EXECUTIVE BLOOD WORK PANEL

Transcription

1 EXECUTIVE BLOOD WORK PANEL Below is a list of all blood and urine testing done on the day of your Executive Medical. MALE Serum Glucose Random Serum Glucose Fasting Creatinine Uric Acid Sodium Potassium Chloride Bicarbonate Protein AST(SGOT) ALT(SGTP) Alk. Phosphatase Bilirubin Cholesterol Ferritin Triglyceride HDL HDL/LDL Urine Microoalbumin HDL/Chol ratio Urinalysis (chemical) Urinalysis (microscopic) CBC (Complete Blood Count) GGT Albumin A/G ratio Urea Fibrinogen HbA1C Homocysteine Hs-CRP Vitamin B12 TSH LDH Testosterone Free testosterone Iron TIBC PSA Free PSA/total Lipoprotein a Apolipopreotein A1 Apolipoprotein B Ur. Microalb/ Creat ratio Random Urine Ceatine Vitamin D *For a comprehensive description of the above blood testing please see pages 3-6 1

2 EXCUTIVE BLOOD WORK PANEL Below is a list of all blood and urine testing done on the day of your Executive Medical. FEMALE Serum Glucose Random Serum Glucose Fasting Creatinine Uric Acid Sodium Potassium Chloride Bicarbonate Protein AST(SGOT) ALT(SGTP) Alk. Phosphatase Bilirubin Cholesterol Ferritin Triglyceride HDL/Chol ratio HDL/LDL Urine Microoalbumin Random Urine Ceatine Vitamin D GGT Albumin A/G ratio Urea Fibrinogen HbA1C Homocysteine Hs-CRP Vitamin B12 TSH LDH Iron TIBC Urinalysis (chemical) Urinalysis (microscopic) Lipoprotein a Apolipopreotein A1 Apolipoprotein B Ur. Microalb/ Creat ratio CBC (Complete Blood Count) *For a comprehensive description of the above blood testing please see pages 3-6 2

3 Blood Panel Overview COMPLETE BLOOD COUNT (CBC) A complete blood count (CBC) looks at the number and types of cells in your blood. The Complete blood count includes the following tests: WHITE BLOOD CELL (WBC): This is the total number of white bloods cells. Changes can indicate problems of Hepatitis C infection or side effects of interferon treatment. RED BLOOD CELL (RBC): This is the total number of red blood cells. Low levels can indicate anemia. HEMATOCRIT (HCT): This is the percentage of blood cells that are red blood cells. Low levels may indicate anemia. HEMOGLOBIN: This is the amount of oxygen carrying protein. Low levels can indicate anemia. PLATELET COUNT: These are the blood products critical for normal clotting: abnormal values (either high or low) may be clues to an underlying blood disorder; platelets are also affected by certain medications, alcohol, infection, liver disease, and even the menstrual cycle. Chemistry Profile TOTAL PROTEIN: This is the combination of albumin and globulin. Abnormal values may occur in kidney, bowel, or liver diseases or malnutrition. Protein fractions can be further characterized by ordering electrophoresis; a lab test, of the blood serum and urine. ALBUMIN: This is the blood protein that is manufactured by the liver which makes up two-thirds of total protein. Marked changes may be related to kidney, bowel or liver disease or to poor nutrition. BILIRUBIN: Total: This is the level of bile pigment in the blood. Elevated levels occur with liver disease or an accelerated breakdown of red blood cells (hemolysis). URIC ACID: Final breakdown product of nucleic acid metabolism. This is elevated mostly in gout. It can also be elevated in excessive alcohol intake, kidney disorders, insulin resistance syndrome, high protein diet, and with certain medications. ALKALINE PHOSPHATASE (ALP): This is the enzyme in the blood related to liver and bone. Various liver diseases where bile ducts are blocked lead to an increase. Elevated levels can also be seen with certain bone disorders. GAMMA-GLUTAMYLTRANSFERASE (GGT): This is a liver enzyme which is elevated with certain liver disorders. It is very sensitive to excessive intake of alcohol and or high cholesterol or triglycerides, excess body weight, and insulin resistance syndrome. ALANINE AMINOTRANSFERASE (ALT) / ASPARATE AMINOTRANSFERASE (AST): These enzymes are found in the liver. Damage to these tissues may increase values. Liver disease tends to increase ALT relatively more than AST. AST is also found in 3

4 muscle cells including heart, and be elevated in conditions where these tissues are damages. LACTATE DEHYDROGENASE (LD OR LDH): This is the enzyme found in blood cells, liver cells and muscle tissue including the heart muscle. The breakdown of red blood cells or damage to liver or muscle tissue may increase values. Mild elevations of no clinical consequences frequently occur with the breakdown of red blood cells (hemolysis) in the blood drawing process. GLUCOSE: Blood sugar levels are frequently elevated in diabetes. This can also be influenced by diet (inadequate fasting) and certain medications. A single elevation, particularly of mild degree, does not necessarily mean that diabetes is present. Low levels called hypoglycemia can be due to excessive medications or certain medical conditions (endocrine disorders, liver disease or rare tumors) or prolonged fasting state. BUN (BLOOD UREA NITROGEN)/ CREATININE: This is a kidney function test which measures how well certain waste products of metabolism are excreted from the body. BUN is frequently elevated with dehydration. SODIUM: Mineral and electrolyte which helps maintain fluid balance and volume. It can be abnormal in kidney disorders, certain endocrine diseases, dehydration, or over hydration. POTASSIUM: A mineral and electrolyte important in nerve impulse condition and body fluid balance. It can be low with use of diuretic therapy, diarrhea, and certain endocrine diseases. Mild elevations of no clinical consequences frequently occur with the breakdown of red blood cells (hemolysis) in the blood drawing process. CHLORIDE: This mineral is important in the maintenance of the electrolyte balance. Low levels are seen after prolonged vomiting or excessive use of diuretics. Mild increases are common and may not be due to any clinically significant condition. Urinalysis and Urine Tests GLUCOSE: This may be present when the blood sugar is too high (as in diabetes) or, rarely, in unusual disorders of the kidney or from low kidney glucose threshold without disease. KETONES: This is often present normally in urine because of the fasting state when the urine was collected. However, this may be present in diabetes, in thyroid disorders, with fever, excess alcohol intake, of with significant dieting. PROTEIN: This is generally present in the urine beyond a trace amount. It may be present in inherited or acquired kidney disease, prostate diseases, or systemic diseases. It can also be found with jogging or excessive exercise prior to the test or in women if urine is contaminated with vaginal secretions. BLOOD: This can be normally seen in small amounts. It may be present with infection, stones, malignancy, diseases of the kidney or prostate, or a combination of the urine by vaginal secretions. After very heavy physical exertion, blood can also be present in the urine. 4

5 LEUKOCYTE ESTERASE: This can normally be seen in small amounts. It may also be present with infection in the urinary tract or contamination of the urine by vaginal secretions. URINE ALBUMIN/CREATININE RATIO: The albumin/ creatinine ratio is a urine test to determine the amount of protein (albumin) present in the urine. In diabetes, the presence of albumin in the urine is suggestive of early diabetic kidney disease. In both diabetics and non-diabetics, elevated urinary albumin/creatinine ratio has also been found to be a predictor or marker for the presence of cardiovascular disease. LIPID PROFILE TOTAL CHOLESTEROL: Blood fat is significant in the development of atherosclerosis. This is made up of HDL, VLDL, and LDL. HDL: High Density Lipoprotein (a combination of fat and protein). This is Good type cholesterol because it removes excess cholesterol from the blood and takes it to the liver. VLDL: This is very Low Density Lipoprotein Bad type cholesterol which is a carrier for triglycerides. LDL: Low Density Lipoprotein. Another bad form of cholesterol because it picks up cholesterol from the blood and takes it to the cells. TRIGLYCERIDES: This is another blood fat which contributes to the development of atherosclerosis. This can be increased by the intake of alcohol or sugar such as in fruits and unsweetened juices, certain medications, and in thyroid and liver disease. OTHER BLOOD ULTRASENSITIVE C-REACTIVE PROTEIN (CRP) This is a protein found in the blood. It is what we call a marker for inflammation, meaning its presence indicates a heightened state of inflammation in the body. The association between C-reactive protein and vascular disease has now been demonstrated in apparently healthy individuals, those with recognized risk factors for vascular disease, and those with established vascular disease. FIBRINOGEN: This is a key protein in clot formation (thrombosis) and platelet aggregation, established as an independent risk factor for vascular disease (heart attack and stroke). Levels rise with age, body weight, stress, infection, underlying inflammatory processes, and physical inactivity, and tend to be higher in women and African Americans. Fibrinogen levels also increase as levels of traditional risk factors for vascular disease risk: cholesterol, blood pressure, and cigarette use. TESTOSTERONE: This hormone in males is produced by the testicles under the control of the pituitary gland and hypothalamus. It affects the sexual function, muscle mass and strength and is important in the maintenance of normal bone density, red blood cell mass, and libido. In females, this hormone is produced in small amounts by the ovaries and adrenal gland normally under the control of the pituitary gland and it helps the normal maintenance of libido. An excess of this hormone in women can cause irregular menses, acne, excess facial hair or thinning of the scalp hair. 5

6 HEMOGLOBIN A1c (glycosylated hemoglobin): This is a measure which reflects the average blood sugar over the preceding three (3) months. HOMOCYSTEINE: This is an amino acid that has been recently established as another risk factor for cardiovascular disease and often found in families with premature heart attack or strokes. High homocysteine levels may be associated with low levels of vitamins B6, B12, and folic acid and kidney or thyroid disease. LIPOPROTEIN: A fraction of the LDL cholesterol that has been linked to increased risk for cardiovascular disease and is frequently present in families with premature vascular disease. It is still unclear if treating this independently reduces risk. If elevated, your physician may work harder to lower your LDL cholesterol level. Aerobic exercise, weight reduction, and in women estrogen therapy may also decrease Lipoprotein. PSA (Prostate Specific Antigen): This is protein produced by the prostate gland. Elevations can be seen in benign prostatic enlargement (a normal, age related change), inflammation or infection of the prostate, and prostate cancer. The level increases with age. Used in conjunction with the digital rectal exam to screen for prostate cancer. TSH (Thyroid Stimulating Hormone): This hormone is secreted by the pituitary gland that in turn regulates the production of thyroid hormones. When increased, may indicate under-function of the thyroid gland or failing gland. When decreased, may indicate overfunction of the thyroid gland or pituitary gland malfunction. Also used to determine appropriate dosing of thyroid replacement medication. VITAMIN B12 (Cobalamin): This is an essential growth factor that plays a role in the metabolism of cells, particularly in the gastrointestinal tract, bone marrow and nervous tissue. Low Vitamin B12 level stops DNA synthesis and affects cell growth and repair. Vitamin B12 deficiency may lead to memory loss, ad problems of the nervous system, anemia, or skin changes. Strict vegetarians, the elderly and those with inflammatory bowel disease are at an increased risk of deficiency. SERUM IRON: Iron and iron-binding capacity (TIBC) are measured together to identify how much iron is being carried in the blood. If the hemoglobin and hematocrit are abnormally low, iron tests can be very useful in determining the cause of anemia. BICARBONATE: The blood bicarbonate level is affected by metabolism and by kidney and lung function. This is a simple screening tool to diagnose and monitor conditions that affect blood bicarbonate levels, including many kidney diseases, some lung, and metabolic conditions. MICROALBUMIN URINE: This test evaluates urine for the presence of a protein called albumin. Albumin is normally found in the blood and filtered by the kidneys. When the kidneys are working properly, albumin is not present in the urine. However, when the kidneys are damaged, small amounts of albumin leak into the urine. 6