Specialist tests A-Z

Specialist tests A-Z

0-5 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Tests beginning with 0-5

5-HIAA

Alternative name 5-Hydroxy Indole Acetic Acid
Sample tube 24hr urine container with HCI preservative
Sample volume 24hr urine
Special requirements (for sample collection) Protect collection from light using a black bag. Various dietary substances interfere with the measurement of 5-HIAA. Bananas, pineapples and walnuts can cause 5-HIAA levels to increase as they contain high amounts of serotonin. Therefore, ingestion of these substances should be avoided on the day of sample collection. A patient information sheet is available upon request.
Special requirements Send frozen aliquot of acidified 24hr urine collection, protected from light, together with a note of the total urine volume collected.
Turnaround time 2 weeks
Reference range <50 μmol/24hr
Clinical application Investigation of carcinoid tumours
Comments Samples cannot be processed unless the total volume of urine collected is noted with the sample aliquot.

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Tests beginning with A

 

Angiotensin Converting Enzyme (serum)

Alternative Name ACE
Sample tube Gel tube (Sarstedt brown top)
Sample volume 1ml blood (0.5ml serum)
Special requirements (for sample collection) None
Special requirements Separate serum and send via first class post. Store separated serum at 2-4oC if not sending same day as collection.
Turnaround time 1 week
Reference range 15-55 U/L 
Clinical application Monitoring in patients with sarcoidosis
Comments Suppressed in patients on ACE inhibitors. Method used: Kinetic spectrophotometric.

Anti-Mullerian Hormone

Alternative name AMH
Sample tube Gel tube (Sarstedt brown top)
Sample volume 1ml blood (0.5ml serum)
Special requirements (for sample collection) None
Special requirements Separate serum and send via first class post. If there will be >48 hours before sending, store the specimen at -20°C. Samples can be sent to us at ambient temperature.
On arrival in Pathology reception Separate on day of collection. Store at -20°C in rack.
Turnaround time 1 week
Reference range

20-29 years   13.1-53.8 pmol/l

30-34 years   6.8-47.8 pmol/l

35-39 years   5.6-37.4 pmol/l

40-44 years   0.7-21.1 pmol/l

45-50 years   0.3-14.7 pmol/l 

Clinical application In female infertility investigations, AMH correlates with ovarian reserve independently of LMP. High levels are associated with PCOS and granulosa cell tumours of the ovary.
Comments Method used: ROCHE cobas electrochemiluminescent immunoassay

AFP (serum)

Alternative name Alpha feto protein
Sample tube Gel tube (Sarstedt brown top)
Sample volume 1ml (0.5ml serum)
Special requirements (for sample collection) Separate serum and send via first class post.
Special requirements None
Turnaround time 2 working days
Reference range <10 kU/L (for use as a tumour marker)
Clinical application Tumour marker; can be useful in teratoma, hepatocellular cancer, neuroblastoma. May also be raised in other malignancies.
Comments This test is not suitable for antenatal screening. Method used: ROCHE cobas electrochemiluminescent immunoassay.

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Tests beginning with B

Beta Hydroxybutyrate

Alternative name N/A
Sample tube No preservative (serum)
Sample volume 1ml blood (0.5ml serum)
Special requirements (for sample collection) None
Special requirements Separate serum and send via first class post.
Turnaround time 1 day
Reference range In the treatment of Diabetic Ketoacidosis (DKA), the target betahydroxybutyrate concentration is <0.3mmol/l. In hypoglycaemia, betahydroxybutyrate should be interpreted in the context of the clinical presentation & other test results.
Clinical application Monitoring of patients with DKA and for paediatric hypoglycaemia screens.
Comments Method used: Enzymatic spectrophotometric

Bile acids

Alternative name N/A
Sample tube Gel tube (Sarstedt brown top)
Sample volume 1ml blood (0.5ml serum)
Special requirements (for sample collection) None
Special requirements Separate serum and send via first class post. Store separated serum at 2-4 oC if not sending same day as collection.
Turnaround time 1 day
Reference range <10 μmol/l
Clinical application Investigation and monitoring of obstetric cholestasis

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Tests beginning with C

CA 125

Alternative name N/A
Sample tube Gel tube (Sarstedt brown top)
Sample volume 1ml (0.5ml serum)
Special requirements (for sample collection) None
Special requirements Separate serum and send via first class post. Store separated serum at 2-4oC if not sending same day as collection.
Turnaround time <3 days
Reference range <35 KU/L
Clinical application Monitoring of patients with malignancy, most often ovarian in origin.
Comments Note that ascites, whatever the cause, can result in a markedly elevated CA 125.

CA 19-9

Alternative name N/A
Sample tube Gel tube (Sarstedt brown top)
Sample volume 1ml blood (0.5ml serum)
Special requirements (for sample collection) None
Special requirements Separate serum and send via first class post. Store separated serum at 2-4oC if not sending same day as collection.
Turnaround time <3 days
Reference range <35 KU/L
Clinical application Monitoring of patients with malignancy, most often pancreatic in origin.

Caeruloplasmin

Alternative name N/A
Sample tube Gel tube (Sarstedt brown top)
Sample volume 2ml
Special requirements (for sample collection) None
Special requirements Separate serum and send via first class post. Store separated serum at 2-4oC if not sending same day as collection.
Turnaround time 1 day
Reference range

Caeruloplasmin (g/l)

0.08-0.23 (0-3 months)

0.12-.035 (4 months-11 months)

0.2-0.4 (1-9 years)

0.15-0.23 (10-12 years)

0.2-0.6 (13 years +)

Clinical application Investigation of Wilson's disease
Comments Interpret with caution in acute illness. Caeruloplasmin shows a negative acute phase response.

Calprotectin

Alternative name N/A
Sample tube Plain universal tube
Sample volume Random stool sample (at least 1g)
Special requirements (for sample collection) None
Special requirements Send to laboratory within 48 hours of collection.
Turnaround time 7 working days
Reference range

< 50µg/g  Calprotectin not suggestive of intestinal inflammation. Results should be interpreted in line with clinical assessment.

< 50µg/g  Elevated calprotectin indicates intestinal inflammation, suggest further information for inflammatory bowel disease (IBS). Note, calprotectin may also be raised in colorectal neoplasia, GI infections, GI bleeding more than 100ml and NSAID use. Results should be interpreted in line with clinical assessment.

Clinical application Investigation of inflammatory bowel disease
Comments A definitive clinical diagnosis should not be based on the results of a single diagnostic method, but should only be made by the physician after all clinical and laboratory findings have been evaluated.

CEA

Alternative name Carcinoembryonic antigen
Sample tube Gel tube (Sarstedt brown top)
Sample volume 1ml blood (0.5ml plasma)
Special requirements (for sample collection) None
Special requirements Separate serum and send via first class post. Store separated serum at 2-4oC if not sending same day as collection.
Turnaround time 1 day
Reference range <7 µg/l
Clinical application Used for monitoring malignancy, mostly in GI tract and colon, with a range of other primary sites

Copper (serum)

Alternative name None
Sample tube Gel tube (Sarstedt brown top) or plain tube for paediatric samples
Sample volume 3ml blood (1ml serum)
Special requirements (for sample collection) None
Special requirements Separate serum and send via first class post. Store separated serum at 2-4oC if not sending same day as collection.
Turnaround time 1 week
Reference range 13-24 μmol/l
Clinical application Investigation of Wilson's disease and deficiency, or toxicity
Comments Increases seen in pregnancy, oestrogen therapy, rheumatoid disease and other inflammatory conditions. Decreases seen in low serum protein states, also in valproate and steroid therapy. Measured by flame atomic absorption spectroscopy.

Cyclosporin A (whole blood)

Alternative names Cyclosporine, ciclosporin, neoral
Sample tube EDTA (Sarstedt grey top or red top)
Sample volume 1ml
Special requirements (for sample collection) Trough sample should be collected (pre-dose)
Special requirements None
Turnaround time < 4 days Analysis is performed on Monday, Wednesday and Friday
Reference range 60-250 μg/l
Clinical application Theraputic drug monitoring and assessment of toxicity
Comments Analysed by tandem mass spectronomy. The therapeutic range varies on the individual requirement and is dependent on the length of time since the transplant was performed.

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Tests beginning with D

Digoxin

Alternative name N/A
Sample tube Gel tube (Sarstedt brown top)
Sample volume 1ml blood (0.5ml serum)
Special requirements (for sample collection) Sample should be taken at least 6hrs post-dose
Special requirements Separate serum and send via first class post. Store separated serum at 2-4oC if not sending same day as collection.
Turnaround time 1 day
Reference range 0.5-2.0 μg/l (target range in heart failure: 0.5-1.0 μg/l)
Clinical application Therapeutic drug monitoring and toxicity
Comments Toxicity exacerbated by hypokalaemia and renal impairment

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Tests beginning with E

Ethanol

Alternative name Alcohol
Sample tube Fluoride EDTA (Sarstedt yellow top)
Sample volume 1ml blood (0.5ml plasma)
Special requirements (for sample collection) None
Special requirements Separate plasma and send via first class post. Store separated plasma at 2-4oC if not sending same day as collection.
Turnaround time 2 days
Reference range 0mg/dl
Comments 17.4mmol/l equivalent to 80mg/dl

Ethanol (urine)

Alternative name Alcohol
Sample tube Fluoride EDTA (Sarstedt yellow top) or plain container
Sample volume 1ml urine
Special requirements (for sample collection) None
Turnaround time 4 days
Reference range 0mg/dl
Comments 17.4mmol/l equivalent to 80mg/dl

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Tests beginning with F

Faecal Occult Blood

Alternative name FOB
Sample tube Sampling kit- available from pathology reception upon request.
Sample volume See sampling kit instructions
Special requirements (for sample collection) Random sample should be collected on 3 consecutive days (instructions in the sampling kit should be followed).
Special requirements None
Turnaround time 1 week
Reference range Reported negative or positive according to a cut off of 10μgHb/g faeces as recommended by NICE.
Clinical application Screen for occult blood loss
Comments Iron therapy can cause false positive results. Samples analysed by OC sensor FIT method.

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Tests beginning with G

Growth Hormone

Alternative name GH
Sample tube Gel tube (Sarstedt brown top)
Special requirements (for sample collection) None
Special requirements Separate serum as soon as possible after collection and freeze at -20oC. Send samples frozen.
Sample volume 2ml (1ml serum)
Turnaround time 1 week
Reference range N/A
Clinical application Baseline GH levels cannot be used to exclude acromegaly, as elevated levels may be due to stress; normal levels are seen in up to 8% of patients subsequently failing to suppress during GTT. 
Comments Protocols for stimulatory or suppression testing available from the Clinical Biochemistry Department. Note that in isolation, a single GH test provides limited diagnostic information. Analysed by IDS iSYS human growth hormone immunoassay.

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Tests beginning with H

HbA1c

Alternative name Glycated haemoglobin
Sample tube EDTA tube (Sarstedt grey top or red top)
Sample volume 1ml blood
Special requirements (for sample collection) None
Special requirements None
Turnaround time 2 days
Reference range HbA1C > 48mmol/mol is diagnostic of diabetes mellitus.
Clinical application Monitoring of diabetic control and diagnosis of diabetes mellitus.
Comments Samples are analysed using Tosoh G11 ion exchange chromatography.

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Tests beginning with I

IGF 1

Alternative name Insuline-like growth factor 1
Sample tube Gel tube (Sarstedt brown top)
Sample volume 2ml blood (1ml serum)
Special requirements (for sample collection) None
Special requirements Separate serum as soon as possible after collection and freeze at -20oC. Send samples frozen.
Turnaround time 2 weeks
Reference range

 Reference ranges are age related and will be provided with the report. Contact the duty biochemist for further information.

Clinical application Investigation of growth hormone deficiency and acromegaly

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Tests beginning with L

Lithium

Alternative name N/A
Sample tube Gel tube (Sarstedt brown top)
Sample volume 1ml blood
Special requirements (for sample collection) Sample should be taken 12 hours post-dose.
Special requirements Separate serum and send via first class post. Store separated serum at 2-4oC if not sending same day as collection.
Turnaround time 4 days
Reference range 0.4-1.0mmol/l
Clinical application Therapeutic drug monitoring
Comments Concern level 1.4mmol/l. Severe toxicity likely at >2.0mmol/l.

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Tests beginning with M

Metadrenalines (urine)

Alternative names Normetadrenaline, metadrenaline, METS, NMA, VMA
Sample tube 24hr urine container with strong acid
Sample volume 24hr urine
Special requirements (for sample collection) Ideally, collection should be made during a period in which the patient is symptomatic. There are no special delivery requirements.
Special requirements None
Turnaround time 2 weeks (a batch will be analysed every fortnight)
Reference range

Metadrenaline <2.0μmol/24hr

Normetadrenaline M <5.3μmol/24hr

F <4.3μmol/24hr

Clinical application Investigation of phaeochromocytoma

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Tests beginning with P

PTH

Alternative name Parathyroid hormone
Sample tube EDTA (Sarstedt red top)
Sample volume 1ml blood (0.5ml plasma)
Special requirements (for sample collection) Sample to arrive in the laboratory within 6 hours.
Special requirements Separate serum immediately and freeze if unable to send within 6 hours of collection. Send frozen.
Turnaround time 2 days
Reference range 1.6-6.8pmol/l
Clinical application Investigation of causes of hyper and hypocalcaemia. Monitoring in renal disease.
Comments Interpretation should be made in relation to accompanying serum calcium.

Phenobarbitone

Alternative names Primidone, phenobarbital
Sample tube Gel tube (Sarstedt brown top)
Sample volume 2ml
Special requirements (for sample collection) Pre-dose samples preferred
Special requirements Separate serum and send via first class post. Store separated serum at 2-4oC if not sending same day as collection.
Turnaround time 1 day
Reference range 10-30mg/l
Clinical application Therapeutic drug monitoring. Target range ill-defined due to 'tolerance'.
Comments Concern level 70mg/l. Conversion factor = μmol/l x 0.232 = mg/l.

Phenytoin

Alternative name N/A
Sample tube Gel tube (Sarstedt brown top)
Sample volume 2ml
Special requirements (for sample collection) Pre-dose sample preferred or at least 1 hour post-dose
Special requirements None
Turnaround time Same day
Reference range 8-15mg/l
Clinical application Therapeutic drug monitoring. Severe toxicity likely if level >40.0mg/l. Concern level 25mg/l.
Comments Note that drug is usually protein bound; those patients with very low serum albumin levels may have high free phenytoin relative to total levels. μmol/L x 0.252 = mg/l.

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Tests beginning with R

Renin

Alternative name Plasma renin concentration
Sample tube EDTA (Sarstedt red top)
Sample volume 2ml blood (1ml plasma)
Special requirements (for sample collection) Stop therapy with spironolactone 4 weeks and β-blockers 2 weeks prior to test. Ensure potassium is within reference range at time of assessment. Please list any other medications.

Sample must arrive in pathology reception within 15 minutes of collection. 

SAMPLES MUST NOT BE TRANSPORTED TO THE LABORATORY ON ICE.
Special requirements Centrifuge sample, aliquot and freeze plasma immediately on arrival. Send frozen plasma aliquot on dry ice.
Turnaround time 2 weeks
Reference range Adults: upright = 5.3-9.9mlu/l
Clinical application Investigation of Conn’s syndrome (primary hyperaldosteronism). Generally combined with assessment of aldosterone to give an aldosterone : renin concentration ratio.
Comments Plasma renin concentration is measured using the IDS iSYS immunoassay.

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Tests beginning with T

Tacrolimus

Alternative name FK506
Sample tube EDTA (Sarstedt grey top or red top). Grey top is the preferred sample type.
Sample volume 1ml whole blood
Special requirements (for sample collection) Pre-dose sample
Special requirements None
Turnaround time < 4 days. Analysis is performed on Monday, Wednesday and Friday.
Reference range 3-15μg/l
Clinical application Therapeutic drug monitoring of immunosuppressant treatment.
Comments Concern level 25μg/l. Measured by LC-MS/MS.

Theophylline

Alternative name Aminophylline
Sample tube Gel tube (Sarstedt brown top)
Sample volume 1ml blood (0.5ml serum)
Special requirements (for sample collection) Pre-dose sample preferred. Otherwise, at least 2 hours post-dose.
Special requirements None
Turnaround time 2 days
Reference range 10-20mg/l
Clinical application Therapeutic drug monitoring, compliance and toxicity.
Comments

Concern level 20 mg/L

Lower levels > 5.0 mg/L may be effective.

Concern level 14.0 mg/L if age < 3 months.

Severe toxicity likely if level > 60.0 mg/L.

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Tests beginning with V

Vancomycin

Alternative name N/A
Sample tube Gel tube (Sarstedt brown top)
Sample volume 1ml (0.5ml serum)
Special requirements (for sample collection) Record time of sample and know how long it is since the last dose was given.
Special requirements None
Turnaround time 1 day
Reference range

Use drug level monitoring chart.

Levels > 4 mg/L will be phoned.

Interpretation depends on the timing of the sample in relation to the last dose. Refer any queries to the microbiologist.

Clinical application

Therapeutic drug monitoring; interpretation depends on the timing of the sample and the time of the last dose.

Trough levels are usually measured: 12 to 24 hours after the last dose.

Vitamin D

Alternative names Calcidol, 25OH vitamin D, 25OH cholecalciferol, 25 hydroxy vitamin D.
Sample tube  Gel tube (Sarstedt brown top)
Sample volume 2ml blood (1ml serum)
Special requirements (for sample collection) None
Special requirements Separate serum and send via first class post. Store separated serum at 2 – 4 oC if not sending same day as collection.
Turnaround time 1 working day
Reference range 50 – 150nmol/L (adequate vitamin D status)
Clinical application Assessment of vitamin D deficiency/excess, investigation of hypo/hypercalcaemia in symptomatic patients.
Comments Assay currently in use measures ‘total’ vitamin D. Seasonal variation seen due to sunlight exposure (D). D2 reflects dietary or supplement origin.

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Tests beginning with Z

Zinc

Alternative name N/A
Sample tube Gel tube (Sarstedt brown top)
Sample volume 2ml blood (1ml serum)
Special requirements (for sample collection) None
Special requirements Separate serum and send via first class post. Store separated serum at 2 – 4 oC if not sending same day as collection.
Turnaround time 1 week
Reference range 10-21μmol/l
Clinical application Assessment of nutritional deficiency
Comments

Note, zinc is highly albumin bound and a negative acute phase reactant, interpret with caution.

Measured by atomic absorption spectrometry.

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