Upon completion of this continuing education course, the professional should be able to:

Transcription

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 1

2 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 # P.A.C.E. Approved: Yes _X No 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. 2

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 Erythrocyte Sedimentation Rate Flow Cytometry Hemoglobin & Hematocrit* Hemoglobin Electrophoresis MCH* MCHC* MCV* determines the number and type of cells in the bone marrow 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 analytic method where cells from blood, bone marrow, or biopsies are sorted and identified by immunofluorescent techniques determines the oxygen carrying capacity of red blood cells and the percentage of red blood cells present in the blood; abbreviated as H & H determines the type and quantity of hemoglobins present in the blood mean corpuscular hemoglobin; determines the average amount of hemoglobin in a population of red blood cells 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 mean corpuscular volume; determines the average size of red blood cells Platelet Count* Red Blood Cell (RBC) Count* RDW* Reticulocyte Count *part of a Complete Blood Count (CBC) frequently abbreviated as plt; determines the number of platelets in the circulating blood determines the number of red blood cells in the circulating blood red cell distribution width; calculation of the differences in the size of the red blood cells Frequently abbreviated as retic; evaluates the bone marrow production of red blood cells 3

4 TESTS COMMONLY PERFORMED IN THE HEMATOLOGY SECTION-cont. Sickle Cell Screen White Blood Cell (WBC) Count * WBC Differential (Diff) *part of a Complete Blood Count (CBC) detects the presence of hemoglobin S determines the number of white blood cells present in the blood 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 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) Bleeding Time (BT) evaluates the intrinsic coagulation pathway; monitors heparin therapy evaluates platelet function Factor Assays Fibrin Degradation Products (FDP) Fibrinogen Platelet Aggregation Prothrombin Time (PT) Thrombin Time (TT) determines the amount of coagulation factors in the plasma; examples Factor VIII, Factor X tests for increased fibrinolysis determines the amount of fibrinogen in plasma evaluates the function of platelets evaluates the extrinsic coagulation pathway; monitors Coumadin therapy 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. 4

5 Acid Phosphatase TESTS COMMONLY PERFORMED IN THE CHEMISTRY SECTION elevated levels indicate prostate cancer Alanine Aminotransferase (ALT) Albumin Alcohol Alkaline Phosphatase (ALP) Ammonia Amylase Aspartate aminotransferase (AST) Bilirubin Blood Urea Nitrogen (BUN) B-Type Natriuretic Peptide (BNP) Calcium Cholesterol Creatine Kinase (CK) Creatine Kinase (CK) Isoenzymes Creatinine Creatinine Clearance C-Reactive Protein (CRP) Drug Screen Electrolytes (Lytes) Gamma Glutamyl Transferase (GGT) Glucose Glucose Tolerance Test (GTT) High Density Lipoprotein (HDL) Lactic Dehydrogenase (LD) Lead Lipase elevated levels indicate liver disorders decreased levels indicate liver or kidney disorders or malnutrition elevated levels indicate intoxication elevated levels indicate bone or liver disorders elevated levels indicate severe liver disorders elevated levels indicate pancreatic disorders elevated levels indicate recent myocardial infarction or liver disorders often abbreviated as bili; elevated levels indicate liver or hemolytic disorders elevated levels indicate kidney disorders used to help diagnose and grade the severity of congestive heart failure abnormal values associated with bone, musculoskeletal, or endocrine disorders elevated levels indicate cardiovascular disease risk elevated levels indicate myocardial infarction or other muscle damage determines the extent of muscle or brain damage elevated levels indicate kidney disorders urine and serum tests used to measure the glomerular filtration rate of the kidney measures inflammation in the body; can be used as a cardiac diagnostic test, among other things detects common drugs of abuse consists of sodium, potassium, chloride, and carbon dioxide; evaluates body fluid balance elevated levels indicate early liver disorders elevated levels indicate diabetes mellitus detects diabetes mellitus or hypoglycemia used with other lipid tests to assess cardiovascular disease risk elevated levels indicate myocardial infarction or lung or liver disorders elevated levels indicate lead poisoning elevated levels indicate pancreatic disorders 5

6 Lithium TESTS COMMONLY PERFORMED IN THE CHEMISTRY SECTION-cont. monitors levels of the antidepressant drug lithium Low Density Lipoprotein (LDL) Peak/Trough Therapeutic Drug Monitoring (TDM) Phosphorus Protein Total Protein (TP) Tumor Markers Triglycerides Uric Acid used with other lipid tests to assess cardiovascular disease risk measures and monitors levels of certain antibiotics, antidepressants, cardiac drugs, bronchodilators, anti-seizure drugs abnormal levels associated with skeletal or endocrine disorders decreased levels associated with liver or kidney disorders decreased levels indicate liver or kidney disorders 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) often abbreviated as trig, trigs, or trigies; used with other lipid tests to assess cardiovascular disease risk 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. ABO & Rh Type (blood type) Antibody Screen Antibody Identification Direct Antihuman Globulin Test (DAT or Direct Coombs) Indirect Antihuman Globulin Test (Indirect Coombs) Transfusion Reaction Type & Crossmatch Type & Screen (T&S) TESTS COMMONLY PERFORMED IN THE BLOOD BANK SECTION 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 detects abnormal antibodies to red cell antigens in many blood group systems; sometimes abbreviated as ab sc or aby sc identifies abnormal antibodies to red cell antigens in many blood group systems; presence of abnormal antibodies can lead to problems providing compatible blood detects antibodies bound to red blood cell antigens; positive in autoimmune diseases, hemolytic transfusion reactions, hemolytic disease of the newborn same as antibody screen a panel of tests performed when a patient has a suspected transfusion reaction; tests are performed to rule out hemolytic reactions 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 a panel of tests performed on a patient when transfusion may occur in the near future; includes and ABO & Rh type and antibody screen 6

7 IMMUNOLOGY The immunology section performs tests to evaluate the body s 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). Anti-HIV TESTS COMMONLY PERFORMED IN THE SEROLOGY SECTION screening test for human immunodeficiency virus Antinuclear Antibody (ANA) Antistreptolysin O (ASO) titer Cold Agglutinins Complement Levels (C3, C4, CH 50) Cytomegalovirus (CMV) Antibody Epstein-Barr (EBV) Virus Febrile Agglutinins Antinuclear Antibody (ANA) Fluorescent Treponemal Antibody (FTA) Hepatitis B Surface Antigen (HBsAg) Hepatitis Panels Herpes simplex (HSV) Virus Antibody Immunoglobulin Levels (IgG, IgM, IgE) Influenza A/B Monospot Polymerase Chain Reaction (PCR) Rapid Plasma Reagin (RPR) Rheumatoid Arthritis (RA) Factor Rubella Titer Strep Group A Venereal Disease Research Laboratory (VDRL) test detects autoantibodies against nuclear proteins; seen in systemic lupus erythematosus; rheumatoid arthritis; other disorders detects a previous infection with the streptococcus bacteria elevated levels indicate atypical pneumonia (caused by Mycoplasma pneumoniae) evaluates the function and activation of the immune system detects current or previous infection with cytomegalovirus confirms the presents of infectious mononucleosis detects antibodies to microorganisms causing fever (tularemia, Rocky Mountain Spotted Fever, typhus); not frequently used any longer detects autoantibodies against various components of cells confirms the presence of syphilis (Treponema pallidum) infection detects the presence of hepatitis B surface antigen detects antigens and antibodies found in viral hepatitis; used to determine if patient has hepatitis A, hepatitis B, or hepatitis C detects past or current infection with herpes virus evaluates the function of the immune system screening test for influenza A and influenza B brand name of a screening test for infectious mononucleosis method used to confirm the presence of infectious diseases that are difficult to grow in culture; i.e., tuberculosis, hepatitis C, HIV, and more screening test for syphilis (Treponema pallidum) performed on blood detects autoantibodies present in rheumatoid arthritis evaluates past or current infection with the organism causing German measles screening test for group A streptococcus infection (strep throat) screening test for syphilis (Treponema pallidum) performed on cerebrospinal fluid 7

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. Blood Culture TESTS COMMONLY PERFORMED IN THE MICROBIOLOGY SECTION detects bacteria, yeast, or viruses in the blood Culture & Sensitivity (C&S) Fungal Culture Gram Stain Occult Blood Ova and Parasites Viral Culture detects and identifies the type of bacteria causing infection and determines the most appropriate antibiotic treatment detects the presence of and identifies the type of fungal infection detects the presence of and assists in the identification of bacteria; presumptive diagnosis can sometimes be made from a Gram stain performed on stool and gastric specimens; detects very small quantities of blood in specimen; sometimes abbreviated as FOB (fecal occult blood) most often performed on stool specimens; detects the presence of and identifies type of parasitic infection; abbreviated as O&P 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. Physical Exam of Urine Chemical Exam of Urine (dipstick) Microscopic Exam of Urine TESTS COMMONLY PERFORMED IN THE URINALYSIS SECTION evaluates the color and clarity of the urine most frequently used dipsticks determine the levels of specific gravity, ph, glucose, ketones, protein, blood, bilirubin, urobilinogen, nitrate, and leukocytes 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. 8

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 9

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: Addison s disease, aldosteronism, Cushing s 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, Parkinson s 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 10

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 Willebrand s 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, Hodgkin s disease, lymphosarcoma, lymphoma Diagnostic Tests: biopsy, complete blood count (CBC), mononucleosis tests, culture and sensitivity, bone marrow biopsy, flow cytometry 11

12 References Lab Tests Online. Directory of Services and Interpretative Guide. Laboratory Corporation of America. The Physician s Guide to Laboratory Test Selection and Interpretation. TEST QUESTIONS Common Laboratory Tests # 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 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 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 What percentage of treatment decisions are reportedly based on laboratory test results? a % b % c % d % 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 12

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 13

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 14

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 15

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. Addison s disease b. Hodgkin s disease c. Parkinson s disease d. von Willebrand s disease 27. Which one of the following is a nervous system disorder? a. Addison s disease b. Hodgkin s disease c. Parkinson s disease d. von Willebrand s disease 28. Which one of the following is a vascular system disorder? a. aortic stenosis b. deep vein thrombosis c. hemophilia d. lymphoma 16

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* 17