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Notre Dame of Jolo College

Health Sciences Department Pharmacy Program


Clinical Pharmacy with Pharmacotherapeutics 1

Name: ______________________________________ Date Performed _________________________


Course/Year/Section __________________________ Date Submitted: _________________________
Group No: __________________________________ Name of Instructor: R. Jairi, RPh

WORKSHEET NO. 5
LABORATORY AND DIAGNOSTIC TESTS
OBJECTIVES:
After completing this exercise, the student should be able to:
1. Give better patient care due to an enhanced knowledge of laboratory test and give diagnostic
procedure,
2. Interpret the common laboratory results from different body system,
3. List and describe common diagnostic tests often used in clinical setting, and
4. Determine which diagnostic test(s) should be chosen to determine a patient’s suspected disease
state.

INTRODUCTION:

Laboratory tests are medical procedures that involve testing samples of blood, urine, or other
tissues or substances in the body.

Laboratory tests are used to (1) identify changes in the health condition before any symptoms
occur, (2) diagnose a disease or condition before the symptoms, (3) plan the treatment for a disease or
condition, (4) evaluate the response to a treatment, (5) monitor the course of a disease over time.

Pharmacists usually monitor laboratory tests to (1) Assess the therapeutic and adverse effects of
the drugs (e.g. Monitoring the serum uric acid level after propranolol is administered) (2) Determine
proper drug dose (e.g. Assessment of the serum creatinine or creatinine clearance value before giving to
patient with renal impairment) (5) Assess the need for additional or alternate drug therapy (e.g.
Assessment of white blood cell count after antibiotic is given to patient) (4) Prevent test misinterpretation
resulting from drug interference (e.g. Determination of a false positive for a urine glucose test after
cephalosporin administration)

Laboratory tests show whether or not the results fall within normal ranges. Normal test values are
usually given as a range, rather than as a specific number, because normal values vary from person to
person. Laboratory data is presented using the International System Unit (SI Unit) and Conventional
Units.

Interpretation of Test Values


1. Quantitative-tests with normal values reported in range
2. Qualitative-tests with positive or negative outcome
3. Semi quantitative-those varying degrees of positivity

Two types of Diagnostic Test


1. Invasive
2. Non-Invasive

Common Laboratory Tests

Hematological Tests
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Health Sciences Department Pharmacy Program
Clinical Pharmacy with Pharmacotherapeutics 1

Laboratory Tests SI Unit Conventional Unit

COMPLETE BLOOD COUNT


Hemoglobin (Hgb) M 138-172 g/L M 13.8-17.2 g/dL
F 121-151 g/L F 12.1-15.1 g/dL
Hematocrit (Hct) or packed cell M 0.407-0.503 M 40.7-50.0%
volume (PCV) F 0.361-0.443 F 36.1-44.3%
Red Blood Cell (RBC) 4-6.2 x 1012/L 4-6.2 x 106 /µL
White Blood Cell (WBC) 4-10 x 109 /L 4-10 x 103/ µL or
4-10 x 103/ mm³
WBC Differentials
Neutrophils 50-65%
Basophils 1-3%
Eosinophils 0.3%
Lymphocytes 25-35%
Monocytes 2-6%
Platelet Count 140-440 x 109 /L 140-440 x 103/ µL
Prothrombin Time 10-12 sec
Erythrocyte sedimentation rate M 0-20 mm/hr
(ESR) F 0-30 mm/hr

CARDIOVASULAR
Laboratory Tests SI Unit Conventional Unit
Creatinine Phosphokinase (CPK) / M 0.50-3.33 µkat/L M 30-200 IU/L
Creatinine Kinase (CK) F- 0.33-2.83 µkat/L F 20- 170 IU/L
Cholesterol
Desirable Less than 5.18 mmol/L Less than 200 mg/dL
Borderline high 5.18-6.19 mmol/L 200-239 mg/dL
High Greater than or equal to 6.2 Greater than or equal to 240
mmol/L mg/dL
Triglyceride Less than 108 mmol/L Less than 160 mg/dL
Lipid Profile
Low Density Lipoprotein
Desirable Less than 3.36 mmol/L
Borderline high risk 3.36-4.11 mmol/L
High risk Greater than or equal to 4.13
mmol/L
High Density Lipoprotein Greater than 0.91 mmol/L

HEPATOBILIARY AND PANCREAS


Laboratory Tests SI Unit Conventional Unit
Aspartate aminotransferase (AST) 0.18-0.78 µkat/L 11.47.IU/L
(SGOT)
Alanine aminotransferase (ALT) 0.12-0.88 µkat/L 7-53 IU/L
(SGPT)
Notre Dame of Jolo College
Health Sciences Department Pharmacy Program
Clinical Pharmacy with Pharmacotherapeutics 1

Alkaline Phosphatase 0.13-2.10 µkat/L 38-126 IU/L


5’ nucleotidase
Gamma-glutamyl transpeptidase 0.05 µkat/L 0.30 IU/L
(GGT)
Albumin 35-50 g/L 3.5-5.0 g/dL
Amylase 0.42-1.92 µkat/L 25-115 IU/L
Lipase 1.7 µkat/L Less than 100 IU/L

RENAL
Laboratory Tests SI Unit Conventional Unit
Creatinine (Cr) M 62-115 µmol/L M 0.7-1.3 mg/dL
F 53-97 µmol/L F 0.6-1.1 mg/dL
Blood Urea Nitrogen (BUN) 2.9-8.9 mmol/L 8-25 mg/dL
Creatinine Clearance (CrCl) 0.82-1.3 mL/s/m² 85-135 mL/min/1.73 m²

HORMONE
Laboratory Tests SI Unit Conventional Unit
Fasting Blood Sugar (FBS) 3.6-6.0 mmol/L 65-109 mg/dL
HBA1-c 0.04-0.06 4.0-6.0%
Triiodothyronine (T3) 0.91-2.70 nmol/L 45-132 ng/dL
Thyroxine (T4) 58-155 nmol/L 4.5-12 mcg/dL
Thyroid stimulating hormone (TSH) 0.35-6.20 milliunits/L 0.95-6.20 microunits/mL

BONES, JOINTS, AND MUSCLES


Laboratory Tests SI Unit Conventional Unit
Rheumatoid factor Negative
C-reactive Protein test Less than 8 mg/L Less than 8 mg/dL
(CRP)
Uric Acid 179-476 µmol/L 3-8 mg/L

ELECTROLYTE/MINERALS
Laboratory Tests SI Unit Conventional Unit
Sodium 135-145 mmol/L 135-145 mEq/L
Potassium 3.3-4.9 mmol/L 3.3-4.9 mEq/L
Chloride 97-110 mmol/L 97-110 mEq/L
Calcium 2.15-2.58 mmol/L 4.3-5.16 mEq/L
Magnesium 0.65-1.10 mmol/L 1.3-2.2 mEq/L
Iron M 8.1-31.3 µmol/L M 45-160 mcg/dL
F 5.4-31.3 µmol/L F 30-160 mcg/dL
Bicarbonate 22-26 mmol/L 22-26 mEq/L
Phosphate 0.18-1.45 mmol/L 2.5-4.5 mg/dL

RESPRITORY
Laboratory Tests SI Unit Conventional Unit
Arterial Blood Gas
pH 7.35-7.45 7.35-7.45
Notre Dame of Jolo College
Health Sciences Department Pharmacy Program
Clinical Pharmacy with Pharmacotherapeutics 1

PO2 10.6-14.0kPa 80-105 mm Hg


PCo2 4.7-6.0kPa 35-45 mm Hg
HCo3 22-26 mmol/L 22-26 mEq/L
O2 saturation 0.95 Greater than or equal to 95%

TUMOR MARKERS
Laboratory Tests SI Unit Conventional Unit
Alpha fetoprotein (AFP) Less than 40
micrograms/liter
Prostate Specific Antigen Below 4.0 ng/mL
(PSA)
CA 19-9 Less than 37kilounits/L Less than 37 units/mL
CA 125 Less than 35kilounits/L Less than 35 units/mL
CA 15-3 Less than 30kilounits/L Less than 30 units/mL
CA 27-29 Less than 38 kilounits/L Less than 38 units/mL
Carcinoembryonic antigen (CEA) 0 to 2.5 mcg/L

Urine
Specific gravity 1.003-1.029
pH 4.5-7.8
Protein Negative/trace (in concentrated urine)
Glucose Negative
Ketones Negative
Bilirubin Negative
Occult blood Negative
WBCs 0-4/hpf
RBCs 0-2 RBCs/hpf
Casts 0-4/lpf hyaline
Bacteria Negative

COMMON DIAGNOSTIC AID

CARDIOVASCULAR
 Electrocardiogram  Stress Test
 Echocardiography  Cardiac Catheterization (Angiogram)
 Computerized Tomography Scan  Halter-monitoring
 Magnetic Resonance Imaging  Doppler and Ultrasound imaging
 Positron Emission Tomography Scan  Tilt Table test

GASTROINTESTINAL
Viewing the upper gastrointestinal tract:
 Abdominal CT Scan
 Barium Swallow
 Fecal occult blood test
 Upper endoscopy or esophagogastroduodenoscopy (EGD)
Notre Dame of Jolo College
Health Sciences Department Pharmacy Program
Clinical Pharmacy with Pharmacotherapeutics 1

Liver, pancreas, gallbladder and bile duct


 Abdominal Ultrasound
 Endoscopic retrograde cholangiopancreatography (ERCP)
 Percutaneous transhepatic cholangiography (PTCA)
Colon
 Anoscopy
 Colonoscopy
 Barium enema
 Flexible sigmoidoscopy

BONES, JOINT, AND MUSCLE


 Bone density test for osteoporosis  Myelography
 Bone Scan  Back x-rays (spine x-rays)
 Computerized tomography (CT) for
back problems

HORMONAL
 Thyroid Scan

RESPIRATORY
 Chest X-Ray  Pulmonary angiography
 Bronchoscopy  Ventilation Perfusion Lung Scan
 Pulse Oximetry  Skin Test
 Pulmonary Function Test

URINARY
 Cystourethrogram
 Cystoscopy
 Intravenous pyelogram
 Radionuclide scan of the kidneys
 Urinalysis

CANCER
 Biopsy
 X-ray
 Ultrasound
 CT Scan
 MRI
 PET Scan
 Endoscopy
 Mammogram
Notre Dame of Jolo College
Health Sciences Department Pharmacy Program
Clinical Pharmacy with Pharmacotherapeutics 1
Notre Dame of Jolo College
Health Sciences Department Pharmacy Program
Clinical Pharmacy with Pharmacotherapeutics 1

Questions:
1. What is the difference between invasive and non-invasive diagnostic tests? Give examples for
each.
Notre Dame of Jolo College
Health Sciences Department Pharmacy Program
Clinical Pharmacy with Pharmacotherapeutics 1

2. How are the WBC differentials distinguished?

3. What are the different types of Biopsy and define each?

4. What are the different factors than can affect the normal range of the test?

5. Identify the following


a. Alpha fetoprotein (AFP)

b. Prostate Specific Antigen (PSA)

c. CA19-9

d. CA 125

e. CA 15-3

f. CA 27-29

g. Carcinoembryonic antigen (CEA)


ANSWERSHEETS
Laboratory and Diagnostic Tests

Disease associated with abnormal blood values


Test Below Above
CBC
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Health Sciences Department Pharmacy Program
Clinical Pharmacy with Pharmacotherapeutics 1

Hemoglobin (Hbg)

Hematocrit (Hct) or packed cell


volume (PCV)
Red Blood Cell (RBC)

White Blood Cells

WBC Differentials
Neutrophils

Basophils

Eosinophils

Lymphocytes

Monocytes

Platelet Count

Prothrombin Time

ESR

CARDIVASCULAR
CPK/CK

Cholesterol

Triglyceride

Test Below Above


Lipid Profile
Low Density Lipoprotein

High Density Lipoprotein

HEPATOBILIARY AND PANCREAS


Aspartate aminotransferase
(AST) (SGOT)
Notre Dame of Jolo College
Health Sciences Department Pharmacy Program
Clinical Pharmacy with Pharmacotherapeutics 1

Alanine Aminotransferase
(ALT) (SGPT)

Alkaline Phosphatase

5’ nucleotidase

Gamma-glutamyl transpeptidase
(GGT)
Albumin

Amylase

Lipase

RENALS
Creatinine (Cr)

Blood Urea Nitrogen (BUN)

Creatinine Clearance (CrCl)


HORMONE
Fasting Blood Sugar (FBS)

HBA1-c

Triiodothyronine (T3)

Thyroxine (t4)

Thyroid stimulating hormone


(TSH)

Test Below Above


BONES, JOINTS, AND MUSCLES
Rheumatoid factor

C-reactive Protein test (CRP)


Uric acid
ELECTROLYE/MINERALS
Sodium

Potassium

Chloride
Notre Dame of Jolo College
Health Sciences Department Pharmacy Program
Clinical Pharmacy with Pharmacotherapeutics 1

Calcium

Magnesium

Iron

Bicarbonate

Phosphate

RESPIRATORY
Arterial Blood Gas

pH

PO2

HCo3

O2 Saturation

TUMOR MARKERS
Alpha fetoprotein (AFP)

Prostate Specific Antigen (PSA)


CA19-9

CA 125

CA 15-3
CA 27-29
Carcinoembryonic antigen
(CEA)

Matching Type
1. It is a small, portable, battery-powered ECG machine worn by a patient to record heartbeats
on tape over a period of 24 to 48 hours-during normal activities.

2. It records the electrical activity of the heart including the timing and duration of each
electrical phase in the heartbeat
3. It is an x-ray picture of the breast. Screening mammograms are used to check for breast
cancer in women who have no signs or symptoms of the disease.
4. It is a non-invasive test that registers the oxygen saturation of the client’s hemoglobin
5. It is the removal of a small amount of tissue for examination under a microscope.
6. It uses sound waves to create a picture of the internal organs.
7. It uses magnetic fields, not x-rays, to produce detailed images of the body.
Notre Dame of Jolo College
Health Sciences Department Pharmacy Program
Clinical Pharmacy with Pharmacotherapeutics 1

8. It creates pictures of organs and tissues inside the body.


9. It is a computer that combines three dimensional images into a detailed, cross-sectional view
that shows any abnormalities or tumors inside the body.
10. It is scan that evaluates blood flow to the lungs.
11. It is a diagnostic test used to detect abnormalities, such as polyps, ulcers or cancerous
changes, in the rectum and sigmoid colon of the large intestine.
12. It is a test that fills the bladder with the liquid dye that shows up on x-rays. It shows the
motion of the bladder as it fills and empties.
13. It is an x-ray test in which dye is injected directly into the spinal canal to help show places
where the vertebrae in the back may be pinching the spinal cord.
14. It is a test that determines the quantity of air breathe with each breath, how efficiently the
patient move air in and out of the lungs, and how well the lungs are delivering oxygen to the
bloodstream.
15. It is a test that takes pictures of the blood vessels in the heart, to evaluate the health of the
heart and detect any narrowing of the blood vessels or other problems.
16. It is an x-ray and an endoscope to see inside the digestive system and diagnose problems
such as tumors, gallstones, and inflammation in the liver, gallbladder, bile ducts or pancreas
17. It is a tolerance test that indicates whether the heart gets enough blood flow and oxygen
when it’s working it’s hardest, such as during exercise.
18. It is a specialized x-ray to measure the thickness and strength of the bones.
19. It is and endoscope that is inserted to the anus and all the way up through the entire colon to
see any abnormalities.
20. It is black-and-white images of the lungs, ribs, heart, and diaphragm.

A Chest x-ray O Flexible Sigmoidoscopy


B Bone density test P Myelography
C ERCP Q Cardiac catheterization
D Pulmonary Function Test R Stress test
E Cystrourethrogram S Colonoscopy
F Ultrasound T Ventilation Perfusion Lung Scan
G PET SCAN
H Pulse Oximetry
I Mammogram
J Holter Monitoring
K ECG
L Biopsy
M MRI
N CT Scan
Notre Dame of Jolo College
Health Sciences Department
Pharmacy Program
Clinical Pharmacy with Pharmacotherapeutics 1

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