Health Care Services

Test Preparation


Health Care Services

Test Preparation




  • ACE (ANGIOTENSIN CONVERTING ENZYME)   

    Indication

    This assay is used for evaluation of patients with suspected Sarcoidosis & confirm Gaucher disease and Leprosy.

    What ‘high’ or ‘increased’ may indicate

    • Sarcoidosis
    • Leprosy
    • Gaucher disease
    • Diabetic retinopathy
    • Liver disease
    • Hyperthyroidism

    Sample

    Plain clotted blood/CSF. Immediately freeze separated serum.

    Patient Preparation

    Overnight fasting is preferred (10hrs). Fasting is defined as no consumption of food or beverages other than water before blood collection.

  • 5 HIAA (5 HYDROXY INDOLE ACITIC ACID)

    Indication

    This assay is useful for biochemical diagnosis and monitoring of intestinal carcinoid syndrome. It is an indicator of serotonin producing tumor.

    Sample

    24hrs urine collection.

    Patient Preparation

    The patient should strictly avoid Banana, Kiwis, Walnut, Avocado, Eggplant, Pineapple, Plum, Tomato, and Promethazine, Alcoholic beverages, Tea/Coffee, Tobacco, and strenuous exercise for at least 72hrs before and during specimen collection. Drugs to be avoided include:

    • Fluorouracil
    • Melphalan
    • Phenothiazines
    • Acetaminophen
    • Guaifenesin
    • Isoniazid
    • MAO inhibitors
    • Mephenesin
    • Methenamine compounds
    • Methocarbamol
    • Methyldopa
    • Phenothiazine
    • Reserpine salicylates
    • Tricyclic antidepressants
  • ACTH (ADRENO CORTICOTROPHIC HORMONE)

    Indication

    Helps differentiate between primary and secondary adrenal insufficiency & helps diagnose Cushing's disease.

    What ‘high’ or ‘increase’ may indicate

    • Addison's disease
    • Cushing's disease

    What ‘low’ or ‘decreased’ may indicate

    • Adrenal - cortex tumor

    Sample

    EDTA blood (Chilled tube). Obtain ice before drawing specimen for transport.

    Patient Preparation

    ACTH should be drawn between 6 - 10am. Limit your physical activities for 10 - 12hrs before the test.

  • INSULIN

    Indication

    This assay is useful in the management of diabetes. It is also used for the diagnosis of insulin resistant status. Helps confirm the diagnosis of hypoglycemia resulting from a tumor, abnormal increase of pancreatic islet cells, glucocorticoid deficiency, or severe liver disease.

    What ‘high’ or ‘increased’ may indicate

    • High insulin levels with a corresponding low blood sugar level suggest insulinoma.
    • Insulin resistant diabetes mellitus

    What ‘low’ or ‘decreased’ may indicate

    • Non-insulin resistant diabetes mellitus

    Sample

    Plain clotted blood

    Patient Preparation

    Preferred fasting. Fasting is defined as no consumption of food or beverages other than water for at least 8 - 12hrs before sample collection.

  • ALDOSTERONE

    Indication

    Investigation of primary Aldosteronism (Adrenal Adenoma/Carcinoma and Adrenal Cortical hypoplasia) and secondary Aldosteronism (Renovascular disease, salt depletion, potassium loading, cardiac failure with ascites and pregnancy).

    What ‘high’ or ‘increased’ may indicate

    • Hypertension Primary Aldosteronism
    • Cancer of the adrenal cortex Overactive adrenal cortex
    • Congestive heart failure Cirrhosis
    • Third trimester of pregnancy

    What ‘low’ or ‘decreased’ may indicate

    • Hypo Aldosteronism Addison's disease
    • Toxemia of pregnancy
    • Loss of too much salt

    Sample

    EDTA blood

    Patient Preparation

    Spend 30 minutes of complete rest before blood collection.

  • Lp(a) (LIPOPROTEIN A)

    Indication

    This assay provides additional information on Coronary Heart Disease (CHD).

    What ‘high’ or ‘increased’ may indicate

    • High HDL generally indicates a healthy state.
    • High LDL generally indicates a higher-than-average risk for developing coronary artery disease.

    Sample

    Plain clotted blood

    Patient Preparation

    10 - 12hrs fasting before blood collection. Fasting is defined as no consumption of food or beverages other than water. Eat a normal diet for 2 weeks before the test.

  • LIPID PROFILE

    Indication

    Lipid disorders help determine the risk of heart disease, especially the risk of coronary artery disease. They evaluate fat metabolism and help confirm the diagnosis of nephrotic syndrome, pancreatitis, liver disease, and hypothyroidism (CHD).

    What 'high' or 'increased' may indicate:

    • Bile-duct blockage
    • Hyperthyroidism
    • Early hepatitis
    • Liver disease
    • Consumption of a high-fat diet
    • Hypothyroidism (Increased risk of coronary artery disease)
    • Pancreatitis

    What 'low' or 'decreased' may indicate:

    • Liver disease
    • Hypothyroidism
    • Malnutrition

    Sample

    Plain clotted blood

    Patient Preparation:

    Overnight fasting is required.
    Adults: 10-12 hours.
    Pediatric less than 6 years: Just before the feed/meal.
    Pediatric older than 6 years: Overnight fasting. (On the clinician’s advice)
    For optimal results, the patient should be on a stable diet for 2 - 3 weeks prior to testing.
    Fasting is defined as no consumption of food or beverages other than water before blood collection.

  • PTH (PARATHYROID HORMONE)

    Indication

    This assay is useful for diagnosis and differential diagnosis of hypercalcemia. It also helps in the diagnosis of Primary/Secondary/Tertiary Hyperparathyroidism and Hypoparathyroidism.

    What 'high' or 'increased' may indicate:

    • Hyperparathyroidism

    What 'low' or 'decreased' may indicate:

    • Hyperparathyroidism
    • Lung cancer
    • Kidney, pancreas, or ovarian cancer

    Sample

    Plain clotted blood.

  • CORTISOL

    Indication

    Adrenocortical function helps confirm the diagnosis of Cushing's disease & Addison's disease. It also helps diagnose secondary adrenal insufficiency.

    What 'high' or 'increased' may indicate:

    • Cushing's disease

    What 'low' or 'decreased' may indicate:

    • Addison's disease
    • ACTH secretion Hypophysectomy
    • Post-partum pituitary necrosis
    • Craniopharyngioma
    • Chromophobe adenoma

    Sample

    Plain clotted blood.

    Patient Preparation:

    Morning 8am - 9am or as per clinician’s requisition.
    Limit physical activity for 10 -12hrs before the test.

  • TESTOSTERONE Free   

    Indication

    Measurement of free testosterone may be useful when disturbances in SHBG are suspected, such as in obesity and estrogen excess.

    Sample:

    Plain clotted blood.

  • C- PEPTIDE

    Indication

    C-peptide is useful in distinguishing insulinomas from exogenous insulin administration. Its concentration is severely decreased or absent in Type I Diabetes mellitus. C-peptide is also useful in monitoring patients who have received Islet cell or pancreatic transplants.

    Sample

    Plain clotted blood.

    Patient Preparation:

    Fasting. Fasting is defined as no consumption of food or beverages other than water for 10 hrs before blood collection.

  • FAECES for OCCULT BLOOD TEST

    Indication

    Suspected colorectal cancers. Polyps, gastrointestinal bleeding.

    What 'abnormal' may indicate:

    • A positive test indicates gastrointestinal bleeding.
    • Varices.
    • Peptic Ulcer.
    • Carcinoma.
    • Ulcerative Colitis.
    • Dysentery.
    • Haemorrhagic disease.

    Sample

    Approximately 5 - 10 g.

    Patient Preparation:

    Specimen should not be collected during or within 3 days of a menstrual period or if the patient suffers from bleeding haemorrhoids or blood in the urine. Alcohol, Aspirin, and other medications in excess may cause gastrointestinal irritation resulting in occult bleeding. Such substances should be discontinued at least 48 hours prior to testing. No dietary restrictions are necessary before testing.

  • FOLATE

    Indication

    Helps distinguish between folic-acid deficiency and vitamin B-12 deficiency.

    What 'high' or 'increased' may indicate:

    • Leukemia
    • Liver disease

    What 'low' or 'decreased' may indicate:

    • Inadequate ingestion of folic acid from natural sources (common in vegetarians)
    • Malabsorption syndrome
    • Hyperthyroidism
    • Pernicious anemia

    Sample

    Plain clotted blood

    Patient Preparation:

    Fasting is preferred. Fasting is defined as no consumption of food or beverages, other than water, for 10 hrs before blood collection. However, your doctor may request that you have blood drawn when you are not fasting. Don't drink any alcohol for 24 hours before the test.

  • SEMINAL FLUID ANALYSIS (Automated)

    Indication

    This assay helps for determining male fertility status.

    What 'abnormal' may indicate:

    • Men who can't deliver any viable spermatozoa in their ejaculation during sexual intercourse are sterile.
    • Subnormal sperm count, decreased sperm motility, and abnormal morphology are associated with decreased fertility.

    Sample

    • Sterile screw capped container

    Specimen must be kept at body temperature after collection. Specimen must reach the lab within 30 minutes of collection.

    Patient Preparation:

    Patients should refrain from ejaculation for 2 - 7 days (ideally 3 days) prior to collection. If you are taking any drugs or medication, discuss this with your doctor.

  • FOLATE, RBC

    Indication

    Folate & iron deficiency.

    Sample

    EDTA blood

    Patient Preparation:

    Fasting is preferred. No consumption of food or beverages other than water for 10 hrs before blood collection. However, your doctor may request that you have blood drawn when you are not fasting. Do not drink any alcohol for 24 hours before the test.

  • URINE VMA (VANILMANDELIC ACID)

    Indication

    This test along with Homovanillic acid is useful for screening children for catecholamine-secreting tumors. Helps detect pheochromocytoma tumors and some disorders of the autonomic nervous system. Evaluates the function of adrenal medulla.

    What 'high' or 'increased' may indicate:

    • Catecholamine-secreting tumor such as pheochromocytoma.
    • Endocrine disorders.

    Sample

    24hr urine collection

    Patient Preparation:

    Patient should strictly avoid Theophylline, Chocolate, Vanilla, Banana, Alcoholic beverages, Tea/Coffee, Tobacco, and strenuous exercise for at least 72hrs before and during sample collection.

    The following drugs may affect test results, you may be asked not to take these medications before the test:

    • Amino salicylic acid (PAS)
    • Penicillin
    • MAO Inhibitors Reserpine
    • Methocarbamol
    • Clofibrate
    • Aspirin
    • Oxytetracycline
    • Bromsulphalein (BSP)
    • PSP
    • Imipramine
    • Guanethidine analogs
    • Phenazopyridine
    • Mephenesin
    • Nalidixic acid
    • Chlorpromazine
    • Glyceryl guaiacolate
    • Bromsuphalein (BSP)
    • Sulfa drugs
  • GASTRIN

    Indication

    This assay is extremely useful in the diagnosis of Gastrinoma. Helps determine the cause of severe ulcer disease of the stomach or small intestine. Helps detect pernicious anemia.

    What 'high' or 'increased' may indicate:

    • Low stomach acid
    • Pernicious anemia
    • Stomach cancer

    Sample

    Plain clotted blood

    Patient Preparation:

    Overnight 12hrs fasting. Fasting is defined as no consumption of food or beverages other than water before blood collection. Don't drink any alcohol for 24 hours before the test.

  • PLATELET AGGREGATION TEST

    Indication

    Determines if blood clots properly. Detects congenital and acquired platelet bleeding disorders.

    What 'low' or 'decreased' may indicate:

    • Bernard-Soulier syndrome
    • Glanzmann's thrombasthenia
    • Polycythemia
    • Storage-pool disease
    • Von-Willebrand's disease

    Sample

    Sodium citrate blood & EDTA blood

    Patient Preparation:

    Avoid the following drugs for 10 days prior to the test:

    • Aspirin & Aspirin compounds
    • Clopidogrel
    • Nonsteroidal and inflammatory drugs
    • Corticosteroids
    • Ticlopidine
    • Garlic concentrates
    • Antibiotics like Penicillin & Cephalosporin

    Fasting for 8 -10hrs. Fasting is defined as no consumption of food or beverages other than water.

  • GH (GROWTH HORMONE)

    Indication

    Anterior pituitary function. This assay is useful for the diagnosis of Acromegaly/Gigantism and assessment of treatment efficacy. It is used to diagnose Growth Hormone deficiency especially in children with short stature, helps confirm diagnosis of Dwarfism and suspected tumor of the Pituitary.

    What 'high' or 'increased' may indicate:

    • Pituitary or hypothalamic tumor, Dwarfism that cause Gigantism in children, acromegaly in adults.

    What 'low' or 'decreased' may indicate:

    • Loss of normal blood supply to the pituitary
    • Metastatic cancer
    • Tumors
    • Dwarfism

    Sample

    Plain clotted blood

    Patient Preparation:

    Fasting 8-12hrs & complete rest 30min before blood collection. Fasting is defined as no consumption of food or beverages other than water before sample collection.

  • METANEPHRINES URINE

    Indication

    This assay is a screening test for the diagnosis of catecholamine-secreting Pheochromocytoma & Paragangliomas.

    Sample

    24hr urine collection.

    Patient Preparation:

    Patients should strictly avoid alpha-methyldopa, buspirone, codeine, isoproterenol metabolite, mandelamine, L dopa, paracetamol, metoclopramide, pepper, alcoholic beverages, tea/coffee, tobacco and strenuous exercise for at least 72 hours before and during specimen collection.

  • GLUCOSE FASTING

    Indication

    Screening for Diabetes mellitus.

    What 'high' or 'increased' may indicate:

    • 100-125 mg/dL - Prediabetes.
    • > 126 Mg/dL - High fasting glucose.

    What 'low' or 'decreased' may indicate:

    • Too much insulin
    • Tumor of pancreas islet cells
    • Hypoglycemia

    Sample

    Na F and potassium oxalate in 1:3 ratio

    Patient Preparation:

    Overnight Fasting
    Adults: 8 - 12 hrs
    Pediatric less than 6 years: Just before the feed/meal
    Pediatric more than 6 years: Overnight fasting
    Fasting is defined as no consumption of food or beverages other than water before blood collection. Avoid strenuous exercise before the test.

  • ORAL GLUCOSE TOLERANCE TEST (OGTT)

    Indication

    The OGTT is used for the diagnosis of diabetes mellitus, where the random or fasting plasma glucose concentration is inconclusive in reaching a diagnosis. The test is also used in pregnancy to diagnose gestational diabetes (GD1v1) in women who are in a high-risk group.

    What 'high' or 'decreased' may indicate:

    • Acromegaly
    • Acute stress (response to trauma, heart attack, and stroke for instance)
    • Chronic kidney failure
    • Cushing syndrome
    • Excessive food intake
    • Hyperthyroidism
    • Pancreatic cancer
    • Pancreatitis

    Sample

    • Na F and potassium oxalate in 1:3 ratio
    • Urine samples

    Patient preparation

    • Three days unrestricted, carbohydrate-rich diet and activity.
    • No medication on the day of the test.
    • Do not eat during the test. Fasting overnight for 10 hours is required. Fasting is defined as no consumption of food or beverages other than water before blood collection.
    • After taking the 1st blood sample, 75g or 100g of glucose is given (according to the doctor’s order). Glucose is dissolved in 200 ml water.
    • The 2nd blood sample will be drawn 30 minutes after glucose.
    • Samples will also be taken in 1 hour, 1½ hours, 2 hours.
    • A urine sample will be taken when each blood sample is drawn.
    • Patients should wait in the hospital premises until the test is over.
  • URINE MICROALBUMIN

    Indication

    This assay is used to evaluate diabetic patients to assess the potential of early onset of nephropathy before overt proteinuria develops.

    Sample

    Early morning second urine sample.

    Patient Preparation:

    Patients should rest before sample collection.

  • METHOD OF COLLECTION OF SPECIMENS FOR MICROBIOLOGICAL EXAMINATION
    • All relevant data should be given on the request form with correct labeling of the container.
    • All specimens should be collected in a sterile container prior to commencing treatment with antimicrobial agents.
    • Specimens of body fluids including, Blood, CSF, Pleural, Peritoneal, Synovial fluids should be collected under strict aseptic conditions. For collection of blood refer instructions given previously.
    • Pus should be collected from the depth of wound or wall of an abscess after wiping surface with sterile saline.
    • Sputum an early morning sample preferable.
    • Urine should be a clean mid-stream specimen and proper instructions should be given to the patient. Clean catch specimen for babies - thoroughly clean the urethral area and perineum with soap and water - wipe with sterile gauze and collect urine into a sterile urine collection bag.
    • Stool the bloody mucoid part of stool should be collected.
    • Collection of urine from a patient with an indwelling catheter - contact Asiri Hospital lab for instructions.





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