Spectra Laboratories Test Menu

Transcription

1 Spectra Laboratories Test Menu Generated on: Tue, 02 Jan :53: /131 - Spectra Laboratories Test Menu

2 A/G RATIO (CALC) Albumin/Globulin Ratio includes Globulin calculation ml serum (SST Gel Tube) Other Requirements Calculated from Total Protein and Albumin Monitoring of protein loss Calculation: Globulin = Total Protein - Albumin A/G Ratio = (Albumin/Globulin) 1. Hemolyzed Specimen 2. Lipemic Specimen Calculation AAMI STANDARD TESTS Performed only at Spectra - Milpitas, CA 800W - WATER 800A - DIALYSATE Trace water container and Yellow conical tube for dialysate sample 2/131 - Spectra Laboratories Test Menu

3 Other Requirements Test Components: AAMI Chemical Contaminant for Water Aluminum, Antimony, Arsenic, Barium, Beryllium, Cadmium, Calcium, Chromium, Copper, Lead, Magnesium, Mercury, Potassium, Selenium, Silver, Sodium, Thallium, Zinc, Fluoride, Nitrates, Sulfates ph Water ph Water, Resistivity, Conductivity Iron Water Nickel Water Phosphorus Water AAMI Dialysate Analysis Aluminum, Antimony, Arsenic, Barium, Beryllium, Cadmium, Calcium, Chromium, Copper, Lead, Magnesium, Mercury, Potassium, Selenium, Silver, Sodium, Thallium, Zinc, Fluoride, Nitrates, Sulfates ph Dialysate Fluid ph Dialysate Fluid, Resistivity, Conductivity Chemical contaminant Testing - Milpitas Max Allowable Levels UOM Aluminum ICPMS 0.01 mg/l Total Chlorine Not performed in lab; AAMI recommends to perform on site. 0.1 mg/l Copper ICPMS 0.1 mg/l Fluoride IC 0.2 mg/l Lead ICPMS mg/l Nitrate (as N) IC 2 mg/l Sulfate IC 100 mg/l 3/131 - Spectra Laboratories Test Menu

4 Zinc ICPMS 0.1 mg/l Calcium ICPMS 2 (0.05) mmol (mg/dl) Magnesium CPMS 4(0.15) mmol (mg/dl) Potassium CPMS 8(0.2) mmol (mg/dl) Sodium CPMS 70(3.0) mmol (mg/dl) Trace Elements Antimony ICPMS mg/l Arsenic ICPMS mg/l Barium ICPMS 0.1 mg/l Beryllium ICPMS mg/l Cadmium ICPMS mg/l Chromium ICPMS mg/l Mercury ICPMS mg/l Selenium ICPMS 0.09 mg/l Silver ICPMS mg/l 4/131 - Spectra Laboratories Test Menu

5 Thallium ICPMS mg/l 2-5 days 14 days AAMI TRACE ELEMENTS, ALUMINUM Al (Performed only at Spectra - Milpitas, CA) 100 ml, use Spectra Laboratories provided bottle Regular monitoring of AAMI Chemical contaminants Sediments, color, odor 2-5 days M - Sat 14 days TRACE ELEMENTS, IRON Fe (Performed only at Spectra - Milpitas, CA) 50 - WATER 50Y - WATER (NY) 50J - WATER (UNT) 100 ml, use Spectra Laboratories provided bottle Monitoring presence or concentration in water sample Sediments, color, odor 2-5 days Stability 14 days 5/131 - Spectra Laboratories Test Menu

6 TRACE ELEMENTS, NICKEL Ni (Performed only at Spectra - Milpitas, CA) 54 - WATER 54J - WATER (UNT) 100 ml, use Spectra Laboratories provided bottle Monitoring presence or concentration in water sample Sediments, color, odor 2-5 days 14 days TRACE ELEMENTS, PHOSPHORUS P (Performed only at Spectra - Milpitas, CA) 57 - WATER 57J - WATER (UNT) 100 ml, use Spectra Laboratories provided bottle Monitoring presence or concentration in water sample Sediments, color, odor 2-5 days Stability 14 days AAMI TRACE ELEMENTS, ZINC Zn (Performed only at Spectra - Milpitas, CA) 6/131 - Spectra Laboratories Test Menu

7 505 - SERUM 65F - DIALYSATE FLUID 65 - WATER 65J - WATER (UNT) 100 ml, use Spectra Laboratories provided bottle Regular monitoring of AAMI Chemical contaminants Sediments, color, odor 3-5 days 14 days ABO GROUP See Rh for Rh Typing (Performed only at Spectra - Rockleigh, NJ) full lavender tube Other Requirements Tube must be labeled with patient's name Determination of ABO antigen phenotype Hemagglutination 2 days T-Sat Refrigerated 7 days 7/131 - Spectra Laboratories Test Menu

8 ABSOLUTE COLONY COUNT Refer to Colony Count for details ACID FAST (TB) CULTURE BLOOD- PERFORMED AT REFERENCE LAB AFB Culture, Mycobacterial Culture, TB Culture 9326 Collect 7 ml whole blood specimen in Yellow SPS tube. Call Spectra to obtain Yellow SPS tube; Store/transport specimen at room temperature No Acid-Fast Bacilli recovered To isolate, identify, and determine Mycobacterium species Broth-based culture, and smear 6-8 weeks before reported as negative T-Sat ACID FAST (TB) CULTURE OTHER- PERFORMED AT REFERENCE LAB AFB Culture, Mycobacterial Culture, TB Culture 9308 Collect specimen in sterile (orange container) and tighten screw cap securely. Place each specimen in an individual, sealed bag. Keep specimen at refrigerated temperature. No growth To isolate, identify, and determine antimicrobial sensitivity of Mycobacterium species Culture 8/131 - Spectra Laboratories Test Menu

9 6-8 weeks before reported as negative T-Sat ACTIVATED PTT Partial Thromboplastin Time; PTT: Activated (APTT) full light blue top tube (3.2% Sodium Citrate, whole blood) Other Requirements The fistula needle must be flushed thoroughly; draw blood culture bottles and tubes without additives prior to APTT tube Lot Dependent. See patient clinical result report for Exception Value All results are sent to fax/printer Alert Value All results are sent to fax/printer 1. Monitoring of heparin therapy 2. Screening for disorders of coagulation and platelet abnormalities Electromagnetic clot detection Rejection Criteria Incomplete filling of tube, over filling Inadequate flushing of heparin from fistula, catheter Results faxed or sent to client's printer the same day specimen is received Refrigerated 2 days 9/131 - Spectra Laboratories Test Menu

10 ACTIVATED PTT, MID-TREATMENT APTT 252M 1 full light blue top tube (citrated whole blood) NOTE: Must be labeled "MID-TREATMENT" (Refer to APTT for test information) ACTIVATED PTT, POST APTT 252P 1 full light blue top tube (citrated whole blood) NOTE: Must be labeled "POST" (Refer to APTT for test information) ALANINE AMINOTRANSFERASE See ALT/SGPT ALBUMIN (BCG), SERUM ml serum (SST Gel Tube) g/dl Exception Value Tier 4 <2.0 > 6.0 g/dl 1. Evaluation of nutritional status 2. Monitoring of protein loss in dialysis patients Colorimetric 10/131 - Spectra Laboratories Test Menu

11 ALBUMIN, POST Not an orderable test for FMCNA clients 0.5 ml Plasma Gold Post Tube (Refer to Albumin for test information) ALBUMIN/CREATININE RATIO, URINE 115X Yellow Conical Tube, Urine Other Requirements Test components are Albumin, Creatinine in Urine mcg/mg To monitor proper kidney function/albuminuria Calculation: Ratio = Albumin Urine/Creatinine Urine X 1000 M - Sat Calculation ALKALINE PHOSPHATASE ml serum (SST Gel Tube) 11/131 - Spectra Laboratories Test Menu

12 Males: U/L, > 15 yrs Females: U/L, > 15 yrs Exception Value Tier 4 > 700 U/L 1. Aids in the diagnosis of bone disease and/or following its progression 2. Aids in the diagnosis of liver disease Colorimetric 1. Hemolyzed specimen 2. Leaving the specimen at room temperature can lead to falsely elevated results ALPHA FETOPROTEIN Performed at Spectra's reference laboratory. For additional test information, visit: ALT/SGPT Alanine Aminotransferase ml serum (SST Gel Tube) 7-52 U/L Exception Value Tier 4 > 90 U/L 1. Aids in the diagnosis of liver disease 2. Serial measurements help track the course of hepatitis 12/131 - Spectra Laboratories Test Menu

13 Kinetic Hemolyzed specimen ALUMINUM AL ml serum (Royal Blue Tube) Other Requirements Do not centrifuge. Allow to clot minutes before refrigeration 0-10 mcg/l Exception Value Tier 3 > 100 mcg/l Tier 4 > 50 mcg/l Monitoring of aluminum levels in order to detect/limit aluminum toxicity Inductively Coupled Plasma Mass Spectrometry (ICP-MS) at Milpitas Lab; Atomic Absorption Furnace at Rockleigh Lab Lipemia and Hemolysis 5 days /131 - Spectra Laboratories Test Menu

14 7 days AMINOPHYLLINE See Theophylline AMYLASE ml serum (SST Gel Tube) U/L Exception Value Tier 3 > 500 U/L Aids in the diagnosis of pancreatic disease Kinetic 1. Hemolyzed specimen 2. Lipemic specimen (may give falsely low results) ANAEROBIC CULTURE Includes Gram Stain 769 Collect specimen in a blue swab. Keep specimen at ambient temperature. Fluids require sterile container. Keep refrigerated; transport with ice packs. Also indicate source 14/131 - Spectra Laboratories Test Menu

15 No anaerobes isolated To isolate, identify possible anaerobic pathogens in body fluid/aspirates or deep wounds Culture 3 days; interim reports are issued each day M-Sun HEPATITIS C VIRUS ANTIBODY WITH REFLEX TO PCR Anti-HCV with reflex to PCR, Hep C virus Ab rflx PCR SST Gel tubes required Other Requirements Stand to clot and centrifuge immediately. Store at 2 C to 8 C Add-on HCV RNA Quant PCR is not allowed Not detected 1. Aids in the diagnosis of HCV infection 2. Predicts response to therapy and monitors therapy 3. Useful in the differential diagnosis of severe autoimmune Hepatitis and Hepatitis C Chemiluminescence Immunoassay, Nucleic Acid Amplification test PCR (Polymerase Chain Reaction), Real Time v 2.0 Unspun SST and Green-stopper (Heparin) tube. Specimens containing particulate material. Severely hemolyzed, heat-inactivated, or lipemic specimens. 3-5 days M - Sat Anti HCV , the reflexed test if Anti HCV is reactive /131 - Spectra Laboratories Test Menu

16 Notes If Anti HCV results are Reactive or Equivocal, test automatically reflexes to Quantitative HCV PCR to confirm active HCV infection. ANTI-HB CORE, IgM See Hepatitis B Virus Core Antibody IgM ANTI-HB CORE, TOTAL See Hepatitis B Virus Core Total ANTI-HBe See Hepatitis Be Virus Antibody APOLIPOPROTEIN A-1 Apo A1 (Performed only at Spectra - Rockleigh, NJ) ml serum (SST Gel Tube) Other Requirements Fasting specimen preferred mg/dl Assessing risk for coronary artery disease Turbidimetric 1. Hemolyzed specimen 2. Lipemic specimen 2 days /131 - Spectra Laboratories Test Menu

17 2 days Apo A1 cannot be added onto an existing sample APOLIPOPROTEIN B Apo B (Performed only at Spectra - Rockleigh, NJ) ml serum (SST Gel Tube) Other Requirements Fasting specimen preferred mg/dl Assessing risk for coronary artery disease Turbidimetric 1. Hemolyzed specimen 2. Lipemic specimen 2 days days Apo B1 cannot be added onto an existing sample APTT See Activated PTT ASPARTATE AMINOTRANSFERASE See AST/SGOT 17/131 - Spectra Laboratories Test Menu

18 AST/SGOT Aspartate Aminotransferase ml serum (SST Gel Tube) U/L Exception Value Tier 4 > 90 U/L 1. Serial monitoring of liver damage 2. As an indication of other tissue damage Kinetic Hemolysis may cause falsely elevated levels B-TYPE NATRIURETIC PEPTIDE BNP (Performed only at Spectra - Milpitas, CA) ml EDTA plasma (Lavender Top Tube) Other Requirements Plasma frozen; centrifuge and transfer plasma to a transport tube and freeze pg/ml Aids in diagnosis of congestive heart failure Chemiluminescence 18/131 - Spectra Laboratories Test Menu

19 3 days Frozen only, none once thawed BETA-2 MICROGLOBULIN ml serum (SST Gel Tube) mg/l 1. Evaluation of renal disease 2. Evaluation of AIDS progression Turbidimetric Administration of radioactive isotopes within one week prior to the test BICARBONATE ml serum (SST Gel Tube) Other Requirements Do not open tube or expose to air 19/131 - Spectra Laboratories Test Menu

20 22-29 meq/l Exception Value Tier 3 < 12 > 32 meq/l Tier 4 < 20 > 29 meq/l Assessment of acid-base balance Enzymatic days Bicarbonate cannot be added onto an existing sample BICARBONATE, DIALYSATE FLUID 106W 8.0 ml aliquot of dialysate fluid (Yellow Conical Tube) Verification of bicarbonate level of dialysate fluid Enzymatic 5 days Bicarbonate cannot be added onto an existing sample BICARBONATE, POST 106P 20/131 - Spectra Laboratories Test Menu

21 0.5 ml plasma (Gold Post Tube) Do not open tube or expose to air. NOTE: Tube must be labeled "POST" (Refer to Bicarbonate for additional test information) days Bicarbonate cannot be added onto an existing sample BILIRUBIN, DIRECT Conjugated Bilirubin, Bili ml serum (SST Gel Tube) Other Requirements Protect specimen from light mg/dl 1. Along with total bilirubin, provides a means to determine indirect (unconjugated) 2. Aids in the diagnosis of obstructive or hepatic jaundice Colorimetric ; protect from light BILIRUBIN, INDIRECT (CALC) Unconjugated Bilirubin /131 - Spectra Laboratories Test Menu

22 1.0 ml serum (SST Gel Tube) Other Requirements Calculated from Total and Direct Bilirubin mg/dl Calculation: Indirect Bilirubin = Total Bilirubin - Direct Bilirubin Calculation BILIRUBIN, TOTAL Direct and Indirect Bilirubin: Conjugated and Unconjugated Bilirubin ml serum (SST Gel Tube) Other Requirements Protect specimen from light mg/dl 1. Assessment of liver function 2. Differential diagnosis of liver diseases 3. Along with direct bilirubin, provides a means to determine indirect (unconjugated) bilirubin Colorimetric ; protect from light 22/131 - Spectra Laboratories Test Menu

23 BLOOD CULTURE First set 750A - Second set 750B - Third set Two blood culture bottles Other Requirements A blood culture consists of an aerobic and anaerobic bottle collected from the same source at the same time. Inoculate each bottle with at least 10 ml of blood. Gram stains will also be performed from positive cultures only. Also indicate source No aerobic or anaerobic growth after 5 days of incubation NOTE: Blood cultures for set 2 and/or set 3 are available so all results are sent to one patient report. Please ensure the proper label is on the sample bottles. Blood culture- 1st set - order as 750 and use label with prefix 60 for aerobic and anaerobic bottles for set#1. Blood culture- 2nd set - order test 750A on the same requisition as set #1 and use labels with prefix 70 to label aerobic and anaerobic bottles for set #2. Blood culture- 3rd set - order test 750B on the same requisition as set #2 and 3 and use labels with prefix 85 to label aerobic and anaerobic bottles for set #3. There is no longer a need to send multiple sets of Blood cultures under separate requisition numbers. Alert Value Tier 1 All Positives To isolate, identify, and determine antimicrobial sensitivity. This aids in the diagnosis of suspected sepsis, fever of unknown origin (FUO), endocarditis, etc. Culture 5 days; interim reports are issued each day in addition to whenever cultures are positive M-Sun BODY FLUID CULTURE Includes Gram Stain 758 Collect specimen in sterile container, orange top. Keep refrigerated; transport with ice packs. Also indicate source 23/131 - Spectra Laboratories Test Menu

24 Negative Alert Value Tier 2 All Positives To isolate, identify, and determine antimicrobial sensitivity of potential pathogens from a body fluid culture Culture 3 days; interim reports are issued each day M-Sun 87071, BUN Blood Urea Nitrogen ml serum (SST Gel Tube) 6-19 mg/dl 1. Used with Creatinine to monitor dialysis efficacy and/or assess residual renal function 2. Assessment of nutritional status (adequacy of protein intake) Kinetic Hemolysis may cause falsely elevated results /131 - Spectra Laboratories Test Menu

25 BUN, POST Blood Urea Nitrogen, Post ml plasma drawn post-dialysis (Gold Post Tube) Note: Must be labeled "POST" 6-19 mg/dl Assessment of dialysis efficacy (Refer to BUN for test information) BUN/CREATININE RATIO (CALC) ml serum (SST Gel Tube) Other Requirements Calculated using BUN and Creatinine values Assists in the interpretation of lab values in assessing dialysis efficacy and/or residual renal function Calculation: BUN/Creatinine Ratio = Bun Creatinine Hemolysis can alter results Calculation BUN/CREATININE RATIO POST (CALC) See BUN/Creatinine Ratio (Calc) for test information 25/131 - Spectra Laboratories Test Menu

26 128P C-REACTIVE PROTEIN (CRP), WIDE RANGE 147W 0.5 ml serum (SST Gel Tube) mg/l; low/high reference range = mg/l Exception Value Tier 4 > 30 mg/l 1. Elucidation of the cause of non-responsiveness to erythropoietin 2. Monitoring of inflammation, infection or tissue injury Turbidimetric CALCIUM, CORRECTED (CALC) ml serum (SST Gel Tube); not orderable; results automatically provided when Calcium and Albumin are ordered mg/dl Exception Value < 8.0 or > 11.0 mg/dl Alert Value <6.0 or > 13.5 mg/dl Assessment of calcium status and/or hyperparathyroidism Calculation: Calcium (corrected) = Calcium (measured) + (4-albumin) x /131 - Spectra Laboratories Test Menu

27 Hemolysis may result in falsely elevated levels CALCIUM, IONIZED ml serum (SST Gel Tube) Other Requirements Do not open tube or expose to air mg/dl Exception Value Tier 3 < 3.0 > 7.0 mg/dl 1. Evaluation of hypoparathyroidism and hyperparathyroidism Ion-Selective Electrode (ISE) Prolonged exposure of the serum to air causes increase in ph that causes increased ionized calcium level days Ionized calcium cannot be added onto an existing sample CALCIUM, POST 107P 27/131 - Spectra Laboratories Test Menu

28 0.5 ml plasma (Gold Post Tube) NOTE: Must be labeled "POST" (Refer to Calcium for test information) CALCIUM, SERUM TOTAL ml serum (SST Gel Tube) Other Requirements Fasting specimen preferred mg/dl Exception Value Tier 3 < 8.0 > 10.2 mg/dl Alert Value Tier 2 < 7.0 > 12 mg/dl Assessment of calcium status and/or hyperparathyroidism Colorimetric Hemolysis may result in falsely elevated levels CALCIUM/PHOSPHORUS PRODUCT (CALC) ml serum (SST Gel Tube) Other Requirements Calculated from Calcium and Phosphorus 28/131 - Spectra Laboratories Test Menu

29 < Monitoring of calcium levels 2. Monitoring of patient compliance Calculation: Ca X Phos Product = Calcium x Phosphorus Hemolyzed specimen; cells in serum Calculation CALCIUM/PHOSPHORUS PRODUCT, CORRECTED (CALC) Refer to Calcium/Phosphorus for test information 129P Calculation: Corrected Ca X Phos Product = Corrected Calcium X Phosphorus CALCIUM/PHOSPHORUS PRODUCT, POST Refer to Calcium/Phosphorus Product for test information 125P CARBAMAZEPINE (TEGRETOL) 424 Collect one 5.0 ml Red Top Tube - No Gel. Pediatric Collect/Transport: 0.2 ml serum at 2-8 C. After collection keep specimen refrigerated. NOTE: Separate serum from cells ASAP. Unacceptable Conditions: EDTA plasma and samples collected in tubes containing separator gels. Frozen - 6 months Exception Value Tier 3 > 12 mcg/ml Tier 4 > 10 mcg/ml 29/131 - Spectra Laboratories Test Menu

30 Monitoring for therapeutic dosing during Carbamazepine therapy Fluorescence Polarization Immunoassay (FPIA) Gross hemolysis; patients on multiple drugs may experience toxicity at levels within the therapeutic range Therapeutic Range mcg/ml CATHETER EXIT SITE CULTURE Includes Gram Stain 751 Collect specimen in a blue swab. Keep specimen at ambient temperature Negative To isolate, identify, and determine antimicrobial sensitivity of potential pathogens from a catheter site Culture 3 days; interim reports are issued each day M-Sun CD4 ABSOLUTE AND CD4 PERCENT Performed at Spectra's reference laboratory. For additional test information, visit: 30/131 - Spectra Laboratories Test Menu

31 CELL COUNT WITH DIFFERENTIAL 752 Collect specimen in full Lavender Top Tube. Keep specimen at refrigerated temperature Description: Clear, Colorless WBC Count: 0-50/mm 3 WBC differential: Mononuclear cells: % Polymorphonuclear cells: 0-25% Exception Value Tier 3 > 50 mm 3 Alert Value Tier 2 > 100 mm 3 Evaluation of PD Fluid for the presence of cellular elements, differential of WBC, and for physical appearance Microscopic and macroscopic examination/hemocytometer counting chamber days CELL COUNT WITHOUT DIFFERENTIAL 749 Collect specimen in full Lavender Top Tube. Keep specimen at refrigerated temperature Description: Clear, Colorless WBC Count: 0-50/mm³ Exception Value Tier 3 > 50 mm 3 Alert Value Tier 2 > 100 mm 3 Evaluation of PD Fluid for the presence of cellular elements and for physical appearance 31/131 - Spectra Laboratories Test Menu

32 Microscopic and macroscopic examination/hemocytometer counting chamber days CHEMICAL ANALYSES ON DIALYSATE 91C - Dialysate Fluid Panel (Na, K, Cl, Ca) Dialysate Fluid Electrolytes (Na, K, Cl, Bicarbonate, Ca) 91 - Dialysate Fluid Panel (Na, K, Cl, Mg, Ca, Gluc, Bicarbonate) Collect specimen in Yellow Conical Tube Other Requirements Refrigerate specimen immediately after collection (Refer to each individual serum test for detailed information) CHLORIDE ml serum (SST Gel Tube) meq/l Used with other electrolytes to evaluate electrolyte acid-base balance Ion-Selective Electrode (ISE) Hemolyzed specimen /131 - Spectra Laboratories Test Menu

33 82435 Unopened: 5 days, Opened: 24 hours CHLORIDE, POST 105P 0.5 ml plasma (Gold Post Tube) NOTE: Must be labeled "POST" meq/l Used with other electrolytes to evaluate electrolyte acid-base balance (Refer to Chloride for additional test information) Unopened: 5 days, Opened: 24 hours CHOLESTEROL, TOTAL ml serum (SST Gel Tube) Venipuncture immediately after or during the administration of Metamizole (Dipyrone) may lead to falsely low results for Cholesterol, Total. Venipuncture should be performed prior to the administration of Metamizole. Other Requirements 1. Fasting Specimen Preferred 2. Fasting Overnight (12-14 hours) < 200 mg/dl: Desirable mg/dl: Borderline 240 mg/dl: High Risk Aids in the assessment of cardiovascular risk Enzymatic Hemolyzed specimen 33/131 - Spectra Laboratories Test Menu

34 CHOLESTEROL/HDL RATIO (CALC) 118H 0.5 ml serum (SST Gel Tube) Refer to individual test for additional information (Standard) Calculation: Cholesterol/HDL Ratio = Cholesterol HDL Calculation CHOLESTEROL/TRIGLYCERIDE RATIO (CALC) 118T 0.5 ml serum (SST Gel Tube) Refer to individual test for additional information Calculation: Cholesterol/Triglyceride Ratio = Cholesterol Triglyceride Calculation 34/131 - Spectra Laboratories Test Menu

35 CHr See Reticulocyte Hemoglobin Content COLONY COUNT Sources: Water, Dialysate, Bicarbonate DIALYSATE BICARBONATE WATER Collect in a sterile cup with integrated sampling device then transfer sample to a red/gray top vacutainer tube without additive Note: Label the tube with the appropriate label to properly define the source. Other Requirements Refrigerate sample immediately after collection and for at least 2 hours prior to shipment to the laboratory. Ship sample with climatized ice packs. Remove ice packs from freezer 1 hour prior to shipment and allow ice packs to sit at room temperature (climatize). Ship sample on the same day of collection whenever possible. For optimal results, samples must be RECEIVED NEXT DAY after collection. If collected on a Sunday, the specimen must be refrigerated until able to ship on Monday. Do not package until ready for courier pickup. AAMI Standards: Acceptable: < 200 CFU/mL Action Level: 50 CFU/mL Exception Value 50 CFU/mL Alert Value 200 CFU/mL Regular monitoring of the microbiological quality of water and dialysate Heterotrophic Plate Count (HPC)- spread plate technique Rejection Criteria 1. Sample received without ice packs 2. Sample is more than 2 days old 3. Incorrect packaging materials used 4. Inappropriate specimen container used 5. Frozen sample received 2 days 35/131 - Spectra Laboratories Test Menu

36 CREATINE KINASE (CK) CPK, Creatine Phosphokinase ml serum (SST Gel Tube) U/L Detection of acute myocardial infarct (AMI) or skeletal muscle damage or central nervous system damage Kinetic Hemolyzed specimen CREATININE ml serum (SST Gel Tube) mg/dl Exception Value Tier mg/dl Tier 4 < 3.1 mg/dl 1. Aids in the determination of dialysis efficacy 2. As an indicator of renal function Kinetic 36/131 - Spectra Laboratories Test Menu

37 Certain drugs may cause falsely elevated levels CREATININE CLEARANCE, URINE Refer to Urine Creatinine Clearance for a complete description and its specimen requirements CREATININE REDUCTION RATIO (CALC) CRR 170Z 0.5 ml serum (SST Gel Tube) drawn pre-dialysis 0.5 ml serum (Gold Post Tube) drawn post-dialysis Other Requirements Calculated from pre and post-dialysis Creatinine values Provides an indication of hemodialysis adequacy The Creatinine Reduction Ratio is calculated as follows: CRR% = 100 x (1 - Post-dialysis Creatinine/Predialysis Creatinine) Calculation 37/131 - Spectra Laboratories Test Menu

38 CREATININE, POST ml plasma drawn post-dialysis (Gold Post Tube) NOTE: Must be labeled "POST" mg/dl Assessment of dialysis efficacy (Refer to Creatinine for test information) CREATININE, URINE RANDOM 102U Random urine sample in a yellow conical tube Other Requirements 1. Urine should be kept refrigerated after collection. Failure to refrigerate the specimen may yield falsely low results 2. Certain drugs may cause falsely elevated or decreased results As an indicator of renal function (See Creatinine, Urine Timed for additional test information) CREATININE, URINE TIMED Creatinine, 24-Hour Urine 157G 38/131 - Spectra Laboratories Test Menu

39 8.0 ml of a 24 hr urine collection (Yellow Conical Tube) Other Requirements 1. Urine should be kept refrigerated during collection 2. Total urine volume required Males: g/24 hr Females: g/24 hr As an indicator of renal function Kinetic 1. Failure to collect the entire 24-hour urine specimen will lead to a falsely low result 2. Failure to refrigerate the specimen may yield a falsely low result 3. Certain drugs may cause falsely elevated or decreased results CYCLOSPORINE CSAll (Performed only at Spectra - Milpitas, CA) Lavender Top Tube (minimum 1.0 ml, EDTA whole blood) ng/ml Alert Value > 400 ng/ml Used to monitor Renal Transplant EMIT Hemolysis, Icteria, Lipemia 39/131 - Spectra Laboratories Test Menu

40 24 hours Sun-Sat DIALYSATE FLUID ELECTROLYTES (Includes Sodium, Potassium, Chloride, Bicarbonate, Calcium) 190 Aliquot of dialysate fluid in a yellow conical tube Verification of electrolyte concentrations in dialysate fluid prior to patient use Enzymatic, Ion-selective electrode (ISE) 5 days DIGOXIN ml serum (SST Gel Tube) Other Requirements Specimen should be drawn 6 to 8 hours after last dose Exception Value Tier 3 > 2.0 ng/ml Alert Value Tier 2 > 3.0 ng/ml Monitoring for therapeutic dosing during digoxin therapy 40/131 - Spectra Laboratories Test Menu

41 Chemiluminescence 1. Serum potassium, calcium or magnesium imbalances may falsely elevate results 2. Gross hemolysis Therapeutic Range ng/ml DILANTIN (PHENYTOIN), FREE ml serum (Red Top Tube - No Gel) Exception Value Tier 3 > 3.5 mcg/ml Monitoring for therapeutic dosing during phenytoin therapy Fluorescence Polarization Immunoassay (FPIA) Therapeutic Range mcg/ml 41/131 - Spectra Laboratories Test Menu

42 DILANTIN (PHENYTOIN) ml serum (Red Top Tube - No Gel) Exception Value Tier 3 >30 mcg/ml Monitoring for therapeutic dosing during phenytoin therapy Fluorescence Polarization Immunoassay (FPIA) Therapeutic Range mcg/ml EAR CULTURE 778 Collect specimen in a blue swab. Keep specimen at ambient temperature Negative To isolate, identify, and determine antimicrobial sensitivity of potential pathogens from an ear site Culture 2 days M-Sun /131 - Spectra Laboratories Test Menu

43 egfr - CKD-EPI est. Glomerular Filtration Rate - Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation 173C 0.5 ml serum (SST Gel Tube). Label tube with accession/bar code; include patient name Other Requirements Calculated from serum Creatinine value. On the requisition, indicate patient age and gender Predicted GFR is expressed in ml/min/1.73 m 2 Helps health care providers detect CKD among those with risk factors diabetes, hypertension, cardiovascular disease, or family history of kidney disease. egfr-ckd-epi may also be used to monitor patients already diagnosed with CKD. The egfr - EPI is calculated as follows: GFR = 141 min (S cr /κ, 1) α max(s cr /κ, 1) x Age [if female] [if black] 1-2 days Calculation ENDOTOXIN LAL Sources: Water, Dialysate, Bicarbonate 851B Bicarbonate 851D Dialysate 851C Dialysate Concentrate Water Collect in a sterile cup with integrated sampling device then transfer sample to a clear top vacutainer tube without additive. Note: Label the tube with the appropriate label to properly define the source. 43/131 - Spectra Laboratories Test Menu

44 Other Requirements Refrigerate specimen immediately for at least 2 hours prior to shipment and allow ice packs to sit at room temperature (climatize). Ship sample on the same day of collection whenever possible. For optimal results, samples must be RECEIVED NEXT DAY after collection. If collected on a Sunday, the specimen must be refrigerated until able to ship on Monday. Do not package until ready for courier pick up. AAMI Standards: Acceptable: < 2.0 EU/mL Action Level: 1.0 EU/mL Exception Value 1.0 EU/mL Alert Value 2.0 EU/mL Regular monitoring of the microbiological quality of water and dialysate Quantitative Kinetic Chromogenic Rejection Criteria 1. Sample received without ice packs 2. Sample is more than 2 days old 3. Incorrect packaging materials used 4. Inappropriate specimen container used 5. Frozen sample received ERYTHROCYTE SEDIMENTATION RATE See Sedimentation Rate, ESR EYE CULTURE 779 Collect specimen in a blue swab. Keep specimen at ambient temperature Other Requirements Gram stain included Negative To isolate, identify, and determine antimicrobial sensitivity of potential pathogens from an eye site Culture 44/131 - Spectra Laboratories Test Menu

45 2 days M-Sun Fast Peritoneal Equilibration Test Fast PET 21 Serum Glucose and Creatinine at 4 hours (SST Gel Tube) Dialysate Glucose and Creatinine at 4 hours (Yellow Conical Tube labeled 4 hours) Other Requirements Steps for performing PET Step 1: 8-12 hours "overnight" 2 L, 2.5% dextrose dwell Step 2: Prepare 2 L, 2.5% dextrose solution Step 3: Drain "overnight" dwell. If submitting sample, collect 8.5 ml PD Fluid in Yellow Conical Tube. Label Timed PD Fluid Step 4: Infuse fresh solution. 400 ml per 2 minutes. Note 0 hour dwell. Step 5: Collect 8.5 ml PD Fluid in Yellow Conical Tube at 0 hour dwell time. Label PD Fluid 0 hr Step 6: Collect 8.5 ml PD Fluid in Yellow Conical Tube at 2 hour dwell time. Label PD Fluid 2 hr Step 7: Collect and spin SST at 2 hour dwell time. Step 8: Drain exchange at 4 hour dwell time. Record volume. Step 9: Collect 8.5 ml PD Fluid in Yellow Conical Tube from 4 hour dwell. Label PD Fluid 4 hr Step 10: Refrigerate and ship samples. Fast PET Calculations Step 1: Plot 4 hr Peritoneal Dialysate Glucose to determine Glucose Transport Classification 4 hr D/P = 4 hr Peritoneal Dialysate Fluid Creatinine/ Serum Creatinine This determines Creatinine Transport Classification Step 2: Additional Patient Solute Transport may be obtained by plotting the Post PET Drain Volume. 2 days FERRITIN /131 - Spectra Laboratories Test Menu

46 0.5 ml serum (SST Gel Tube) Males: ng/ml; Females: ng/ml 1. Assessment of a patient's iron stores 2. Aids in the differential diagnosis of anemia Chemiluminescence 1. Gross hemolysis 2. Gross lipemia 2 days FOLATE, RBC Performed only at Spectra - Rockleigh, NJ full Lavender Top Tubes (EDTA whole blood) Other Requirements 1. Gently invert both tubes 2. Immediately freeze one lavender tube; ship frozen 3. Store and ship the second full lavender tube refrigerated ng/ml 1. Detection of folic acid deficiency 2. Evaluation of anemia/response to therapy Chemiluminescence Bacterial contamination may invalidate results 46/131 - Spectra Laboratories Test Menu

47 2 days T-F RBC Folate cannot be added onto an existing sample FOLATE, SERUM Folic Acid ml serum (SST Gel Tube) Other Requirements 1. Fasting specimen preferred 2. Protect specimen from light 3. Refrigerate ng/ml 1. Detection of folic acid deficiency 2. Evaluation of anemia/response to therapy Chemiluminescence 1. Hemolysis falsely elevates results 2. Specimen not protected from light /131 - Spectra Laboratories Test Menu

48 FOLLICLE STIMULATING HORMONE Performed at Spectra's reference laboratory. For additional test information, visit: FRUCTOSAMINE, SERUM Glycated Serum Protein ml serum (SST Gel Tube) Other Requirements Fasting specimen preferred mcmol/l Monitor diabetic control over a shorter period of time (2-3 weeks) than that represented by glycated hemoglobin (4-8 weeks) Colorimetric Albumin levels < 3.0 may falsely lower Fructosamine FUNGAL (MYCOLOGY) CULTURE Mold Culture, Yeast Culture (Performed only at Spectra - Rockleigh, NJ) 775, 742 Culture, Fungus (PDF) Collect specimen in a blue swab. Keep specimen at ambient temperature, OR collect in a sterile container, orange top. Keep refrigerated; transport with ice packs. Also indicate source 48/131 - Spectra Laboratories Test Menu

49 No Fungi isolated To isolate and identify fungus from a culture specimen Culture 4 weeks; interim reports will be issued at 48 hrs, 1 week, 2 weeks, 3 weeks, 4 weeks or whenever the cultures are positive M-Sun or FUNGAL CULTURE (BLOOD ONLY) 777 This culture consists of an aerobic and anaerobic bottle collected from the same source at the same time. Inoculate each bottle with at least 10 ml of blood. Gram stains performed on positive cultures only. Also indicate source No Fungi isolated To isolate and identify fungus from a blood culture specimen Culture 4 weeks; interim reports will be issued at 48 hrs, 1 week, 2 weeks, 3 weeks, 4 weeks or whenever the cultures are positive M-Sun GAMMA GLUTAMYL TRANSFERASE GGT, GGTP ml serum (SST Gel Tube) 49/131 - Spectra Laboratories Test Menu

50 Other Requirements Fasting specimen preferred; patients should refrain from alcohol for 24 hours prior to the test Males: 8-61 U/L Females: 5-36 U/L Evaluation of progression of liver disease and hepatic metastasis Kinetic Hemolyzed specimen GC (GONORRHEA) CULTURE Culture for GC only, Gonorrhea Culture, JEMBEC Culture 768 Collect specimen in a blue swab. Keep specimen at ambient temperature OR, collect in a sterile container, orange top. Keep refrigerated; transport with ice packs. Also indicate source Gonorrhea not recovered Alert Value Tier 4 All Positives To isolate and identify gonorrhea from a culture specimen Culture 2 days M-Sun /131 - Spectra Laboratories Test Menu

51 GENITAL CULTURE 767 Collect specimen in a blue swab. Keep specimen at ambient temperature. Normal genital flora To isolate, identify, and determine sensitivity of potential pathogens from the genital area. Aids in the diagnosis of suspected genital infection (not gonorrhea) Culture 2 days M-Sun GENTAMICIN, PEAK 420P 0.5 ml serum (Red Top Tube - No Gel). Peak is drawn minutes after IM injection or 60 minutes after IV infusion. NOTE: Label tube as Peak Exception Value Tier 3 > 10.0 mcg/ml Monitoring for therapeutic/safe dosing during Gentamicin therapy (Refer to Gentamicin, Random for remaining test information) Therapeutic Range mcg/ml (Peak) GENTAMICIN, RANDOM 420R 0.5 ml serum (Red Top Tube - No Gel) 51/131 - Spectra Laboratories Test Menu

52 Exception Value Tier 3 > 10.0 mcg/ml Monitoring for therapeutic/safe dosing during Gentamicin therapy Fluorescence Polarization Therapeutic Range mcg/ml (Peak) < 2.0 mcg/ml (Trough) GENTAMICIN, TROUGH 420T 0.5 ml serum (Red Top Tube - No Gel). Trough drawn within 30 minutes of next scheduled dose. NOTE: Label tube as Trough Exception Value Tier 3 > 4.0 mcg/ml Tier 4 > 2.0 mcg/ml Monitoring for therapeutic/safe dosing during Gentamicin therapy (Refer to Gentamicin, Random for remaining test information) Therapeutic Range < 2.0 mcg/ml (Trough) GLUCOSE Blood Sugar 52/131 - Spectra Laboratories Test Menu

53 ml serum (SST Gel Tube) mg/dl Exception Value Tier 4 >250 mg/dl Alert Value Tier 2 < 50 > 500 mg/dl 1. Evaluation of blood sugar levels 2. Evaluation of carbohydrate metabolism Enzymatic GLUCOSE, ESTIMATED AVERAGE 525E 1 full Lavender Top Tube (EDTA whole blood) Calculation eag = (28.7 X A1C) eag (estimated average glucose) M - Sat Calculation 53/131 - Spectra Laboratories Test Menu

54 GLUCOSE, POST 116P 0.5 ml plasma (Gold Post Tube) NOTE: Must be labeled "POST" (Refer to Glucose for test information) GRAM STAIN 753 Representative sample using a sterile swab. Keep specimen at ambient temperature, OR collect in a sterile container, orange top. Keep refrigerated; transport with ice packs. Also indicate source Dependent on source of specimen (See Patient's Report) Microscopic observation of stained microorganisms Gram Stain M-Sun Haptoglobin Performed only at Spectra - Rockleigh, NJ ml serum (SST Gel Tube) Other Requirements Serum free of gross lipemia and hemolysis mg/dl 54/131 - Spectra Laboratories Test Menu

55 Decreased to absent levels occur more with intravascular than extravascular hemolysis: haptoglobin binds hemoglobin, and carries it to the reticuloendothelial system. Thus, haptoglobin is useful in work-up for hemolytic states. It is low in the megaloblastic anemias, which have a hemolytic component. It is decreased in infectious mononucleosis. Decreases can occur with hematoma or tissue hemorrhage. Hapatoglobin can be low with liver disease. Congenital absence occurs (small fraction of African Americans/Asians have ahaptoglobinemia, absence of detectable haptoglobin). Frequently elevated as an acute phase reactant, in inflammatory disorders (e.g., collagen diseases, infections, tissue destruction, and with advanced malignant neoplasms). Turbidimetry Grossly hemolyzed specimens Refrigerated 7 days HCV GENOTYPE BY SEQUENCING HCV Genotype; Performed at Spectra's reference laboratory; For additional information, visit Small SST allowed to clot and spin Other Requirements Refrigerate. Will be poured off and frozen at the lab. This test is run by our reference laboratory at ARUP. On report Determining subtypes of HCV for treatment purposes RT-PCR / Genetic sequencing May be unable to perform test if viral load is log3.6 or 4000 IU/mL 3-6 days 55/131 - Spectra Laboratories Test Menu

56 Sun-Sat Refrigerated: 3 days Ambient temperature: 6 hours HDL CHOLESTEROL High-Density Lipoprotein Cholesterol ml serum (SST Gel Tube) Other Requirements Fasting specimen preferred <40 mg/dl - Low HDL Cholesterol 60 mg/dl - High HDL Cholesterol Risk assessment of coronary heart disease Enzymatic HEMATOCRIT HCT 200D 56/131 - Spectra Laboratories Test Menu

57 1 full Lavender Top Tube (EDTA whole blood) NOTE: One tube is sufficient for all hematology tests Other Requirements Specimen must be stored and transported cold with ice packs as HCT values can rise artifactually if left at room temperature Males: 42-52% Females: 37-47% Exception Value Tier 3 < 24% Alert Value Tier 2 < 20% > 50% 1. Evaluation of anemia 2. Determination of efficacy of erythropoietin therapy Automated calculation from MCV and RBC 1. Hemolyzed specimen 2. Specimen storage at room temperature can increase MCV, which in turn can lead to false elevations in HCT days HEMOGLOBIN Hgb 200C 1 full Lavender Top Tube (EDTA whole blood) NOTE: One tube is sufficient for all hematology tests Males: g/dl Females: g/dl Exception Value Tier 3 < 9.0 > 14.0 g/dl 57/131 - Spectra Laboratories Test Menu

58 Alert Value Tier 2 < 8.0 > 18.0 g/dl 1. Evaluation of anemia 2. Determination of efficacy of erythropoietin therapy Colorimetric Results falsely elevated by lipemic samples, chylomicrons, or extremely high bilirubin days HEMOGLOBIN A 1C HbA 1c full Lavender Top Tube (EDTA whole blood) % Provides an indication of how well blood glucose levels have been controlled over the previous 3 month period Immunoturbidimetric Falsely decreased values can occur in the presence of anemia /131 - Spectra Laboratories Test Menu

59 HEMOGLOBIN ELECTROPHORESIS Performed at Spectra's reference laboratory. For additional test information, visit: HEMOGRAM A Hemogram includes the following individual test components: RBC (Red Blood Cell) WBC (White Blood Cell) HCT (Hematocrit) HGB (Hemoglobin) MCV (Mean Corpuscular Volume) MCH (Mean Corpuscular Hemoglobin) MCHC (Mean Corpuscular Hemoglobin Concentration) RDW (Red Cell Distribution Width) full Lavender Top Tube (EDTA whole blood) NOTE: One tube is sufficient for all hematology tests. You can also order the following Hemogram tests: Hemogram with Platelet Hemogram with Differential and Platelet Alert Value See individual test components See individual test components 1. Evaluation of the cellular components of the blood as part of an evaluation for anemia 2. Monitoring of response to routine adjunctive or erythropoietin therapy for anemia 3. Evaluation of symptoms of infection 4. Also see individual test components See individual test components 1. Hemolyzed sample 2. Clotted sample 3. Incompletely filled tube 4. Diluted sample obtained from fistula needle which was not cleared of saline/heparin 5. Also see individual test components 59/131 - Spectra Laboratories Test Menu

60 See individual test components for CPT information Refrigerated 3 days HEPATITIS A VIRUS ANTIBODY, IgM Anti-HAV IgM, HAV-Ab IgM ml serum (SST Gel Tube) Negative This assay is indicated for use as an aid in the diagnosis and monitoring of acute or recent Hepatitis A virus infection Chemiluminescence 2 days Refrigerated 2 days HEPATITIS A VIRUS ANTIBODY, TOTAL Anti-HAV Total, HAV-Ab Total ml serum (SST Gel Tube) Negative 60/131 - Spectra Laboratories Test Menu

61 Assessment of Hepatitis A infection Chemiluminescence 2 days HEPATITIS B VIRUS CORE ANTIBODY, IgM Anti-HB Core IgM ml serum (SST Gel Tube) Negative Indicates acute Hepatitis B infection Chemiluminescence 2 days HEPATITIS B VIRUS CORE ANTIBODY, TOTAL Anti-HBc Total 61/131 - Spectra Laboratories Test Menu

62 ml serum (SST Gel Tube) Negative 1. Differential diagnosis of Hepatitis 2. In conjunction with other Hepatitis B markers, to assess the stage of infection Chemiluminescence 2 days HEPATITIS B VIRUS DNA QUANTITATIVE BY PCR HBV DNA Quant RT-PCR SST Gel tube required This test requires a separate SST Gel tube. Other Requirements Stand to clot then centrifuge immediately. Store at 2 C to 8 C. Add-on HBV DNA Quant PCR is not allowed. Not detected 1. Aids in the management of patients with chronic HBV infection undergoing antiviral therapy 2. Can be used to measure HBV DNA levels at baseline and during treatment to aid in assessing response to treatment Nucleic Acid Amplification test PCR (Polymerase Chain Reaction) Real Time v /131 - Spectra Laboratories Test Menu

63 Unspun SST Severely hemolyzed, heat-inactivated or lipemic specimens 3-5 days M - Sat (IU/mL) (log IU/mL) HEPATITIS B VIRUS SURFACE ANTIBODY HBsAb, anti-hbs ml serum (SST Gel Tube) < 10 miu/ml, Non- Immune Indicates clinical recovery or immunity to Hepatitis B and monitors response to vaccine Chemiluminescence Specimens containing precipitate 2 days HEPATITIS B VIRUS SURFACE ANTIGEN HBsAg, Hepatitis B Surface Ag 63/131 - Spectra Laboratories Test Menu

64 ml serum (SST Gel Tube) Negative Alert Value For newly confirmed positive - Tier 2, laboratory calls results on the same day of release (within normal clinic business hours); report is also transmitted to the clinic Differential diagnosis and staging of Hepatitis B infection Chemiluminescence False reactives may occur following vaccination of Hepatitis B Vaccination 2 days (positive results require an additional 2 to 4 days for confirmation) Confirmatory Test HBsAg Neutralization test is performed on all first-time positive results and is not billed HEPATITIS Be VIRUS ANTIBODY Anti-HBe, HBeAb (Performed only at Spectra - Rockleigh, NJ) ml serum (SST Gel Tube) Other Requirements Test should be ordered only when recent infection with Hepatitis B has been ascertained Negative Differential diagnosis and staging of Hepatitis infection Enzyme Immunoassay (EIA) 64/131 - Spectra Laboratories Test Menu

65 2 days T-Sat HEPATITIS Be VIRUS ANTIGEN HBeAg, Hepatitis Be Ag (Performed only at Spectra - Rockleigh, NJ) ml serum (SST Gel Tube) Negative Differential diagnosis and staging of Hepatitis B infection Enzyme Immunoassay (EIA) 2 days T-Sat HEPATITIS C VIRAL RNA GENOTYPE, LiPA HCV RNA GENOTYPE LiPA Performed at Spectra's reference laboratory. For additional information, visit large SST Gel Tube 65/131 - Spectra Laboratories Test Menu

66 See report 1. Determines whether to begin antiviral therapy in patients with chronic Hepatitis C Virus (HCV) 2. Determines duration and dosage of treatment 3. Predicts response to therapy Multi Probe Reverse Hybridization 5-6 days Refrigerated 14 days HEPATITIS C VIRUS ANTIBODY HCV, Anti-HCV ml serum (SST Gel Tube) Non-reactive 1. Detection and diagnosis of chronic Hepatitis C virus infection. 2. Predicts responsiveness to therapy and monitors therapy 3. Useful in the differential diagnosis of severe autoimmune Hepatitis and Hepatitis C Chemiluminescence Immunoassay; Reactive screening test results by chemiluminescence immunoassay should be followed by a supplemental or confirmatory test, such as nucleic acid tests for HCV RNA Gross hemolysis, lipemia and icterus /131 - Spectra Laboratories Test Menu

67 Confirmatory Test HCV RNA by PCR HEPATITIS C VIRUS RNA QUANTITATIVE PCR SST Gel tube required This test requires a separate SST Gel tube Other Requirements Stand to clot then centrifuge immediately. Store at 2 C to 8 C. Add-on HCV RNA Quant PCR is not allowed. Not detected 1. Aids in the diagnosis of HCV infection 2. Predicts response to therapy and monitors therapy 3. Useful in the differential diagnosis of severe autoimmune Hepatitis and Hepatitis C Nucleic Acid Amplification test PCR (Polymerase Chain Reaction), Real Time v 2.0 Unspun SST. Severely hemolyzed, heat-inactivated or lipemic specimens. 3-5 days M - Sat HIV 1/2 ANTIBODY SCREEN Human Immunodeficiency Virus Antibody ml serum (SST Gel Tube) Non-reactive Diagnosis of acquired immune deficiency syndrome (AIDS) 67/131 - Spectra Laboratories Test Menu

68 Chemiluminescence 3-7 days T-Sat Confirmatory Test All reactive tests will be sent for Western Blot testing at an additional charge. Refrigerated 7 days HIV-1 RNA QUANTITATIVE REAL - TIME PCR Performed at Spectra's reference laboratory. For additional test information, visit: HOMOCYSTEINE ml serum (SST Gel Tube). Sample should be kept on ice until separated mcmol/l This diagnostic test is designed to quantitatively measure Homocysteine in serum. Such measurement can aid in the diagnosis and treatment of patients suspected of having homocysteinuria or hyperhomocysteinemia. Homocysteine may also be used as a weak-graded risk factor for cardiovascular disease or stroke. Chemiluminescence Certain drugs (e.g. carbamazepine, phenytoin, and methotrexate) may cause elevated levels. False elevations of serum homocysteine may occur if the serum is not promptly separated from the cells at the time of collection. Serum specimens that are hemolyzed, lipemic, icteric, proteinemic are prone to interferences, may cause false result. 2 days 68/131 - Spectra Laboratories Test Menu

69 Refrigerated 2 days HUMAN CHORIONIC GONADOTROPIN, QUALITATIVE HCG QUALITATIVE ml serum (SST Gel Tube) Negative <10 miu/ml and Positive 10 miu/ml Determine the presence of hcg in patients with gestational trophoblastic disease, evaluate and monitor male patients with testicular tumors, and monitor molar pregnancy. Chemiluminescence Gross hemolysis, lipemia, icteria, proteinemia. Heterophilic antibodies in the human serum hcg qualitative HUMAN CHORIONIC GONADOTROPIN, QUANTITATIVE Performed at Spectra's reference laboratory. For additional test information, visit: IRON, SERUM Fe 69/131 - Spectra Laboratories Test Menu

70 ml serum (SST Gel Tube) Females: mcg/dl Males: mcg/dl 1. Monitoring for iron toxicity/overload or its treatment with deferoxamine 2. Evaluation of ferrokinetics during erythropoietin treatment 3. Evaluation of iron transport/metabolism Colorimetric 1. Severe hemolysis 2. Parenteral administration of iron dextran within one month of test date KOH PREP Fungal Smear, Potassium Hydroxide Prep 776 Collect specimen in a blue swab. Keep specimen at ambient temperature, OR collect in a sterile container. Keep specimen at refrigerated temperature. No fungal elements seen Microscopic observation of specimens to detect the presence of fungal elements Potassium Hydroxide treatment of specimen 70/131 - Spectra Laboratories Test Menu

71 M-Sun , Kt/V, Daugirdas II Kt/V, Natural Log 180X 0.5 ml serum (SST Gel Tube) drawn pre-dialysis 0.5 ml plasma (Gold Post Tube) drawn post-dialysis Determination of dialysis adequacy Calculation: -LN ((Post BUN/Pre BUN)-0.008*Time) + (4-3.5)*(Post BUN/Pre BUN) * UF/W Where Time = Time of dialysis treatment (hours) UF = Pre weight - Post weight W = Post weight (after receiving all missing order data) Calculation Kt/V, QUICK - KESHAVIAH 180K 0.5 ml serum (SST Gel Tube) drawn pre-dialysis 0.5 ml plasma (Gold Post Tube) drawn post-dialysis Determination of dialysis adequacy Calculations: KESHAVIAH = 1.162*LN (PRE BUN/POST BUN) 71/131 - Spectra Laboratories Test Menu