Antistreptolysin O Titer

How is it used? The ASO test is primarily ordered by itself or along with an anti-DNase B to help determine whether a person has had a recent streptococcal infection. In most cases, strep infections are identified and treated with antibiotics and the infections resolve. In cases where they do not cause identifiable symptoms and/or go untreated, however, post-streptococcal complications (sequelae), namely rheumatic fever and glomerulonephritis, can develop in some patients, especially young children. The test, therefore, is ordered if a person presents with symptoms suggesting rheumatic fever or glomerulonephritis and has had a recent history of sore throat or a confirmed streptococcal infection. Since the incidence of poststreptococcal complications has dropped in the U.S., so has the use of the ASO test. When is it ordered? The ASO test is ordered when a person has symptoms that the doctor suspects may be due to an illness caused by a previous streptococcal infection. It is ordered when the symptoms emerge, usually in the weeks following a sore throat or skin infection. The test may be ordered twice over a period of 10-14 days to determine if the antibody level is rising, falling, or remaining the same. Some symptoms of rheumatic fever may include: Fever Joint swelling and pain in more than one joint, especially in the ankles, knees, elbows and wrists, sometimes moving from one joint to another Small, painless nodules under the skin Rapid, jerky movements (Sydenham's chorea) Skin rash Sometimes the heart can become inflamed (carditis); this may not produce any symptoms but also may lead to shortness of breath, heart palpitations, or chest pain Some symptoms of glomerulonephritis may include: Fatigue, decreased energy Decreased urine output Bloody urine Rash Joint pain Swelling (edema) High blood pressure However, these symptoms can be seen in other conditions. The test may be performed twice, with samples collected about two weeks apart, for acute and convalescent ASO titers. This is done to determine if the antibody level is rising, falling, or remaining the same. What does the test result mean? ASO antibodies are produced about a week to a month after an initial strep infection. ASO levels peak at about 4 to 6 weeks after the illness and then taper off but may remain at detectible levels for several months after the strep infection has resolved. If the test is negative or if ASO is present in very low concentrations, then the person tested most likely has not had a recent strep infection. This is especially true if a sample taken 10 to 14 days later is

also negative or low level and if an anti-DNase B test is also negative. A small percentage of those with a post-streptococcal complication will not have an elevated ASO. If the ASO level is high or is rising, then it is likely that a recent strep infection has occurred. ASO levels that are initially high and then decline suggest that an infection has occurred and may be resolving. The ASO test does not predict if complications will occur following a streptococcal infection, nor do they predict the type or severity of the disease. If symptoms of rheumatic fever or glomerulonephritis are present, an elevated ASO level may be used to help confirm the diagnosis.

RPR Test
How is it used? The RPR test detects antibodies of the bacteria that causes syphillis (Treponema pallidum) in blood, body fluid, or tissue. The tests are used to screen for or to confirm a syphilis infection. Syphilis is a sexually transmitted disease (STD) that is usually spread during sexual contact, including kissing or oral sex. A syphilis infection can spread through the bloodstream to all parts of the body. If not treated, syphilis can cause severe heart disease, brain damage, spinal cord damage, blindness, and death. Tests used to screen for syphilis include: Venereal disease research laboratory (VDRL) test. The VDRL test checks for an antibody that can be produced in people who have syphilis. This antibody is not produced as a reaction to the syphilis bacteria specifically, so this test is sometimes not accurate. The VDRL test may be done on a sample of blood or spinal fluid. The VDRL test is not very useful for detecting syphilis in very early or advanced stages. Rapid plasma reagin (RPR) test. The RPR test also detects syphilis antibodies by means of analysis of a blood sample drawn from the vein in the arm. Enzyme immunoassay (EIA) test. This is a newer blood test that check for antibodies to the bacteria that cause syphilis. A positive EIA test should be confirmed with either the VDRL or RPR tests. Tests used to diagnose syphilis include: Fluorescent treponemal antibody absorption (FTA-ABS) test. The FTA-ABS test detects antibodies to the bacteria that cause syphilis and can be used to detect syphilis except during the first 3 to 4 weeks after exposure to syphilis bacteria. It is more difficult to do and may be used to confirm a syphilis infection after another method tests positive for the syphilis bacteria. The test can be done on a sample of blood or spinal fluid. Treponema pallidum particle agglutination assay (TPPA). The TPPA test is used to confirm a syphilis infection after another method tests positive for the syphilis bacteria. This test detects antibodies to the bacteria that cause syphilis and can be used to detect syphilis in all stages, except during the first 3 to 4 weeks. This test is not done on spinal fluid. Darkfield microscopy. This test uses a special microscope to examine a sample of fluid or tissue from an open sore (chancre) for the syphilis bacteria. If syphilis is present, it can be seen as corkscrew-shaped objects on the microscope slide. This test is used mainly to diagnose syphilis in an early stage. Microhemagglutination assay (MHA-TP). The MHA-TP is used to confirm a syphilis infection after another method tests positive for the syphilis bacteria. The MHA-TP test detects antibodies to the

bacteria that cause syphilis and can be used to detect syphilis in all stages, except during the first 3 to 4 weeks. This test is not done on spinal fluid. The MHA-TP test is rarely used any more. When is it ordered? A test for syphilis is done to Screen for syphilis or monitor treatment for a syphilis infection. It is categorized asSTD Tests for Men as well as STD Tests for Women. What does the test result mean? Syphilis tests of blood and spinal fluid Normal Syphilis test results: No antibodies to syphilis are present. This is called a nonreactive or negative result. Abnormal Syphilis test results: Antibodies to syphilis bacteria are present. This is called a reactive or positive test. A result that is not clearly normal or abnormal is called inconclusive or equivocal. Venereal disease research laboratory (VDRL) and rapid plasma reagin (RPR) tests Normal: The antibody to the syphilis bacteria (reagin) is not present. This is called a nonreactive or negative result. Abnormal: The antibody reagin is present. This is called a reactive or positive test.

Prostate Specific Antigen

How is it used? If prostate cancer is diagnosed, the total PSA test may be used as a monitoring tool to help determine the effectiveness of treatment. It may also be ordered at regular intervals after treatment to detect recurrence of the cancer. The total PSA test and digital rectal exam (DRE) may be used to screen both asymptomatic and symptomatic men for prostate cancer. If either the PSA or the DRE are found to be abnormal, then the doctor may choose to follow this testing with a prostate biopsy and perhaps imaging tests, such as an ultrasound. If the DRE is normal but the PSA is moderately elevated, the doctor may order a free PSA test to look at the ratio of free to total PSA. This can help to distinguish between prostate cancer and other non-cancer causes of elevated PSA. Since the total PSA test can be elevated temporarily for a variety of reasons, a doctor may order another PSA a few weeks after the first to determine if the PSA is still elevated. Currently there is no consensus about using the PSA test to screen for prostate cancer in asymptomatic men. While prostate cancer is a relatively common type of cancer in men, it is an uncommon cause of death. In cases where the cancer appears to be slow-growing, the doctor and patient may decide to monitor its progress rather than pursue immediate treatment (called "watchful waiting"). Total PSA levels may be ordered at intervals to monitor the change in PSA over time. The complexed PSA (cPSA) is a relatively new test that may be ordered, along with the DRE, as an alternative to the total PSA. There is hope that this test could be more specific than the total PSA better at detecting cancer-related PSA, but findings have been mixed and its ultimate clinical utility has yet to be established. The cPSA is an option that doctors can discuss with their patients. Its use may expand and/or be better defined as additional studies are conducted and findings are reported.

When is it ordered? There is currently no consensus among the experts about when the PSA test should be ordered to screen asymptomaticmales. Over-diagnosing, identifying cases of prostate cancer that may never cause significant health problems, must be balanced against missing the detection of aggressive cancers. National organizations reflect this lack of consensus, giving conflicting recommendations on routine PSA-based screening of asymptomatic men. Some organizations such as the American Urological Association recommend screening, while others such as the U.S. Preventive Services Task Force feel that the harms associated with over-diagnosis and over-treatment outweigh the potential benefits. The American Cancer Society (ACS) recommends that men discuss the advantages and disadvantages of PSA-based screening for prostate cancer with their doctor before making an informed decision about whether to be screened or not. For men who wish to be screened, the ACS recommends that healthy men of average risk consider waiting to get tested until age 50; for those at high risk, such as American men of African descent and men with a family history of the disease, the recommendation is to consider beginning testing at age 40 or 45. The American Urological Association recommends a baseline PSA and DRE at age 40. (See Screening Tests for Adults (30-49): Prostate cancer and Screening Tests for Adults (50 and Up): Prostate cancer for details on screening recommendations.) The total PSA test and DRE may also be ordered when a man has symptoms that could be due to prostate cancer, such as difficult, painful, and/or frequent urination, back pain, and/or pelvic pain. Since these symptoms are seen with a variety of other conditions, including infection and prostatitis, the doctor will also frequently order other tests, such as a urine culture. Some of these conditions can themselves cause temporary increases in PSA levels. If a total PSA level is elevated, a doctor may order a repeat test a few weeks later to determine whether the PSA concentrations have returned to normal. A free PSA is primarily ordered when a man has a moderately elevated total PSA. The results give the doctor additional information about whether the person is at an increased risk of having prostate cancer and helps with the decision of whether to biopsy the prostate. The total PSA may be ordered during treatment of men who have been diagnosed with prostate cancer to verify the effectiveness of treatment and at regular intervals after treatment to monitor for cancer recurrence. It is also ordered at regular intervals when a man with cancer is participating in "watchful waiting" and not currently treating his prostate cancer.

What does the test result mean? PSA test results can be interpreted a number of different ways and there may be differences in cutoff values between different laboratories. The normal value for total PSA is considered to be less than 4.0 ng/ml (nanograms per milliliter of blood). There are some that feel that this level should be lowered to 2.5 ng/ml in order to detect more cases of prostate cancer. Others argue that this would exacerbate overdiagnosing and over-treating cancers that are not clinically significant. There is agreement that men with a total PSA level greater than 10.0 ng/ml are at an increased risk for prostate cancer (more than a 67% chance, according to the ACS). Levels between 4.0 ng/ml and 10.0 ng/ml may indicate prostate cancer (about a 25% chance, according to the ACS), BPH, or prostatitis. These conditions are more common in the elderly, as is a general increase in PSA levels. Concentrations of total PSA between 4.0 ng/ml and 10.0 ng/ml are often referred to as the "gray zone." It is in this range that the free PSA is the most useful. When men in the gray zone have decreased levels of free PSA, they have a higher probability of prostate cancer; when they have elevated levels of free PSA, the risk is

diminished. The ratio of free to total PSA can help the doctor decide whether or not a prostate biopsy should be performed. When the complexed PSA (cPSA) test is used as a screening tool, increased levels may indicate an increased risk of prostate cancer, while lower levels indicate a decreased risk. In addition to the introduction of the free PSA and cPSA tests, there have been efforts to increase the usefulness of the total PSA as a screening tool. They include: PSA velocity. This is the change in PSA concentrations over time. If the PSA continues to rise significantly over time (at least 3 samples at least 18 months apart), then it is more likely that prostate cancer is present. If it climbs rapidly, then the affected person may have a more aggressive form of cancer. PSA doubling time. This is another version of the PSA velocity. It measures how rapidly the PSA concentration doubles. PSA density. This is a comparison of the PSA concentration and the volume of the prostate (as measured by ultrasound). Men with larger prostates tend to produce more PSA, so this factor is an adjustment to compensate for the size. Age-specific PSA ranges. Since PSA levels naturally increase as a man ages, it has been proposed that normal ranges be tailored to a man's age.

During treatment for prostate cancer, the PSA level should begin to fall. At the end of treatment, it should be at very low or undetectable levels in the blood. If concentrations do not fall to very low levels, then the treatment has not been fully effective. Following treatment, the PSA test is performed at regular intervals to monitor the person for cancer recurrence. Since even tiny increases can be significant, those affected may want to have their monitoring PSA tests done by the same laboratory each time so that testing variation is kept to a minimum. A relatively new test called "ultrasensitive PSA" (USPSA) has been reported. It has been suggested that this test may be useful in monitoring for persistence or recurrence of cancer after treatment. This test detects PSA at much lower levels than the traditional test. It has been suggested that increases in PSA due to the persistence or return of cancer can be identified much sooner with this test. However, results of this test must be interpreted with caution. Because the test is very sensitive, there can be an increase in PSA levels from one time to the next even when no cancer is present (false positive).

Carcinoembryonic Antigen
How is it used? The CEA test may be used: To monitor the treatment of people diagnosed with colon cancer. It may also be used as a marker for medullary thyroid cancer and cancers of the rectum, lung, breast, liver, pancreas, stomach, and ovaries. An initial CEA test is typically ordered prior to treatment as a "baseline" value. If the level is elevated, then the test can be used to monitor a person's response to therapy and to determine whether the cancer has progressed or recurred. To determine prognosishow likely the cancer is to progress To stage cancercancer staging involves evaluating the size of the tumor as well as how far it has spread. Testing CEA in a body fluid sample may help to determine if cancer has spread to a body cavity (e.g., pleural or peritoneal cavity).

A CEA test may be used in combination with other tumor markers in the evaluation of cancer. Not all cancers produce CEA, and a positive CEA test is not always due to cancer. Therefore, CEA is not recommended for screening the general population. When is it ordered? A CEA test may be ordered when a person has been diagnosed with colon cancer or other specific types of cancer. It will be measured before therapy is initiated and then on a regular basis to evaluate the success of treatment and to detect recurrence. Sometimes a CEA test may be performed when cancer is suspected but not yet diagnosed. This is not a common use for the test because CEA can be elevated with many conditions, but it may provide the doctor with additional information. A CEA test may sometimes be performed on a fluid other than blood when a doctor suspects that a cancer has metastasized (e.g., spread to pleural or peritoneal cavity). What does the test result mean? For treatment, recurrence monitoring: When CEA levels are initially elevated and then decrease to normal after therapy, it means the cancer has been successfully treated. A steadily rising CEA level is often the first sign of tumor recurrence. For prognosis and/or staging: On initial testing, people with smaller and early-stage tumors are likely to have a normal or only slightly elevated CEA value. People with larger tumors, later-stage cancer, or tumors that have spread throughout the body are more likely to have a high CEA value. Testing for metastasis: If CEA is present in a body fluid other than blood, then the person's cancer is likely to have spread into that area of the body. For example, if CEA is detected in cerebrospinal fluid, this may indicate a central nervous system metastasis. Since not all cancers produce CEA, it is possible to have cancer but also have a normal CEA. If a cancer does not produce CEA, then the test will not be useful as a monitoring tool.

AFP Tumor Markers

How is it used? AFP is used as a tumor marker to help detect and diagnose cancers of the liver, testes, and ovaries. Though the test is often ordered to monitor people with chronic liver diseases such as cirrhosis, chronic hepatitis B or hepatitis C because they have an increased lifetime risk of developing liver cancer, most current guidelines do not recommend this use. A doctor may order an AFP test, along with imaging studies, to try to detect liver cancer when it is in its earliest and most treatable stages. If a person has been diagnosed with hepatocellular carcinoma or another form of AFP-producing cancer, an AFP test may be ordered periodically to help monitor the person's response to therapy and to monitor for cancer recurrence. An AFP-L3% is sometimes also ordered to compare the amount of the AFP variant called AFPL3 to the total amount of AFP. The AFP-L3% test is not yet widely used in the U.S. but has gained wider acceptance in other countries such as Japan. The test is used to help evaluate the risk of developing

hepatocellular carcinoma, especially in those with chronic liver disease, and also to evaluate response of hepatocellular carcinoma to treatment. When is it ordered? A physician may order an AFP blood test when: It is suspected that someone has liver cancer or certain cancers of the testes or ovaries; cancer may be suspected when, for example, lumps are felt in the abdominal area during a physical exam or when imaging tests detect possible tumors. Someone who has been diagnosed with and treated for a cancer of the liver, testes, or ovaries is being monitored for the effectiveness of treatment Someone is being monitored for cancer recurrence An AFP-L3% is sometimes ordered to help evaluate the risk of hepatocellular carcinoma when a person has chronic liver disease or to test the effectiveness of treatment of of hepatocellular carcinoma or monitor for its recurrence. What does the test result mean? Increased AFP levels may indicate the presence of cancer, most commonly liver cancer, cancer of the ovary, or germ cell tumor of the testes. However, not every liver, ovarian, or testicular cancer will produce significant quantities of AFP. Elevated levels may sometimes be seen with other cancers such as stomach, colon, lung, breast, and lymphoma, although it is rarely ordered to evaluate these conditions. Other diseases such as cirrhosis and hepatitis can also cause increased levels. When AFP is used as a monitoring tool, decreasing levels indicate a response to treatment. If concentrations after cancer treatment do not significantly decrease, usually to normal or near normal levels, then some of the tumor tissue may still be present. If concentrations begin to increase, then it is likely that the cancer is recurring. However, since AFP can be increased in hepatitis or cirrhosis, AFP levels can sometimes be misleading. If AFP levels are not elevated prior to treatment, then the test will not generally be useful to monitor the effectiveness of treatment or to monitor for recurrence. When the AFP concentrations of people with chronic liver disease go from moderately elevated to greatly elevated, their risk of developing liver cancer increases. When total AFP and AFP-L3% are significantly elevated, then the affected person has an increased risk of having or developing hepatocellular carcinoma in the next year or two. However, both AFP and AFP-L3% concentrations can be elevated, and fluctuate, in people with chronic hepatitis and cirrhosis. In these cases, a sharp increase in AFP is more important than the actual numerical value of the test result.

Blood Urea Nitrogen

How is it used? The blood urea nitrogen or BUN test is primarily used, along with the creatinine test, to evaluate kidney function in a wide range of circumstances, to help diagnose kidney disease, and to monitor people with acute or chronic kidney dysfunction or failure. It also may be used to evaluate a person's general health status when ordered as part of a basic metabolic panel (BMP) or comprehensive metabolic panel (CMP). When is it ordered? BUN is part of both the BMP and CMP, groups of tests that are widely used: When someone has non-specific complaints As part of a routine testing panel

To check how the kidneys are functioning before starting to take certain drug therapies When an acutely ill person comes to the emergency room and/or is admitted to the hospital During a hospital stay

BUN is often ordered with creatinine when kidney problems are suspected. Some signs and symptoms of kidney dysfunction include: Fatigue, lack of concentration, poor appetite, or trouble sleeping Swelling or puffiness (edema), particularly around the eyes or in the face, wrists, abdomen, thighs, or ankles Urine that is foamy, bloody, or coffee-colored A decrease in the amount of urine Problems urinating, such as a burning feeling or abnormal discharge during urination, or a change in the frequency of urination, especially at night Mid-back pain (flank), below the ribs, near where the kidneys are located High blood pressure BUN also may be ordered: At regular intervals to monitor kidney function in those with chronic diseases or conditions such as diabetes, congestive heart failure, and myocardial infarction (heart attack) At regular intervals to monitor kidney function and treatment in people with known kidney disease Prior to and during certain drug treatments to monitor kidney function At regular intervals to monitor the effectiveness of dialysis What does the test result mean? Increased BUN levels suggest impaired kidney function. This may be due to acute or chronic kidney disease, damage, or failure. It may also be due to a condition that results in decreased blood flow to the kidneys, such as congestive heart failure, shock, stress, recent heart attack, or severe burns, to conditions that cause obstruction of urine flow, or to dehydration. BUN concentrations may be elevated when there is excessive protein breakdown (catabolism), significantly increased protein in the diet, or gastrointestinal bleeding (because of the proteins present in the blood). Low BUN levels are not common and are not usually a cause for concern. They may be seen in severe liver disease, malnutrition, and sometimes when a person is overhydrated (too much fluid volume), but the BUN test is not usually used to diagnose or monitor these conditions. Both decreased and increased BUN concentrations may be seen during a normal pregnancy. If one kidney is fully functional, BUN concentrations may be normal even when significant dysfunction is present in the other kidney.

Creatinine

How is it used? The creatinine blood test is used along with a BUN (blood urea nitrogen) test to assess kidney function. Both are frequently ordered as part of a basic or comprehensive metabolic panel (BMP or CMP), groups of tests that are performed to evaluate the function of the bodys major organs. BMP or CMP tests are used to screen healthy people during routine physical exams and to help evaluate acutely or chronically ill people in the emergency room and/or hospital. If the creatinine and BUN tests are found to be abnormal or if someone has an underlying disease, such as diabetes, that is known to affect the kidneys, then these two tests may be used to monitor the progress of kidney dysfunction and the effectiveness of treatment. Blood creatinine and BUN tests may also be ordered to evaluate kidney function prior to some procedures, such as a CT (computed tomography) scan, that may require the use of drugs that can damage the kidneys. A combination of blood and urine creatinine levels may be used to calculate a creatinine clearance. This test measures how effectively the kidneys are filtering small molecules like creatinine out of the blood. Urine creatinine may also be used with a variety of other urine tests as a correction factor. Since it is produced and removed at a relatively constant rate, the amount of urine creatinine can be compared to the amount of another substance being measured. This stable excretion rate is useful when evaluating both 24-hour urine samples and random urine samples. Examples of this are when creatinine is measured with protein to calculate a urine protein/creatinine ratio (UP/CR) and when it is measured with microalbumin to calculate a microalbumin/creatinine ratio. The microalbumin/creatinine ratio is calculated to help determine how much albumin is escaping from the kidneys into the urine. People who have consistently detectable amounts of albumin in their urine (microalbuminuria) have an increased risk of developing progressive kidney failure and cardiovascular disease in the future. Serum creatinine measurements (along with age, weight, and gender) also are used to calculate the estimated glomerular filtration rate (eGFR), which is used as a screening test to look for evidence of kidney damage. When is it ordered? Creatinine may be ordered routinely as part of a comprehensive or basic metabolic panel, during a health examination. It may be ordered when a person has non-specific health complaints, when someone is acutely ill, and/or when a doctor suspects that a person's kidneys are not working properly. Some signs and symptoms of kidney dysfunction include: Fatigue, lack of concentration, poor appetite, or trouble sleeping Swelling or puffiness, particularly around the eyes or in the face, wrists, abdomen, thighs or ankles Urine that is foamy, bloody, or coffee-colored A decrease in the amount of urine Problems urinating, such as a burning feeling or abnormal discharge during urination, or a change in the frequency of urination, especially at night Mid-back pain (flank), below the ribs, near where the kidneys are located High blood pressure The creatinine blood test may be ordered, along with BUN test and microalbumin, at regular intervals when someone has a known kidney disorder or has a disease that may affect kidney function or be exacerbated by dysfunction. Both BUN and creatinine may be ordered when a CT scan is planned, prior to and during certain drug therapies, and before and after dialysis to monitor the effectiveness of treatments.

What does the test result mean? Increased creatinine levels in the blood suggest diseases or conditions that affect kidney function. These can include: Damage to or swelling of blood vessels in the kidneys (glomerulonephritis) caused by, for example, infection or autoimmune diseases Bacterial infection of the kidneys (pyelonephritis) Death of cells in the kidneys' small tubes (acute tubular necrosis) caused by, for example, drugs or toxins Prostate disease, kidney stone, or other causes of urinary tract obstruction Reduced blood flow to the kidney due to shock, dehydration, congestive heart failure, atherosclerosis, or complications of diabetes Creatinine blood levels can also increase temporarily as a result of muscle injury and are generally slightly lower during pregnancy. Low blood levels of creatinine are not common, but they are also not usually a cause for concern. They can be seen with conditions that result in decreased muscle mass. Levels of 24-hour urine creatinine are evaluated with blood levels as part of a creatinine clearance test. Random urine creatinine levels have no standard reference ranges. They are usually used with other tests to reference levels of other substances measured in the urine. Some examples include the microalbumin test and microalbumin/creatinine ratio and the urine protein test.

ABO and Rh Typing

What is being tested? Red blood cells (RBCs) have markers or antigens on the surface of the cells. Two major antigens or surface identifiers on human RBCs are the A and B antigens. Blood is grouped according to the presence or absence of these antigens. People whose red blood cells have A antigens are considered to be blood group A; those with B antigens are group B; those with both A and B antigens are group AB; and those who do not have either of these markers are considered to have blood group O. Another important surface antigen is called Rh factor. If it is present on the red blood cells, a person's blood type is Rh+ (positive); if it is absent, the person's blood is type Rh- (negative). Our bodies naturally produce antibodies against the A and B antigens we do not have on our red blood cells. For example, a person who is blood type A will have antibodies directed against the B antigens on red blood cells and someone who is type B will have anti-A antibodies and so on. The following table indicates the type of antibodies a person is expected to have based on their blood type. A PERSON WITH BLOODTYPE ... WILL HAVE ANTIBODIES TO ... A B AB B antigen A antigen Neither antigen

A PERSON WITH BLOODTYPE ... WILL HAVE ANTIBODIES TO ... O A and B antigens

These antibodies are useful for determining a person's ABO group and are significant in defining the types of blood that they can safely receive. If a person who is group A with antibodies directed against the B antigen, for example, were to be transfused with blood that is type B, the antibodies would target and destroy the transfused red blood cells, causing severe, potentially fatal complications. Thus it is critical to match a person's blood type with the blood that is to be transfused. How is the sample collected for testing? A sample of blood is drawn from a vein in your arm or from the tip of your finger (fingerstick). In newborns, blood from the umbilical cord or a small amount of blood from a heelstick may be used for testing.