Mosby's Manual of Diagnostic and Laboratory Tests

1. Mosby’s® Manual of Diagnostic & Laboratory Tests - p. i 2. Cover image - p. i 3. Title page - p. ii 4. Disclaimer - p. ii 5. Table of Contents - p. iii 6. Common reference ranges for healthy adults - p. iii 7. Copyright - p. iv 8. Dedication - p. v 9. Quick overview for using this manual - p. vi 10. Preface - p. vii 11. Listing of tests for common clinical problems - p. x 12. List of Illustrations - p. xxiii 13. List of Tables - p. xxiv 14. 1.  Guidelines for proper test preparation and performance - p. 1 15. 2.  Blood studies - p. 6 16. Overview - p. 6 17. Acetylcholine receptor antibody panel (AChR Ab, Anti–AChr antibody) - p. 14 18. Acid phosphatase (prostatic acid phosphatase [PAP], tartrate-resistant acid phosphatase [TRAP]) - p. 16 19. Activated clotting time ([ACT], activated coagulation time) - p. 17 20. Acute kidney injury biomarkers (AKI biomarkers) - p. 19 21. Adiponectin - p. 20 22. Adrenal steroid precursors (androstenediones [ADs], dehydroepiandrosterone [DHEA], dehydroepiandrosterone sulfate [DHEAS], 11-deoxycortisol, 17-hydroxyprogesterone, 17-hydroxypregnenolone, pregnenolone) - p. 21 23. Adrenocorticotropic hormone ([ACTH], corticotropin) - p. 23 24. Adrenocorticotropic hormone stimulation (ACTH stimulation with cosyntropin, cortisol stimulation) - p. 25 25. Adrenocorticotropic hormone stimulation with metyrapone (metyrapone, ACTH stimulation with metyrapone) - p. 26 26. Age-related macular degeneration risk analysis (Y402H and A69S) - p. 28 27. Alanine aminotransferase ([ALT], formerly serum glutamic–pyruvic transaminase [SGPT]) - p. 29 28. Aldolase - p. 30 29. Aldosterone - p. 31 30. Alkaline phosphatase (ALP) - p. 34 31. Alpha-1 antitrypsin (AAT, A1AT, AAT phenotyping) - p. 36 32. Alpha fetoprotein ([AFP], alpha-1 fetoprotein) - p. 37 33. Aluminum (chromium and other heavy metals) - p. 39 34. Amino acid profiles (amino acid screen) - p. 40 35. Ammonia - p. 42 36. Amylase, blood - p. 43 37. Angiotensin - p. 45 38. Angiotensin-converting enzyme (ACE, serum angiotensin-converting enzyme [SACE]) - p. 46 39. Anion gap ([AG], R factor) - p. 47 40. Anticentromere antibody (centromere antibody) - p. 49 41. Antichromatin antibody (antinucleosome antibodies [anti-NCS], antihistone antibody [anti-HST, AHA]) - p. 50 42. Anticyclic citrullinated peptide antibody (citrullinated peptide antibody, [CCP] IgG, anti-CCP) and antimutated citrullinated vimentin (anti-MCV) - p. 51 43. Antidiuretic hormone ([ADH], vasopressin, arginine vasopressin [AVP]) - p. 52 44. Antidiuretic hormone suppression (ADH suppression, water load) - p. 53 45. Anti-DNA antibody (antideoxyribonucleic acid antibodies, antibody to double-stranded DNA, anti-double-stranded DNA [anti-dsDNA], DNA antibody, native double-stranded DNA) - p. 55 46. Antiextractable nuclear antigen ([anti-ENA], antibodies to extractable nuclear antigens, anti–Jo-1 [antihistidyl transfer synthase], antiribonucleoprotein [anti-RNP], antiSmith [antiSm]) - p. 56 47. Anti–factor Xa (anti-Xa) - p. 57 48. Antiglomerular basement membrane antibody ([anti-GBM] antibody, [AGBM], glomerular basement antibody, goodpasture antibody) - p. 59 49. Antiglycan antibodies (Crohn disease prognostic panel, multiple sclerosis antibody panel) - p. 59 50. Antiliver/kidney microsomal type 1 antibodies (anti-LKM-1 antibodies) - p. 60 51. Antimitochondrial antibody (AMA, mitochondrial antibodies) - p. 61 52. Anti-müllerian hormone ([AMH], müllerian-inhibiting substance [MIS], müllerian-inhibiting factor [MIF], müllerian-inhibiting hormone, [MIH]) - p. 62 53. Antimyocardial antibody (AMA) - p. 63 54. Antineutrophil cytoplasmic antibody (ANCA) - p. 64 55. Antinuclear antibody (ANA) - p. 65 56. Antiparietal cell antibody (APCA) - p. 69 57. Antipolymyositis–scleromyositis-75 and PM–Scl-100 antibodies ([PM]–[Scl]-75 and PM/Scl-100 antibodies) - p. 70 58. Anti-RNA polymerase antibody (anti-RNA polymerase I, II, III, [RNAP], [ARA]) - p. 71 59. Antiscleroderma antibody ([Scl]-70 antibody, anti-topoisomerase I, scleroderma antibody, RNA polymerase III antibody) - p. 71 60. Antismooth muscle antibody (ASMA, F-actin smooth muscle antibody) - p. 72 61. Antispermatozoal antibody (sperm agglutination and inhibition, sperm antibodies, antisperm antibodies, infertility screen) - p. 73 62. Anti-SS–A (Ro), anti-SS–B (La), and anti-SS–C antibody (anti-Ro, anti-La, Sjögren antibodies) - p. 75 63. Antithrombin activity and antigen assay (antithrombin III [AT III] activity/assay, functional antithrombin III assay, heparin cofactor, immunologic antithrombin III, serine protease inhibitor) - p. 76 64. Antithyroglobulin antibody (thyroid autoantibody, thyroid antithyroglobulin antibody, thyroglobulin antibody) - p. 78 65. Antithyroid peroxidase antibody ([anti-TPO], [TPO-Ab], antithyroid microsomal antibody, thyroid autoantibody, thyroid microsomal antibody) - p. 79 66. Arterial blood gases (ABGs, blood gases) - p. 80 67. Aspartate aminotransferase ([AST], formerly serum glutamic oxaloacetic transaminase [SGOT]) - p. 88 68. Basic metabolic profile (BMP, chemistry panel, chem 7, sequential multiple analysis [SMA] 7, SMAC 7, chemistry screen) - p. 89 69. Beta-hydroxybutyrate - p. 90 70. Bile acids (cholic acid, chenodeoxycholic acid, deoxycholic acid, ursodeoxycholic acid) - p. 91 71. Bilirubin - p. 92 72. Blood typing (blood group microarray testing) - p. 95 73. Blood urea nitrogen (BUN, urea nitrogen) - p. 99 74. Brain trauma indicator ([BTI], ubiquitin carboxy-terminal hydrolase L1 [UCH-L1], glial fibrillary acidic protein [GFAP]) - p. 101 75. Calcitonin (human calcitonin [HCT], thyrocalcitonin) - p. 102 76. Calcium, blood (total/ionized calcium, [Ca]) - p. 104 77. Cancer tumor markers (tumor markers [TMS], tumor-associated markers) - p. 107 78. Carbon dioxide content (CO2 content, CO2-combining power, HCO3−) - p. 109 79. Carboxyhemoglobin ([COHb], carbon monoxide [CO]) - p. 110 80. Cell-free DNA testing (cell-free fetal DNA testing [cffDNA], liquid biopsy, fluid biopsy, paternity testing, donor-derived cell-free DNA [ddcfDNA]) - p. 112 81. Cell surface immunophenotyping (flow cytometry cell surface immunophenotyping, lymphocyte immunophenotyping, AIDS T-lymphocyte cell markers, CD4 marker, CD4:CD8 ratio, CD4 percentage) - p. 114 82. Ceramides - p. 116 83. Ceruloplasmin (Cp) - p. 117 84. Chloride, blood (Cl) - p. 118 85. Cholesterol - p. 119 86. Cholinesterase ([CHS], pseudocholinesterase [PChE], cholinesterase RBC, red blood cell cholinesterase, acetylcholinesterase) - p. 121 87. Chromosome karyotype (blood chromosome analysis, chromosome studies, cytogenetics, karyotype) - p. 123 88. Coagulating factor concentration (factor assay, coagulating factors, blood-clotting factors) - p. 125 89. Coagulation profile (coagulation panel) - p. 129 90. Cold agglutinins - p. 130 91. Complement assay (total, C3, and C4 complement) - p. 131 92. Complete blood cell count and differential count ([CBC] and diff) - p. 133 93. Comprehensive metabolic panel ([CMP], chem 12, chemistry panel, sequential multiple analysis [SMA] 12, SMA 20) - p. 134 94. Coombs test, direct (direct antiglobulin test [DAT]) - p. 135 95. Coombs test, indirect (blood antibody screening, indirect antiglobulin test [IAT]) - p. 137 96. Corticotropin-releasing hormone stimulation test (CRH stimulation test) - p. 138 97. Cortisol, blood (hydrocortisone, serum cortisol, salivary cortisol total cortisol, free cortisol) - p. 139 98. C-peptide (connecting peptide insulin, insulin C-peptide, proinsulin C-peptide) - p. 141 99. C-reactive protein ([CRP], high-sensitivity C-reactive protein [hs-CRP], ultra-sensitive CRP) - p. 142 100. Creatine kinase (CK, creatine phosphokinase [CPK]) - p. 144 101. Creatinine, blood (serum creatinine) - p. 145 102. Creatinine clearance (CrCl) - p. 147 103. Cryoglobulin - p. 149 104. Cutaneous immunofluorescence antibodies (indirect immunofluorescence antibodies [IFAs], antibasement zone antibodies, anticell surface antibodies) - p. 150 105. Cystatin C - p. 151 106. Cytokines - p. 152 107. Cytolethal distending toxin B (CdtB) and antivinculin antibodies - p. 153 108. d-dimer (fragment d-dimer, fibrin degradation product [FDP], fibrin split products) - p. 154 109. Dexamethasone suppression ([DS], prolonged/rapid DS, cortisol suppression, adrenocorticotropic hormone suppression) - p. 156 110. Diabetes mellitus autoantibody panel (diabetes-associated autoantibodies, insulin autoantibody [IAA], islet cell antibody [ICA], glutamic acid decarboxylase antibody [GAD Ab]) - p. 158 111. 2,3-Diphosphoglycerate ([2,3-DPG] in erythrocytes) - p. 160 112. Disseminated intravascular coagulation screening (DIC screening) - p. 161 113. Drug monitoring (therapeutic drug monitoring [TDM]) - p. 163 114. Epi ProColon (methylated sept9, SEPT9, Septin 9 methylated DNA). - p. 165 115. Erythrocyte fragility (osmotic fragility [OF], red blood cell fragility) - p. 166 116. Erythrocyte sedimentation rate (ESR, sed rate test) - p. 166 117. Erythropoietin (EPO) - p. 168 118. Estrogen fraction (estriol excretion, estradiol, estrone) - p. 169 119. Ethanol (ethyl alcohol, blood alcohol, blood EtOH) - p. 172 120. Factor V-Leiden ([FVL], Leiden factor V, mutation analysis) - p. 173 121. Febrile antibodies (febrile agglutinins) - p. 175 122. Ferritin - p. 175 123. Fetal hemoglobin testing (kleihauer-betke test) - p. 177 124. Fetal scalp blood pH - p. 178 125. Fibrinogen (factor I, quantitative fibrinogen) - p. 180 126. Folic acid (folate) - p. 181 127. Galectin-3 (GAL-3) - p. 183 128. Gamma-glutamyl transpeptidase ([GGTP, g-GTP], gamma-glutamyl transferase [GGT]) - p. 183 129. Gastrin - p. 185 130. Gliadin, endomysial, and tissue transglutaminase antibodies ([tTG], serum antitissue transglutaminase IgA [tTG-IgA], IgA antitissue transglutaminase, IgA anti-tTG, celiac disease testing, celiac disease antibody testing, tTG-IgA test) - p. 186 131. Glucagon - p. 187 132. Glucose measurements (blood sugar, fasting blood sugar, glucose, blood; glycosylated hemoglobin [GHb], glycohemoglobin, glycosylated hemoglobin, hemoglobin [Hb A1c}], diabetic control index) - p. 189 133. Glucose, postprandial (glucose tolerance test [GT, GTT], oral glucose tolerance [OGT]), postprandial (2-hour postprandial glucose [2-hour PPG], 2-hour postprandial blood sugar), 1-hour glucose screen for gestational diabetes mellitus (O’Sullivan test) - p. 192 134. Glucose-6-phosphate dehydrogenase (G-6-PD screen, G-6-PD quantification, glucose-6-phosphate dehydrogenase deficiency [G-6-PD] DNA sequencing) - p. 194 135. Growth hormone ([GH], human growth hormone [HGH], somatotropin hormone [SH]) - p. 196 136. Growth hormone stimulation (GH provocation, insulin tolerance [IT], arginine) - p. 198 137. Haptoglobin - p. 200 138. Heinz body preparation - p. 201 139. Hematocrit ([Hct], packed red blood cell volume, packed cell volume [PCV]) - p. 202 140. Hemoglobin (Hgb, Hb) - p. 205 141. Hemoglobin electrophoresis (Hgb electrophoresis) - p. 208 142. Hexosaminidase (hexosaminidase A, hex A, total hexosaminidase, hexosaminidase A and B) - p. 210 143. HIV drug resistance testing (HIV genotype, HIV tropism) - p. 211 144. HIV RNA quantification (HIV viral load) - p. 213 145. Homocysteine (HCY) - p. 214 146. Human chorionic gonadotropin ([hCG], pregnancy tests, hCG beta subunit) - p. 216 147. Human lymphocyte antigen ([HLA] antigen, HLA-B27 antigen, human leukocyte A antigen, white blood cell antigens, histocompatibility leukocyte A antigen) - p. 218 148. Human placental lactogen ([hPL], human chorionic somatomammotropin [HCS]) - p. 219 149. 21-hydroxylase antibodies - p. 221 150. Immunoglobulin quantification - p. 221 151. Insulin assay - p. 224 152. Insulin-like growth factor ([IGF]-1, somatomedin C, insulin-like growth factor–binding proteins [IGFBPs]) - p. 225 153. Intrinsic factor antibody (IF Ab) - p. 228 154. Iron level (Fe), total iron-binding capacity (TIBC), transferrin, transferrin saturation - p. 229 155. Ischemia-modified albumin (IMA) - p. 232 156. Lactic acid (lactate) - p. 233 157. Lactic dehydrogenase (LDH, lactate dehydrogenase) - p. 234 158. Lactose tolerance (hydrogen breath test) - p. 236 159. Legionnaires’ disease antibody - p. 238 160. Leucine aminopeptidase ([LAP], aminopeptidase cytosol) - p. 239 161. Normal findings - p. 239 162. Indications - p. 239 163. Test explanation - p. 239 164. Procedure and patient care - p. 240 165. Test results and clinical significance - p. 240 166. Lipase (pancreatic lipase, lipoprotein lipase) - p. 240 167. Lipoprotein-associated phospholipase A2 ([Lp-PLA2], PLAC test) - p. 241 168. Lipoproteins and apolipoproteins - p. 242 169. Lipoproteins (high-density lipoproteins [HDL, HDL-C] low-density lipoproteins [LDL, LDL-C], very low–density lipoproteins [VLDL], lipoprotein electrophoresis, lipoprotein phenotyping, lipid fractionation, non-HDL cholesterol, lipid profile) - p. 242 170. Apolipoproteins (apolipoprotein A-I [ApoA-I], Apolipoprotein B [ApoB], lipoprotein [a] [Lp{a}], apolipoprotein E [ApoE]) - p. 242 171. Liver function tests ([LFTs], liver profile, hepatic function panel) - p. 247 172. Luteinizing hormone (LH, lutropin) and follicle-stimulating hormone (FSH) assay - p. 248 173. Lyme disease - p. 250 174. Magnesium (Mg) - p. 252 175. Marijuana (THC) test (cannabinoid or cannabis testing, tetrahydrocannabinol [THC] testing) - p. 253 176. Maternal screen testing (maternal triple screen, maternal quadruple screen) - p. 255 177. Metal testing (lead, arsenic, mercury) - p. 257 178. Metanephrine, plasma free (fractionated metanephrines) - p. 258 179. Methemoglobin (Hemoglobin M) - p. 259 180. Methylated Septin 9 DNA assay (mSEPT9, ColoVantage) - p. 260 181. Microglobulin (beta-2 microglobulin [B2M], alpha 1 microglobulin, and retinol-binding protein) - p. 261 182. Mycoplasma pneumoniae antibodies, IgG and IgM - p. 263 183. Myoglobin - p. 264 184. Natriuretic peptides (atrial natriuretic peptide [ANP], brain natriuretic peptide [BNP], C-type natriuretic peptide [CNP], B-type natriuretic peptide [BNP], ventricular natriuretic peptide, CHF peptides) - p. 265 185. Neuron-specific enolase (NSE) - p. 266 186. Neutrophil antibody screen (granulocyte antibodies, polymorphonucleocyte antibodies [PMN abs], antigranulocyte antibodies, antineutrophil antibodies, neutrophil antibodies) - p. 267 187. Newborn metabolic screening - p. 268 188. 5’-Nucleotidase - p. 271 189. Osmolality, blood (serum osmolality) - p. 271 190. Pancreatic elastase ([PE], elastase-1 [EL1], fecal elastase, pancreatopeptidase) - p. 273 191. Parathyroid hormone (PTH, parathormone) - p. 274 192. Partial thromboplastin time, activated (aPTT, partial thromboplastin time [PTT]) - p. 276 193. Pepsinogen - p. 278 194. Pheochromocytoma suppression and provocative testing (clonidine suppression test [CST], glucagon stimulation test) - p. 279 195. Phosphate (PO4), phosphorus (P) - p. 281 196. Phosphatidylinositol antigen (PI-linked antigen) - p. 283 197. Phospholipase A2 receptor antibodies (anti-PLA2R) - p. 284 198. Phospholipid antibodies (aPL antibodies [aPLA], anticardiolipin antibodies [aCL antibodies, ACA], cardiolipin antibodies, antiphospholipid antibodies, beta-2 glycoprotein 1 antibody, lupus anticoagulant [LA]) - p. 285 199. Placental growth factor ([PGF], soluble fms-like tyrosine kinase-1[sFlt-1]) - p. 286 200. Plasminogen (fibrinolysin) - p. 287 201. Plasminogen activator inhibitor 1 antigen/activity (PAI-1) - p. 288 202. Platelet aggregation - p. 289 203. Platelet antibody (antiplatelet antibody detection) - p. 291 204. Platelet count (thrombocyte count) - p. 292 205. Platelet function assay (platelet closure time [PCT], aspirin resistance tests, bleeding time [BT], 11-Dehydro-thromboxane B2) - p. 295 206. Platelet volume, mean (mean platelet volume [MPV]) - p. 297 207. Potassium, blood (K) - p. 298 208. Prealbumin ([PAB], thyroxine-binding prealbumin [TBPA], thyretin, transthyretin [TTR]) - p. 300 209. Pregnancy-associated plasma protein-a (PAPP-A) - p. 302 210. Procalcitonin (PCT, ProCT) - p. 303 211. Progesterone assay - p. 304 212. Prolactin level (PRL) - p. 306 213. Prostate-specific antigen (PSA) - p. 308 214. Protein (albumin, globulins, total protein) - p. 310 215. Protein C, protein S - p. 313 216. Protein electrophoresis (immunofixation electrophoresis) - p. 315 217. Prothrombin time (PT, pro-time, international normalized ratio [INR]) - p. 321 218. Red blood cell count (RBC count, erythrocyte count) - p. 323 219. Red blood cell indices (RBC indices, mean corpuscular volume [MCV], mean corpuscular hemoglobin [MCH], mean corpuscular hemoglobin concentration [MCHC], blood indices, erythrocyte indices, red blood cell distribution width [RDW]) - p. 326 220. Renin assay, plasma (renin activity, plasma renin activity [PRA], plasma renin concentration [PRC]) - p. 329 221. Reticulocyte count (retic count) - p. 333 222. Rheumatoid factor (RF, rheumatoid arthritis [RA] factor) - p. 335 223. Ribosome P antibodies (ribosomal P Ab, anti-ribosome P antibodies) - p. 336 224. Serotonin (5-hydroxytryptamine [5-HT]) and chromogranin A - p. 336 225. Sickle cell screen (Sickledex, hemoglobin S [Hgb S]) - p. 338 226. Sodium, blood (Na) - p. 339 227. Streptococcus serologic testing (antistreptolysin O titer [ASO], antideoxyribonuclease-B titer [anti-DNase-B, ADB], streptococcus group B antigen detection, streptozyme) - p. 342 228. Syphilis detection (serologic test for syphilis [STS], venereal disease research laboratory [VDRL], rapid plasma reagin [RPR], fluorescent treponemal antibody [FTA]) - p. 344 229. Testosterone (total testosterone serum level) - p. 346 230. Thromboelastography ([TEG], thromboelastometry [TEM]) - p. 349 231. Thrombosis indicators (fibrin monomers [fibrin degradation products {FDPs}], fibrin split products [FSPs], fibrinopeptide A [FPA], prothrombin fragment 1 + 2 [F1 + 2], soluble fibrin monomer complex [SFMC]) - p. 351 232. Thyroglobulin ([Tg], thyrogen-stimulated thyroglobulin) - p. 353 233. Thyroid-stimulating immunoglobulins ([TSIs], long-acting thyroid stimulator [LATS], thyroid-binding inhibitory immunoglobulin [TBII], thyrotropin receptor antibody) - p. 355 234. Thyrotropin (thyroid-stimulating hormone [TSH]) - p. 355 235. Thyroxine, total and free (T4, thyroxine screen, FT4) - p. 357 236. Thyroxine-binding globulin (TBG, thyroid-binding globulin) - p. 359 237. Toxoplasmosis antibody titer - p. 361 238. Transferrin receptor assay (TfR) - p. 362 239. Triglycerides (TGs) - p. 363 240. Triiodothyronine (total T3 radioimmunoassay [T3 by RIA], free T3) - p. 365 241. Troponins (cardiac-specific troponin T [cTnT], cardiac-specific troponin I [cTnI]) - p. 367 242. Uric acid, blood - p. 369 243. Vitamin B12 and methylmalonic acid (MMA) - p. 371 244. Vitamin D (25-hydroxy-vitamin D2 and D3; 1,25-dihydroxyvitamin D [1,25(OH)2D]) - p. 373 245. White blood cell count and differential count (WBC and differential, leukocyte count, neutrophil count, lymphocyte count, monocyte count, eosinophil count, basophil count) - p. 376 246. D-xylose absorption (xylose tolerance) - p. 381 247. Zinc protoporphyrin (ZPP) - p. 383 248. 3.  Electrodiagnostic tests - p. 385 249. 4.  Endoscopic studies - p. 417 250. 5.  Fluid analysis studies - p. 457 251. 6.  Manometric studies - p. 503 252. 7.  Microbiologic studies and associated testing - p. 516 253. 8.  Nuclear scanning - p. 569 254. 9.  Stool tests - p. 611 255. 10.  Ultras ound studies - p. 626 256. 11.  Urine studies - p. 660 257. 12.  X-ray studies - p. 717 258. 13.  Miscellaneous studies - p. 793 259. Illustration credits - p. 847 260. Appendix A.  Alphabetical list of tests - p. 848 261. Appendix B.  Panel testing - p. 858 262. Appendix C.  Abbreviations for diagnostic and laboratory tests - p. 861 263. Index - p. 866 264. Inside back cover - p. 902 265. Inside back cover - p. IBC