BLOOD TEST CLINICAL SIGNIFICANCE

The listings below discuss a few of the more common things measured in chemistry and
hematology tests and their clinical significance.

TESTS CLINICAL NORMAL

SIGNIFICANCE RANGE
PROFILES
LYTES Why get tested? NA: 132-142 mmol/L
Centrifuge specimen and refrigerate if To detect a problem with K: 3.6-5.0 mmol/L
pickup time is more than 2 hrs. the body’s electrolyte CL: 101-111 mmol/L
balance CO2: 21-31 mmol/L
When to get tested? Anion Gap: 6-16
As part of routine health
screening, or when your
doctor suspects that you
have an excess or deficit of
one of the electrolytes
(usually sodium or
potassium), or if your
doctor suspects an acid-
base imbalance
BASIC METABOLIC PANEL (BMP) The Basic Metabolic Panel GLUC: 60-110 mg/d
Centrifuge specimen and refrigerate if (BMP) is a group of 8 tests BUN: 8-24 mg/dL
pickup time is more than 2 hrs. (or sometimes 7 tests) that CRET: 0.9-1.6 mg/dL
is ordered as a screening CA: 8.4-10.7 mg/dL
tool to check for conditions, NA: 132-142 mmol/L
such as diabetes and kidney K: 3.6-5.0 mmol/L
disease. The BMP uses a CL: 101-111 mmol/L
tube of blood collected by CO2: 21-31 mmol/L
inserting a needle into a Anion Gap: 6-16
vein in your arm. Fasting
for 10 to 12 hours prior to
the blood draw may be
preferred.

The BMP is often ordered

in the hospital emergency
BASIC METABOLIC PANEL (BMP)
(CON’T)
COMPREHENSIVE METALBOIC
PANEL (CMP)
Centrifuge specimen and refrigerate if frequently ordered group of
pickup time is more than 2 hrs.
room setting because its
components give your
doctor important
information about the
current status of your
kidneys, electrolyte and
acid/base balance, and
blood sugar level.
Significant changes in these
test results can indicate
acute problems, such as
kidney failure, insulin
shock or diabetic coma,
respiratory distress, or heart
rhythm changes.
The BMP is also used to
monitor some known
conditions, such as
hypertension and
hypokalemia (low
potassium level). If your
doctor is interested in
following two or more
individual BMP
components, he may order
the entire BMP because it
offers more information.
Alternatively, he may order
an electrolyte panel to
monitor your sodium,
potassium, chloride, and
CO2. If your doctor wants
even more information, he
may order a complete
metabolic panel.
The Comprehensive GLUC: 60-110 mg/d
Metabolic Panel (CMP) is a BUN: 8-24 mg/dL
CRET: 0.9-1.6 mg/dL
14 tests that gives your TBIL: 0.0-1.2 mg/dL
doctor important ALKP: 49-142 IU/L
information about the SGOT: 16-49 IU/L
current status of your SGPT: 10-60 IU/L
kidneys, liver, and TP: 6.1-8.0 g/dL
electrolyte and acid/base ALB: 3.2-5.5 g/dL
balance as well as of your CA: 8.4-10.7 mg/dL
COMPREHENSIVE METALBOIC blood sugar and blood NA: 132-142 mmol/L
PANEL (CMP) (CON’T) proteins. Abnormal results, K: 3.6-5.0 mmol/L
and especially combinations CL: 101-111 mmol/L
of abnormal results, can CO2: 21-31 mmol/L
indicate a problem that Anion Gap: 6-16
needs to be addressed.

The CMP is used as a broad

screening tool to check for
conditions such as diabetes,
liver disease, and kidney
disease. It is also used to
monitor complications of
diseases or side effects of
medications used to treat
diseases. The CMP is
routinely ordered as part of
a blood work-up for a
medical exam or yearly
physical and is collected by
inserting a needle into a
vein in your arm. Usually
fasting for 10 to 12 hours
prior to the blood draw is
preferred. While the tests
are sensitive, they do not
usually tell your doctor
specifically what is wrong.
Abnormal test results or
groups of test results are
usually followed-up with
other specific tests to
confirm or rule out a
suspected diagnosis.

The CMP is also used to

monitor some known
problems, such as
hypertension, and drug
therapies, such as
cholesterol-lowering drugs.
If your doctor is interested
in following two or more
individual CMP
components, s/he may order
the entire CMP because it
COMPREHENSIVE METALBOIC offers more information.
PANEL (CMP) (CON’T)

LIPID PANEL The lipid profile is a group TGL: mg/dL

of tests that are often Normal= <150
Borderline = 150-199
ordered together to High = 200-499
determine risk of coronary Very High = >500
heart disease. The tests that CHOL: mg/dL
make up a lipid profile are Desirable <200
tests that have been shown Borderline 200-239
High > or = 240
to be good indicators of HDL: 40-59 mg/dL
whether someone is likely Cal. LDL: mg/dL
to have a heart attack or Optimal <100
stroke caused by blockage Near 100-129
of blood vessels (hardening Borderline 130-159
High 160-189
of the arteries). Very High >190
LIVER PANEL A liver panel, also known TBIL: 0.0-1.2 mg/dL
as liver (hepatic) function DBIL: 0.0-0.2 mg/dL
tests or LFT, is used to IBIL: 0.0-0.1 mg/dL
detect liver damage or ALKP: 49-142 IU/L
disease. It usually includes SGOT: 16-49 IU/L
seven tests that are run at SGPT: 10-60 IU/L
the same time on a blood ALB: 3.2-5.5 g/dL
sample.
CHEMISTRY
ALBUMIN INCREASED absolute 3.2-5.5 g/dL
serum albumin content is
not seen as a natural
condition. Relative
increase may occur in
hemoconcentration.
Absolute increase may
occur artificially by
infusion of hyperoncotic
albumin suspensions.
DECREASED serum
albumin is seen in states of
decreased synthesis
(malnutrition,
malabsorption, liver
disease, and other chronic
diseases), increased loss
(nephritic syndrome, many
GI conditions, thermal
burns, etc.), and increased
catabolism (thyrotoxicosis,
ALBUMIN (CON’T) cancer chemotherapy,
Cushing’s disease, familial
hypoproteinemia).
ALKALINE PHOSPHATASE INCREASED serum 49-142 IU/L
alkaline phosphatase is seen
in states of increased
osteoblastic activity
(hyperparathyroidism,
osteomalacia, primary and
metastatic neoplasms),
hepatobiliary diseases
characterized by some
degree of intra- or
extrahepatic cholestasis,
and in sepsis, chronic
inflammatory bowel
disease, and thyrotoxicosis.
Isoenzymes determination
may help determine the
organ/tissue responsible for
an alkaline phosphatase
elevation.
DECREASED serum
alkaline phosphatase may
not be clinically significant.
However, decreased serum
levels have been observed
in hypothyroidism, scurvy,
kwashiorkor,
achrondroplastic dwarfism,
deposition of radioactive
materials in bone, and in the
rare genetic condition
hypophosphatasia.
There are probably more
variations in the way in
which alkaline phosphatase
is assayed than any other
enzyme. Therefore, the
reporting units vary from
place to place. The
reference range for the
assaying laboraotory must
be carefully studied when
interpreting any individual
result.
ALT (SGPT) INCREASE of serum 10-60 IU/L
alanine aminotransferase
(ALT, formerly called
“SGPT”) is seen in any
condition involving
necrosis of hepatocytes,
myocardial cells,
erythrocytes, or skeletal
muscle cells.
AMYLASE Why get tested? 25-125 U/L
To diagnose pancreatitis or
other pancreatic diseases
When to get tested?
If you have symptoms of a
pancreatic disorder, such as
severe abdominal pain,
fever, loss of appetite, or
nausea
AST (SGOT) INCREASE of aspartate 16-49 IU/L
aminotransferase (AST,
formerly called “SGOT”) is
seen in any condition
involving necrosis of
hepatocytes, myocardial
cells, or skeletal muscle
cells.
DECREASED serum AST
is of no known clinical
significance.
ASO, TITER Antistreptolysin O (ASO) 0-100 IU/mL
titer is a blood test used to
help diagnose a current or
past infection with Group A
strep (Streptococcus
pyogenes). It detects
antibodies to streptolysin O,
one of the many strep
antigens. This test is rarely
ordered now compared to
thirty years ago. For an
acute strep throat infection,
this test is not performed;
the throat culture is used.
However, if a doctor is
trying to find out if
someone had a recent strep
ASO, TITER (CON’T) infection that may not have
been diagnosed, this test
could be helpful. In
addition, it may be used to
help diagnose rheumatic
fever, which occurs weeks
after a strep throat infection
when the throat culture
would no longer be
positive.
BUN Serum urea nitrogen (BUN) 8-24 mg/dL
is INCREASED in acute
and chronic intrinsic renal
disease, in state
characterized by decreased
effective circulating blood
volume with decreased
renal perfusion, in postrenal
obstruction of urine flow
and in high protein intake
states.
DECREASED serum urea
nitrogen (BUN) is seen in
high carbohydrate/low
protein diets, states
characterized by increased
anabolic demand (late
pregnancy, infancy,
acromegaly), malabsorption
states and severe liver
damage.
TOTAL BILIRUBIN Serum total bilirubin is TBIL: 0.0-1.2 mg/dL
DIRECT BILIRUBIN INCREASED in DBIL: 0.0-0.2 mg/dL
INDIRECT BILIRUBIN hepatocellular damage IBIL: 0.0-1.1 mg/dL
(infectious hepatitis,
alcoholic and other toxic
hepatopathy, neoplasms),
intra- and extrahepatic
biliary hemolysis,
physiologic neonatal
jaundice, Crigler-Najjar
syndrome, Gilbert’s
disease, Dubin-Johnson
syndrome, and fructose
intolerance.
Disproportionate
TOTAL BILIRUBIN ELEVATION of direct
DIRECT BILIRUBIN (conjugated) bilirubin is
INDIRECT BILIRUBIN seen in cholestasis and late
(CON’T) in the course of chronic
liver disease. Indirect
(unconjugated) bilirubin
tends to predominate in
hemolysis and Gilbert’s
disease.
DECREASED serum total
bilirubin is probably not of
clinical significance but has
been observed in iron
deficiency anemia.
BNP Why get tested? 0-100 pg/mL
To help diagnose the
presence and severity of
heart failure
When to get tested?
If you have symptoms of
heart failure, such as
shortness of breath and
fatigue, or if you are being
treated for heart failure

CALCIUM HYPERCALCEMIA is 8.4-10.7 mg/dL

seen in malignant
neoplasms (with or without
bone involvement), primary
and tertiary
hyperparathyroidism,
sarcoidosis, Vitamin D
intoxication, milk-alkali
syndrome, Paget’s disease
of bone (with
immobilization),
thyrotoxicosis, acromegaly,
and diuretic phase of renal
acute tubular necrosis. For
a given total calcium level,
acidosis increases the
physiologically active
ionized form of calcium.
Prolonged tourniquet
pressure during
venipuncture may
CALCIUM (CON’T) spuriously increase total
calcium. Drugs producing
hypercalcemia include
alkaline antacids, DES,
diuretics (chronic
administration), estrogens
(including oral
contraceptives) and
progesterone.
HYPOCALCEMIA must
be interpreted in relation to
serum albumin
concentration. True
decrease in the
physiologically active
ionized form of Ca++
occurs in may situations,
including
hypoparathyroidism,
Vitamin D deficiency,
chronic renal failure,
magnesium deficiency,
prolonged anticonvulsant
therapy, acute pancreatitis,
massive transfusion,
alcoholism, etc. Drugs
producing hypocalcemia
include most diuretics,
estrogens, fluorides,
glucose, insulin, excessive
laxatives, magnesium salts,
methicillin and phosphates.
CEA Why get tested? Non-Smokers: <2.8 n g/mL
To determine whether Smokers: <7.4 ng/mL
cancer is present in the
body and to monitor cancer
treatment
When to get tested?
When your doctor thinks
your symptoms suggest the
possibility of cancer and
before starting cancer
treatment as well as at
intervals during and after
therapy
CHOLESTEROL Total cholesterol has been
found to correlate with total
CHOLESTEROL (CON’T) found to correlate with total CHOL: mg/dL
and cardiovascular Desirable <200
Borderline 200-239
mortality in the 30-50 year High > or = 240
age group. Cardiovascular
mortality increases 9% for
each 10 mg/dL increase in
total cholesterol over the
baseline value of 180
mg/dL. Approximately
80% of the adult male
population has values
greater than this, so the use
of median 95% of the
population to establish
normal range (as is
traditional in lab medicine
in general) has no utility for
this test. Excess mortality
has been shown not to
correlate with cholesterol
levels in the >50 years age
group, probably because of
the depressive effects on
cholesterol levels expressed
by various chronic diseases
to which older individuals
are prone.
CK Why get tested? FEMALE: 34-204 IU/L
To determine if you have MALE: 41-277 IU/L
had a heart attack and if
other muscles in your body
have been damaged.
When to get tested?
If you have chest pain or
muscle pain and weakness;
immediately after a
suspected heart attack and
every few hours for a total
of 3 or 4 tests
CREATININE Serum creatinine level and CRET: 0.9-1.6 mg/dL
CREATININE CLEARANCE “creatinine clearance” are
different ways of
determining kidney
function.
Creatinine is a protein
produced by muscle and
CREATININE
CREATININE CLEARANCE (CON’T)
released into the blood.
The amount produced is
relatively stable in a given
person. The creatinine
level in the serum is
therefore determined by the
rate it is being removed,
which is roughly a measure
of kidney function. If
kidney function falls (say a
kidney is removed to donate
to a relative), the creatinine
level will rise. Normal is
about 1 for an average
adult. Infants that have
little muscle will have
lower normal levels (0.2).
Muscle bound weight lifters
may have a higher normal
creatinine. Serum
creatinine only reflects
renal function in a steady
state. After removing a
kidney, if the donor’s blood
is checked right away the
serum creatinine will still
be 1. In the next day the
creatinine will rise to a new
steady state (usually about
1.8). If both kidneys were
removed (say for cancer)
the creatinine would
continue to rise daily until
dialysis is begun. How fast
it rises depends on
creatinine production,
which is again related to
how much muscle one has.
Creatinine clearance is
technically the amount of
blood that is “cleared” of
creatinine per time period.
It is usually expressed in
mL per minute. Normal is
120 mL/min for an adult. It
is roughly, inversely related
CREATININE to serum creatinine: If the
CREATININE CLEARANCE (CON’T) clearance drops to one half
of the old level, the serum
creatinine doubles (in the
steady state). So for an
adult, serum creatinine of 2
is roughly a creatinine
clearance of 60 mL/min;
creatinine 3 is roughly a
clearance of 30; creatinine
of 4 is roughly a clearance
of 15, etc. So why didn’t
the creatinine rise to only 2
when a kidney was
removed? The answer is
that the remaining kidney
“hyperfilters” and seems to
work harder, therefore
kidney function is not quite
halved.
Usually, an adult will need
dialysis because symptoms
of kidney failure appear at a
clearance of less than 10
mL/min. Creatinine
clearance has to be
measured by urine
collection (usually 12 or 24
hours). It is a more precise
estimate of kidney function
than serum creatinine since
it does not depend on the
amount of muscle one has.
CRP Why get tested? 0.0-0.99 mg/dL
To identify the presence of
inflammation and to
monitor response to
treatment [Note: to test for
your risk of heart disease, a
more sensitive test (hs-
CRP) is used.]
When to get tested?
When your doctor suspects
that you might be suffering
from an inflammatory
disorder (as with certain
CRP (CON’T) types of arthritis and
autoimmune disorders or
inflammatory bowel
disease) or to check for the
presence of infection
(especially after surgery)
HIGH SENSITIVITY CRP Why get tested? mg/dL
May be helpful in assessing Lowest Risk <0.06
risk of developing heart Low Risk 0.07-0.11
disease Mod. Risk 0.12-0.19
When to get tested? High Risk 0.20-0.38
No current consensus exists Highest Risk >0.39
on when to get tested; the
test is most often done in
conjuction with other tests
that are ordered to assess
risk of heart disease, such
as lipid profiles.
DLDL To help determine your risk mg/dL
of developing heart disease Optimal <100
and to monitor lipid Near Optimal 100-129
lowering lifestyle changes Borderline 130-159
and drug therapies. To High 160-189
accurately determine your Very High >190
low-density lipoprotein
(LDL) level when you are
nonfasting.
FERRITIN The test is done to learn 24-336 ng/mL
about your body’s ability to
store iron for later use.
You should get tested when
your doctor suspects you
may not have enough iron
or too much iron in your
system
VITAMIN B12 Why get tested? pg/mL
To help diagnose the cause Normal 180-707
of anemia or neuropathy Indeterminate 141-179
(nerve damage), to evaluate Deficient <141
nutritional status in some
patients, to monitor
effectiveness of treatment
for B12 or folate
deficiency.
When to get tested?
When you have large red
VITAMIN B12 (CON’T) blood cells, when you have
symptoms of anemia and/or
of neuropathy. When you
are being treated for B12 or
folate deficiency.
FOLATE Why get tested? ng/mL
To help diagnose the cause Normal >3.1
of anemia or neuropathy Indeterminate 2.5-3.1
(nerve damage), to evaluate Deficient <2.5
nutritional status in some
patients, to monitor
effectiveness of treatment
for B12 or folate
deficiency.
When to get tested?
When you have large red
blood cells, when you have
symptoms of anemia and/or
of neuropathy. When you
are being treated for B12 or
folate deficiency.
GLUCOSE Why get tested? 60-110 mg/dL
To determine whether or
not your blood glucose
level is within normal
ranges; to screen for,
diagnose, and monitor
diabetes, pre-diabetes, and
hypoglycemia (low blood
glucose)
When to get tested?
As part of a yearly physical
and when you have
symptoms suggesting
hyperglycemia (high blood
glucose) or hypoglycemia,
or if you are pregnant; if
you are diabetic, up to
several times a day to
monitor glucose levels
3.3-5.6 %
HEMOGLOBIN A1C Why get tested?
(GLYCOHEMOGLOBIN) To monitor a person’s
diabetes and to aid in
treatment decisions
When to get tested?
HEMOGLOBIN A1C When first diagnosed with
(GLYCOHEMOGLOBIN) diabetes and then 2 to 4
(CON’T) times per year
IRON Iron is needed to help form ug/dL
adequate numbers of Male 50-160
normal red blood cells, Female 40-150
which carry oxygen
throughout the body. Iron is
a critical part of
hemoglobin, the protein in
red blood cells that binds
oxygen in the lungs and
releases it as blood travels
to other parts of the body.
Iron is also needed by other
cells, especially muscle
(which contains another
oxygen binding protein
called myoglobin). Low
iron levels can lead to
anemia, in which the body
does not have enough red
blood cells. Other
conditions can cause you to
have too much iron in your
blood.
Serum Iron level measures
the level of iron in the
liquid part of your blood.
IMMUNOELECTROPHORESIS Why get tested?
To help diagnose and
monitor multiple myeloma
and a variety of other
conditions that affect
protein absorption,
production, and loss as seen
in severe organ disease and
altered nutritional states
When to get tested?
If you have an abnormal
total protein or albumin
level or if your doctor
suspects that you have a
condition that affects
protein concentrations in
the blood and/or causes
IMMUNOELECTROPHORESIS protein loss through the
(CON’T) urine
LD Why get tested? IU/L
To help identify the cause Male 140-304
and location of tissue Female 142-297
damage in the body, and to
monitor its progress;
historically, has been used
to help diagnose and
monitor a heart attack, but
troponin has largely
replaced LDH in this role.
When to get tested?
Along with other tests,
when your doctor suspects
that you have an acute or
chronic condition that is
causing tissue or cellular
destruction and he wants to
identify and monitor the
problem.
LIPASE Why get tested? 22-51 U/L
To diagnose pancreatitis or
other pancreatic disease
When to get tested?
If you have symptoms of a
pancreatic disorder, such as
severe abdominal pain,
fever, loss of appetite, or
nausea
MAGNESIUM Why get tested? 1.8-2.5 mg/dL
To evaluate the level of
magnesium in your blood
and to help determine the
cause of abnormal calcium
and/or potassium levels
When to get tested?
If you have symptoms (such
as weakness, irritability,
cardiac arrhythmia, nausea,
and/or diarrhea) that may be
due to too much or too little
magnesium or if you have
abnormal calcium or
potassium levels
PHOSPHOROUS Why get tested? 4.0-7.0 mg/dL
To evaluate the level of
phosphorus in your blood
and to aid in the diagnosis
of conditions known to
cause abnormally high or
low levels
When to get tested?
As a follow-up to an
abnormal calcium level, if
you have a kidney disorder
or uncontrolled diabetes,
and if you are taking
calcium or phosphate
supplements

POTASSIUM Why get tested? 3.6-5.0 mmol/L

To diagnose levels of
potassium that are too high
(hyperkalemia) or too low
(hypokalemia)
When to get tested?
As part of a routine medical
exam or to investigate a
serious illness, such as high
blood pressure or kidney
disease
PROSTATIC SPECIFIC ANTIGEN Why get tested? 0.00-4.00 ng/mL
(PSA) To get screened for -- and
to monitor -- prostate
cancer
When to get tested?
There is some debate over
this (see prostate cancer
screening). Generally, for
men over 50, as
recommended by your
physician (may be annually
or less frequently); annually
starting at age 45 for
African-American men and
men with a family history
of prostate cancer.
RHEUMATOID FACTOR Why get tested? IU/mL
To help diagnose Negative <20
rheumatoid arthritis (RA) Weak Positive 20-50
RHEUMATOID FACTOR (CON’T) and Sjögren’s syndrome Positive >50
When to get tested?
If your doctor thinks that
you have symptoms of RA
or Sjögren’s syndrome
TRANSFERRIN Why get tested? mg/dL
To learn about your body’s Male 215-365
ability to transport iron Female 250-380
When to get tested?
When your doctor suspects
you may have too much or
too little iron in your body
because of a variety of
conditions; the test also
helps to monitor liver
function and nutrition
TOTAL PROTEIN Why get tested? 6.1-8.0 g/dL
To determine your
nutritional status or to
screen for certain liver and
kidney disorders as well as
other diseases
When to get tested?
If you experience
unexpected weight loss or
fatigue or if your doctor
thinks that you have
symptoms of a liver or
kidney disorder
URIC ACID Why get tested? 3.8-8.9 mg/dL
To detect high levels of uric
acid, which could be a sign
of the condition gout
When to get tested?
When your doctor thinks
that you might have gout or
when monitoring certain
chemotherapy or radiation
therapies for cancer
URINE CHEMISTRY
MICROALBUMIN Why get tested?
To get screened for a
possible kidney disorder
When to get tested?
Annually after a diagnosis
of diabetes or hypertension
ENDOCRINOLOGY
CORTISOL Why get tested? ug/dL
To help diagnose Cushing A.M. 8.7-22.4
syndrome or Addison P.M. <10
disease
When to get tested?
If your doctor suspects
damage to the adrenal gland
HCG, QUALITATIVE AND Why get tested? Negative
QUANTITATIVE To confirm and monitor
pregnancy or to diagnose
trophoblastic disease or
germ cell tumors
When to get tested?
As early as 10 days after a
missed menstrual period
(some methods can detect
hCG even earlier, at one
week after conception) or if
a doctor thinks that your
symptoms suggest ectopic
pregnancy, a failing
pregnancy, trophoblastic
disease, or germ cell tumors
FOILICLE STIMULATING Why get tested? 1.24-19.26 mIU/mL
HORMONE (FSH) To evaluate your pituitary
function, especially in terms
of fertility issues
When to get tested?
If you are having difficulty
getting pregnant or are
having irregular menstrual
periods or if your doctor
thinks that you have
symptoms of a pituitary or
hypothalamic disorder
LUTEINIZING HORMONE Why get tested? 1.24-8.62 mIU/mL
(LH) To evaluate your pituitary
function, especially in terms
of fertility issues
When to get tested?
If you are having difficulty
getting pregnant or are
having irregular menstrual
periods or if your doctor
thinks that you have
LUTEINIZING HORMONE symptoms of a pituitary or
(LH) (CON’T) hypothalamic disorder
PROLACTIN Why get tested? 2.64-13.13 ng/mL
To determine whether or
not your prolactin levels are
higher (or occasionally
lower) than normal
When to get tested?
When you have symptoms
of an elevated prolactin,
such as: galactorrhea and/or
visual disturbances and
headaches, as part of a
workup for female and male
infertility, and for follow up
of low testosterone in men.
TESTOSTERONE, TOTAL Why get tested? 175-781 ng/dL
To determine if your
testosterone levels are
abnormal, which may help
to explain difficulty getting
an erection (erectile
dysfunction), inability of
your partner to get pregnant
(infertility), or premature or
delayed puberty if you are
male, or masculine physical
features if you are female
When to get tested?
If you are male and your
doctor thinks that you may
be infertile or if you are
unable to get or maintain an
erection; if you are a boy
with either early or delayed
sexual maturity; if you are a
female but have male traits,
such as a low voice or
excessive body hair, or are
infertile
THYROID STIMULATING Why get tested? 0.318-5.90 uIU/mL
HORMONE (TSH) To screen for and diagnose
thyroid disorders; to
monitor treatment of
hypothyroidism
When to get tested?
THYROID STIMULATING For screening: There is no
HORMONE (TSH) (CON’T) consensus within the
medical community as to at
what age adult screening
should begin or whether it
should even be done;
however, newborn
screening is widely
recommended. For
monitoring treatment: as
directed by your doctor.
Otherwise: as symptoms
present.

T4 Why get tested? 6.09-12.23 ug/dL

DRAW IN A PLAIN RED TOP To diagnose
TUBE. THE GEL IN THE GOLD hypothyroidism or .
TOPS CAUSE INTERFERENCE hyperthyroidism in adults;
to screen for
hypothyroidism in
newborns.
When to get tested?
Usually is ordered in
response to an abnormal
TSH test result. Commonly
performed on newborns.
URINALYSIS
URINALYSIS Why get tested?
SPECIMEN GOOD FOR 8 HOURS To screen for metabolic and
REFRIGERATED OR 1 HOUR AT kidney disorders
ROOM TEMP. When to get tested?
Regularly on admission to a
hospital; in a work-up for a
planned surgery; as part of
an annual physical exam; or
when evaluating a new
pregnancy. May be done if
you have abdominal pain,
back pain, frequent or
painful urination, or blood
in the urine.

HEMATOLOGY/COAGULATION MIX TUBES WELL

HEMOGLOBIN/HEMATOCRIT Why get tested? HCT: 38-50 %
(H&H) If you have anemia (too few HGB: 13.0-17.0 g/Dl
red blood cells) or
HEMOGLOBIN/HEMATOCRIT
(H&H) (CON’T)
CLOTTED SPECIMENS HAVE TO
BE REJECTED.
PLATELET COUNT
CLOTTED SPECIMENS HAVE TO
BE REJECTED.
COMPLETE BLOOD COUNT
(CBC)
CLOTTED SPECIMENS HAVE TO
BE REJECTED.
COMPLETE BLOOD COUNT WITH
DIFFERENTIAL
(CBCD)
CLOTTED SPECIMENS HAVE TO
BE REJECTED.
ESR (SEDIMENTATION RATE)
SPECIMEN CAN BE HELD FOR 12
HOURS IF REFRIGERATED.
polycythemia (too many red
blood cells), to assess its
severity, and to monitor
response to treatment
When to get tested?
As part of a complete blood
count (CBC), which may be
ordered for a variety of
reasons
Why get tested? 140-400 THOUS
To diagnose a bleeding
disorder or a bone marrow
disease
When to get tested?
As part of a regular
complete blood count
(CBC) or to
diagnose/monitor a bone
marrow/blood disease
Why get tested? WBC: 3.5-11.0 THO/MM3
To determine general health RBC: 4.2-5.7 MIL/MM3
HGB: 13.0-17.0 g/dL
status and to screen for a HCT: 38-50 %
variety of disorders, such as MCV: 80-99 Fl
anemia and infection, as MCH: 27-34 uug
well as nutritional status MCHC: 33-36 g/Dl
and exposure to toxic RDW: 11.2-15.2%
PLT: 140-400 THOUS
substances MPV: 7.3-10.1
When to get tested?
As part of a routine medical
exam or as determined by
your doctor
Why get tested? WBC: 3.5-11.0 THO/MM3
To diagnose an illness RBC: 4.2-5.7 MIL/MM3
HGB: 13.0-17.0 g/dL
affecting your immune HCT: 38-50 %
system, such as an infection MCV: 80-99 Fl
When to get tested? MCH: 27-34 uug
As part of a complete blood MCHC: 33-36 g/Dl
count (CBC), which may be RDW: 11.2-15.2%
PLT: 140-400 THOUS
ordered for a variety of MPV: 7.3-10.1
reasons
Why get tested?
To detect and monitor the mm/hr
activity of inflammation as Male 0-15
an aid in the diagnosis of Female 0-20
the underlying cause
When to get tested?
ESR (SEDIMENTATION RATE)
(CON’T)
PROTHROMBIN TIME (PT)
PROTHROMBIN TIME IS GOOD
FOR 24 HOURS REFRIGERATED.
TUBE MUST BE FILLED
COMPLETELY.
PARTIAL THROMBOPLASTIN TIME
(PTT)
PTT MUST BE RUN WITHIN 4
HOURS.
TUBE MUST BE FILLED
COMPLETELY.
WHITE BLOOD CELL COUNT
(WBC)
When your doctor thinks
that you might have a
condition that causes
inflammation and to help
diagnose and follow the
course of temporal arteritis
or polymyalgia rheumatica
Why get tested? With anticoagulant:
To check how well blood- <45 sec
thinning medications (anti- Without anticoagulant:
coagulants) are working to 10.5-13.8 sec
prevent blood clots; to help
detect and diagnose a
bleeding disorder
When to get tested?
If you are taking an anti-
coagulant drug or if your
doctor suspects that you
may have a bleeding
disorder
Why get tested? 22.0-37.0 sec
As part of an investigation
of a bleeding or thrombotic
episode. To help evaluate
your risk of excessive
bleeding prior to a surgical
procedure. To monitor
heparin anticoagulant
therapy.
When to get tested?
When you have
unexplained bleeding or
blood clotting. When you
are on heparin
anticoagulant therapy.
Sometimes as part of a pre-
surgical screen.
Why get tested? 3.5-11.0 THO/MM3
If your doctor thinks that
you might have an infection
or allergy and to monitor
treatment
When to get tested?
As part of a complete blood
count (CBC), which may be
ordered for a variety of
 reasons
D-DIMER Why get tested? 0-400 ng/mL
To help diagnose or rule out
thrombotic (blood clot
producing) diseases and
conditions
When to get tested?
When you have symptoms
of a disease or condition
that causes acute and/or
chronic inappropriate blood
clot formation such as:
DVT (Deep Vein
Thrombosis), PE
(Pulmonary Embolism), or
DIC (Disseminated
Intravascular Coagulation),
and to monitor the progress
and treatment of DIC and
other thrombotic
conditions.
SEROLOGY
ANTI-NUCLEAR ANTIBODY Why get tested? Negative
(ANA) To help diagnose systemic
lupus erythematosus (SLE)
and drug-induced lupus and
rule out certain other
autoimmune diseases
When to get tested?
If your doctor thinks that
you have symptoms of SLE
or drug-induced lupus
HIV Why get tested? Negative
To determine if you are
infected with HIV
When to get tested?
Three to six months after
you think you may have
been exposed to the virus
H. PYLORI ANTIBODY SCREEN Why get tested? Negative
To diagnose an infection
with Helicobacter pylori
When to get tested?
If you have gastrointestinal
pain or symptoms of an
ulcer
MONO SCREEN Why get tested? Negative
To get screened for
mononucleosis
When to get tested?
If you have symptoms of
mononucleosis, including
fever, sore throat, swollen
glands, and fatigue
FLU A&B Why get tested? Negative
To determine whether or
not you have the influenza
A or B; to help your doctor
make rapid treatment
decisions; and to help
determine whether or not
the flu has come to your
community.
When to get tested?
When it is flu season and
your doctor wants to
determine whether your flu-
like symptoms are due to
influenza A or B, or to
other causes. Within 48
hours of the onset of your
symptoms, to help
determine treatment
options.
MICROBIOLOGY
URINE CULTURE Why get tested?
To diagnose a urinary tract
infection (UTI)
When to get tested?
If you experience
symptoms of a UTI, such as
pain during urination
AFB CULTURE Why get tested?
To help identify a
mycobacterial infection, to
diagnose tuberculosis (TB),
to monitor the effectiveness
of treatment

When to get tested?

When you have symptoms,
such as a chronic cough,
AFB CULTURE weight loss, fever, chills,
(CON’T) and weakness, that may be
due to TB or due to another
mycobacterial infection.
When your doctor suspects
that you have active TB.
When your doctor wants to
monitor the effectiveness of
TB treatment.
HERPES CULTURE Why get tested?
To screen for or diagnose
infection with the herpes
simplex virus
When to get tested?
If you have symptoms of an
infection with the herpes
simplex virus, such as
blisters or sores around
your mouth or in the genital
area
RAPID BETA SCREEN Why get tested?
To determine if a sore
throat (pharyngitis) is
caused by a Group A
streptococcal bacteria
(“strep throat”)
When to get tested?
If you have a sore throat
and fever and your doctor
thinks it may be due to an
upper respiratory infection
CHLAMYDIA SCREEN Why get tested?
To screen for or diagnose
chlamydia infection
When to get tested?
If you are sexually active,
pregnant, have one or more
risk factors for developing
chlamydia, or have a
cervical infection;
depending on your risk
factors, may be annually
GC SCREEN Why get tested?
To screen for Neisseria
gonorrhoeae, which causes
the sexually transmitted
GC SCREEN (CON’T) disease gonorrhea
When to get tested?
If you have symptoms of
gonorrhea or are pregnant
MRSA SCREEN The goal of laboratory
testing for staph wound
infections is to identify the
presence of S. aureus, to
determine whether it is a
MRSA strain, and to
evaluate the staph’s
susceptibility to available
antibiotics. If an infection is
due to MRSA, it should be
investigated to determine
where it came from and
how it was acquired. This is
especially important in CA-
MRSA to prevent further
cases from occurring.
VRE SCREEN VRE are specific types of
antimicrobial-resistant
staph bacteria. While most
staph bacteria are
susceptible to the
antimicrobial agent
vancomycin some have
developed resistance. VRE
cannot be successfully
treated with vancomycin
because these organisms are
no longer susceptibile to
vancomycin. However, to
date, all VRE isolates have
been susceptible to other
Food and Drug
Administration (FDA)
approved drugs.
FECAL ANALYSIS
BLOOD Why get tested? Negative
To screen for
gastrointestinal bleeding,
which may be an indicator
of colon cancer
When to get tested?
As part of a routine
BLOOD (CON’T) examination, annually after
age 50 (as recommended by
the American Cancer
Society and other major
organizations), and as
directed by your doctor
C DIFFICILE TOXIN Why get tested? Negative
To detect the presence of
Clostridium difficile toxin
When to get tested?
When a patient has acute
diarrhea that persists for
several days, abdominal
pain, fever, and/or nausea
following antibiotic therapy
GIARDIA SPECIFIC ANTIGEN This test detects protein Negative
structures on the giardia
parasite. It is more sensitive
and specific for this
particular parasite than the
O&P microscopic exam.
WBC’S Stool WBC (white None Seen
blood cells) may be
present in the stool
when there is a bacterial
infection.