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Get more medical books and resources at www.medicalbr.tk Frontmatter Title A MANUAL i OF Laboratory and Diagnostic Tests NINTH EDITION Fischbach_FM_printer_file.indd i 11/4/13 10:43 PM Fischbach_FM_printer_file.indd ii 11/4/13 10:43 PM A MANUAL OF Laboratory and Diagnostic Tests NINTH EDITION Frances Talaska Fischbach, RN, BSN, MSN Associate Clinical Professor of Nursing School of Nursing University of Wisconsin-Milwaukee Milwaukee, Wisconsin Associate Professor of Nursing (Ret) School of Nursing University of Wisconsin-Milwaukee Milwaukee, Wisconsin Marshall Barnett Dunning III, BS, MS, PhD Professor of Medicine & Physiology Department of Medicine Division of Pulmonary/Critical Care Medicine Medical College of Wisconsin Milwaukee, Wisconsin Fischbach_FM_printer_file.indd iii 11/4/13 10:43 PM Acquisitions Editor: Patrick Barbera Managing Editor: Roxanne Halpine Ward Design Coordinator: Holly McLaughlin Art Director, Illustration: Jennifer Clements Production Project Manager: Cynthia Rudy Manufacturing Coordinator: Karin Duffield Prepress Vendor: Absolute Service, Inc 9th Edition Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Copyright © 2004, 2000 by Lippincott Williams & Wilkins Copyright © 1996 by Lippincott-Raven Publishers Copyright © 1992, 1988, 1984, 1980 by J B Lippincott Company All rights reserved This book is protected by copyright No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews Materials appearing in this book prepared by individuals as part of their official duties as U.S government employees are not covered by the above-mentioned copyright To request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at permissions@lww.com, or via our website at lww.com (products and services) 987654321 Printed in China Library of Congress Cataloging-in-Publication Data ISBN: 978-1-4511-9089-2 Cataloging-in-Publication Data available on request from the publisher Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication Application of this information in a particular situation remains the professional responsibility of the practitioner; the clinical treatments described and recommended may not be considered absolute and universal recommendations The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with the current recommendations and practice at the time of publication However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions This is particularly important when the recommended agent is a new or infrequently employed drug Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in his or her clinical practice LWW.COM Fischbach_FM_printer_file.indd iv 11/4/13 10:43 PM To the memory of Marshall B Dunning III Dear friend and coauthor 1947–2013 Fischbach_FM_printer_file.indd v 11/4/13 10:43 PM Contributors, Consultants, and Research Assistants Margaret A Fischbach, RN, BA, JD Compliance Officer Allay Home & Hospice, Inc Brookfield, Wisconsin Mary Fischbach Johnson, BA, MS Research Assistant New York, New York Patricia A Van Kampen Student Nurse Research Assistant Wausau, Wisconsin Patti Cobb, RD, CD Chief Clinical Dietitian Food and Nutrition Services Froedtert Hospital Milwaukee, Wisconsin Carol Colasacco, CT(ASCP), CMIAC Cytotechnologist, Department of Pathology Fletcher Allen Health Care Burlington, Vermont Faye Enriquez, RN, BSN, MSN Associate Clinical Professor School of Nursing University of Wisconsin Milwaukee, Wisconsin Ann Shafranski Fischbach, RN, CAOHC, CPID Case Manager Restore Wheaton Franciscan Health Care Milwaukee, Wisconsin Gary Hoffman Manager, Laboratory for Newborn Screening State of Wisconsin Madison, Wisconsin Paul J Jannetto, PhD, MT(ASCP), DABCC Associate Professor, Pathology Director, Clinical Chemistry/Toxicology Medical College of Wisconsin Milwaukee, Wisconsin Jennifer Johnson RN, BSN Cardiothoracic Procurement Coordinator Loyola University Medical Center Maywood, Illinois Karen Kehl, PhD Associate Professor-Pathology Children’s Hospital of Wisconsin Milwaukee, Wisconsin Stanley F Lo, PhD, DABCC, FACB Associate Professor, Pathology Associate Director, Clinical Laboratories Technical Director, Clinical Chemistry, Point of Care, and Biochemical Genetics Directory, Reference Standards Laboratory Children’s Hospital of Wisconsin Medical College of Wisconsin Milwaukee, Wisconsin Charles R Myers, PhD Professor of Pharmacology and Toxicology Medical College of Wisconsin Milwaukee, Wisconsin Christine Naczek, MT(ASCP) Manager, Blood Banking and Pre-Transfusion Testing Department of Pathology United Regional Medical Services, Inc Milwaukee, Wisconsin Anne Witkowiak Nezworski, RN, BSN Maternity and Newborn Specialist Marshfield Clinic, Eau Claire Center Eau Claire, Wisconsin vi Fischbach_FM_printer_file.indd vi 11/4/13 10:43 PM Contributors, Consultants, and Research Assistants Joseph Nezworski, ES, RN, BSN Chief Deputy Medical Examiner Eau Claire County Nursing Supervisor Sacred Heart Hospital Eau Claire, Wisconsin Rochelle Olive-Harmon, MS RT (R) Program Director School of Radiologic Technology Froedtert Hospital Medical College of Wisconsin Milwaukee, Wisconsin Hershel Raff, PhD Department of Endocrinology Medical College of Wisconsin St Luke’s Medical Center Milwaukee, Wisconsin Tracy A Schweitzer, PhD, RN, BSN, MA Clinical Assistant Professor Marquette University Milwaukee, Wisconsin John Shalkham, MA, SCT(ASCP) Program Director for School of Cytotechnology State Laboratory of Hygiene Clinical Assistant Professor Department of Pathology University of Wisconsin Madison, Wisconsin Jean M Trione, RPh Clinical Specialist Wausau Hospital Wausau, Wisconsin Patti Wilson BSN, RN, CIC Infection Control Coordinator Froedtert Hospital Milwaukee, Wisconsin Michael Zacharisen, MD Professor of Pediatrics Children’s Hospital of Wisconsin Milwaukee, Wisconsin Reviewers Sheryl F Banak, MSN, RN, CNE Faculty RN Program Baptist Health Schools Little Rock Little Rock, Arkansas Simone Bollaerts, BN, RN, IIWCC Professor in Nursing Mohawk College of Applied Arts and Technology Hamilton, Ontario, Canada Susan Weber Buchholz, PhD, RN Professor Rush University College of Nursing Chicago, Illinois Frank G Steffel, BS, CNMT Program Director–Nuclear Medicine/PET Technology Froedtert Hospital Milwaukee, Wisconsin Susan K Callen, MSN, RN, CNE Nursing Instructor II UPMC Shadyside School of Nursing Pittsburgh, Pennsylvania Corrinne Strandell, RN, BSN, MSN, PhD Nursing Research, Home Care and Rehabilitation Specialist West Allis, Wisconsin Sandi Casey MS, RNC-MNN Nursing Instructor Connors State College Muskogee, Oklahoma Thudung Tieu, MT(ASCP) Quality Assurance & Safety Manager Dynacare Laboratories Milwaukee, Wisconsin Karen Chandra, MSN, MBA, RN Associate Professor of Nursing Harper College Palatine, Illinois Fischbach_FM_printer_file.indd vii vii 11/4/13 10:43 PM viii Reviewers Christine M Cunningham, MS, MT (ASCP) Associate Professor New York Chiropractic College Seneca Falls, New York Pasquale Fiore, RN, BScN, MSc, Health Adm, Cert Ed Nurse Educator Camosun College University of Victoria Victoria, British Columbia, Canada Paula Green, MSN Assistant Professor Nursing & Allied Sciences Bronx Community College - CUNY Bronx, New York Nancy E Pea, MSN, RN Associate Professor St Louis Community College Ferguson, Missouri Carswella Phillips, DNP, MSN, ARNP Assistant Professor Florida Agricultural and Mechanical University, School of Nursing Tallahassee, Florida Vanessa Pomarico-Denino, MSN, APRN, FNP-BC Interim Director and Lead Faculty Family Nurse Practitioner Track Southern Connecticut State University New Haven, Connecticut Cathy R Kessenich, DSN, ARNP, FAANP Professor of Nursing University of Tampa Tampa, Florida Charlene Strumpel, MSN, RN Instructor University of British Columbia, Okanagan Campus Kelowna, British Columbia, Canada Julie A Koch, DNP, RN, FNP-BC Assistant Professor and Coordinator of the FNP Program Valparaiso University College of Nursing Valparaiso, Indiana Angela Trott, MSN-Ed, BSN, RN Associate Degree Nursing Instructor Coastal Carolina Community College Jacksonville, North Carolina Diane M Lew-Snide, PhD, RN Professor of Nursing Columbia-Greene Community College Hudson, New York Catherine Mbewe, MS, RN Assistant Professor Nursing and Allied Health Sciences Bronx Community College - CUNY Bronx, New York S Wendy Whillans, MScN, RN Faculty, School of Nursing Canadore College North Bay, Ontario, Canada Mary Ellen Wilkosz, PhD, MSN, BSN, RN, FNP-BC Associate Professor and Assistant Director FNP Program Sonoma State University Rohnert Park, California Janet O’Connell, MA Ed, BN Professor of Nursing Ryerson University, Centennial College, George Brown College Collaborative BScN Program Toronto, Ontario, Canada Fischbach_FM_printer_file.indd viii 11/4/13 10:43 PM ... Research and Quality (AHRQ), and Clinical Laboratory Improvement Act (CLIA) U.S Department of Transportation Occupational Safety and Health Administration (OSHA) Clinical and Laboratory Standards Institute... differential diagnoses, follow-up, and case management Professional practice parameters of American Nurses Association (ANA), American Medical Association (AMA), American Society for Clinical Pathology... follow-up Each phase of testing requires that a specific set of guidelines and standards be followed for accurate, optimal test results Patient care standards and standards of professional practice are

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  • Cover

  • Half-Title Page

  • Title Page

  • Copyright

  • Dedication

  • Contributors, Consultants, and Research Assistants

  • Reviewers

  • Preface

    • PURPOSE

    • ORGANIZATION

    • CHAPTER CONTENT AND FEATURES

      • Introductory Information

      • Reference Values

      • Procedures

      • Clinical Implications

      • Interventions

    • REVISIONS AND ADDITIONS TO THE NINTH EDITION

    • CURRENT DEVELOPMENTS IN LABORATORY AND DIAGNOSTIC TESTING

  • Acknowledgments

  • Contents

  • 1: Diagnostic Testing

    • OVERVIEW OF THE CLINICIAN’S ROLE: RESPONSIBILITIES, STANDARDS, AND REQUISITE KNOWLEDGE

    • PRETEST PHASE: ELEMENTS OF SAFE, EFFECTIVE, INFORMED CARE

      • Basic Knowledge and Necessary Skills

      • Testing Environments

      • History and Assessment

      • Reimbursement for Diagnostic Services

      • Methodology of Testing

      • Interfering Factors

      • Avoiding Errors

      • Proper Preparation

      • Patient Education

      • Testing Protocols

      • Patient Independence

      • Test Results

      • Laboratory Reports

      • Margins of Error

      • Ethics and the Law

      • Patient’s Bill of Rights and Patient Responsibilities

      • Cultural Sensitivity

    • INTRATEST PHASE: ELEMENTS OF SAFE, EFFECTIVE, INFORMED CARE

      • Basic Knowledge and Required Skills

      • Infection Prevention

      • Collaborative Approaches

      • Risk Management

      • Specimens and Procedures

      • Equipment and Supplies

      • Family Presence

      • Positioning for Procedures

      • Administration of Drugs and Solutions

      • Management of Environment

      • Latex Sensitivity and Allergy

      • Pain Control, Comfort Measures, and Patient Monitoring

      • Sedation and Analgesia

    • POSTTEST PHASE: ELEMENTS OF SAFE, EFFECTIVE, INFORMED CARE

      • Basic Knowledge and Necessary Skills

      • Abnormal Test Results

      • Follow-Up Counseling

      • Monitoring for Complications and Sedation Effects

      • Test Result Availability

      • Integration

      • Referral and Treatment

      • Follow-Up Care

      • Documentation, Record Keeping, and Reporting

      • Guidelines for Disclosure

      • Patient Responses to Diagnosis

      • Expected and Unexpected Outcomes

    • RECOVERED MEDICAL ERRORS

    • LABORATORY RESPONSE NETWORK

    • BIOSAFETY

    • IMPORTANCE OF COMMUNICATION

    • CONCLUSION

    • BIBLIOGRAPHY

  • 2: Blood Studies: Hematology and Coagulation

    • OVERVIEW OF BASIC BLOOD HEMATOLOGY AND COAGULATION TESTS

      • Composition of Blood

      • Blood Tests

    • BLOOD SPECIMEN COLLECTION PROCEDURES

      • Capillary Puncture (Skin Puncture)

      • Venipuncture

      • Arterial Puncture

      • Bone Marrow Aspiration

    • BASIC BLOOD TESTS

      • Hemogram

      • Complete Blood Count (CBC)

    • TESTS OF WHITE BLOOD CELLS

      • White Blood Cell Count (WBC; Leukocyte Count)

      • Differential White Blood Cell Count (Diff; Differential Leukocyte Count)

      • Segmented Neutrophils (Polymorphonuclear Neutrophils, PMNs, Segs, Polys)

      • Eosinophils

      • Basophils

      • Monocytes (Monomorphonuclear Monocytes)

      • Lymphocytes (Monomorphonuclear Lymphocytes); CD4, CD8 Count; Plasma Cells

      • Lymphocyte Immunophenotyping (T and B Cells)

    • STAINS FOR LEUKEMIAS

      • Sudan Black B (SBB) Stain

      • Periodic Acid–Schiff (PAS) Stain

      • Terminal Deoxynucleotidyl Transferase (TDT) Stain

      • Leukocyte Alkaline Phosphatase (LAP) Stain

      • Tartrate-Resistant Acid Phosphatase (TRAP) Stain

    • TESTS FOR RED BLOOD CELLS

      • Red Blood Cell Count (RBC; Erythrocyte Count)

      • Hematocrit (Hct); Packed Cell Volume (PCV)

      • Hemoglobin (Hb)

      • Red Blood Cell Indices

      • Mean Corpuscular Volume (MCV)

      • Mean Corpuscular Hemoglobin Concentration (MCHC)

      • Mean Corpuscular Hemoglobin (MCH)

      • Red Cell Size Distribution Width (RDW)

      • Stained Red Cell Examination (Film; Stained Erythrocyte Examination)

      • Reticulocyte Count

      • Sedimentation Rate (Sed Rate); Erythrocyte Sedimentation Rate (ESR)

    • TESTS FOR PORPHYRIA

      • Erythropoietic Porphyrins; Free Erythrocyte Protoporphyrin (FEP)

      • Porphyrins; Fractionation of Erythrocytes and of Plasma

    • ADDITIONAL TESTS FOR HEMOLYTIC ANEMIA

      • Pyruvate Kinase (PK)

      • Erythrocyte Fragility (Osmotic Fragility and Autohemolysis)

      • Glucose-6-Phosphate Dehydrogenase (G6PD)

      • Heinz Bodies; Heinz Stain; Glutathione Instability

      • 2,3-Diphosphoglycerate (2,3-DPG)

    • IRON TESTS

      • Iron (Fe), Total Iron-Binding Capacity (TIBC), and Transferrin Tests

      • Ferritin

      • Iron Stain (Stainable Iron in Bone Marrow; Prussian Blue Stain)

    • TESTS FOR HEMOGLOBIN DISORDERS

      • Hemoglobin Electrophoresis

      • Fetal Hemoglobin (Hemoglobin F; Alkali-Resistant Hemoglobin)

      • Hemoglobin A2 (Hb A2)

      • Hemoglobin S (Sickle Cell Test; Sickledex)

      • Methemoglobin (Hemoglobin M)

      • Sulfhemoglobin

      • Carboxyhemoglobin; Carbon Monoxide (CO)

      • Myoglobin (Mb)

      • Haptoglobin (Hp)

      • Bart’s Hemoglobin

      • Paroxysmal Nocturnal Hemoglobinuria (PNH) Test; Acid Hemolysis Test; Ham’s Test

    • OTHER BLOOD TESTS FOR ANEMIA

      • Vitamin B12 (VB12)

      • Folic Acid (Folate)

      • Erythropoietin (Ep)

    • TESTS OF HEMOSTASIS AND COAGULATION

      • Hypercoagulability States

      • Disorders of Hemostasis

      • Tests for Disseminated Intravascular Coagulation (DIC)

      • Bleeding Time (Ivy Method; Template Bleeding Time)

      • Platelet Count; Mean Platelet Volume (MPV)

      • Platelet Aggregation

      • Thrombin Time (TT); Thrombin Clotting Time (TCT)

      • Partial Thromboplastin Time (PTT); Activated Partial Thromboplastin Time (aPTT)

      • Activated Clotting Time (ACT)

      • Prothrombin Time (Pro Time; PT)

      • Coagulant Factors (Factor Assay)

      • Plasminogen (Plasmin; Fibrinolysin)

      • Fibrinolysis (Euglobulin Lysis Time; Diluted Whole Blood Clot Lysis)

      • Fibrin Split Products (FSPs); Fibrin Degradation Products (FDPs)

      • D-Dimer

      • Fibrinopeptide A (FPA)

      • Prothrombin Fragment (F1 + 2)

      • Fibrin Monomers (Protamine Sulfate Test; Fibrin Split Products)

      • Fibrinogen

      • Protein C (PC Antigen)

      • Protein S

      • Antithrombin III (AT-III; Heparin Cofactor Activity)

    • BIBLIOGRAPHY

  • 3: Urine Studies

    • OVERVIEW OF URINE STUDIES

      • Urine Formation

      • Urine Constituents

      • Types of Urine Specimens

    • URINE TESTING

      • Laboratory Testing for Routine Urinalysis

      • Dipstick Testing

    • COLLECTION OF URINE SPECIMENS

      • Single, Random Urine Specimen

      • Long-Term, Timed Urine Specimen (2-Hour, 24-Hour)

    • ROUTINE URINALYSIS (UA) AND RELATED TESTS

      • Urine Volume

      • Urine Specific Gravity (SG)

      • Urine Osmolality

      • Urine Appearance

      • Urine Color

      • Urine Odor

      • Urine pH

      • Urine Blood or Hemoglobin (Hb)

      • Urine Protein (Albumin), Qualitative and 24-Hour

      • Microalbuminuria/Albumin (24-Hour Urine)

      • Urine B2-Microglobulin

      • Urine Glucose (Sugar)

      • Urine Ketones (Acetone; Ketone Bodies)

      • Urine Nitrite (Bacteria)

      • Urine Leukocyte Esterase

      • Urine Bilirubin

      • Urine Urobilinogen, Random and Timed

    • MICROSCOPIC EXAMINATION OF URINE SEDIMENT

      • Urine Red Blood Cells and Red Blood Cell Casts

      • Urine White Blood Cells and White Blood Cell Casts

      • Urine Epithelial Cells and Epithelial Casts

      • Urine Hyaline Casts

      • Urine Granular Casts

      • Urine Waxy Casts or Broad Casts (Renal Failure Casts) and Fatty Casts

      • Urine Crystals

      • Urine Shreds

    • URINE CHEMISTRY

      • Urine Pregnancy Test; Human Chorionic Gonadotropin (hCG) Test

      • Urine Estrogen, Total and Fractions (Estradiol [E2] and Estriol [E3]), 24-Hour Urine, and Total Estrogen—Blood

    • URINE DRUG INVESTIGATION SPECIMENS

      • Witnessed Urine Sampling for Suspected Substance Abuse

    • TIMED URINE TESTS

      • Urine Chloride (Cl), Quantitative (24-Hour)

      • Urine Sodium (Na), Quantitative (24-Hour)

      • Urine Potassium (K), Quantitative (24-Hour) and Random

      • Urine Uric Acid, Quantitative (24-Hour)

      • Urine Calcium (Ca), Quantitative (24-Hour)

      • Urine Magnesium (Mg), Quantitative (24-Hour)

      • Urine Oxalate, Quantitative (24-Hour)

      • Urine Pregnanediol (24-Hour)

      • Urine Pregnanetriol (24-Hour)

      • Urine 5-Hydroxyindoleacetic Acid (5-HIAA) (24-Hour)

      • Urine Vanillylmandelic Acid (VMA); Catecholamines (24-Hour)

      • Urine Porphyrins and Porphobilinogens (24-Hour and Random); Δ-Aminolevulinic Acid (ALA, Δ-ALA)

      • Urine Amylase Excretion and Clearance (Random, Timed Urine, and Blood)

      • Phenylketonuria (PKU); Urine Phenylalanine (Random Urine and Blood)

      • D-Xylose Absorption (Timed Urine and Blood)

      • Urine Creatinine; Blood (Serum) Creatinine, Creatinine Clearance (CrCl) (Timed Urine and Blood), Estimated Glomerular Filtration Rate (eGFR)

      • Urine Cystine (Random and 24-Hour)

      • Urine Hydroxyproline (Timed Urine and Blood)

      • Urine Lysozyme (Random, 24-Hour Urine, and Blood)

      • Urine Amino Acids, Total and Fractions (Random, 24-Hour Urine, and Blood)

    • BIBLIOGRAPHY

  • 4: Stool Studies

    • OVERVIEW OF STOOL STUDIES

    • STOOL ANALYSIS

      • Random Collection and Transport of Stool Specimens

      • Collection and Transport of Specimens for Ova and Parasites

      • Collection and Transport of Specimens for Enteric Pathogens

    • STOOL STUDIES

      • Stool Consistency, Shape, Form, Amount, and Odor

      • Stool Color

      • Blood in Stool; Occult Blood

      • Apt Test for Swallowed Blood

      • Mucus in Stool

      • Stool pH

      • Stool Reducing Substances Test

      • Leukocytes in Stool

      • Collection and Transport of 24-, 48-, 72-, and 96-Hour Stool Specimens

      • Fat in Stool; Fecal Fat Stain

      • Meat Fibers in Stool; Stool Muscle Fiber

      • Urobilinogen in Stool

      • Trypsin in Stool: Fecal Chymotrypsin

      • Stool Electrolytes: Sodium, Chloride, Potassium, and Osmolality

    • BIBLIOGRAPHY

  • 5: Cerebrospinal Fluid Studies

    • OVERVIEW OF CEREBROSPINAL FLUID (CSF)

      • Description, Formation, and Composition of CSF

      • Explanation of Tests

    • CEREBROSPINAL FLUID TESTS

      • Lumbar Puncture (Spinal Tap)

      • CSF Pressure

      • CSF Color and Appearance

      • CSF Microscopic Examination of Cells; Total Cell Count; Differential Cell Count

      • CSF Glucose

      • CSF Glutamine

      • CSF Lactic Acid, L-Lactate

      • CSF Lactate Dehydrogenase (LD/LDH); CSF Lactate Dehydrogenase (LDH) Isoenzymes

      • CSF Total Protein

      • CSF Albumin and Immunoglobulin G (IgG)

      • CSF Protein Electrophoresis; Oligoclonal Bands; Multiple Sclerosis Panel

      • CSF Syphilis Serology

    • BIBLIOGRAPHY

  • 6: Chemistry Studies

    • OVERVIEW OF CHEMISTRY STUDIES

      • General Biochemical Profiles

      • Use of the Autoanalyzer

    • DIABETES TESTING, BLOOD GLUCOSE, BLOOD SUGAR, AND RELATED TESTS

      • Fasting Blood Glucose (FBG); Fasting Blood Sugar (FBS); Fasting Plasma Glucose (FPG); Casual Random Plasma Glucose (PG)

      • Hemoglobin A1c (HbA1c); Glycohemoglobin (G-Hb); Glycated Hemoglobin (GhB); Diabetic Control Index; Glycated Serum Protein (GSP)

      • Gestational Diabetes Mellitus (GDM)

      • Glucose Tolerance Test (GTT); Oral Glucose Tolerance Test (OGTT)

      • Lactose Tolerance; Breath Hydrogen Test

      • Related Tests That Influence Glucose Metabolism

      • C-Peptide

      • Glucagon

      • Insulin

    • END PRODUCTS OF METABOLISM AND OTHER TESTS

      • Ammonia (NH3)

      • Bilirubin

      • Neonatal Bilirubin, Total and Fractionated (“Baby Bili”)

      • Blood Urea Nitrogen (BUN, Urea Nitrogen)

      • Albumin

      • Prealbumin (PAB)

      • Cholinesterase, Serum (Pseudocholinesterase); Cholinesterase, Red Blood Cell (Acetylcholinesterase)

      • Creatinine and Estimated Glomerular Filtration Rate

      • Cystatin C

      • Uric Acid

      • Lead (Pb)

      • Osteocalcin (Bone G1a Protein)

    • HORMONE TESTS

      • Androstenedione

      • Aldosterone

      • Antidiuretic Hormone (ADH); Arginine Vasopressin Hormone

      • Brain Natriuretic Peptide (BNP) and NT-proBNP

      • Cortisol (Hydrocortisone)

      • Cortisol Suppression (Dexamethasone Suppression; DST)

      • Cortisone Stimulation (Cosyntropin, Cortrosyn Stimulation); Adrenocorticotropin Hormone (ACTH) Stimulation

      • Gastrin

      • Growth Hormone (hGH); Somatotropin

      • Parathyroid Hormone Assay; Parathyrin; Parathormone (PTH-C-Terminal); Intact PTH

      • Somatomedin C (SM-C); Insulin-Like Growth Hormone

    • FERTILITY TESTS

      • Chorionic Gonadotropin; Human Chorionic Gonadotropin (hCG) β Subunit; Pregnancy Test

      • Follicle-Stimulating Hormone (FSH); Luteinizing Hormone (LH)

      • Prolactin (hPRL)

      • Progesterone

      • Testosterone, Total and Free

    • ENZYME TESTS

      • Acid Phosphatase; Prostatic Acid Phosphatase (PAP)

      • Prostate-Specific Antigen (PSA)

      • Alanine Aminotransferase (Aminotransferase, ALT); Serum Glutamic-Pyruvic Transaminase (SGPT)

      • Alkaline Phosphatase (ALP), Total; 5′ -Nucleotidase

      • Alkaline Phosphatase Isoenzymes (ISO)

      • Angiotensin-Converting Enzyme (ACE)

      • Amylase and Lipase

      • Aspartate Transaminase (Aminotransferase, AST); Serum Glutamic-Oxaloacetic Transaminase (SGOT)

      • Cardiac Troponin T (cTnT); Troponin I (cTnI)

      • Creatine Phosphokinase (CPK); Creatine Kinase (CK); CPK and CK Isoenzymes

      • Galactose-1-Phosphate Uridyltransferase (GPT); Galactokinase; Galactose-1-Phosphate

      • Lactate Dehydrogenase (LD, LDH)

      • Lactate Dehydrogenase (LDH, LD) Isoenzymes (Electrophoresis)

      • Renin (Angiotensin); Plasma Renin Angiotensin (PRA)

      • Renin Stimulation/Challenge Test

      • Tryptase

      • γ-Glutamyltransferase (γ-Glutamyl Transpeptidase, GGT, γGT)

      • Homocysteine (tHcy)

      • α1 -Antitrypsin (AAT)

    • DRUG MONITORING

      • Therapeutic Drug Management

      • Blood, Saliva, and Breath Alcohol Content (BAC; Ethanol [Ethyl Alcohol, ETOH])

    • LIPOPROTEIN TESTS/LIPOPROTEIN PROFILES

      • Cholesterol (C)

      • High-Density Lipoprotein Cholesterol (HDL-C)

      • Very-Low-Density Lipoprotein (VLDL); Low-Density Lipoprotein (LDL)

      • Apolipoprotein A and B (Apo A-I, Apo B)

      • Triglycerides

      • Lipoprotein Electrophoresis

      • Free Fatty Acids; Fatty Acid Profile

    • THYROID FUNCTION TESTS

      • Patient Care for Thyroid Testing

      • Calcitonin

      • Free Thyroxine (FT4)

      • Free Triiodothyronine (FT3)

      • Free Thyroxine Index (FTI, T7)

      • Neonatal Thyroid-Stimulating Hormone (TSH)

      • Neonatal Thyroxine (T4); Neonatal Screen for Hypothyroidism

      • Thyroglobulin (Tg)

      • Thyroid-Stimulating Hormone (TSH; Thyrotropin)

      • Thyroxine-Binding Globulin (TBG)

      • Thyroxine (T4), Total

      • Triiodothyronine (T3), Total

      • Triiodothyronine Uptake (T3 U)

    • BIBLIOGRAPHY

  • 7: Microbiologic Studies

    • OVERVIEW OF MICROBIOLOGIC STUDIES

      • Diagnostic Testing and Microbes

      • Basic Concepts of Infectious Disease

      • Host Factors

    • COLLECTION AND TRANSPORT OF SPECIMENS

      • General Principles

      • Sources of Specimens

      • Transport of Specimens by Mail

      • Diagnosis of Bacterial Disease

      • Studies of the Susceptibility of Bacteria to Antimicrobial Agents

      • Diagnosis of Mycobacterial Infections

      • Diagnosis of Mycobacterium tuberculosis

      • Diagnosis of Rickettsial Disease

      • Diagnosis of Parasitic Disease

      • Diagnosis of Fungal Disease

      • Diagnosis of Spirochetal Disease

      • Diagnosis of Viral and Mycoplasmal Infection

      • Diagnosis of West Nile Virus, West Nile Fever, and West Nile Encephalitis

      • Diagnosis of Human Monkeypox Virus

      • Diagnosis of Severe Acute Respiratory Syndrome (SARS)

      • Diagnosis of Avian Influenza (“Bird Flu”)

      • Diagnosis of Sexually Transmitted Infection

      • Diagnosis of Food Poisoning

    • BIOTERRORISM: INFECTIOUS AGENTS

      • Diagnosis of Botulism Infection

      • Diagnosis of Anthrax Infection

      • Diagnosis of Hemorrhagic Fever, Hantaan Virus, 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

    • DIAGNOSTIC PROCEDURES

      • The Smear and Stain

      • Cultures

      • Tissue Biopsy

      • Serologic Testing

      • Skin Testing

      • Blood Cultures

      • Urine Cultures

      • Eye and Ear Cultures

    • RESPIRATORY TRACT CULTURES

      • Sputum Cultures

      • Throat Cultures (Swab or Washings)

      • Nasopharyngeal Cultures (Swab)

    • OTHER CULTURES AND SMEARS

      • Wound and Abscess Cultures

      • Skin Cultures

      • Stool and Anal Cultures and Smears

      • Cerebrospinal Fluid (CSF) Cultures and Smears

      • Cervical, Urethral, Anal, and Oropharyngeal Cultures and Smears for Gonorrhea and Other Sexually Transmitted Infections

      • Tissue, Bone, and Body Fluid Cultures

    • SKIN TESTS

      • Tuberculin Skin Test (TB Test); Two-Step TB Test

      • Mumps Test

      • Candida and Tetanus Toxoid Tests

    • BIBLIOGRAPHY

  • 8: Immunodiagnostic Studies

    • OVERVIEW OF IMMUNODIAGNOSTIC STUDIES

      • Types of Tests

      • Collection of Serum for Immunologic Tests

      • Interpreting Results of Immunologic Tests

      • Serologic Versus Microbiologic Methods

    • BACTERIAL TESTS

      • Syphilis Detection Tests

      • Lyme Disease Tests

      • Legionnaires’ Disease Antibody Test

      • Chlamydia Antibody IgG Test

      • Streptococcal Antibody Tests: Antistreptolysin O Titer (ASO), Streptozyme, Antideoxyribonuclease-B Titer (Anti-DNase-B, ADNase-B) (ADB, Streptodornase)

      • Helicobacter pylori (HPY) IgG Antibody Serum, Stool, and Breath (PY) Test

    • VIRAL TESTS

      • Epstein-Barr Virus (EBV) Antibody Tests: Infectious Mononucleosis (IM) Slide (Screening) Test, Heterophile Antibody Titer, Epstein-Barr Antibodies to Viral Capsid Antigen and Nuclear Antigen

      • Hepatitis Tests: Hepatitis A (HAV), Hepatitis B (HBV), Hepatitis C (HCV), Hepatitis D (HDV), Hepatitis E (HEV), Hepatitis G (HGV)

      • Human Immunodeficiency Virus (HIV-1/2) Antibody Tests, HIV Group O, Antibody to Human Immunodeficiency Virus (HIV-1/2); Acquired Immunodeficiency Syndrome (AIDS) Tests

    • VIRAL ANTIBODY TESTS TO ASSESS IMMUNE STATUS

      • Rubella Antibody Tests

      • Measles (Rubeola) Antibody Tests

      • Mumps Antibody Tests

      • Varicella-Zoster (Chickenpox) Antibody Test

      • 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

      • Parvovirus B-19 Antibody Test

      • Rabies Antibody Tests

    • FUNGAL TESTS

      • Fungal Antibody Tests: Histoplasmosis, Blastomycosis, Coccidioidomycosis

      • Candida Antibody Test

      • Aspergillus Antibody Test

      • Cryptococcus Antibody Test

    • PARASITIC TESTS

      • Toxoplasmosis (TPM) Antibody Tests

      • Amebiasis ( Entamoeba histolytica ) Antibody Test

      • TORCH Test

    • IMMUNOLOGIC TESTS FOR IMMUNE DYSFUNCTION AND RELATED DISORDERS OF THE IMMUNE SYSTEMS

      • Quantitative Immunoglobulins: IgA, IgG, IgM

      • Protein Electrophoresis (PEP), Serum and Urine

      • Immunofixation Electrophoresis (IFE), Serum and Urine

      • Cold Agglutinin

      • Cryoglobulin Test

      • Total Hemolytic Complement (CH50)

      • C3 Complement Component

      • C4 Complement Component

      • C′ 1 Esterase Inhibitor (C′ 1 INH)

    • TESTS FOR AUTOIMMUNITY AND SYSTEMIC RHEUMATIC DISEASE (SRD)

      • Antinuclear Antibody (ANA) Test

      • Anticentromere Antibody Test

      • Anti-dsDNA Antibody Test, IgG

      • Rheumatoid Factor (Rheumatoid Arthritis [RA] Factor) Test

      • Antibodies to Extractable Nuclear Antigens (ENAs): Anti-Ribonucleoprotein (RNP); Anti-Smith (Sm); Anti-Sjögren’s Syndrome (SSA, SSB); Anti-Scleroderma (Scl-70); Anti-Jo-1 (Jo-1)

      • Cardiolipin Antibodies, IgA, IgG, IgM

      • Autoimmune Thyroiditis, Thyroid Antibody Tests: Thyroglobulin Antibody, Thyroid Microsomal Antibody, Thyroperoxidase Antibody

    • AUTOIMMUNE LIVER DISEASE TESTS

      • Anti–Smooth Muscle Antibody (ASMA) Test

      • Antimitochondrial Antibody (AMA) Test

      • Anti–Liver/Kidney Microsome Type 1 Antibody (LKM) Test

      • Antiparietal Cell Antibody (APCA) Test

      • Antiglomerular Basement Membrane (AGBM) Antibody Test

      • Acetylcholine Receptor (AChR) Binding Antibody Test

      • Anti-Insulin Antibody Test

      • Gliadin Antibodies, IgA and IgG

      • Antineutrophil Cytoplasmic Antibodies (ANCAs)

    • SPERM ANTIBODIES

      • Antisperm Antibody Test

    • ALLERGY TESTING

      • IgE Antibody, Single Allergen

      • Latex Allergy Testing (Latex-Specific IgE)

    • PROTEIN CHEMISTRY TESTING/SERUM PROTEINS: ACUTE-PHASE PROTEINS AND CYTOKINES

      • Ceruloplasmin

      • α1 -Antitrypsin

      • C-Reactive Protein (CRP) and High-Sensitivity C-Reactive Protein (hs-CRP)

      • Prion Proteins

      • Cytokines

      • Tumor Markers

    • BLOOD BANKING OR IMMUNOHEMATOLOGY TESTS

      • Donated Blood Testing and Blood Processing

      • Blood Groups (ABO Groups)

      • Rh Typing

      • Rh Antibody Titer Test

      • Rosette Test, Fetal Red Cells (Fetal-Maternal Bleed)

      • Kleihauer-Betke Test (Fetal Hemoglobin Stain)

      • Crossmatch (Compatibility Test)

      • Coombs’ Antiglobulin Test

    • TYPES OF TRANSFUSION REACTIONS

      • Acute Hemolytic Transfusion Reaction (HTR)

      • Bacterial Contamination

      • Cutaneous Hypersensitivity Reactions

      • Noncardiogenic Pulmonary Reactions (NPR)

      • Febrile Nonhemolytic (FNH) Reactions

      • Anaphylactic Reactions

      • Circulatory Overload

      • Leukoagglutinin Test

      • Platelet Antibody Detection Test

      • Human Leukocyte Antigen (HLA) Test

    • ORGAN AND TISSUE TRANSPLANT TESTING

      • Pretest Donor

      • Pretest and Posttest of Recipient

    • BIBLIOGRAPHY

  • 9: Nuclear Medicine Studies

    • OVERVIEW OF NUCLEAR MEDICINE STUDIES

      • Principles of Nuclear Medicine

      • Principles of Imaging

      • General Procedure

      • Benefits and Risks

      • Clinical Considerations

      • Interventions

      • Pediatric Nuclear Medicine Considerations

    • CARDIAC STUDIES

      • Myocardial Perfusion: Rest and Stress (Sestamibi/Tetrofosmin/Thallium Stress Test)

      • Myocardial Infarction (PYP) Imaging

      • Multigated Acquisition (MUGA) Imaging: Rest and Stress

      • Cardiac Flow Study (First-Pass Study; Shunt Imaging)

    • ENDOCRINE STUDIES

      • Thyroid Imaging

      • Radioactive Iodine (RAI) Uptake Test

      • Adrenal Gland (MIBG) Imaging

      • Parathyroid Imaging

    • GENITOURINARY STUDIES

      • Renogram: Kidney Function and Renal Blood Flow Imaging (With Furosemide or Captopril/Enalapril)

      • Testicular (Scrotal) Imaging

      • ProstaScint Imaging

      • Vesicoureteric Reflux (Bladder and Ureters) Imaging

    • GASTROINTESTINAL STUDIES

      • Hepatobiliary (Gallbladder, Biliary) Imaging With Cholecystokinin

      • Gastroesophageal Reflux Imaging

      • Gastric Emptying Imaging

      • Gastrointestinal Bleeding Imaging

      • Parotid (Salivary) Gland Imaging

      • Liver/Spleen Imaging and Liver RBC Imaging

      • Meckel’s Diverticulum Imaging

    • NEUROLOGIC STUDIES

      • Brain Imaging and Cerebral Blood Flow Imaging

      • Cisternography (Cerebrospinal Fluid Flow Imaging)

      • DaTscan Imaging

    • PULMONARY STUDIES

      • Lung Scan (Ventilation and Perfusion Imaging)

    • ORTHOPEDIC STUDIES

      • Bone Imaging

      • Bone Mineral Density (Bone Densitometry; Osteoporosis Imaging)

    • TUMOR IMAGING STUDIES

      • Gallium ( 67Ga) Imaging

    • OVERVIEW OF MONOCLONAL ANTIBODY TUMOR IMAGING (ONCOSCINT, PROSTASCINT, OCTREOTIDE, AND OTHER PEPTIDES)

      • Antibody and Peptide Tumor Imaging

      • Iodine-131 Whole-Body (Total-Body) Imaging

      • Breast Imaging (Scintimammography); Lymph Node Imaging (Lymphoscintigraphy)

    • INFLAMMATORY PROCESS IMAGING

      • Leukocyte (WBC) Imaging (Indium- or Ceretec-Labeled WBCs)

    • OVERVIEW OF RADIONUCLIDE ( NON-RADIOIMMUNOASSAY) LABORATORY STUDIES

      • Total Blood Volume; Plasma Volume; Erythrocyte (RBC) Volume

      • Red Blood Cell (RBC) Survival Time Test

    • OVERVIEW OF POSITRON EMISSION TOMOGRAPHY (PET) IMAGING STUDIES

      • Brain Imaging

      • Cardiac Imaging

      • Tumor Imaging

    • BIBLIOGRAPHY

  • 10: X-Ray Studies

    • OVERVIEW OF X-RAY STUDIES

    • USE OF CONTRAST AGENTS

    • ADVERSE REACTIONS TO CONTRAST AGENTS

      • Clinical Considerations When Iodine Contrast Agents Are Used

      • Clinical Considerations When Barium Contrast Is Used

    • RISKS OF RADIATION

      • Safety Measures

      • General Precautions

      • Precautions to Be Used With Pregnant Patients

      • Responsibilities in Ordering, Scheduling, and Sequencing X-Ray Examinations

    • PLAIN CONVENTIONAL X-RAYS/RADIOGRAPHY

      • Chest X-Ray

      • Mammography (Breast X-Ray)

      • Orthopedic X-Ray: Bones, Joints, and Supporting Structures

      • Abdominal X-Ray: Plain Film or KUB (Kidney, Ureters, Bladder); Scout Film; Abdominal Series

      • Dental X-Rays

    • CONTRAST X-RAYS/RADIOGRAPHY

      • Contrast X-Ray of the Stomach: Gastric X-Ray Including Upper Gastrointestinal Examination (Upper GI [UGI] Series, Barium Swallow, Esophagram)

      • Small Bowel X-Ray: Intestinal Radiography and Fluoroscopy

      • Colon X-Ray: Defecography (DEF); Barium Enema; Air Contrast Study

      • Bile Duct X-Ray (Cholangiography), T-Tube Cholangiogram, Operative Cholangiogram, Percutaneous Transhepatic Cholangiogram

      • Intravenous Urography (IVU); Excretory Urography or Intravenous Pyelography (IVP)

      • Retrograde Pyelography

      • Arthrography (Joint X-Ray)

      • Myelogram

      • Hysterosalpingography (Uterine and Fallopian Tube X-Rays)

      • Angiography (Digital Subtraction Angiography [DSA], Transvenous Digital Subtraction, Vascular X-Ray)

      • Lymphangiography (X-Rays of Lymph Nodes and Vessels)

    • COMPUTED TOMOGRAPHY (CT)

      • Computed Tomography (CT) of the Head and Neck; Brain, Eyes, and Sinus

      • Computed Tomography (CT) of the Body; Chest, Spine, Extremities, Abdomen, and Pelvis

    • BIBLIOGRAPHY

    • INTERNET SITES

  • 11: Cytologic, Histologic, and Genetic Studies

    • OVERVIEW OF CYTOLOGIC (CELLS) AND HISTOLOGIC (TISSUE) STUDIES

      • Cytologic Studies

      • Histologic Studies

    • CYTOLOGIC AND HISTOLOGIC STUDIES

      • Fine-Needle Aspirates: Cell (Cytologic) and Tissue (Histologic) Study

      • Sentinel Node Location Before Biopsy (Breast, Melanoma); Special Prebiopsy Study

      • Tissue (Histologic) Biopsy Studies: Overview; Prognostic and Predictive Markers

      • Breast Biopsy: Cell (Cytologic) and Tissue (Histologic) Study and Prognostic Markers

      • Ductal Lavage of Breast Cells (Cytologic) Study; Gail Index of Breast Cancer Risk

      • Liver Biopsy: Cell (Cytologic) and Tissue (Histologic) Study

      • Kidney Biopsy: Cell (Cytologic) and Tissue (Histologic) Study

      • Respiratory Tract: Cell (Cytologic) and Tissue (Histologic) Study

      • Gastrointestinal Tract: Cell (Cytologic) and Tissue (Histologic) Study

      • Papanicolaou (Pap) Smear: Cell (Cytologic) Study of the Female Genital Tract, Vulva, Vagina, and Cervix; DNA Test for Human Papillomavirus (HPV)

      • Anal Smears: Cell (Cytologic) Study

      • Aspirated Breast Cysts and Nipple Discharge: Cell (Cytologic) Study, Fine-Needle Aspiration (FNA) and Cytologic Study of Breast Aspirate and Biomarkers of Cancer Risk

      • Urine: Cell (Cytologic) Study

      • Cerebrospinal Fluid (CSF): Cell (Cytologic) Study

      • Effusions (Thoracentesis and Paracentesis): Cell (Cytologic) Study

      • Skin/Cutaneous Immunofluorescence Biopsy: Cell (Cytologic) Study and Tissue (Histologic) Study

      • Estrogen/Estradiol Receptor (ER), Progesterone Receptor (PR) Tissue (Histologic) Study and DNA Ploidy (Tumor Aneuploidy)

    • OVERVIEW OF GENETIC STUDIES

      • Indications for Testing

      • Inheritance in Human Disorders

      • Genetic Counseling

      • Treatment of Genetic Diseases

    • GENETIC STUDIES

      • Direct Detection of Abnormal Genes by DNA Testing

    • CYTOGENETICS

      • Chromosomal Analysis

      • Special Chromosomal Studies

      • Newborn Screening for Congenital Disorders

    • SPECIAL TYPES OF GENETIC STUDIES

      • Biochemical Genetics

      • Population Genetics

      • Pharmacogenomics

    • BIBLIOGRAPHY

  • 12: Endoscopic Studies

    • OVERVIEW OF ENDOSCOPIC STUDIES

      • Mediastinoscopy

      • Bronchoscopy

      • Thoracoscopy

      • Esophagogastroduodenoscopy (EGD); Upper Gastrointestinal (UGI) Study; Endoscopy; Gastroscopy

      • Esophageal Manometry

      • Endoscopic Retrograde Cholangiopancreatography (ERCP) and Manometry

      • Enteroscopy, Virtual Enteroscopy

      • Colposcopy

      • Loop Electrosurgical Excision Procedure (LEEP), Cone Biopsy, Cervical Conization

      • Flexible Proctoscopy; Sigmoidoscopy; Proctosigmoidoscopy

      • Colonoscopy, Virtual Colonoscopy (VC), Optical Colonoscopy

      • Peritoneoscopy; Laparoscopy; Pelviscopy; Fertiloscopy

      • Cystoscopy (Cystourethroscopy)

      • Urodynamic Studies: Cystometrogram (CMG); Urethral PressureProfile (UPP); Rectal Electromyogram (EMG); Cystourethrogram

      • Arthroscopy

      • Sinus Endoscopy

    • BIBLIOGRAPHY

    • INTERNET SITES

  • 13: Ultrasound Studies

    • OVERVIEW OF ULTRASOUND STUDIES

      • Principles and Techniques

      • Implications of Ultrasound Studies

    • OBSTETRIC AND GYNECOLOGIC SONOGRAMS

      • Obstetric Sonogram

      • Fetal Echocardiography (Fetal Doppler)

      • Pelvic Gynecologic (GYN) Sonogram; Pelvic (Uterine Mass) Ultrasound Diagnosis; Intrauterine Device (IUD) Localization

    • ABDOMINAL SONOGRAMS

      • Kidney (Renal) Sonogram

      • Urinary Bladder Sonogram

      • Hepatobiliary Sonogram; Gallbladder (GB) Ultrasound; Liver Ultrasound

      • Abdominal Aorta Sonogram

      • Abdominal Ultrasound

    • OTHER BODY STRUCTURE SONOGRAMS

      • Breast Sonogram (Sonomammography)

      • Prostate Sonogram (Transurethral Ultrasound [TRUS])

      • Scrotal Sonogram

      • Eye and Orbit Sonograms

      • Thyroid Sonogram (Neck Ultrasound)

    • VASCULAR ULTRASOUND STUDIES (DUPLEX SCANS)

      • Cerebrovascular Ultrasound (Carotid and Vertebral Arteries) Duplex Scans: Carotid Intima Media Thickness (CIMT)

      • Peripheral Arterial Doppler Studies; Lower Extremity Arterial (LEA) and Upper Extremity Arterial (UEA) Duplex Scans

      • Ankle-Brachial Index (ABI) and Segmental Pressures

      • Peripheral Venous Doppler Studies; Lower Extremity Venous (LEV) and Upper Extremity Venous (UEV) Duplex Scans

    • HEART ULTRASOUND STUDIES

      • Heart Sonogram (Echocardiogram; Doppler Echocardiography)

      • Transesophageal Echocardiogram (TEE)

    • BIBLIOGRAPHY

    • INTERNET SITES

  • 14: Pulmonary Function, Arterial Blood Gases (ABGs), and Electrolyte Studies

    • OVERVIEW OF PULMONARY FUNCTION TESTS

      • Pulmonary Physiology

      • Purpose of Tests

      • Indications for Tests

      • Classification of Tests

      • Symbols and Abbreviations

    • AIRWAY FLOW RATES

      • Spirometry, Forced Expiratory Maneuver Volume-Time Spirogram (V-T Tracing); Flow-Volume Spirogram (F-V Loop)

      • Peak Inspiratory Flow Rate (PIFR)

      • Peak Expiratory Flow Rate (PEFR)

    • LUNG VOLUMES AND CAPACITIES

      • Functional Residual Capacity (FRC)

      • Residual Volume (RV)

      • Expiratory Reserve Volume (ERV)

      • Inspiratory Capacity (IC)

      • Vital Capacity (VC)

      • Total Lung Capacity (TLC)

    • GAS EXCHANGE (DIFFUSING CAPACITY), TRANSFER FACTOR

      • Carbon Monoxide Diffusing Capacity (D LCO , DL), Diffusing Capacity, Transfer Factor

    • OTHER PULMONARY FUNCTION TESTS

      • Maximum Voluntary Ventilation (MVV)

      • Maximal Respiratory Pressure (MRP), Maximal Expiratory Pressure (MEP), Maximal Inspiratory Pressure (MIP)

      • Closing Volume (CV)

      • Volume of Isoflow (VISO V)

      • Body Plethysmography: Thoracic Gas Volume (VTG), Compliance (CL), Airway Resistance (Raw), Airway Conductance (Gaw)

      • Bronchial Provocation: Methacholine Challenge, Histamine Challenge

      • Carbon Dioxide (CO2) Response

      • Exercise Stress Testing, Maximum Oxygen Consumption (VO2 max) Test

    • OVERVIEW OF BLOOD GASES, ACID-BASE BALANCE, AND OXYGENATION STATUS (TISSUE OXYGENATION, GAS EXCHANGE IN LUNGS)

      • Arterial Blood Gas Tests

      • Alveolar-to-Arterial Oxygen Gradient (A-aDO2); Arterial-to-Alveolar Oxygen Ratio (a/A Ratio)

      • Partial Pressure of Carbon Dioxide (PCO2)

      • Oxygen Saturation (SO2)

      • Oxygen Content (CO2)

      • Partial Pressure of Oxygen (PO2), Brain Tissue (PbtO2)

      • Carbon Dioxide (CO2) Content; Total Carbon Dioxide (TCO2)

      • Blood pH

      • Base Excess or Deficit

      • Anion Gap (AG)

      • Lactic Acid

    • ELECTROLYTE TESTS

      • Calcium (Ca2+)

      • Chloride (Cl-)

      • Phosphate (P); Inorganic Phosphorus (PO4)

      • Magnesium (Mg2+)

      • Potassium (K+)

      • Sodium (Na+)

      • Osmolality and Water-Load Test (Water-Loading Antidiuretic Hormone Suppression Test)

      • Sweat Test

    • BIBLIOGRAPHY

  • 15: Prenatal Diagnosis and Tests of Fetal Well-Being

    • OVERVIEW OF PRENATAL DIAGNOSIS

    • FIRST AND SECOND TRIMESTER SCREENING

      • Maternal Serum Alpha-Fetoprotein (MS-AFP)

      • Circulating Cell-Free DNA

      • Hormone Testing

      • Estriol (E3)

      • Human Placental Lactogen (hPL) (Chorionic Somatomammotropin)

      • Fetal Fibronectin (fFN)

    • TESTS TO PREDICT FETAL OUTCOME AND RISK FOR INTRAUTERINE ASPHYXIA

      • Contraction Stress Test (CST)

      • Oxytocin Challenge Test (OCT); Nipple Stimulation Test; Breast Stimulation Test (BST)

      • Nonstress Test (NST)

      • Fetal Activity Acceleration Determination (FAD)

      • Continuous Fetal Heart Rate (FHR) Monitoring

      • Fetal Biophysical Profile (FBP) (Biophysical Profile [BPP])

      • Fetoscopy

      • Percutaneous Umbilical Blood Sampling (PUBS) (Cordocentesis)

      • Chorionic Villus Sampling (CVS)

    • AMNIOTIC FLUID STUDIES

      • Amniocentesis

      • Amniotic Fluid Alpha1-Fetoprotein (AFP)

      • Amniotic Fluid Total Volume

      • Amniotic Fluid Index (AFI)

      • Amniotic Fluid Creatinine

      • 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 Foam Stability Index (FSI)

      • Amniotic Fluid Fern Test

      • Placental Alpha Macroglobulin-1 Protein Assay (AmniSure)

      • Amniotic Fluid Color

      • Amniotic Fluid Bilirubin Optical Density (OD)

      • Amniotic Fluid and Desaturated Phosphatidylcholine (DSPC)

    • ADDITIONAL MEASUREMENTS

      • Group B Streptococcal (GBS) Screening

      • Fetal Oxygen Saturation (FSpO2) Monitoring

      • Fetal Nuchal Translucency (FNT)

      • Fetal Alcohol Syndrome (FAS), Alcohol in Pregnancy

    • BIBLIOGRAPHY

  • 16: Special Diagnostic, Special Specimen Collection, and Postmortem Studies

    • OVERVIEW OF SPECIAL DIAGNOSTIC STUDIES

    • THE EYE

      • Visual Field Testing

      • Retinal Imaging

      • Retinal Nerve Fiber Analysis

      • Fluorescein Angiography (FA)

      • Electro-oculography (EOG)

      • Electroretinography (ERG)

      • Eye and Orbit Sonograms

    • BRAIN AND NERVOUS SYSTEM

      • Electroencephalography (EEG) and Epilepsy/Seizure Monitoring

      • Evoked Responses/Potentials: Brainstem Auditory Evoked Response (BAER); Visual Evoked Response (VER); Somatosensory Evoked Response (SSER)

      • Cognitive Tests: Event-Related Potentials (ERPs)

      • Brain Mapping: Computed Tomography

      • Electromyography (EMG); Electroneurography; Electromyoneurogram (EMNG)

      • Electronystagmogram (ENG)

    • HEART

      • Electrocardiography (ECG or EKG) and Vectorcardiogram

      • Signal-Averaged Electrocardiogram (SAE)

      • Cardiac Event Monitoring; ECG Continuous Monitoring; Holter Monitoring; 30-Day Event Monitoring; Implantable Monitor

      • Stress Test/Exercise Testing (Graded Exercise Tolerance Test), Submaximal Effort

      • Cardiac Catheterization and Angiography (Angiocardiography, Coronary Arteriography)

      • Electrophysiology (EP) Studies; His Bundle Procedure

      • Transesophageal Echocardiography (TEE)

    • OTHER ORGANS AND BODY FUNCTIONS

      • Magnetic Resonance Imaging (MRI); Magnetic Resonance Angiography (MRA); Magnetic Resonance Spectroscopy (MRS)

    • SLEEP STUDIES

      • Types and Indications of Tests

      • Classification of Tests

      • Polysomnography (PSG)

      • Sleepiness Test; Multiple Sleep Latency Test (MSLT); Maintenance of Wakefulness Test (MWT)

      • Nasal Continuous Positive Airway Pressure (nCPAP) Titration

    • OVERVIEW OF SPECIAL SPECIMEN COLLECTION STUDIES

      • Gastric Analysis (Tube Gastric Analysis); Gastric Fluids

      • DNA Typing or Fingerprinting

      • Hair, Nails, Saliva, Sputum, and Breath Specimen Collection

      • Evidentiary Specimen Collection in Forensic Medicine

    • POSTMORTEM TESTS

      • Death Investigation

      • Death Interpretation

      • Time of Death

      • Autopsy

      • Organs for Donation

    • BIBLIOGRAPHY

  • Appendices

    • A: Standard Precautions for Prevention and Control of Infection

      • COMMON CATEGORIES OF BODY SUBSTANCES, SECRETIONS, AND FLUIDS ENCOUNTERED DURING INVASIVE PROCEDURES, PROCURING AND HANDLING SPECIMENS, AND LAB TESTING

      • IF A BLOOD EXPOSURE OCCURS

      • RISK FOR INFECTION AFTER OCCUPATIONAL EXPOSURE

        • Hepatitis B Virus

        • Hepatitis C Virus

        • Human Immunodeficiency Virus

      • SAFE PRACTICE

      • STANDARD PRECAUTIONS, GUIDELINES, AND PRACTICES FOR SPECIFIC SITUATIONS

        • Personal Protection Equipment

        • Disposal of Medical Wastes

        • Placement of Warning Tags and Signs

        • General Environmental Cautions

        • In Case of Exposure to Human Immunodeficiency Virus or Hepatitis B Virus

        • Handwashing Protocols

      • SAFE PRACTICE DOMAINS FOR SPECIFIC SITUATIONS

      • PROTOCOLS FOR FIRST RESPONDERS

      • PANDEMIC PREPAREDNESS

      • BIBLIOGRAPHY

    • B: Guidelines for Specimen Transport and Storage

      • CENTERS FOR DISEASE CONTROL AND PREVENTION SHIPPING INSTRUCTIONS FOR SPECIMENS COLLECTED FROM PEOPLE WHO MAY HAVE BEEN EXPOSED TO CHEMICAL-TERRORISM AGENTS

        • Collecting Specimens

        • Labeling Specimens

        • Packaging Specimens

        • Shipping Specimens

      • BIBLIOGRAPHY

    • C: Vitamins in Human Nutrition

      • Vitamin Testing

      • BIBLIOGRAPHY

    • D: Minerals in Human Nutrition

      • Mineral Testing

      • BIBLIOGRAPHY

    • E: Effects of Drugs on Laboratory Tests (Blood, “Whole” Plasma, Serum, Stool, and Urine)

      • DRUGS AND LABORATORY TEST OUTCOMES

        • Discoloration of Feces Caused by Drugs

        • Discoloration of Urine Caused by Drugs

      • BIBLIOGRAPHY

  • Index

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