panduan patologi kimia 2015
Transcription
panduan patologi kimia 2015
PANDUAN PERKHIDMATAN PATOLOGI KIMIA HOSPITAL SULTANAH AMINAH JOHOR BAHRU 2015 PANDUAN PERKHIDMATAN PATOLOGI KIMIA HOSPITAL SULTANAH AMINAH JOHOR BAHRU VERSI 1 (2015) KANDUNGAN M/S Pengenalan 1 Lokasi Makmal 1 Skop Perkhidmatan 1 Waktu Perkhidmatan 1 Hubungi Makmal 1 Informasi Pegawai 2 Senarai Ujian yang dijalankan di makmal Patologi Kimia, HSAJB 3-10 Senarai Ujian yang dirujuk ke makmal luar 11-21 Lampiran 22 Lampiran 1: Senarai Ujian STAT 23 Lampiran 2: Jadual Penghantaran Spesimen ke makmal rujukan 24 Lampiran 3: Panduan Bekas Spesimen 25 Lampiran 4: Panduan Order of Draw For Multiple Tube Collections 26 Lampiran 5: Panduan ujian Renin dan Aldosterone 27-28 Lampiran 6: Panduan Ujian Inborn Error of Metabolism 29-31 Lampiran 7: Borang-Borang 32-42 1 PERKHIDMATAN PATOLOGI KIMIA PENGENALAN Unit Patologi Kimia menawarkan perkhidmatan analisa spesimen dan konsultasi keputusan untuk tujuan membantu perawatan pesakit di Hospital Sultanah Aminah, Johor Bahru. Unit ini juga menjadi makmal rujukan bagi ujian-ujian khas tertentu untuk seluruh Negeri Johor. LOKASI Tingkat Bawah, Bangunan Teratai Hospital Sultanah Aminah SKOP PERKHIDMATAN Perkhidmatan Patologi Kimia meliputi analisa dan interpretasi perubahan biokimia dalam darah dan cecair badan untuk tujuan penyaringan, diagnosa dan pemantauan penyakit. Perkhidmatan dibahagikan kepada beberapa seksyen iaitu: main chemistry, immunoassay, special protein, diabetic tests, urine and body fluids, miscellaneous tests dan seksyen dadah. Unit ini juga mengendalikan pemprosesan dan penghantaran spesimen bagi ujian biokimia ke makmal-makmal rujukan sekiranya ujian tidak ditawarkan di sini. WAKTU PERKHIDMATAN 24 jam sehari Setiap hari termasuk cuti umum HUBUNGI MAKMAL Makmal Patologi Kimia No Tel: 07-2231666 (ext 2630) Fax: 07-2231803 PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 2 INFORMASI PEGAWAI NAMA PEGAWAI Dr Shahannim Binti Izham NO TELEFON No Tel: 07-2231666 (ext 2633) Pakar Patologi Kimia Ketua Unit Patologi Kimia Dr Yong Pei Wen No Tel: 07-2231666 (ext 2630) Pegawai Perubatan Encik Abdul Halim bin Gahar No Tel: 07-2231666 (ext 2634) Pegawai Sains Kanan Ketua Pegawai Sains Pn Noor Hayati A. Kadir No Tel: 07-2231666 (ext 2633) Pegawai Sains Kanan Y/M Seksyen Dadah Pegawai-pegawai Sains: No Tel: 07-2231666 (ext 2630) Pn Deviga Balakersnan Pn Nooraishah Pairan Pn Suhana Razali Encik Khairul Anuar Abu Kasim Juruteknologi Makmal Perubatan Kanan: No Tel: 07-2231666 (ext 2630) Pn Ashila Jaafar En Sudin Suni PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 SENARAI UJIAN YANG DIJALANKAN DI MAKMAL PATOLOGI KIMIA, HSAJB NO TESTS SECTION Main Chemistry TYPE OF SPECIMEN Blood SPECIMEN CONTAINER Li Heparin VOLUME OF SPESIMEN 4 mls Main Chemistry Blood Li Heparin 4 mls CSF 1 ml LAB TURN AROUND TIME 1 hour (STAT) 4 hours (routine) 1 hour (STAT) 4 hours (routine) 1 hour (STAT) 1 Alanine Transaminase (ALT) 2 Albumin 4 mls 4 mls 4 hours 3 working days Alkaline Phosphatase (ALP) Alpha feto protein (AFP) Main Chemistry Immunoassay Blood Blood 5 Ammonia Main Chemistry Blood EDTA 2.5 mls 1 hour (STAT) 6 Amylase Main Chemistry Blood Li Heparin 4 mls Urine Urine container 5 mls Universal/urine container Heparinized syringe >1 ml 1 hour (STAT) 4 hours (routine) 1 hour (STAT) 4 hours (routine) 1 hour 0.5-1 mls 30 minutes (STAT) 1 hour (STAT) 4 hours (routine) 3 working days 7 Apt Test Miscellaneous 8 Arterial blood gas (ABG) 1) pH 2) pO2 3) pCO2 4) HCO3 Aspartate Transaminase (AST) STAT Blood in gastric aspirate/stool Blood Main Chemistry Blood Li Heparin 4 mls Immunoassay Blood Li Heparin 4 mls 11 Beta Human Chorionic Gonadotrophic (BHCG) Bilirubin, Total Main Chemistry Blood Li Heparin 4 mls* 12 Bilirubin, Direct Main Chemistry Blood Li Heparin 4 mls* 9 10 Requesting specialist’s signature is required Send EDTA tube in ice Send sample in ice 1 hour (STAT) 4 hours (routine) 1 hour (STAT) 4 hours (routine) 3 PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 3 4 Plain container/Bijou bottle Li Heparin Li Heparin REMARK 4 NO TESTS SECTION PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 Main Chemistry TYPE OF SPECIMEN - SPECIMEN CONTAINER - VOLUME OF SPESIMEN - LAB TURN AROUND TIME 1 hour (STAT) 4 hours (routine) 13 Bilirubin, Indirect 14 Main Chemistry Body fluid Universal container 4 mls 4 hours 15 Body fluid for biochemistry 1) Total protein 2) Albumin 3) LDH 4) Amylase 5) Glucose CA 125 Immunoassay Blood Li Heparin 4 mls 3 working days 16 Carcinoembryonic Antigen (CEA) Immunoassay Blood Li Heparin 4 mls 3 working days 17 Cardiac enzymes (CE) 1) CK 2) AST 3) LDH C-Reactive Protein (CRP) Complement 3 (C3) Complement 4 (C4) Calcium Main Chemistry Blood Li Heparin 4 mls 4 hours Main Chemistry Special Protein Special Protein Main Chemistry Blood Blood Blood Blood Li Heparin Li Heparin Li Heparin Li Heparin 4 mls 4 mls 4 mls 4 mls Urine random/24 hours Urine container/ 24hr urine container Plain container/Bijou bottle 5 mls/ 24 hours collection 4 hours 2 days 2 days 1 hour (STAT) 4 hours (routine) 4 hours 18 19 20 21 22 Cerebrospinal Fluid (CSF) for biochemistry 1) Appearance 2) Protein 3) Glucose 4) Lactate Main Chemistry CSF 1 ml 1 hour (STAT) REMARK Calculated from total bilirubin and direct bilirubin Requesting specialist’s signature is required Requesting specialist’s signature is required Send CSF sample immediately to lab. NO TESTS SECTION 23 Chloride Main Chemistry TYPE OF SPECIMEN Blood SPECIMEN CONTAINER Li Heparin VOLUME OF SPESIMEN 4 mls CSF 1 ml Urine random/24 hours Plain container/Bijou bottle Urine container/ 24hr urine container 5 mls/ 24 hours collection 4 hours 1 hour (STAT) 4 hours (routine) 3 working days Cholinesterase Main Chemistry Blood Li Heparin 4 mls 25 Cortisol Immunoassay Blood Li Heparin 4 mls 26 27 Creatine Kinase (CK) Creatinine Main Chemistry Main Chemistry Blood Blood Li Heparin Li Heparin 4 mls 4 mls Urine random/24 hours Urine container/ 24hr urine container 5 mls/ 24 hours collection Send CSF sample immediately to lab. 4 hours 1 hour (STAT) 4 hours (routine) 4 hours 28 29 Estradiol Ferritin Immunoassay Immunoassay Blood Blood Li Heparin Li Heparin 4 mls 4 mls 30 Folate Immunoassay Blood 4 mls 31 Follicle Stimulating Hormone (FSH) Free Triiodothyronine (FT3) Free Thyroxine (FT4) Gamma Glutamyl Transferase (GGT) Immunoassay Blood Plain tube/ Li Heparin Li Heparin 5 working days 3 hours (STAT*) 3 working days 3 working days 4 mls 5 working days Immunoassay Immunoassay Main Chemistry Blood Blood Blood Li Heparin Li Heparin Li Heparin 4 mls 4 mls 4 mls 3 working days 3 working days 4 hours 32 33 34 REMARK *STAT testing for severe dengue cases 5 PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 24 LAB TURN AROUND TIME 1 hour (STAT) 4 hours (routine) 1 hour (STAT) 6 NO TESTS SECTION PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 Main Chemistry TYPE OF SPECIMEN - SPECIMEN CONTAINER - VOLUME OF SPESIMEN - LAB TURN AROUND TIME 4 hours 35 Globulin 36 Glucose Main Chemistry Blood Fluoride tube 2 mls 37 38 39 40 41 42 HBA1C Immunoglobulin A (IgA) Immunoglobulin G (IgG) Immunoglobulin M (IgM) Iron, Total Iron profile/Study 1) Total iron 2) Unbound iron binding capacity (UIBC) 3) Total iron binding capacity (TIBC) Miscellaneous Special protein Special protein Special protein Main Chemistry Main Chemistry Blood Blood Blood Blood Blood Blood EDTA tube Li Heparin Li Heparin Li Heparin Li Heparin Li Heparin 2.5 mls 4 mls 4 mls 4 mls 4 mls 4 mls 1 hour (STAT) 4 hours (routine) 3 working days 2 working days 2 working days 2 working days 2 working days 2 working days 43 Lactate Main Chemistry Blood Fluoride tube 4 mls 1 hour (STAT) 44 Lactate Dehydrogenase, (LDH) Main Chemistry Blood Li Heparin 4 mls 45 46 Leutinizing Hormone (LH) Lipid Profile 1) Total Cholesterol, (TC) 2) HDL-Cholesterol 3) LDL-Cholesterol 4) Triglycerides (TG) Liver Function Test 1) Total Protein 2) Albumin 3) Globulin 4) Total bilirubin 5) ALP 6) ALT Immunoassay Main Chemistry Blood Blood Li Heparin Li Heparin 4 mls 4 mls 1 hour (STAT) 4 hours (routine) 5 working days 2 working days Main Chemistry Blood Li Heparin 4 mls 47 1 hour (STAT*) 4 hours (routine) REMARK Calculated from total protein and albumin TIBC is calculated from Total iron and UIBC LDL-Cholesterol is calculated from TC, HDL-C and TG * STAT request is offered for acute liver failure, pre-eclampsia and severe dengue cases only. Call Medical Officer/Chemical Pathologist on call for urgent requests for other indications NO TESTS SECTION SPECIMEN CONTAINER Li Heparin VOLUME OF SPESIMEN 4 mls 48 Magnesium (MG) Main Chemistry Urine random/24 hours Urine container/ 24hr urine container 5 mls/ 24 hours collection Blood Blood Urine Blood Li Heparin Plain tube Urine Container Li Heparin 4 mls 2 mls 2 mls 4 mls Urine random/24 hours Urine container/ 24hr urine container 5 mls/ 24 hours collection Blood Li Heparin 4 mls Urine random/24 hours Urine container/ 24hr urine container 5 mls/ 24 hours collection Main Chemistry Blood Li Heparin 4 mls 1 hour (STAT) 4 hours (routine) Immunoassay Immunoassay Blood Blood Li Heparin Li Heparin 4 mls 4 mls 3 working days 5 working days 49 50 Myoglobin Osmolality Immunoassay Miscellaneous 51 Phosphate Main Chemistry 52 53 54 55 Potassium Pre-eclampsia profile (PE profile) 1) Sodium 2) Potassium 3) Chloride 4) Urea 5) Creatinine 6) Uric acid 7) ALT 8) AST Prolactin Progesterone Main Chemistry LAB TURN AROUND TIME 1 hour (STAT) 4 hours (routine) 4 hours REMARK 4 hours (routine) 3 hours 3 hours 1 hour (STAT) 4 hours (routine) 4 hours 1 hour (STAT) 4 hours (routine) 4 hours 7 PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 TYPE OF SPECIMEN Blood 8 NO TESTS SECTION 56 Prostate Specific Antigen (PSA) 57 Renal Profile 1) Sodium 2) Potassium 3) Chloride 4) Urea 5) Creatinine Rheumatoid Factor Sodium 58 59 60 61 62 Immunoassay TYPE OF SPECIMEN Blood SPECIMEN CONTAINER Li Heparin VOLUME OF SPESIMEN 4 mls LAB TURN AROUND TIME 3 working days Main Chemistry Blood Li Heparin 4 mls 1 hour (STAT) 4 hours (routine) Special Protein Main Chemistry Blood Blood Li Heparin Li Heparin 4 mls 4 mls Urine random/24 hours Urine container/ 24hr urine container 5 mls/ 24 hours collection 2 days 1 hour (STAT) 4 hours (routine) 4 hours PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 Miscellaneous Immunoassay Immunoassay Stool Blood Blood Urine container Li Heparin Li Heparin 1 gm 4 mls 4 mls 3 hours 3 working days 3 working days Immunoassay Blood Li Heparin 4 mls 3 working days 64 Stool occult blood Testosterone Thyroid function test 1) TSH 2) Free T4 Thyroid Stimulating Hormone, TSH Total Iron Binding Capacity, TIBC Main Chemistry - - - 2 days 65 Total Protein Main Chemistry Blood Li Heparin 4 mls Urine random/24 hours Urine container/ 24hr urine container Li Heparin 5 mls/ 24 hours collection 1 hour (STAT) 4 hours (routine) 4 hours 63 66 Total Serum Bilirubin (TSB) 1) Total bilirubin 2) Direct Bilirubin Main Chemistry Blood 4 mls (*400-600ul in microtainer tube for pediatric patients) 1 hour (STAT) 4 hours (routine) REMARK Requesting specialist’s signature is required Calculated from Total Iron and UIBC NO TESTS SECTION 67 Troponin T 68 Unbound Iron Binding Capacity, UIBC Urea 69 STAT TYPE OF SPECIMEN Blood SPECIMEN CONTAINER Li Heparin VOLUME OF SPESIMEN 4 mls LAB TURN AROUND TIME 1 hour (STAT) Main Chemistry Blood Li Heparin 4 mls 2 days Main Chemistry Blood Li Heparin 4 mls Urine random/24 hours Urine container/ 24hr urine container 5 mls/ 24 hours collection 1 hour (STAT) 4 hours (routine) 4 hours Uric acid Main Chemistry Blood Urine random/24 hours Li Heparin Urine container/ 24hr urine container 4 mls 5 mls/ 24 hours collection 4 hours 4 hours 71 Urine microalbumin Main Chemistry Urine random/24 hours Urine container/ 24hr urine container 5 mls/ 24 hours collection 4 hours 72 Urine albumin Creatinine Ratio (ACR) Main Chemistry urine Urine Container 5 mls random 4 hours 73 74 75 76 77 78 Urine hemoglobin Urine myoglobin Urine paraquat Urine reducing sugar Urine pregnancy test Vitamin B 12 Miscellaneous Miscellaneous Miscellaneous Miscellaneous Miscellaneous Immunoassay urine urine urine urine urine Blood Urine container Urine container Urine container Urine container Urine container Li Heparin 2 mls 2 mls 5 mls 2 mls 2 mls 4 mls 3 hours 3 hours 1 hour 3 hours 3 hours 3 working days ACR is calculated from urine microalbumin and urine creatinine 9 PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 70 REMARK 10 NO TESTS SECTION 79 Morphine screening and confirmation Cannabinoid screening and confirmation Amphethamine type stimulant (ATS) screening and confirmation 80 81 Drug TYPE OF SPECIMEN Urine SPECIMEN CONTAINER Urine container VOLUME OF SPESIMEN 20 mls LAB TURN AROUND TIME 5 working days Drug Urine Urine container 20 mls 5 working days Drug Urine Urine container 20 mls 14 working days REMARK Use form UDP 1 (PINDAAN) *PER.PAT301 form is strictly for inpatient only PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 SENARAI UJIAN PATOLOGI KIMIA YANG DI RUJUK KE MAKMAL LUAR TESTS HOSPITAL 1. Acid alpha glucosidase 2. 3. Adenocorticotrophic Hormone (ACTH) Aldosterone Biochemistry unit, IMR HKL 4. VOLUME OF SPESIMEN 3 circles of blood spot 3 mls REFERRAL LAB TURN AROUND TIME 15 working days Blood SPECIMEN CONTAINER Whatmann 903 filter paper EDTA in ice Putrajaya Blood EDTA 3 mls 6 weeks Alpha-1-acid glycoprotein Ampang Blood Plain tube 4 mls 10 working days 5. 6. Alpha-1-antitrypsin, Quantitation Alpha-1-antitrypsin, Phenotyping Blood Blood Plain tube Plain tube 3 mls 4 mls 5 working days 10 working days 7. Alpha-2-macroglobulin HKL Molecular and Protein Unit, IMR Ampang Blood Plain tube 4 mls 10 working days 8. Amino acid Biochemistry Unit, IMR CSF Universal container Lithium heparin Urine container Plain tube Plain tube Plain tube Plain tube 0.5 mls 10 working days 4 mls 5 mls 3 mls 3 mls 3 mls 4 mls 6 weeks 20 working days 20 working days 10 days 9. Androstenedione Putrajaya 10. Apolipoprotein A HKL 11. Apolipoprotein B HKL 12. Beta-2-microglobulin Ampang * Use PER PAT 301 form unless otherwise stated. TYPE OF SPECIMEN Dried blood spot Blood Urine Blood Blood Blood Blood REMARK* IEM form 5 working days Send sample rapidly to lab but NOT in ice Use different tubes for Renin and aldosterone. Only single form is required for aldosterone & renin. IMR/UMDP/01 form IEM form 11 PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 NO 12 NO TESTS HOSPITAL PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 TYPE OF SPECIMEN Dried blood spot in filter paper SPECIMEN CONTAINER Whatmann 903 Filter paper 13. Biotinidase Enzyme Activity Biochemistry Unit, IMR 14. 15. 16. 17. CA 15-3 CA 19-9 Caeruloplasmin Carnitine, Total and Free, plasma 18. Blood Blood Blood Blood Plain tube Plain tube Plain tube Lithium heparin Cathecholamine HKL HKL HKL Biochemistry Unit, IMR Putrajaya Urine 19. Copper HKL Blood Urine 20. Cortisol, Urine Free Cortisol HKL Urine 21. 22. C-Peptide CSF Electrophoresis (oligoclonal bands) 23. Dehydroepiendosterone Sulphate (DHEAS) 24. Delta-Amino Levulinic Acids (DALA) HKL Molecular and Protein Unit, IMR Diabetes and endocrine unit, IMR Biochemistry Unit, IMR 25. Free light chain kappa & lambda Molecular and Protein Unit, IMR 26. Fructosamine Ampang * Use PER PAT 301 form unless otherwise stated. VOLUME OF SPESIMEN 3 circles of Dried blood spots 3 mls 3 mls 3 mls 4 mls REFERRAL LAB TURN AROUND TIME 10 working days 24 hours urine collection 3.5 mls 24 hour urine collection 6 weeks 24 hour urine collection 3 working days Blood Paired blood and CSF samples 24 hours urine container with 10 mls of 25% HCL Plain tube 24 hour urine container without preservative 24 hour urine container without preservative Plain tube Plain tube/ sterile container 3 mls 4 mls blood 1 ml CSF 5 working days 10 working days Blood Plain tube 3 mls 4 weeks Urine 24 hour 24 hour urine collection 15 working days IEM form Blood 24 hour urine container with 10 mls glacial acetic acid Plain tube 4 mls 5 working days IMR/UMDP/01 form Blood Plain tube 4 mls 10 working days 2 working days 2 working days 5 working days 5 working days REMARK* IEM form 10 working days 10 working days IMR/UMDP/01 form NO TESTS HOSPITAL 27. Biochemistry Unit, IMR Biochemistry Unit, IMR 29. Galactose, Total/Screening, blood spot Galactose-1-phosphate Uridyl Transferase (GALT/G1PUT), blood spot Glycosaminoglycan (GAG), urine 30. Growth Hormone 31. 32. 33. 34. 35. 36. Haptoglobulin Homocysteine Ig E, Specific Ig E, Total Insulin Insulin Like Growth Factor-1 (IGF1) 37. Intact Parathyroid hormone 38. Lead 39. Lipoprotein (a) electrophoresis 40. Lithium 41. Lysosomal enzymes screening 28. Biochemistry Unit, IMR 42. Mercury, urine Toxicology and Pharmacology, IMR * Use PER PAT 301 form unless otherwise stated. SPECIMEN CONTAINER Whatmann 903 Filter paper Whatman 903 Filter paper VOLUME OF SPESIMEN 3 circles of dried blood spots 3 circles of dried blood spots REFERRAL LAB TURN AROUND TIME 5 working days REMARK* 5 working days IEM form First morning urine Blood Urine container 5 mls 10 working days IEM form Plain tube 3 mls 4 weeks Blood Blood Blood Blood Blood Blood Plain tube Plain tube in ice Plain tube Plain tube Plain tube Plain tube 3 mls 3 mls 3 mls 3 mls 3 mls 3 mls 5 working days 20 working days 5 working days 5 working days 10 working days 4 weeks Blood EDTA 2.5 mls 4-5 weeks Blood Lithium heparin 2 mls 14 working days Blood Plain tube 4 mls blood 10 working days IMR/UMDP/01 form Blood Plain tube 3 mls Dried blood spot Whatmann 903 Filter paper Urine container 3 circles of dried blood spots 10 mls Same working day (STAT 1 hour) 10 working days Need appointment for STAT request IEM form Dried blood spot Urine IEM form 14 working days 13 PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 Biochemistry Unit, IMR Diabetes and Endocrine Unit, IMR HKL HKL Allergy, IMR Allergy, IMR HKL Diabetes and Endocrine Unit, IMR Diabetes and Endocrine Unit, IMR Toxicology and Pharmacology, IMR Molecular and Protein Unit, IMR Permai TYPE OF SPECIMEN Dried blood spot 14 NO TESTS HOSPITAL 43. Biochemistry Unit, IMR 47. Metabolic Screening, blood spot (Test for amino acids and acylcarnitines) Metabolic Screening, urine(Test for amino acids and acylcarnitines) Mucopolysaccharides Screening (MPS), urine Oligosaccharide & tetraglucoside, urine Organic Acids, urine 48. Orotic Acids, urine 49. Phytanic Acid 50. Pipecolic acid 51. Porphobilinogen, urine 52. Porphyrin, urine 53. 54. Pre-albumin Protein electrophoresis 44. 45. 46. PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 TYPE OF SPECIMEN Dried blood spot SPECIMEN CONTAINER Whatmann 903 Filter paper Biochemistry Unit, IMR Urine, random Biochemistry Unit, IMR Biochemistry Unit, IMR Biochemistry Unit, IMR Biochemistry Unit, IMR Biochemistry Unit, IMR Biochemistry Unit, IMR Biochemistry Unit, IMR Biochemistry Unit, IMR Ampang Molecular and Protein Unit, IMR * Use PER PAT 301 form unless otherwise stated. REFERRAL LAB TURN AROUND TIME 3 working days REMARK* Urine container VOLUME OF SPESIMEN 3 circles of dried blood spots 2 mls 10 working days IEM form First morning urine First morning urine Urine, random Urine container 5 mls 10 working days IEM form Urine container 5 mls 15 working days IEM form Urine container 5 mls 5 working days IEM form Urine, random Urine container 5 mls 5 working days IEM form Blood 4 mls 10 working days IEM form Blood EDTA/Lithium heparin Lithium heparin 4 mls 10 working days IEM form Urine, random Urine container 5 mls 15 working days IEM form Urine, random Urine container 5 mls 15 working days IEM form Blood Blood Urine Plain tube Plain tube Urine container 4 mls 4 mls 24 hour collection preferable 10 working days 30 working days 30 working days IMR/UMDP/01 form IEM form TESTS HOSPITAL 55. Renin Putrajaya 56. Sialic Acid, Total and Free 57. S-Sulphocysteine, urine 58. Succinylacetone, urine 59. Sweat Test Biochemistry Unit, IMR Biochemistry Unit, IMR Biochemistry Unit, IMR HKL 60. Thyroglobulin Diabetes and endocrine unit, IMR 61. Transferrin HKL 62. Transferin Isoform for CDG Type I Molecular and and Type II screening Protein Unit, IMR 63. Transferin Isoform for CDG type II Molecular and confirmatory profiling Protein Unit, IMR 64. Uroporphobilinogen, urine Biochemistry Unit, IMR * Use PER PAT 301 form unless otherwise stated. TYPE OF SPECIMEN Blood SPECIMEN CONTAINER EDTA VOLUME OF SPESIMEN 3 mls REFERRAL LAB TURN AROUND TIME 6 weeks First morning urine Urine, random Urine container 5 mls 15 working days Urine container 5 mls 10 working days IEM form Urine, random Urine container 5 mls 15 working days IEM form Not applicable REMARK* Send sample rapidly to lab but NOT in ice Use different tubes for Renin and aldosterone. Only single form is required for aldosterone & renin. IEM form Need approval from pediatric chest specialist. (call ext 6902, HKL for appointment) Blood Plain tube 3 mls 4-5 weeks Blood Blood Plain tube Plain tube 3 mls 5 mls blood 5 working days 15 working days IMR/UMDP/01 form Blood Plain tube 5 mls blood 20 working days IMR/UMDP/01 form Urine, random Urine container 5 mls 10 working days 15 PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 NO 16 NO TESTS HOSPITAL 65. Very Long Chain Fatty Acid (VLCFA), plasma/serum Vitamin D 5-Hydroxyindol-acetic acid (5HIAA) Biochemistry Unit, IMR Putrajaya Biochemistry, IMR 66. 67. 68. 17-Hydryoxyprogesterone Diabetes and endocrine unit, IMR * Use PER PAT 301 form unless otherwise stated. TYPE OF SPECIMEN Blood Blood Urine, 24 hours Blood SPECIMEN CONTAINER EDTA/Lithium heparin Plain tube 24 hour urine container with 10 mls 25% HCL Plain tube VOLUME OF SPESIMEN 3 mls REFERRAL LAB TURN AROUND TIME 10 working days 3 mls 24 hours collection 6 weeks 10 working days 4 mls 4 to 5 weeks REMARK* PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 SENARAI UJIAN GENETIC/MOLECULAR Notes: NO A) 1. 2. PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 3. 4. 5. 6. B) 16. 17. 18. All specimen for Genetic/Molecular Testing will be send to Unit of Molecular Diagnostics and Protein (UMDP), Specialized Diagnostic Centre, IMR Use Request Form for Molecular Diagnostic Services (IMR/UMDP/o2, version 4.2) Consent from patient or legal guardian is required. Requesting specialist signature is required. All Samples are blood in EDTA tubes or blood spots on Whatman 903 Filter paper unless otherwise stated Volume required is 1-2 x 2.5 mls blood in EDTA tubes or 4 circles of dried blood spots unless otherwise stated. All Laboratory TAT is 30 working days unless otherwise stated DISEASE (TEST NAME) METABOLIC DISORDERS Amino Acids Metabolism Disorders Maple Syrup Urine Disease (BCKDHA, BCKDHB, DBT, DLD gene sequence) Non Ketotic Hyperglycinemia (AMT , GCSH, GLDC gene sequence, GLDC Del/Dup analysis) N-Acetylglutamate Synthase Deficiency (NAGS gene sequence) Urea Cycle Disorder, Carbamoyl Phosphate Synthetase 1 Deficiency (CPS1 gene sequence) *LTAT: 60 days Urea Cycle disorders, Ornithine Transcarbamylase Deficiency (OTC gene sequence, OTC Del/Dup analysis) Urea cycle disorders- Type I Citrullinemia/Argininosuccinate Synthase Deficiency (ASS1 gene sequence) Urea cycle disorder-Arginosuccinic aciduria/Argininosuccinate Lyase Deficiency (ASL gene sequence) Fatty acid metabolism disorders Fatty acid oxidation defects-Carnitine Palmitoyltransferase 1 Deficiency (CPT1A gene sequence) Fatty acid oxidation defects-Carnitine Palmitoyltransferase 2 Deficiency (CPT2 gene sequence) Carnithine-Acylcarnitine Translocase Deficiency (SLC25A20 gene sequence) 7. 8. 9. 10. 11. 12. 13. Lysinuric Protein Intolerance (SLC7A7 gene sequence) Classical Homocysteinuria (CBS gene sequence) Isolated Methylmalonic Acidemia (MMAA, MMAB, MUT gene sequence) Methylmalonic Aciduria and Homocystinuria Type C (MMACHC gene sequence) Methylmalonic Aciduria and Homocystinuria Type D (MMADHC gene sequence) Methylmalonyl-CoA Epimerase Deficiency (MCEE gene sequence) Methylenetetrahydrofolate Reductase Deficiency (MTHFR gene sequence) Glutaric Aciduria Type 1 (GCDH gene sequence) 14. 19. 20. 21. Carnithine Uptake Deficiency (OCTN2 gene sequence) Long-Chain 3-Hydroxyacyl-CoA Dehydrogenase Deficiency (HADHA gene sequence) Short-Chain 3-Hydroxyacyl-CoA Dehydrogenase Deficiency (HADH gene sequence) 17 18 C) 22. 23. D) 26. 27. E) 30. 31. 32. 33. 39. PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 40. 41. 42. Carbohydrate metabolism Classical Galactosemia (GALT gene sequence) Galactokinase Deficiency (GALK1 gene sequence) Purine & Pyrimidine Metabolism Disorders Dihydropyriminidase Deficiency (DPYS gene sequence) Purine Nucleoside Phosphorylase Deficiency (PNP gene sequence) Others Urea cycle disorder-Type II citrullinemia/Citrin Deficiency (SLC25A13 gene sequence) Tyrosine Hydroxylase Deficiency (TH gene sequence) Aromatic Amino Acid Decarboxylase Deficiency (DDC gene sequence) Ethylmalonic Encephalopathy (ETHE1 gene sequence) MITOCHONDRIAL DISORDERS Leigh Syndrome (8993 hotspot/mtATP5 gene sequence*,SURF1 gene sequence, mtDNA full panel) *LTAT 14 days for hotspot Mitochondrial DNA Deletion Syndromes – Pearson Syndrone, KearnSayre Syndrome (KSS)*, Chronic Progressive External Ophthalmopegia (CPEO)* Test for mtDNA genes deletion/ duplication analysis * accepted samples: muscle biopsy in sterile container/ 10-20 mls of early morning urine/1-2 X 2.5mL blood EDTA Leber Hereditary Optic Neuropathy (LHON) Syndrome Test for mtDNA genes sequence (LHON Panel) Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-Like Episodes (MELAS) Syndrome (3243 hotspot/ mt-tRNA Leu sequence, full panel) * accepted samples: muscle biopsy in sterile container/ 20 mls of early morning urine/1-2 X 2.5mL blood EDTA **LTAT for hotspot: 14 working days 24. 25. Fructose-1,6-Bisphosphatase Deficiency (FBP1 gene sequence) Galactosemia Epimerase Deficiency (GALE gene sequence) 28. 29. Lesch-Nyhan Syndrome (HPRT1 gene sequence) Hereditary Orotic Aciduria (UMPS gene sequence) 34. 35. 36. 37. 38. Pompe Disease (GAA gene sequence) Pyruvate Dehydrogenase Deficiency (PDHA1 gene sequence) Alpha-1-antitrypsin Deficiency (SERPINA1 gene sequence) Sulfite Oxidase Deficiency (SUOX gene sequence) X-linked Adrenoleukodystrophy (ABCD1 gene sequence) 43. Myoclonic Epilepsy with Ragged-Red Fibers (MERRF) Syndrome (8344 hotspot/Test for mt-tRNA Lys sequence * accepted samples: muscle biopsy in sterile container/ 20 mls of early morning urine/1-2 X 2.5mL blood EDTA **LTAT : 14 working days Neuropathy, Ataxia and Retinitis Pigmentosa (NARP) Syndrome (8993 hotspot/Test for mtATP6 gene sequence) *LTAT: 14 working days POLG-Related Disorders (POLG gene sequence) Mitochondrial DNA Depletion Syndromes (ANT1, DGUOK, MPV17, POLG, RRM2B ,SUCLA2, SUCLG1, TWINKLE, TYMP gene sequence) Multiple Respiratory Chain Deficiencies (Mitochondrial Translation Defect) (GFM1 gene sequence) Multiple Respiratory Chain Deficiencies (Mitochondrial Translation Defect) (GFM1 gene sequence) Whole mitochondrial DNA (hotspot and Full panel: mtDNA genes sequence & deletion/ duplication) Note: Request only by Clinical Geneticist/Neurologist. 44. 45. 46. 47. 48. 49. 50. 51. 52. 56. 57. 60. 61. 64. 65. 66. 67. 68. 53. 54. 55. 58. 59. 69. 70. 71. 72. 73. 74. 75. 76. 77. 78. Alagilles syndrome (JAG1 gene sequence and deletion&duplication analysis and NOTCH2 gene sequence) Noonan Syndrome (PTPN11 gene sequence) Schinzel Giedion Syndrome (SETBP1 gene sequence) MCT8-Specific Thyroid Hormone Cell Transporter Deficiency (SLC16A2 gene sequence) Lissencephaly (LIS1 gene sequence) Early-onset Primary Dystonia (TOR1A gene sequence) Hypophosphatasia (ALPL gene sequence) Leopard Syndrome (PTPN11 gene sequence) Maroteaux-Lamy Syndrome, MPS VI (ARSB gene sequence) Medium Chain Acyl-CoA Dehydrogenase (ACADM gene sequence) Very Long Chain Acyl-CoA Dehydrogenase (ACADVL gene sequence) Metachromatic Leukodystrophy (MLD)/ Arylsulphatase A (ARSA gene sequence) PTEN-associated Diseases (PTEN gene sequence & deletion / duplication) Severe Congenital Neutropenia (ELANE gene sequence) DNA Extraction and Storage LTAT: 2 working days 19 PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 62. 63. GENETIC SYNDROMES Fragile X Syndrome (FRAXA: Expansion of CGG repeats of FMR1 gene & FRAXE Expansion of GCC repeats of FMR2 gene) Prader-Willi Syndrome (Test for Absence of non-methylated paternal copy of SNRPN exon 1/ promoter regions) Angelman Syndrome (Test for Absence of non-methylated maternal copy of SNRPN exon 1/ promoter regions and UBE3A gene sequence & deletion/duplication analysis) NEUROGENETIC DISORDERS Spinal Muscular Atrophy (SMN gene deletion, copy number & sequence) Primary Dystonia (THAP1 gene sequence) OTHER GENETIC DISORDERS Pseudorheumatoid Dysplasia (WISP3 gene sequence) Berardinelli Congenital Lipodystrophy (AGPAT2, BSCL2 gene sequence) Retinoblastoma (RB1 gene sequence & deletion/duplication) X-Chromosome Inactivation (Androgen receptor Exon 1 fragment analysis) Acute intermittent porpohyria (HMBS gene sequence & deletion/duplication) Alexander disease (GFAP gene sequence) Biotinidase Deficiency (BTD gene sequence) CADASIL (NOTCH3 Hotspot and Full gene Sequencing*) LTAT for full gene sequencing: 45 days Congenital Disorder of Glycosylation (CDG) Genotyping/ Phosphomannomutase 2 Deficiency (PMM2 gene sequence) 20 SENARAI UJIAN RESEARCH BASED DI UNIT BIOKIMIA, IMR. (TEMUJANJI DIPERLUKAN) NO TESTS 1. 2. 3. 4. Alpha-aminoadipic semialdehyde Alpha-fucosidase Alpha-galactosidase Alpha-hexosaminidase (Alpha-N-acetyl glucosaminidase) Alpha-iduronidase Alpha-mannosidase, leucocytes Alpha-mannosidase, plasma Aryl sulphatase A Arylsulphatase B (N-acetylgalactosamine 4sulfatase) Aspartyl-glucosaminidase Beta Hexosaminidase A Beta Hexosaminidase A + B Beta-galactosidase Beta-glucosidase Beta-glucuronidase Beta-mannosidase A+B (TOTAL) Biogenic amines (5-HIAA, HVA, VMA) Biogenic amines (5-HIAA, HVA, VMA, 3 MD) Carnitine, urine Creatine Galactocerebrosidase Galactose-1-phosphate Galactose-6-sulphatase Glycogen branching enzyme Iduronate-2-sulphatase N-acetylglucosamine-6-sulphatase Palmitoyl-protein thioesterase Pterins, urine Sugar & Polyols, urine Sulphamidase 5. 6. 7. 8. 9. PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. TYPE OF SPECIMEN Urine Whole blood Whole blood Whole blood SPECIMEN CONTAINER VOLUME OF SPESIMEN Urine container EDTA EDTA EDTA 2 mls 2 x 2.5 mls blood in EDTA tubes 2 x 2.5 mls blood in EDTA tubes 2 x 2.5 mls blood in EDTA tubes REFERRAL LAB TURN AROUND TIME 15 working days 15 working days 15 working days 15 working days Whole blood Whole blood Whole blood Whole blood Whole blood EDTA EDTA EDTA EDTA EDTA 2 x 2.5 mls blood in EDTA tubes 2 x 2.5 mls blood in EDTA tubes 2 x 2.5 mls blood in EDTA tubes 2 x 2.5 mls blood in EDTA tubes 2 x 2.5 mls blood in EDTA tubes 15 working days 15 working days 15 working days 15 working days 15 working days Whole blood Whole blood Whole blood Whole blood Whole blood Whole blood Whole blood Urine CSF 24 hour urine Urine, random Whole blood Whole blood Whole blood Whole blood Whole blood Whole blood Whole blood Urine, random Urine, random Whole blood EDTA EDTA EDTA 2 x 2.5 mls blood in EDTA tubes 2 x 2.5 mls blood in EDTA tubes 2 x 2.5 mls blood in EDTA tubes 2 x 2.5 mls blood in EDTA tubes 2 x 2.5 mls blood in EDTA tubes 2 x 2.5 mls blood in EDTA tubes 2 x 2.5 mls blood in EDTA tubes 2mls 2mls 24 hours urine collection 2 mls 2 x 2.5 mls blood in EDTA tubes 2 x 2.5 mls blood in EDTA tubes 2 x 2.5 mls blood in EDTA tubes 2 x 2.5 mls blood in EDTA tubes 2 x 2.5 mls blood in EDTA tubes 2 x 2.5 mls blood in EDTA tubes 2 x 2.5 mls blood in EDTA tubes 5 mls 5 mls 2 x 2.5 mls blood in EDTA tubes 15 working days 15 working days 15 working days 15 working days 15 working days 15 working days 15 working days 15 working days 15 working days 10 working days 15 working days 15 working days 10 working days 15 working days 15 working days 15 working days 15 working days 15 working days 15 working days 16 working days 15 working days EDTA EDTA EDTA Urine container Special container from IMR 24 hour urine container Urine container EDTA EDTA EDTA EDTA EDTA EDTA EDTA Urine container Urine container EDTA SENARAI UJIAN DI JABATAN KIMIA NO TESTS* (includes but not limited to) REFERRAL LAB TURN AROUND TIME 1. 2. 3. 4. 5. 6. Alcohol (ethanol) Insecticide (organophosphate) Drugs (Barbiturates, cocaine) Corrosive agents Gas Heavy metals (Aluminium, arsenic, bromide, cadmium, chromium, lead, nikel, mercury, selenium, zinc) Solvents Others 1 – 2 Months 7. 8. TYPES OF SPECIMEN/CONTAINER/ SPECIMEN VOLUME Blood, urine, gastric content, gastric lavage content, vomitus, others. REMARK Please consult officer in charge (toxicology unit), before sending samples. Jabatan Kimia Malaysia, Cawangan Johor: 07-222 6366/07-222 6569 21 PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 22 LAMPIRAN-LAMPIRAN PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 23 LAMPIRAN 1: SENARAI UJIAN STAT SENARAI UJIAN STAT DI MAKMAL PATOLOGI KIMIA, HSA BIL 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 UJIAN LTAT Arterial Blood Gas Ammonia Amylase Bilirubin Calcium Chloride Creatinine CSF chemistry Glucose Lactate Magnesium Paraquat (urine) Phosphate Potassium Renal Function test Sodium Troponin T Urea LFT* (untuk kes-kes acute liver failure, preeclampsia dan severe dengue sahaja) 30 minit 1 jam 1 jam 1 jam 1 jam 1 jam 1 jam 1 jam 1 jam 1 jam 1 jam 1 jam 1 jam 1 jam 1 jam 1 jam 1 jam 1 jam 1 jam NOTA: 1. Ujian-ujian lain yang diperlukan STAT hendaklah dipohon melalui pegawai perubatan/pakar patologi Kimia yang bertugas. 2. Sekiranya ujian STAT dipohon bersama dengan ujian-ujian lain (yang tiada dalam senarai STAT) dalam satu spesimen atau ujian STAT dihantar secara batch, ujian tersebut akan dijalankan secepat mungkin tetapi LTAT STAT mungkin tidak terjamin. PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 24 LAMPIRAN 2: JADUAL PENGHANTARAN SPESIMEN KE MAKMAL RUJUKAN 1) Jadual penghantaran spesimen ke makmal rujukan. MAKMAL RUJUKAN HARI PENGHANTARAN Hospital Kuala Lumpur Isnin & Rabu Institute of Medical Research Isnin & Rabu Hospital Ampang Isnin & Rabu Hospital Putrajaya Rabu Jabatan Kimia Malaysia, cawangan Johor Khamis Permai Mengikut permintaan *Spesimen yang diterima selepas pukul 10 pagi pada hari penghantaran akan dihantar pada hari penghantaran yang berikutnya 2) Semua permohonan hendaklah disertakan dengan borang PER.PAT 301, kecuali dinyatakan sebaliknya. 3) Semua ujian yang di rujuk ke makmal di luar HSA dianggap ujian khas dan perlu tandatangan pakar yang memohon dan sejarah pesakit yang lengkap. Borang yang tidak lengkap akan ditolak. PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 25 LAMPIRAN 3: PANDUAN BEKAS SPESIMEN TUBES COLOUR Lithium heparin Green Plain tube Red TUBES COLOUR Urine container 24 hour urine container Gold K2-EDTA Lavender Fluoride Oxalate Grey Heparinized syringe Bijou bottle Whatman 903 filter paper Syringe must be labeled. Unlabeled syringe will be rejected. PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 26 LAMPIRAN 4: RECOMMENDED ORDER OF DRAW FOR MULTIPLE TUBE COLLECTIONS ORDER OF DRAW CLOSURE COLOR COLLECTION TUBE MIXED BY INVERTING Blood culture 8 to 10 times Citrate tube 3 to 4 times Serum tube (with or without gel) 5 times Heparin Tube 8 to 10 times EDTA 8 to 10 times Fluoride 8 to 10 times FIRST Or LAST PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 27 LAMPIRAN 5: PANDUAN UJIAN RENIN DAN ALDOSTERONE PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 28 PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 29 Whatman 903 filter paper. PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 30 PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 31 PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 32 LAMPIRAN 6: BORANG-BORANG BORANG PER. PAT 301 PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 33 REQUEST FORM FOR MULTIPLE MYELOMA AND SPECIFIC PROTEIN (IMR/UMDP/01) PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 34 REQUEST FORM FOR MOLECULAR DIAGNOSTIC SERVICES (IMR/UMDP/02) (PAGE 1 OF 3) PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 35 REQUEST FORM FOR MOLECULAR DIAGNOSTIC SERVICES (PAGE 2 OF 3) PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 36 REQUEST FORM FOR MOLECULAR DIAGNOSTIC SERVICES (PAGE 3 OF 3) PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 37 IEM REQUEST FORM (PAGE 1 OF 2) PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 38 IEM REQUEST FORM (PAGE 2 OF 2) PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 39 BORANG UJIAN DADAH (UPD 1 PINDAAN) PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 40 BORANG PERMOHONAN BAGI PEMERIKSAAN FORENSIK/TOKSIKOLOGI - JABATAN KIMIA (PAGE 1 OF 3) PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 41 BORANG PERMOHONAN BAGI PEMERIKSAAN FORENSIK/TOKSIKOLOGI - JABATAN KIMIA (PAGE 2 OF 3) PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 42 BORANG PERMOHONAN BAGI PEMERIKSAAN FORENSIK/TOKSIKOLOGI - JABATAN KIMIA (PAGE 3 OF 3) PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015 NOTA PANDUAN PERKHIDMATAN PATOLOGI KIMIA, HSA, VERSI 1, 2015