis A IgG Antibody
(d)
Antenatal Screening:
Hepatitis C Antibody (Hep C)
Other HBV tests can be added if desired
(e)
Follow-up of known Hepatitis B Positive patients:
Hepatitis B e Antigen (HB e Ag)
Hepatitis B e Anitbodies
(f)
Needlestick - PLEASE SPECIFY Donor or Recipient ( if not specified Needle Stick
routine tests will be done; HBsAg, anti-HBS, Anti HB core HCV, HIV)
Note: These are initial tests only. For follow-up testing please discuss with
Clinical Microbiologist
RECIPIENT (Urgent Serology Test)
Hepatitis C Antibody
HIV Antibody
DONOR (Urgent Serology Test)
HIV Antibody
Comment:
Reported as Detected or Not Detected for Hepatitis with appropriate interpretive comments.
HEPATITIS B DNA (Quant Hep B antibodies, Hep B DNA PCR, Hep B viral Band)
Specimen required: 3 x EDTA . DO NOT USE HEPARINISED BLOOD Dedicated tubes are required.
Department:
Note:
Required minimum sample of 200ul. Separate sample within 3 hours of collection. Freeze and
transport frozen if the sample is to arrive at testing Laboratory longer than 72 hours after
collection.
Referred test
Patient must be HbsAg positive before this test will be performed.
Usually only accepted if request is from a hepatologist specialist, must be discussed with the
clinical microbiologist and Pathwest notified.
HEPATITIS B VIRAL LOAD
Specimen required: 3 x EDTA dedicated tubes. No add on facility available
10-Nov-2014 Page 61 of 122
H
HEPATITIS C GENOTYPING
Specimen required:
Department:
Comment:
Serum (2x SMALL SST) Dedicated tube is required
Referred test
Performed in patients on HCV treatment and follow-up but only in discussion with
microbiologist or if requested by hepatologist. (No add on test available)
HEPATITIS C RNA (PCR)
Specimen required:
Department:
Note:
Serum (2 x SMALL SST). Dedicated tube is required.
Referred test
Can be requested as Hep C PCR (No add on test available)
HEPATITIS C RNA (QUANTITATIVE/VIRAL LOAD)
Specimen required:
Department:
Note:
Serum (2 x SMALL SST) Dedicated tube is required
Referred test
Performed on patients on HCV treatment and follow-up but only in discussion with
microbiologist or if requested by hepatologist. (No add on test available)
HEPATITIS D ANTIBODY
Specimen required:
Department:
Note:
Serum (1 x SMALL SST)
Referred test
Only performed if HBsAg is positive
HEPATITIS E ANTIBODY
Specimen required:
Department:
Serum (1 x SMALL SST)
Referred test
HERBICIDES (No Rebate)
Specimen required:
Department:
Note:
Spot urine sample after exposure to herbicides.
Referred test
Specimens are referred. A private fee will apply for the test. Please specify herbicides if
known.
HEREDITARY SPHEROCYTOSIS SCREENING TEST
Department:
Referred
Comment:
Must arrive at RPH within 48 hours of collection. DO NOT collect on Fridays.
HERPES SIMPLEX I AND II
Specimen Required: PCR: Dry swab for PCR is the preferred method (Dry orange swab)
IMMUNOFLUORESCENCE: Special slides to be submitted using HSV I and HSV II kit,
available from Laboratory. Herpes can be detected rapidly (1-2 days turn-around time) by
immunofluorescence if lesions are fresh. i.e. not healing yet
See also:
VIRUS DETECTION
HERPES SIMPLEX I AND II IGG ANTIBODY
Specimen required:
Department:
Results:
Comment:
Serum (1 x SST)
Referred test
Reported as Detected or Not Detected with appropriate interpretative comments.
Demonstrates past Herpes Simplex infection. If lesions are present then Viral PCR is the
appropriate test.
HFE GENE see HAEMOCHROMATOSIS GENE STUDIES
10-Nov-2014 Page 62 of 122
H
HISTAMINE or Whole blood Histamine
Specimen required:
Department:
Comment:
HISTOPATHOLOGY
Comment:
2 X Lithium Heparin. Only collect at Main Laboratory
Transport frozen, collect with Ice pack
Referred test
Diet 24hrs prior to and during test should contain no fish, seafood, cheese or cheese spread.
Routine processing of surgical biopsies is undertaken 6 days per week (Monday to Saturday)
and most written reports are obtainable by mid morning, (Monday to Friday), for specimens
processed the previous working day.
Some specimens such as large excision specimens, fatty specimens and excessively bloody
specimens may require longer fixation for proper processing and hence the result may be
delayed 24hrs.
Cases requiring additional stains are usually available by the afternoon, but in some cases may
take longer. The Doctor concerned is usually notified of protracted delays in having reports
finalised.
For urgent biopsies, a verbal report is obtainable early morning, providing they are clearly
labelled as “urgent” and are received by 8.00pm the previous day. Urgent reports can also be
generated by direct contact with any of the pathologists or scientific staff.
All requests should identify the site of the lesion and the type of biopsy specimen eg excisional,
incisional, punch, shave curettage etc. Some indication as to the clinical diagnosis, eg
?dysplastic naevus, greatly assists the pathologist in making the final report.
Customised skin biopsy request forms are available on request
COLLECTION PROCEDURES:
1) Routine biopsies: Should be placed in a specimen jar containing 10% buffered formalin as
soon as possible after removal. The amount of formalin necessary for adequate fixation is
about ten times the volume of the specimen. Formalin jars are blue topped and labelled as
containing 10% buffered formalin. The Laboratory provides formalin jars on request.
Specimens accompanying paps should be double bagged to ensure formalin vapour is
contained. Pap Smears and Histo specimens should never be placed in the same bag.
Please note that it is a NATA requirement that specimen jars are labelled with the full
name of the patient and the date of birth. Please also ensure that the site given on the
specimen jar and the request form are identical.
2) Special biopsies: e.g. lymph nodes, skin biopsies for immunofluorescence. All biopsies or
tissues received fresh without formalin should be couriered to the Main Laboratory within the
hour and urgently brought to the attention of a Histopathology staff member. Packing in ice
can help prevent degeneration.
Skin biopsies for immunofluorescence can also be placed into a specific transport medium
which is available on request from the laboratory. (Please provide 24hrs notice for delivery)
3) Frozen section: Frozen section analysis is currently only performed at Bunbury Pathology.
HIV P24 ANTIGEN
Specimen required:
Department:
Note:
Serum (1 x SST)
Referred test
This may also include a non-quantitative test for HIV RNA.
Routine HIV testing includes testing for p24 and antibodies to HIV1/2 (Combination test)
Not to be confused with viral load testing.
10-Nov-2014 Page 63 of 122
H
HIV SEROLOGY ( HUMAN IMMUNODEFICIENCY VIRUS ANTIGEN AND ANTIBODIES )
Specimen required:
Department:
Test performed:
Note:
Comment:
Serology
Combined Test: HIV 1/2 antibodies + p24 antigen
Informed consent for patient HIV testing must be obtained by the requesting practitioner.
CODED HIV SPECIMENS
Medicare Australia will not pay benefits when requests are coded.
If coding patients for HIV and other tests are required (uncoded) then please fill out 2 request
forms
e.g. for John Citizen DOB 23/09/60:
Code one form for the HIV test (this could be JC230960). Please ensure sample
supplied matches code (i.e. label specimen JC230960).
Another form for any non-coded tests (for billing purposes) must be filled out with
correct patient details and extra specimens, labelled with the patients true details.
HIV RNA (VIRAL LOAD)
Specimen required: 3 x EDTA (Dedicated)
Department:
Note:
Referred test
Sample separated within 6 hours of collection and FROZEN.
Transported FROZEN to RPH Immunology. When separated at least 2ml Plasma must be
present in the tube. No add on test available.
HLA – B27 ( HUMAN LEUCOCYTE ANTIGEN )
Specimen required:
Department:
Reference range:
Interpretation:
HLA ANTIBODIES
Specimen required:
Department:
Reference range:
1 x ACD / CPDA tubes
DO NOT REFRIGERATE
Collected Mon-Sat,
but not over a long weekend. No add on test available.
Haematology
Negative.
A negative result virtually excludes ankylosing spondylitis. HLA-B27 is present in Reiter’s
syndrome, inflammatory bowel disease and uveitis and can be of little diagnostic value.
2 x Serum (SST)
Referred test
HLA DQ 2/8 (HLA for Coeliac)
Specimen required: 1 x ACD / CPDA DO NOT REFRIGERATE
Collected Mon-Sat, but NOT over a long weekend.
Department:
Referred test
Reference range:
HLA - H
See HAEMOCHROMATOSIS STUDIES
HLA TYPING ( OTHER ANTIGENS )
Specimen required: 1 x ACD / CPDA DO NOT REFRIGERATE
Collected Mon-Sat, but NOT over a long weekend.
Can now be collected at ACC’s. No add on test available.
Department:
Referred test
Reference range:
As stated on report. Routine testing may have a 3 week turnaround time.
10-Nov-2014 Page 64 of 122
H
HMMA ( 3-METHOXY-4-HYDROXYMANDELIC ACID )
Specimen required:
Department:
Note:
HNPP GENE
Specimen required:
Department:
24 hour urine collection.
Referred test
2x EDTA. Must only be colleted Mon-Thur
Referred test
HOMOCYSTEINE (HOCY)
Specimen required:
Department:
Reference range:
Interpretation:
Note:
1 x PPT dedicated tube – must be full tube. Can be same tube as PTH
Patient MUST be FASTING. Mark sample as Process Immediately. No add on test available.
Biochemistry
Fasting 5.0 - 15.0 umol/L
Elevations are associated with independent risk of cardiovascular disease
1) Sample must be centrifuged at the centre or arrive in the Laboratory within 3 hours of
collection and centrifuged immediately on receipt. Sample must be placed on ice until
centrifuged
2) If requested in children for "? homocysteinuria" then a spot urine is the sample of choice referred to PMH.
HORMONE (OVULATION) TRACKING
Specimen required:
Department:
Comment:
Note:
HPV
See HUMAN PAPILLOMA VIRUS (HPV) DNA TESTING
HS CRP
Specimen required:
Department:
hsTnt
HSV
Serum (1 x SST)
Biochemistry
Recommended hormones- oestradiol, FSH, LH and progesterone.
Weekdays To ensure results are available on the same day, it is requested that patients are
bled at collection centres by 9 am Monday to Friday.
Collection staff should then contact the courier department to organise an URGENT pick-up.
Saturdays A number of collection centres are available for sample collection. Please ask
patient to phone the centre the day prior to the blood test to ensure Saturday collection for
Hormone Tracking is available.
Samples must be collected from patients before 9 am to ensure same day results.
1xSST
Biochemistry
See Troponin-High sensitivity
See HERPES SIMPLEX ANTIBODY or HERPES SIMPLEX I AND II (IF FOR PCR)
10-Nov-2014 Page 65 of 122
H
HUMAN CHORIONIC GONADOTROPHIN (QUANTITATIVE) RANGES IN PREGNANCY
Specimen required:
Department:
Results:
Serum (1 x SST) Process Immediately sticker
Biochemistry
Weeks after
HCG mlU/ml
fertilisation
Median
5-95th percentile
1
17.5
5.8 - 71.2
2
141
9.5 - 750
3
1398
217 - 7138
4
3339
158 - 31795
5
39759
3697 - 163563
6
90084
32065 - 149571
7
106257
63803 - 151410
8
85172
46509 - 186977
10
66676
27832 - 210612
12
34440
13950 - 62530
13
28962
12039 - 70971
14
23930
9040 - 56541
15
20860
8175 - 55868
16
19817
8099 - 58176
HUMAN CHORIONIC GONADOTROPHIN (HCG) - TOTAL (PREVIOUSLY BETA HCG)
Specimen required:
Department:
Reference range:
Serum (1 x SST) Process Immediately sticker
Urine can also be used but this is not as sensitive in early pregnancy.
Biochemistry
Female:
> 20 U/L
- Consistent with pregnancy
5 - 20 U/L
- Equivocal
< 5 U/L
- Negative
Male:
< 2 U/L
- As a tumour marker
Premenopausal female < 1 U/L
Postmenopausal female < 7 U/L
HUMAN IMMUNODEFICIENCY VIRUS ( HIV )
See HIV serology
HUMAN PAPILLOMA VIRUS (HPV) DNA TESTING
Specimen required:
Department:
Note:
Comment:
1) ThinPrep Sample; for Digene-Hybrid Capture II
2) Digene Swab; for Digene-Hybrid Capture II
3) Dry Swab or ThinPrep sample to be sent for PCR testing.
Referred
A Medicare rebate is available on this test (for 2 tests in 24 months) for those patients who
have had treatment for a High Grade Epithelial Lesion or previously had a positive test for high
risk HPV.
Test results are available within 14 days.
Molecular biology tests are used for the specific detection of high risk types of HPV. The most
precise way of detecting the virus is by PCR or DNA Hybrid Capture using a sample from a
ThinPrep vial or DIGENE SWAB.
HUMAN T-CELL LYMPHOTROPIC VIRUS (HTLV) TYPE I & II ANTIBODIES
Specimen required:
Department:
Serum (1 x SST)
Referred test
HVS ( HIGH VAGINAL SWAB )
10-Nov-2014 Page 66 of 122
H
HYDATID SEROLOGY
Specimen required:
Department:
Comment:
Serum (1 x SST)
Referred test
Disease caused by the tapeworm Echinococcus granulosus. Hydatid cysts may grow in any
organ but are most common in the liver and lungs.
HYDROXYCHOLECALCIFEROL
See Vitamin D
HYDROXYINDOLACETIC ACID (5HIAA)
Specimen required:
Department:
Reference range:
Comment:
Note:
HYDROXY PROLINE
Specimen required:
Department:
Urine – 24 hour collection in a strong acid preservative.
Preservative = 20 mls of 50% HCl. Warn Patient of acid risk
Referred test
As stated on report
Elevated levels found with carcinoid tumours. Falsely elevated levels may be seen after
ingestion of certain foodstuffs. If requested with ADRENALINE / NORADRENALINE
(Catecholamines), only ONE 24 hour specimen is required.
Please see Patient instructions PIBI-008 for special dietary requirements regarding this test
Urine – Spot
Protect from light: Wrap in alfoil
Referred test
HYDROGEN BREATH TEST
Specimen Required: 6 samples of breath over 3hrs
This test can only be collected at the specialised test collection centre at Selby St Osborne Park
Patients need to ring 9371 4531 to make a booking
This test is not covered by Medicare, out of pocket expences will be discussed at the time of booking.
Department:
Referred
10-Nov-2014 Page 67 of 122
I
I
IA-2 ANTIBODIES
Serum (1 x SST)
Referred test
Specimen required:
Department:
IEP OR IFE
See Immunofixation below
IGE
Serum (1 x SST)
Biochemistry
As stated on report
HIGH - Allergy, atopic eczema. RAST tests done in conjunction can help pinpoint specific
allergens. Other causes of an increased serum IgE level include parasite infestations, chronic
bronchopulmonary fungal disease and some immunodeficiency syndromes.
Specimen required:
Department:
Reference range:
Interpretation:
IGF-1
See INSULIN LIKE GROWTH FACTOR 1
IGF-BP3 -see Insulin like growth factor BP3
IGG SUBCLASSES
Serum (1 x SST)
Referred test
As stated on report
Different ranges apply to children. Age must be specified.
Specimen required:
Department:
Reference range:
IL-6
See INTERLEUKIN 6
IL-28 – BUNBURY ONLY
Specimen:
Department:
1 x SST 1 x EDTA
Referred Test
IMIPRAMINE ( TOFRANIL )
Specimen required:
Department:
Reference range:
1 x Lith Hep Collect PRE-DOSE sample (Trough).
Referred
As stated on report
Toxic levels at greater than 500ug/L.
Peak Level:
1 - 2 hours after oral dose
Half Life:
9 - 24 hours.
IMMUNOFIXATION ( IFE )
Specimen required:
Department:
Reference range:
Comment:
Serum (1 x SST)
Biochemistry
Not applicable.
If an abnormal band is detected in the QEP, the band(s) should be confirmed and typed using
I.F.E.
IMMUNOFLUORESCENT SKIN BIOPSY
Specimen required:
Department:
Note:
Contact Laboratory 24 hours before collection to organise solutions
Immunology
Useful for specific inflammatory skin conditions e.g. Suspected Lupus and Bullous pemphigus
10-Nov-2014 Page 68 of 122
I
IMMUNOGLOBULINS (IGA, IGG, IGM)
Specimen required:
Department:
Reference range:
Interpretation:
Serum (1 x SST)
Biochemistry
IgA
0.7 - 4.0 g/L adults
IgG
7.0 - 16.0 g/L adults
IgM
0.4 - 2.3 g/L adults
Low Levels:
Often associated with primary or acquired immunodeficiency syndromes.
High Levels:
(i) Polyclonal. Infections, liver disease etc
(ii) Monoclonal. Myeloma, Lymphoma, Macroglobulinaemia
IMMUNOPHENOTYPING ( IPT1 / IPT2 / IPT2A )
Specimen required:
Department:
Comment:
Reference range:
Note:
1 x ACD/CPDA blood (Pale yellow top) and 1 x EDTA. No add on test available.
Haematology
Includes requests for CD4/CD8 RATIO, NK CELLS, LYMPHOCYTE SURFACE MARKERS,
T-CELLS & SUBSETS, B CELLS, CD MARKERS and LYMPHOCYTE ACTIVATION
MARKERS
CD3 *
- Circulating T cells
CD4 *
- T Helper cells
CD8 *
- T Suppressor cells
CD5&/orCD56
- Mature T cells, B cells subset, thymocytes
CD16
- NK Cells
CD19
- B cells, precursor B cells
CD20
- B cells, precursor B cell subset
HLA DR+
- B cells, activated T cells
Kappa / Lambda light chains
* Reported as a percentage of total lymphocytes as well as absolute values where indicated.
For immunological assessment
CD3, 4, 8, 16, 56 and 19 are performed. A CD 4/8 Ratio is calculated.
For investigation of lymphocytic leukaemia, chronic lymphoma or chronic lymphocytosis, the
additional markers CD5, 20 and HLA DR+ are performed. Kappa/Lambda studies performed as
required.
As reported. Haematologist comment where relevant
For other immunophenotyping - 5 ml of EDTA blood is required (referred to RPH Immunology
Department).
For CD57/58 only - collect 2 x EDTA
Refer to RPH do not collect after midday Thursday
IM SCREEN ( Infectious Mononucleosis Screen, Monospot, Paul Bunnell, Heterophil Abs)
Specimen required:
Department:
Reference range:
Note:
INFLUENZA PCR
Specimen required:
Department:
See also:
Comment:
Haematology
Negative.
This test may be negative in children with EBV infection. Specific EBV serology (IgG & IgM) is
also available. See EBV SEROLOGY
Throat and/or anterior nasal dry swab (no transport media)
Referred test
VIRUS DETECTION
Viral transport media should be used if viral culture is required
INDIRECT COOMBS
See Blood grouping antibodies
10-Nov-2014 Page 69 of 122
I
INFLUENZA (RAPID TEST)
Test no longer performed
INFLUENZA SEROLOGY
Specimen required:
Department:
Indications:
See also:
Serum (1 x SST)
Referred test
May include fever, fatigue, headache, myalgia and pneumonia.
Consider also Mycoplasma, Bordetella, and Chlamydia, Legionella, other bacterial pneumonias
and respiratory viruses.
RESPIRATORY VIRUS DETECTION
INFLUENZA VIRUS IMMUNOFLUORESCENCE
See RESPIRATORY VIRUS IMMUNOFLUORESCENCE
INHIBIN (No Rebate)
Specimen required:
Department:
Note:
Serum (1 x SST). Spin and freeze ASAP
Referred test.
Patient will receive account $90 (July 2014) and must sign informed patient consent form from
Syndey Southwest Pathology services
I N R ( INTERNATIONAL NORMALISED RATIO)
See PROTHROMBIN TIME
INSULIN
Specimen required:
Department:
Reference range:
Note:
Serum (1 x SST) – Fluoride Oxalate NOT suitable. No Add on test available.
Biochemistry
Fasting - < 20 mU/L
Performed as a FASTING test together with a Glucose assay. Hyperinsulinaemia is associated
with insulin Type 2 Diabetes mellitus, PCOS and metabolic syndrome.
INSULIN ANTIBODIES
Specimen required:
Department:
Serum (1 x SST). Patient must be fasting. Spin and freeze ASAP
Referred test
INSULIN LIKE GROWTH FACTOR 1 ( IGF-1 )
Note:
Specimen required:
Department:
No add on test available
If collected with Growth hormone, patient needs to be Fasting, and resting for ~30 min.
Serum (1 x SST) – Separate and freeze as soon as possible after collection
Biochemistry
INSULIN LIKE GROWTH FACTOR BP-3 (IGF-BP3)
Specimen Required: Patient needs to be fasting, and resting for ~30 min. No add on test available,
Serum (1 x SST) – Spin and freeze as soon as possible (urgent courier NOT required).
Department:
Referred test
INSULIN RESISTANCE
See Glucose/Insulin Ratio
INTERLEUKIN 6 (No Rebate + Up front collection and processing fee)
Specimen required:
Department:
Note:
Serum (1 x SST) - Refrigerate
Referred test
No medicare rebate is available for this test. Please contact Duty manager for current cost if
required.
10-Nov-2014 Page 70 of 122
I
INTRINSIC FACTOR ANTIBODIES
Specimen required:
Department:
Serum (1 x SST)
Referred test
INTRAVENOUS CATHETER TIP CULTURE
Specimen required:
Department:
Cut off tip with sterile scissors and place in sterile yellow topped jar
Microbiology
IODINE LEVELS (No Rebate)
Specimen required:
Department:
Note:
Spot urine or 24 hour urine (no preservative)
Referred test
Not Medicare rebatable
IONISED CALCIUM
See CALCIUM (IONISED)
IPT1 OR IPT2/IPT2A
IR
See INSULIN RESISTANCE
IRON ( FE )
Specimen required:
Department:
Reference range:
Interpretation:
IRON STUDIES (IS)
Specimen required:
Department:
Tests include:
Serum (1 x SST)
Biochemistry
Males:
8.1 – 28.6 umol/L
Females: 5.4 – 28.6 umol/L
LOW - Iron deficiency anaemia, acute and chronic disease states, diurnal variation
HIGH - Iron therapy, haemochromatosis, and liver disease
Serum (1 x SST)
Biochemistry
SERUM IRON, TRANSFERRIN, SATURATION (%), FERRITIN.
ISLET CELL ANTIBODIES
Specimen required:
Department:
Serum (1 x SST)
Referred test
10-Nov-2014 Page 71 of 122
J
J
JAK2 (JANUS KINASE 2 or V617F MUTATION)
Specimen required:
Department:
2 x EDTA
Referred test
JAPANESE B ENCEPHALITIS
Specimen required:
Department:
Note:
JC VIRUS
Specimen required:
Department:
Note:
See also:
Serum (1 x SST)
Referred test (Urgent)
Japanese B is one of the flaviviruses, flavivirus screen
CSF
Referred test
One of the polyoma viruses; can cause progressive multifocal leucoencephalopathy
BK virus
JOINT FLUID
See SYNOVIAL FLUID
10-Nov-2014 Page 72 of 122
CLINIPATH PATHOLOGY
K
K
KATAYAMA FEVER (Acute Schistosomiasis)
Specimen required:
Department:
Haematology for FBE and blood film for eosinophils
Serology for Schistosomas Referred test
KARYOTYPING
See CYTOGENETIC STUDIES
KEPPRA
See LEVETIRACETAM
KETONES
Specimen required: 1 x Heparin no Gel
KLM OR LKM
See Anti Liver/Kidney Microsomal Antibodies
KLEIHAUER TEST
Specimen required:
Department:
Note:
Comment:
1 x EDTA
Referred test
Collect Mon-Thurs only, before 1pm as specimen must be at KEMH by 3.00pm
Used in the detection and quantification of transplacental haemorrhage so test is
marked as Urgent
KUNJIN
See MURRAY VALLEY ENCEPHALITIS
KRYPTOPYROLE LEVEL
Patient must contact main laboratory - Osborne Park 08 9371 4530
10-Nov-2014 Page 73 of 122
CLINIPATH PATHOLOGY
L
L
LACTATE
Specimen required:
Department:
Reference range:
1 x Fluoride Oxalate
Routine test: Special processing no longer required
Biochemistry
0.5 - 2.2 mmol/L, at rest
LACTATE DEHYDROGENASE ( LDH )
Specimen required:
Department:
Reference range:
Interpretation:
Serum (1 x SST)
Biochemistry
< 240 U/L
HIGH
- Myocardial infarction (late stage), muscle damage, liver disease
(especially hepatocellular)
FALSE HIGH - Haemolysed blood specimen.
LACTIC ACID
See LACTATE
LACTOSE TOLERANCE TEST
Note:
Please contact Main Laboratory prior to testing. A special lactose preparation is required
and patient must be fasting prior to the test. During the test please note on the request
form whether patient has symptoms (abdominal cramps, diarrhea etc) after taking
lactose.
Specimens required: 1 x Fluoride oxalate (glucose) tube collected:
At fasting, 1/2 hour, 1 hour and 2 hours post Lactose load.
Load:
Contact Duty Manager for lactose load. (50gms load for adults or 1 gm/kg body weight for
children).
Department:
Biochemistry
Reference range:
A rise in blood glucose of >1.7 mmol/L above fasting is normal, levels of 1.1-1.7 are equivocal
Interpretation:
Lactase deficient (lactose intolerance) maybe seen where blood glucose levels do not rise
above fasting levels.
LAMICTAL
See LAMOTRIGINE
LAMOTRIGINE ( LAMICTAL )
Specimen required:
Department:
Reference range:
1 x Heparin NO GEL
Sample just prior to next dose (TROUGH LEVEL)
Referred test
2 – 14 mg/L
LANOXIN
See DIGOXIN
LATS (LONG ACTING THYROID STIMULATION)
Specimen required:
Department:
Serum (1 x SST)
Referred test
10-Nov-2014 Page 74 of 122
CLINIPATH PATHOLOGY
L
LEAD ( Pb )
2 x Trace element Tube (Royal Blue top with blue stripe)
Biochemistry
NHMRC Recommended < 0.24 umol/L
Lead Workers
If level
< 1.90 µmol/L, retest in 12 months time.
If level 2.0 - 2.9 µmol/L, retest within 3 - 6 months.
If level
> 2.9 µmol/L, requires immediate action.
Note:
Whole Blood is the specimen of choice; 24 hr urine (with no preservative) can be used to
assess chelation therapy
Specimen required:
Department:
Reference range:
Interpretation:
LEGIONELLA URINARY ANTIGEN
Specimen required:
Department:
Note:
Urine
Referred test
Specific for Legionella pneumophila SG 1
LEGIONELLA SEROLOGY (including legionella longbeachae, potting mix legionella
most likely in this state)
Specimen required:
Department:
Indications:
Serum (1 x SST)
Referred test
This test forms part of the atypical pneumonia screen.
May include fever, fatigue, headache, myalgia and pneumonia.
Consider also Mycoplasma, Chlamydia, Bordetella, other bacterial pneumonias and respiratory
viruses.
LEIDEN FV
See FACTOR V LEIDEN
LEPTOSPIROSIS SEROLOGY
Specimen required:
Department:
Indications:
Serum (1 x SST)
Referred test
Fever, headache, myalgia, conjunctival redness, meningitis, rash, jaundice, renal failure and
myocarditis.
LEPTIN
Specimen required:
LEVETIRACETAM
Specimen required:
Department:
1 x SST, referred test , patient to sign consent form agreeing to pay cost of test.
1 X Lithium Heparin
Referred test
LIGHT CHAINS
See FREE LIGHT CHAINS
LIPASE
Specimen required:
Department:
Reference range:
Note:
Serum (1 x SST)
Biochemistry
13 – 60 U/L
More specific than amylase as a pancreatic marker.
LIPID STUDIES/PROFILE
Note:
Specimen required:
Department:
Tests include:
See also:
Lipid Studies or Lipid Profile is not a valid request for HDL and only Chol & Trig will be
performed unless HDL is specified; e.g. Chol/Trig/HDL.
Serum (1 x SST) - Fasting preferred, non fasting specimens will elevate triglycerides
Biochemistry
TOTAL CHOLESTEROL.
HDL CHOLESTEROL, TRIGLYCERIDES
VLDL - calculation olny
LDL CHOLESTEROL calculated (only valid if TG < 4.0 mmol/L)
APOLIPOPROTEINS
10-Nov-2014 Page 75 of 122
CLINIPATH PATHOLOGY
L
LIPOGRAM
See CHOLESTEROL
LIPOPROTEIN (a) (A1) (B1)
Specimen required:
Department:
Reference range:
Serum (1 x SST) - Fasting.
Referred Test
As stated on report
LISTERIA MONOCYTOGENES
Specimen required: Blood Culture x 2-3
NO SEROLOGY AVAILABLE
Department:
Microbiology
Comment:
Causes Listeriosis, which is dangerous in pregnancy.
Faeces not routinely indicated as it may represent colonisation.
LISTERIA SEROLOGY
Test not performed, see LISTERIA MONOCYTOGENES
LITHIUM
Specimen required:
Department:
Results:
Note:
Serum (1 x SST) - Taken 12 hrs post dose, or trough sample.
MUST be a SERUM SAMPLE
Biochemistry
Therapeutic Range:
0.6 - 1.2 mmol/L
Potentially Toxic:
> 1.6 mmol/L (at 12 hrs post dose)
Peak Level:
Half Life:
14 - 33 hours.
Please note time of collection and last dose.
LIVER FUNCTION TESTS ( LFT )
Specimen required:
Department:
Tests include:
See also:
Serum (1 x SST)
Biochemistry
AST.
ALT
ALKALINE PHOSPHATASE.
GAMMA GT.
BILIRUBIN.
TOTAL PROTEIN.
ALBUMIN.
Specific individual tests.
LUPUS ANTICOAGULANT ( LA )
Specimen required:
Department:
Reference range:
1 x Sodium citrate. Bunbury Pathology to collect 3 x Na Citrate. Add on testing not available.
Haematology
Negative
LUTEINISING HORMONE ( LH )
Specimen required:
Department:
Reference range:
Serum (1 x SST)
Biochemistry
Female:
Follicular
2 – 7 U/L
Mid Cycle
9 – 74 U/L
Luteal
1 – 9 U/L
Menopausal 19 - 100 U/L
Male:
1 - 9 U/L
LIVER FIBROSIS (No Rebate)
Specimen required: Serum 1 x SST
10-Nov-2014 Page 76 of 122
CLINIPATH PATHOLOGY
LYCOPENE
Specimen required:
Department:
Note:
L
Serum (1 x SST)
Referred test
Protect from light (wrap sample in Alfoil)
LYME DISEASE SEROLOGY
See BORRELIA BURGDORFERI SEROLOGY
Comment:
This disease is not believed to exist in Australia but is prevalent in Europe and North America
and is seen in returned travellers.
LYMPHOCYTE CELL MARKERS
LYMPHOCYTE SURFACE MARKERS
LYMPHOGRANULOMA VENEREUM (LGV)
Specimen required:
Department:
Note:
Comment:
Dry swab for Chlamydia trachomatis PCR
Aspirated fluid
Chlamydia PCR: Microbiology
LGV Serology: Referred test:
Currently used Chlamydia PCR detects all strains of Chlamydia trachomatis including L1, L2
and L3 strains which cause LGV. To specify a positive PCR as due to LGV strains, additional
molecular sub typing may be needed.
An ulcerating genital disease resulting in enlarged lymph nodes and abscesses. Causative
agent L1, 2, 3 types of Chlamydia trachomatis.
LYMPH NODE CULTURE
Discuss with Microbiologist/Histopathologist.
10-Nov-2014 Page 77 of 122
CLINIPATH PATHOLOGY
M
M
MAGNESIUM (Mg)
Specimen required:
Department:
Reference Range:
Interpretation:
Serum (1 x SST)
Biochemistry
0.65 - 1.10 mmol/L
HIGH - Renal failure, hyperalimentation.
LOW - Decreased intake, extra renal loss (e.g. diarrhoea), renal loss (e.g. diuretics,
.hyperaldosteronism), and cyclosporin therapy.
MALARIAL PARASITES (Malarial Film)
Specimen required:
Department:
MALARIA PCR
Specimen required:
Department:
Note:
2 x EDTA blood. Mark as Urgent
Thick and thin films recommended over 12-24 hours.
Haematology
2 x EDTA dedicated tubes required
Referred test
May be requested for cryptic cases of malaria
MALARIA SEROLOGY
Test no longer performed see MALARIAL PCR
MANGANESE (Mn ) - SERUM
Specimen required:
Department:
Reference Range:
2 x Trace Element (Royal Blue Top K 2 EDTA) dedicated tube
Referred test
As stated on report
MANGANESE ( Mn ) – WHOLE BLOOD
Specimen required:
Department:
Reference Range:
Referred test
As stated on report
MANNOSE BINDING LECTIN (MBL)
Specimen required:
Department:
1 x small SST
Referred test
MANTOUX TESTING (TUBERCULIN SKIN TEST) (Must meet specific requirements for rebate
Specimen required:
Comment:
Tuberculin skin test : Skin reaction read 48-72 hours after inoculation with Tuberculin antigen.
Testing is only performed at the main laboratory. Patients should ring for an appointment and
need to be aware that they will be inoculated on the first visit and then have to return to the
Main Laboratory 48-72 hrs later to have the test read. Testing is performed according to the
following schedule
Inocculation on Monday tests read, Wednesday
Inocculation on Wednesday tests read Friday
Inocculation on Friday tests read Monday .
Quantiferon (whole blood Interferon Gamma Assay) available and may be more suitable for
some patients.
May incur a non-medicare rebatable fee ($75).
10-Nov-2014 Page 78 of 122
CLINIPATH PATHOLOGY
M
MAST CELL TRYPTASE
Specimen required:
Department:
Note:
Serum (1 x SST) attach Process immediately sticker
Referred test
Specimen must be frozen upon receipt at Laboratory
MATERNAL SERUM SCREEN ( MSS )
Replaced by FIRST and SECOND TRIMESTER SCREENING
MBA20 (Multiple Biochemical analysis – 20 tests)
Specimen required:
Department:
Note:
1 x Serum (SST) AND 1 x Glucose Tube (Oxalate)
Patient should be FASTING unless known Diabetic.
Biochemistry
This request is NOT available for Medicare requests. This test combination is only available for
insurance or employment medicals. (incl Chol, Trig , HDL)
MC&S (MICRO CULTURE & SENSITIVITY)
See SWABS
MEASLES PCR
NOTE:
Specimen required:
Department:
Patient should not attend a collection center, refer patient to domicillary service for specimen collection
Dry Nasal and Throat swabs +/- Urine for PCR
Referred test
MEASLES VIRUS SEROLOGY IGG & IGM
Specimen required:
Department:
Results:
Indications:
Comment:
Note:
Serology
Reported as Detected / Not Detected with appropriate interpretive comment.
Characterised by rash and inflammation of the conjunctiva, fever.
Treat as urgent
if recent
suspected.and rickettsiae.
Consider
also Parvo
B19,exposure
Rubella, isarboviruses
Outbreaks can occur with imported measles. Notify by telephone to Public Health Unit if IgM+.
MEDITERRANEAN FEVER (FAMILIAL) PCR
Specimen required:
Department:
MELANIN
Specimen required:
Department:
1 x EDTA
Referred test
Spot Urine – Protect sample from light
Referred test
MELATONIN (No rebate + Up front collection and processing fee)
Specimen required:
Department:
MENINGITIS
Specimen required:
Department:
Note:
See also:
Saliva 2ml
Referred test
CSF for bacterial culture and/or viral PCR tests
Microbiology
Test is Urgent
NEISSERIA MENINGITIS
MELIOIDOSIS SEROLOGY
See BURKHOLDERIA PSEUDOMALLEI SEROLOGY
10-Nov-2014 Page 79 of 122
CLINIPATH PATHOLOGY
MERCURY ( Hg )
Specimen required:
Department:
Reference Range:
M
Spot Urine - Testing for exposure to inorganic or unspecified Hg
2 x Trace Element (Royal Blue Top K 2 EDTA) dedicated tube - Testing for exposure to
organic Hg
Referred test
As reported
MESOMARK (No rebate)
Specimen required:
Department:
Note:
Serum (1 x SST)
Referred test
This is a Mesothelioma test and is non-rebatable test, please contact Laboratory for current
cost to patient.
METABOLIC BONE STUDY - FASTING
Specimen collection: Spot urine plus
Fasting 1 x PPT (EDTA Plasma) for PTH spin and place in fridge, transport between 2-8C
(PTH is heat labile)
1 x SST for the other biochemistry.
Regional Labs 2 x SST and 2 x Urine
Please attach a process immediately sticker
Note:
INSTRUCTIONS TO PATIENT:
1) Patient should fast from 12 midnight on the night prior to the test (water is permitted).
2) On the morning of the test the patient should empty their bladder on rising and drink two
glasses of water.
3) DO NOT eat or smoke. Before leaving home the patient should again empty their bladder if
required.
4) DO NOT take any CALCIUM medication but take all other normal medications, unless
instructed not to by their Medical Practitioner.
Comment:
Tests Performed: Urine: creatinine, calcium, phosphate and n-Telopeptide
Blood: ALP, phosphate, creatinine, albumin, calcium, vitamin D, PTH and ionised calcium.
METABOLIC SCREEN ( PAEDIATRIC URINE)
Specimen required:
Department:
Spot Urine – 5 to 10 mls required, No preservative
FREEZE SAMPLE as soon as possible after collection.
Mainly done on children to screen for inborn metabolic error.
Referred test
METADRENALINE PLASMA FREE
See METANEPHINES below
METANEPHRINES - PLASMA
Specimen required:
Department:
Note:
This test can only be collected at the main laboratory. No add on testing available
2 x HNG (pre-chilled) collect onto a cup of ice, spin chilled, separate plasma and freeze
FREEZE SAMPLE as soon as possible after collection.
Referred test
Patient should fast overnight and rest for 20min before collection.
METHADONE
See DRUGS OF ABUSE
METHAEMOGLOBIN
Specimen required:
Department:
Reference Range:
1 x Heparin NO Gel - Please send patient to Clinipath Pathology Main Laboratory for
sample collection.
Sample must be dispatched immediately after collection, to be tested within the hour.
Referred test
As reported.
10-Nov-2014 Page 80 of 122
CLINIPATH PATHOLOGY
M
METHYLENE TETROHYRDOFOLATE REDUCTASE GENE TEST PCR (Patient must meet
Specimen Required: 2 x EDTA dedicated tubes
specific requirements
Department:
Referred test
for rebate)
METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) SCREEN
Specimen required:
Department:
Comment:
Note:
All swabs are Blue Gel swabs not Orange dry swabs
(i) Nasal swabs from both anterior nares.
(ii) Throat swab.
(iii) Hand swabs from interdigital spaces and wrists of both hands.
(iv) Swab of any lesions, if present
(v) Other variations including Axilla and groin to be included if indicated
Microbiology
At least 48 hours is required before a report can be issued.
In house results can make reasonable prediction of the strain, either transmissible variants
requiring additional infection controls, and strains with lower transmissibility. (WAMRSA)
Molecular sub-typing confirmation takes 7-14 days.
METHYL MALONIC ACID ( MMA )
Specimen required: For children See METABOLIC SCREEN (PEDIATRIC URINE)
For adults collect 1 x Lith Heparin dedicated tube
Department:
Referred
MICROALBUMIN ( MALB )
Specimen required:
Department:
Reference Range:
Interpretation:
Note:
Urine. Spot or 24 hour collection (12 hour collection is sometimes requested)
Biochemistry
Spot Urine :
Normalbuminuria < 20 mg/L
Microalbuminuria 20 - 200 mg/L
Persistent proteinuria > 200 mg/L
24 Hour Urine :
Normalbuminuria < 30 mg/day
Microalbuminuria 30 - 300 mg/day
Persistent proteinuria > 300 mg/day
Useful as an indicator of incipient (and potentially reversible) diabetic nephropathy.
12 hour collection is called ‘Timed Overnight Microalbumin’. Collect between 8pm & 8am in a
24 hour container
MINIMAL INHIBITORY CONCENTRATION
Specimen required:
Department:
Comment:
Contact Laboratory for specific details if testing required
Microbiology
Specialised antibiotic susceptibility tests performed as per microbiological protocols.
MOLECULAR STUDIES
See UNDER FOLLOWING HEADINGS
COAGULATION:
HAEMOCHROMATOSIS:
HAEMATOLOGY:
GASTROENTEROLOGY:
NEUROLOGY:
MOLYBDENUM
Specimen required:
Department:
see THROMBOPHILIA SCREENING
see HAEMOCHROMATOSIS
See Gene Re-arrangement Studies; BCR-ABL PCR and
Haemophilia Gene Studies
see CYSTIC FIBROSIS GENE STUDIES
Consult with pathologist
Referred test
MONOSPOT
See IM TEST
10-Nov-2014 Page 81 of 122
CLINIPATH PATHOLOGY
M
MPO
See ANTI NEUTROPHIL CYTOPLASMIC ANTIBODY
MRSA (SWABS)
See METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) SCREEN
MTHFR GENE TEST
See Methylene Tetrohyrdofolate Reductase Gene Test PCR
MULTIPLE BIOCHEMICAL ANALYSIS
See MBA20
MUMPS PCR
Specimen required:
Department:
Dry Mouth swab for PCR
Referred test
MUMPS VIRUS ANTIBODY IGG & IGM
Specimen required:
Department:
Results:
Indications:
Serology
Reported as Detected / Not Detected with appropriate interpretive comment.
Bilateral or unilateral parotitis. Extra salivary symptoms may include meningitis, encephalitis,
epididymoorchitis, oophoritis, polyarthritis and pancreatitis.
MURRAY VALLEY ENCEPHALITIS SEROLOGY ( MVE )
Specimen required:
Department:
Serum (1 x SST) Urgent Serology Test
Murray Valley Encephalitis is caused by an ARBOVIRUS
Referred test
MYOBACTERIUM
See Tuberculosis
MYCOPHENOLATE (Mofetil, MMF)
Specimen required:
Department:
MYCOPLASMA PCR
Specimen required:
Department:
Note:
1x Heparin no Gel, Red Top Clot
Referred test
First void urine or SWAB (Plain Dry Swabs)
Referred test
This test is Mycoplasma genus specific and also detects Ureaplasma.
MYCOPLASMA PCR FOR CHRONIC FATIGUE
Specimen Required:
Department:
Note:
See also:
Mycoplasma PCR will only be performed on respiratory specimens.
Referred test
Contact Laboratory for further information regarding specimen requirements.
Mycoplasma Pneumoniae below
MYCOPLASMA PNEUMONIAE SEROLOGY
Specimen required:
Symptoms:
Department:
Results:
Serum (1 x SST)
Atypical pneumonia.
Referred test
Titre with appropriate interpretive comment.
10-Nov-2014 Page 82 of 122
CLINIPATH PATHOLOGY
N
N
N ACETYL GALACTOSAMINIDASE
see ALPHA N ACETYL GALACTOSAMINIDASE
NAIL CLIPPINGS FOR ONYCHOLYSIS
Specimen required:
Department:
Generous nail clippings AND tissue beneath areas of onycholysis
Microbiology
NAP SCORE
TEST NOT PERFORMED SINCE 2005 REPLACED WITH JAK-2
NEEDLE STICK INJURY BLOOD TESTS
Specimen required:
Department:
Consists of:
Note:
1 x SST preferred, can be done from 1 x EDTA
Serology
HIV Antibody
Recommend repeat tests 3 months after original exposure.
See also: Hepatitis serology, HIV.
NEISSERIA GONORRHOEA
See Genital Specimens
NEISSERIA MENINGITIDIS
Specimen required:
Department:
Note:
CSF; 1 x EDTA for PCR; Blood culture x 3
Microbiology Urgent Microbiology Test
Notify Duty Manager immediately.
NEONATAL SEROLOGY
Specimen required:
Department:
Comment:
Mother:
Neonate:
Haematology
Consists of:
1 x Serum (SST) and 1 x EDTA blood.
10mL clotted cord blood.
ROUTINE POST NATAL SEROLOGY
(Rh Negative Mothers)
MATERNAL ANTIBODY SCREEN
NEONATAL BLOOD GROUP & Rh
NEONATAL DIRECT COOMBS
NEURON SPECIFIC ENOLASE ( NSE )
Specimen required:
Department:
Reference Range:
Note:
Serum (1 x SST) ONLY - Plasma not suitable.
Specimen must not be haemolysed. Freeze and send frozen.
Referred test
As stated on report
Used as a tumour marker for small cell carcinoma of the lung.
NEUTROPHIL ALKALINE PHOSPHATASE ( NAP ) SCORE
TEST NO LONGER PERFORMED
NEUTROPHIL FUNCTION TEST Patient needs to contact PMH on 9340 8381 Clinipath does not collect this test
10-Nov-2014 Page 83 of 122
CLINIPATH PATHOLOGY
N
NEUTROPHIL ANTIBODIES
Specimen:
Department:
NICKEL
Sample required:
Department:
1 x SST and 1 x EDTA
Referred Test
2 x Trace Element (Royal blue top K 2 EDTA)
Referred test
NK-CELLS
NON INVASIVE PRENATAL TESTING (NIPT) see Verify
NOROCLOMIPRAMINE
See CLOMIPRAMINE
NORTRYPTYLINE
Sample required:
Department:
1 x Heparin NO GEL. Collect pre dose sample (trough)
Referred test
N – TELOPEPTIDE (NTX)
Sample required:
Department:
Note:
Reference Interval:
NSE
20 mL spot urine (second void of the day preferred). Keep refrigerated.
Referred test
To be collected after an overnight fast and in the morning.
As stated on report
See NEURON SPECIFIC ENOLASE
10-Nov-2014 Page 84 of 122
O
O
OBSTETRIC SCREEN
See FIRST TRIMESTER SCREEN and SECOND TRIMESTER SCREEN
OCCULT BLOOD
See FAECES: OCCULT BLOOD
OESTRIOL UNCONJUGATED (UE3)
Specimen required:
Department:
Comment:
OESTRADIOL ( E2 )
Specimen required:
Department:
Reference range:
See also:
OESTRONE (E1)
Specimen required:
Department:
OLANZAPINE
Specimen required:
Department:
Therapeutic Range:
Serum (1 x SST)
Biochemistry
This test of foetoplacental function is detectable only in the third trimester of pregnancy and has
virtually been displaced by ultrasound testing.
Serum (1 x SST)
Biochemistry
Female:
Follicular
77 - 920
Mid Cycle
139 - 2381
Luteal
77 - 1145
Menopausal
< 100
Male:
40 - 160
Salivary Hormones
pmol/L
pmol/L
pmol/L
pmol/L
pmol/L
Serum (1 x SST)
Referred
1 x Heparin NO GEL
Referred test
Trough levels. 10 ug/L
OMMA see Ca125
OPIATES
See DRUGS of ABUSE
ORF VIRUS (PCR)
Specimen required:
Department:
Smear or Dry Swab (no transport media)
Referred test
ORGANOPHOSPHATES/CHLORIDES
See CHOLINESTERASE
OSMOLALITY (SERUM )
Specimen required:
Department:
Reference range:
Comment:
1 x SST
Biochemistry
275 - 295 mOsmol/kg up to 60 years
280 – 301 mOsmol/kg >60 years
In water and electrolyte disturbances, osmolality measurements can be helpful if plasma
and spot urine samples are taken at the same time.
10-Nov-2014 Page 85 of 122
O
OSMOLALITY ( URINE )
Specimen required:
Department:
Reference range:
Comment:
Spot Urine
Referred test
50 - 1200 mOsmol/kg (Depending upon fluid intake)
Usually requested together with plasma osmolality.
OSMOTIC FRAGILITY
Test no longer performed, replaced with Hereditary Spherocytosis Screening Test
OSTEOCALCIN (No rebate)
Specimen required:
Department:
Reference Interval:
Comment:
Interpretation:
Serum (1 x SST) – Patient must be bled at Main Laboratory.
Specimen must be frozen within 30 minutes of collection.
Referred test
As stated on report
Marker of bone deposition.
HIGH - High turnover osteoporosis, Paget's disease, primary hyperparathyroidism and
metastatic bone disease.
OVA, CYSTS & PARASITES (OCP)
See FAECES
Ovarian Adrenal Abs
Specimen required: Serum (1xSST)
OVARIAN TUMOUR MARKERS
See CA 125
OVULATION TRACKING see Hormone Tracking
OXALATE ( URINE )
Specimen required:
Preservative:
Department:
Urine (24 hour collection).
20 mLs of 50% HCl. Warn patient of the acid risk
Referred test
Reference range:
Interpretation:
Note:
As stated on report
HIGH - Calcium oxalate renal stone formation, congenital.
(i) Transient increase follows ingestion of certain fruits and vegetables, e.g. rhubarb,
strawberries, spinach, tomatoes, sorrel, etc.
(ii) Elevated urinary oxalate occurs in a proportion of normal subjects on high Vitamin C intake.
10-Nov-2014 Page 86 of 122
CLINIPATH PATHOLOGY
P
P
P1NP (BONE FORMATION MARKER)
Specimen required:
Department:
Serum (1 x SST)
Referred test
P4
See PROGESTERONE
PAPP - A
See FIRST TRIMESTER SCREEN
PAP SMEAR
See CYTOLOGY (Gynaecological & Non-Gynaecological) and THIN PREP
PANCREATIC ELASTIN TEST
See FAECAL ELASTASE
PANCREATIC ISLETS AUTO ANTIBODY
See ISLETS AUTO ANTIBODY
PANCREATIC ENZYMES See Amylase and Lipase
PANCREATIC LIPASE
See LIPASE
PANCREATIC POLYPEPTIDE (No Rebate)
Specimen required:
Department:
Note:
2 x SST (Serum)
Referred test
This is a non-rebatable test. Patients will receive a private account from the testing laboratory.
PARACETAMOL ( ACETOMINOPHEN )
Specimen required:
Department:
Results:
Interpretation:
Serum (1 x SST)
Referred test (Also performed in Bunbury)
Refer to relevant Paracetamol Treatment Nomogram
For cases of overdose a time of ingestion is useful in establishing a prognosis.
PARAINFLUENZA VIRUS
See RESPIRATORY VIRUS DETECTION
PARAPROTEIN
See PROTEIN ELECTROPHORESIS
PARATHYROID HORMONE ( PTH )
Specimen required:
Department:
Reference range:
Interpretation:
PPT (EDTA plasma)) dedicated tube. Spin and Refrigerate specimen after collection and transport
o
between 2-8 C. Treat as Process Immediately specimen for special processing.
Preferably fasting, but if known renal impairment, non-fasting is OK. Specimen should reach
Laboratory within six hours of collection. Added on tesing not available.
Biochemistry
1.3 – 7.0 pmol/L
HIGH – Hyperparathyroidism
– Vitamin D deficiency
LOW
– Hypoparathyroidism
10-Nov-2014 Page 87 of 122
CLINIPATH PATHOLOGY
P
PARTIAL THROMBOPLASTIN TIME ( APTT, PTTK )
Specimen required:
Department:
Results:
PARVOVIRUS B19
Specimen required:
Department:
Results:
Symptoms:
Note:
Comment:
1 x Sodium citrate No adding on testing availabe.
Haematology
Reference range: Less than 34 seconds.
Therapeutic Range: 1.5 - 2.5 times the normal control for heparin therapy monitoring.
Serum (1 x SMALL SST). 2 x dedicated EDTA should be collected for PCR if requested
Serology
Reported as Detected / Not detected with appropriate interpretive comments.
May include rash, arthropathy, red cell aplasia, spontaneous abortions, hydrops fetalis
Consider also Rubella, Measles, Scarlet Fever, Ross River Virus or Barmah Forest Virus.
A PCR confirmatory test for IgM positive sera is also available if needed
PAVOVIRUS B19 also known as ERYTHEMA INFECTOSUM - SLAPPED FACE DISEASE,
FIFTH DISEASE
PATERNITY TESTING
See DNA Paternity Testing
PAUL BUNNELL
See IM SCREEN (Monospot)
PCA-3 (No Rebate)
Specimen required:
Department:
Note:
Special test kit required – Contact Duty Manager 9371 4440
Referred
Special test for prostate cancer not medicare rebatable cost at Nov 2014 $515.00
PCR TESTING (POLYMERASE CHAIN REACTION)
Specimen required:
Note:
PERHEXILINE
Specimen required:
Department:
Therapeutic range:
Various sample types e.g. urine, sputum, swabs and blood.
1) SWABS
Swabs should be plain dry swabs (orange top handle).
DO NOT USE SWABS WITH TRANSPORT MEDIUM (gel for
transport interferes with PCR tests)
If more than two PCR tests are being requested; two swabs should
be sent in to ensure there is enough material to perform all tests.
2) BLOOD
NOTE: All PCR blood test must have dedicated tubes.
EBV PCR
1 x EDTA whole blood
CMV Viral Load
2 x EDTA
Parvovirus B19
1 x EDTA whole blood (by special arrangement
only)
HIV Provirus PCR 2 x EDTA whole blood
Hep C PCR
2 x 10mL SST.
Hep B PCR
2 x EDTA
3) FIRST VOID URINE
Chlamydia trachomatis and Neisseria gonorrhoea (See also listing
for Chlamydia DNA detection)
HSV
Mycoplasma + Ureaplasma
Please see specific infection for further information
1 x Heparin NO GEL
Collect blood just prior to next dose.
Referred test
As stated on report
10-Nov-2014 Page 88 of 122
CLINIPATH PATHOLOGY
P
PERTUSSIS TESTS (incl serology and PCR)
Specimens required: Perinasal Aspirate for culture, PCR and nasal IgA (Note one ml required)
Throat swab for PCR and Serum (1 x SST) for IgA if PNA not possible
Nasal swabs x2 are acceptable in an outbreak if no PNA.
Department:
Microbiology
Note:
Prefer PNA for acute symptoms and Serum IgA for chronic symptoms (2-4 weeks)
IgA can also be done on PNA if the volume is >1mL, usually paediatric only
See also:
Respiratory viruses as tests are often combined
PESTICIDE SCREEN ( ORGANOCHLORINES )
Specimen required:
Department:
Reference range:
Note:
1 x Heparin NO GEL
Referred test
For ORGANOPHOSPHATE Pesticides please see CHOLINESTERASE.
Specimens referred to a reference laboratory. Please list pesticides in contact if known.
Medicare rebate available only if applicable. Patient may receive a private account.
PHAECHROMOCYTOMA
Specimen required:
Department:
Tests include:
PHENOBARBITONE
Specimen required:
Department:
Therapeutic range:
Note:
PHENYLALANINE
Specimen required:
Department:
1 x 24hr acid urine, 1 x SST
Referred test
Urinary catecholamines and Chromogranin A
Serum (1 x SST)
Biochemistry
10 - 30 umol/L
Peak level:
6 - 18 hours after oral administration,
1.5 hours after IM injection
Half life:
2 - 6 days.
(i) Due to phenobarbitone’s long half life sampling time is unimportant. However, when making
comparative measurements sampling time should be consistent. Please note down time of
last dose and collection.
(ii) Valproate may potentiate the effects of phenobarbitone.
1 x Heparin NO GEL
Referred test
PHENYTOIN (DILANTIN)
Serum (1 x SST). Trough levels, just prior to next dose.
(Peak levels are only used if toxicity is suspected)
Department:
Biochemistry
Results:
Therapeutic range: 10 - 20 mg/L
Peak level:
See Prostate Health Index
Specimen required:
PHI
PHOSPHATE ( INORGANIC ) – SERUM
Specimen required:
Department:
Reference range:
Interpretation:
Serum (1 x SST)
Biochemistry
0.70 - 1.50 mmol/L
LOW
– Hyperparathyroidism, osteomalacia, Fanconi’s syndrome
HIGH
– Vitamin D excess, hypoparathyroidism, renal insufficiency
FALSE HIGH – Haemolysed specimen
10-Nov-2014 Page 89 of 122
CLINIPATH PATHOLOGY
P
PHOSPHATE ( INORGANIC ) – URINARY
Specimen required:
Department:
Reference range:
Interpretation:
Urine - 24 hour collection with NO PRESERVATIVE.
Biochemistry
10 - 45 mmol/day
HIGH – Hyperparathyroidism, renal tubular damage
LOW
– Hypoparathyroidism, parathyroidectomy
PHOSPHOLIPID ANTIBODIES
PITUITARY HORMONE TESTING
Specimen required:
Department:
Tests include:
Serum (1 x SST) 1 x PPT Collect Main Lab only
Biochemistry
ACTH, Growth Hormone, FSH, LH, TSH and Prolactin
PLASMA VISCOSITY
See WHOLE BLOOD VISCOSITY
PLASMA FREE METADRENALINES
See METANEPHRINES - PLASMA
PLATELET AGGREGATION STUDIES
Specimen required:
Department:
Reference range:
4 x Sodium Citrate tubes - Please send patient to Clinipath Pathology Main Laboratory.
Must arrive at RPH within 2 hours of collection AND before 2:00pm Monday-Thursday,
Note: On Fridays sample must arrive before 12:00 noon.
Referred test
PLATELET ANTIBODIES
See ANTI PLATELET ANTIBODIES
PLATELET FUNCTION TEST
Specimen required:
Department:
Reference range:
Note:
Clinipath Pathology collect - 1 x Sodium Citrate
Bunbury Pathology collect - 3 x Sodium citrate
Do not spin. Do not refrigerate. Process immediately sticker. Must be at Main Laboratory
within 4 hours of collection. Add on testing not available.
Haematology
NOT part of a Coagulation Profile and MUST be specifically requested
PLATELET SEROTONIN
See SEROTONIN
PNA
See POST NASAL ASPIRATE
PNEUMOCOCCAL ANTIBODIES
Specimen required:
Department:
Serum (1 x SST)
Test is used in the investigation of immune response to Pneumovax vaccination. Pre and 2 - 4
week post vaccination samples are taken. NOT to be used as a diagnostic test in pneumonia
infections.
Referred test
10-Nov-2014 Page 90 of 122
CLINIPATH PATHOLOGY
P
PNEUMOCYSTIS
Specimen required:
Department:
Comment:
Bronchial lavage, sputum.
Referred test
Cause of pneumonia in immunocompromised patients, particularly in HIV patients.
POLIO SEROLOGY
Test not available
POLYCYSTIC OVARIAN SYNDROME
Specimen required:
Serun (1xSST)
PORPHYRINS SCREEN
Specimen required:
Department:
Reference range:
Interpretation:
1 x Heparin NO GEL and a Spot Urine.
Specimens must be protected from the light at all times (wrap in aluminium foil).
Referred test
Qualitative tests are initially performed.
Laboratory will assist, if required.
POST NASAL ASPIRATE ( PNA ) FOR BORDETELLA CULTURE (also other pathogens
such as influenza, RSV and Human Metapneumovirus)
Note:
Collection of PNA is only available at selected collection centres. Please contact Main
Laboratory for advice.
Specimen collection: A post nasal aspirate (PNA) is the preferred specimen for diagnosis of pertussis, although a
posterior nasal swab can also be used, although special flexible wire swabs will be needed
optimally for this to be performed, (available from the Laboratory if required.)
Department:
Serology / Microbiology
Comment:
Tests performed include:
(i) Bordetella culture - requires at least 7 days for final result. Posterior nasal SWABS for culture
should be placed in Amies transport medium.
(ii) Bordetella PCR on aspirate. If a posterior nasal SWAB is collected for PCR, an orange
capped wire transported dry in the sheath is the nearest available sampling swab, if flexible wire
not available. (Flexible wire swabs available from the Laboratory on request.)
Note:
Collection of PNA is only available at selected collection centres. Please contact Main
Laboratory for advice.
See also:
BORDETELLA SEROLOGY.
POST PRANDIAL 2 HR GLUCOSE
Sample Required:
Department:
Reference Interval:
POTASSIUM ( K+ )
Specimen required:
Department:
Reference range:
Interpretation:
Note:
1 x Fluoride Oxalate. Collected 2hrs after patient has consumed food
Biochemistry
As stated on report
Serum (1 x SST) - DO NOT refrigerate specimen.
The specimen MUST NOT be haemolysed.
If Whole Blood or Red Cell Potassium requested - Heparin NO GEL.
Biochemistry
3.5 - 5.4 mmol/L
HIGH - Increased intake, renal failure, Addison’s disease, uncontrolled diabetes
Low - Insulin therapy, renal loss (especially diuretics), gastrointestinal loss
FALSE HIGH - Haemolysed specimen or overnight, unseparated specimen.
Refrigeration speeds up the release of potassium from red cells. Store at room temperature.
POX VIRUS
See OFR virus PCR
PPD (PURIFIED PROTEIN DERIVITIVE)
See Mantoux test
10-Nov-2014 Page 91 of 122
CLINIPATH PATHOLOGY
P
PREGNANCY PATHOLOGY ASSESSMENT ( PPA )
See Antenatal Basic Screening Test
PREGNELONONE
PR – 3
See ANTI NEUTROPHIL CYTOPLASM ANTIBODY
PRIMIDONE
See PHENOBARBITONE.
Specimen required: Serum (1 x SST). Trough specimen.
Department:
Biochemistry
Peak level:
3 hours after oral dose.
Half life:
8 hours.
Comment:
Primodone is measured via its main metabolite, Phenobarbitone, which accumulates in the body
(Half Life 2-6 days).
PRO - BNP
See BRAIN NATRIURETIC PEPTIDE
PROCALCITONIN
Specimen required:
Department:
Hep no Gel, frozen
Referred test
PROGESTERONE ( P4 )
Specimen required:
Department:
Reference range:
Also see:
Serum (1 x SST)
Biochemistry
Female:
Follicular
< 1.0
nmol/L
Luteal
3.8 - 50.0
nmol/L
Menopausal
< 0.6
nmol/L
Pregnancy (1st trimester) > 40.0 nmol/L consistent with viability.
Male:
< 0.6
nmol/L
SALIVARY HORMONES
17-OH PREGNELONONE
SEE PREGNELONONE
17– OH PROGESTERONE
Prostate Cancer Test PCA3
Prostate Health Index (PHI) (No rebate)
Specimen required: Serum (1 x SST) Add ontersting not availabe
10-Nov-2014 Page 92 of 122
CLINIPATH PATHOLOGY
P
PROLACTIN ( PROL )
Specimen required:
Department:
Note:
Reference range:
Interpretation:
Serum (1 x SST)
Biochemistry
A Resting prolactin may be requested to rule out stress elevation. Patient must rest for 30
minutes prior to taking the sample.
Female:
25 - 628 mIU/L
Male:
54 - 380 mIU/L
High in pituitary tumours, hypothalamic disorders, hypothyroidism, stress, some drugs
(e.g.phenothiazines), macroprolactin
PROSTATIC MASSAGE
Specimen required:
Department:
Note:
Urine for differential culture before and after massage +/- MSU
Microbiology
Deliver to Laboratory within 2 hours or refrigerate
PROSTATE SPECIFIC ANTIGEN - FREE (FPSA)
Specimen required:
Department:
Note:
Serum (1 x SST)
Biochemistry
Only recommended when the total PSA falls between 2.0 and 10.0 µg/L.
The test is useful in discriminating between benign prostatic hyperplasia and cancer of the
prostate. Due to the stability of free PSA, this test cannot be added on more than 24hrs
after collection.
PROSTATE SPECIFIC ANTIGEN – TOTAL (PSA)
Specimen required:
Department:
Reference range:
Interpretation:
Note:
Serum (1 x SST) No Add on testing available
Biochemistry
Age Related
40 - 49 years
< 2.5 ug/L
50 - 59 years
< 3.5 ug/L
60 - 69 years
< 4.5 ug/L
≥ 70 years
< 6.5 ug/L
HIGH - Prostatic cancer, benign prostatic hyperplasia.
Medicare rebatable for 1 episode in a 12 month period in the absence of prostatic disease
PROTEIN C
Specimen Required: 1 x Sodium Citrate. Bunbury Pathology to collect 3 x Na Citrate. No add on testing available
Department:
Haematology
Reference range:
70 – 150%
PROTEIN ELECTROPHORESIS ( QEP, EPP, EPG )
Specimen required:
Department:
Interpretation:
Serum (1 x SST) Plasma NOT suitable.
Biochemistry
Quantitative assessment of serum proteins. Screen for paraproteinaemia/myeloma.
PROTEIN S
Specimen Required: Clinipath Pathology - 1 x Sodium Citrate. No add on testing available
Bunbury Pathology – 3 x Citrate
Department:
Haematology
Reference range:
50 – 150%
PROTEIN – TOTAL
Specimen required:
Department:
Reference range:
Interpretation:
Serum (1 x SST)
Biochemistry
63 - 83 g/L
LOW - Over hydration, nephrotic syndrome, malabsorption
HIGH - Dehydration, chronic diseases, paraproteinaemias
10-Nov-2014 Page 93 of 122
CLINIPATH PATHOLOGY
P
PROTEIN – URINE
Specimen required:
Department:
Reference range:
Interpretation:
Comment:
Urine – 24 hour collection – NO PRESERVATIVE
OR Spot urine sample
Biochemistry
24 hour collection
Less than 0.15 g/day
Spot sample
0.5 – 11.5 mg/mmol creatinine
HIGH - Renal disease, UTI, pre-eclampsia, etc.
Normal persons may show trace proteinuria with dipstick testing. See also Microalbumin.
PROTHIADIN
See DOTHIEPIN
PROTHROMBIN GENE 20210 (Patient must meet specific requirements for rebate)
Specimen Required: 1 x EDTA No add on testing available
Department:
Referred test
PROTHROMBIN TIME ( PT/INR )
Specimen required:
Department:
Note:
Comment:
Reference range:
1 x Sodium citrate tube. No add on testing available
Haematology
Specimen must be “Full Draw” to the required level. Finger prick specimens are not suitable.
All results are routinely FAXED to the requesting practitioner.
9 - 13 seconds for non-warfarinised patients.
Therapeutic Range:
INR
1.5 - 2.5
2.0 - 3.0
2.0 - 3.0
2.0 - 3.0
2.0 - 3.0
2.5 - 3.5
Condition
Atrial fibrillation
Bioprosthetic valve
Acute MI
Cardioembolic CVA, Rec.DVT/PE and dilated cardiomyopathy
Venous thrombosis & PE
Mechanical heart valve
PROTHROMBOTIC SCREEN
PSA
Length of Treatment
Long term.
3 months
3 months (> if AF)
Long term
3 - 6 months
Long term
see Thrombophillia screen
See PROSTATE SPECIFIC ANTIGEN
PSEUDOCHOLINESTERASE
See CHOLINESTERASE
PSITTACOSIS SEROLOGY
Specimen required:
Department:
Symptoms:
See also:
PTH
Serum (1 x SST)
Referred test
Infection of the lower respiratory tract caused by the organism Chlamydophila psittaci.
Chlamydia pneumoniae Serology
see Parathyroid Hormone
PTTK
See PARTIAL THROMBOPLASTIN TIME
PYRIDOXAL
See VITAMIN B6
10-Nov-2014 Page 94 of 122
CLINIPATH PATHOLOGY
P
PYROLLE URINARY (Upfront collection and processing charge)
Specimen required:
Department:
Note:
Special Collection is required - Please refer patient directly to Main Laboratory or contact
the Duty Manager at Clinipath Pathology.
Referred test
Patient is required to pay $80.00 up front collection /shippingcost and will receive a private
account from testing laboratory.
PYRUVATE
Test no longer perfomed at Clinipath Pathology, refer patient to Pathwest
10-Nov-2014 Page 95 of 122
CLINIPATH PATHOLOGY
Q
Q
QEP
See PROTEIN ELECTROPHORESIS
Q FEVER VIRUS SEROLOGY (IGM & IGG) (COXIELLA BURNETII INFECTION)
Specimen required:
Department:
Symptoms:
Note:
Serum (1 x SST) (Done in house for pre-vaccination testing only)
Referred test
May include fever, headache, rash, myalgia, arthralgia, malaise, pneumonia, hepatomegaly and
hepatitis.
Consider also mycoplasma, EBV, CMV and Toxoplasmosis.
Patient must also have pre-vaccination skin test for Q Fever.
QUANTIFERON TEST (No rebate)
Specimen required:
Department:
Results:
QUINIDINE
Specimen required:
Department:
Reference range:
Peak Level:
Half Life:
Note:
Due to special collection and processing requirements, this test can only be performed
at the main laboratory. (Before 3:00pm on Fridays) or by special arrangement with
the Duty Manager (9371 4440). No add on testing available
Bunbury Pathology Collect Mon-Thur before 11.30 See Bunbury Pathology Instructions
Referred test
This assay detects T-lymphocytes that react with antigens from Mycobacterium tuberculosis or
Mycobacterium avium. Medicare item available if immuno-suppressed.
1 x Lith Hep
Referred test
As stated on report
Rapid release, 1 - 3 hours.
Slow or sustained release > 3 hours.
6 - 7 hours.
Sample should be taken just prior to the next dose.
Please note time of last dose and collection.
10-Nov-2014 Page 96 of 122
CLINIPATH PATHOLOGY
R
R
RABIES
Specimen required:
Department:
Serum (1 x SST)
Referred test
Specimen required:
Department:
Interpretation:
Serum (1 x SST)
Biochemistry
Allergy testing for specific allergens or combinations of allergens, which elicit an IgE-mediated
response.
Includes a panel for airborne allergens (grasses, house dusts mites, animal dander and mould).
Testing should be restricted to foods where there is a clinical suggestion of allergy.
Penicillin, Amoxycillin, Cefaclor are available.
Other Allergens available on request (eg bee, wasp venom, latex)
Contact dermatology is not an indication for RAST testing.
RAST
Inhalant Screen:
Food Testing:
Antibiotics:
Note:
REARRANGEMENT STUDIES
See GENE REARRANGEMENT STUDIES
RECTUM / BOWEL / COLON TUMOUR MARKERS
See CA19-9 CEA and Faeces- Occult Blood
RED CELL COPPER
RED CELL FOLATE
Specimen required: 1 x Heparin no gel
See FOLIC ACID (RED CELL)
RED CELL MAGNESIUM
Specimen required:
Department:
Reference range:
Referred Test
1.7 – 2.8 mmol/L
RED CELL POTASSIUM
Specimen required:
Reference range:
1 x Heparin NO GEL
80 - 140 mmol/L
RED CELL THIAMINE
See Vitamin B1
RED CELL ZINC
Specimen required:
Department:
Reference range:
Referred test
As stated on report
RENAL FUNCTION TESTS
Specimen required:
Department:
Note:
Serum (1 x SST)
Biochemistry
We routinely perform Na+, K+, Cl- and HCO3-, urea and creatinine.
10-Nov-2014 Page 97 of 122
CLINIPATH PATHOLOGY
RENAL STONES
Specimen required:
Department:
Interpretation:
RENIN
Note:
Specimen required:
Department:
R
Renal stone.
Referred test
To test for the presence of calcium, oxalate, cystine, uric acid, phosphate, ammonium,
carbonate, magnesium, xanthine or other constituents. The exact crystalline structure is
determined geochemically; this information is of assistance to the physician in the resolution of
the causes for the formation of the calculus.
COLLECTED AT MAIN LABORATORY ONLY. Please note medications on request form
1 x PPT (at least 1 mL PLASMA required) collect between 8.00am-9.00am
Ensure sample is collected while patient is erect or supine (as indicated by requesting doctor).
Sample should be taken following 20 minutes in each position. Label accordingly and freeze
immediately. Preferred but not essential to be non-fasting
Referred test. If requested ffor RPH - 2 x EDTA are required
RESPIRATORY SYNCYTIAL VIRUS (RSV) SEROLOGY
Specimen required:
Department:
Indications:
Serum (1 x SST)
Referred test
Infection of the respiratory tract. Consider also other respiratory viruses.
RESPIRATORY SYNCYTIAL VIRUS (RSV)
See RESPIRATORY VIRUS DETECTION
RESPIRATORY VIRUS DETECTION
RESPIRATORY VIRUS - SEROLOGY
Specimen:
Department:
Note:
Serum (1 x SST) antibody testing
Choice between respiratory secretions or serology will be determined by the request form. If in
doubt ring the Duty Manager for advice.
Referred test
Serology for respiratory viruses including:
Influenza Types A & B
Parainfluenza Types 1, 2 & 3
Adenovirus
RSV (infants and the elderly)
Consider also serology for bacteria including: Bordetella pertussis, Chlamydophylla
pneumoniae Chlamydia psittaci and Legionella pneumoniae and longbeachae.
S AF E T Y N O T E :
I t i s n o w r e q u i r e d t h a t f o r yo u r o w n p e r s o n a l p r o t e c t i o n w h i l e c o l l e c t i n g a n y r o u t i n e
respiratory samples (e.g. throat and nasal swabs including those for viral studies) a
s u r g i c a l f a c e m a s k , e ye p r o t e c t i o n ( e ye s h i e l d s ) , g l o v e s a n d d i s p o s a b l e p l a s t i c a p r o n
must be worn.
RESPIRATORY VIRUS - IMMUNOFLUORESCENCE (RAPID) TEST
Specimen required:
Department:
Note:
Post Nasal Aspirate
Referred test
Panel includes Influenza A, B; Adenovirus; Parainfluenza 1, 2, 3; RSV plus culture if
Immunofluorescence is negative. Culture for Metapneumovirus, Rhinovirus, Enteroviruses,
Corona viruses etc is processed routinely and then referred for PCR
10-Nov-2014 Page 98 of 122
CLINIPATH PATHOLOGY
R
RESPIRATORY VIRUS – PCR
Note:
See also:
RETICULOCYTES
Specimen required:
Department:
Reference range:
Respiratory secretions: posterior nasal swab, post nasal aspirate, (only available at certain
collection centres) throat swab. If unspecified, do a posterior nasal swab. Orange topped wire
swab returned to lab in dry sheath for PCR testing.
PCR for respiratory viruses may include:
Influenza Types A & B
Parainfluenza Types 1, 2 & 3
Human Metapneumovirus
RSV (infants and the elderly)
Less common - Rhinovirus
- Coronavirus
must be separately requested
- Adenovirus
Pertussis detection
1 x EDTA blood (Must be fresh blood - processed same day as collection).
Haematology
Adult
0.2 - 2.0%
RETINOL BINDING PROTEIN (No rebate)
Specimen required:
Department:
Serum (1 x SST), wrap specimen in foil
Referred test
REVERSE T3 (No rebate)
Specimen required:
Department:
Note:
1 x SST (Serum). Freeze ASAP
Referred Test
This is a non Medicare rebatable test. The patient will receive an account form the testing
laboratory.
RH ANTIBODIES
See BLOOD GROUP ANTIBODIES
RHEUMATOID FACTOR
Specimen required:
Department:
Reference range:
See also:
RHIT
Serum (1 x SST)
Biochemistry
0 - 14 IU/L.
Anti CCP (ANTI CYCLIC CITRULLINATED PEPTIDE)
See RUBELLA
RISTOCETIN CO-FACTOR
See VON WILLEBRANDS SCREEN
RICKETTSIA SEROLOGY (TYPHUS)
Specimen required:
Department:
Indications:
Serum (1 x SST)
Referred test
May include fever, headache, rash, myalgia, arthralgia, malaise, pneumonia, hepatomegaly and
hepatitis.
Consider also measles and arboviruses.
RIVAROXABAN (Anti Coagulation Medication)
Specimen required:
Department:
2 x Citrate
Referred test
ROSS RIVER VIRUS SEROLOGY ( RRV ) IGG & IGM
Specimen required:
Department:
Results:
Indications:
Serology
IgG and IgM reported as Positive or Negative.
May include fever, rash, polyarthritis, myalgia and fatigue. Concider also Barmah Forest Virus
or Parvo B19, rubella
and Collection
rickettsiae.
Specimen
Guide
10-Nov-2014 Page 99 of 122
CLINIPATH PATHOLOGY
R
RPR ( VDRL )
See SYPHILIS (SEROLOGY)
RUBELLA VIRUS ANTIBODY ( IGG & IGM )
Specimen required:
Note:
Department:
Comment:
Reference range:
Indications:
Specimens collected less than 8 or more than 21 days after the onset of symptoms may not
contain enough IgM to record a positive result.
Serology
For routine screening an enzyme immunoassay test for Rubella IgG is performed. If the history
suggests recent exposure or if specifically requested, a Rubella IgM is performed by enzyme
immunoassay.
As reported
May include low-grade fever, maculopapular rash, arthralgia and arthritis.
Consider also Measles Virus, Parvo B19 or meningococcaemia, RRV, BFV
Rubella PCR
Specimen required: Dry Nasal and Throat swab +/- Urine
10-Nov-2014 Page 100 of 122
CLINIPATH PATHOLOGY
S
S
SALICYLATES ( ACETYLSALICYLIC ACID – ASPIRIN )
Specimen required:
Department:
Results:
Note:
Serum (1 x SST)
Referred test
As stated on report
Half life: Dose dependent, approx 3-6 hours.
Collect 1-3 hours post-dose or immediately for overdose. Note times of dose and collection.
SALIVARY CORTISOL (Up front collection and processing fee)
See CORTISOL, SALIVARY
SALIVARY HORMONES - PROGESTERONE / TESTOSTERONE / OESTRADIOL
Specimen required:
Department:
Collection:
Note:
0.5 - 1.0mL Saliva - See below (NO REBATE)
Biochemistry
Must obtain saliva from mouth NOT sputum from lungs. Generally taken after 1 hour fast and
the mouth has been rinsed out first. Make a note of any hormone therapy.
This is NOT a Medicare rebatable item. Contact the Laboratory for current cost to patient.
SALMONELLA SEROLOGY
Specimen required:
Department:
1 x SST (Serum). Diagnosis of salmonella is best done on culture – see below
Referred test.
SALMONELLA TYPHI, PARATYPHI A,B (ENTERIC FEVER)
Specimen required:
Department:
Blood cultures x 3
+/- Stool sample for MCS
+/- Urine for MCS
Microbiology/Referred test.
SARS VIRUS
Specimen required: NOTIFY MICROBIOLOGIST ASAP PRIOR TO ANY SAMPLING.
SEE ALSO INFLUENZA
SCHILLINGS TEST
TEST DISCONTINUED
Comment:
The European manufacturer of the Schillings test kits has withdrawn the product from service
due to strict controls to combat BSE (Mad Cow Disease). It is unlikely that the test kits will
become available in the future. Recommended tests are B12, Parietal cell antibodies (see auto
antibodies), Intrinsic Factor antibodies, and serum Gastrin (see GASTRIN). Suggest
consultation with a Haematologist to discuss other options.
SCHISTOSOMIASIS ( BILHARZIA ) SEROLOGY
Specimen required:
Department:
Note:
Serum (1 x SST)
Referred test
Testing at least 3-4 months after exposure is optimum
SCHISTOSOMIASIS (BILHARZIA ) URINE
Specimen required:
Department:
Note:
See also:
Collect the terminal stream of urine, after exercising if possible. Between 10.00am-2.00pm
Microbiology
Testing should be performed at least 4-8 weeks post exposure and repeated up to at least 3
months after exposure.
SCHISTOSOMIASIS (BILHARZIA) SEROLOGY for additional testing.
10-Nov-2014 Page 101 of 122
CLINIPATH PATHOLOGY
S
SCOLINE APNOEA
See CHOLINESTERASE
SCSA
see Sperm Chromatin Structure Assay
SECOND TRIMESTER SCREENING ( TRIPLE TEST )
Specimen required:
Department:
Note:
Comment:
Serum (1 x SST) Collect sample between 14 weeks and 17 weeks gestation.
NOTE: NO ULTRASOUND is performed with this test
Referred test
Please fill out checklist supplied for this test.
Information Required: - Last Menstrual Period (LMP),
- Estimated Date Delivery (EDD) by ultrasound result
- Weight of mother
- History of previous Downs, NTD or diabetes
Samples collected with gestation 14 -15 weeks will be tested; however a risk of NTD will NOT
be reported.
SECRETOR STATUS
SELENIUM
Specimen required:
Department:
Reference range:
Interpretation:
Referred Test
0.6 - 1.8 µmol/L.
LOW – Dialysis, cirrhosis, malignancy, alcoholics, Crohn’s disease, coeliac disease.
SEMEN
Department:
Microbiology
(A) FOR FERTILITY INVESTIGATIONS
Specimen Required: 1. Seminal fluid is best collected by masturbation. The entire sample is required to accurately
calculate sperm concentration. Coitus interruptus is not acceptable. Condoms should NOT
be used as these contain substances which are spermicidal.
2. Three (3) days must elapse between the day of collection and the previous ejaculation.
3. The specimen should not be cooled.
4. The following information is required with the sample:
a) Method and time of collection.
b) Date of previous ejaculation.
c) Complete or incomplete sample.
Note:
The specimen should be delivered to the Main Laboratory as soon as possible after
collection (maximum 1 hour). Specimens delivered to other collection centres may
provide misleading results. Specimens to be collected at the main laboratory can only be
performed between 07.30am to 09.30am and 1500hrs to 1750hrs
Reference range:
Count
> 20 x 106/mL
Motility
> 50 % actively motile or ≥ 25 % with rapid progression.
Volume
> 2 mL
Morphology
≥ 15 % normal forms
(B) POST VASECTOMY
Specimen Required: 1. Seminal fluid is best collected by masturbation. The entire sample is required to accurately
calculate sperm concentration. Coitus interruptus is not acceptable. Condoms should NOT
be used as these contain substances which are spermicidal.
2. Three (3) days must elapse between the day of collection and the previous ejaculation.
3. The specimen should not be cooled.
4. The following information is required with the sample:
a) Method and time of collection.
b) Date of previous ejaculation.
c) Complete or incomplete sample.
Note:
The specimens for post vasectomy checks can be delivered to any collection centre and
forwarded to the laboratory with the next courier. Please mark process immediately. For
post vasectomy specimens, the specimen should reach the laboratory within four (4)
hours of colection.
10-Nov-2014 Page 102 of 122
CLINIPATH PATHOLOGY
S
SEMEN (CONT.)
(C) FOR CULTURE
Specimen required: Spot sample collected into a sterile container. There is no urgency for delivery to the Laboratory.
The specimen will routinely be cultured for bacterial pathogens.
(D) FOR PCR
Semen for Chlamydia PCR. Mycoplasma/Ureaplasma PCR may be possible with consultation
with microbiologist
(E) SCSA
Sperm Chromatin Structure Assay.
SEROTONIN
Specimen Required: 4 x EDTA whole blood
Do not centrifuge or refrigerate, sample stable for 24hrs at room temperature. Send sample
same day of collection at room temperature, samples to reach RPH within 22 hours of
collection.
DO NOT collect Friday, Saturday or Sunday.
Department:
Referred test
SEROLOGICAL INVESTIGATIONS:
Specimen Required: (i) For some viruses, detection of IgM antibodies in a single sample is diagnostic of recent
infection.
(ii) For other viruses, two specimens of clotted blood taken two (2) weeks apart are required.
The first specimen should be collected as early as possible after the onset of symptoms,
and the second during the convalescent period. A four fold rise in titre or significant
elevation in OD, is regarded as diagnostic.
See also:
Entries for individual viruses for more information.
SERTRALINE
Specimen Required: 1 x Heparin NO GEL - Collect sample just prior to next dose.
Department:
Referred test
Therapeutic Range: As stated on report
SERUM FREE LIGHT CHAINS
See FREE LIGHT CHAINS
SERUM FOLATE
See FOLIC ACID
SEX HORMONE BINDING GLOBULIN ( SHBG )
Specimen Required: Serum (1 x SST)
Department:
Biochemistry
Reference range:
Male (17-40yr): 15 - 45 nmol/L
(14-65yr): 14 - 50 nmol/L
Female: (17-50): 26 -110 nmol/L
(>50): 14 - 69 nmol/L
Comment:
Transport protein. Aids in interpretation of Androgen Studies; included in Free Androgen Index.
Interpretation
LOW
– Hirsutism, polycystic ovary disease and virilisation.
HIGH – Hormone replacement therapy, hyperthyroidism, pregnancy.
SGOT
SG
See LIVER FUNCTION TESTS
See OSMOLALITY
SIFE IMMUNOFIXATION
See IMMUNOELECTRPHORESIS
10-Nov-2014 Page 103 of 122
CLINIPATH PATHOLOGY
S
SIROLIMUS
Department:
Referred
SKIN SCRAPINGS FOR FUNGI OR SCABIES
Specimen required:
Plucked hairs, skin scales, particularly from the active edge of the lesion, crusts, vesicle tops,
nail clippings as appropriate. Ask the patient where the most recent outbreak area is and
sample from here.
Department:
Microbiology
Specimen collection: Before taking the specimen the affected part should be thoroughly cleaned, using 70% alcohol if
possible, treatment should NOT be applied 3 days prior to scraping. As much specimen as
possible should be collected.
In the case of infected nails, pare well into the diseased area and collect any soft material
beneath the nail.
Skin and nail specimens should be scraped directly onto black transport cards provided by the
laboratory and then tipped into a sterile MSU jar. After collecting the sample, discard the blade
in the sharps container and the black card into the rubbish bin.
Do not send the blade to the laboratory.
Comment:
A report will be issued following direct microscopy indicating the findings. The specimen will
then be cultured for up to four (4) weeks and progress reports will be issued as appropriate.
Note:
PBS access to restrictive oral medications can proceed if microscopy is positive for fungal
elements.
SLE
See ANTI NUCLEAR ANTIBODIES
SMA 20
See MBA 20
SODIUM ( Na + )
Specimen required:
Department:
Reference range:
Serum (1 x SST)
Biochemistry
134 - 146 mmol/L
Interpretation:
HIGH
– Dehydration, excessive intake.
LOW
- Renal failure, oedematous states (cirrhosis, CCF,
nephrotic syndrome), Addison’s disease, over hydration, diuretics, vomiting,
sweating, syndrome of inappropriate ADH secretion, pseudohyponatraemia
(hyperlipidaemia, hyperproteinaemia)
SOLUBLE LIVER ANTIGEN
Specimen required:
Department:
Serum 1 x red top no gel
Referred test
SOLUBLE TRANSFERRIN RECEPTOR ( STFR ) (No rebate)
Specimen required:
Department:
Indication:
SOLVS
Specimen required:
Serum (1 x SST)
Referred test
Soluble transferrin receptor concentration increases in response
to iron deficiency but does not change in the anaemia of chronic disease
where iron deficiency is not a feature.
Self obtained lower vaginal swab (collected by patient)
SOMATOMEDIN C
See Insulin like growth factor 1
10-Nov-2014 Page 104 of 122
CLINIPATH PATHOLOGY
SPERM ANTIBODIES
Specimen required:
Department:
S
DIRECT assay Semen Sample (DIRECT)
INDIRECT assay - Serum (1 x SST) (INDIRECT)
Referred test
SPERM CHROMATIN STRUCTURE ASSAY - Specimen required: Semen
SPERM COUNT
See SEMEN – FOR FERTILITY INVESTIGATIONS or POST VASECTOMY
SPUTUM
(A) FOR EXAMINATION FOR TUBERCULOSIS - SEE TUBERCULOSIS.
Department:
Microbiology
(B) FOR ROUTINE EXAMINATION
Specimen required:
Department:
Comment:
Purulent lower respiratory tract secretions with minimal contamination by saliva.
The Patient should be asked to take a deep breath and cough as vigorously as possible, spitting
the sputum into the container. If possible an early morning specimen should be collected.
Patient instruction sheets are available on request.
Microbiology
All specimens must be refrigerated after collection. This is essential to prevent overgrowth by
contaminants.
SPUTUM (FOR MALIGNANT CELLS)
See CYTOLOGY
STAPHYLOLYSIN SEROLOGY
STREPTOCOCCAL SEROLOGY
Specimen required:
Department:
Note:
Comment:
Serum (1 x SST)
Referred test
Tests available are ANTI-DNAse B and ASOT
Group A streptococci produce many exoenzymes to which antibodies are raised in the
convalescent phase of an infection, both upper respiratory tract infection and pyoderma. Several
tests are available which measure different antibodies and some are more relevant for poststreptococcal complications e.g. Glomerulonephritis we recommend ASOT and anti DNAase B.
STRONGYLOIDES SEROLOGY
Specimen required:
Department:
Comment:
See also:
Serum (1 x SST)
Referred test
Parasite of the intestinal tract (Strongyloides stercoralis).
Faeces for parasites
SWABS - FOR MICRO CULTURE & SENSITIVITY- MC&S
Specimen Required: Nose or Throat swabs:
(i)
Plain cotton tipped swab in transport medium. (gel swab)
(ii)
PCR testing from throat swabs requires plain dry swab (No transport medium)
Ear Swabs:
(i)
Plain cotton tipped swab in transport medium. (gel swab)
(ii)
Smear of discharge on a clean glass slide - air dried.
Eye Swabs:
(i)
Plain cotton tipped swab in transport medium (gel swab). If no obvious discharge then
swab may be moistened in sterile saline.
(ii)
Plain dry swab (NO transport medium) for viral PCR or swab in virus transport medium
if viral culture required (Referred test.)
(iii)
PCR Chlamydia Swab (see Chlamydia PCR Detection). Plain dry swab
10-Nov-2014 Page 105 of 122
CLINIPATH PATHOLOGY
S
Pus or Wound swabs:
(i)
Plain cotton tipped swab in transport medium (gel swab) . If a sinus is present, a wire
swab should be inserted as deeply as possible into the sinus, avoiding skin
contamination, and then placed in transport medium.
(ii)
If possible, prepare a direct smear on a clean glass slide and allow to air dry.
(iii)
Please indicate site and supply relevant history e.g. "dog bite" etc.
Nasopharyngeal Swabs for Pertussis Culture:
(i)
If it is not possible to send the patient to the Main Laboratory for a post nasal aspirate
(see PNA) then a dry throat swab for PCR can be collected. PNA is the preferred
specimen.
Fluids:
(i)
Department:
Note:
Collect with a sterile syringe and transfer to a sterile yellow top container. Please note
site of fluid collection. For joint aspirates see SYNOVIAL FLUID.
Urethral and Vaginal Swabs:
See GENITAL SWABS
Microbiology
1. Paediatric patients: If gel swab is too large for patient e.g. young child, collect sample
using dry (PCR) swab and place the swab into gel medium.
2. If more than two PCR tests are requested i.e. more that Chlamydia and Gonorrhoeae, two
swabs should be sent in to ensure there is enough material to perform all tests.
It is essential that all specimens are accompanied by a Request Form outlining relevant clinical
details such as recent and present antibiotic therapy, the physical nature of discharges, the
clinical appearance and site of rashes, wounds, etc. This is to ensure that suitable media are set
up to isolate all likely pathogens and to get the maximum information from each specimen.
Plain cotton tipped wooden swabs with transport medium (gel swab) are available from the
Laboratory and are suitable for the majority of aerobic and anaerobic organisms. Wire cotton
tipped swabs are also available for nasopharyngeal, ear, sinus and chlamydial swabs.
SYNACTHEN STIMULATION TEST
Specimen required:
Department:
Reference range:
Interpretation:
SYNOVIAL FLUID
Specimen required:
Department:
Comment:
See collection procedure below (By appointment at the Main Laboratory after
consultation with the Chemical Pathologist)
COLLECTION PROCEDURE:
1.
The patient should be resting.
2.
Collect Serum (SST) for basal Cortisol level.
3.
Intramuscular injection of synacthen 0.25 mg should be given.
4.
Collect Serum (SST) at 30 minutes post injection.
5.
Collect Serum (SST) at 60 minutes post injection.
Biochemistry
30 and 60 minutes post injection: Should exceed basal level by 200 nmol/L and be above 550
nmol/L.
Failure to respond indicates adrenal insufficiency.
The joint should be aspirated aseptically and fluid placed in a sterile container. A small portion of
the aspirate should be placed in an EDTA tube for a cell count.
Microbiology
All joint aspirates are examined for uric acid and calcium pyrophosphate crystals.
Positive culture results are reported immediately.
SYNTHETIC CANNABINOIDS
Specimen required:
Department:
1 x Urine supervised collection as per routine drug screening. Can be performed in conjunction
with routine drug screening but attracts an additional fee of $132 (Nov 2014)
Toxicology
10-Nov-2014 Page 106 of 122
CLINIPATH PATHOLOGY
S
SYPHILIS SEROLOGY
Specimen required:
Department:
Tests Performed:
SYPHILIS PCR TEST
Specimen required:
Department:
See also:
Serology
(i) RPR (VDRL)
(ii) Syphilis IgG
(iii) If either RPR or Syphilis IgG are reactive the specimen is referred for confirmation tests.
Dry swab of chancre
Referred test
ULCER PCR
10-Nov-2014 Page 107 of 122
CLINIPATH PATHOLOGY
T
T
T4 / T8 RATIO
TACROLIMUS
Department:
Referred
TAENIA SEROLOGY
Specimen required:
Department:
See also:
Serum (1 x SST)
Referred test
TAPEWORM IDENTIFICATION
TAPEWORM IDENTIFICATION
Specimen required:
Department:
Comment:
Note:
Faeces sample. Tapeworm proglottids are mobile when fresh. Capture 3-4 Tapeworm
proglottids and preserve in sterile water in yellow topped urine jar.
Microbiology
Microbiology will confirm the presence of Taenia and perform speciation. i.e. T. sagimata v’s T.
solium as there are some extra precautions with T solium management.
Taemia serology is available i.e. cysticercosis serology.
Tapeworm proglottids disintegrate in faeces specimens.
TB
See TUBERCULOSIS
T-CELLS
TACROMILUS
See FK 506
TAURINE
Specimen required:
Department:
1 x Heparin NO GEL Attach process immediately sticker
Sample must be promptly separated and frozen.
Transport sample frozen.
Referred test
T- CELL SUBSETS
TEGRETOL
See CARBAMAZEPINE
10-Nov-2014 Page 108 of 122
CLINIPATH PATHOLOGY
T
TESTOSTERONE – TOTAL
Specimen required:
Department:
Reference Range:
Comment:
Serum (1 x SST)
Biochemistry
Male:
9.9 - 27.8 nmol/L
Female:
0.2 – 2.9 nmol/L
A better assessment of androgen status in females is to perform a Free Androgen Index, in
which Testosterone and Sex Hormone Binding Globulin are measured and FAI is calculated. In
males, calculated free testosterone is preferred (calculated from SHBG, albumin and
testosterone)
TFT
See THYROID FUNCTION TESTS
THALASSAEMIA
THC ( CANNABINOIDS )
See DRUGS of ABUSE
THEOPHYLLINE
Specimen required:
Department:
Results:
Note:
Serum (1 x SST)
Biochemistry
Therapeutic range: 10 - 20 mg/L
Peak level:
Half life:
3 - 8 hours.
(i) Dose requirements should be based on ideal body weight.
(ii) Elimination of theophylline is decreased in chronic obstructive airways disease, congestive
. cardiac failure, acute pulmonary oedema and reduced hepatocellular function.
(iii) Please note time of collection and last dose.
THIAMINE
See Vitamin B1
THIOPURINE METHYL TRANSFERASE
Specimen required:
Department:
2 x EDTA dedicated tubes required. If genotyping requested collect 1 x EDTA
Referred Test
THIN PREP – PAP (No rebate)
Specimen required:
Cervical sample in ThinPrep collection vial (ThinPrep vials available on request from
Laboratory). Please ensure the expiry date on these vials is checked before use
Specimen Collection:
(i)
(ii)
Department:
Note:
See also:
Collect the sample as normal, using a Cervex™ brush, available from the Laboratory
Prepare the conventional smear by wiping, first one side of the brush on the glass slide
and then the other. Apply fixative immediately.
(iii) Rinse the Cervix™ brush in a vial of preservative fluid and discard. Note: The end of the
Cervex™ brush should not be left in the vial once rinsed.
(iv) Label glass slide and vial with the patient’s surname, first name and date of birth.
(v) Send prepared slide and ThinPrep vial to Laboratory for analysis.
Cytology
Currently the split sampling technique is employed within this Laboratory, which involves the
analysis of both the conventional smear and the ThinPrep sample. The ThinPrep sample is not
routinely processed without a conventional slide.
CYTOLOGY, CHLAMYDIA AND HUMAN PAPILLOMA VIRUS.
10-Nov-2014 Page 109 of 122
CLINIPATH PATHOLOGY
THROMBIN TIME
Specimen required:
Department:
Reference Range:
T
1 x Sodium citrate tube. No add on testing available
Haematology
12.5 - 17.5 seconds
THROMBOPHILIA SCREEN (HALASCA SCREEN)
Specimen Required: Patient must be fasting, however if referred by a fertility group patient does not have to
fast. No add on testing available
2 x Sodium citrate tubes. Bunbury Pathology to collect 3 x Na Citrate
1 x EDTA
1 x SST
1 x PPT (for HOMOCYSTEINE)
Department:
Haematology
Comment:
Screen consists of: Homocysteine
APC Resistance
Lupus Anticoagulant
Antithrombin III
Protein S
Protein C
Anticardiolipin Antibodies
Prothrombin 20210 gene referred if indicated
Note:
To qualify for Medicare benefits for this screen, a history of venous thromboembolism or a firstdegree relative of a person who has a proven defect of any of ATIII, Prot C, S, or APC
resistance, must be given in writing. Any queries can be directed to Haematology.
THYROGLOBULIN - specimen required 1 x SST
THYROID ANTIBODIES ( THYROID PEROXIDASE & THYROGLOBULIN ANTIBODIES )
Specimen required:
Methodology:
Department:
Reference Range:
Note:
Serum (1 x SST)
Immunoassay.
Biochemistry
Thyroperoxidase antibodies ≤ 5.6 lU/ml
Thyroglobulin antibodies
≤ 4.1 lU/ml
Elevation of one or both is associated with autoimmune thyroid disease.
THYROID RECEPTOR ANTIBODIES ( TRAB )
Specimen required:
Department:
Serum (1 x SST)
Referred test
THYROID FUNCTION TEST ( TFT )
Specimen required:
Department:
Interpretation:
Note:
Comment:
Serum (1 x SST)
Biochemistry
Comments are made on all results by this Laboratory.
Please indicate if patient is being treated for thyroid illness.
Clinipath Pathology routinely performs THYROID STIMULATING HORMONE (TSH) only. If HIC
approved clinical criteria are satisfied, (e.g. previous thyroid disease), then TSH and FT4/FT3
can be performed.
THYROXINE – FREE T4
Specimen required:
Department:
Reference Range:
Serum (1 x SST)
Biochemistry
As stated on report
THYROTROPIN – TSH
Specimen required:
Department:
Reference Range:
Serum (1 x SST)
Biochemistry
As stated on report
10-Nov-2014 Page 110 of 122
CLINIPATH PATHOLOGY
T
TISSUE TRANSGLUTAMINASE ANTIBODIES (TTG IGA)
Specimen required:
Department:
Reference Range:
Note:
Serology
< 7 U/mL
This test is useful in the diagnosis and monitoring of Coeliac disease.
When the significance of a positive tTG autoantibody test is unclear, HLA DQ2/8 typing is a very
sensitive exclusion test.
TMPI (RENAL THRESHOLD PHOSPHATE)
Specimen required:
Department:
Comment:
Reference Interval:
Notes:
TOBRAMYCIN
Specimen required:
Department:
Therapeutic Range:
See also:
Spot urine sample (plain bottle)
Serum (1 x SST)
1 x Heparin (NO GEL)
Biochemistry
Includes Urine calcium, phosphate, Serum calcium, plasma phosphate, creatinine
0.75 – 1.35 mmol/L GF
Requested by Dr Paul Glendenning
Serum (1 x SST)
Usually collected as a pair of PEAK and TROUGH samples.
PEAK sample - 1 hour post IM dose or ½ hour post infusion.
TROUGH
- just prior to next dose.
Referred test
TROUGH should be less than 2.0 mg/L
PEAK levels between 5.0 – 10.0 mg/L
GENTAMICIN ASSAY/AMINOGLYCOSIDE MONITORING for once daily dosing.
TORCH SCREEN
See individual listings for TOXOPLASMOSIS, RUBELLA SEROLOGY, CMV, HEPATITIS B, AND HERPES
TOXOPLASMOSIS SEROLOGY (IGG & IGM)
Specimen required:
Department:
Results:
Symptoms:
Comment:
Serology
Reported as Detected / Not Detected with appropriate interpretive comments.
May include headache, sore throat, lymphadenopathy and is an important cause of congenital
infections. Can cause severe infections in the immunosuppressed.
Consider also EBV or CMV.
Additional Testing can include, Avidity test - High avidity IgG antibody suggests infection
>3mths before. Usually requested in pregnant females with IgM + and after discussion with
microbiologist
TPHA/TPPA
TREPONEMA PALLIDUM HAEM-AGGLUTINATION
TREPONEMA PALLIDUM PARTICLE AGGLUTINATION
See SYPHILIS SEROLOGY
TPMT
See THIOPURINE METHYL TRANSFERASE
TRANSFERRIN
Specimen required:
Department:
Reference Range:
Comment:
Interpretation:
Serum (1 x SST)
Biochemistry
25 - 45 µmol/L
Used in the calculation of Iron Saturation.
LOW - Chronic diseases, malnutrition, malabsorption.
HIGH - Oestrogen therapy, liver disease.
SATURATION LOW - Iron deficiency anaemia.
SATURATION HIGH - Haemochromatosis, iron therapy
10-Nov-2014 Page 111 of 122
CLINIPATH PATHOLOGY
T
TRBA
See THYROID RECEPTOR ANTIBODIES
TREPONEMA PALLIDUM ANTIBODIES
TREPONEMA PALLIDUM (SYPHILIS)
Specimen required:
Department:
See also:
Dry swab of ulcer/chancre for PCR
Referred test
ULCER PCR
TRIGLYCERIDES ( TRIGS )
Specimen required:
Department:
Reference Range:
Interpretation:
Serum (1 x SST) Patient fasting preferably.
Biochemistry
< 1.8 mmol/L
High levels seen in primary (familial) and secondary (eg diabetes, obesity, alcoholism,
pancreatitis) hyperlipidaemias.
TRICYCLIC ANTIDEPRESSANTS ( TOTAL )
Specimen required:
Department:
Therapeutic Range:
See also:
1 x Lithium Heparin
Referred test
Specific Tricyclic Antidepressants
AMITRIPTYLINE
CLOMIPRAMINE
DOTHIEPIN
DOXEPIN
IMIPRAMINE
TRI-IODOTHYRONINE – FREE T3
Specimen required:
Department:
Reference Range:
Interpretation:
Serum (1 x SST)
Biochemistry
2.6 – 5.7 pmol/L
Thyroid results are generally interpreted when reported.
TRIPLE TEST / MATERNAL SERUM SCREEN (MSS)
TEST REPLACED BY FIRST (9 – 13 weeks 6 days) & SECOND (14 – 17 weeks) TRIMESTER SCREENING
Comment:
Screening test for Down's Syndrome and Neural Tube Defect
TROPHERYMA WHIPPLEI PCR
Specimen required:
Departmetn:
1 x EDTA
Referred Test
TROPONIN T – HIGH SENSITIVITY
Specimen required:
Department:
Reference Range:
Interpretation:
Serum (1 x SST) ALWAYS TREAT AS URGENT. No Add on testing available.
Biochemistry
< 15ng/L
Normal
Troponin T is the preferred bio-marker in the diagnosis of myocardial infarction. Troponin T will
usually be detected within 6 hours following myocardial infarction and may remain elevated for
up to 2 weeks.
TRYPTASE - specimen required: 1 x SST
TRYPANOSOMIASIS (CHAGAS DISEASE)
Specimen required:
Department:
Serum (1 x SST)
Referred test
10-Nov-2014 Page 112 of 122
CLINIPATH PATHOLOGY
TRYPTOPHAN
Specimen required:
Department:
T
1 x Heparin NO GEL.
Special pick up required as specimen is promptly separated on arrival at the Main
Laboratory
Referred test
TSH RECEPTOR ABS
See THYROID RECEPTOR ANTIBODIES
TUBERCULOSIS / ACID FAST BACILLI
Specimen required:
Department:
Comment:
(a) Sputum: Three (3) consecutive early morning specimens which should be delivered to the
Laboratory daily.
(b) Urine: Three (3) early morning specimens are required. This should be the full specimen,
not a midstream specimen. Special sterile jars are available from the Laboratory.
(c) Skin and other tissue: The specimen should be sent dry, in a sterile container.
(d) Early morning gastric aspirates: These may be used if sputum cannot be obtained. The
gastric acid must be neutralised if the specimen cannot be processed within 1/2 hour, and
suitable containers with buffer are available from the Laboratory as required.
(e) Blood cultures- should be collected in a special Bacterial Blood Culture bottle available
from the microbiology Laboratory.
(f) Sterile aliquot of bone marrow aspirate.- Contact Clinical Microbiologist
Referred test
The results of direct microscopy are reported. Culture may take up to 12 weeks to complete. For
positive microscopy specimens an interim rapid molecular test is usually performed and
available 2-3 days after microscopy. This test detects mycobacterium TB complex.
TUMOUR MARKERS
See Individual Markers
Tumour Marker
ADH (Antidiuretic Hormone)
AFP (Alpha-feto protein)
CA 15-3 (carbohydrate antigen 15-3)
CA 19-9
CA 125
Calcitonin
CEA (Carcinoembryonic antigen)
HCG (Human chorionic gonadotrophin)
LDH (Lactic dehydrogenase)
NSE (Neuron-specific enolase)
PSA (Prostate specific antigen)
Primary Cancer Site
Small cell lung cancer, adenocarcinoma
Liver, germ cell tumour of ovaries or testes
Breast
Pancreas, colorectal
Ovarian
Thyroid medullary carcinoma
Colon, lung
Trophoblastic disease
Lymphoma, seminoma, acute leukaemia, metastatic carcinoma.
Neuroblastoma, small cell lung cancer
Prostate
TYPHOID SEROLOGY
See WIDAL AGGLUTININS, Salmonella Typhi
TYPHUS SEROLOGY
See Rickettsia
TYROSINE
Specimen required:
Department:
1 x Heparin (no Gel)
Referred test
10-Nov-2014 Page 113 of 122
CLINIPATH PATHOLOGY
U
U
UEBG
Collect for UREA, ELECTROLYTES, BLOOD GLUCOSE
ULCER PCR
Specimen required:
Department:
Note:
Dry swab for PCR
Referred test
There are several PCR tests now available for Ulcers depending on the site of infection.
Non-genital e.g. eye
Herpes I/II PCR
Adenovirus
Genital may include
Herpes I/II
Treponema pallidum
Haemophilus ducreyi
Lymphogranuloma venereum
Granuloma inguinale
UNSTABLE HAEMOGLOBIN
URATE
See URIC ACID
UREA BREATH TEST
See HELICOBACTER BREATH TEST
UREA
Specimen required:
Department:
Reference range:
Interpretation:
Serum (1 x SST)
Biochemistry
2.5 - 9.0 mmol/L > 60 years
2.5 - 8.0 mmol/L < 60 years
HIGH – Renal insufficiency (e.g. CCF, intrinsic renal disease, urinary tract obstruction),
gut bleeds.
LOW
– Liver disease, overhydration.
UREAPLASMA
See PCR COLLECTION FIRST VOID URINE
URIC ACID ( UA ) – SERUM
Specimen required:
Department:
Reference range:
Interpretation:
URIC ACID – URINE
Specimen required:
Department:
Reference range:
Interpretation:
Serum (1 x SST)
Biochemistry
Male:
0.20 - 0.42 mmol/L
Female:
0.15 - 0.36 mmol/L
HIGH - “Hyperuricaemia” – not necessarily gout. Renal insufficiency.
LOW - Uricosuric drug, renal tubule defect.
Urine – Spot.
Biochemistry
< 4.0 mmol/day
HIGH - Urate overproduction.
LOW - Urate underexcretion.
10-Nov-2014 Page 114 of 122
CLINIPATH PATHOLOGY
U
URINE - ALDOSTERONE
Specimen required:
Department:
Urine – 24 hour collection with NO PRESERVATIVE.
Referred test
URINE COPPER
See COPPER
URINE PROTEIN ELECTROPHORESIS (BENCE JONES PROTEINS)
Specimen required:
Department:
Interpretation:
Early morning spot urine for screening unless a 24 hour urine is specifically requested.
Biochemistry
In multiple myeloma and light chain disease, abnormal proteins may be detected.
URINE FOR CYTOLOGY
See CYTOLOGY
URINE FOR AFB / TB / MYCOBACTERIOLOGY
See TUBERCULOSIS
URINE FOR MICRO CULTURE & SENSITIVITY ( MC&S )
Department:
Microbiology
Specimen collection:
1. Midstream urine: mid stream clean catch specimens are required.
Female: The labia are separated with one hand. If needed a sterile water wipe can be used
to prepare labia. Keeping the labia apart, the midstream of the urine is collected into a sterile
container.
Male:
If needed, retract the foreskin, clean the area with a sterile water wipe as required.
The midstream of the urine is then collected into a sterile container.
2. Paediatric urine: mid stream clean catch specimens are optimal if feasible.
With cooperative toddlers, a 'clean catch' urine specimen is preferred. For babies and smaller
children, a collecting bag might have to be used over the child’s genitalia and a nappy put on
and the child given a drink. The bag should be checked frequently so that it can be removed
immediately it is seen to contain urine. The urine is then transferred into a sterile yellow capped
container for analysis.
3. Catheter specimens: Specimens must be collected from the catheter itself using a sterile syringe, not the
collecting bag. If a catheter is being changed, the specimen is taken after insertion of the new
catheter, not from the old one. Once a catheter is permanently removed, urine is checked for
infection by collecting an M.S.U. 24-48 hours after removal. Indwelling urinary catheters
universally become colonised with coliform and other bacteria. Bacteria cultured from IDC urine
generally represent colonisers rather than pathogens and results should be interpreted with
caution.
4. Ileal conduits:
Comment:
Ileal conduit urine specimens are likely to be contaminated by colonising bacteria. Bacteria
cultured from these specimens generally represent colonisers rather than pathogens and
results should be interpreted with caution. Bag specimens are not acceptable as they are
contaminated by stomal organisms. A catheter introduced aseptically into the stroma will result
in a more reliable specimen.
(1)
All urines are examined using the Iris automated urine microscopy analyzer. Leucocytes and
red cells are reported as the number per litre. Any significant findings on microscopy are
reported. When red cell morphology is required, a fresh specimen of urine should be delivered
to the Laboratory as soon as possible. Culture results are expressed as number of bacteria per
litre of urine. Cut-off values differentiate between bacteria that are likely to represent pathogens
and those that are likely to represent contaminants. Contamination of urines may also be
indicated by the presence of squarmous epithelial cells.
(2) Significant bacteriuria occurs when a culture result is >108 /L. In older asymptomatic patients,
treatment may not be warranted initially. Occasionally, smaller numbers may be relevant in
symptomatic ambulatory patients. In pregnant women, any quantity of Group B Streptococcus
may be associated with a likely carrier status at delivery.
10-Nov-2014 Page 115 of 122
CLINIPATH PATHOLOGY
U
(3) Where microscopy indicates no evidence of infection, a report will be issued on the
same day. Where subsequent significant bacterial growth occurs, an amended report
will be issued.
Note:
Urines should be refrigerated after collection as bacteria can multiply exponentially and
quantitative results will be potentially inaccurate.
UROBILINOGEN
See PORPHYRIN SCREEN
10-Nov-2014 Page 116 of 122
CLINIPATH PATHOLOGY
V
V
VALPROIC ACID ( EPILIM )
Specimen required:
Department:
Results:
Note:
VANCOMYCIN
Specimen required:
Department:
Results:
Interpretation:
VANADIUM
Specimen required:
Department:
Serum (1 x SST) - Sample prior to next dose.
Biochemistry
Therapeutic range:
350 – 700 umol/L
Peak level:
Half life:
6 - 15 hours.
(i) Valproate may potentiate the effect of ethosuximide and phenobarbitone.
(ii) Valproate prolongs skin bleeding time.
(iii) Valproate in high doses may cause ketonuria which may interfere with urine testing.
(iv) Valproate competes with phenytoin for protein binding sites.
(v) Please note time of collection and last dose.
Serum (1 x SST) - Trough and peak levels.
Trough - collect immediately prior to next dose.
Peak - collect 30 minutes post IV infusion or 60 minutes post IM injection.
Referred test
Therapeutic Range: Trough < 10 mg/L
Peak 20 - 50 mg/L
Half life: Adult 4 - 10 hours.
Children 2 - 3 hours.
High trough levels may result in nephrotoxicity.
1 x Spot urine
Referred test
VARICELLA DIRECT DETECTION (PCR)
See VIRUS DETECTION
VARICELLA SEROLOGY ( IGG & IGM ANTIBODIES )
Specimen required:
Note:
Department:
Indications:
Results:
Note:
A swab of an active lesion for PCR is the preferred method of diagnosis for acute Chicken Pox
and Shingles
Serology
Can be helpful for retrospective diagnosis
Chickenpox - Fever and vesicular rash, common in children.
Shingles - Painful circumscribed eruptions of vesicular lesions, mainly in adults.
May be a severe or fatal disease in the immunosuppressed.
Consider also Herpes simplex virus (viral culture or PCR of vesicular lesions).
Reported as Positive or Negative with appropriate interpretive comments.
(i) Please telephone the Laboratory (Serology Dept) if URGENT immune status testing is
required, e.g. pregnant and exposed.
(ii) Definitive testing when rash is present is a dry swab for PCR from vesicles/lesions.
VASOACTIVE INTESTINAL PEPTIDE (VIP)
Specimen required:
Note:
Department:
Patient needs to be fasting Can only be collected at main laboratory due to special
collection requirements. Consult with Duty manager.
2 x EDTA tubes containing 0.2ml Aprotinin are required
Collect blood and ensure blood in mixed well with Aprotinin. Place tubes in an ice bath and
deliver immediately to SRA for centrifugation in chilled centrifuge or chilled centrifuge buckets.
Separate and freeze ASAP after centrifugation.
Referred test
10-Nov-2014 Page 117 of 122
CLINIPATH PATHOLOGY
V
VASOPRESSIN (ANTI DIURETIC HORMONE OR ADH)
See Anti Diuretic Hormone
VDRL
(See Chemistry lab scientist before collecting)
Specimen required: 1 x Heparin No Gel
Venous Gases
VENLAFAXINE
Specimen required:
Department:
1 x Hep No Gel
Referred Test
VERIFY TEST (NIPT) (No rebate)
This test is by appointment only at the main laboratory and specific regional collection centres. Patient should phone 9371 4531 to
arrange an appointment. As of Nov 2014 this test had a fee of $595.
VIRAL CULTURE
See VIRUS DETECTION
VIRAL LOAD FOR HIV
See HIV RNA
VIRAL STUDIES
Note:
Specimens requesting “Viral Studies” CANNOT be processed.
The Request Form must either indicate the viruses suspected, or must give good clinical
details, so that the Microbiologist can advise on the appropriate investigations. Clinical details
should include time of onset of illness, any travel, major manifestations, e.g. rash, myocarditis,
encephalitis, paralysis, diarrhoea, pneumonia, pharyngitis.
VIRUS DETECTION ( PCR AND CULTURE )
Specimen Required: Skin swabs:
If there are any blisters then the best results are obtained by de-roofing the blister and
collecting the serous exudate as well as swabbing the base of the lesion (where the majority of
virus laden cells reside). Viral skin infections may be diagnosed by PCR for HSV 1 & 2,
Varicella, Orf and Molluscum contagiosum virus, hand, foot and mouth (enterovirus) etc.
Scabby Wounds:
Remove the scab and swab the base of the lesion.
Throat swabs:
Collect as a normal throat swab for viral PCR with a plain dry swab, no transport medium.
Upper Respiratory Tract Infection:
Nasopharyngeal swab or aspirate or throat swab for PCR
Intestinal Infection:
Faeces.
Meningitis, Encephalitis, Paralysis:
CSF, nose and throat swab and faeces.
Vesicular Rash:
Vesicle fluid or scrapings from the base of the lesion or onto dry swab.
Myocarditis, Pericarditis:
Faeces, and throat swabs.
Department:
Comment:
See also:
Referred test (except HSV Immunofluoresence which is performed at Clinipath Pathology)
We refer all our viral culture samples. Turn around time is now improved with the advent of
routine rapid PCR techniques, at about 4-5 days - URGENT cultures e.g. in pregnancy can be
processed in 24-48 hours.
PCR techniques have largely replaced Virus Culture. The correct sample for viral PCR of skin
lesions, is a plain dry swab of the infected area. DO NOT PLACE SWAB INTO AMIES
TRANSPORT MEDIUM. Replace swab into empty receptacle and transport as is. For
respiratory viruses, a nasal swab or respiratory secretions eg Post Nasal Aspiration, in a sterile
container is required.
Herpes simplex type I / II rapid Direct Immunofluorescence.
10-Nov-2014 Page 118 of 122
I
CLINIPATH PATHOLOGY
V
VISCOSITY
See WHOLE BLOOD VISCOSITY
VITAMIN A
Specimen required:
Note:
Department:
Reference range:
Serum (1 x SST) - Protect sample from light, wrap in alfoil. No add on testing available
Referred test
As stated on report
VITAMIN B1 ( THIAMINE )
Specimen required:
1 x EDTA dedicated tube. Patient must be fasting. After collection wrap specimen in
alfoil and refrigerate. No add ontesting available.
Department:
Reference range:
Note:
Referred test
Antibiotics interfere with this assay. Collect 2 weeks after cessation of antibiotic therapy.
VITAMIN B2 ( RIBOFLAVIN )
Specimen required:
Note:
Patient must be fasting. After collection wrap specimen in alfoil and refrigerate
1 x EDTA dedicated tube. No add on testing available.
Department:
Referred test
B2 is a precursor of FAD or FMN
VITAMIN B3 (NIACIN)
Sample required:
Department:
24 hour urine with acid preservative (20ml 50% HCL), warn patient of the acid risk
Referred test, no add on testing available.
VITAMIN B6 ( PYRIDOXAL )
Patient must be fasting. After collection wrap specimen in alfoil and refrigerate
1 x EDTA dedicated tube
Department:
Referred test
Reference range:
Varying with age and sex. These factors should be included with request.
Specimen required:
VITAMIN B12 ( CYANOCOBALAMIN ) +/- FOLATE
Specimen required:
Department:
Reference range:
Note:
Serum (1 x SST)
Biochemistry
NORMAL
139 – 651 pmol/L
INDETERMINATE
74 – 138 pmol/L
DEFICIENT
< 74 pmol/L
Specimens with B12 results below 260 pmol/L will be automatically tested for Active B12
(Holotranscobalamin).
VITAMIN C ( ASCORBIC ACID )
Specimen required:
Note:
Department:
Reference range:
Note:
1 x Lithium Heparin Protect sample from light, wrap in alfoil
Attach process immediately sticker, must be processed within 1 hour of collection
Referred test
Specimen can only be collected at Main Laboratory and Bicton ACC due to the labile
nature of Vitamin C. The specimen is then frozen and wrapped in alfoil to protect it from light.
No add on testing available
10-Nov-2014 Page 119 of 122
CLINIPATH PATHOLOGY
V
VITAMIN D ( 25–OH CHOLECALCIFEROL OR 25 VIT D)
Specimen required:
Department:
Reference range:
Comment:
1 x SST, must be full draw
Referred test
40 - 150
LOW – Osteoporosis
Levels between 40 – 60 may be associated with deficiency and compensating increased PTH.
VITAMIN D3
See Vitamin D
VITAMIN E ( TOCOPHEROL )
Specimen required:
Note:
Department:
Reference range:
Serum (1 x SST) - Protect sample from light, wrap in alfoil. No add on testing available
Referred test
VITAMIN K
Not performed see Prothrombin Time
VMA ( VANILLYLMANDELIC ACID )
Specimen required:
Department:
Note:
24 hour urine collection.
Referred test
VON WILLEBRAND’S FACTOR TESTING
Specimen required:
Department:
Co
2 x Sodium citrate tubes. Bunbury Pathology to collect 3 x Sodium Citrate tubes.
No add on testing available
Haematology
Consists of:
(i)
APTT
(ii)
Factor VIII (F8)
(iii)
Von Willebrand’s Factor (VWF)
(iv)
Ristocetin Cofactor (Ricof
V2V - see Varicella serology
V617F Mutation see JAK-2
10-Nov-2014 Page 120 of 122
CLINIPATH PATHOLOGY
W
W
WHIPPLES DISEASE
See Tropheryma Whipplei PCR
WHOLE BLOOD INTERFERON-GAMMA ASSAY (QUANTIFERON GOLD)
See Quantiferon
WHOLE BLOOD LEAD (PB)
See Lead
WHOLE BLOOD MAGNESIUM (MG)
See both MAGNESIUM (Serum) and RED CELL MAGNESIUM
WHOLE BLOOD MERCURY (HG)
See MERCURY
WHOLE BLOOD POTASSIUM (K+)
Specimen required:
Department:
Reference range:
1 x Heparin NO GEL
Biochemistry
30 - 50 mmol/L
WHOLE BLOOD SELENIUM
Whole blood test not available. See SELENIUM (Serum)
WHOLE BLOOD VISCOSITY
Specimen required:
Department:
Reference range:
4 x EDTA tubes. Please send patient to Clinipath Pathology Main Laboratory.
Samples dispatched immediately after collection (must arrive at the testing Laboratory within 1
hour of collection and before 2pm). No add on testing available.
Referred test
As reported.
WHOLE BLOOD ZINC (ZN)
See both ZINC (Serum) and RED CELL ZINC
WHOOPING COUGH
See BORDETELLA PERTUSSIS SEROLOGY, CULTURE, PCR
WIDAL AGGLUTININS (TYPHOID SEROLOGY)
Specimen required:
Department:
Note:
Serum (1 x SST)
Referred test
Test for Typhoid and Paratyphoid, which has poor sensitivity and specificity. Culture remains
the definitive test for these salmonella infections. See blood culture x3 and faecal culture.
WOUND SWAB / ASPIRATE
Specimen required: 1) Swab in gel tube for superficial wounds.
2) Prefer aspirated volume of pus for abscess culture including anaerobes. Place in sterile
jar e.g. urine jar. Send to Laboratory as Urgent/Priority specimen
Department:
Microbiology
10-Nov-2014 Page 121 of 122
CLINIPATH PATHOLOGY
XYZ
X
XYLOSE ABSORPTION TEST
TEST NO LONGER PERFORMED - REPLACED BY ENDOSCOPY.
Y
YERSINIA ENTEROCOLITICA
See FAECES CULTURE
YERSINIA SEROLOGY
Specimen:
Department:
Serum (1 x SST)
Referred Test
Z
ZINC ( Zn )
Specimen required:
Department:
Reference range:
Interpretation:
Biochemistry
9 - 19 umol/L.
LOW – Cirrhosis, diarrhoea, malabsorption, alcoholism, drugs (e.g. steroids, diuretics).
HIGH – May be due to zinc therapy.
ZOLOFT
See SERTRALINE
ZOSTER PCR
See virus detection
10-Nov-2014 Page 122 of 122

CLINIPATH PATHOLOGY SPECIMEN COLLECTION GUIDE

Transcription

Similar documents

VS120 - Olympus

The VS120: Providing a Complete Spectrum of

Specimen Identification and Tracking System

(peripheral blood or bone marrow aspirate

9. FOSSIL PRIMITIVE INSECTS FROM ONYX

superanal

GeniStrong Rev I

ANTIDEPRESIVOS TRICICLICOS (TCA)

PriorLux POL - Prior Scientific

PDF Slides