Common Laboratory Tests

Laboratory Test Characteristics Indication/ Condition

related
I. Blood/Hematological Tests
1. COMPLETE BLOOD COUNT (CBC)
a. Hemoglobin Is a protein in RBC that Low hemoglobin level may
carries oxygen be due to:
Hemoglobin test measures - Various types of anemia
how much hemoglobin is in - GI bleeding/heavy
the blood menstrual period
- Low levels of folate, iron,
vitamin B6 or B12
Levels higher than normal
indicates:
-Certain birth defects of the
heart
- Cor pulmonale - causes
the right ventricle to enlarge and
pump blood less effectively than
it should. The ventricle is then
pushed to its limit and ultimately
fails. This condition is often
prevented when the high
pressure of blood going to the
lungs is controlled.
b. Hematocrit It measures percentage by Low HCT:
volume of packed RBCs in -anemia, hemodilution or
a whole blood sample massive blood loss
High HCT:
- polycythaemia vera (too
many RBC),
- hemoconcentration due to
blood loss & dehydration
c. White Blood Cell Differential
1. Neutrophils Most abundant WBC Low levels: increased risk of
infection
High levels:
Bacterial infection
2. Basophils Basophilia present in
malignant disorders such as
leukemia and myelofibrosis
(disrupts your body's normal
production of blood cells
leading to severe anemia,
weakness)
3. Eosinophil Inactivation of mediators of High levels: allergies,
released from mast cells infections with parasites
 therefore it is apparent in
allergic reactions
4. Lymphocytes Second most abundant Low levels: hepatitis,
WBC, usually found in the lymphoma or AIDS
spleen and lymphatic High levels: Viral infection
tissues
5. Monocytes High levels: blood diseases,
certain infections or
autoimmune diseases
d. Red Cell Indices - Provide important information about the size, Hgb concentration,
and Hgb weight of an average RBC
- Aid in the diagnosis of and classification of anemia
1. Mean corpuscular volume (MCV) – average size of erythrocytes, and indicates
whether they are microcytic, macrocytic, or normocytic
2. Mean corpuscular hemoglobin (MCH) – gives the weight of Hgb in an average
RBC
3. Mean corpuscular hemoglobin concentration (MCHC) – concentration of
hemoglobin in 100 mL of packed RBCs.
e. Platelet count Is one of the most important A decrease can result from
screening tests of platelet aplastic or hypoplastic bone
functions marrow, increased platelet
Used to evaluate platelet destruction
production, assess the An increase is due to
effects of hemorrhage, iron deficiency
chemotherapy/radiation anemia, recent surgery,
therapy of platelet pregnancy
production, diagnose and Can aid in the detection of
monitor dengue fever.
thrombocytopenia
(increased risk of
bleeding due to injury or
disease)
f. Erythrocyte Measure of settling rate of Used primarily to measure
Sedimentation Rate red cells in a sample of progress &response to
(ESR) anticoagulated blood treatment of inflammatory
diseases
2. MONITORING OF ANTICOAGULANT THERAPY
a. Prothrombin Time (PT)
- Responsive to depression of 3 vitamin K dependent factors (II, VII, X)
b. International Normalized Ratio (INR)
- Ratio of PT of the patient compared to that of the normal control
c. Activated Partial Thromboplastin Time (aPTT)
- Most common method of monitoring unfractionated heparin therapy
* INR is a calculation based on results of a PT and is used to monitor individuals who are being
treated with the blood-thinning medication (anticoagulant) warfarin (Coumadin®).
The PT and INR are used to monitor the effectiveness of the anticoagulant warfarin.
II. Cardiovascular
a. Creatine Kinase (CK) Is an enzyme that catalyzes the creatine (important energy
CK isoenzymes: storage in muscle metabolism)
• CKBB (CK1)
• CKMB (CK2) Purpose:
• CKMM (CK3)  To detect and diagnose MI and reinfarction
 To evaluate possible causes of chest pain
 Monitor severity of myocardial ischemia
b. Total Cholesterol - Used to measure the circulating levels of free cholesterol and
cholesterol esters
High serum cholesterol levels may be associated with an increased risk of
coronary artery disease
c. Lipid profile/lipid panel/cholesterol test
(Needs fasting prior to the test)
Fasting means you don't eat or drink anything usually for 8 to 12 hours beforehand.
1. Cholesterol = used to build cells and certain hormones
2. Triglycerides = store unused calories and provide your body with energy
3. LDL= ↑ levels= cholesterol deposits in the arteries
4. HDL= ↑ levels= lower risk of developing heart disease
5. VLDL =↑ levels= risk of heart disease/pancreatitis
III. Hepatobiliary and Pancreas
Liver Function Test (Needs fasting prior to the test)
a. AST / SGOT - Evaluates how much of the liver enzyme is in the blood.
(Aspartate - Extremely high levels can cause severe liver damage.
aminotransferase/
serum glutamic-
oxaloacetic
transaminase)
b. ALT / SGPT (Alanine -Necessary for tissue energy production
aminotransferase/serum - Found primarily in the liver
glutamic-pyruvic - Sensitive indicator of hepatocellular damage
transaminase)
c. Amylase - Synthesized primarily in the pancreas and salivary glands
- Helps to digest starch and glycogen in the mouth,
stomach, and intestine
- Serum or urine AML is the most important laboratory
test in cases of suspected acute pancreatic disease
Most common symptom of pancreatitis: Pain in the stomach
that radiates into the back
d. Lipase - Converts triglycerides and other fats into fatty acids and
glycerol
- The destruction of pancreatic cells cause large amounts of
lipase to be released in the blood
IV. Renal
a. Creatinine (Cr)
b. Blood Urea Nitrogen
(BUN)
c. Creatinine Clearance
(CrCl)
V. Hormones
a. Fasting Blood Sugar
(FBS)
(Needs fasting prior to the
test)
b. Glycosylated
Hemoglobin/Hemoglobin
A1C (HbA1C)
(Needs fasting prior to the
test)
c. Thyroid Function Test
1. Thyroxine (T4)
2. Triiodothyronine (T3)
- Creatinine in a non- Elevated SCr levels indicate
protein end product of renal disease that has
creatine metabolism that seriously damaged 50% or
appears in the blood more of nephrons
proportional to the body’s
muscle mass
- Serum creatinine levels
provides a more sensitive
measure of renal damage
than BUN levels
- Formed in the liver from ammonia and excreted in the
kidneys
- BUN level reflects protein intake and renal excretory
capacity
- UREA: waste product form protein metabolism (liver)
excreted by the kidneys
- Excellent diagnostic Low creatinine clearance –
indicator of renal function reduced renal blood flow,
- CrCl test determines how heart failure, severe
efficiently the kidneys are dehydration
clearing creatinine from the
blood
- Used to measure plasma Elevated levels: associated
glucose levels after a 12- with Diabetes Mellitus (DM)
to 14-hour fast and insulin resistance, in
which the body cannot
properly handle sugar
- Total fasting hemoglobin
- Reflects the average blood sugar for the two to three
month period before the test
-An amine secreted by the Elevated T4 level is
thyroid gland in response to consistent with
TSH hyperthyroidism
Low levels indicate
hypothyroidism
A thyroid hormone that Elevated T3 level is
affects almost every consistent with
physiological process in the hyperthyroidism
body, including growth & Low levels indicate
development, metabolism, hypothyroidism
 body temperature, and
heart rate.
3. Thyroid Stimulating -Promotes increases in the size, number, and activity of the
Hormone (TSH) thyroid cells
-Stimulates the release of T3 and T4
VI. Bones, Joints and Muscles
a. Rheumatoid Factor - An immunologic test for
(RF Test) confirming Rheumatoid
Arthritis (RA)
b. C – Reactive Protein Biologic marker of systemic -Elevated level may be
(CRP) inflammation.
c. Uric Acid - Used to measure plasma
and urine levels of uric
acid
High values can also be
caused by the use of
diuretics.
VII. Electrolytes / Minerals
a. Potassium (K+) - Major ICF
- Essential for cardiac
function, CNS function by
regulating muscle and
nerve excitability , enzyme
activity , and glycogen use
b. Sodium (Na+) - Acid-base imbalance,
*Important for stable blood osmolality and water
pressure level. retention, enzyme activity
- Major extracellular cation
Elevated levels: rheumatoid
nodules, Rheumatoid
Arthritis
present in RA, MI, cancer,
acute bacterial and viral
infections, IBD
-Elevated levels: Gout,
arthritis, kidney stones and
kidney disease
- Low level of Potassium:
Hypokalemia
-High level of Potassium:
Hyperkalemia
*Loop diuretics
(Ex: Furosemide,
bumetanide) and Thiazide
diuretics
(Ex: Hydrochlorothiazide) can
cause hypokalemia
- Low level of Sodium:
Hyponatremia
- High level of Sodium:
Hypernatremia

c. Calcium (Ca2+) Essential for blood - Low level of Calcium:

d. Chloride (Cl-)
e. Phosphorus (P+)
coagulation, endocrine Hypocalcemia
function and neuromuscular - High level of Calcium:
function such as muscular Hypercalcemia
contraction and nerve
excitability
- Tissue osmolality, K+ retention, CO2 transport and
formation of HCl in GIT
- Found in the bone and ICF
- Forming and storing of energy (ATP), neuromuscular
function, formation of bones and teeth, body metabolism
f. Magnesium (Mg2+) - Enzyme activity, cardiac and neuromuscular function
VIII. Respiratory
a. Arterial Blood Gas Measures the amount of Imbalances in the oxygen,
(ABG) Analysis oxygen and carbon carbon dioxide, and pH
dioxide in the blood. levels of your blood can
indicate the presence of:
kidney failure
heart failure
uncontrolled diabetes
hemorrhage
chemical poisoning
drug overdose

IX. Tumor Markers

a. Prostate-Specific - Released into a man’s -Elevated levels: prostate
Antigen (PSA) blood by prostate gland infections, BPH and
- Amount of PSA in the prostate CA
blood normally increases as
a man's prostate enlarges
with age
b. Alpha fetoprotein - Marker for hepatic carcinoma
c. Carcinoembryonic - It is associated with rapid multiplication of digestive
antigen (CEA) system epithelial cells and is used to monitor tumor
recurrence like in colorectal cancer and breast cancer
d. Cancer antigen - A type of antigen released by - A high CA 19-9 is related
(CA 9-9) pancreatic cancer cells. to pancreatic cancer,
gallstones, pancreatitis,
liver disease
e. Cancer antigen 125 -The only tumor marker - A high CA-125 is related
(CA-125) recommended for clinical use to ovarian cancer.
in the diagnosis and
management of ovarian
cancer.
f. Cancer antigen 15-3/ - tumor markers that are used A high CA 15-3 / CA 27-29
27-29 (CA 15-3 / CA 27- primarily for monitoring your is related to breast
29) response to therapy for breast cancer.
cancer
Biopsy - a medical test commonly performed by a physician (surgeon) that involves
extraction of sample cells or tissues for examination to determine the presence or extent
of a disease.

Some Types of Biopsies are as follows:

1. Needle biopsy - most biopsies are needle biopsies, meaning a needle is used to
access the suspicious tissue.
2. CT-guided biopsy - a person rests in a CT-scanner; the scanner's images help
doctors determine the exact position of the needle in the targeted tissue.
3. Ultrasound-guided biopsy - an ultrasound scanner helps a doctor direct the
needle into the lesion.
4. Bone biopsy - a bone biopsy is used to look for cancer of the bones via CT scan or
by an orthopedic surgeon.
5. Bone marrow biopsy - a large needle is used to enter the pelvis bone to collect bone
marrow. This detects blood diseases such as leukemia or lymphoma.
6. Liver biopsy - a needle is injected into the liver through the skin on the belly,
capturing liver tissue.
7. Kidney biopsy - a needle is injected through the skin on the back, into the kidney.
8. Aspiration biopsy - a needle withdraws material out of a mass. This simple
procedure is also called fine-needle aspiration.
9. Prostate biopsy - multiple needle biopsies are taken at one time from the prostate
gland.
10. Skin biopsy - a punch biopsy is the main biopsy method. It uses a circular blade to
get a cylindrical sample of skin tissue.
11. Surgical biopsy - either open or laparoscopic surgery may be necessary to obtain a
biopsy of hard-to-reach tissue. Either a piece of tissue or the whole lump of tissue may
be removed.