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Fischbach's Manual of Laboratory and Diagnostic Tests
Subclassification of Anion Gap Metabolic Acidosis (Hypobicarbonatemia)
Table of Contents
Free Topics
1.1. Goals of Test Selection with Examples
1.3. Factors That Increase a Patient's Risk for Complications and May Affect Test Outcomes
1.3. Sample Test Results
1.7. Blood Specimen Collection Tube Colors
1.9. Behavioral Responses
2.1. Normal Values for Bone Marrow
2.9. Laboratory Tests to Measure Hemostasis
3.1. Urinalysis Chemstrip Screen
3.1. Urine Testing by Dipstick/Reagent Strip
3.5. Comparison of Urine Urobilinogen and Urine Bilirubin Values
3.7. Interpreting Urine Laboratory Findings
4.2. Normal Values in Stool Analysis
Acknowledgments
Alanine Aminotransferase (Aminotransferase, ALT)
Antidiuretic Hormone (ADH); Arginine Vasopressin Hormone
Arterial Puncture
Basic Blood Test
Bibliography
Blood Tests
Blood Urea Nitrogen (BUN, Urea Nitrogen)
Chapter Content and Features
Chorionic Gonadotropin
Collection and Transport of Random Specimens
Conclusion
Contributors, Consultants, and Research Assistants
Cortisone Stimulation (Cosyntropin, Cortrosyn Stimulation)
CSF Color and Appearance
CSF Lactic Acid, L-Lactate
Current Developments in Laboratory and Diagnostic Testing
Description, Formation, and Composition of CSF
Differential White Blood Cell Count (Diff)
D-Xylose Absorption (Timed Urine and Blood)
Equipment and Supplies
Erythropoietic Porphyrins; Free Erythrocyte Protoporphyrin (FEP)
Expected and Unexpected Outcomes
Fetal Hemoglobin (Hemoglobin F; Alkali-Resistant Hemoglobin)
Fibrin Split Products (FSPs); Fibrin Degradation Products (FDPs)
Folic Acid (Folate)
Integration
Intratest Phase: Elements of Safe, Effective, Informed Care
Iron Tests
Mean Corpuscular Volume (MCV)
Monitoring for Complications and Sedation Effects
Myoglobin (Mb)
Organization
Overview of Basic Blood, Hematology, and Coagulation Tests
Overview of Laboratory and Diagnostic Testing
Patient Independence
Plasminogen (Plasmin; Fibrinolysin)
Platelet Aggregation
Positioning for Procedures
Posttest Phase: Elements of Safe, Effective, Informed Care
Preface
Pretest Phase: Elements of Safe, Effective, Informed Care
Purpose
Red Blood Cell (RBC) Count (Erythrocyte Count)
Reimbursement for Diagnostic Services
Related Tests That Influence Glucose Metabolism
Reviewers
Revisions and Additions to the Tenth Edition
Sedimentation Rate (Sed Rate); Erythrocyte Sedimentation Rate (ESR)
Standards and Guidelines
Stool Color
Stool Electrolytes: Sodium, Chloride, Potassium, and Osmolality
Stool Studies
Testing Protocols
Tests of Hemostasis and Coagulation
Types of Urine Specimens
Uric Acid
Urine ß (2)-Microglobulin
Urine Color
Urine Hyaline Casts
Urine Leukocyte Esterase
Urine Potassium (K), Quantitative (24-Hour) and Random
Urine Pregnanetriol (24-Hour)
Urine Protein (Albumin), Qualitative and 24-Hour
Urine White Blood Cells and White Blood Cell Casts
1: Diagnostic Testing
1: Diagnostic Testing
Chart(s)
1.1. Grading Guidelines for Scientific Evidence
1.2. Tests Covered by Most Insurance Carriers
1.3. Factors That Increase a Patient's Risk for Complications and May Affect Test Outcomes
1.4. Items Containing Latex
1.5. Examples of Sedatives and Analgesic Drugs Used
1.6. Agents and Toxins Reportable to the APHIS or CDC
1.7. Diseases and Conditions Reportable by Laboratory Directors and Healthcare Providers
Diagnostic Testing and the Healthcare Delivery System
Diagnostic Testing and the Healthcare Delivery System
Reimbursement for Diagnostic Services
Testing Environments
The Healthcare Provider’s Role in Laboratory and Diagnostic Testing
Elements of Safe, Effective, Informed Care throughout the Testing Process
Avoidance of Errors
Communication
Cultural Sensitivity
Elements of Safe, Effective, Informed Care throughout the Testing Process
Ethics and the Law
Patient Independence
Patient's Bill of Rights and Patient Responsibilities
Testing Protocols
Figure(s)
1.1. A Model for the Role of the Clinical Team in Diagnostic Care and Services
Intratest Phase: Elements of Safe, Effective, Informed Care
Administration of Drugs and Solutions
Basic Knowledge and Necessary Skills-Intratest Phase: Elements of Safe, Effective, Informed Care
Collaborative Approaches
Equipment and Supplies
Infection Prevention
Intratest Phase: Elements of Safe, Effective, Informed Care
Latex Sensitivity and Allergy
Management of Environment
Pain Control, Comfort Measures, and Patient Monitoring
Positioning for Procedures
Presence of Family or Significant Others
Risk Management
Sedation and Analgesia
Specimens and Procedures
Overview of Laboratory and Diagnostic Testing
Clinical Value of a Test
Overview of Laboratory and Diagnostic Testing
Standards and Guidelines
Test Results
Test Selection and Evidence-Based Guidelines
The Diagnostic Testing Model
Posttest Phase: Elements of Safe, Effective, Informed Care
Abnormal Test Results
Basic Knowledge and Necessary Skills-Posttest Phase: Elements of Safe, Effective, Informed Care
Bibliography
Biosafety
Conclusion
Documentation, Record Keeping, and Reporting
Expected and Unexpected Outcomes
Follow-Up Care
Follow-Up Counseling
Guidelines for Disclosure
Integration
Laboratory Response Network
Monitoring for Complications and Sedation Effects
Patient Responses to Diagnosis
Posttest Phase: Elements of Safe, Effective, Informed Care
Recovered Medical Errors
Referral and Treatment
Test Result Availability
Pretest Phase: Elements of Safe, Effective, Informed Care
Basic Knowledge and Necessary Skills
History and Assessment
Methodology of Testing
Patient Education
Patient Preparation
Pretest Phase: Elements of Safe, Effective, Informed Care
Table(s)
1.1. Goals of Test Selection with Examples
1.10. Test Outcomes
1.2. Standards for Diagnostic Evaluation
1.3. Sample Test Results
1.4. Examples of Conversions to Systeme International (SI) Units
1.5. Classification of Risk Factors for a Higher Incidence of Adverse Reactions
1.6. Errors in Collection
1.7. Blood Specimen Collection Tube Colors
1.8. Biocultural Considerations
1.9. Behavioral Responses
2: Blood Studies: Hematology and Coagulation
2: Blood Studies: Hematology and Coagulation
Basic Blood Test
Basic Blood Test
Complete Blood Count (CBC)/Hemogram
Blood Specimen Collection Procedures
Arterial Puncture
Blood Specimen Collection Procedures
Bone Marrow Aspiration
Capillary Puncture (Skin Puncture)
Venipuncture
Chart(s)
2.1. Anemias Characterized by Deficient Hemoglobin Synthesis
Figure(s)
2.1. Evacuated Tubes
2.2. In vivo, the Clotting Process Follows Two Pathways: Blood Coagulation Cascade and Platelet Activation
2.3. Intrinsic, Extrinsic, and Common Pathways of Coagulation
2.4. Stage Four Activation of the Fibrinolytic System
Iron Tests
Ferritin
Iron (Fe), Total Iron-Binding Capacity (TIBC), and Transferrin Tests
Iron Stain (Stainable Iron in Bone Marrow; Prussian Blue Stain)
Iron Tests
Overview of Basic Blood, Hematology, and Coagulation Tests
Blood Tests
Composition of Blood
Overview of Basic Blood, Hematology, and Coagulation Tests
Stains for Leukemias
Leukocyte Alkaline Phosphatase (LAP) Stain
Periodic Acid-schiff (PAS) Stain
Stains for Leukemias
Sudan Black B (SBB) Stain
Tartrate-Resistant Acid Phosphatase (TRAP) Stain
Terminal Deoxynucleotidyl Transferase (TDT) Stain
Table(s)
2.1. Normal Values for Bone Marrow
2.10. Therapeutic Context
2.2. Normal Values for Hemogram
2.3. Leukocyte Abnormalities and Diseases
2.4. Normal Values for Red Blood Cells
2.5. Peripheral Red Blood Cell Abnormalities
2.6. Ferritin, Iron, and Iron Saturation Changes in Anemias
2.7. The Complex Chain of Coagulation Reactions
2.8. Proteins Involved in Blood Coagulation
2.9. Laboratory Tests to Measure Hemostasis
Tests for Anemia
Erythropoietin (Ep)
Folic Acid (Folate)
Tests for Anemia
Vitamin B (12) (VB(12))
Tests for Hemoglobin Disorders
Bart's Hemoglobin
Carboxyhemoglobin; Carbon Monoxide (CO)
Fetal Hemoglobin (Hemoglobin F; Alkali-Resistant Hemoglobin)
Haptoglobin (Hp)
Hemoglobin A (2) (HbA(2))
Hemoglobin Electrophoresis
Hemoglobin S (Sickle Cell Test; Sickledex)
Methemoglobin (Hemoglobin M)
Myoglobin (Mb)
Paroxysmal Nocturnal Hemoglobinuria (PNH) Test
Sulfhemoglobin
Tests for Hemoglobin Disorders
Tests for Hemolytic Anemia
2,3-Diphosphoglycerate (2,3-DPG)
Erythrocyte Fragility (Osmotic Fragility and Autohemolysis)
Glucose-6-Phosphate Dehydrogenase (G6PD)
Heinz Bodies; Heinz Stain; Glutathione Instability
Pyruvate Kinase (PK)
Tests for Hemolytic Anemia
Tests for Porphyria
Erythropoietic Porphyrins; Free Erythrocyte Protoporphyrin (FEP)
Porphyrins; Fractionation of Erythrocytes and of Plasma
Tests for Porphyria
Tests for Red Blood Cells
Hematocrit (Hct); Packed Cell Volume (PCV)
Hemoglobin (Hb)
Mean Corpuscular Hemoglobin (MCH)
Mean Corpuscular Hemoglobin Concentration (MCHC)
Mean Corpuscular Volume (MCV)
Red Blood Cell (RBC) Count (Erythrocyte Count)
Red Blood Cell Indices
Red Cell Size Distribution Width (RDW)
Reticulocyte Count
Sedimentation Rate (Sed Rate); Erythrocyte Sedimentation Rate (ESR)
Stained Red Cell Examination (Film; Stained Erythrocyte Examination)
Tests for Red Blood Cells
Tests of Hemostasis and Coagulation
Activated Clotting Time (ACT)
Antithrombin III (AT-III; Heparin Cofactor Activity)
Bibliography
Bleeding Time (Ivy Method; Template Bleeding Time)
Coagulant Factors (Factor Assay)
D-Dimer
Disorders of Hemostasis
Fibrin Monomers (Protamine Sulfate Test; Fibrin Split Products)
Fibrin Split Products (FSPs); Fibrin Degradation Products (FDPs)
Fibrinogen
Fibrinolysis (Euglobulin Lysis Time; Diluted Whole Blood Clot Lysis)
Fibrinopeptide A (FPA)
Hypercoagulability States
Partial Thromboplastin Time (PTT)
Plasminogen (Plasmin; Fibrinolysin)
Platelet Aggregation
Platelet Count; Mean Platelet Volume (MPV)
Protein C (Pc Antigen)
Protein S
Prothrombin Fragment (F1 + 2)
Prothrombin Time (Pro Time; PT)
Tests for Disseminated Intravascular Coagulation (DIC)
Tests of Hemostasis and Coagulation
Thrombin Time (TT); Thrombin Clotting Time (TCT)
Tests of White Blood Cells
Basophils
Differential White Blood Cell Count (Diff)
Eosinophils
Lymphocyte Immunophenotyping (T and B Cells)
Lymphocytes (Monomorphonuclear Lymphocytes)
Monocytes (Monomorphonuclear Monocytes)
Segmented Neutrophils (Polymorphonuclear Neutrophils, PMNs, Segs, Polys)
Tests of White Blood Cells
White Blood Cell (WBC) Count (Leukocyte Count)
3: Urine Studies
3: Urine Studies
Chart(s)
3.1. Overview of the Urinary System and Related Tests
Collection of Urine Specimens
Collection of Urine Specimens
Long-Term, Timed Urine Specimen (2-Hour, 24-Hour)
Single, Random Urine Specimen
Figure(s)
3.1. Urinalysis Chemstrip Screen
3.2. Sample Reports of Routine Urinalysis (A) and Culture Sensitivity (B)
Microscopic Examination of Urine Sediment
Microscopic Examination of Urine Sediment
Procedure for Microscopic Urine Examination
Urine Crystals-Microscopic Examination of Urine Sediment-Urine Studies
Urine Epithelial Cells and Epithelial Casts
Urine Granular Casts
Urine Hyaline Casts
Urine Red Blood Cells and Red Blood Cell Casts
Urine Waxy Casts or Broad Casts (Renal Failure Casts) and Fatty Casts
Urine White Blood Cells and White Blood Cell Casts
Overview of Urine Studies
Overview of Urine Studies
Types of Urine Specimens
Urine Constituents
Urine Formation
Routine Urinalysis (UA) and Related Tests
Microalbuminuria/Albumin (24-Hour Urine)
Routine Urinalysis (UA) and Related Tests
Urine à (2)-Microglobulin
Urine Appearance
Urine Bilirubin
Urine Blood or Hemoglobin (Hb)
Urine Color
Urine Glucose (Sugar)
Urine Ketones (Acetone; Ketone Bodies)
Urine Leukocyte Esterase
Urine Nitrite (Bacteria)
Urine Odor
Urine Osmolality
Urine pH
Urine Protein (Albumin), Qualitative and 24-Hour
Urine Specific Gravity (SG)
Urine Urobilinogen, Random and Timed
Urine Volume
Table(s)
3.1. Urine Testing by Dipstick/Reagent Strip
3.10. Specimen Values
3.11. Mean Creatinine Clearance (mL/min/1.73 m2)
3.12. Aminoacidurias
3.13. Absence of Amino Acids
3.2. Collection of Urine by Type of Specimen
3.3. 24-Hour Collection: Standards for Timed Urine Specimen Collection
3.4. Normal Values in Urinalysis
3.5. Comparison of Urine Urobilinogen and Urine Bilirubin Values
3.6. Microscopic Examination of Urine Sediment
3.7. Interpreting Urine Laboratory Findings
3.8. Common Correlations in Urinalysis
3.9. Urine Crystals
Timed Urine Tests
Bibliography
D-Xylose Absorption (Timed Urine and Blood)
Phenylketonuria (PKU); Urine Phenylalanine (Random Urine and Blood)
Timed Urine Tests
Urine 5-Hydroxyindoleacetic Acid (5-HIAA) (24-Hour)
Urine Amino Acids, Total and Fractions (Random, 24-Hour Urine, and Blood)
Urine Amylase Excretion and Clearance (Random, Timed Urine, and Blood)
Urine Calcium (Ca), Quantitative (24-Hour)
Urine Chloride (Cl), Quantitative (24-Hour)
Urine Creatinine
Urine Cystine (Random and 24-Hour)
Urine Hydroxyproline (Timed Urine and Blood)
Urine Lysozyme (Random, 24-Hour Urine, and Blood)
Urine Magnesium (Mg), Quantitative (24-Hour)
Urine Oxalate, Quantitative (24-Hour)
Urine Porphyrins and Porphobilinogens (24-Hour and Random)
Urine Potassium (K), Quantitative (24-Hour) and Random
Urine Pregnanediol (24-Hour)
Urine Pregnanetriol (24-Hour)
Urine Sodium (Na), Quantitative (24-Hour)
Urine Uric Acid, Quantitative (24-Hour)
Urine Vanillylmandelic Acid (VMA); Catecholamines (24-Hour)
Urine Chemistry
Urine Chemistry
Urine Estrogen, Total and Fractions (Estradiol [E (2)] and Estriol [E(3)]), 24-Hour Urine, and Total Estrogen-Blood
Urine Pregnancy Test; Human Chorionic Gonadotropin (hCG) Test
Urine Testing
Dipstick Testing
Laboratory Testing for Routine Urinalysis
Urine Testing
4: Stool Studies
4: Stool Studies
Overview of Stool Studies
Stool Analysis
Stool Specimen Collection and Transport Procedures
Collection and Transport of 24-, 48-, 72-, and 96-Hour Stool Specimens
Collection and Transport of Random Specimens
Collection and Transport of Specimens for Enteric Pathogens
Collection and Transport of Specimens for Ova and Parasites
Collection and Transport Procedures for All Types of Stool Collection
Stool Specimen Collection and Transport Procedures
Stool Studies
Apt Test for Swallowed Blood
Bibliography
Blood in Stool; Occult Blood
Fat in Stool; Fecal Fat Stain
Leukocytes in Stool
Mucus in Stool
Stool Color
Stool Consistency, Shape, Form, Amount, and Odor
Stool Electrolytes: Sodium, Chloride, Potassium, and Osmolality
Stool pH
Stool Reducing Substances Test
Stool Studies
Trypsin in Stool: Fecal Chymotrypsin
Urobilinogen in Stool
Table(s)
4.1. Stool Testing for Infections
4.2. Normal Values in Stool Analysis
5: Cerebrospinal Fluid Studies
5: Cerebrospinal Fluid Studies
Cerebrospinal Fluid Collection Procedure
Cerebrospinal Fluid Collection Procedure
Lumbar Puncture (Spinal Tap)
Cerebrospinal Fluid Tests
Bibliography
Cerebrospinal Fluid Tests
CSF Albumin and Immunoglobulin G (IgG)
CSF Color and Appearance
CSF Glucose
CSF Glutamine
CSF Lactate Dehydrogenase (Ld/LDH)
CSF Lactic Acid, L-Lactate
CSF Microscopic Examination of Cells
CSF Pressure
CSF Protein Electrophoresis
CSF Total Protein
Figure(s)
5.1. Cerebrospinal Fluid Analysis Report
5.2. Spinal Tap Technique
5.3. Cerebrospinal Fluid Report-Patient with Multiple Sclerosis
Overview of Cerebrospinal Fluid (CSF)
Description, Formation, and Composition of CSF
Explanation of Tests
Overview of Cerebrospinal Fluid (CSF)
Table(s)
5.1. Normal CSF Values
5.2. Tumor Markers in CSF
5.3. Color Changes in CSF Suggestive of Disease States
5.4. Differentiation of Bloody CSF Caused by Subarachnoid Hemorrhage versus Traumatic Lumbar Puncture
5.5. Cell Counts
5.6. Major Cells Seen in Microscopic Examination of CSF
5.7. Abnormal CSF Findings in Types of Meningitis
6: Chemistry Studies
6: Chemistry Studies
Chart(s)
6.1. Heart Failure
6.2. Grading Heart Diseases
6.3. Homocysteine Testing
6.4. Recommendations by the American Heart Association to Lower the Risk for Cardiovascular Disease in Women
6.5. Example of Lipid Test Outcomes, Interpretation, and Intervention
Diabetes Testing, Blood Glucose, Blood Sugar, and Related Tests
Diabetes Testing, Blood Glucose, Blood Sugar, and Related Tests
Fasting Blood Glucose (FBG)
Gestational Diabetes Mellitus (GDM)
Glucose Tolerance Test (GTT); Oral Glucose Tolerance Test (OGTT)
Hemoglobin A (1c) (HbA(1c))
Lactose Tolerance; Breath Hydrogen Test
End Products of Metabolism and Other Tests
Albumin
Ammonia (NH (3))
Bilirubin
Blood Urea Nitrogen (BUN, Urea Nitrogen)
Cholinesterase, Serum (Pseudocholinesterase)
Creatinine and Estimated Glomerular Filtration Rate
Cystatin C
End Products of Metabolism and Other Tests
Lead (Pb)
Neonatal Bilirubin, Total and Fractionated ("baby Bili")
Osteocalcin (Bone G1a Protein)
Prealbumin (PAB)
Uric Acid
Enzyme Tests
α (1)-Antitrypsin (AAT)
Acid Phosphatase; Prostatic Acid Phosphatase (PAP)
Alanine Aminotransferase (Aminotransferase, ALT)
Alkaline Phosphatase (ALP), Total; 5'-Nucleotidase
Alkaline Phosphatase Isoenzymes (ISO)
Amylase and Lipase
Angiotensin-Converting Enzyme (ACE)
Aspartate Transaminase (Aminotransferase, AST)
Cardiac Troponin T (cTnT); Troponin I (cTnI)
Creatine Phosphokinase (CPK)
Enzyme Tests
Galactose-1-Phosphate Uridyltransferase (GPT)
gamma-Glutamyltransferase (gamma-Glutamyl Transpeptidase, GGT, gammaGT)
Homocysteine (tHcy)
Lactate Dehydrogenase (Ld, LDH)
Lactate Dehydrogenase (LDH, Ld) Isoenzymes (Electrophoresis)
Prostate-Specific Antigen (PSA)
Renin (Angiotensin); Plasma Renin Angiotensin (PRA)
Renin Stimulation/Challenge Test
Tryptase
Fertility Tests
Chorionic Gonadotropin
Fertility Tests
Follicle-Stimulating Hormone (FSH); Luteinizing Hormone (LH)
Progesterone
Prolactin (hPRL)
Testosterone, Total and Free
Figure(s)
6.1. Portable Blood Glucose Analyzer
6.2. Nomogram for Designation of Risk
6.3. Relationship of Brain Natriuretic Peptide (BNP) to Heart Disease
6.4. Example of Laboratory Test Results (54-Year-Old Female, Annual Physical Examination)
Hormone Tests
Aldosterone
Androstenedione
Antidiuretic Hormone (ADH); Arginine Vasopressin Hormone
Brain Natriuretic Peptide (BNP) and NT-proBNP
Cortisol (Hydrocortisone)
Cortisol Suppression (Dexamethasone Suppression Test; DST)
Cortisone Stimulation (Cosyntropin, Cortrosyn Stimulation)
Gastrin
Hormone Tests
Human Growth Hormone (hGH); Somatotropin
Parathyroid Hormone Assay
Somatomedin C (Sm-C); Insulin-Like Growth Hormone
Lipoprotein Tests/Lipoprotein Profiles
Apolipoprotein A and B (Apo A-I, Apo B)
Cholesterol (C)
Free Fatty Acids; Fatty Acid Profile
High-Density Lipoprotein Cholesterol (HDL-C)
Lipoprotein Electrophoresis
Lipoprotein Tests/Lipoprotein Profiles
Triglycerides
Very-Low-Density Lipoprotein (VLDL); Low-Density Lipoprotein (LDL)
Overview of Chemistry Studies
General Biochemical Profiles
Overview of Chemistry Studies
Use of the Autoanalyzer
Related Tests That Influence Glucose Metabolism
C-Peptide
Glucagon
Insulin
Related Tests That Influence Glucose Metabolism
Table(s)
6.1. Common Screening Profiles
6.10. Suggested Age-Specific Prostate-Specific Antigen (PSA) Reference Ranges
6.11. Cardiac Markers
6.12. Abnormal Lactate Dehydrogenase Isoenzyme Patterns
6.13. Stages of Treatment for High Lactate Dehydrogenase Levels
6.14. LDL-C/HDL-C Ratio
6.15. Values for Triglycerides
6.16. Application of Equation to Determine Thyroxine Uptake
6.17. Implications of Conditions for T3 (T3 U) Testing
6.2. Standard Panels
6.3. Glucose Tolerance Test Levels
6.4. Total Bilirubin Comparison
6.5. Indications for Exchange Transfusion
6.6. Centers for Disease Control and Prevention Classifications of Blood Lead Levels
6.7. Effects of Increased Blood Lead Levels on Children
6.8. Values for Somatomedin C
6.9. Values for Luteinizing and Follicle-Stimulating Hormones
Thyroid Function Tests
Bibliography
Calcitonin
Free Thyroxine (FT (4))
Free Thyroxine Index (FTI, T (7))
Free Triiodothyronine (FT (3))
Neonatal Thyroid-Stimulating Hormone (TSH)
Neonatal Thyroxine (T (4)); Neonatal Screen for Hypothyroidism
Patient Care for Thyroid Testing
Thyroglobulin (Tg)
Thyroid Function Tests
Thyroid-Stimulating Hormone (TSH; Thyrotropin)
Thyroxine (T (4)), Total
Thyroxine-Binding Globulin (TBG)
Triiodothyronine (T (3)), Total
Triiodothyronine Uptake (T (3) U)
7: Microbiologic Studies
7: Microbiologic Studies
Bioterrorism and Emergency Response: Infectious Agents
Bibliography
Bioterrorism and Emergency Response: Infectious Agents
Diagnosis of Anthrax Infection
Diagnosis of Botulism Infection
Diagnosis of Hemorrhagic Fever, Hantavirus, Ebola Virus, Marburg Virus, and Yellow Fever Infection
Diagnosis of Plague, Bubonic Plague, Pneumonic Plague, and Primary Septicemic Plague Infection
Diagnosis of Smallpox Infection
Diagnosis of Tularemia Infection
Blood, Urine, Eye, and Ear Cultures
Blood Cultures
Blood, Urine, Eye, and Ear Cultures
Eye and Ear Cultures
Urine Cultures
Chart(s)
7.1. Some Common Pathogens Detectable in Body Tissues and Fluids by Diagnostic Methods
7.2. Classification of the Tuberculin Skin Test Reaction
7.3. Viral Infections in Infants, Children, and Adults
7.4. Collecting Specimens for Inhalation and Cutaneous Anthrax
Collection and Transport of Specimens
Collection and Transport of Specimens
Collection Procedures
General Principles
Transport of Specimens by Mail
Diagnosis of Microbial Disease
Diagnosis of Bacterial Disease
Diagnosis of Foodborne Illness (Food Poisoning)
Diagnosis of Fungal Disease
Diagnosis of Highly Pathogenic Asian Avian Influenza A (H5N1) ("bird Flu")
Diagnosis of Human Monkeypox Virus
Diagnosis of Microbial Disease
Diagnosis of Mycobacterial Infections
Diagnosis of Mycobacterium Tuberculosis
Diagnosis of Parasitic Disease
Diagnosis of Rickettsial Disease
Diagnosis of Severe Acute Respiratory Syndrome (SARS)
Diagnosis of Sexually Transmitted Infections (STIs)
Diagnosis of Spirochetal Disease
Diagnosis of Viral and Mycoplasmal Infection
Diagnosis of West Nile Virus (WNV), West Nile Fever, and West Nile Encephalitis
Studies of the Susceptibility of Bacteria to Antimicrobial Agents
Diagnostic Testing Procedures
Cultures
Diagnostic Testing Procedures
Serologic Testing
Skin Testing
The Smear and Stain
Tissue Biopsy
Figure(s)
7.1. Method for Obtaining the Rectal Culture
7.2. Method for Obtaining the Endocervical Specimen
7.3. Method for Obtaining the Urethral Specimen
7.4. Disk Diffusion Method for Evaluation of Antibiotic Susceptibility
7.5. Broth Dilution Method for Determining the Minimal Inhibitory Concentration Necessary to Fight Infection
7.6. Class II, Type A2 Biological Safety Cabinet
Other Cultures and Smears
Cerebrospinal Fluid (CSF) Cultures and Smears
Cervical, Urethral, Anal, and Oropharyngeal Cultures and Smears for Gonorrhea and Other Sexually Transmitted Infections (STIs)
Other Cultures and Smears
Skin Cultures
Stool and Anal Cultures and Smears
Tissue, Bone, and Body Fluid Cultures
Wound and Abscess Cultures
Overview of Microbiologic Studies
Basic Concepts of Infectious Disease
Diagnostic Testing and Microbes
Host Factors
Overview of Microbiologic Studies
Respiratory Tract Cultures
Nasopharyngeal Cultures (Swab)
Respiratory Tract Cultures
Sputum Cultures
Throat Cultures (Swab or Washings)
Skin Tests
Candida and Tetanus Toxoid Tests
Intradermal Tests
Mumps Test
Skin Tests
Tuberculin Skin Test (TB Test); Two-Step TB Test
Table(s)
7.1. Bacterial Infections and Their Laboratory Diagnosis
7.2. Mycobacterial Infections and Their Laboratory Diagnosis
7.3. Rickettsial Diseases and Their Laboratory Diagnosis
7.4. Parasitic Diseases and Their Laboratory Diagnosis
7.5. Fungal Diseases and Their Laboratory Diagnosis
7.6. Spirochetal Diseases and Their Laboratory Diagnosis
7.7. Viral Infections and Their Laboratory Diagnosis
7.8. Sexually Transmitted Infections and Their Laboratory Diagnosis
8: Immunodiagnostic Studies
8: Immunodiagnostic Studies
Allergy Testing
Allergy Testing
IgE Antibody, Single Allergen
Latex Allergy Testing (Latex-Specific IgE)
Autoimmune Liver Disease Tests
Acetylcholine Receptor (AChR) Binding Antibody Test
Antiglomerular Basement Membrane (AGBM) Antibody Test
Anti-Insulin Antibody Test
Anti-liver/Kidney Microsome Type 1 Antibody (LKM) Test
Antimitochondrial Antibody (AMA) Test
Antineutrophil Cytoplasmic Antibodies (ANCAs)
Antiparietal Cell Antibody (APCA) Test
Anti-smooth Muscle Antibody (ASMA) Test
Autoimmune Liver Disease Tests
Gliadin Antibodies, IgA and IgG
Bacterial Tests
Bacterial Tests
Chlamydia Nucleic Acid Amplification Test (NAAT)
Helicobacter Pylori (HPY) IgG Antibody Serum, Stool, and Breath (PY) Test
Legionnaires' Disease Antibody Test
Lyme Disease Tests
Streptococcal Antibody Tests
Syphilis Detection Tests
Blood Banking Or Immunohematology Tests
Blood Banking Or Immunohematology Tests
Blood Groups (ABO Groups)
Coombs' Antiglobulin Test
Crossmatch (Compatibility Test)
Donated Blood Testing and Blood Processing
Kleihauer-Betke Test (Fetal Hemoglobin Stain)
Rh Antibody Titer Test
Rh Typing
Rosette Test, Fetal Red Cells (Fetomaternal Bleed)
Chart(s)
8.1. Procedure for Donating Blood
Figure(s)
8.1. Time Course for Appearance of Viral and Serologic Markers During Primary HIV Infection
8.2. The Complement System
Fungal Tests
Aspergillus Antibody Test
Candida Antibody Test
Cryptococcus Antibody Test
Fungal Antibody Tests
Fungal Tests
Immunologic Tests for Immune Dysfunction and Related Disorders of the Immune Systems
C'1 Esterase Inhibitor (C'1 INH)
C3 Complement Component
C4 Complement Component
Cold Agglutinin
Cryoglobulin Test
Immunofixation Electrophoresis (IFE), Serum and Urine
Immunologic Tests for Immune Dysfunction and Related Disorders of the Immune Systems
Protein Electrophoresis (PEP), Serum and Urine
Quantitative Immunoglobulins: IgA, IgG, IgM
Total Hemolytic Complement (Ch (50))
Overview of Immunodiagnostic Studies
Collection of Serum for Immunologic Tests
Interpreting Results of Immunologic Tests
Overview of Immunodiagnostic Studies
Serologic Versus Microbiologic Methods
Types of Tests
Parasitic Tests
Amebiasis (Entamoeba Histolytica) Antibody Test
Parasitic Tests
Torch Test
Toxoplasmosis (TPM) Antibody Tests
Protein Chemistry Testing/Serum Proteins: Acute-Phase Proteins and Cytokines
α (1)-Antitrypsin
Ceruloplasmin
C-Reactive Protein (CRP) and High-Sensitivity C-Reactive Protein (Hs-CRP)
Cytokines
Prion Proteins
Protein Chemistry Testing/Serum Proteins: Acute-Phase Proteins and Cytokines
Tumor Markers
Table(s)
8.1. Some Tests That Determine Antigen-Antibody Reactions
8.10. Enzyme-Linked Immunosorbent Assay Screening for Specific Systemic Rheumatic Disease (SRD)
8.11. Prevalence of Autoantibodies in Liver Disease
8.12. Tumor-Specific and Tumor-Associated Agents
8.13. Types of Cytokines, Cellular Origin, and Clinical Implications
8.14. Antigen Values for Blood Types
8.15. Relationship Between Blood Antigens and Antibodies
8.16. Comparison of Terms Used in Rh System Nomenclatures
8.17. Incidence and Frequency of Blood Group and Rh Type
8.18. Recommendations for Dose of Rh Immune Globulin in Massive Fetomaternal Blood
8.19. Antibodies Found in Crossmatching
8.2. Sensitivity of Commonly Used Serologic Tests for Syphilis
8.3. Nonsyphilitic Conditions Giving Biologic False-Positive Results
8.4. Hepatitis Test Findings in Various Stages
8.5. Summary of Clinical and Epidemiologic Features of Viral Hepatitis Agents
8.6. Differential Diagnosis of Viral Hepatitis
8.7. Viruses for Which Clinical Signs and Symptoms Mimic Hepatitis
8.8. Markers That Appear After Infection
8.9. Diagnostic Testing for HIV
Tests for Autoimmunity and Systemic Rheumatic Disease (SRD)
Antibodies to Extractable Nuclear Antigens (ENAs)
Anticentromere Antibody Test
Anti-double-Stranded DNA (Anti-dsDNA) Antibody Test, IgG
Antinuclear Antibody (ANA) Test
Autoimmune Thyroiditis, Thyroid Antibody Tests
Cardiolipin Antibodies, IgA, IgG, IgM
Rheumatoid Factor (Rheumatoid Arthritis [RA] Factor) Test
Tests for Autoimmunity and Systemic Rheumatic Disease (SRD)
Types of Transfusion Reactions
Acute Hemolytic Transfusion Reaction (HTR)
Anaphylactic Reactions
Bacterial Contamination
Bibliography
Circulatory Overload
Cutaneous Hypersensitivity Reactions
Febrile Nonhemolytic (FNH) Reactions
Human Leukocyte Antigen (HLA) Test
Leukoagglutinin Test
Noncardiogenic Pulmonary Reactions (NPR)
Platelet Antibody Detection Test
Types of Transfusion Reactions
Viral Antibody Tests to Assess Immune Status
Cytomegalovirus (CMV) Antibody Test
Herpes Simplex Virus (HSV) Antibodies (HSV-1 and HSV-2 Tests)
Human T-Cell Lymphotropic Virus (HTLV-I/II) Antibody Test
Measles (Rubeola) Antibody Tests
Mumps Antibody Tests
Parvovirus B-19 Antibody Test
Rabies Antibody Tests
Rubella Antibody Tests
Varicella-Zoster (Chickenpox) Antibody Test
Viral Antibody Tests to Assess Immune Status
Viral Tests
Epstein-Barr Virus (EBV) Antibody Tests
Hepatitis Tests
HIV-1/2 Tests
Viral Tests
9: Nuclear Medicine Studies
9: Nuclear Medicine Studies
Cardiac Studies
Cardiac Flow Study (First-Pass Study; Shunt Imaging)
Cardiac Studies
Multigated Acquisition (MUGA) Imaging: Rest and Stress
Myocardial Infarction Pyrophosphate (PYP) Imaging
Myocardial Perfusion
Endocrine Studies
Adrenal Gland Metaiodobenzylguanidine (MIBG) Imaging
Endocrine Studies
Parathyroid Imaging
Radioactive Iodine (RAI) Uptake Test
Thyroid Imaging
Gastrointestinal Studies
Gastric Emptying Imaging
Gastroesophageal Reflux Imaging
Gastrointestinal Bleeding Imaging
Gastrointestinal Studies
Hepatobiliary (Gallbladder, Biliary) Imaging with Cholecystokinin
Liver/Spleen Imaging and Liver RBC Imaging
Meckel's Diverticulum Imaging
Parotid (Salivary) Gland Imaging
Genitourinary Studies
Genitourinary Studies
Prostascint Imaging
Renogram
Testicular (Scrotal) Imaging
Vesicoureteric Reflux (Bladder and Ureters) Imaging
Inflammatory Process Imaging
Inflammatory Process Imaging
Leukocyte (WBC) Imaging (Indium- or Ceretec-Labeled WBCs)
Neurologic Studies
Brain Imaging and Cerebral Blood Flow Imaging
Cisternography (Cerebrospinal Fluid [CSF] Flow Imaging)
DaTscan Imaging
Neurologic Studies
Orthopedic Studies
Bone Imaging
Bone Mineral Density (Bone Densitometry; Osteoporosis Imaging)
Orthopedic Studies
Overview of Monoclonal Antibody Tumor Imaging
Antibody and Peptide Tumor Imaging
Breast Imaging (Scintimammography)
Iodine-131 Whole-Body (Total-Body) Imaging
Overview of Monoclonal Antibody Tumor Imaging
Overview of Nuclear Medicine Studies
Benefits and Risks
Clinical Considerations
General Procedure
Overview of Nuclear Medicine Studies
Pediatric Nuclear Medicine Considerations
Principles of Imaging
Principles of Nuclear Medicine
Overview of Positron Emission Tomography (PET) Imaging Studies
Bibliography
Brain Imaging
Cardiac Imaging
Indications for the Test
Overview of Positron Emission Tomography (PET) Imaging Studies
Tumor Imaging
Overview of Radionuclide (Non-Radioimmunoassay) Laboratory Studies
Overview of Radionuclide (Non-Radioimmunoassay) Laboratory Studies
Red Blood Cell (RBC) Survival Time Test
Total Blood Volume; Plasma Volume; Erythrocyte (RBC) Volume
Pulmonary Studies
Lung Scan (Ventilation and Perfusion Imaging)
Pulmonary Studies
Table(s)
9.1. Potential Side Effects in the Administration of Radiopharmaceuticals
Tumor Imaging Studies
Gallium ([67]ga) Imaging
Tumor Imaging Studies
10: X-Ray and Computed Tomography (CT) Studies
10: X-Ray and Computed Tomography (CT) Studies
Adverse Reactions to Contrast Agents
Adverse Reactions to Contrast Agents
Clinical Considerations When Barium Contrast Is Used
Clinical Considerations When Iodine Contrast Agents Are Used
Chart(s)
10.1. Comparisons of Core Needle and Vacuum-Assisted Biopsy
10.2. Clinical Note
10.3. Tests Used to Examine the Urinary System
Computed Tomography (CT)
Bibliography
Computed Tomography (CT)
Computed Tomography (CT) of the Body
Computed Tomography (CT) of the Head and Neck; Brain, Eyes, and Sinus
Contrast X-Rays/Radiography
Angiography (Digital Subtraction Angiography, Transvenous Digital Subtraction, Vascular X-Ray)
Arthrography (Joint X-Ray)
Bile Duct X-Ray (Cholangiography)
Colon X-Ray: Defecography; Barium Enema; Air Contrast Study
Contrast X-Ray of the Stomach
Contrast X-Rays/Radiography
Hysterosalpingography (Uterine and Fallopian Tube X-Rays)
Intravenous Urography (IVU)
Lymphangiography (X-Rays of Lymph Nodes and Vessels)
Myelogram
Retrograde Pyelography
Small Bowel X-Ray: Intestinal Radiography and Fluoroscopy
Figure(s)
10.1. Half of All Breast Cancers Develop in the Upper Outer Section
10.2. Examples of Whole Breast Compression (A) and Spot Compression (B)
10.3. Approximate Size of Tumors Found by Mammography Compared to Commonly Used Coins
10.4. Computed Tomography (CT) Scanner Showing Patient Position, x-Ray Tube, and Detectors
Overview of X-Ray Studies
Plain (Conventional) X-Rays/Radiography
Abdominal X-Ray
Chest X-Ray
Mammography (Breast X-Ray)
Orthopedic X-Ray: Bones, Joints, and Supporting Structures
Plain (Conventional) X-Rays/Radiography
Risks of Radiation
General Precautions
Precautions to Be Used with Pregnant Patients
Responsibilities in Ordering, Scheduling, and Sequencing X-Ray Examinations
Risks of Radiation
Safety Measures
Table(s)
10.1. Signs, Symptoms, and Incidence of Reactions to Iodine Contrast Media
10.2. Principal Early Effects of Radiation Exposure on Humans and Approximate Threshold Dose
10.3. Relative Risk for Childhood Leukemia After Irradiation in Utero by Trimester
10.4. Summary of Effects After 10 Radians in Utero
10.5. Representative Radiation Quantities From Various Diagnostic X-Ray Procedures
10.6. Likelihood of Diagnosis of Breast Cancer in Next 10 Years
Use of Contrast Agents
11: Cytologic, Histologic, and Genetic Studies
11: Cytologic, Histologic, and Genetic Studies
Chart(s)
11.1. Bethesda System for Reporting Cervical-Vaginal Diagnoses
11.2. Types of Genetic Disorders
11.3. Definition and Nomenclature of Karyotype
11.4. Disorders Currently Detectable Through Newborn Screening
Cytogenetics
Chromosomal Analysis
Cytogenetics
Newborn Screening for Congenital Disorders
Special Chromosomal Studies
Cytologic and Histologic Studies
Anal Smears: Cytologic (Cell) Study
Aspirated Breast Cysts and Nipple Discharge
Breast Biopsy
Cerebrospinal Fluid (CSF): Cytologic (Cell) Study
Cytologic and Histologic Studies
Ductal Lavage of Breast Cells (Cytologic) Study
Effusions (Thoracentesis and Paracentesis): Cytologic (Cell) Study
Estrogen/Estradiol Receptor (ER), Progesterone Receptor (PR) Histologic (Tissue) Study and DNA Ploidy (Tumor Aneuploidy)
Fine-Needle Aspirates: Cytologic (Cell) and Histologic (Tissue) Study
Gastrointestinal Tract: Cytologic (Cell) and Histologic (Tissue) Study
Histologic (Tissue) Biopsy Studies
Kidney Biopsy: Cytologic (Cell) and Histologic (Tissue) Study
Liver Biopsy: Cytologic (Cell) and Histologic (Tissue) Study
Papanicolaou (Pap) Smear
Respiratory Tract: Cytologic (Cell) and Histologic (Tissue) Study
Sentinel Node Location Before Biopsy (Breast, Melanoma)
Skin/Cutaneous Immunofluorescence Biopsy
Urine: Cytologic (Cell) Study
Figure(s)
11.1. A Ductal Lavage Microcatheter
11.2. The Human Papillomavirus (HPV) DNA High-Risk and Low-Risk Subtypes and Their Relationship
11.3. Papanicolaou (Pap) Smear Procedure (A); Normal Cells (B); and Malignant Cells (C)
11.4. Sample Cytopathology Report
Genetic Studies
Direct Detection of Abnormal Genes by DNA Testing
Genetic Studies
Overview of Cytologic (Cells) and Histologic (Tissue) Studies
Cytologic Studies
Histologic Studies
Overview of Cytologic (Cells) and Histologic (Tissue) Studies
Overview of Genetic Studies
Genetic Counseling
Indications for Testing
Inheritance in Human Disorders
Overview of Genetic Studies
Special Types of Genetic Studies
Bibliography
Biochemical Genetics
Pharmacogenomics
Population Genetics
Special Types of Genetic Studies
Table(s)
11.1. Nucleic Acid Testing Performed in Gynecologic Cytology
11.2. Useful Information from a Single Biopsy Specimen
11.3. Cervical Cancer Screening Guidelines for Average-Risk Women
11.4. Recommendations for Liquid-Based Cytology and HPV Testing
11.5. Further Testing After Abnormal Results of Pap Testing
11.6. Comparison of Exudate and Transudate Effusions
12: Endoscopic Studies
12: Endoscopic Studies
Figure(s)
12.1. Fiberoptic Bronchoscope (Olympus BF Type P60)
12.2. View of the Airway through a Bronchoscope
Overview of Endoscopic Studies
Arthroscopy
Bibliography
Bronchoscopy
Colonoscopy, Virtual Colonoscopy (VC), Optical Colonoscopy
Colposcopy
Cystoscopy (Cystourethroscopy)
Endoscopic Retrograde Cholangiopancreatography (ERCP) and Manometry
Enteroscopy, Virtual Enteroscopy
Esophageal Manometry
Esophagogastroduodenoscopy (EGD)
Flexible Proctoscopy; Sigmoidoscopy; Proctosigmoidoscopy
Loop Electrosurgical Excision Procedure (LEEP), Cone Biopsy, Cervical Conization
Mediastinoscopy
Overview of Endoscopic Studies
Peritoneoscopy; Laparoscopy; Pelviscopy; Fertiloscopy
Sinus Endoscopy
Thoracoscopy
Urodynamic Studies
Table(s)
12.1. Correlation of Colposcopic and Histologic (Tissue) Findings
12.2. Pros and Cons of Colposcopy and Cytology (Examination of Cells)
13: Ultrasound Studies
13: Ultrasound Studies
Abdominal Ultrasounds
Abdominal Aorta Ultrasound
Abdominal Ultrasound
Abdominal Ultrasounds
Hepatobiliary Ultrasound
Kidney (Renal) Ultrasound
Urinary Bladder Ultrasound
Cardiac Ultrasound Studies
Bibliography
Cardiac Ultrasound (Echocardiogram; Doppler Echocardiography)
Cardiac Ultrasound Studies
Transesophageal Echocardiogram (TEE)
Chart(s)
13.1. Uses of Ultrasound
13.2. Major Uses of Obstetric UltrasoundLevels I and II
Figure(s)
13.1. Placement of Transducer During Portable Bladder Scan
13.2. Blood Velocity Tracings Show Direction, Phasicity, Pulsatility, and Resistivity of Flow
Obstetric and Gynecologic Ultrasounds
Fetal Echocardiography (Fetal Doppler)
Obstetric and Gynecologic Ultrasounds
Obstetric Sonogram
Pelvic Gynecologic Ultrasound
Other Body Structure Ultrasounds
Breast Ultrasound
Eye and Orbit Ultrasounds
Other Body Structure Ultrasounds
Prostate Ultrasound (Transurethral Ultrasound)
Scrotal Ultrasound
Thyroid Ultrasound (Neck Ultrasound)
Overview of Ultrasound Studies
Implications of Ultrasound Studies
Overview of Ultrasound Studies
Principles and Techniques
Vascular Ultrasound Studies (Duplex Scans)
Ankle-Brachial Index (ABI) and Segmental Pressures
Cerebrovascular Ultrasound (Carotid and Vertebral Arteries) Duplex Scans
Peripheral Arterial Doppler Studies
Peripheral Venous Doppler Studies
Vascular Ultrasound Studies (Duplex Scans)
14: Pulmonary Function, Arterial Blood Gases (ABGs), and Electrolyte Studies
14: Pulmonary Function, Arterial Blood Gases (ABGs), and Electrolyte Studies
Airway Flow Rates
Airway Flow Rates
Peak Expiratory Flow Rate (PEFR)
Peak Inspiratory Flow Rate (PIFR)
Spirometry, Forced Expiratory Maneuver Volume-Time Spirogram (V-T Tracing)
Chart(s)
14.1. Gas Volumes: Symbols and Abbreviations
14.2. Combinations of Symbols and Abbreviations
14.3. Lung Volume Symbols: Pulmonary Function Terminology
14.4. Miscellaneous Symbols
Electrolyte Tests
Bibliography
Calcium (Ca[2+])
Chloride (Cl[-])
Electrolyte Tests
Magnesium (Mg[2+])
Osmolality and Water-Load Test (Water-Loading Antidiuretic Hormone [ADH] Suppression Test)
Phosphate (P); Inorganic Phosphorus (Po (4))
Potassium (K[+])
Sodium (Na[+])
Sweat Test
Figure(s)
14.1. Pulmonary Function Report of a 47-Year-Old Woman Whose Chief Complaint is Shortness of Breath
14.2. Orbit Portable Spirometer
14.3. Subdivisions of Lung Volume in the Normal Adult Male
14.4. Vmax Autobox Whole-Body Plethysmograph
14.5. ABL800 FLEX Blood Gas Analyzer
14.6. Pulse Oximeters
14.7. Potassium Changes Reflected on Electrocardiogram
Gas Exchange (Diffusing Capacity), Transfer Factor
Carbon Monoxide Diffusing Capacity (Dlco, DL), Diffusing Capacity, Transfer Factor
Gas Exchange (Diffusing Capacity), Transfer Factor
Lung Volumes and Capacities
Expiratory Reserve Volume (ERV)
Functional Residual Capacity (FRC)
Inspiratory Capacity (IC)
Lung Volumes and Capacities
Residual Volume (RV)
Total Lung Capacity (TLC)
Vital Capacity (VC)
Other Pulmonary Function Tests
Body Plethysmography
Bronchial Provocation: Methacholine Challenge, Histamine Challenge
Carbon Dioxide (CO (2)) Response
Closing Volume (CV)
Exercise Stress Testing, Maximum Oxygen Consumption (O (2max)) Test
Maximal Respiratory Pressure (MRP), Maximal Expiratory Pressure (MEP), Maximal Inspiratory Pressure (MIP)
Maximum Voluntary Ventilation (MVV)
Other Pulmonary Function Tests
Volume of Isoflow (V (ISO) V)
Overview of Blood Gases, Acid-Base Balance, and Oxygenation Status
Alveolar-to-Arterial Oxygen Gradient (A-aDo (2))
Anion Gap (AG)
Arterial Blood Gas (ABG) Tests
Base Excess or Deficit
Blood pH
Carbon Dioxide (CO (2)) Content; Total Carbon Dioxide (Tco(2))
Lactic Acid (Lactate)
Overview of Blood Gases, Acid-Base Balance, and Oxygenation Status
Oxygen Content (Co (2))
Oxygen Saturation (So (2))
Partial Pressure of Carbon Dioxide (Pco (2))
Partial Pressure of Oxygen (Po (2)), Brain Tissue (Pbto(2))
Overview of Pulmonary Function Tests
Classification of Tests
Indications for Tests
Overview of Pulmonary Function Tests
Pulmonary Physiology
Purpose of Tests
Symbols and Abbreviations
Table(s)
14.1. Conditions That Affect Ventilation
14.2. Ventilatory and Arterial Blood Gas Responses to Graded Exercise
14.3. Normal Values for Commonly Ordered Arterial Blood Gas and Electrolyte Studies
14.4. Summary of Ventilatory and Acid-Base Changes in Four Underlying Conditions of Acid-Base Imbalance
14.5. Subclassification of Anion Gap Metabolic Acidosis (Hypobicarbonatemia)
14.6. Classification of Anion Gap Metabolic Alkalosis (Hyperbicarbonatemia) on the Basis of Urinary Excretion
14.7. Normal Values for Calcium
15: Prenatal Diagnosis and Tests of Fetal Well-Being
15: Prenatal Diagnosis and Tests of Fetal Well-Being
Additional Measurements
Additional Measurements
Bibliography
Fetal Alcohol Syndrome (FAS), Alcohol in Pregnancy
Fetal Nuchal Translucency (FNT)
Fetal Oxygen Saturation (FSpo (2)) Monitoring
Group B Streptococcus (GBS) Screening
Amniotic Fluid Studies
Amniocentesis
Amniotic Fluid Alpha (1)-Fetoprotein (AFP)
Amniotic Fluid and Desaturated Phosphatidylcholine (DSPC)
Amniotic Fluid Bilirubin Optical Density (OD)
Amniotic Fluid Color
Amniotic Fluid Creatinine
Amniotic Fluid Fern Test
Amniotic Fluid Foam Stability Index (FSI)
Amniotic Fluid Index (AFI)
Amniotic Fluid Lecithin-to-Sphingomyelin (L/S) Ratio, Surfactant-to-Albumin (S/A) Ratio, Phosphatidylglycerol (PG) (Surfactant Components), Lamellar Body Counts
Amniotic Fluid Shake Test (Foam Stability Test)
Amniotic Fluid Studies
Amniotic Fluid Total Volume
Placental Alpha Macroglobulin-1 Protein Assay (Amnisure)
Chart(s)
15.1. Characteristics for Diagnosing Fetal Alcohol Syndrome
First and Second Trimester Screening
Circulating Cell-Free DNA
Estriol (E (3))
Fetal Fibronectin (fFN)
First and Second Trimester Screening
Hormone Testing
Human Placental Lactogen (hPL) (Chorionic Somatomammotropin)
Maternal Serum Alpha-Fetoprotein (MS-AFP)
Overview of Prenatal Diagnosis
Table(s)
15.1. Maternal Fetal Testing During Pregnancy
Tests to Predict Fetal Outcome and Risk for Intrauterine Asphyxia
Chorionic Villus Sampling (CVS)
Continuous Fetal Heart Rate (FHR) Monitoring
Contraction Stress Test (CST)
Fetal Activity Acceleration Determination (FAD)
Fetal Biophysical Profile (FBP) (Biophysical Profile [BPP])
Fetoscopy
Nonstress Test (NST)
Oxytocin Challenge Test (OCT)
Percutaneous Umbilical Blood Sampling (PUBS) (Cordocentesis)
Tests to Predict Fetal Outcome and Risk for Intrauterine Asphyxia
16: Special Diagnostic Studies
16: Special Diagnostic Studies
Brain and Nervous System
Brain and Nervous System
Brain Mapping: Computed Tomography (CT)
Cognitive Tests: Event-Related Potentials (ERPs)
Electroencephalogram (EEG) and Epilepsy/Seizure Monitoring
Electromyography (EMG); Electroneurography; Electromyoneurogram (EMNG)
Electronystagmogram (ENG)
Evoked Responses/Potentials
Chart(s)
16.1. Wave and Standard Deviation Measurements for Evoked Response/Potential
16.2. Grading of Coronary Occlusions
16.3. Cardiac Treatment Procedures
16.4. Features of Interventional or Therapeutic Electrophysiology (EP) Studies
16.5. Advantages of Open Magnetic Resonance Imaging
Figure(s)
16.1. Humphrey Field Analyzer II-i and Visual Field Grid
16.2. Patient Report of a Single Visual Field Analysis of the Right Eye
16.3. Commonly Measured Complex Components
16.4. His Bundle Electrogram
16.5. Electrocardiogram Electrode Placement
16.6. Sample of a Cardiac Catheterization Report
16.7. Discovery MR750w Wide-Bore Scanner
16.8. Optima MR430s Extremity Scanner
16.9. Polysomnography Study in a Laboratory Environment
Heart
Cardiac Catheterization and Angiography (Angiocardiography, Coronary Arteriography)
Cardiac Event Monitoring
Electrocardiogram (ECG or EKG) and Vectorcardiogram
Electrophysiology (EP) Studies; His Bundle Procedure
Heart
Signal-Averaged Electrocardiogram (SAE)
Stress Test/Exercise Testing (Graded Exercise Tolerance Test), Submaximal Effort
Transesophageal Echocardiography (TEE)
Other Organs and Body Functions
Magnetic Resonance Imaging (MRI)
Other Organs and Body Functions
Overview of Special Diagnostic Studies
Sleep Studies
Bibliography
Classification of Tests-Sleep Studies
Nasal Continuous Positive Airway Pressure (nCPAP) Titration
Polysomnography (PSG)
Sleep Studies
Sleepiness Test
Types and Indications of Tests
Table(s)
16.1. Comparison of the Electrocardiogram and Vectorcardiogram
The Eye
Electroretinography (ERG)
Eye and Orbit (Ophthalmic) Ultrasound
Fluorescein Angiography (FA)
Retinal Nerve Fiber Analysis
The Eye
Visual Field Testing
Appendices
A: Standard Precautions for Prevention and Control of Infection
A.1. Needle Safety Device - Fig
A.1. Pandemic Severity Index - Chart(s)
A.2. Pandemics are Assigned One of Five Categories of Increasing Severity (Category 1 to 5) - Fig
A: Standard Precautions for Prevention and Control of Infection
Bibliography
Common Categories of Body Substances
Disposal of Medical Wastes - Standard Precautions, Guidelines, and Practices for Specific Situations
General Environmental Cautions - Standard Precautions, Guidelines, and Practices for Specific Situations
Handwashing Protocols - Standard Precautions, Guidelines, and Practices for Specific Situations
Hepatitis B Virus - Risk for Infection After Occupational Exposure
Hepatitis C Virus - Risk for Infection After Occupational Exposure
HIV - Risk for Infection After Occupational Exposure
If a Blood Exposure Occurs
In Case of Exposure to HIV or Hepatitis B Virus - Standard Precautions, Guidelines, and Practices for Specific Situations
Introduction
Pandemic Preparedness
Personal Protection Equipment (PPE) - Standard Precautions, Guidelines, and Practices for Specific Situations
Placement of Warning Tags and Signs - Standard Precautions, Guidelines, and Practices for Specific Situations
Protocols for First Responders
Risk for Infection After Occupational Exposure
Safe Practice
Safe Practice Domains for Specific Situations
Standard Precautions, Guidelines, and Practices for Specific Situations
B: Guidelines for Specimen Transport and Storage
B.1. Definitions of Substances and Diagnostic Specimens - Chart(s)
B.1. Proper Technique for Packaging and Shipping Clinical Specimens Using Triple Packaging System - Fig
B.1. Transporting, Packaging, and Mailing Specimens - Table
B.2. Classification of Substances and Specimens - Chart(s)
B.2. Etiologic Agents Logo - Fig
B.3. Examples of Category A Infectious Substances - Chart(s)
B.3. Infectious Substance Label - Fig
B: Guidelines for Specimen Transport and Storage
Bibliography
Centers for Disease Control and Prevention Shipping Instructions
Collecting Specimens - Centers for Disease Control and Prevention Shipping Instructions
Introduction
Labeling Specimens - Centers for Disease Control and Prevention Shipping Instructions
Packaging Specimens - Centers for Disease Control and Prevention Shipping Instructions
Shipping Specimens - Centers for Disease Control and Prevention Shipping Instructions
C: Vitamins in Human Nutrition
Bibliography
C.1. Vitamin Levels and Ranges - Table
C: Vitamins in Human Nutrition
Clinical Implications - Vitamin Testing
Interfering Factors - Vitamin Testing
Interventions - Vitamin Testing
Procedure - Vitamin Testing
Reference Values - Vitamin Testing
Vitamin Testing
D: Minerals in Human Nutrition
Bibliography
Clinical Implications - Mineral Testing
D.1. Mineral Levels and Ranges - Table
D: Minerals in Human Nutrition
Interfering Factors - Mineral Testing
Interventions - Mineral Testing
Mineral Testing
Procedure - Mineral Testing
Reference Values - Mineral Testing
E: Effects of Drugs on Laboratory Tests (Blood, Whole Plasma, Serum, Stool, and Urine)
Bibliography
Discoloration of Feces Caused by Drugs - Drugs and Laboratory Test Outcomes
Discoloration of Urine Caused by Drugs - Drugs and Laboratory Test Outcomes
Drugs and Laboratory Test Outcomes
E.1. Effects of the Most Commonly Used Drugs on Frequently Ordered Laboratory Tests - Table
E: Effects of Drugs on Laboratory Tests (Blood, Whole Plasma, Serum, Stool, and Urine)
Front Matter
Contributors, Consultants, and Research Assistants
Preface
Acknowledgments
Chapter Content and Features
Current Developments in Laboratory and Diagnostic Testing
Organization
Preface
Purpose
Revisions and Additions to the Tenth Edition
Reviewers
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