mosbys diagnostic and laboratory test reference 12th ed

ROUTINE BLOOD TESTING Many diagnostic and laboratory tests include the direction to perform routine blood testing and/or routine urine testing The protocol for those tests is presented here and will be cross-referenced within the many tests requiring them Before Explain the procedure to the patient Tell the patient if fasting is necessary (Fasting is most commonly required with glucose and lipid studies.) If fasting is required, instruct the patient not to consume any food or fluids Only water is permitted Fasting requirements usually vary from to 12 hours Instruct the patient to continue taking medications unless told otherwise by the healthcare provider During • Collect the blood in a properly color-coded test tube (Table A, page xiv), which indicates the presence or absence of additives Tube stopper colors may vary with different manufacturers If uncertain, verify with the laboratory After • Apply pressure or a pressure dressing to the venipuncture site • Assess the site for bleeding = Patient teaching ROUTINE URINE TESTING Many diagnostic and laboratory tests include the direction to perform routine blood testing and/or routine urine testing The protocol for those tests is presented here and will be cross-referenced within the many tests requiring them Before Explain the procedure to the patient Inform the patient if food or fluid restrictions are needed During Random, fresh, or spot specimen: • Instruct the patient to urinate into an appropriate nonsterile container 24-hour specimen: Begin the 24-hour collection by discarding the first specimen Collect all urine voided during the next 24 hours Show the patient where to store the urine Keep the urine on ice or refrigerated during the collection period Foley bags are kept in a basin of ice Some collections require a preservative Check with the laboratory Post the hours for the urine collection in a prominent place to prevent accidentally discarding a specimen Instruct the patient to void before defecating so that urine is not contaminated by stool Remind the patient not to put toilet paper in the urine collection container Collect the last specimen as close as possible to the end of the 24-hour period Add this urine to the collection After • Transport the specimen promptly to the laboratory = Patient teaching MOSBY’S DIAGNOSTIC AND LABORATORY TEST REFERENCE Twelfth Edition Kathleen Deska Pagana, PhD, RN Professor Emeritus Department of Nursing Lycoming College Williamsport, Pennsylvania http://www.KathleenPagana.com President, Pagana Keynotes & Presentations Timothy J Pagana, MD, FACS Medical Director The Kathryn Candor Lundy Breast Health Center Susquehanna Health System Williamsport, Pennsylvania Theresa Noel Pagana, MD, FAAEM Emergency Medicine Physician Virtua Voorhees Hospital Voorhees, New Jersey 3251 Riverport Lane St Louis, Missouri 63043 MOSBY’S DIAGNOSTIC AND LABORATORY TEST REFERENCE,╇╇╇╇╇╇╇╇╇ISBN: 978-0-323-22576-2 TWELFTH EDITION Copyright © 2015, 2013 by Mosby, an imprint of Elsevier Inc Copyright © 2011, 2009, 2007, 2005, 2003, 2001, 1999, 1997, 1995, 1992 by Mosby, Inc., an affiliate of Elsevier Inc All rights reserved No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein) Notice Knowledge and best practice in this field are constantly changing As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein ISBN: 978-0-323-22576-2 Content Strategist: Jamie Randall Content Development Manager: Jean Sims Fornango Publishing Services Manager: Hemamalini Rajendrababu Project Manager: Manchu Mohan Designer: Karen Pauls/Renee Duenow Printed in the United States of America Last digit is the print number: 9â•…8â•…7â•…6â•…5â•…4â•…3â•…2â•…1 With love and adoration, we dedicate this book to our grandchildren: Ella Marie Gaul Jocelyn Elizabeth Gaul Timothy William Gaul Justin Aquinas Gaul Juliana Kathleen Pericci Luke Michael Pericci John Henry Bullen, V reviewers Crystal Botkin, MPH, CNMT, PET Assistant Professor and Clinical Coordinator Nuclear Medicine Technology Program Doisy College of Health Sciences Saint Louis University St Louis, Missouri Noelle C Bowdler, MD Clinical Professor of Obstetrics and Gynecology University of Iowa Hospitals and Clinics Iowa City, Iowa Eileen M Burd, PhD, D(ABMM) Director, Clinical Microbiology Emory University Atlanta, GA Disaya Chavalitdhamrong, MD Division of Gastroenterology, Hepatology and Nutrition Department of Medicine University of Florida Gainesville, Florida Laurence M Demers, PhD, DSc, DABCC, FACB Distinguished Professor Emeritus, Pathology and Medicine M.S Hershey Medical Center Pennsylvania State University Hershey, Pennsylvania Sandra C Hollensead, MD Emerita Professor of Pathology and Laboratory Medicine School of Medicine University of Louisville Louisville, Kentucky Frederick L Kiechle, MD, PhD Medical Director, Clinical Pathology Pathology Consultants of South Broward Memorial Healthcare System Hollywood, Florida iv reviewersâ•… v Chuany Mark Lu, MD, PhD Professor of Laboratory Medicine University of California Chief, Hematology and Hematopathology/Laboratory Medicine Service Veterans Affairs Medical Center San Francisco, California Alexander J McAdam, MD, PhD Associate Professor of Pathology Harvard Medical School Boston, Massachusetts Ravinder Jit Singh, PhD Director of Endocrine Laboratory Mayo Clinic Rochester, Minnesota preface The 12th edition of Mosby’s Diagnostic and Laboratory Test Reference provides the user with an up-to-date, essential reference that allows easy access to clinically relevant laboratory and diagnostic tests A unique feature of this handbook is its consistent format, which allows for quick reference without sacrificing the depth of detail necessary for a thorough understanding of diagnostic and laboratory testing All tests begin on a new page and are listed in alphabetical order by their complete names The alphabetical format is a strong feature of the book; it allows the user to locate tests quickly without first having to place them in an appropriate category or body system The User’s Guide to Test Preparation and Procedures section outlines the responsibilities of health care providers to ensure that the tests are accurately and safely performed Use of this guide should eliminate the need for test repetition resulting from problems with patient preparation, test procedures, or collection techniques Every feature of this book is designed to provide pertinent information in a sequence that best simulates priorities in the clinical setting The following information is provided, wherever applicable, for effective diagnostic and laboratory testing: Name of test Tests are listed by their complete names A complete list of abbreviations and alternate test names follows each main entry Type of test This section identifies whether the test is, for example, an x-ray procedure, ultrasound, nuclear scan, blood test, urine test, sputum test, or microscopic examination of tissue This section helps the reader identify the source of the laboratory specimen or location of the diagnostic procedure Normal findings Where applicable, normal values are listed for the infant, child, adult, and elderly person Also, where appropriate, values are separated into male and female It is important to realize that normal ranges of laboratory tests vary from institution to institution This variability is even more obvious among the various laboratory textbooks For this reason, we have deliberately chosen not to add a table of normal values as an appendix, and we encourage the user to check the normal values at the institution where the test is performed This should be relatively easy because laboratory reports include normal values Results are given in both conventional units and the International System of Units (SI units) where possible viâ•…  prefacê•… vii Possible critical values These values give an indication of results that are well outside the normal range These results require health care provider notification and usually result in some type of intervention The Joint Commission is looking at the timely and reliable communication of critical laboratory values as one of its patient safety goals Test explanation and related physiology This section provides a concise yet comprehensive description of each test It includes fundamental information about the test itself, specific indications for the test, how the test is performed, what disease or disorder the various results may show, how it will affect the patient or client, and relevant pathophysiology that will enhance understanding of the test Contraindications These data are crucial because they alert health care providers to patients to whom the test should not be administered Patients highlighted in this section frequently include those who are pregnant, are allergic to iodinated or contrast dyes, or have bleeding disorders Potential complications This section alerts the user to potential problems that necessitate astute assessments and interventions For example, if a potential complication is renal failure, the implication may be to hydrate the patient before the test and force fluids after the test A typical potential complication for many x-ray procedures is allergy to iodinated dye Patient symptoms and appropriate interventions are described in detail Interfering factors This section contains pertinent information because many factors can invalidate the test or make the test results unreliable An important feature is the inclusion of drugs that can interfere with test results Drugs that increase or decrease test values are always listed at the end of this section for consistency and quick access A drug symbol ( ) is used to emphasize these drug interferences Procedure and patient care This section emphasizes the role of nurses and other health care providers in diagnostic and laboratory testing by addressing psychosocial and physiologic interventions Patient teaching priorities are noted with a special icon ( ) to highlight information to be communicated to patients For quick access to essential information, this section is divided into before, during, and after time sequences Before This section addresses the need to explain the procedure and to allay patient concerns or anxieties If patient consent is usually required, this is listed as a bulleted item indexâ•… 1055 Phenotyping, alpha1-antitrypsin, 37–38 Phenylketonuria (PKU), 657–659 Phenytoin, 348t Pheochromocytoma, 636, 974 Pheochromocytoma suppression and provocative testing, 704–705 Phlebography, 980–981 Phosphate (PO4), 706–707 Phosphatidylglycerol (PG), 50 Phosphatidylinositol antigen, 708 Phosphatidylinositol glycan A (PIGA) gene, 708 Phospholipid antibodies, 64 Phosphorus (P), 706–707 Photostimulation, 367 Physiologic jaundice of newborn, 142 PI-linked antigen, 708 PIFR (peak inspiratory flow rate), 775 Pilocarpine iontophoresis, 875 PINP (amino-terminal propeptide of type I procollagen), 175–176 Pinworms, 863 Pittsburgh Agent B (PIB), 58 PKU (phenylketonuria), 657–659 PLAC test, 586 Placental growth factor (PGF), 709 Plague, 147t, 149 Plasma free metanephrine testing, 636–637 Plasma renin activity (PRA), 800–804, 801f Plasma renin concentration (PRC), 800–804, 801f Plasma thromboplastin antecedent, 261t, 265t Plasminogen, 710–711 Plasminogen activator inhibitor (PAI-1), 712–713 Platelet, examination of, 158 Platelet aggregation test, 714–715 Platelet antibody detection, 716–717 Platelet closure time (PCT), 721–723 Platelet count, 718–720 Platelet function assay, 721–723 Platelet precursors, 167 Platelet sequestration, 167–168 Platelet volume, mean, 724 Plethysmography, 725–726, 775 Pleural biopsy, 727–728 Pleural fluid analysis, 883–888, 884f Pleural tap, 883–888, 884f PMN ab (polymorphonucleocyte antibodies), 654 PMNs (polymorphonuclear leukocytes), 992 Pneumonic plague, 149 PNH (paroxysmal nocturnal hemoglobinuria), 708 PNH with FLAER assay, 708 Po2, 112 PO4 (phosphate), 706–707 Polys (polymorphonuclear leukocytes), 992 Polyangiitis, microscopic, 84 Polyclonal gamma globulin, 762t Polycystic ovary syndrome, 19 Polycythemia, 395 Polycythemia vera, 167 Polymerase chain reaction (PCR) for C difficile, 259 culture, for tuberculosis, 936 Polymorphonuclear leukocytes (PMNs), 992 Polymorphonucleocyte antibodies (PMN ab), 654 Polysomic cells, 678 Polysomnography (PSG), 845–848 Pontiac fever, 582 Porphobilinogens, 729–730 Porphobilinogen deaminase, 337 Porphyria, 337, 729, 972 Porphyrins, 729–730 Portal hypertension, 594 Positron emission mammography (PEM), 734 Positron emission tomography (PET), 731–735 Postcoital cervical mucus test, 840–841 Postprandial glucose (PPG), 477 Posttransfusion purpura, 716 Potassium (K) blood, 736–738 urine, 739 PPD (purified protein derivative) test, 934–935 PPG (postprandial glucose), 477 PR3-ANCA, 84 PR interval, 361, 361f PRA (plasma renin activity), 800–804, 801f PRA (progesterone receptor assay), 748–749 PRC (plasma renin concentration), 800–804, 801f Prealbumin (PAB), 740–741 Pregnancy activated partial thromboplastin time, 694 alpha-fetoprotein in, 39 amniocentesis in, 49, 49t chorionic villus sampling in, 254–256, 255f folic acid in, 443 human chorionic gonadotropin in, 530–532, 531t karyotyping in, 258 pregnanediol in, 744 rubella antibody test in, 810 sexual assault and, 826 tests for, 530–532 TORCH test in, 917 toxoplasmosis antibody titer in, 920 triple/quadruple screen in, 628–630 ultrasound in, 697–699 Pregnancy-associated plasma protein-A (PAPP-A), 742–743 Pregnancy tests, 530–532, 531t Pregnanediol, 744–745 Pregnenolone, 18–19 Pressure CSF, 597 urethral, 323 vascular, 215t Prick-puncture test, 33 Primary biliary cirrhosis, 82, 87t PRL (prolactin) levels, 750–751 Proaccelerin, 261t, 262t, 265t Proconvertin, 261t, 262t, 264f, 265t Proctoscopy, 838–839 1056â•… index Progesterone assay, 746–747 Progesterone receptor (PR) assay, 748–749 Progressive systemic sclerosis (PSS), 91 Proinsulin C-peptide, 304–305 Prolactin (PRL) levels, 750–751 Prolactin (PRL) stimulation tests, 750 Prolactin (PRL) suppression tests, 750 Prolonged dexamethasone suppression test, 339–341 Propoxyphene, 870t Propranolol, 348t Prostaglandin D(2) (PGD[2]), 141 Prostate cancer, 752 PSA in, 756 Prostate cancer-specific biomarkers, 757–758 Prostate gland CT of, 286t ultrasound of, 754–755, 754f Prostate/rectal ultrasound, 754–755, 754f Prostate-specific antigen (PSA), 756–759 Prostate-specific proteins, 757 Prostatic acid phosphatase (PAP), 7–8 Prostatic cancer, Prostatic-specific membrane antigen, 757 Proteins Bence Jones, 139–140 blood, 760–764, 762t CSF, 596 peritoneal fluid, 686 pleural fluid, 884–885 urinary, 139, 760–764, 762t, 952, 955, 960, 963 Protein C, 765–766 activated, 417, 694 Protein/creatinine ratio, 955 Protein electrophoresis, 139, 760–764, 762t Protein S, 765–766 Proteinase 3-ANCA (PR3-ANCA), 84 Proteinuria, 955, 958 Prothrombin, 261–263, 261t, 262t, 264f, 265t Prothrombin fragment (F1+2), 896–897 Prothrombin time (PT), 767–770, 768t Protoporphyrin, zinc, 1002 Provocholine challenge test, 777 Proximal hip, in bone densitometry, 162 PSA (prostate-specific antigen), 756–759 Pseudocholinesterase (PChE), 251–253 Pseudomonas, 953 PSG (polysomnography), 845–848 PT (prothrombin time), 767–770, 768t PTH (parathyroid hormone), 689–690 PTT (partial thromboplastin time), 693–695 Pulmonary angiography, 771–772 Pulmonary anthrax, 146 Pulmonary artery pressure, 215t Pulmonary embolism (PE), 335, 607 Pulmonary function tests (PFTs), 773–777, 774f Pulmonary scintiphotography, 607–609 Pulmonary wedge pressure, 215t Pulse oximetry, 113, 673–674, 674f Purified protein derivative (PPD) test, 934–935 Purpura idiopathic thrombocytopenia, 716–717 posttransfusion, 716 P wave, 360–361, 361f PYD (pyridinium), 174 crosslinks, 176 Pyelography, 778–783 Pyridinium (PYD), 174 crosslinks, 176 Q QCT (quantitative computed tomography), for bone mineral density, 163 QFT-G (quantiFERON-TB Gold) test, 938–940 QRS complex, 361, 361f Qualitative fetal hemoglobin stool test, 108 QuantiFERON-TB Gold (QFT-G test), 938–940 Quantitative computed tomography (QCT), for bone mineral density, 163 Quantitative fibrinogen, 439–440 Quantitative stool fat determination, 419–420 Quantitative ultrasound, 163 Queckenstedt-Stookey test, 602 R R factor, 62–63 RA (rheumatoid arthritis), 807 Rabies-neutralizing antibody test, 784–811 Radioallergosorbent test (RAST), 31–32 Radionuclide renal imaging, 796–799 Radionuclide scan see Nuclear scan Radiorenography, 796–799 Rape, 7, 826, 827b Rapid dexamethasone suppression test, 340 Rapid mononucleosis test, 645 Rapid plasma reagin (RPR), 877–878 Rapid stimulation test, 13–14 Rapid urease testing, for Helicobacter pylori, 495 RAST (radioallergosorbent test), 31–32 RBCs see Red blood cells (RBCs) RDW (red blood cell distribution width), 790 Real-time ultrasonography, 189 Rectal culture, 831f Rectal EMG procedure, 371–372 Rectal ultrasound, 754–755, 754f Red blood cells (RBCs) antibodies to, 297 bone marrow, 167 CSF, 596, 598 2,3-diphosphoglycerate in, 343–344 fragility of, 391–392 Heinz body in, 493 hematocrit of, 497, 498f hemoglobin of, 500 microscopic examination of, 156–158, 156b indexâ•… 1057 Red blood cells (RBCs) (Continued) morphology, 156–158, 156b peritoneal fluid, 686 pleural fluid, 884 sedimentation rate (ESR), 393–394 synovial fluid, 122 urinary, 952, 959, 961, 965 zinc protoporphyrin in, 1002 Red blood cell (RBC) casts, 959 Red blood cell (RBC) cholinesterase, 251–253 Red blood cell (RBC) count, 785–787 Red blood cell (RBC) distribution width (RDW), 790 Red blood cell (RBC) indices, 788–791, 789t Red blood cell (RBC) volume, 918–919 Reductase, 957 Reflectance meter, 476 Reflex, oculovestibular, 206–207 Renal angiography, 117 Renal biopsy, 792–795, 793f Renal blood flow (perfusion) scan, 796 Renal calculus analysis, 966–967 Renal failure (RF), aluminum toxicity in, 42 Renal function scan, 797 Renal function studies, 312–313, 947 Renal hypertension scan, 797 Renal obstruction scan, 797 Renal scanning, 796–799 Renal structural scan, 796–797 Renal vein assays, 801–802 Renin, 59 Renin assay, 800–804, 801f Renin stimulation test, 802 Renogram, 797 Renovascular hypertension, 801, 801f Residual volume (RV), 774f, 775 Resin, 154 Respiratory acidosis, 110, 111t, 112t, 115–116 Respiratory alkalosis, 111t, 112t, 115–116 Respiratory distress syndrome (RDS), 49–50 RET proto-oncogene, 467 Retic count, 805–806 Reticulocyte count, 805–806 Reticulocyte index, 805 Retinol binding protein, 643 Retrograde pyelography, 778–783 Retroperitoneum, CT of, 286t Reverse-transcriptase polymerase chain reaction (RT-PCR), for HIV infection, 517 RF (rheumatoid factor), 69, 807–808 Rh factors, 160 Rh isoimmunization, fetal status affected by, 51 Rh negative (Rh-), 160 Rheumatoid arthritis (RA), 69, 87t, 88f, 122, 807 Rheumatoid factor (RF), 69, 807–808 Rho(D), as Rh factor, 160 RhoGAM, 160, 256, 430–431 Ribosomal P antibodies, 809 Ribosome P antibodies, 809 RNA polymerase III antibody, 91–92 Ro antibodies, 96 Routine urine testing, for proteins, 139 RPR (rapid plasma reagin), 877–878 RT-PCR (reverse-transcriptase polymerase chain reaction), for HIV infection, 517 Rubella antibody test, 810–811, 810t Rubeola antibody, 631 Rupture of membranes, assessment for, 51–52 RV (residual volume), 774f, 775 S S-phase fraction, in breast cancer, 184, 185 SACE (serum angiotensin-converting enzyme), 60–61 Sacral spine x-ray studies, 856–857 SAECG (signal-averaged ECG), 362 Salicylate, 348t Salivary cortisol, 301–303 Salivary duct x-ray, 834 Salivary gland nuclear imaging, 812–878 Sarcoidosis, 60 SARS (severe acute respiratory syndrome) viral testing, 814–815 SBF (small bowel follow-through), 849–851 sBPP (soluble amyloid beta protein precursor), 58, 58t Scintigraphy see Nuclear scan Scintiphotography, pulmonary, 607–609 Scl-70 antibody, 91–92 Scleroderma, antibodies in, 87t, 88f, 91–92 Scratch test, 33 Scrotal ultrasound, 816–817 SDFA (sperm DNA fragmentation assay) test, 819 Secretin and pancreozymin, 675 Secretin test, 457 Sed rate test, 393–394 Segmented gradient gel electrophoresis (SGGE), 587 Semen analysis, 818–820 Sentinel lymph node biopsy (SLNB), 821–822 Septic arthritis, synovial fluid glucose value in, 122 Septicemic plague, 149 Septin DNA methylation assay, 640 Serine protease inhibitor, 98–100 Seroconversion window, 521 Serologic test for syphilis (STS), 877–878 Serologic testing for Helicobacter pylori infection, 495 for herpes simplex, 510 for HIV, 521t Serotonin, 823–824 SERs (somatosensory-evoked responses), 413–414 Serum angiotensin-converting enzyme (SACE), 60–61 Serum calcium, 203–205 Serum cortisol, 301–303 1058â•… index Serum creatinine, 312–314 Serum ferritin study, 421 Serum glutamic-oxaloacetic transaminase (SGOT), 129–131, 131t Serum haptoglobin test, 491 Serum osmolality test, 669 Serum protein electrophoresis (SPEP), 760–764, 762t Serum protein quantification, 551–552 Sestamibi cardiac scan, 221–224 Severe acute respiratory syndrome (SARS) viral testing, 814–815 Sex hormone-binding globulin (SHBG), 880 Sexual assault testing, 825–827, 827b Sexually transmitted disease testing, 828–833, 828t, 831f, 832f SGGE (segmented gradient gel electrophoresis), 587 SGOT (serum glutamic-oxaloacetic transaminase), 129–131, 131t SH (somatotropin hormone), 486–488 Shake test, 50 SIADH (syndrome of inappropriate antidiuretic hormone), 71 Sialography, 834–835 Sickle cell anemia, 335 Sickle cell disease, 504t, 658, 836 Sickle cell trait, 504t Sickledex test, 836–837 Sigmoidoscopy, 838–839 Signal-averaged ECG (SAECG), 362 Sims-Huhner test, 840–841 Single-photon emission computed tomography (SPECT), 450 cardiac, 221 for hormone-producing tumors, 667 liver, 594 Sjögren antibodies, 87t, 88f, 96–97 Sjögren syndrome, 87t, 96 Skin biopsy, 842–843 Skin immunohistopathology, 842–843 Skin testing, 31, 33 Skull x-ray, 844 SLE see Systemic lupus erythematosus (SLE) Sleep EEG, 367 Sleep studies, 845–848 SLNB (sentinel lymph node biopsy), 821–822 Small bowel enema, 849–851 Small bowel follow-through, 849–851 Small pox, 147t, 149–150 SMCD (systemic mast cell disease), 141 Sodium (Na) blood, 852–853 fractional excretion of, 854 potassium level and, 736 urine, 854–855 Soluble amyloid beta protein precursor (sBPP), 58, 58t Somatomedins, 486, 556 Somatomedin C, 487, 556–557, 556t Somatosensory-evoked responses (SERs), 413–414 Somatotropin see Growth hormone (GH) Sonogram see Ultrasound SPA (sperm penetration assay), 818–819 Specific gravity, urinary, 952, 956–957, 960, 963 SPECT see Single-photon emission computed tomography (SPECT) Spectroscopy, magnetic resonance, 617 SPEP (serum protein electrophoresis), 760–764, 762t Sperm agglutination and inhibition, 94–95 Sperm antibodies, 94–95 Sperm chromatin structure assay test, 819 Sperm count, 818–820 Sperm DNA fragmentation assay (SDFA) test, 819 Sperm examination, 818–820 Sperm penetration assay (SPA), 818–819 Sphingomyelin, 49–50 Spinal tap, 596–603, 602f see also Cerebrospinal fluid (CSF) Spinal x-ray, 647–649, 856–857 Spinnbarkeit, 840 Spirometry, 773, 774f Spleen in bilirubin metabolism and excretion, 143f CT of, 286t nuclear scan of, 594–595 Spleen scanning, 594–595 Sputum culture and sensitivity, 858–859 Sputum cytology, 860 Sputum smear, 936–937 SQID (superconducting quantum interference device), 365 Squamous cell carcinoma (SCC) antigen, 861 ST segment, 361, 361f Stab cells, 992 Stable factor, 262t, 264f, 265t STD (sexually transmitted disease) culture, 828–833, 828t, 831f, 832f Steatorrhea, 419 Stein-Leventhal syndrome, 19 Stereotactic biopsy, 625, 625f Stones, kidney, 966 Stool Apt test for, 108 culture and sensitivity of, 862–863 DNA sample of, 864–866 fat in, 419–420 lactoferrin in, 573–574 occult blood testing of, 864–866 for ova and parasites, 862–863 Stool for swallowed blood, 108 Streptococcus group B antigen, 867–868 Streptococcus serologic testing, 867–868 Streptolysin O, 867–868 Streptozyme, 867–868 Stress testing, 225 Stroke volume (SV), 215t STS (serologic test for syphilis), 877–878 Stuart factor, 261t, 262t, 264f, 265t Substance abuse testing, 869–872, 870t Succinylcholine, 251 Superconducting quantum interference device (SQID), 365 indexâ•… 1059 Superscan, 172 Supine abdominal x-ray study, 665 Suprapubic aspiration, of urine, 969 Surfactant activity, measurement of, 50 SV (stroke volume ), 215t Swallowing examination, 873–874 Sweat electrolytes test, 875–876 Syndrome of inappropriate antidiuretic hormone (SIADH), 71 Synovial fluid analysis, 121–124 Syphilis, 828t serology for, 600 Syphilis detection test, 877–878 Systemic lupus erythematosus (SLE), 75, 87t anti-DNA antibody in, 73 anti-SS-A antibody in, 96–97 antinuclear antibodies in, 67, 86, 87t, 88f drug-induced, 67 ribosome P antibodies in, 809 Systemic mast cell disease (SMCD), 141 Systemic mastocytosis (systemic mast cell disease, SMCD), 141 Systolic left ventricular pressure, 215t T T cells, 992 in AIDS, 234 T wave, 361, 361f T3 (triiodothyronine), 929–930 T4 (thyroxine), 912–914 Tandem mass spectrometry, 657 Tap test, 50 Tape test, 863 Tartrate-resistant acid phosphatase (TRAP), 7–8 Tau protein, 58 Tay-Sachs disease (TSD), 513 genetic testing, 464–465 TB see Tuberculosis (TB) TBG (thyroxine-binding globulin), 915–916, 915t TBII (thyroid-binding inhibitory immunoglobulin), 907–908 TBPA (thyroxine-binding prealbumin), 740–741 TBV (total blood volume), 918–919 TEE (transesophageal echocardiography), 357, 921–924, 922f “Test meal,”, 454 Testes, ultrasound of, 816–817 Testosterone, 879–940, 879t TfR (transferrin receptor) assay, 925–926 Tg (thyroglobulin), 101, 898–900 Tg (thyroglobulin) antibody, 101 TGs (triglycerides), 927–928, 927t α-Thalassemia, 504t β-Thalassemia major, 504t β-Thalassemia trait, 504t Thallium scan, 221–224 Theophylline, 348t Therapeutic drug monitoring (TDM), 347–351, 348t pharmacogenetics, 349 ThinPrep Imaging System, for Pap smear, 681 ThinPrep slide, 152 Thiopurine methyltransferase (TPMT), 349 Thoracentesis, 883–888, 884f Thoracic spine x-ray studies, 856–857 Thoracoscopy, 889–890 Thoracotomy, video-assisted, 889 Three-dimensional echocardiography, 356 Three-dimensional mammography, 625 Three-phase bone scan, 172 Throat culture, 891–892 Thrombocyte count, 718–720 Thrombocytopenia, 716, 718 Thrombocytosis, 718 Thromboelastography, 893–895, 894f Thromboelastometry, 893–895, 894f Thromboplastin, 265t Thromboplastin time, activated partial, 9, 693–695 Thrombosis indicators, 335, 896–897 Thyretin, 740–741 Thyrocalcitonin, 201–202 Thyrogen-stimulated thyroglobulin, 898–900, 898t Thyroglobulin (Tg), 101, 898–900, 898t Thyroglobulin antibody, 101 Thyroid antithyroglobulin antibody, 101 Thyroid autoantibody, 101, 102–103 Thyroid-binding inhibitory immunoglobulin (TBII), 907–908 Thyroid cancer, 462–469, 898 medullary, 201 Thyroid cancer genetic testing, 467 Thyroid echogram, 909 Thyroid nodules, 901 Thyroid-releasing hormone (TRH) stimulation test, 904 Thyroid scanning (thyroid scintiscan), 901–903 Thyroid-stimulating hormone receptor (TSHR) antibodies, 907–908 Thyroid-stimulating hormone (TSH), 898–899, 904–905 Thyroid-stimulating hormone (TSH) stimulation test, 906 Thyroid-stimulating immunoglobulins (TSIs), 907–908 Thyroid ultrasound (echogram, sonogram), 909 Thyroiditis, 87t, 101 autoimmune, 101 chronic lymphocytic, 101 Hashimoto, 101 Thyrotropin, 904–905 Thyrotropin receptor antibody, 907–908 Thyrotropin-releasing hormone (TRH) stimulation test, 910–911 Thyroxine (T4), 906 Thyroxine (T4) screen, 912–914 Thyroxine-binding globulin (TBG), 915–916, 915t Thyroxine-binding prealbumin (TBPA), 740–741 TIBC (total iron-binding capacity), 561–564 Tidal volume (TV), 774f, 775 Tilt-table test, 378, 380 1060â•… index Tissue factor, 265t Tissue transglutaminase antibody, 470 TLC (total lung capacity), 774f, 775 Tobramycin, 348t Toluidine blue dye test, 826 TORCH (toxoplasmosis, other, rubella, cytomegalovirus, herpes) test, 917 Total blood volume (TBV), 918–919 Total calcium, 203–205 Total hexosaminidase, 513–514 Total iron-binding capacity (TIBC), 561–564 Total lung capacity (TLC), 774f, 775 Total serum bilirubin level, 144 Total thyroxine (T4), 912–914 Toxicology screening, 869–872, 870t Toxoplasmosis, 659 Toxoplasmosis antibody titer, 920 TPMT (thiopurine methyltransferase), 349 TPMT (thiopurine methyltransferase) gene mutation testing, 349 TPO-Ab (thyroid peroxidase) antibodies, 102–103 TRALI (transfusion-related acute lung injury), 654 Transesophageal echocardiography (TEE), 357, 921–924, 922f Transferrin, 561–564 Transferrin receptor (TfR) assay, 925–926 Transferrin saturation (TS), 561–564 Transfusion-related acute lung injury (TRALI), 654 Transhepatic cholangiography, percutaneous (PTHC), 384 Transluminal coronary angioplasty, percutaneous, 217 Transthoracic echocardiography, 356–358 Transthyretin, 740–741 Transudates, peritoneal, 684 TRAP (tartrate-resistant acid phosphatase), 7–8 Trastuzumab, 185 Treponema pallidum, 877 TRF (thyrotropin-releasing factor) stimulation test, 910–911 TRH (thyroid-releasing hormone) stimulation test, 904 TRH (thyrotropin-releasing hormone) stimulation test, 910–911 Trichomonas vaginalis, 828t, 829 Triglycerides (TGs), 885, 927–928, 927t Triiodothyronine (T3), 929–930 Trisomy 21, 628 Troponins, 931–932 Trough level, drug, 347–349 Trypsin, 675–677 Trypsin-like immunoreactivity, 675 Trypsinogen, 675 TS (transferrin saturation), 561–564 TSH (thyroid-stimulating hormone), 898–899, 904–905 TSH (thyroid-stimulating hormone) stimulation test, 906 TSHR (thyroid-stimulating hormone receptor) antibodies, 907–908 TSIs (thyroid-stimulating immunoglobulins), 907–908 TST (tuberculin skin test), 934–935 tTG-Ab (tissue transglutaminase antibody), 470 Tuberculin skin test (TST), 934–935 Tuberculin test, 934–935 Tuberculosis (TB) blood test, 938–940 culture in, 936–937 Gold test in, 938–940 nucleic acid amplification for, 938–940 serology, 939 testing, 938–940, 938t Tubular disease, microglobulin in, 641 Tubular (epithelial) casts, 959, 964 Tularemia, 147t, 150 Tumor markers AFP, 39–40 CA 15-3, 196–334 CA 19-9, 197–198 CA 27.29, 196–334 CA-125, 199–200 CEA, 212–213 CSF, 599 NMP22, 152–153 TV (tidal volume), 774f, 775 Two-dimensional echocardiography, 356 Two-hour postprandial glucose (2-hour PPG), 477–478 Type I diabetes mellitus, 342 Type diabetes (adult onset), 554 Tyrosinemia, 659 U U wave, 361f, 362 UBT (urea breath test), 944–945 UIBC (unsaturated iron binding capacity), 561 Ultrasound abdominal, 1–131, 2f breast, 189–190 cardiac, 356–358 carotid, 229–230 fetal, 697–699 intravascular, 558–559 pelvic, 697–699 prostate, 754–755, 754f quantitative, 163 rectal, 754–755, 754f scrotal, 816–817 thyroid, 909 vascular, 558–559, 977–979 Ultrasound absorption, 163 Ultrasound mammography, 189–190 Umbilical artery velocity, 425 Unconjugated (indirect) bilirubin, 142, 143f Universal donors, 160 Universal recipients, 160 Unsaturated iron binding capacity (UIBC), 561 UPP (urethral pressure profile), 323 Upper gastrointestinal (UGI) endoscopy, 401–404 Upper gastrointestinal x-ray study, 941–972 indexâ•… 1061 Upper GI series, 941–972 Upright MRI, 619–620 Urea breath test (UBT), 944–945 Urea nitrogen blood test, 946–948 Urethra cystoscopy of, 326, 327f herpes simplex virus infection of, 511–512 Urethral culture, 831, 832f Urethral pressure profile (UPP), 323 Uric acid, 949–951 Uricosuria, 950 Urinalysis, 952–965, 954t Urinary calcium, 204 Urinary stone analysis, 966–967 Urinary tract infection, 968 Urine amylase in, 57 appearance of, 952, 953, 959, 962 Bence Jones protein, 139–140 11 beta-prostaglandin F(2) alpha in, 141 bilirubin in, 957–958, 960–961 bladder cancer markers, 152 bone turnover markers in, 174, 177 casts in, 952, 958–959 catecholamine in, 974 cellular casts in, 958 collection of, 961, 968 color of, 952, 953, 954t, 959 cortisol in, 301–303 crystals in, 952, 958, 961, 964 d-xylose in, 1000–1001 11-dehydro-thromboxane B2 in, 722 delta-aminolevulinic acid in, 337–338 fatty casts in, 958, 964 glucose in, 952, 956, 963 granular casts in, 958, 964 for HIV, 522–523 hyaline casts in, 958, 964 17-hydroxycorticosteroids in, 541–542 5-hydroxyindoleacetic acid in, 543–544 ketones in, 952, 957, 960, 964 leukocyte esterase in, 952, 957, 960, 963 luteinizing hormone in, 610 methylmalonic acid in, 986 microalbumin in, 641–642 nitrates in, 952, 957, 963 odor of, 952, 953, 959, 962 osmolality of, 671–672, 956 pH of, 952, 953–955, 959–960, 962 porphyrins in, 729 potassium in, 739 prealbumin in, 740 pregnanediol in, 744 protein in, 139, 952, 955, 960, 963 red blood cells in, 952, 959, 961, 965 sodium in, 854–855 specific gravity of, 952, 956–957, 960, 963 suprapubic aspiration of, 969 tubular (epithelial) casts in, 959, 964 uric acid in, 949–951 urobilinogen in, 957–958, 960–961 vanillylmandelic acid in, 974 waxy casts in, 958, 964 white blood cells in, 952, 959, 961, 965 Urine culture and sensitivity, 832, 968–969 Urine drug testing, 869–872, 870t Urine flow studies, 970–971 Urine M-spike, 139 Urine osmolar gap, 671 Urobilinogen, 957–958, 960–961 Urochrome, 953 Urodynamic studies, 970–971 Uroflowmetry, 970 Urography CT, 283 intravenous, 778–783 Uroporphyrinogen-1-synthase, 972 Uterosalpingography, 546–547 Uterotubography, 546–547 Uterus CT of, 286t endoscopy of, 548, 549f x-ray of, 546–547 V Vagina colposcopy of, 274–275, 274f ultrasound of, 697–699 Valproic acid, 348t Vancomycin, 348t Vanillylmandelic acid (VMA), 973–990 urinary, 636 Varices, 136 Variola major, 149–150 Variola minor, 149–150 Variola virus, 147t, 149–150 Vascular ultrasound studies, 977–979 Vasopressin, 70–72 Vasopressor syncope syndrome, 378 VAT (video-assisted thoracotomy), 889 VC (vital capacity), 774f, 775 forced, 773 VCUG (voiding cystourethrography), 321–322 VDRL (Venereal Disease Research Laboratory) test, 877–878 Venereal Disease Research Laboratory (VDRL) test, 877–878 Venogram, 980–981 Venography, lower extremity, 980–981 Venous Doppler ultrasound, 977–979 Venous duplex scan, 977–979 Ventilation/perfusion scanning (VPS), 607–609 Ventricular natriuretic peptide, 651–664 Ventriculography, 214–220, 215t, 216f Vertebral Fracture Assessment (VFA), 163 Very-low-density lipoproteins (VLDLs), 587–590 VFA (Vertebral Fracture Assessment), 163 Video-assisted thoracotomy (VAT), 889 Videofluoroscopy swallowing examination, 873–874 Viral culture, 982–983, 983t Viral load hepatitis B (HBV), 508 in HIV infection, 517–520, 518t, 519t 1062â•… index Virtual autopsy, 283 Virtual colonoscopy, 282 Virus testing, 984–985 VisoV (volume of isoflow), 776 Visual-evoked responses (VERs), 413 Visually read test, 476 Vital capacity (VC), 774f, 775 forced, 773 Vitamin B12, 986–987 Vitamin B12 absorption, 986 Vitamin D, 988–990 Vitamin D deficiency, 989 Vitamin K oxidoreductase (VKOR), 769 VLDLs (very-low-density lipoproteins), 587–590 VMA (vanillylmandelic acid), 973–990 urinary, 636 Voiding cystography, 321–322 Voiding cystourethrography (VCUG), 321–322 Volume of isoflow (VisoV), 776 von Willebrand factor, 262t, 263 VPS (ventilation/perfusion scanning), 607–609 W Warfarin, prothrombin time monitoring of, 768t, 769 Warfarin pharmacogenomic test panel, 769 Warts, genital, 534 Wassermann test, 877 Water deprivation test, 70–71 Water load test, 71 Water-soluble contrast material, in myelography, 647 Waxy casts, 958, 964 WBCs see White blood cells (WBCs) Wegener granulomatosis (WG), 84 Western blot test, 521–524 White blood cells (WBCs) bone marrow, 167 in CSF, 596, 598 lactoferrin assay for, 573 on peripheral blood smear, 156 pleural fluid, 884 synovial fluid, 122 urinary, 952, 959, 961, 965 White blood cell (WBC) antigens, 533 White blood cell (WBC) casts, 959 White blood cell (WBC) count and differential count, 991–999, 991t, 994t causes of abnormalities in, 994t White blood cell (WBC) scan, 996–997 Whole-body thyroid scan, 901–902 Wireless capsule endoscopy, 401–402 Wound culture and sensitivity, 998–999 X X-ray see also Arteriography (angiography); Computed tomography (CT) barium enema, 132 barium swallow, 136 bladder, 321 bone, 178–179 bone density, 162 chest, 240–242 lower extremity, 980 obstruction series in, 665–666 renal, 778 salivary duct, 834 skull, 844 small bowel, 849 spinal, 647–649, 856–857 swallowing, 873–874 upper GI series, 941–972 uterine, 546–547 venous, 980 Xylose tolerance test, 1000–1001, 1000t Y Y402H, 20 Yellow fever, 147t Yersinia pestis, 147t, 149 Z Zinc protoporphyrin (ZPP), 1002 Zollinger-Ellison (ZE) syndrome, 456 Zona pellucida, 94 ZPP (zinc protoporphyrin), 1002 notes notes notes abbreviations for diagnostic and laboratory tests A B C AAT Alpha1-antitrypsin ABGs Arterial blood gases ACE Angiotensin-converting enzyme ACT Activated clotting time ACTH Adrenocorticotropic hormone ADH Antidiuretic hormone AFB Acid-fast bacilli AFP Alpha-fetoprotein A/G ratio Albumin/globulin ratio AIT Agglutination inhibition test ALA Aminolevulinic acid ALP Alkaline phosphatase ALT Alanine aminotransferase AMA Antimitochondrial antibody ANA Antinuclear antibody ANCA Antineutrophil cytoplasmic antibody ANP Atrial natriuretic peptide APCA Antiparietal cell antibody APTT Activated partial thromboplastin time ASMA Anti–smooth muscle antibody ASO Antistreptolysin O titer AST Aspartate aminotransferase BE Barium enema BMC Bone mineral content BMD Bone marrow density BNP Brain natriuretic peptide BRCA Breast cancer (gene) BSAP Bone-specific alkaline phosphatase BTA Bladder tumor antigen BUN Blood urea nitrogen C&S Culture and sensitivity CBC Complete blood count CC Creatinine clearance CEA Carcinoembryonic antigen CK Creatine kinase CMV Cytomegalovirus CO Carbon monoxide CO2 Carbon dioxide COHb Carboxyhemoglobin test CPK, CP Creatine phosphokinase CRP C-reactive protein CSF Cerebrospinal fluid CST Contraction stress test CT Computed tomography cTnI Cardiac troponin I cTnT Cardiac troponin T CVB Chorionic villus biopsy CVS Chorionic villus sampling CXR Chest x-ray D E F G H I D&C Dilation and curettage DEXA Dual-energy x-ray absorptiometry DSA Digital subtraction angiography DSMA Disodium monomethane arsonate DST Dexamethasone suppression test ECG, EKG Electrocardiography EEG Electroencephalogram EGD Esophagogastroduodenoscopy EIA Enzyme immunoassay ELISA Enzyme-linked immunosorbent assay EMG Electromyography ENG Electroneurography EP Evoked potential EPCA Early prostate cancer antigen EPO Erythropoietin EPS Electrophysiologic study ER Estrogen receptor ERCP Endoscopic retrograde cholangiopancreatography ESR Erythrocyte sedimentation rate EUG Excretory urography FBS Fasting blood sugar FDPs Fibrin degradation products %FPSA Percent free PSA FSH Follicle-stimulating hormone FSPs Fibrin split products FT4 Thyroxin, free FTA-ABS Fluorescent treponemal antibody absorption test FVL Factor V Leiden GE reflux Gastroesophageal reflux scan GGT Gamma-glutamyl transferase GGTP Gamma-glutamyl transpeptidase GH Growth hormone GHb, GHB Glycosylated hemoglobin GI series Gastrointestinal series GTT Glucose tolerance test HAA Hepatitis-associated antigen HAI Hemagglutination inhibition Hb, Hgb Hemoglobin HCG Human chorionic gonadotropin HCO3 Bicarbonate Hct Hematocrit Hcy Homocysteine HDL High-density lipoprotein 5-HIAA Hydroxyindoleacetic acid HIDA Hepatic iminodiacetic acid HIV Human immunodeficiency virus HLA-B27 Human lymphocyte antigen B27 HTLV Human T-cell lymphotrophic virus IAA Insulin autoantibody ICA Islet cell antibody Ig Immunoglobulin INR International normalized ratio IV-GTT Intravenous glucose tolerance test IVP Intravenous pyelography IVU, IUG Intravenous urography K L M N O P KS Ketosteroid KUB Kidney, ureter, and bladder LAP Leucine aminopeptidase LATS Long-acting thyroid stimulator LDH Lactic dehydrogenase LDL Low-density lipoprotein LFTs Liver function tests LH Luteinizing hormone LP Lumbar puncture L/S ratio Lecithin/sphingomyelin ratio LS spine Lumbosacral spine MA Microalbumin MCH Mean corpuscular hemoglobin MCHC Mean corpuscular hemoglobin concentration MCV Mean corpuscular volume MEG Magnetic encephalography M/E ratio Myeloid/erythroid ratio MMA Methylmalonic acid MPG Mean plasma glucose MPV Mean platelet volume MRI Magnetic resonance imaging MUGA Multigated acquisition cardiac scan NMP 22 Nuclear matrix protein 22 NST Nonstress test NTx N-telopeptide O&P Ova and parasites OB Occult blood OCT Oxytocin challenge test OGTT Oral glucose tolerance test 17-OHCS 17-Hydroxycorticosteroids PAB Prealbumin PAI-1 Plasminogen activator inhibitor-1 PAP Prostatic acid phosphatase pCO2 Partial pressure of carbon dioxide PCR Polymerase chain reaction PET Positron emission tomography PFTs Pulmonary function tests pH Hydrogen ion concentration PKU Phenylketonuria PMN Polymorphonuclear PNH Paroxysmal nocturnal hemoglobinuria pO2 Partial pressure of oxygen PO4 Phosphate PPBS Postprandial blood sugar PPD Purified protein derivative PPG Postprandial glucose PR Progesterone receptor PRA Plasma renin assay PSA Prostate-specific antigen PT Prothrombin time PTH Parathormone, parathyroid hormone PTHC, PTC Percutaneous transhepatic cholangiography PTT Partial thromboplastin time PYD Pyridinium crosslink R S T U V W RAST Radioallergosorbent test RBC Red blood cell RDW Red blood cell distribution width RF Rheumatoid factor RIA Radioimmunoassay RPR Rapid plasma reagin test S&A Sugar and acetone SACE Serum angiotensin-converting enzyme SBF Small bowel follow-through SGOT Serum glutamic-oxaloacetic transaminase SGPT Serum glutamic-pyruvic transaminase SLNB Sentinel lymph node biopsy SPA Sperm penetration assay SPECT Single-photon emission computed tomography STS Serologic test for syphilis T3 Triiodothyronine T4 Thyroxine T&C Type and crossmatch T&S Type and screen TBG Thyroxine-binding globulin TBPA Thyroxine-binding prealbumin TEE Transesophageal echocardiography Tg Thyroglobulin TGs Triglycerides TIBC Total iron-binding capacity TRF Thyrotropin-releasing factor TRH Thyrotropin-releasing hormone TSH Thyroid-stimulating hormone TSI Thyroid-stimulating immunoglobulins TTE Transthoracic echocardiography UA Urinalysis UGI series Upper gastrointestinal series UPP Urethral pressure profile US Ultrasound VCUG Voiding cystourethrography VDRL Venereal Disease Research Laboratory VLDL Very-low-density lipoprotein VMA Vanillylmandelic acid VPS Ventilation/perfusion scanning WBC White blood cell ...ROUTINE BLOOD TESTING Many diagnostic 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