1

COURSE DESCRIPTION This CE course will describe commonly performed laboratory tests and their usefulness in diagnosis and treatment of disease. The tests are listed by the section of the laboratory where the tests are performed. However, this may vary by facility. The disease states are listed by body system. Please note that these lists are not meant to be all-inclusive.

Rev 3.0 4/2014

2

OBJECTIVES Upon completion of this continuing education course, the professional should be able to: 1. Name the commonly ordered laboratory tests. 2. Describe the usefulness of the commonly ordered laboratory tests in the diagnosis of disease and the maintenance of health. 3. Correlate the most frequently ordered laboratory tests with body system disorders. Disclaimer The writers for NCCT continuing education courses attempt to provide factual information based on literature review and current professional practice. However, NCCT does not guarantee that the information contained in the continuing education courses is free from all errors and omissions.

COURSE TITLE: Common Laboratory Tests & Their Use in

Diagnosis & Treatment

Author: Lucia Johnson, MA Ed, MT(ASCP)SBB Vice President, Recertification NCCT Number of Clock Hours Credit: 3.0 Course # 1221108 P.A.C.E. Approved: Yes _X No

3

INTRODUCTION Laboratory tests are an important, yet often underappreciated, part of healthcare. They are essential for the diagnosis and treatment of illness and maintenance of health. Billions of dollars are spent annually on laboratory tests. Research indicates laboratory test results influence 60% 70% of treatment decisions, but they account for about 3% of Medicare all Medicare Part B payments This CE course describes commonly performed laboratory tests and their usefulness in diagnosis and treatment of disease. The tests are listed by the section of the laboratory where the tests are performed. However, this may vary by facility. The disease states are listed by body system. Please note that these lists are not meant to be all-inclusive.

COMMON LABORATORY TESTS HEMATOLOGY The hematology section performs laboratory tests to identify diseases associated with the blood and blood-forming tissues. Hematology tests assist the physician in diagnosing infections, leukemia, polycythemia, anemia, and other blood abnormalities. The most commonly ordered hematology tests are listed in the following table.

TESTS COMMONLY PERFORMED IN THE HEMATOLOGY SECTION

Body Fluid Analysis

determines the number and type of cells in various body fluids

Bone Marrow Aspiration & Evaluation

determines the number and type of cells in the bone marrow

Erythrocyte Sedimentation Rate

also known as sed rate or ESR; a nonspecific test for inflammatory disorders that determines the rate of red blood cell sedimentation; referred to as sed rate

Flow Cytometry analytic method where cells from blood, bone marrow, or biopsies are sorted and identified by immunofluorescent techniques

Hemoglobin & Hematocrit*

determines the oxygen carrying capacity of red blood cells and the percentage of red blood cells present in the blood; abbreviated as H & H

Hemoglobin Electrophoresis

determines the type and quantity of hemoglobins present in the blood

MCH*

mean corpuscular hemoglobin; determines the average amount of hemoglobin in a population of red blood cells

MCHC* mean corpuscular hemoglobin concentration; determines the average weight of hemoglobin in a red blood cell population and compares it with the size of the cell

MCV* mean corpuscular volume; determines the average size of red blood cells

Platelet Count* frequently abbreviated as plt; determines the number of platelets in the circulating blood

Red Blood Cell (RBC) Count*

determines the number of red blood cells in the circulating blood

RDW* red cell distribution width; calculation of the differences in the size of the red blood cells

Reticulocyte Count

Frequently abbreviated as retic; evaluates the bone marrow production of red blood cells

*part of a Complete Blood Count (CBC)

4

TESTS COMMONLY PERFORMED IN THE HEMATOLOGY SECTION-cont.

Sickle Cell Screen detects the presence of hemoglobin S

White Blood Cell (WBC) Count *

determines the number of white blood cells present in the blood

WBC Differential (Diff)

determines the percentage of the different types of white blood cells and evaluates red blood cell and platelet appearance; WBC types include neutrophil, lymphocyte, monocyte, eosinophil, basophil

*part of a Complete Blood Count (CBC)

COAGULATION The coagulation section of a laboratory evaluates the overall process of hemostasis (the stoppage of blood flow from an injured vessel). This includes the coagulation mechanism and the mechanism that dissolves blood clots. Platelet numbers and function, blood vessel integrity, coagulation factors, fibrinolysis, coagulation inhibitors, and anticoagulant therapy are evaluated in the coagulation section. Disease conditions such as hemophilia and disseminated intravascular coagulation are diagnosed using results of tests performed in this section. A table of the most commonly ordered coagulation tests follows.

TESTS COMMONLY PERFORMED IN THE COAGULATION SECTION

Activated Partial Thromboplastin Time (aPTT or PTT)

evaluates the intrinsic coagulation pathway; monitors heparin therapy

Bleeding Time (BT)

evaluates platelet function

Factor Assays

determines the amount of coagulation factors in the plasma; examples Factor VIII, Factor X

Fibrin Degradation Products (FDP)

tests for increased fibrinolysis

Fibrinogen

determines the amount of fibrinogen in plasma

Platelet Aggregation

evaluates the function of platelets

Prothrombin Time (PT)

evaluates the extrinsic coagulation pathway; monitors Coumadin therapy

Thrombin Time (TT)

determines the ability to convert fibrinogen to fibrin

CHEMISTRY

The chemistry section of the laboratory is often the largest and performs the majority of laboratory tests. Examples of tests performed in this section are glucose, triglycerides, cholesterol, electrolytes (sodium, potassium, chloride, and carbon dioxide), uric acid, creatinine, blood urea nitrogen (BUN), bilirubin, serum proteins, iron, pregnancy tests, cardiac enzymes, liver enzymes, and more. The chemistry section also performs both therapeutic drug monitoring and drugs of abuse detection.

5

TESTS COMMONLY PERFORMED IN THE CHEMISTRY SECTION

Acid Phosphatase

elevated levels indicate prostate cancer

Alanine Aminotrans- ferase (ALT)

elevated levels indicate liver disorders

Albumin decreased levels indicate liver or kidney disorders or malnutrition

Alcohol elevated levels indicate intoxication

Alkaline Phosphatase (ALP)

elevated levels indicate bone or liver disorders

Ammonia

elevated levels indicate severe liver disorders

Amylase elevated levels indicate pancreatic disorders

Aspartate amino- transferase (AST)

elevated levels indicate recent myocardial infarction or liver disorders

Bilirubin often abbreviated as bili; elevated levels indicate liver or hemolytic disorders

Blood Urea Nitrogen (BUN)

elevated levels indicate kidney disorders

B-Type Natriuretic Peptide (BNP)

used to help diagnose and grade the severity of congestive heart failure

Calcium abnormal values associated with bone, musculoskeletal, or endocrine disorders

Cholesterol

elevated levels indicate cardiovascular disease risk

Creatine Kinase (CK)

elevated levels indicate myocardial infarction or other muscle damage

Creatine Kinase (CK) Isoenzymes

determines the extent of muscle or brain damage

Creatinine elevated levels indicate kidney disorders

Creatinine Clearance urine and serum tests used to measure the glomerular filtration rate of the kidney

C-Reactive Protein (CRP)

measures inflammation in the body; can be used as a cardiac diagnostic test, among other things

Drug Screen detects common drugs of abuse

Electrolytes (Lytes) consists of sodium, potassium, chloride, and carbon dioxide; evaluates body fluid balance

Gamma Glutamyl Transferase (GGT)

elevated levels indicate early liver disorders

Glucose

elevated levels indicate diabetes mellitus

Glucose Tolerance Test (GTT)

detects diabetes mellitus or hypoglycemia

High Density Lipoprotein (HDL)

used with other lipid tests to assess cardiovascular disease risk

Lactic Dehydrogenase (LD)

elevated levels indicate myocardial infarction or lung or liver disorders

Lead

elevated levels indicate lead poisoning

Lipase

elevated levels indicate pancreatic disorders

6

TESTS COMMONLY PERFORMED IN THE CHEMISTRY SECTION-cont.

Lithium

monitors levels of the antidepressant drug lithium

Low Density Lipoprotein (LDL)

used with other lipid tests to assess cardiovascular disease risk

Peak/Trough Therapeutic Drug Monitoring (TDM)

measures and monitors levels of certain antibiotics, antidepressants, cardiac drugs, bronchodilators, anti-seizure drugs

Phosphorus abnormal levels associated with skeletal or endocrine disorders

Protein decreased levels associated with liver or kidney disorders

Total Protein (TP) decreased levels indicate liver or kidney disorders

Tumor Markers small proteins in blood that are elevated in certain types of cancer; examples-- CA-125 (ovarian), CEA (colorectal, others), PSA (prostate cancer), CA 15-3 (breast)

Triglycerides often abbreviated as trig, trigs, or trigies; used with other lipid tests to assess cardiovascular disease risk

Uric Acid elevated levels indicate kidney disorders or gout

BLOOD BANK/TRANSFUSION SERVICES

The blood bank section of the laboratory is where blood and blood components donated by volunteers at community blood centers or Red Cross centers are stored and prepared for transfusion. Patients receive transfusions of red blood cells, platelets, fresh frozen plasma, cryoprecipitate, injections of Rh immune globulin, and specially prepared coagulation factors. Blood samples from donors and patients must be carefully tested before a transfusion can be administered so that incompatibility and transfusion reactions can be avoided. Failure to follow patient identification and specimen labeling procedures can cause a patient to die if an incompatible unit is transfused.

TESTS COMMONLY PERFORMED IN THE BLOOD BANK SECTION

ABO & Rh Type (blood type)

identifies the presence or absence of antigens in the ABO and Rh blood group systems; single most important test to do prior to transfusion of blood

Antibody Screen

detects abnormal antibodies to red cell antigens in many blood group systems; sometimes abbreviated as ab sc or aby sc

Antibody Identification

identifies abnormal antibodies to red cell antigens in many blood group systems; presence of abnormal antibodies can lead to problems providing compatible blood

Direct Antihuman Globulin Test (DAT or Direct Coombs)

detects antibodies bound to red blood cell antigens; positive in autoimmune diseases, hemolytic transfusion reactions, hemolytic disease of the newborn

Indirect Antihuman Globulin Test (Indirect Coombs)

same as antibody screen

Transfusion Reaction

a panel of tests performed when a patient has a suspected transfusion reaction; tests are performed to rule out hemolytic reactions

Type & Crossmatch

a panel of tests performed on a patient prior to transfusion of blood; includes ABO & Rh type, antibody screen, and compatibility tests; abbreviated as T&C

Type & Screen (T&S)

a panel of tests performed on a patient when transfusion may occur in the near future; includes and ABO & Rh type and antibody screen

7

IMMUNOLOGY

The immunology section performs tests to evaluate the bodys immune response, i.e., the production of antibodies and cellular activation. Tests in the section detect the presence of antibodies to bacteria, fungi, parasites, viruses, and antibodies produced against body substances (as seen in autoimmune disease).

TESTS COMMONLY PERFORMED IN THE SEROLOGY SECTION

Anti-HIV

screening test for human immunodeficiency virus

Antinuclear Antibody (ANA)

detects autoantibodies against nuclear proteins; seen in systemic lupus erythematosus; rheumatoid arthritis; other disorders

Antistreptolysin O (ASO) titer

detects a previous infection with the streptococcus bacteria

Cold Agglutinins

elevated levels indicate atypical pneumonia (caused by Mycoplasma pneumoniae)

Complement Levels (C3, C4, CH 50)

evaluates the function and activation of the immune system

Cytomegalovirus (CMV) Antibody

detects current or previous infection with cytomegalovirus

Epstein-Barr (EBV) Virus

confirms the presents of infectious mononucleosis

Febrile Agglutinins

detects antibodies to microorganisms causing fever (tularemia, Rocky Mountain Spotted Fever, typhus); not frequently used any longer

Antinuclear Antibody (ANA)

detects autoantibodies against various components of cells

Fluorescent Treponemal Antibody (FTA)

confirms the presence of syphilis (Treponema pallidum) infection

Hepatitis B Surface Antigen (HBsAg)

detects the presence of hepatitis B surface antigen

Hepatitis Panels

detects antigens and antibodies found in viral hepatitis; used to determine if patient has hepatitis A, hepatitis B, or hepatitis C

Herpes simplex (HSV) Virus Antibody

detects past or current infection with herpes virus

Immunoglobulin Levels (IgG, IgM, IgE)

evaluates the function of the immune system

Influenza A/B

screening test for influenza A and influenza B

Monospot

brand name of a screening test for infectious mononucleosis

Polymerase Chain Reaction (PCR)

method used to confirm the presence of infectious diseases that are difficult to grow in culture; i.e., tuberculosis, hepatitis C, HIV, and more

Rapid Plasma Reagin (RPR)

screening test for syphilis (Treponema pallidum) performed on blood

Rheumatoid Arthritis (RA) Factor

detects autoantibodies present in rheumatoid arthritis

Rubella Titer evaluates past or current infection with the organism causing German measles

Strep Group A screening test for group A streptococcus infection (strep throat)

Venereal Disease Research Laboratory (VDRL) test

screening test for syphilis (Treponema pallidum) performed on cerebrospinal fluid

8

MICROBIOLOGY The microbiology section is responsible for the identification of pathogenic microorganisms and for hospital infection control. In large laboratories, the section is divided into bacteriology, mycology, virology, and parasitology. The majority of microbiology specimens are obtained from the blood, urine, throat, sputum, genitourinary tract, wounds, and feces. The tests most frequently performed in the microbiology section are listed in the table that follows.

TESTS COMMONLY PERFORMED IN THE MICROBIOLOGY SECTION

Blood Culture

detects bacteria, yeast, or viruses in the blood

Culture & Sensitivity (C&S)

detects and identifies the type of bacteria causing infection and determines the most appropriate antibiotic treatment

Fungal Culture

detects the presence of and identifies the type of fungal infection

Gram Stain detects the presence of and assists in the identification of bacteria; presumptive diagnosis can sometimes be made from a Gram stain

Occult Blood performed on stool and gastric specimens; detects very small quantities of blood in specimen; sometimes abbreviated as FOB (fecal occult blood)

Ova and Parasites most often performed on stool specimens; detects the presence of and identifies type of parasitic infection; abbreviated as O&P

Viral Culture detects the presence of and identifies the type of viral infection

URINALYSIS

Urinalysis is a routine screening procedure to detect disorders and infection of the kidney and detect metabolic disorders such as diabetes mellitus and liver disease. A routine urinalysis exam consists of physical, chemical, and microscopic examination of the urine.

TESTS COMMONLY PERFORMED IN THE URINALYSIS SECTION

Physical Exam of Urine

evaluates the color and clarity of the urine

Chemical Exam of Urine (dipstick)

most frequently used dipsticks determine the levels of specific gravity, pH, glucose, ketones, protein, blood, bilirubin, urobilinogen, nitrate, and leukocytes

Microscopic Exam of Urine

identifies and quantitates the presence of red blood cells, white blood cells, epithelial cells, casts, bacteria, yeast, parasites, and crystals

ANATOMIC AND SURGICAL PATHOLOGY

Histology This section of the laboratory processes and stains samples of tissues from biopsy, autopsy, and surgery procedures. The prepared slides of specimens are referred to a pathologist for microscopic examination. Malignancy, infection, inflammation, and other disease processes are identified from the microscopic examination.

9

Cytology The cytology section of the laboratory processes body fluids and tissues using a specific method called the Papanicolaou test or Pap smear. The microscopic evaluation of cells processed by the Pap smear technique is useful in the early detection of cancer.

USE OF LABORATORY TESTS IN DIAGNOSIS & TREATMENT SKELETAL SYSTEM

Disorders: arthritis, bursitis, gout, osteomyelitis, osteocondritis, osteoporosis, rickets, tumors Diagnostic Tests: alkaline phosphatase, calcium, complete blood count (CBC), erythrocyte sedimentation rate, phosphorus, synovial fluid analysis, uric acid, vitamin D, biopsy MUSCULAR SYSTEM

Disorders: atrophy, muscular dystrophy, myalgia, tendinitis Diagnostic Tests: autoimmune antibodies, creatine phosphokinase (CK), CK isoenzymes, lactic acid, lactic dehydrogenase (LD), myoglobin, biopsy REPRODUCTIVE SYSTEM

Disorders: cervical cancer, infertility, ovarian cancer, ovarian cyst, prostate cancer, sexually transmitted diseases (STDs), uterine cancer Diagnostic Tests: acid phosphatase, estrogen, follicle stimulating hormone (FSH), human chorionic gonadotropin (HCG), luteinizing hormone (LH), microbiologic cultures, Pap smear, rapid plasma reagin (RPR), testosterone, viral tissue studies, VDRL, FTA, biopsy DIGESTIVE SYSTEM

Disorders: appendicitis, cholecystitis, colitis, diverticulosis, gastritis, gastroenteritis, hepatitis, pancreatitis, peritonitis, ulcer, cancer, tumors, malabsorption syndromes Diagnostic Tests: amylase, bilirubin, carcinoembryonic antigen (CEA), carotene, cholesterol, complete blood count (CBC), glucose, lipase, occult blood, ova and parasitology (O & P), triglycerides, vitamin B12, folate, fecal fat, biopsy

10

ENDOCRINE SYSTEM Disorders:

pituitary disorders: dwarfism, acromegaly, gigantism, diabetes insipidus, tumor

thyroid disorders: congenital hypothyroidism, cretinism, goiter, hyperthyroidism, hypothyroidism, myxedema, tumor

parathyroidism: hypersecretion, hyposecretion, tumor

adrenal disorders: Addisons disease, aldosteronism, Cushings syndrome, tumor pancreatic disorders: diabetes mellitus type I and type II, hyperinsulinism,

hypoglycemia, tumor Diagnostic Tests: adrenocorticotropic hormone (ACTH), aldosterone, antidiuretic hormone (ADH), cortisol, erythropoietin, glucagon, glucose tolerance test (GTT), growth hormone (GH), insulin level, renin, serotonin, thyroid studies (T3, T4, thyroid stimulating hormone {TSH}), biopsy NERVOUS SYSTEM

Disorders: amyotrophic lateral sclerosis (ALS), encephalitis, epilepsy, hydrocephalus, meningitis, multiple sclerosis, neuralgia, Parkinsons disease, shingles, tumor

Diagnostic Tests: acetylcholine receptor antibody, CSF analysis (cell count, glucose, protein, culture), cholinesterase, drug levels, biopsy URINARY SYSTEM

Disorders: renal failure, nephritis, uremia, kidney stones, cystitis, urinary tract infection, tumor Diagnostic Tests: albumin, ammonia, blood urea nitrogen (BUN), creatinine, creatinine clearance, electrolytes, osmolality, urinalysis, urine culture and sensitivity, biopsy INTEGUMENTARY SYSTEM (SKIN, HAIR, NAILS) Disorders: acne, cancer, dermatitis, fungal infections, herpes, impetigo, keloid, pediculosis, pruritis, psoriasis Diagnostic Tests: biopsy, skin scrapings for culture, tissue cultures, microbiology cultures RESPIRATORY SYSTEM

Disorders: upper respiratory infection, tonsillitis, asthma, bronchitis, cystic fibrosis, emphysema, pleurisy, pneumonia, pulmonary edema, tuberculosis, respiratory distress syndrome, respiratory syncytial virus (RSV), rhinitis, tumor

11

RESPIRATORY SYSTEM-continued Diagnostic Tests: alkaline phosphatase, arterial blood gases (ABG), complete blood count (CBC), drug levels, electrolytes, microbiology cultures and sensitivity, pleuracentensis (cell count, glucose, protein, culture), skin tests, biopsy CARDIAC SYSTEM

Disorders: angina pectoris, aortic stenosis, bacterial endocarditis, congestive heart failure (CHF), myocardial infarction (MI) Diagnostic Tests: arterial blood gases (ABG), aspartate aminotransferase (AST), cholesterol, creatine kinase (CK) and CK isoenzymes, electrocardiograph (ECG), lactic dehydrogenase (LD), potassium, triglycerides, lipid ratios, B-type natriuretic peptide (BNP) VASCULAR SYSTEM

Disorders: aneurysm, arteriosclerosis, atherosclerosis, pulmonary embolism, embolus, hemorrhoids, phlebitis, thrombophlebitis, deep vein thrombosis (DVT), varicose veins Diagnostic Tests: disseminated intravascular coagulation (DIC) screen, lipoproteins, protime (PT), activated partial thromboplastin time (aPTT), triglycerides HEMATOPOIETIC/HEMOSTATIC SYSTEMS Disorders: anemia, leukemia, leukocytosis, leukopenia, polycythemia, thrombocytosis, thrombocytopenia, coagulation disorders (hemophilia, von Willebrands disease) Diagnostic Tests: bone marrow aspiration and examination, complete blood count (CBC), white blood cell differential, eosinophil count, erythrocyte sedimentation rate, ferritin, hematocrit (HCT), hemoglobin (HGB), indices (MCV, MCH, MCHC, RDW), iron, total iron binding capacity (TIBC), hemoglobin electrophoresis, coagulation factor assays, activated clotting time (ACT), bleeding time (BT), prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrin degradation products, bone marrow biopsy, flow cytometry LYMPHATIC SYSTEM

Disorders: lymphangitis, lymphadenitis, lymphadenopathy, splenomegaly, Hodgkins disease, lymphosarcoma, lymphoma Diagnostic Tests: biopsy, complete blood count (CBC), mononucleosis tests, culture and sensitivity, bone marrow biopsy, flow cytometry

12

References Lab Tests Online. www.labtestsonline.org Directory of Services and Interpretative Guide. Laboratory Corporation of America. www.labcorp.com The Physicians Guide to Laboratory Test Selection and Interpretation. www.arup.com TEST QUESTIONS Common Laboratory Tests #1221108 Directions:

Before taking this test, read the instructions on how to correctly complete the answer sheets. If taking the test online, log in to your User Account on the NCCT website www.ncctinc.com.

Select the response that best completes each sentence or answers each question from the information presented in the module.

If you are having difficulty answering a question, go to www.ncctinc.com and select Forms/Documents. Then select CE Updates and Revisions to see if course content and/or a test questions have been revised. If you do not have access to the internet, call Customer Service at 800-875-4404.

1. What percentage of treatment decisions are reportedly based on laboratory test results? a. 10-20% b. 30-40% c. 50-60% d. 60-70% 2. Which one of the following tests is a nonspecific test for inflammatory disorders? a. complete blood count b. red cell distribution width c. sedimentation rate d. thrombin time 3. Which one of the following tests determines the type and quantity of hemoglobins present in blood? a. hemoglobin electrophoresis b. hemoglobin and hematocrit c. mean corpuscular hemoglobin d. red blood count

13

4. A white blood cell (WBC) differential determines the __________. a. blood clotting abilities of the white blood cells b. bone marrow production of the white blood cells c. number of white blood cells in the blood d. percentage and type of white blood cells in the blood 5. Which one of the following tests monitors Coumadin therapy? a. activated partial thromboplastin time b. bleeding time c. prothrombin time d. thrombin time 6. Which one of the following tests monitors heparin therapy? a. activated partial thromboplastin time b. bleeding time c. prothrombin time d. thrombin time 7. Which one of the following tests monitors platelet function? a. platelet aggregation b. platelet count c. prothrombin time d. potassium 8. The tests included in electrolyte testing are __________. a. calcium, carbon dioxide, potassium, sodium b. carbon dioxide, chloride, potassium, sodium c. carbon dioxide, chloride, phosphorus, sodium d. carbon dioxide, potassium, lithium, sodium 9. Which one of the following laboratory tests is used to detect pancreatic disorders? a. bilirubin b. creatinine c. lipase d. uric acid 10. Decreased levels of __________ can indicate malnutrition. a. acid phosphatase b. albumin c. cholesterol d. creatinine

14

11. Which of these laboratory tests can be used to identify liver disorders? a. alkaline phosphatase (ALP), ammonia, amylase, bilirubin b. ammonia, bilirubin, c-reactive protein (CRP) , gamma glutamyl transferase (GGT) c. alanine aminotransferase (ALT), ammonia, bilirubin, gamma glutamyl transferase (GGT) d. gamma glutamyl transferase (GGT), phosphorus, protein, total protein 12. An indirect antihumanglobulin test is the same as a/an __________. a. ABO type b. antibody screen c. direct Coombs d. Rh type 13. Which tests are performed prior to a blood transfusion? a. ABO, Rh, antibody screen, compatibility b. ABO, Rh, direct antihuman globulin, compatibility c. Antibody screen, compatibility, direct antihuman globulin d. Antibody identification, compatibility 14. Which test is used to confirm a diagnosis of syphilis? a. antinuclear antibody b. fluorescent treponemal antibody c. IgE, IgG, IgM levels d. rapid plasma reagin 15. Which one of the following is a screening test for infectious mononucleosis? a. antinuclear antibodies b. cold agglutinins c. Monospot b. polymerase chain reaction 16. Which one of the following is NOT a test for syphilis? a. FTA b. RA c. RPR d. VDRL

15

17. Which one of the following tests can be used to detect autoantibodies against nuclear antigens? a. ANA b. ASO c. CH 50 d. CMV 18. Which one of the following tests can be used to detect a current or past infection with German measles? a. ASO titer b. EBV antibodies c. HSV antibodies d. rubella titer 19. A blood culture can detect ________. a. bacteria, yeasts, viruses b. bacteria, parasites, viruses c. fungi d. ova and parasites 20. Occult blood tests can be performed on __________ specimens. a. blood and stool b. blood and gastric c. gastric and stool d. sputum and stool 21. In addition to identifying bacteria, a culture and sensitivity provides information on __________. a. antibiotics useful for treating the identified bacteria b. allergic reactions the patient may have to an antibiotic c. autoantibodies the patient has against an antibiotic d. what antibiotics the patient is currently taking 22. Ova and parasite tests are most often performed on __________ specimens. a. blood b. gastric c. sputum d. stool

16

23. Which one of the four substances below CAN NOT be found in urine using a dipstick? a. blood b. glucose c. potassium d. specific gravity 24. Which of the tests below can be useful in diagnosing and treating skeletal system disorders? a. alkaline phosphatase, human chorionic gonadotropin, myoglobin b. amylase, bilirubin, sedimentation rate c. bleeding time, culture and sensitivity, uric acid d. calcium, phosphorus, vitamin D 25. Amylase, lipase, and vitamin B12 can be useful in diagnosing _________ disorders. a. cardiac system b. digestive system c. reproductive system d. urinary system 26. Which one of the following is an endocrine system disorder? a. Addisons disease b. Hodgkins disease c. Parkinsons disease d. von Willebrands disease 27. Which one of the following is a nervous system disorder? a. Addisons disease b. Hodgkins disease c. Parkinsons disease d. von Willebrands disease 28. Which one of the following is a vascular system disorder? a. aortic stenosis b. deep vein thrombosis c. hemophilia d. lymphoma

17

29. Creatinine, blood urea nitrogen (BUN), and electrolytes can be useful in diagnosing __________ disorders. a. endocrine system b. hematopoietic system c. nervous system d. urinary system 30. Biopsies, skin scrapings, and tissue cultures can be useful in diagnosing __________ disorders. a. lymphatic system b. muscular system c. integumentary system d. vascular systems

*End of Test*