A simple explanation of what all

blood, urine, faeces and other pathology tests mean.

 

The reason for performing them,

the normal range of results,

what abnormalities may mean

and the way in which they work.

 

Written for nurses

and patients who

wish to know more about

the way in which doctors investigate illnesses.

 

Written by the author of a pathology guide for doctors

that has been published in 85 countries and eleven languages.

 

Doctors, when faced with a challenging or sometimes relatively routine problem in a patient, reach for a pad of pathology request slips, and start ordering tests, often using obscure abbreviations and terms that are totally beyond the comprehension of those without a medical degree. When the results return, the patient is usually told no more than they are all right or not, and the further explanation is left in the hands of the doctor.

 

Many patients would like to know more. Why is the test being ordered? What is the test? How does it work, and not only what the normal results should be, but what does an abnormal result mean.

 

Nurses also often want to know why their patient is being investigated and what the results may mean.

 

This book will answer those questions in terms that nurses and the average lay person should be able to understand.

 

Every pathology test that can be performed on any bodily fluid is included in this extraordinarily comprehensive guide, from common tests such as a full blood count, to esoteric tests for unusual inherited diseases.

 

Tests can be looked up under both their full name and their abbreviation, and they are arranged under the substance being tested, so that all blood tests are in one section (by far the largest) while urine tests are in another, and even the more obscure tests on substances such as amniotic fluid (around the baby in a pregnant woman’s uterus) and cerebrospinal fluid (from the spinal cord and around the brain) are in their own sections.

 

Each section starts with an explanation of the test substance (eg. blood, urine and how it is collected and tested. Tests that are commonly known (eg. PSA for prostate cancer) and the extremely rare are all covered in this very comprehensive book.

 

Any terms or abbreviations that may be unfamiliar to the reader should be defined in the Definitions or Abbreviations sections near the beginning of the book.

 

At the back, this book has a guide to the less common diseases that may be mentioned in the text so that the conditions mentioned in the pathology section can be better understood.

 

Patients should find this book useful in managing their own health, and nurses in managing the health of their patients.

 

This book and the data it contains, are available for publishing or electronic use.

BOOK MANUSCRIPTS AVAILABLE FOR PUBLICATION

Blood, Urine, Sweat and Even Tears

(Medical Pathology Tests Explained)

EXTRACTS FROM

 BLOOD, URINE, SWEAT

AND EVEN TEARS

 

BLOOD TESTS

 

Activated Partial Thromboplastin Time

[APTT]

NR:    30 to 45 seconds

Ind:    Blood clotting (coagulation) disorders

Int:    HIGH - Treatment with the medication heparin, or blood clotting disorders that require further investigation

Phys:    Nonspecific test measuring numerous blood clotting factors, but not factors VII and XIII

See also Coagulation Screen

 

Activated Protein C Resistance

[APC Resistance]

(Factor V Leiden Mutation)

NR:    Negative (ratio greater than 2.2)

Ind:    Recurrent abnormal blood clotting (thromboembolism).

Int:    POSITIVE (less than 2.0) - Familial thromobophilia (an inherited tendency to develop blood clots in the body).

Phys:    An inherited resistance to the anticoagulant (blood clot prevention) action of activated protein C (a specific protein in blood) resulting in removal of a check on the clotting mechanism. The ratio of clotting time with and without activated protein C is measured.

 

Acute Phase Reactants

See C- Reactive Protein; Erythrocyte Sedimentation Rate

 

Adenosine Deaminase

NR:    Varies between laboratories.

Ind:    Abnormal immune system.

Int:    LOW - Severe immunodeficiency due to lack of adenosine deaminase. Patients are more likely to develop infections and cancers.

Phys:    Rarely used screening test in patients whose recurrent infections and cancers cannot be explained. The test is performed on the red blood cells within blood.

 

ADH

See Antidiuretic Hormone

 

Adrenal Cell Antibodies

[AdCA]

NR:    Absent.

Ind:    Suspected Addison's disease.

Int:    PRESENT - Addison's disease.

Phys:    The adrenal glands sit on top of each kidney, and produce hormones that control the level of vital elements in the body and regulate the breakdown of food. Addison's disease occurs when these glands do not produce sufficient hormone. It is rare, with symptoms of weakness, lack of appetite, diarrhoea and vomiting, skin pigmentation, mental instability, low blood pressure, loss of body hair and absence of sweating. This test measures the antibodies produced in the blood in response to the adrenal gland damage.

 

Adrenocorticotrophic Hormone  

[ACTH]

NR:    10 to 80 ng/L (0 to 0.5 mU/100 mL, 2.2 to 17.8 pmol/L). The  test must be performed in the morning.

Ind:    Diseases of the pituitary gland in the brain.

Int:    LOW  - Under active pituitary gland,  Cushing's disease from taking large doses of cortisone to control a wide range of diseases (including asthma and rheumatoid arthritis), or excess steroid production by other disease processes outside the pituitary gland.

    HIGH - Cushing's disease coming from the pituitary gland (caused by an over production of steroids such as cortisone in the body. Headache, obesity and muscle weakness are common symptoms), adrenal gland insufficiency, a pituitary tumour, and some types of lung cancer (oat cell carcinoma).

Phys:    ACTH is produced in the pituitary gland and stimulates production of some  hormones in the adrenal glands which sits on each kidney. Blood sample should be taken between 8 and 10 am. Rapid assessment and special transportation of the specimen is required.

 

AFP

See Alpha-Fetoprotein

 

AIDS

See HIV Antibody

 

Al

See Aluminium

 

Alanine Amino Transferase

[ALT]

(Alanine Transaminase, Glutamic Pyruvic Transaminase) [SGPT]

NR:    3 to 40 U/L

Ind:    Liver or heart disease.

Int:    VERY HIGH - Severe hepatitis, severe liver damage.

    HIGH - Jaundice due to gall stones or cancer blocking the exit of bile from the liver, persistent hepatitis, liver cancer, cirrhosis, heart attack (myocardial infarct), glandular fever (infectious mononucleosis), Reye syndrome, generalised severe viral infection or alcohol abuse.

    LOW - Kidney failure, lack of vitamin B6.

Phys:    Liver tissue is rich in the enzyme ALT, as are the heart, kidney and muscle. The ALT test  is more liver specific.

See also Aspartate Amino Transferase

 

Albumin  

NR:    35 to 55 g/L (45 to 55%)

Ind:    Used as a guide to the severity and likely outcome of significant liver and other diseases.

Int:    LOW - Severe liver damage (hepatic necrosis), hepatitis, liver cirrhosis, starvation, poor absorption of foods, nephrotic syndrome (a type of  kidney failure), generalised infections, long term  inflammation, autoimmune diseases (body inappropriately rejects its own tissue), heart failure, excess fluid in the body, glomerulonephritis (kidney inflammation), leukaemia, Wilms tumour (kidney cancer) and severe burns. Albumin levels are also lower in pregnancy and the elderly.

    HIGH - Low blood pressure from blood loss, dehydration and steroid treatment. A collection error caused by prolonged application of a  tourniquet can give a false high reading.

 

Alcohol  

[C2H5OH]

(Ethanol)

NR:    Zero

Ind:    Suspected alcohol intoxication.

Int:    Over 0.05 g/100 mL (over 11 mmol/L) - Reflexes impaired. Legally liable in some States.

    From  0.08 to 0.3g/100 mL (17 to 66 mmol/L) - Stuporous

    From 0.3 to 0.5 g/100 mL (66 to 110 mmol/L) - Comatose

    Over 0.5 g/100 mL (over 110 mmol/L) - Potentially fatal

Phys:    Alcohol is absorbed from the stomach and broken down by the liver. In unchanged form, it is excreted from the kidneys at a fixed rate.


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