A-Z TESTS BIOCHEMISTRY

Transcription

1 A-Z TESTS BIOCHEMISTRY Specimen requirements and reference ranges for blood analyses (Adults) 11-deoxy cortisol nmol/l 4 weeks Yellow top tube (Serum) Must be sent to the laboratory on ice for immediate separation 17 a OH Progesterone 0-10 nmol/l 1 2 weeks Yellow top tube (Serum) 18 hydroxy cortisol Supine nmol/l Ambulant nmol/l 4-8 weeks Acid - Base status Urgent; 30 mins ph pco2 - arterial kpa po2 - arterial kpa po2-capillary kpa actual bicarbonate mmol/l base excess -2.3 to mmol/l -3.0 to mmol/l Purple Top Tube (EDTA plasma) or Yellow top tube (Serum) Blood gas syringe. Remove needle, cap syringe. Do not send this specimen by pneumatic tube fe ACTH hr Adrenaline see Catecholamines ADH (Argenine vasopressin) 0-46 ng/l 2-4 weeks Green top tube (plasma) Do not use glass tube. Send to lab in ice immediately. Requires rapid separation 2 x Green top tubes (plasma) Send on ice for immediate separtation, 5 ml of plasma is required AFP - as tumour marker < 10 KU/L 1 week Albumin Adult >18 years 0-4 days 4 days 14 yrs yrs g/l g/l g/l 32 45g/L Aldosterone Random pmol/l Overnight recumbent 100/450 pmol/l 4 weeks Green top tube (Plasma) Must be sent to the laboratory immediate separation but must not be sent in ice. Aldosterone / Renin Ratio >1000 suggests primary hyperaldosteronism >2000 indicated that the patient almost certainly has hyperaldosteronism 4 weeks Green top tube (Plasma) Must be sent to the laboratory immediate separation but must not be sent in ice. DLM User Guide 2008 Page 42 of 90

2 Alkaline phosphatase Age Fe Male (U/L) 1-5d <231 <231 6d -1y <449 <449 1y-6y <269 <269 7y-12y <300 <300 13y-17y <187 <390 Adults Alpha 1 Antitrypsin g/l Phenyotyping will be done if results are; 1 week Adult <1.28 g/l Children <1.5 g/l Alcohol - See ethanol and methanol in Toxicology section ALT 5 40 U/L Ammonia Premature neonates; <150 umol/l Term neonates; <100 umol/l Infants, Children, Adults; <40umol/L. Purple top tube. (EDTA) Contact lab on 4697 prior to collection. Sample must be fresh send to lab in ice immediately. Amylase < 100 U/L Androstenedione nmol/l nmol/l 2-4 weeks fe Anion-Gap mmol/l Yellow top tube (Serum) Angeotensin converting IU/L 1 2 weeks Yellow top tube (Serum) enzyme (ACE) APO-E genotype 2-4 weeks Purple top (EDTA plasma) DLM User Guide 2008 Page 43 of 90

3 AST 5 45 U/L Bicarbonate mmol/l Yellow top tube (Serum) Bile Acids < 14 umol/l Next day Mon-Fri Yellow top tube (Serum) Bilirubin (total) adult >18yrs neonate 0 12 hr neonate 12hr 5 days 5 days -18 years < 22 µmol/l < 115 µmol/l < 170 µmol/l 2 14 µmol/l Yellow top tube, Serum (Adults) Green top micrtoainer Bilirubin (Conjugated/direct) No range Bone Markers; CTX ng/l 2-4 weeks Purple top tube (plasma) P1NP ug/l Ca-125,Ca19-9,Ca15-3,CEA see tumour markers Caeruloplasmin g/l 1 week Carbohydrate deficient transferrin Carboxyhaemoglobin Negative <2.6% of total transferrin Positive >2.6% of total transferrin <2% non smokers <10% for smokers (approximate) Calcitonin < 5.5ng/L Fe < 18.9 ng/l Male Calcium (total Calcium (corrected) mmol/l mmol/l 2-4 weeks Yellow top tube (serum ) Urgent; 30 mins If sent with blood gas; Blood gas syringe. Remove needle, cap syringe. Do not send this specimen by pneumatic tube If separate sample; Green Top tube (Plasma) 4 weeks Send to lab in ice immediately. Requires rapid separation DLM User Guide 2008 Page 44 of 90

4 Catecholamine (Plasma) Adrenaline nmol/l Noradenaline nmol/l 4 weeks Purple top tube ( EDTA plasma)send to lab in ice immediately. Requires rapid separation Chloride mmol/l Chromogranin A < 60 pmol/l 8 weeks Purple top tube ( EDTA plasma) Chromogranin B < 150 pmol/l 8 weeks Purple top tube ( EDTA plasma) Cholesterol JBS 2 Dec 2005 treatment targets; total HDL HDL fe <4.0 mmol/l >1.0 mmol/l >1.2 mmol/l See European Arthrosclerosis Society Guidelines Cholinesterase CK total total phenotype fe ku/l See interpretive result report issued up to 190 U/L up to 165 U/L 4 weeks Apnoea investigations should wait until patient is fully recovered. CKMBmass Less than 5 ng/ml Test only available for A&E Chest Pain Assessment MRI DLM User Guide 2008 Page 45 of 90

5 Copper umol/l 2-4 weeks Blue top tube (serum) Cortisol midnight hr nmol/l nmol/l Next day Mon-Fri All samples taken as part of a Synactehn test should be sent to the laboratory in a single batch. C-peptide Level depends on glucose concentration C-reactive protein (CRP) mg/l Creatinine Adults Male Fe Children s Neonates (full term) 2-12 months 1-<3 years 3- <5 years 5-< 7 years 7- < 9 years 9-< 11 years 11- <13 years 13-< 15 years CTX- See Bone Markers DHEA sulphate fe FSH fe pre-menopause post menopause µmol/l µmol/l µmol/l µmol/l µmol/l µmol/l µmol/l µmol/l µmol/l µmol/l µmol/l 4 weeks Yellow top tube (Serum) Must be sent to the laboratory on ice for immediate separation µmol/l µmol/l 2-4 weeks 2-15 IU/L 2-15 IU/L > 20 IU/L Fructosamine mmol/l 2-3 weeks Gamma-GT < 65 U/L GHRH 4-8 weeks Red Top (serum) Glucose fasting adult newborn prem/sfd Glycated non-diabetic Haemoglobin diabetic HbA1c (well controlled) GTT Growth Hormone mmol/l mmol/l mmol/l % up to 7% Interpretation of results is provided with each report following WHO guidelines. Level dependant on age, sex and clinical circumstance Next day, Mon-Fri Analysed same day as test carried out on ward Grey top tube (plasma) Purple top top tube (EDTA plasma) Contact Programmed Investigation Unit extn 4697 to arrange ward appointment 2-4 weeks DLM User Guide 2008 Page 46 of 90

6 Gut hormones; Gastrin Glucagon Neurotensin Pancreatic polypeptide Somatostatin VIP <40 pmol/l <50 pmol/l <100 pmol/l <300 pmol/l <150 pmol/l <30 pmol/l 4 weeks Must sent in ice and collected in special tube provided by the laboratory. HCG ( as tumour marker) 0-2 IU/L 1 week Homocysteine <15 umol/l 2-4 weeks Grey Top (Fl.ox. plasma) Must be sent to the laboratory for immediate separation Fasting sample preferred Immuno-reactive trypsin See report 2-4 weeks Green top tube, whole blood or preferably blood spots Inhibin B pg/ml 2-4 weeks Insulin Insulin Like Growth Factor 1 IGF U/L (fasting) Complex age related ranges, these are listed in a separate table on page 30 1 week Yellow top tube (Serum) Must be sent to the laboratory on ice for immediate separation 1-2 weeks Red top tube (Serum) DLM User Guide 2008 Page 47 of 90

7 7 29 µmol/l µmol/l Iron Total iron binding capacity (TIBC) For investigation of iron deficiency Ferritin assay (Haematlogy) % iron saturation Lactate adult neonates Lead Enviroment exposure guidlines adult child 15%-45% mmol/l mmol/l < 250 ug/l < 100 ug/l Routine 5 working days Grey top tube (plasma) Specimen to be sent to laboratory immediately Purple top tube ( EDTA Plasma) LDH U/L By special arrangement LH Magnesium Manganese fe/ fe mid cycle post menopause adults Neonates 2 14 IU/L IU/L > 15 IU/L mmol/l mmol/l <1 year 7-18 ug/l > 1yr 4-12 ug/ Next day, Mon-Fri Met-haemoglobin < 1.5% Noradrenalin see Catecholamines Oestradiol fe follicular mid cycle luteal pmol/l pmol/l pmol/l pmol/l Yellow top tube. (serum) 2-4 weeks Purple top tube ( EDTA Plasma) Special tube from Toxicology for paediatrics Next day, Mon-Fri If sent with blood gas; Blood gas syringe. Remove needle, cap syringe. Do not send this specimen by pneumatic tube If separate sample; Green Top tube (Plasma) Yellow top top tube Discuss with Biochemistry for monitoring H.R.T. Orosomucoid mg/l 2-4 weeks Yellow top tube Osmolality (serum) mmol/kg Osmoalar Gap <10 mmol/l DLM User Guide 2008 Page 48 of 90

8 Analyte Reference ranges Turnaround time Specimen notes Oxalate 2-4 weeks Purple top ( EDTA Plasma) Must be separated and frozen within 1h minutes of collection P1NP See Bone Markers PIIINP ug/l 2-3 weeks Phosphate Neonates up to 28 days Children 28 days-1 year 1 year -12 years Adult and over 12 years Potassium adults neonates Pregnancy test; see Quantitative HCG Progesterone follicular luteal peak Prostate Specific Antigen (PSA) yrs yrs 70 and over 1.4 mmol/l-2.8mmol/l 1.2 mmol/l- 2.2mmol/l 1.0 mmol/l-1.8mmol/l 0.7 mmol/l-1.4mmol/l mmol/l mmol/l < 3 nmol/l nmol/l <3.0 ng/ml <4.0 ng/ml <5.0 ng/ml ( Department of Health Referral Guidelines 2002) Next day, Mon-Fri Next day, Mon-Fri Prolactin Next day, Mon-Fri Males Fes mu/l mu/l Protein (total) > 12 months <1 month 1-12 months g/l g/l g/l PTH pg/ml Same day Purple top (EDTA plasma) PTHrp Set report 2-4 weeks Special tube from Liverpool, must be sent on ice for rapid separtation Quantitative HCG If used for Ectopic Pregnancy see Clinical Guildline Quantitive HCG used as a pregnancy test; A result of >25 U/L would normally inducate a positive test. But, a result of <25 U/L does not exclude early pregnancy. Same Day Renin 2-4 weeks Green top tube (Plasma) Over night recumbent 30 minutes upright Random nmol/l/hr nmol/l/hr nmol/l/hr Must be sent to the laboratory immediate separation but must not be sent in ice. Retinol Binding Protein mg/l 1-2 weeks DLM User Guide 2008 Page 49 of 90

9 Selenium See report 2-4 weeks Special tube from Toxicology umol/l SHBG nmol/l 1-2 weeks fe nmol/l Sodium mmol/l. Hyponatraemia Guidelines Available Tri-oidothinoine Free (free T3) not routinely available Tri-iodothinoine Total (T3) nmol/l 1-2 weeks Not standard part of Thyroid Function Test Testosterone fe nmol/l < 2.4 nmol/l Thiopurine methyl 1-2 weeks transferase (TPMT) Thyroglogulin (Thyro) < 55 ug/l 1-2 weeks Thyroid Binding Globulin 1-2 weeks (TBG) Thyroxine- Free (free T4) 9 24 pmol/l 1-2 weeks Total Protein <1 month 51-68g/l Routine ; same day 1m 12 m g/l >12m 60-80g/L Transferrin g/l Routine ; same day Triglycerides fasting JBS 2 Dec 2005 Same day treatment targets; <1.7 mmol/l Troponin T < 0.01ng/mL Urgent; 1 hour Yellow top tube TSH mu/l Same day Yellow top tube Tumour Markers; CA 15-3 <32 KU/L All 1-2 weeks CA 19 9 CA 125 CEA <31 U/mL <30 U/mL ug/l (nonsmoker) Urate s fes mmol/l mmol/l Yellow top tube Urea mmol/l Yellow top tube VLCFA (Very long chain fatty See individual reports 1-2 weeks Purple top (EDTA plasma) acids) Vitamins; Vitamin A Vitamin B1 See individual reports 1-2 weeks Vit A & E ;Yellow top tube B Vitamins; Purple top (EDTA plasma) Vitamin B2 Vitamin B6 Vitamin E White cell enymes See individual reports 1-2 weeks Purple top (EDTA plasma) Zinc umol/l 2-4 weeks Blue top tube DLM User Guide 2008 Page 50 of 90

10 IGF-1 reference ranges Age Male range (ug/l) Fe Range (ug/l) 0-7d <25 < days <40 <40 <4 years >4y <9y years >4y <10y years years years years years years years years years years years years years years DLM User Guide 2008 Page 51 of 90