Reflex Testing Summary

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Sandra Beasley
7 years ago
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1 CHEMISTRY Drug Screen Positive Confirmation Testing COAGULATION Lupus Anticoagulant Screen PT Prolonged - not drug related PT Mixing Study aptt Prolonged aptt Mixing Study MRVVT Prolonged Confirm + Ratio MRVVT Mixing Study PTT-LA Prolonged PTT-LA Mixing Study Prolonged combination of PT, aptt, MRVVT or PTT-LA Sta-Clot LA Patient is on heparin PT - heparin removed aptt - heparin removed TT - heparin removed Patient is on coumadin PTT-LA is not performed Patient is on heparin & coumadin PT - heparin removed rev. 6/28/2010 Page 1 of 8

2 aptt - heparin removed TT - heparin removed PTT-LA is not performed Hypercoagulation Screen PT Prolonged - not drug related PT Mixing Study aptt Prolonged aptt Mixing Study MRVVT Prolonged Confirm + Ratio MRVVT Mixing Study PTT-LA Prolonged PTT-LA Mixing Study Patient is on heparin PT - heparin removed aptt - heparin removed TT - heparin removed Patient is on coumadin PTT-LA is not performed Protein C Antigen Protein S Free Protein C Functional / Factor X ratio rev. 6/28/2010 Page 2 of 8

3 Patient is on heparin & coumadin PT - heparin removed aptt - heparin removed TT - heparin removed PTT-LA is not performed Protein C Functional Low Protein C Antigen Protein S Activity Low Protein S Free CYTOGENETICS Chromosome/Bone marrow/unstimulated peripheral blood Normal karyotype with MDS positive path report DNA FISH for EGR1 Optional CYTOPATHOLOGY PAP Smear Abnormal Findings Pathologist Review PAP Smear ASCUS HPV HEMATOLOGY Sickle Cell Screen Positive sickle screen, 1st time Hgb-ELP Morph When no CBC is ordered CBC IMMUNOLOGY rev. 6/28/2010 Page 3 of 8

4 ANA Positive ANA Titer ANCA Positive ANCA Titer AMA Positive AMA Titer ASMA Positive ASMA Titer APCA Positive APCA TITER ASO Positive ASO Titer CRYPT Positive CRYPTO Ag Titer CACSF Positive CRYPTO Ag Titer HIV12 Positive - First patient positive in S&W medical record HIVWB, HIV2, HIV2WB HBSAG Positive - Patient has NO positive confirmation within last 6 months CONFR QHIV Positive HIV12 Screen & blot RF Positive RF Titer RPR Positive - First patient positive in S&W medical record RPR Titer, If Positive then TPPA VDRL Positive VDRL Titer, If Positive then TPPA rev. 6/28/2010 Page 4 of 8

5 VDCSF Positive VDRL Titer, FTA VDTIT Positive - First patient positive in S&W medical record TPPA MICROBIOLOGY Aerobic (Routine) Culture Pathogen growth ID & Susceptibility Anaerobe Culture Positive (Sterile Body sites ) ID & Susceptibility Acid Fast Culture Positive ID & Susceptibility Acid Fast Culture Respiratory specimen Concentration Blood Culture Positive ID & Susceptibility Blood Culture for Acid Fast Positive ID & Susceptibility Blood Culture for Fungus Positive ID & Susceptibility Body Fluid Cell Count >0 WBC's Differential Body Fluid Gram Stain Automatic Concentration Body Tissue Culture Tissue Homogenization CSF Cell Count >0 WBC's Differential CSF Culture Automatic Gram Stain Fungus Culture Positive ID & Susceptibility rev. 6/28/2010 Page 5 of 8

6 Rapid Strep Screen Negative Strep Screen Culture Sputum Culture Automatic Gram Stain Stool Culture Pathogen growth ID & Susceptibility Synovial Analysis >1000 WBC's Differential Tracheal/Endotrach Culture Automatic Gram Stain Viral Culture Automatic Number of vials stained Wound/Abcess Culture Positive ID & Susceptibility Wound/Abcess Culture Automatic Gram Stain MOLECULAR Flu PCR Postive Flu ID Flu Rapid Positive Flu PCR POCT PT INR INR >4 Send collection tube to laboratory Whole Blood Glucose >400 mg/dl or <50 mg/dl Serum Glucose Optional TRANSFUSION rev. 6/28/2010 Page 6 of 8

7 Antibody screen/possibly an ID if ABO/Rh reverse has unexpected reactivity; Discrepancy between forward and other antigen typing (anti-a1 lectin) if reverse type applicable; cold antibody panel if applicable Antibody ID (possibly including cold Antibody Screen Positive antibody screen, serum adsorptions, elution, direct coombs) ; titer if prenatal DAT (Direct Antiglobulin Test) Polyspecific and IgG are positive Elution Fetal Bleed Screen Positive Kleihuaer-Betke Stain Type & Screen Positive Antibody ID (possibly including cold antibody screen, serum adsorptions, elution, direct coombs) antigen typing, crossmatch X 2 Type & Cross Positive Antibody ID (possibly including cold antibody screen, serum adsorptions, elution, direct coombs), antigen typing (patient and RBCs), crossmatch X 2 URINALYSIS Urinalysis Positive glucose dipstick on a child <2 yrs old Reducing substance rev. 6/28/2010 Page 7 of 8

8 Urine Dipstick - RRH Urine is NOT yellow, straw or colorless Urine appearance is NOT clear Protein results are MORE than trace Glucose results are MORE than 1+ Any other chemical parameter is POSITIVE Microscopic examination Urine Dipstick - BCS Color is pyridium orange or Bloody specimen with hemolyzed supernatant Microscopic examination if there is qualified tech to perform UA with Microscopic completed in Temple if qualified staff not available to perform rev. 6/28/2010 Page 8 of 8

Urinalysis and Body Fluids CRg. Synovial Fluid. Synovial Fluid. Unit 4. Composition and formation. Functions. Reasons for analysis.

Urinalysis and Body Fluids CRg Unit 4 Synovial Fluid Synovial Fluid Composition and formation Secreted by cells of synovial membrane Very viscous, clear ultrafiltrate of plasma Contains Hyaluronic acid