Common Pathological Tests

Pathology tests
Pathology means the study of disease and its causes and
progression. Pathology tests cover blood tests, and tests on urine,
stools (faeces) and bodily tissues.
A pathologist interprets the results of blood and pathology tests and
looks for abnormalities that may point to disease, such as cancer
and other chronic illnesses, or health risks, such as pre-diabetes.
Pathology tests can be done on :
blood
urine
faeces
sputum (phlegm or mucus that you cough up)
swabs taken from your nose and throat (such as COVID-19 testing)
swabs taken from elsewhere, such as your skin, cervix or genitals
(for example, cervical screening tests or testing for sexually
transmitted infections)
samples obtained from tissues by needle or biopsy
 Screen for certain health conditions to find them early, before symptoms develop. for
example, a Pap smear or mammogram may reduce the risk of some common women’s
Pathology cancers through early detection)

tests can Identify potential health risks –determining future risk of disease, for example, looking at
cholesterol levels or the risk of inherited conditions such as familial breast cancer)

be used Diagnose a disease – if you’re sick, your doctor may need test results to pinpoint the cause,
and make an accurate diagnosis and treatment plan
to help Track disease prognosis –Blood and pathology tests can help doctors determine disease
to: prognosis (likely health outcome or course of your disease). For eg., if someone has cancer,
your doctor would use tests to work out the stage your disease has reached

Prepare for treatment –doctors may need to take a blood test to determine your blood type
before surgery or transfusion.

Monitor a disease or response to medications – your doctor will order tests to work out
whether your illness is getting better or worse or remaining stable. They may also want to
assess medication levels in your blood and the effects of some medications on your organs.
Can help diagnose, detect and monitor conditions such as:
• allergies
• cancers
• diabetes
• heart disease
• hormone problems
• infections
• inflammatory conditions
• kidney disease
 Common Pathological Tests
1. Complete Blood Count (CBC)
2. Liver Function Tests
3. Iron studies
4. Thyroid function test- TSH (Thyroid Stimulating
Hormone) Quantification
5. Urinalysis
6. INR (International Normalized Ratio)
7. Lipid panel test
8. Basic metabolic panel
9. Comprehensive metabolic panel
10. Cultures
 Complete blood count (CBC)
• A measure of the number of red blood cells, white blood cells, and platelets in the blood. This test gives your doctor
information about the numbers and development of cells in the blood (red cells, white cells, and platelets).
• Abnormalities in the CBC blood test can be caused by anaemia, infections, some blood cancers such as leukaemias
and some inherited conditions. Also called blood cell count, CBC, and full blood count.
A complete blood count (CBC) test measures the following:
• The number of white blood cells (WBC count)
• The number of red blood cells (RBC count)
• The number of platelets
• The total amount of hemoglobin in the blood
• The fraction of the blood composed of red blood cells (hematocrit)

The CBC test also provides information about the following measurements:
• Mean red blood cell volume (MCV)
• Mean hemoglobin amount per red blood cell (MCH)
• The mean amount of hemoglobin relative to the size of the cell (hemoglobin concentration) per red blood cell
(MCHC)
Complete blood count (CBC). Blood is collected by inserting a
needle into a vein and allowing the blood to flow into a tube. The
blood sample is sent to the laboratory and the red blood cells,
white blood cells, and platelets are counted. The CBC is used to
test for, diagnose, and monitor many different conditions.
CBC-Normal Results
Blood counts may vary with altitude. In general, normal results are:
RBC count:
• Male: 4.7 to 6.1 million cells/mcL
• Female: 4.2 to 5.4 million cells/mcL
WBC count:
• 4,500 to 10,000 cells/mcL
Hematocrit:
• Male: 40.7% to 50.3%
• Female: 36.1% to 44.3%
Hemoglobin:
• Male: 13.8 to 17.2 gm/dL
• Female: 12.1 to 15.1 gm/dL
Red blood cell indices:
• Mean corpuscular volume (MCV) : 80 to 95 femtoliter
• Mean Corpuscular Hemoglobin (MCH): 27 to 31 pg/cell
• Mean corpuscular hemoglobin concentration (MCHC): 32 to 36 gm/dL
Platelet count:
• 150,000 to 450,000/dL
 CBC- Interpretation
High RBC, hemoglobin, or hematocrit may be due to:
• A lack of enough water and fluids, such as from severe diarrhea, excessive sweating, or water pills used to treat high blood pressure
• Kidney disease with high erythropoietin production
• Low oxygen level in the blood for a long time, most often due to heart or lung disease, chronic carbon monoxide exposure, or living at a high
altitude
• Polycythemia vera
• Smoking
• Use of testosterone
Low RBC, hemoglobin, or hematocrit is a sign of anemia, which can result from:
• Blood loss ( heavy menstrual periods over a long time)
• Bone marrow failure (for example, from radiation, infection, or tumor)
• Breakdown of red blood cells (hemolysis)
• Cancer and cancer treatment
• Certain long-term (chronic) medical conditions, such as chronic kidney disease, ulcerative colitis, or rheumatoid arthritis
• Iron deficiency
• Leukemia, Multiple myeloma
• Long-term infections such as hepatitis
• Poor diet and nutrition, causing too little iron, folate, vitamin B12, or vitamin B6
 CBC- Interpretation
A lower than normal white blood cell count is called leukopenia. A decreased WBC count may be due to:
• Alcohol abuse and liver damage
• Autoimmune diseases (such as systemic lupus erythematosus)
• Bone marrow failure (for example, due to infection, tumor, radiation, or fibrosis)
• Chemotherapy medicines used to treat cancer
• Disease of the liver or spleen
• Enlarged spleen
• Infections caused by viruses, such as mono or AIDS
• Medicines
A high WBC count is called leukocytosis. It can result from:
• Certain medicines, such as corticosteroids
• Infections
• Diseases such as lupus, rheumatoid arthritis, or allergy
• Leukemia
• Severe emotional or physical stress
• Tissue damage (such as from burns or a heart attack)
CBC- Interpretation
A high platelet count may be due to:
• Bleeding
• Diseases such as cancer or blood disease
• Iron deficiency
• Problems with the bone marrow
A low platelet count may be due to:
• Disorders where platelets are destroyed
• Pregnancy
• Enlarged spleen
• Bone marrow failure (for example, due to infection, tumor, radiation, or
fibrosis)
• Chemotherapy medicines used to treat cancer
 Liver function tests
The liver has a significant role in:
• metabolism,
• digestion,
• detoxification, and
• elimination of substances from the
body.

Liver Function Tests (LFTs) is a group of tests

that are performed together to:
• detect,
• evaluate, and
• monitor liver disease or damage.
Liver function tests
• Alanine aminotransferase (ALT) – an enzyme mainly found in the liver; the best test for
detecting hepatitis
• Alkaline phosphatase (ALP) – an enzyme related to the bile ducts; often increased when they
are blocked
• Aspartate aminotransferase (AST) – an enzyme found in the liver and a few other places,
particularly the heart and other muscles in the body
• Total bilirubin – measures all the yellow bilirubin pigment in the blood. Another test, direct
bilirubin, measures a form combined with another compound in the liver and is often requested
with total bilirubin in infants with jaundice.
• Albumin – measures the main protein made by the liver and tells whether or not the liver is
making an adequate amount of this protein
• Gamma-glutamyl transferase (GGT) - an enzyme found mainly in the liver and is a useful marker
for detecting bile duct problems
• Total protein - measures albumin and all other proteins in blood, including antibodies made to
help fight off infections.
Iron Test
• Iron is needed to help form adequate numbers of normal red blood cells
• Iron is a critical part of haemoglobin, the protein in red blood cells that binds
oxygen in the lungs and releases it as blood travels to other parts of the body.
• Iron is also needed by other cells, especially muscle (which contains another
oxygen binding protein called myoglobin).
• Low iron levels can lead to anaemia, in which the body does not have enough
red blood cells. Other conditions can cause you to have too much iron in your
blood.
Iron Test
• Serum iron - measures the level of iron in the liquid part of your blood.
• Ferritin - measures the amount of stored iron in your body. Ferritin is the main protein that stores iron,
especially in the liver and the bone marrow (the inside cavity in bones, where blood cells are made).
• Transferrin or total iron binding capacity (TIBC) - A laboratory usually measures one of either
transferrin or TIBC. Transferrin is the main transport protein of iron. TIBC is a good indirect measurement
of transferrin.
• Transferrin saturation: this is a calculation that represents the percentage of transferrin that is saturated
with iron. It is a calculation using either the transferrin or TIBC value, when the serum iron concentration is
known.
Thyroid-stimulating hormone tests
• The test measures the amount of thyroid-stimulating hormone (TSH) in your blood.
• TSH is made by the pituitary gland.
• TSH is one of the pituitary gland’s messengers — it tells the thyroid gland to start making thyroid
hormone.
• If too much thyroid hormone (tri-iodothyronine or T3 and thyroxine or T4) is being produced by the
thyroid this sends a signal to the pituitary gland which turns down the production of TSH.
• Conversely, if too little T3 and T4 are being produced the pituitary gland steps up production of
TSH.
• In healthy people this system regulates itself perfectly. However, in thyroid or pituitary diseases the
system becomes unbalanced. The pattern of changes can help diagnose the underlying problem.
• The TSH test looks for or monitors thyroid disorders such as hypothyroidism (insufficient thyroid hormone),
hyperthyroidism(excess thyroid hormone), some cancers, and autoimmune conditions.
 Urinalysis
• Urinalysis is used Urinalysis is used to detect and manage a wide range of problems such
as urinary tract infections, kidney disorders and diabetes.
• Urinalysis involves checking the appearance, concentration and content of urine.

This can be done by:

1. Chemical examination, which tests chemically for a number of substances such as sugar
(glucose), protein and nitrites that provide valuable information about health and disease;
and
2. Microscopic examination, which identifies and counts the type of cells and other
components (bacteria, casts and crystals) that can be present in urine.
Urinalysis- Chemical Examination
• Acidity (pH): indicates the acidity of the urine – abnormal levels may be associated with
kidney stones or kidney disorders or UTI
• Concentration (specific gravity): shows how concentrated the urine is
• Protein: large amounts may indicate a kidney problem
• Glucose (sugar): any detection of sugar usually calls for diabetes testing
• Ketones: any amount of ketones could signal the possibility of diabetes
• Nitrites/leukocyte esterase: a product of white blood cells might be a sign of urinary
tract infection
• Blood: finding blood in urine may be a sign of urinary tract infection but other conditions
such as kidney stones, kidney or bladder cancer or blood disorders can also cause this.
Urinalysis- Microscopic Examination
• White blood cells (pus cells or leukocytes): increased level may be a sign of
infection
• Red blood cells (erythrocytes): an increase may indicate kidney disease, blood
disorder or another conditions such as bladder cancer
• Bacteria or yeasts: may indicate infection (in the presence of symptoms)
• Casts: tube shaped proteins that may indicate kidney disorders
• Crystals: may be a sign of kidney stones