Bronchiolitis

Bronchiolitis is swelling and mucus buildup in the smallest air passages in the lungs (bronchioles), usually due to a viral infection.
Causes
Bronchiolitis usually affects children under the age of 2, with a peak age of 3 - 6 months. It is a common, and sometimes severe illness. Respiratory syncytial virus (RSV) is the most common cause. Other viruses that can cause bronchiolitis include:
    * Adenovirus
    * Influenza
    * Parainfluenza

The virus is transmitted from person to person by direct contact with nasal fluids, or by airborne droplets. Although RSV generally causes only mild symptoms in an adult, it can cause severe illness in an infant.

Bronchiolitis is seasonal and appears more often in the fall and winter months. It is a very common reason for infants to be hospitalized during winter and early spring. It is estimated that by their first year, more than half of all infants have been exposed to RSV.

Risk factors include:

    * Exposure to cigarette smoke
    * Age younger than 6 months old
    * Living in crowded conditions
    * Lack of breast-feeding
    * Prematurity (being born before 37 weeks gestation)

Symptoms

Some children have infections with few or minor symptoms.

Bronchiolitis begins as a mild upper respiratory infection. Over a period of 2 - 3 days, it can develop into increasing respiratory distress with wheezing and a "tight" wheezy cough.

Symptoms include:

    * Bluish skin due to lack of oxygen (cyanosis)
    * Cough, wheezing, shortness of breath, or difficulty breathing
    * Fever
    * Intercostal retractions
    * Nasal flaring in infants
    * Rapid breathing (tachypnea)


Treatment

Sometimes, no treatment is necessary.

Supportive therapy can include:

    * Chest clapping
    * Drinking enough fluids. Breast milk or formula are okay for children younger than 12 months. Offer warm lemonade or apple juice if your child is over 4 months.
    * Breathing moist (wet) air helps loosen the sticky mucus that may be choking your child. You can use a humidifier to moisten the air your child is breathing. Follow the directions that come with the humidifier.
    * Getting plenty of rest
    * Do not let anyone smoke in the house, car, or anywhere near your child.

Antibiotics are not effective against viral infections. Most medications have little effect on bronchiolitis. Children in the hospital may need oxygen therapy and fluids given through a vein (IV) to stay hydrated.

In extremely ill children, antiviral medications (such as ribavirin) are used in rare cases.

How to breathe when you are short of breath

Pursed lip breathing helps you use less energy to breathe. It can help you relax. When you are short of breath, it helps you slow the pace of your breathing and can help you feel less short of breath.
Use pursed lip breathing when you do things that make you short of breath:
    * Exercising
    * Bending
    * Lifting
    * Climbing stairs
You can practice pursed lip breathing anytime. Try to practice 4 or 5 times a day when:
    * You are watching TV.
    * You are using your computer.
    * You are reading a newspaper.

How to Do Pursed Lip Breathing
Relax the muscles in your neck and shoulders. Sit in a comfortable chair with your feet on the floor.
Do these steps in this order:
   1. Breathe in (inhale) slowly through your nose for 2 counts.
   2. Feel your belly get larger as you breathe in.
   3. Pucker your lips, as if you were going to whistle or blow out a candle.
   4. Breathe out (exhale) slowly through your lips for 4 or more counts.

Exhale normally. Do not force the air out. Do not hold your breath when you are doing pursed lip breathing. Repeat these steps until your breathing slows.

How Drugs are Developed??

Eating extra calories when you are sick - children

If your child is sick or getting treatment, he or she may not feel like eating. But your child will need to get enough protein and calories to grow and develop. Eating well will help your child handle their illness and side effects of treatment better.

Change your child's eating habits to help them get more calories:

    * Let your child eat when they are hungry, not just at mealtimes.
    * Give your child 5 or 6 small meals a day instead of 3 large ones.
    * Keep healthy snacks handy.
    * Do not let your child fill up on water or juice before or during meals.

Make eating more pleasant and fun:

    * Play music your child likes.
    * Eat with family or friends.
    * Let your child listen to the radio or watch TV when they are eating.
    * Try new recipes or new foods you think your child will like.

Ways to Add Calories to Your Child's Food

Infants and babies:

    * Feed your baby infant formula or breast milk when they are thirsty, not juices or water.
    * Feed your baby solid food when they are 4 to 6 months old. Use foods that have a lot of calories.

Toddlers and preschool children:

    * Give your child whole milk with meals, not juices, low fat milk, or water.
    * Sauté or fry food (ask your doctor first about this).
    * Add butter or margarine to foods when you are cooking, or put them on foods that are already cooked.
    * Feed your child peanut butter sandwiches, or put peanut butter on some vegetables or fruits, such as carrots and apples.
    * Mix canned soups with half-and-half or cream.
    * Use half-and-half or cream in casseroles and mashed potatoes, or on cereal.
    * Add protein supplements to yogurt, milkshakes, fruit smoothies, or pudding.
    * Offer your child eggnog (with no alcohol), milkshakes, or prepared liquid supplements between meals.
    * Add cream sauce or melt cheese over vegetables.
    * Ask your child's doctor if liquid nutrition drinks are okay to try.

Energy Drinks Pose Serious Health Risks for Young People

A lack of research and regulation associated with energy drinks, combined with reports of toxicity and high consumption, may result in potentially dangerous health consequences in children, adolescents, and young adults, according to a review of scientific literature and Internet sources.

According to the review, self-report surveys indicate that energy drinks are regularly consumed by 30% to 50% of children, adolescents, and young adults. The current trial questions the use of energy drinks in these young populations, as they provide no therapeutic benefit and are associated with risks for serious adverse health effects.

The authors note that because energy drinks are categorized as nutritional supplements, they avoid the limit of 71 mg caffeine per 12 fluid ounces that the US Food and Drug Administration has set for soda, as well as the safety testing and labeling that is required of pharmaceuticals. As a consequence, energy drinks can contain as much as 75 to 400 mg caffeine per container, with additional caffeine not included in the listed total often coming from additives such as guarana, kola nut, yerba mate, and cocoa.

"Of the 5448 US caffeine overdoses reported in 2007, 46% occurred in those younger than 19 years,"

One study included in the review, conducted in New Zealand, found that on average, all children, teenagers, and young men would exceed an adverse effect level of 3 mg/kg per day of caffeine after consuming a single retail unit of energy drink or energy shot in addition to baseline dietary exposure.

Although US poison centers have only recently begun tracking toxicity of energy drinks, Germany, Australia, and New Zealand have reported numerous adverse outcomes associated with energy drink consumption. These include liver damage, kidney failure, respiratory disorders, agitation, confusion, seizures, psychotic conditions, nausea, vomiting, abdominal pain, rhabdomyolysis, tachycardia, cardiac dysrhythmias, hypertension, myocardial infarction, heart failure, and death.

Despite these reports, there has been a lack of research into the physiological effects of individual energy drink ingredients. Drug interactions and dose-dependent effects remain largely unknown, although the current study reports that the ingredients 5-hydroxy tryptophan, vinpocetine, yohimbine, and ginseng have the potential for drug interactions that could result in adverse effects.

Seifert and colleagues also describe populations at highest risk for adverse health effects from energy drink consumption; these include children, adolescents, and young adults with cardiac conditions, attention-deficit hyperactivity disorder, eating disorders, and diabetes, and those taking other medications or consuming alcohol. The researchers also note that the caffeine in energy drinks may interfere with bone mineralization during a critical period of skeletal development.

Thyroid Antibodies : labtest

Why Get Tested?
To help diagnose and monitor autoimmune thyroid diseases and to distinguish these from other forms of thyroiditis; to help guide treatment decisions
When to Get Tested?
When you have a goiter and/or when your other thyroid tests, such as T3, T4, and TSH, indicate thyroid dysfunction; along with a thyroglobulin test when your doctor is using it as a monitoring tool; at intervals recommended by your doctor when you have a known autoimmune thyroid disorder
Sample Required?
A blood sample drawn from a vein in your arm

How is it used?
Thyroid antibody testing is primarily ordered to help diagnose an autoimmune thyroid disease and to separate it from other forms of thyroiditis. It may be ordered to help investigate the cause of a goiter and/or performed as a follow-up when other thyroid test results (such as T3, T4, and/or TSH) show signs of thyroid dysfunction.
One or more thyroid antibody tests may also be ordered if a person with a known non-thyroid-related autoimmune condition, such as systemic lupus erythematosus, rheumatoid arthritis, or pernicious anemia, develops symptoms that suggest thyroid involvement. This involvement may occur at any time during the course of the other condition(s).

ENA Panel : labtest

Why Get Tested?
To help diagnose and distinguish between autoimmune disorders
When to Get Tested?
When your ANA (Antinuclear Antibody) test is positive; when you have symptoms that suggest an autoimmune disorder
Sample Required?
A blood sample drawn from a vein in your arm

How is it used?
The ENA panel is usually ordered following a positive ANA test in people who have clinical signs of an autoimmune disorder. The 4-test ENA panel is used to help diagnose mixed connective tissue disease (MCTD), systemic lupus erythematosus (SLE), and Sjögren's syndrome. The 6-test ENA can also help identify scleroderma and polymyositis.
For more on these diseases, visit the American Autoimmune Related Diseases Association web site.

An ENA panel may also be ordered if a doctor suspects that a person with a known autoimmune disorder has developed an additional disorder.

CCP : labtest

Why Get Tested?
To help diagnose rheumatoid arthritis (RA) and differentiate it from other types of arthritis; sometimes to help evaluate the prognosis of a patient with RA
When to Get Tested?
When a doctor suspects RA in a patient who has joint inflammation and/or undiagnosed or undifferentiated inflammatory arthritis, with symptoms that suggest but do not yet meet the criteria of RA
Sample Required?
A blood sample drawn from a vein in your arm

How is it used?
A CCP test may be ordered along with or following a Rheumatoid factor (RF) test to help diagnose Rheumatoid arthritis (RA). CCP may also be ordered to help evaluate the likely development of RA in patients with undifferentiated arthritis – those whose symptoms suggest but do not yet meet the ACR criteria for RA. According to American College of Rheumatology, approximately 95% of patients with a positive CCP will develop RA in the future.

Amylase : labtest

Why Get Tested?
To diagnose and monitor pancreatitis or other pancreatic diseases
When to Get Tested?
When you have symptoms of a pancreatic disorder, such as severe abdominal pain, fever, loss of appetite, or nausea
Sample Required?
A blood sample drawn from a vein in the arm; sometimes a 24-hour urine sample or a sample of peritoneal fluid

How is it used?
The blood amylase test is ordered, often along with a lipase test, to help diagnose and monitor acute or chronic pancreatitis and other disorders that may involve the pancreas. A urine amylase test may also be ordered. Typically, its level will mirror blood amylase concentrations, but both the rise and fall will occur later. Sometimes a urine creatinine clearance may be ordered along with the urine amylase to help evaluate kidney function since decreased kidney function can result in a slower rate of amylase clearance. In certain cases, an amylase test may be performed on peritoneal fluid to help make a diagnosis of pancreatitis.
Amylase tests are sometimes used to monitor treatment of cancers involving the pancreas and after the removal of gallstones that have caused gallbladder attacks.

Amniotic Fluid Analysis : labtest

Why Get Tested?
To detect and diagnose some birth defects, genetic diseases, and chromosome abnormalities in a fetus, especially if pregnancy screening tests are abnormal; to evaluate fetal lung maturity; to help diagnose and monitor hemolytic disease in a fetus
When to Get Tested?
Between 15 and 20 weeks of gestation to test for genetic diseases, chromosome abnormalities, and open neural tube defects; when there is an increased risk of premature delivery, after 32 weeks to evaluate fetal lung maturity; when it is suspected that a fetus has hemolytic disease, about every 14 days
Sample Required?
A sample of amniotic fluid is obtained using a procedure called amniocentesis

How is it used?
Amniotic fluid analysis may used for several different reasons and the specific testing that is done depends on the reason for testing. The following list includes some of the more common ways that this analysis may be used:
Chromosome abnormalities or genetic disorders

Chromosome analysis, a cytogenetics test that may also be called karyotyping. Chromosome analysis will detect chromosome abnormalities associated with a variety of disorders. It evaluates the 22 paired chromosomes and the sex chromosomes (XY) in the nucleus of cells cultured from those collected in the sample of amniotic fluid and can be used to diagnose a variety of chromosomal disorders. Some of these include:
Down syndrome (Trisomy 21), caused by an extra chromosome 21 in all or most cells of the body
Edwards syndrome (Trisomy 18), associated with severe mental retardation; caused by an extra chromosome 18
Patau syndrome (Trisomy 13), caused by an extra chromosome 13
Klinefelter syndrome, the most common sex chromosome abnormality in males; caused by an extra X chromosome
Turner syndrome, caused by missing one X chromosome in females
As a byproduct, chromosome analysis can also definitely determine the sex of the fetus.
Genetic testing, also called molecular testing. It looks at fetal DNA to identify specific gene mutations and diagnose a variety of inherited diseases. Each test is ordered separately based upon the parents' personal and family histories. If a specific gene mutation is known to be present in the mother's or father's family, then that specific gene mutation can be tested for. While there are hundreds of genetic tests that can be performed, only a few are associated with relatively common disorders. Typically, only the most common mutations are tested; therefore, a fetus can still have an inherited disorder even though genetic testing did not identify one. A few examples of genetic tests more frequently performed include those for:
Cystic Fibrosis
Tay-Sachs disease
Canavan disease
Familial dysautonomia
Sickle cell anemia
Thalassemia
Birth defects
Testing for open neural tube defects (NTDs), such as spina bifida (spinal defect) or anencephaly (brain does not develop), detects chemicals that may be present in abnormal quantities when the fetus has an anatomic abnormality.

AFP (alpha-fetoprotein)—increased with neural tube defects
Acetylcholinesterase—increased with neural tube defects and also other anatomic abnormalities
Fetal Lung Maturity
Testing to evaluate fetal lung maturity may be performed if a woman is at an increased risk for premature delivery or an early birth is necessary for the baby or mother's health. The tests are based upon the presence of adequate protective liquid substances called surfactants in the lungs, which are necessary for proper lung function. If there are insufficient surfactants, a newborn may develop life-threatening neonatal respiratory distress syndrome (RDS). Tests include:

Fluorescence polarization (FPOL, surfactant/albumin ratio)
Lamellar body count
Phosphatidylglycerol (PG)
Lecithin/sphingomyelin (L/S) ratio (less common than FPOL)
Rh and other blood type incompatibilities and diseases
When a mother has been previously exposed through prior pregnancies or blood transfusions to red blood cell antigens that she does not have on her own red cells, she may develop antibodies against those red cell antigens (become sensitized). If the antigens are present on the red blood cells of the fetus (inherited from the father), then the fetus is at risk for a maternal-fetal incompatibility. The mother's antibodies can cross the placenta and bind to and destroy the fetus's red blood cells, causing hemolytic anemia. An affected fetus can be born with hemolytic disease of the newborn. One of the most commonly encountered incompatibilities is due to Rh, but there are many other blood types that may also cause this problem.

Tests for bilirubin may be performed on a regular basis, starting at about 25 weeks of pregnancy, to detect, evaluate and monitor the severity of the hemolytic anemia in the fetus.
Fetal Distress
Evaluation of amniotic fluid color – may be indicative of fetal distress

Green tinged – indicates that meconium, the fetus's first stool, has been released
Yellow to amber – may indicate bilirubin in the fluid
Red tinged – blood from the mother or the fetus

Ammonia : labtest

Why Get Tested?
To detect elevated levels of ammonia in the blood, to help evaluate changes in consciousness, severe liver disease, and certain genetic urea cycle disorders; to support the diagnosis of hepatic encephalopathy and Reye’s syndrome
When to Get Tested?
When a patient experiences mental changes or lapses into a coma of unknown origin; when an infant or child experiences frequent vomiting and increased lethargy as a newborn or about a week after a viral illness
Sample Required?
A blood sample drawn from a vein in your arm

How is it used?
The ammonia test is primarily used to help investigate the cause of changes in behavior and consciousness. It may be ordered, along with other tests such as glucose, electrolytes, and kidney and liver function tests, to help diagnose the cause of a coma of unknown origin or to help support the diagnosis of Reye's syndrome or hepatic encephalopathy caused by various liver diseases. An ammonia level may also be ordered to help detect and evaluate the severity of a urea cycle defect.
Some doctors use the ammonia test to monitor the effectiveness of treatment of hepatic encephalopathy, but there is not widespread agreement on its clinical utility. Since hepatic encephalopathy can be caused by the build-up of a variety of toxins in the blood and brain, blood ammonia levels correlate poorly with the degree of impairment.

AMA : labtest

Why Get Tested?
To help diagnose primary biliary cirrhosis (PBC)
When to Get Tested?
When a doctor suspects that a person may have PBC
Sample Required?
A blood sample drawn from a vein in your arm

How is it used?
The AMA test is ordered to help diagnose primary biliary cirrhosis (PBC). PBC is a serious condition in which the biliary system in the liver is gradually destroyed. (For more about this disease, see the links listed under Elsewhere on the Web).
Other tests that may be ordered include:

Smooth muscle antibodies (SMA)
Antinuclear antibodies (ANA)
Alkaline phosphatase
IgM level
Bilirubin
Albumin
Prothrombin time
C-reactive protein
GGT
These tests often help detect PBC, distinguishing it from other autoimmune conditions causing liver damage, and may be useful predictors of need for a liver transplant.

Tau/Aß42 : labtest

Why Get Tested?
To help discriminate between Alzheimer's Disease and other forms of early-onset dementia
When to Get Tested?
These tests may be ordered along with cognitive and brain-imaging tests in patients who demonstrate some form of dementia. These tests are not routine laboratory tests and are available only in research settings or memory clinics.
Sample Required?
A sample of cerebrospinal fluid collected using a spinal tap

How is it used?
Tests for Tau protein and Aß42 may be used as supplemental tests to help establish a diagnosis of Alzheimer's Disease.
If someone has symptoms of dementia, such as memory loss, behavioral changes, and decreased ability to perform daily life functions, the doctor will do a thorough work-up to try to determine the cause. This work-up may include a variety of cognitive tests (Minimal Mental State Exam) to assess memory and possibly PET scanning tests (Pittsburgh Compound-B) of the brain to look for abnormalities.

Tryptase : labtest

Why Get Tested?
To help diagnose the cause of anaphylaxis, mastocytosis, or mast cell activation
When to Get Tested?
When you have symptoms such as flushing, nausea, throat swelling or low blood pressure that may be due to a life-threatening allergic reaction; when your doctor suspects that you have mastocytosis or mast cell activation
Sample Required?
A blood sample drawn from a vein in your arm

How is it used?
The tryptase test is a useful indicator of mast cell activation. It may be ordered to confirm a diagnosis of anaphylaxis and to help diagnose mastocytosis. In most cases, a total tryptase is ordered, but sometimes both a total and mature tryptase may be ordered and the ratio of the two compared. As the predominant mature tryptase in the blood is usually beta tryptase, this is essentially a comparison between total tryptase and beta tryptase.
Anaphylaxis is primarily diagnosed clinically, but a total tryptase may be ordered, along with a histamine test, to help confirm anaphylaxis as the cause of someone's acute symptoms. This is especially true if the person has recurrent episodes and/or if the diagnosis is uncertain.

A tryptase test may be ordered to help diagnose mastocytosis or mast cell activation disorder. While cutaneous mastocytosis typically only causes skin problems (particularly hives), people with systemic mastocytosis or mast cell activation disorder may experience anaphylaxis and its associated symptoms. Persons with systemic mastocytosis may also have persistent symptoms related to the organs affected by mast cell infiltration. If systemic mastocytosis is suspected, an abnormal tryptase test is typically followed by a bone marrow aspiration and biopsy to determine if systemic mastocytosis is present. (Typically there are increased numbers of mast cells in the bone marrow in this disease.)

Other testing may be ordered to evaluate a person's health status and to help rule out other conditions that can cause similar symptoms. These may include specific allergy tests to help determine the cause of an allergic reaction, tests such as a CBC (Complete Blood Count) to evaluate red and white blood cells, a CMP (Comprehensive Metabolic Panel) to evaluate organ function, and/or a 5-HIAA (5-hydroxyindoleacetic acid) urine test to rule out a carcinoid tumor that may cause similar symptoms, such as flushing, diarrhea, and/or wheezing. If stomach or intestinal ulcers are also present, a gastrin test may be done to determine if high gastrin may be the cause.

Occasionally, a tryptase test may be performed postmortem to help determine if anaphylaxis was the cause of a person's death.

Allergy Blood Testing : labtest

Why Get Tested?
To screen for allergies; sometimes to monitor the effectiveness of immunotherapy (desensitization) treatment
When to Get Tested?
When you have symptoms such as hives, dermatitis, nasal congestion, red itchy eyes, asthma, or abdominal pain that your doctor suspects may be caused by an allergy
Sample Required?
A blood sample drawn from a vein in your arm

How is it used?
The allergen-specific IgE antibody test is a blood test used to screen for an allergy to a specific substance or substances if a person presents with acute or chronic allergy-like symptoms. This is especially true if symptoms are recurrent and appear to be tied to triggers, such as exposures to particular foods or environments, and if other family members are known to have allergies.
A variety of different types of allergy tests may be performed by exposing a person to different substances under careful medical supervision (see FAQ #1). The usefulness of these tests, however, can be affected by skin conditions, such as significant dermatitis or eczema, and by medications, such as histamines and some anti-depressants. With some tests there is also the potential for severe reactions, including a severe reaction that may be life-threatening. In these cases, the allergen-specific IgE antibody test may be ordered as an alternative, as it is performed on a blood sample and does not have an effect on the person being tested.

The allergen-specific IgE antibody test may also be done to monitor immunotherapy (desensitization) or to see if a child has outgrown an allergy. It can only be used in a general way, however, as the level of IgE present does not correlate to the severity of an allergic reaction, and someone who has outgrown an allergy may have a positive IgE for many years afterward.

Aldosterone and Renin : labtest

Why Get Tested?
To determine if your aldosterone and renin levels are abnormal
When to Get Tested?
When you develop features associated with increased aldosterone production, such as elevated blood pressure, muscle weakness, and low potassium
Sample Required?
A blood sample drawn from a vein in your arm or a 24-hour urine sample; sometimes blood from the renal or adrenal veins is also collected.

How is it used?
Aldosterone and renin tests are used to evaluate whether appropriate amounts of aldosterone are being produced and to distinguish between the potential causes of excess or deficiency. Aldosterone may be measured in the blood or in a 24-hour urine sample; renin is always measured in blood. These tests are most useful in screening for primary hyperaldosteronism, also known as Conn's syndrome, which causes high blood pressure. If the screening test is positive, aldosterone production may be further evaluated through the use of stimulation and suppression testing.
Both aldosterone and renin levels are highest in the morning and vary throughout the day. They are affected by a person's position, by stress, and by a variety of prescribed medications.

Ethanol : labtest

Why Get Tested?
To determine if a person has consumed ethanol and to measure the amount of ethanol present
When to Get Tested?
When someone has symptoms that suggest ethanol toxicity or when a person is suspected of violating drinking-related laws or as part of a drug testing panel
Sample Required?
Ethanol may be determined from a blood sample, a urine sample, a saliva sample or a breath sample. Blood, urine, and saliva samples must be sent to a laboratory for analysis. A breath sample is analyzed immediately on site using a Breathalyzer.

How is it used?
The ethanol/alcohol test is used for both medical and legal purposes. Samples and results for each use are usually collected and tested separately.
Medical: The goal of medical testing is to identify the presence of alcohol in order to effectively treat the intoxicated person's symptoms. For medical purposes, blood, and sometimes urine, alcohol tests are used to detect the presence of ethanol and to evaluate its concentration. One or more of these tests may be ordered when a patient presents to the Emergency Room with symptoms suggesting ethanol toxicity. Other tests, such as a Complete Blood Count (CBC), glucose, and electrolytes are often ordered at the same time as there are a variety of other conditions that can cause similar symptoms. Additional drug testing and testing for the presence of other more toxic alcohols (such as methanol and isopropyl alcohol) may also be performed if the use of other substances is suspected.

Legal (Forensic): The goal of legal testing is to identify the presence of alcohol and to evaluate its presence in the context of a variety of different laws. Legal testing must be done by specially trained people and must have a strict chain-of-custody. Testing may be ordered to determine whether an erratic driver has a blood alcohol concentration that is over the legal limit, to determine whether an under-age minor has been drinking, whether someone on parole has abstained from alcohol, and to determine whether alcohol consumption has contributed to an accident. Post-mortem ethanol testing may be done to determine whether alcohol contributed to a person's death. Legal ethanol testing may also be performed randomly or "with cause" as part of an employer's drug testing program to determine whether an employee has alcohol in their system. It may also be part of the testing that is done as part of an application for life insurance. These uses are considered legal alcohol tests because they require chain-of-custody documents.

Samples tested for legal purposes may include blood, breath, urine, and/or saliva testing. Breath testing is the most common test performed on drivers. It uses the tail end sample of breath from deep in the lungs and uses a conversion factor to estimate the amount of alcohol in the blood. Blood alcohol testing may be ordered to confirm or refute findings and/or ordered as an alternative to breath testing. Urine testing may also be performed as an alternative. Usually, a patient collects and discards a urine sample and then collects a second sample 20 to 30 minutes later. The amount of alcohol in the first sample will be variable because it is unknown how long the urine has been in the bladder. The second sample will reflect a timed sample and a different conversion factor can then be used to estimate blood alcohol. A random urine sample is sometimes ordered to monitor people for the presence of alcohol. Saliva alcohol testing is not as widely used but may be used as an alternate screening test.

ALT : labtest

Why Get Tested?
To screen for liver damage and/or to help diagnose liver disease
When to Get Tested?
When your doctor thinks that you have symptoms of a liver disorder
Sample Required?
A blood sample drawn from a vein in your arm

How is it used?
The alanine aminotransferase (ALT) blood test is typically used to detect liver injury. It is often ordered in conjunction with aspartate aminotransferase (AST) or as part of a liver panel to screen for and/or help diagnose liver disease. AST and ALT are considered to be two of the most important tests to detect liver injury, although ALT is more specific than AST. Sometimes AST is compared directly to ALT and an AST/ALT ratio is calculated. This ratio may be used to distinguish between different causes of liver damage.
ALT values are often compared to the results of other tests such as alkaline phosphatase (ALP), total protein, and bilirubin to help determine which form of liver disease is present.

ALT is often used to monitor the treatment of persons who have liver disease, to see if the treatment is working, and may be ordered either by itself or along with other tests for this purpose.

Porphyrin Tests : labtest

Why Get Tested?
To help diagnose and sometimes to monitor porphyrias
When to Get Tested?
When a patient has symptoms that suggest an acute neurologic/psychiatric porphyria, such as abdominal pain, tingling in hands or feet, and/or confusion or hallucinations, or that suggest a cutaneous porphyria, such as reddening, blistering, or scarring on sun-exposed skin
Sample Required?
A blood sample drawn from a vein in your arm, a random or 24-hour urine sample, and/or a stool sample

How is it used?
Porphyrin testing is used to help diagnose and sometimes to monitor porphyrias. Since the symptoms associated with these disorders may also be seen in a variety of other conditions, testing is also used to help rule out the presence of a porphyria in someone who presents with neurologic/psychiatric or cutaneous symptoms.
For acute attacks, porphobilinogen (PBG) and urine porphyrins may be ordered on a random urine sample. If these are abnormal, they are followed by delta-Aminolevulinic Acid (ALA), PBG, and/or porphyrin testing on a 24-hour urine sample. Fecal porphyrins may be ordered to help distinguish between VP and HCP.

For cutaneous porphyrias, whole blood and urine porphyrins are the most frequently ordered tests. They are used to help diagnose a porphyria and may be used to monitor a porphyria. Enzyme testing, such as PBG deaminase, may be ordered to help detect latent porphyrias in family members of a patient with a diagnosed porphyria.

HIV Antibody :labtest

Why Get Tested?
To determine if you are infected with Human immunodeficiency virus (HIV)
When to Get Tested?
One month to three months after you think you may have been exposed to the virus; the average time for the antibody to be detected is two weeks after exposure to the virus
Sample Required?
A blood sample collected from a vein in your arm; there are also tests available that can be performed on urine and/or oral fluid

How is it used?
HIV antibody testing is used to screen for and diagnose HIV infections. Early treatment of HIV infection and immune system monitoring can greatly improve long-term health. Also, knowing your HIV status may help you change behaviors that would put you and others at risk.
Antibodies to the HIV virus are often detected by a screening test called an ELISA. The ELISA test is repeated if positive. The ELISA method is very sensitive but requires another test, a Western Blot, to confirm the results because false positives can occur. These tests can be done on blood, urine or oral sample in a doctor’s office or a local clinic. There are several rapid tests available in which results are generated in about 20 minutes. However, these too must have confirmatory testing before a final diagnosis can be made.

There is also a home collection kit approved by the US Food and Drug Administration (FDA) that is available for HIV antibody testing. This allows you to take a sample of your blood from a finger at home and mail it to a testing center. You would then hear your results later over the phone, along with appropriate counseling. There are, however, no available tests that can be performed at home. (For more, see the article on Home Testing and the FDA webpage on HIV home tests.)

Triple Screen or Quad Screen : labtest

Why Get Tested?
To assess the risk of carrying a fetus with abnormalities, such as Down syndrome, Edwards syndrome (trisomy 18), and open neural tube defects during the second trimester of pregnancy
When to Get Tested?
Women in the 15th to 21st week of pregnancy
Sample Required?
A blood sample drawn from a vein in the arm

How is it used?
The triple or quad screen is used as a screening test in the second trimester of pregnancy. It is ordered to help evaluate the risk that a fetus has certain abnormalities, including Down syndrome (trisomy 21), Edwards syndrome (trisomy 18), and neural tube defects such as spina bifida or a condition called anencephaly.
These tests have been established as a triple or quad screen because their power lies in their use together. A mathematical calculation involving the levels of these 3 or 4 substances (AFP, hCG, unconjugated estriol, and, sometimes, inhibin A) and considerations of maternal age, family history, weight, race, and diabetic status are used to determine a numeric risk for Down syndrome and for a few other chromosomal abnormalities such as Edwards syndrome (trisomy 18) in the fetus. This risk is compared with an established cut-off. If the risk is higher than the cut-off value, then it is considered a positive screening test or increased risk exists for carrying a fetus with one of the discussed abnormalities.

An AFP test may be performed by itself and not as part of a triple or quad screen, especially when First Trimester Screening has already been used to assess the risk for chromosomal abnormalities. The AFP is used to help determine the risk of neural tube defects.

AFP Tumor Markers : labtest

Why Get Tested?
To help diagnose and monitor therapy for certain cancers of the liver, testes, or ovaries
When to Get Tested?
When your doctor suspects that you have certain cancers of the liver, testes, or ovaries; at intervals during and after treatment for one of these cancers; sometimes when you have chronic hepatitis or cirrhosis
Sample Required?
A blood sample drawn from a vein in the arm

How is it used?
AFP is used to help detect and diagnose cancers of the liver, testes, and ovaries. It is often ordered to monitor people with chronic liver diseases such as cirrhosis or chronic hepatitis B because they have an increased lifetime risk of developing liver cancer. A doctor may order an AFP test, along with imaging studies, to try to detect liver cancer when it is in its earliest, and most treatable, stages.
If a patient has been diagnosed with hepatocellular carcinoma or another form of AFP-producing cancer, an AFP test may be ordered periodically to help monitor a patient's response to therapy and to monitor for cancer recurrence.

A relatively new test, called AFP-L3%, is sometimes also ordered to compare the amount of total AFP to the amount of one of the AFP variants called AFP-L3. The AFP-L3% test is not yet widely used in the U.S. but has gained wider acceptance in other countries such as Japan. The test is used to help evaluate the risk of developing hepatocellular carcinoma, especially in those with chronic liver disease. An increase in the percentage of L3 to total AFP indicates an increased risk of rapidly developing this disease and also of having less chance of survival.

Bacterial Wound Culture: labtest

Why Get Tested?
To detect a bacterial wound infection, to determine which specific bacteria are present, and to isolate and grow the bacteria for subsequent susceptibility testing
When to Get Tested?
When the doctor suspects that your wound is infected by a pathogenic microorganism; sometimes after treatment of an infection to evaluate its effectiveness
Sample Required?
A sterile swab used to collect cells or pus from the site of the suspected infection; may also include aspirations of fluid from deeper wounds into a syringe and/or a tissue biopsy

How is it used?
A bacterial wound culture is primarily ordered to help determine whether a wound is infected, to identify the bacteria causing the infection, and to prepare a sample for susceptibility testing where required.
If a wound culture reveals the need for a susceptibility test, it is often performed automatically and without an additional test having to be ordered by the doctor. This can save time so that antimicrobial therapy can begin as soon as possible.

Gram stains are routinely performed on the original sample that is collected for the wound culture. This is done to give the doctor an initial evaluation of the wound - to look for any bacteria that might be present in the original sample. A gram stain that does not show the presence of bacteria does not rule out a wound infection.

A wound culture may also sometimes be ordered on a patient who has undergone treatment for a wound infection, to determine whether the treatment was effective. It may also be ordered at intervals on a person who has a chronic infection, to help guide further treatment.

If a fungal infection is suspected, then a fungal culture of the wound specimen may be ordered along with the bacterial wound culture. Yeast and some fungi may grow on the same media as bacteria, but many fungi are slow-growing. The media used to recover fungi inhibits bacterial growth and supports fungal growth for several weeks.

ADH :labtest

Why Get Tested?
To help detect, diagnose, and determine the cause of antidiuretic hormone (ADH) deficiency or excess; to investigate low blood sodium levels (hyponatremia); to distinguish between the two types of diabetes insipidus
When to Get Tested?
When you have hyponatremia or have persistent thirst, frequent urination, and dehydration
Sample Required?
A blood sample drawn from a vein in your arm

How is it used?
The antidiuretic hormone (ADH) test is ordered by itself or along with or following other tests to help detect, diagnose, and determine the cause of antidiuretic hormone deficiencies and excesses. However, this test is not widely used; diagnoses of these conditions are often based on clinical history and other laboratory tests, such as blood and urine osmolality as well as electrolytes.
Symptoms of ADH deficiency are often seen with one of two types of diabetes insipidus. Central diabetes insipidus is a decrease in the production of ADH by the hypothalamus or in the release of ADH from the pituitary; nephrogenic diabetes insipidus is characterized by a decrease in the kidney's response to ADH. A water deprivation ADH stimulation test is sometimes used to distinguish between these types. It involves fluid restriction, an ADH test, and the administration of ADH (vasopressin). Several blood and urine osmolality measurements are performed at timed intervals before and after vasopressin is given in order to monitor the body's response to the drug. This procedure must be performed under close medical supervision as it can sometimes lead to severe dehydration and can pose a risk to some people with underlying diseases.

Symptoms of increased levels of ADH are often seen with "Syndromes of Inappropriate ADH production" or SIADH. Testing for SIADH may include blood and urine osmolality, sodium, potassium, and chloride tests as well as an ADH measurement. A water loading ADH suppression test is sometimes performed. With this procedure, a fasting person is given specific quantities of water and then the amount of urine produced and the changes in urine and blood osmolality are monitored over time. An ADH test is also performed. This procedure must also be performed under medical supervision as it can be risky in those with kidney disease and can sometimes result in severe hyponatremia.

Other testing may be performed to help distinguish SIADH from other disorders that can cause edema, hyponatremia, and/or decreased urine production, such as congestive heart failure, liver disease, kidney disease, and thyroid disease.

Acute Viral Hepatitis Panel : labtest

Why Get Tested?
To detect and diagnose an infection with a hepatitis virus
When to Get Tested?
When you have symptoms of hepatitis and a viral infection is suspected to be the cause; when you have been exposed to one or more of the three most common hepatitis viruses: Hepatitis A, B, or C
Sample Required?
A blood sample drawn from a vein in your arm

How is it used?
An acute hepatitis panel is used to help detect and/or diagnose an acute liver infection due to one of the three most common hepatitis viruses: Hepatitis A virus (HAV), Hepatitis B virus (HBV), or Hepatitis C virus (HCV). There are several causes of hepatitis and the accompanying symptoms, so these tests are used to determine if symptoms are due to a current infection with a virus and to identify which virus in particular is causing the disease. These tests may also help determine if someone has been exposed to one of the viruses even before symptoms develop. An acute hepatitis panel typically consists of the following tests:
Hepatitis A antibody, IgM—If you are exposed to Hepatitis A, your body will first produce Hepatitis A IgM antibodies. These antibodies typically develop 2 to 3 weeks after first being infected and persist for about 2 to 6 months. Hepatitis A IgM antibodies develop early in the course of infection, so a positive Hepatitis A IgM test is usually considered diagnostic for acute Hepatitis A.
Hepatitis B core antibody, IgM—This is an antibody produced against the Hepatitis B core antigen. It is the first antibody produced in response to a Hepatitis B infection and, when detected, may indicate an acute infection. It may also be present in people with chronic hepatitis B when flares of disease activity occur.
Hepatitis B surface Ag—This is a protein present on the surface of the Hepatitis B virus. It is the earliest indicator of an acute infection but may also be present in the blood of those chronically infected.
Hepatitis C antibody—This test detects antibodies produced in response to an HCV infection. It cannot distinguish between an active or previous infection. If positive, it is typically followed up with other tests to determine is the infection is a current one. (See the article on Hepatitis C for more on this.)
In acute hepatitis, other tests such as a liver panel or individual tests such as bilirubin, ALT, and AST, may be performed to help diagnose the condition.

There are some other tests that may be offered as part of a hepatitis panel, depending on the laboratory performing the tests. These may include:

HAV antibody, total and HBV core antibody, total—These tests detect both IgM and IgG antibodies and may be used as part of the panel to determine if someone has had a previous infection.
HBV surface antibody—The test for this antibody may sometimes be included in a panel to help determine if an infection has resolved or if a person has developed the antibody after receiving the hepatitis B vaccine and achieved immunity for protection against HBV.

PTT :labtest

Why Get Tested?
As part of an investigation of a possible bleeding disorder or thrombotic episode; to monitor unfractionated (standard) heparin anticoagulant therapy
When to Get Tested?
When you have unexplained bleeding or blood clotting; when you are on unfractionated (standard) heparin anticoagulant therapy; sometimes as part of a pre-surgical screen
Sample Required?
A blood sample drawn by needle from a vein in the arm

How is it used?
The PTT test is used to investigate unexplained bleeding or clotting. It may be ordered along with a PT (Prothrombin Time) test to evaluate hemostasis, the process that the body uses to form blood clots to help stop bleeding. The PTT evaluates the coagulation factors XII, XI, IX, VIII, X, V, II (prothrombin), and I (fibrinogen) as well as prekallikrein (PK) and high molecular weight kininogen (HK). A PT test evaluates the coagulation factors VII, X, V, II, and I (fibrinogen). By evaluating the results of the two tests together, a doctor can gain clues as to what bleeding or clotting disorder may be present.
A PTT is often used to monitor standard (unfractionated, UF) heparin anticoagulant therapy. Heparin is a drug that is given intravenously (IV) or by injection to prevent and to treat thromboemboli. When it is administered for therapeutic purposes, it must be closely monitored. If too much is given, the treated person may bleed excessively; with too little, the treated person may continue to clot.

If the PTT is prolonged and the cause is not anticoagulant therapy or heparin contamination, then a second PTT test is performed by mixing the patient's plasma with pooled normal plasma (a collection of plasma from a number of normal donors). If the PTT time returns to normal ("corrects"), it suggests a deficiency of one or more of the coagulation factors in the patient's plasma. If the time remains prolonged, then the problem may be due to the presence of an abnormal factor inhibitor (autoantibody). Further studies can then be performed to identify what factors may be deficient or determine if an inhibitor is present in the blood. Nonspecific inhibitors, such as lupus anticoagulant and anticardiolipin antibodies, are associated with clotting episodes and with recurrent miscarriages, especially those that occur in the second or third trimester. For this reason, PTT testing may be performed to help investigate recurrent miscarriages.

Based on carefully obtained patient histories, the PTT and PT tests are sometimes selectively performed as pre-surgical procedures to screen for potential bleeding tendencies.

Other testing that may be done along with a PTT includes:

Platelet counts – should always be monitored during heparin therapy to promptly detect any heparin-induced thrombocytopenia
Thrombin time testing – sometimes ordered to help rule out heparin contamination
Fibrinogen testing – may be done to rule out hypofibrinogenemia as a cause of PTT prolongation

ACTH :labtest

Why Get Tested?
To help diagnose adrenal and pituitary diseases such as Cushing’s syndrome, Cushing’s disease, Addison’s disease, adrenal tumors, and pituitary tumors
When to Get Tested?
When you have symptoms associated with excess or deficient cortisol production; when your doctor suspects that you have a hormone imbalance that could be caused by a problem in your pituitary or adrenal glands
Sample Required?
A blood sample drawn from a vein in your arm

How is it used?
ACTH levels in the blood are measured to help detect, diagnose, and monitor conditions associated with excessive or deficient cortisol in the body. These conditions include:

Cushing's disease: excess cortisol that is due to an ACTH-producing tumor in the pituitary gland (usually a benign tumor)
Cushing's syndrome: refers to the symptoms and signs associated with excess exposure to cortisol. In addition to Cushing's disease, Cushing's syndrome may be due to an adrenal tumor, adrenal hyperplasia, the use of steroid medications, or due to an ACTH-producing tumor that is ectopic, located outside the pituitary (such as in the lungs).
Addison's disease, primary adrenal insufficiency: decreased cortisol production due to adrenal gland damage
Secondary adrenal insufficiency: decreased cortisol production because of pituitary dysfunction
Hypopituitarism: pituitary dysfunction or damage that leads to decreased (or no) hormone production by the pituitary, including ACTH production
Measuring both ACTH and cortisol can help to differentiate among some of these conditions because the level of ACTH normally changes in the opposite direction to the level of cortisol.

Smooth Muscle Antibody : labtest

Why Get Tested?
To help diagnose chronic active autoimmune hepatitis and distinguish it from other causes of liver injury
When to Get Tested?
When a patient has hepatitis that the doctor suspects may be due to an autoimmune-related process
Sample Required?
A blood sample drawn from a vein in your arm

How is it used?
The smooth muscle antibody (SMA) test is primarily ordered along with antinuclear antibodies (ANA) to help diagnose autoimmune hepatitis. Other autoantibodies, such as liver-kidney microsomal type 1 (LKM1) antibodies and antimitochondrial antibodies (AMA), may also be ordered to help diagnose autoimmune hepatitis and distinguish it from other causes of liver disease or injury.
The anti-actin test may sometimes be ordered as an initial screening test for autoimmune hepatitis instead of the SMA test. If it is positive, it may be followed by the SMA to confirm the finding. The anti-actin test is relatively new and, in some cases, is taking the place of the SMA test. The ultimate clinical utility of the anti-actin test has yet to be established.

ACT :labtest

Why Get Tested?
To monitor heparin and other anticoagulation when undergoing cardiopulmonary bypass, coronary angioplasty, and dialysis
When to Get Tested?
When you are receiving high dose heparin to prevent clotting during surgical procedures such as a cardiopulmonary bypass; when heparin levels are too high to allow monitoring with a PTT test and/or when a rapid result is necessary to monitor treatment
Sample Required?
A blood sample drawn from a vein in your arm

How is it used?
The ACT test is used to monitor the effect of high dose heparin before, during, and shortly after surgeries that require intense anticoagulation measures, such as cardiac bypass surgery, cardiac angioplasty, and dialysis. It is ordered in situations where the PTT test is not clinically useful or takes too long. The ACT is sometimes used, along with the prothrombin time (PT) to help determine whether a bleeding episode is due to excessive anticoagulation or to depletion of coagulation factors.

Microalbumin and Microalbumin/Creatinine Ratio : labtest

Why Get Tested?
To get screened for a possible kidney disorder or for early damage to the kidneys in those with diabetes
When to Get Tested?
Annually after a diagnosis of diabetes or hypertension
Sample Required?
A random, timed, overnight, or 24-hour urine sample

How is it used?
The random microalbumin test or microalbumin/creatinine ratio is frequently ordered as a screening test on patients with chronic conditions, such as diabetes and hypertension, that put them at an increased risk of developing kidney failure. Studies have shown that identifying the very early stages of kidney disease (microalbuminuria) helps patients and doctors adjust treatment. With better control of diabetes and hypertension by maintaining tight glycemic control and reducing blood pressure, the progression of diabetic kidney disease can be slowed or prevented.
A timed microalbumin test (4 hour or overnight) may be ordered as an alternative screening tool. If significant amounts of microalbumin are detected with these screening tests, they may be confirmed with a 24-hour microalbumin test.

Cardiolipin Antibodies : labtest

Why Get Tested?
To help investigate inappropriate blood clot formation, to help determine the cause of recurrent miscarriage, or as part of an evaluation for antiphospholipid syndrome
When to Get Tested?
When you have had one or more unexplained venous or arterial thrombotic episodes; when you have had recurrent miscarriages, especially in the second and third trimesters
Sample Required?
A blood sample drawn from a vein in your arm

How is it used?
Tests for IgG and IgM cardiolipin antibodies are frequently ordered to help determine the cause of an unexplained thrombotic episode, recurrent miscarriage, or thrombocytopenia. They may be ordered along with lupus anticoagulant testing to help investigate the cause of a prolonged PTT (activated partial thromboplastin time), especially if clinical findings suggest that the patient may have SLE or another autoimmune disorder. If the primary test results are unremarkable but clinical suspicions still exist, then IgA cardiolipin antibody testing may be ordered.
If one or more of the classes of cardiolipin antibodies is detected, then the same test(s) are usually repeated at least 6 weeks apart to help determine whether their presence is persistent or temporary. If a patient with a known autoimmune disorder tests negative for cardiolipin antibodies, they may be retested later as these antibodies may develop at any time in the future.

AFB Smear and Culture : labtest

Why Get Tested?
To help identify a mycobacterial infection; to diagnose tuberculosis (TB); to monitor the effectiveness of treatment
When to Get Tested?
If you have symptoms, such as a chronic cough, weight loss, fever, chills, and weakness, that may be due to TB or another mycobacterial infection; if your doctor suspects that you have active TB; if your doctor wants to monitor the effectiveness of TB treatment
Sample Required?
Usually, three sputum samples are collected early in the morning on different days. If the patient is unable to produce sputum samples, a bronchoscope may be used to collect fluid during a procedure called a bronchoscopy. In children, gastric washings/aspirates may be collected. Depending on symptoms, urine, cerebrospinal fluid (CSF), other body fluids, or biopsied tissue samples may be submitted for culture.

How is it used?
AFB smears and cultures are used to determine whether you have an active Mycobacterium tuberculosis infection, an infection due to another member of the Mycobacterium family, or TB-like symptoms due to another cause. They are used to help determine whether the TB is confined to the lungs (pulmonary) or has spread to organs outside the lungs (extrapulmonary). They are ordered to identify M. tuberculosis and determine the most effective antimicrobial agents to treat the infection. M. tuberculosis may be resistant to one or more drugs commonly used to treat TB. If the bacteria are resistant to more than one or the primary drugs used for therapy, the organisms are called multi-drug resistant TB (MDR TB), and if the organisms are resistant to multiple first and second lines of therapy, they are called extensively drug-resistant tuberculosis (XDR TB). AFB cultures can be used to monitor the effectiveness of treatment and can help determine when a patient is no longer infectious.
Since TB is transmitted by airborne droplets from respiratory secretions, it is a public health risk. It can spread in confined populations, such as correctional facilities, nursing homes, and schools. Those who are very young, elderly, or have diseases and conditions such as AIDS that compromise their immune systems tend to be especially vulnerable. AFB smears and cultures can help track and minimize the spread of TB in these populations and help determine the effectiveness of treatment.

Cholinesterase Tests : labtest

Why Get Tested?
To determine if you have been exposed to and/or poisoned by certain organophosphate chemicals found in pesticides; to monitor cholinesterase levels if you work with pesticides
Sometimes to identify individuals with inherited pseudocholinesterase deficiency before they are given anesthesia with the muscle relaxant succinylcholine or to help determine the cause of prolonged apnea after surgical anesthesia

When to Get Tested?
When you have symptoms of pesticide poisoning or on a regular basis when you are at risk of exposure to organophosphates, such as through work in the agriculture industry and/or frequent use of organophosphate insecticides
When you or a close relative have experienced prolonged apnea and muscle paralysis after use of the drug succinylcholine for a surgical operation

Sample Required?
A blood sample drawn from a vein in your arm

How is it used?
Cholinesterase testing has two main uses:
It can be used to detect and diagnose organophosphate pesticide exposure and/or poisoning. It may also be used to monitor those who may be at increased risk of exposure to organophosphate compounds, such as those who work in agricultural and chemical industries, and to monitor those who are being treated for exposure. Typically, tests for red blood cell (RBC) acetylcholinesterase (AChE) and serum pseudocholinesterase (PChE) are used for this purpose.
It can be used several days prior to a surgical procedure to determine if someone with a history of or family history of post-operative paralysis following the use of succinylcholine, a common muscle relaxant used for anesthesia, is at risk of having this reaction. In these cases, the test for pseudocholinesterase is usually used. A second test, referred to as a dibucaine inhibition test, may be done to help determine the extent to which the activity of the enzyme is decreased.

Blood Ketones : labtest

Why Get Tested?
To determine whether excessive ketones are present in the blood, to detect diabetic ketoacidosis
When to Get Tested?
When you have symptoms associated with ketoacidosis
Sample Required?
A blood sample drawn from a vein in your arm or from a fingerstick

How is it used?
Blood ketones are primarily used to screen for, detect, and monitor diabetic ketoacidosis (DKA) in people with type 1 and sometimes type 2 diabetes. DKA can occur when a diabetic’s blood sugar is significantly increased, with illness, severe infection, pregnancy, and a variety of other conditions.
DKA is associated with acute hyperglycemia, a severe insulin deficiency, and a disruption of the body’s acid-base balance. Excess ketones and glucose are dumped into the urine by the kidneys in an effort to flush them from the body. This causes increased urination, thirst, dehydration, and a loss of electrolytes. The affected person may also experience symptoms such as rapid breathing, shortness of breath, a fruit-scent to the breath, nausea, vomiting, fatigue, confusion, and eventually coma.

Ketosis and ketoacidosis may also be seen with starvation, alcoholism, and with high-fat low-carbohydrate diets. It may be induced on purpose in some children with epilepsy who have frequent seizures and do not respond to available medications or other treatments.

Blood ketones are sometimes used, along with other tests such as blood gases, glucose, and electrolytes to detect ketoacidosis in non-diabetics if they have signs and symptoms of DKA due to, for example, ingestion of excessive amounts of alcohol.

Acetaminophen : labtest

Why Get Tested?
To determine if an overdose has occurred; to determine risk of liver damage; to help determine if treatment with an antidote is required
When to Get Tested?
When it is suspected that a person has ingested an overdose of acetaminophen or has signs and symptoms of toxicity, such as nausea, vomiting, and abdominal pain; when following a patient, every 4 to 6 hours after an overdose of the drug is ingested
Sample Required?
A blood sample drawn from a vein in the arm

How is it used?
The test for acetaminophen is used to measure the level of drug in the blood in order to establish a diagnosis of overdosage, to assess the risk of liver damage, and to help decide on the need for treatment. Prompt diagnosis and treatment are important for a positive outcome.
Since high levels of acetaminophen can be toxic to the liver, tests such as AST and ALT may be used to detect liver damage. A PT may be used to detect impaired liver function.

ACE : labtest

Why Get Tested?
To help diagnose and monitor sarcoidosis; to help differentiate this systemic condition from other disorders causing similar symptoms

When to Get Tested?
When you have granulomas that create small bumps under the skin, a lingering cough, red watery eyes, and/or other symptoms suggestive of sarcoidosis; regularly when you have active sarcoidosis to monitor its course

Sample Required?
A blood sample drawn from a vein in your arm

How is it used?
ACE is primarily ordered to help diagnose and monitor sarcoidosis. It is often ordered as part of an investigation into the cause of a group of troubling chronic symptoms that may or may not be due to sarcoidosis. ACE will be elevated in 50% to 80% of patients with active sarcoidosis. Concentrations of ACE tend to rise and fall with disease activity. If it is initially elevated in someone with sarcoidosis, ACE can be ordered at regular intervals to monitor the course of the disease and the effectiveness of corticosteroid treatment.

Blood Typing : labtest

Why Get Tested?
To determine ABO blood group and Rh type

When to Get Tested?
When you need to be transfused with blood or blood components or when you donate blood at a collection facility; pregnant women are tested to determine the risk of Rh incompatibility between the mother and fetus
Sample Required?
A blood sample drawn from a vein in your arm or from a heelstick in the case of an infant

How is it used?
Blood typing is used to determine your blood group and what type of blood or blood components you can safely receive. It is important to ensure that there is compatibility between a patient who requires a transfusion of blood or blood components and the ABO and Rh type of the unit of blood that will be transfused. A potentially fatal transfusion reaction can occur if a unit of blood containing an ABO antigen to which a patient has an antibody is transfused to that patient. For example, people with blood group O have both anti-A and anti-B antibodies in their blood. If a unit of blood that is group A, B, or AB is transfused to this patient, the antibodies in the patient’s blood will react with the red cells, destroying them and causing potentially serious complications.
If an Rh-negative patient is transfused with Rh-positive blood, it is likely that the patient will produce antibodies against Rh-positive blood. Although this does not cause problems for the patient during the current transfusion, a future transfusion with Rh-positive blood could result in a serious transfusion reaction.

Rh typing is especially important during pregnancy because a mother and her fetus could be incompatible. If the mother is Rh-negative but the father is Rh-positive, the fetus may be positive for the Rh antigen. As a result, the mother’s body could develop antibodies against the Rh antigen. The antibodies may cross the placenta and cause destruction of the baby’s red blood cells, resulting in a condition known as hemolytic disease of the fetus and newborn. To prevent development of Rh antibodies, an Rh-negative mother is treated with an injection of Rh immune globulin during her pregnancy and again after delivery if the baby is Rh-positive. The Rh immune globulin “masks” any Rh antigen from the fetus that the mother may be exposed to during her pregnancy and delivery and prevents her from becoming sensitized and developing antibodies against the Rh antigen.

Blood typing is also used to determine the blood group of potential donors at a collection facility. Units of blood that are collected from donors are blood typed and then appropriately labeled so that they can be used for patients that require a specific ABO group and Rh type.

Blood Gases : labtest

Why Get Tested?
To determine if your lungs are functioning well enough to exchange oxygen and carbon dioxide if you are having symptoms of a respiratory problem; to determine if you have an imbalance in the amount of oxygen gas (O2) or carbon dioxide gas (CO2) in your blood or an acid-base imbalance, which may indicate a respiratory, metabolic, or kidney disorder.

When to Get Tested?
When you have difficulty breathing, shortness of breath, or rapid breathing; when you have symptoms of an oxygen/carbon dioxide imbalance or an acid-base imbalance; periodically when you have a condition that causes an acute or chronic oxygen shortage and you are on oxygen therapy; during certain surgeries to monitor your blood's oxygen and carbon dioxide levels
Sample Required?
Most often a blood sample collected from an artery, usually the radial artery in the wrist, which is located on the inside of the wrist, below the thumb, where you can feel your pulse; sometimes a blood sample drawn from a vein in the arm; capillary blood from a heelstick may be used for babies

How is it used?
Blood gas measurements are used to evaluate your oxygenation and acid/base status. They are typically ordered if you have worsening symptoms of an acid/base imbalance, difficulty breathing, or shortness of breath. Blood gases may be ordered along with other tests, such as electrolytes to determine if an electrolyte imbalance is present, glucose to evaluate blood sugar concentrations, and BUN and creatinine tests to evaluate kidney function.
If you are on continuing supplemental oxygen therapy, blood gases may be used to monitor the effectiveness of that treatment.

Red Blood Cell Antibody Identification : labtest

Why Get Tested?
To identify the specific antibody present when a direct antiglobulin test (DAT) or indirect antiglobulin test (IAT) is positive; to help identify the cause of a transfusion reaction or the cause of hemolytic disease of the newborn (HDN)
When to Get Tested?
When an IAT screening test is positive when performed as part of a prenatal workup or prior to a blood transfusion; when a person has a positive DAT following a suspected transfusion reaction or is suspected to have an autoimmune hemolytic anemia; when a newborn has HDN
Sample Required?
A blood sample drawn from a vein in your arm

How is it used?
Antibody identification is used as a follow-up test to a positive indirect antiglobulin test (IAT). The IAT is typically performed during each pregnancy to determine whether the mother has developed any red blood cell (RBC) antibodies and before RBC transfusions as part of a "type and screen" or "type and crossmatch." The antibody identification test is used to determine the RBC antigen(s) that the antibody or antibodies are directed against to determine if they are likely to be clinically significant, i.e., if they are likely to cause a transfusion reaction or hemolytic disease of the newborn (HDN). Some RBC antibodies are known to cause moderate to severe reactions while other less significant ones may cause a positive IAT but few to no symptoms or complications in the blood transfusion recipient or baby.
If one or more clinically significant RBC antibodies are identified, then donor blood that lacks the corresponding RBC antigens must be used for transfusion. When someone has a condition that requires recurrent transfusions, they are exposed to many foreign RBC antigens and may develop multiple RBC antibodies over time, making the process of finding compatible blood increasingly challenging.

An IAT and antibody identification test may be used as part of an investigation if a person has a transfusion reaction. Sometimes an RBC antibody may be present in such a small quantity that it does not cause a positive IAT during pre-transfusion blood compatibility testing. But after the blood is given to the recipient, it can trigger renewed, rapid antibody production and cause a delayed hemolytic transfusion reaction several days later.

If RBC antibodies have been identified in a pregnant woman, then the baby's condition will be monitored. Whether or not the antibodies will affect the baby's condition depends upon the antibody present, the RBC antigens that the fetus has, and when the mother's antibodies come into contact with the fetus's blood. Some antibodies can cross the placenta from mother to baby and cause HDN.

A1c and eAG : labtest

Why Get Tested?
To monitor a person's diabetes and to aid in treatment decisions; to screen for and/or diagnose diabetes and prediabetes
When to Get Tested?
When first diagnosed with diabetes and then 2 to 4 times per year; as part of a health checkup or if you have symptoms of diabetes
Sample Required?
A blood sample drawn from a vein in the arm or from a fingerstick

How is it used?
The A1c test and eAG calculation are used to monitor the glucose control of diabetics over time. The goal of those with diabetes is to keep their blood glucose levels as close to normal as possible. This helps to minimize the complications caused by chronically elevated glucose levels, such as progressive damage to body organs like the kidneys, eyes, cardiovascular system, and nerves. The A1c test and eAG result give a picture of the average amount of glucose in the blood over the last few months. They can help you and your doctor know if the measures you are taking to control your diabetes are successful or need to be adjusted.
A1c is frequently used to help newly diagnosed diabetics determine how elevated their uncontrolled blood glucose levels have been. It may be ordered several times while control is being achieved, and then several times a year to verify that good control is being maintained.

The A1c test may be used to screen for and diagnose diabetes. However, A1c should not be used for diagnosis in pregnant women, people who have had recent severe bleeding or blood transfusions, those with chronic kidney or liver disease, and people with blood disorders such as iron-deficiency anemia, vitamin B12 anemia, and hemoglobin variants. Also, only A1c tests that have been referenced to an accepted laboratory method (standardized) should be used for diagnostic or screening purposes. In these cases, a fasting plasma glucose or oral glucose tolerance test may be used for screening or diagnosis. Currently, point-of-care tests, such as those that may be used at a doctor's office or a patient's bedside, are too variable for use in diagnosis but can be used to monitor treatment (lifestyle and drug therapies).

Alpha-1 Antitrypsin : labtest

Why Get Tested?
To help diagnose the cause of early onset emphysema and/or liver dysfunction; to establish the risk of developing alpha-1 antitrypsin deficiency-related emphysema and/or liver disease and determine the likelihood that children might inherit the risk
When to Get Tested?
When you show signs of liver disease as an infant or young child, when you develop emphysema before age 40, or when you have a close relative with alpha-1 antitrypsin deficiency
Sample Required?
A blood sample drawn from a vein in your arm

How is it used?
An alpha-1 antitrypsin level is ordered to help diagnose the cause of early onset emphysema, especially when a person does not have obvious risk factors such as smoking or exposure to lung irritants such as dust and fumes.
Alpha-1 antitrypsin is also ordered to help diagnose the cause of persistent jaundice and other signs of liver dysfunction. This is done primarily in infants and young children but may also be done in patients of any age.

Alpha-1 antitrypsin phenotype testing may be ordered if the alpha-1 antitrypsin concentration is lower than normal. It looks at the amount and type of AAT being produced and compares it to normal patterns.

DNA testing may be done as a follow-up to an alpha-1 antitrypsin level and phenotype. Once it has been established that an abnormality exists, then the DNA genetic testing can be ordered to establish which SERPINA1 gene alleles are present. This test does not test for every variant, just the most common ones - M, S, and Z, as well as any that may be common in a particular geographical area or family. Once the affected person’s SERPINA1 gene alleles have been determined, other family members may be tested to establish their own possible risk of developing emphysema and/or liver involvement as well as the likelihood that their children might inherit it.

Test Procedure : 17-Hydroxyprogesterone

Test Procedure   :  17-Hydroxyprogesterone

Why Get Tested?

To screen for, detect, and monitor treatment for congenital adrenal hyperplasia (CAH); sometimes to help rule out other conditions

When to Get Tested?

As part of a routine newborn screen, when an infant has ambiguous genitalia, when a young female has hirsutism or other symptoms of virilization, when a male child has premature sexual development, and periodically to monitor CAH treatment

Sample Required?

A blood sample drawn from a vein in your arm or blood from a heelstick for an infant