Lab Guide Chemistry Section Lab Guide

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Lab Guide - 2018 Chemistry Section Lab Guide

Acetaminophen Full : Acetaminophen, Anacin-3, Datril, Liquiprin, Paracetamol, Panadol, Panex, Phenaphen, Tylanol, Tampra Short name: ACTM Blood Specimen Serum - Plain tube (Red or yellow). Plasma-Lithium heparin Tube ("To be drawn 4 hours after the ingestion ) 2-30 o C Routine: 8 Hours STAT: 1 Hour Immunoturbidometry Unit : μmol/l Therapeutic range Range : 66 199 μmol/l Rejection criteria See Management of Laboratory Specimen (CL 7067)

ALBUMIN Full : ALBUMIN Short name: ALB Blood Specimen - Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube STAT :1 Hour Routine :8 Hours Endpoint Unit: g/l Male/ Female 30-46 0-1Yrs 34-47 1-5Yrs 36-49 5-10Yrs 33-50 10-14Yrs 33-49 14-20Yrs 35-50 20-150Yrs Rejection criteria See Management of Laboratory Specimen (CL 7067);

ALCOHOL Full : Ethanol, Ethyl Alcohol, Blood Alcohol Short name: ETOH (ALC) Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube 24/7 STAT STAT : 1 hour Enzymatic rate method Unit: mmol/l Age Female & Male 0-150 Y < 0.87 Rejection criteria See Management of Laboratory Specimen (CL 7067);

ALKALINE PHOSPHATASE Full : ALKALINE PHOSPHATASE Short name: ALK PHOS Cerner name: ALP Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube STAT :1 Hour Routine :8 Hours Kinetic Rate. Unit: U/L Age : Female: Male: < 14D 90 273 90-273 14D 1Y 134 518 134 518 1Y 10Y 156 369 156 369 10Y 13Y 141 460 141 460 Rejection criteria 13Y 15Y 62 280 127 517 15Y 17Y 54 128 89 365 17Y 19Y 48 95 59 164 >19Y 40 150 40 150 See Management of Laboratory Specimen (CL 7067);

ALT Full : Alanine aminotransferase Short name: ALT, sgpt Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube 2-30 ºC Routine: 8 Hrs STAT : 1 Hr Kinetic Rate Unit: U/L Female : 0-1Yrs 5-33 1-13Yrs 9-25 13-19Yrs 8-22 >18Yrs 0-55 Male: 0-1Yrs 5-33 1-13Yrs 9-25 13-19Yrs 8-22 >18Yrs 0-55 Rejection criteria See Management of Laboratory Specimen (CL 7067);

Ammonia Full : Ammonia Short name: NH3 Cerner name: AMM Full tube of blood in ice in lavender top tube with EDTA -Immediately place in ice In ice STAT/Routine :Sunday - Saturday (24/7 Days) STAT : 1 hr Endpoint Unit: umol/l Female: 1D-1M 21-95 1M-1Y 18-74 Rejection criteria 1-14Y 17-68 14-18Y 22-66 >18 Y 19-63 Male : 1D-1M 21-95 1M-1Y 18-74 1-14Y 17-68 14-18Y 22-66 >18Y 21-71 -See Management of Laboratory Specimen (CL 7067); - Samples received without ice

AMYLASE Full : AMYLASE (Pancreatic) Short name: P-AMY Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube Routine: 8 hours STAT : 1 hour Immuno inhibition method Unit: U/L Age Female : Age Male: 0Min-6M 0Min-6M 6-2Y 3-26 6-2 Y 3-30 2-8Y 9-36 2-5 Y 8-35 8-11Y 8-43 5-8 Y 7-35 11-14Y 9-45 8-11 Y 7-41 14-17Y 8-44 11-14 Y 11-37 17-150Y 8-51 14-17 Y 11-44 17-150 Y 8-51 Rejection criteria See Management of Laboratory Specimen (CL 7067);

AST Full : Aspartate aminotransferase Short name: AST, sgot Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube Routine: 8 hours STAT: 1 hour Kinetic rate method Unit: U/L Age: Female & Male: 0-14 D 32-162 15D -1Y 20-67 1-7 Y 21-44 7-12 Y 18-36 12-19 Y 13-26 19-150 Y 5-34 Rejection criteria See Management of Laboratory Specimen (CL 7067);

B-HCG Full : Human chorionic gonadotropin (Beta subunit) Short name: B-HCG Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube 4 ml tube (Fill until the required mark) 2-25 o C STAT / Routine: Sunday-Saturday (24/7 Days) STAT : 2 hours Routine: 8 hours Chemiluminiscent Immunoassay Unit: IU/L Female/male: < 5 Rejection criteria See Management of Laboratory Specimen (CL 7067);

Beta-Hydroxybutyrate (Beta-Ketone) Full : Beta-Hydroxybutyrate (Beta-Ketone) Short name: B-OHB Blood specimen- Lithium heparin tube delivered to the lab within 60 minutes 2-30ºC STAT:30 minutes Electro-chemical (Optium sensor from Abbott) Unit: mmol/l 0.0 1.0 Rejection criteria - Wrong container - Frozen blood - Transportation time exceeds 60 min from collection.

BICARBONATE Full : BICARBONATE Short name: CO2, TCO2 Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube Routine: 8 Hours STAT : 1 hour Diff. Rate PH Unit: mmol/l Age: Female Male: 0-1 Y 10.6-22.5 11.9-22.9 1-5 Y 14.1-22 12.3-22.2 5-10 Y 15.1-24.8 13.4-22.6 10-14 Y 14-24.6 15.2-24 14-20 Y 16.2-25.4 13.6-24.2 20-150 Y 22-29 22-29 Rejection criteria See Management of Laboratory Specimen (CL 7067);

Bilirubin (Direct) Full : Bilirubin (Direct) Short name: DBIL Blood Specimen Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube Routine: 8 hours STAT: 1 hour DIAZO Unit: mmol/l Age: Female & Male: 0-1 Y 1.8-1.83 1-5 Y 1.8-6.8 5-10 Y 1.8-7.4 10-14 Y 1.8-9.4 14-20 Y 1.8-10.9 20-150 Y 0-8.6 Rejection criteria See Management of Laboratory Specimen (CL 7067);

Bilirubin (Total) Full : Bilirubin (Total) Short name: TBIL Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube STAT :1 Hour Routine : 8 hours DIAZO-method Unit: μmol/l Age: Female & Male: 0 mts - 2D 0-87 2-3D 0-123 3-5D 0-176 5D - 150Y 3.4-20.5 Rejection criteria See Management of Laboratory Specimen (CL 7067);

CALCIUM Full : CALCIUM, CALCIUM (Corrected) Short name: CA, CA-C Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube STAT: 1 Hour Routine : 8 Hours ISE:INDIRECT Unit: mmol/l Age: Female Male: 0-1 Y 2.19 2.88 2.19 2.88 1Y - 5Y 2.29-2.74 2.29-2.74 5Y - 10Y 2.28-2.62 2.28-2.62 10Y - 14Y 2.23-2.58 2.23-2.58 14Y 20Y 2.27-2.62 2.27-2.62 >20 Y 2.10-2.55 2.10-2.55 This is an estimate of calcium concentration, assuming a normal albumin concentration which is 40 g/l Rejection criteria See Management of Laboratory Specimen (CL 7067);

CARBAMAZEPINE Full : CARBAMAZEPINE, TEGRETOL Short name: CARB 2 ml blood in: - Plain tube without gel or Lithium heparin Tube *Recommended trough measurement, blood should be withdrawn just before next dosage 2-30 o C Routine: 8 hour STAT : 1 hour Immunoturbidimetry Therapeutic range Unit: μmol/l Therapeutic Range : Toxic Levels: 17 51 μmol/l Toxic multiple drug Regimen > 34 μmol/l Toxic single drug Regimen >51 μmol/l Rejection criteria See Management of Laboratory Specimen (CL 7067);

CARBOXYHEMOGLOBIN Full : Carboxyhemoglobin Rejection criteria Short name: COHb Whole blood collected in - Lithium heparin tube or - Blood gas capillary kit Should be in ice STAT / Routine: Sunday Sunday ( 24/7 Days ) STAT: 30 minutes Potentiometry, amperometry, and conductance Unit: % Non Smoker : < 1.5 % of total Hb Smoker : 1.5-5.0 % of total Hb Wrong container Samples not in Ice Sample received after 60 minutes of collection time

Chloride Full : Chloride Short name: CL Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube Routine: 8 Hours STAT: 1 hour Therapeutic range ISE:INDIRECT Unit: mmol/l Female& Male : >18Y 96-110 Rejection criteria See Management of Laboratory Specimen (CL 7067);

Cholesterol Full : Cholesterol Short name: CHOL Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube Routine: 8 hours STAT : 1 hour Therapeutic range Timed Endpoint method Unit: mmol/l Female & Male : <5.17mmol/L Desirable 5.17-6.18 mmol/l Border line-high > 6.18 mmol/l High Rejection criteria See Management of Laboratory Specimen (CL 7067);

CORTISOL Full : CORTISOL Short name: CORT Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube Rejection criteria 4 ml tube (Fill until the required mark) 2-25 o C STAT / Routine: Sunday - Thursday Routine : 2 days CHEMILUMINISCENT IMMUNOASSAY Unit: umol/l Age Female: Male: 0-5 D 17-546 17-546 5D-1 Y 66-632 66-632 1-13 Y 69-32 69-632 13-15 Y 66-789 69-632 15-18 Y 66-789 66-789 18-150 Y AM : 185-624 PM : <276 See Management of Laboratory Specimen (CL 7067);

C-Reactive Protein Full : C-Reactive Protein Short name: CRP Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube 4 ml tube (Fill until the required mark) Routine: 8 Hours STAT: 1 hour Interpretation Immunoturbidometry This is not the high-sensitive CRP, it s not intended to be used for assessment of risk of future coronary heart diseases Unit :mg/l Female & Male: Rejection criteria < 5 See Management of Laboratory Specimen (CL 7067);

CK (Creatine Kinase) Full : Creatine Kinase Short name: CK; CPK Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube 4 ml tube (Fill until the required mark) STAT: 1 hour Routine :8 hours Enzymatic rate method Unit: U/L Age Female: Male: 0-3M 43 474 29-303 3M - 1Y 27 242 25-172 1Y - 3Y 2 134 2-163 Rejection criteria 3Y - 6Y 8 147 28-162 6Y - 9Y 26 145 2-177 9Y - 12Y 6 137 6-219 12Y - 15Y 2 143 2-251 15Y - 18Y 13 144 34-147 >18 Y 29 168 30-200 See Management of Laboratory Specimen (CL 7067);

CREATININE Full : CREATININE Short name: CREA Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube 4 ml tube (Fill until the required mark) STAT: 1 hour Routine : 8 hours Rate Jaffe method Unit: μmol/l Age Female: Male: 0-1Y 35 58 35-58 1Y - 5Y 41 67 41-67 5Y - 10Y 47 75 47-75 10Y - 14Y 55 92 55-92 14Y - 20Y 54 95 54-95 >20Y 50 98 64-110 Rejection criteria See Management of Laboratory Specimen (CL 7067);

CSF GLUCOSE Full : CSF GLUCOSE Short name: CSF-G spinal fluid in clean sterile tube, if there is contamination with RBCs then preferred in fluoride tube. *It is recommended to collect plasma glucose at the same time. 2-30 o C Routine: 8 Hrs STAT: 1 Hr Therapeutic Range Rejection criteria Enzymatic UV (Hexokinase) Unit: mmol/l Normal range for CSF glucose is 60-80% of plasma glucose. See Management of Laboratory Specimen (CL 7067); -Gross presence of blood

CSF Protein Full : CSF Protein Therapeutic Range Short name: CSF-P 1 ml spinal fluid in clean sterile tube. 2-30 o C Routine: 8 Hrs STAT: 1 Hr Timed endpoint method Unit: g/l Male / Female : 0-7 Days 0.4-1.2 7-30 Days 0.2-0.8 30 D-150 Y 0.15-0.45 Rejection criteria See Management of Laboratory Specimen (CL 7067); Gross presence of blood in CSF specimen invalidates the protein value.

CSF-LDH Full : CSF-LDH Short name: CSF-LDH 1 ml Spinal fluid in a sterile container 2-30 o C Routine: 8 Hrs STAT: 1 Hr Therapeutic Range Rejection criteria -Enzymatic Rate method (Lactate to Pyruvate.) Unit: IU/L About 10% of serum levels. See Management of Laboratory Specimen (CL 7067);

DIGOXIN Full : DIGOXIN,, Lanoxicaps, Lanoxin Short name: DGN 4 ml blood in: Lithium heparin tube *blood should be drawn pre-dose or at least 6 hrs post-dose 2-30 o C Routine: 8 Hrs STAT: 1 Hr Therapeutic Range Immunoturbidimetry Unit: nmol/ L

Therapeutic Range : 1.15-2.56 nmol/ L Toxic Levels : > 2.6 nmol/l Panic Levels: > 3.8 nmol/l *Result should be considered in the clinical context, ex: renal function. *This test measures total digoxin and in case of treatment with digi band very false high value may occur. *In neonate and old people interefere form digoxin like substance may happen. Rejection criteria See Management of Laboratory Specimen (CL 7067); ESTRADIOL Full : ESTRADIOL Short name: ESTRADIOL Blood Specimen- Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube Therapeutic Range 4 ml tube (Fill until the required mark) STAT / Routine: Sunday - Thursday Routine: 2 Days Chemiluminiscent Immunoassay Unit: pmol/l Male: 73-275 Female :

Follicular 88-418 Midcycle 228-1960 Luteal 294-1102 Post Menstrual 73-323 Rejection criteria See Management of Laboratory Specimen (CL 7067); Ferritin Full : Ferritin Short name: FRE Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube 4 ml tube (Fill until the required mark) STAT / Routine: Sunday - Thursday Routine: 2 Days Chemiluminiscent Immunoassay Age : Female: male: <5 Y 6 24 6-24

5 9 Y 10 55 10 55 9 14Y 6 40 23-70 14 19Y 6 44 23-70 19-150 Y 11 304 24-336 Rejection criteria See Management of Laboratory Specimen (CL 7067); Folate Full : Folate, Serum Short name: FOLS/Folic Acid Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube 4 ml tube (Fill until the required mark) STAT / Routine: Sunday - Thursday Routine: 2 Days Chemiluminiscent Immunoassay Unit: nmol/l Age Female Male

0 1 yr. 14.3 51.5 16.3 50.8 2 3 yrs. 3.9-35.6 5.7 34.0 4 6 yrs. 6.1 31.9 1.1 29.4 7 9 yrs 5.4 30.4 5.2 27.0 10 12 yrs. 2.3 23.1 3.4 24.5 13 18 yrs. 2.7 16.3 2.7 19.9 >18 yrs. 4.0 45.3 4.0 45.3 Rejection criteria See Management of Laboratory Specimen (CL 7067); Follicle Stimulating Hormone Full : Follicle Stimulating Hormone HORMONE Short name: FSH Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube 4 ml tube (Fill until the required mark) STAT / Routine: Sunday - Thursday Routine: 2 Days Chemiluminiscent Immunoassay Unit: IU/L Age : Female: Male :

0-2 Y 0.2-6.6 0.2-1.8 2-5 Y 0.2-3.8 0.2-1.4 5-13Y 0.2-2.7 0.2-1.3 13-150Y 1-19 Follicular :4-9 Midcycle : 5-23 Luteal : 2-5 Post menopausal :17-114 Rejection criteria See Management of Laboratory Specimen (CL 7067); Free PSA Full : Free PSA Short name: FPSA Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube 4 ml tube (Fill until the required mark) STAT / Routine: Sunday - Wednesday Routine: 2 Days Chemiluminiscent Immunoassay

Unit: ng/ml Rejection criteria PSA > 4ng/ml & FPSA/Total PSA ratio < 25% indicates increased risk of prostatic cancer. Free PSA is reflex testing if TPSA is between > 4.0 - < 10.0 ng/ ml. See Management of Laboratory Specimen (CL 7067); FREE THYROXINE Full : FREE THYROXINE Short name: FT4 Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube 4 ml tube (Fill until the required mark /Analyzer STAT / Routine: Sunday -Thursday Routine: 2 days Chemiluminiscent Immunoassay Unit: pmol/l Male & Female:

Age From Age To Sex Reference Range 0 Day <20 Days Both 17.4 57.7 20 Days < 3 years Both 9.5 17.8 3 years 19 years <19 years 150 years Both 7.9 13.6 Both 8.4 19.1 For Pregnant : 1 st Trimester 2 nd Trimester 3 rd Trimester Female 6.67 14.12 Female 5.79 12.7 Female 6.11 12.2 Rejection criteria See Management of Laboratory Specimen (CL 7067); Performing Lab Location GGT Full : Gamma-glutamyltransferase Short name: GGT, g-gt Blood Specimen- Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube 4 ml tube (Fill until the required mark Routine: 8 Hrs STAT : 1 Hr Enzymatic rate method Unit: U/L

Age Female Male 0 7D 18 148 25-168 7D 1M 16 140 23-174 1M 4M 16 140 16 147 4M -7M 12 123 5-93 7M-1Y 8 59 8 38 1Y 5Y 2 15 2-15 5Y 10Y 6 19 6-16 10Y 18Y 8 23 7-26 >18Y 7 37 10-29 Rejection criteria See Management of Laboratory Specimen (CL 7067); Gentamycin Collection time Therapeutic Range Full : Gentamycin Short name: Genta Trough: Just prior to next dose Peak: 1 hour after the end of infusion 2 ml blood in: - Plain red tube or yellow tube 2-30 o C - Lithium heparin tube Routine: 8 Hrs STAT: 1 Hr Immunoturbidimetry Unit :μg/ml

Trough: < 2 μg/ml Peak: 5 10 μg/ml Rejection criteria See Management of Laboratory Specimen (CL 7067); Glucose Full : Glucose, Fasting Blood Glucose, Random Blood Glucose Short name: GLU, FBS, RBS Blood specimen Fasting blood or random blood glucose - Grey top tube or - Plain tubes (red or yellow top)

2 30 o C Routine: 8 Hrs STAT: 1 Hr Therapeutic Range Timed end point (Hexokinase) Unit: mmol/l Serum/Plasma : 3.3-5.5 mmol / L Random Blood Glucose : 3.3-11.1 mmol/l Categories of increased risk for diabetes: Fasting 5.6-6.9 mmol/l 2hrs PG (75g) 7.8 11.1 mmol/l Hb A1c 5.7 6.4 % Criteria for the diagnosis of diabetes Hb A1c Fasting glu OR 2hrs PG (75g) OR Random PG OR (in a patient with classic symptoms of hyperglycemia) Rejection criteria See Management of Laboratory Specimen (CL 7067) Glucose Tolerance Test (75 gms) Full : Glucose Tolerance Test (75 gms) Short name: GTT-75 gms 2 ml blood in grey top- flouride tube: GTT1 (for pregnant) - Fasting blood is extracted - Ingestion of 75 gm glucose solution - Two samples are collected after glucose solution administration at the following timings: 1hr, 2hrs 2 ml blood in grey top-flouride tube: GTT2 (for adult non-pregnant/male)

- Fasting blood is extracted - Ingestion of 75 gm glucose solution - Sample is collected after 2 hours of oral glucose intake 2 30 o C Routine: 8 Hrs STAT: 1 Hr Timed end point (Hexokinase) 75 gm for pregnant: The diagnosis of gestational diabetes mellitus is made when any of the following plasma glucose values are exceeded: o Fasting 5.1 mmol/l o 1 hr 10.0 mmol/l o 2 hr 8.5 mmol/l 75 gm for adult non-pregnant/male o Fasting between 6.1 6.9mmol/l is impaired fasting. o Two hours between 7.8 11.1 is impaired glucose tolerance. o If fasting is 7.0mmol/l or two hours is 11.1mmol/l, diagnosis of diabetes. Rejection criteria See Management of Laboratory Specimen (CL 7067); Hemoglobin A1c Full : Hemoglobin A1c, Glycated Hb, Glycated Hemoglobin Short name: HbA1c EDTA whole blood. SUN-THU (08:00 14:00)

Routine : 3 days Rejection criteria Colorimetric / Turbidimetric Unit :% Female / MALE Normal range: (4.8-6.0 ) % HbA1C See Management of Laboratory Specimen (CL 7067); -Clotted blood sample. HDL- Cholesterol Full : High Density Lipoprotein Cholesterol Short name: HDL, HDL-C Blood Specimen - Serum - Plain tube (Red or yellow). - Plasma - Lithium heparin tube

Routine: 8 Hrs STAT : 1 Hr Hemogeneous,colorimetric Unit: mmol/l FEMALE / MALE > 1.00 mmol/l Rejection criteria See Management of Laboratory Specimen (CL 7067) IRON Full : IRON Short name: Fe Blood Specimen - Serum - Plain tube (Red or yellow).

- Plasma - Lithium heparin tube Routine: 8 Hrs STAT: 1 Hr Timed Endpoint Unit: μmol/l Age Female Male 0-14 Y 2.9-22.9 2.9-22.9 14Y-19 Y 3.6-29 5.6-30.1 19Y-150 Y 9-30.4 11.6-31.3 Rejection criteria See Management of Laboratory Specimen (CL 7067); -Hemolysed samples Lactate ( Lactic Acid) Full : Lactate ( Lactic Acid) Short name: LA

Whole blood collected in syringes /tubes containing dry Lithium Heparin Minimum 200 µl in 1mL Syringe,Minimum 2ml in 4ml tube. STAT: 1 hr Potentiometry,Amperometry,Conductance Unit: mmol/l 0 3 M 1.0-3.5 3M 2Y 1.0-3.3 2Y 18Y 1.0-2.4 >18Y 0.5-2.20 Rejection criteria Clotted samples, Samples with unacceptable anticoagulant. LDH - Lactate Dehydrogenase

Full : Lactate Dehydrogenase Short name: LDH Blood Specimen - Serum - Plain tube (Red or yellow). - Plasma - Lithium heparin tube Routine: 8 hrs STAT : 1 Hr Enzymatic rate method (Lactate to Pyruvate) Unit: U/L Age Female: Male: 1-14 D 309-1222 309-1222 14 D-1 Y 163-452 163-452 1-10 Y 192-321 192-321 10-15 Y 152-272 170-283 15-19 Y 130-250 130-250 19-150 Y 125-220 125-220 Rejection criteria See Management of Laboratory Specimen (CL 7067). LIPASE

Full : LIPASE Short name: LIP Blood Specimen - Serum - Plain tube (Red or yellow). - Plasma - Lithium heparin tube Routine: 8 Hrs STAT: 1 Hr Enzymatic rate method Unit: U/L Age : Female: Male: 0-19 Y 4-39 4-39 19-150 Y 8-78 8-78 Rejection criteria See Management of Laboratory Specimen (CL 7067);

LDL - Cholesterol Full : Low Density Lipoprotein-Cholesterol (calculated) Short name: LDL-C - Recommended to order with cholesterol, triglyceride and HDL at the same time. Blood Specimen - Serum - Plain tube (Red or yellow). - Plasma - Lithium heparin tube Routine: 8 Hrs STAT : 1 Hr Calculated Unit: mmol/l Adults Desirable: < 3.36 Borderline: 3.36-4.11 High Risk: > 4.12 Rejection criteria See Management of Laboratory Specimen (CL 7067);

LUTEINIZING HORMONELUTEINIZING Full : LUTEINIZING HORMONELUTEINIZING MONEUTEINIZING HORMONE Short name: LH Blood specimen: Serum - Plain red tube or yellow SST (2 ml - 5 ml) Plasma - Lithium heparin tube 4 ml tube (Fill until the required mark) STAT / Routine: Sunday - Thursday Routine: 2 Days Chemiluminiscent Immunoassay Unit: IU/L Age : Female: Male: 0-1 Y 0.1-1.7 1.7-2.7 1-5 Y 0.1-1.7 0.1-1.7 5-10Y 0.1-1.7 0.1-1.7 10-18Y 1.7-4.7 1.7-7.7 >18 Y 1-9 Follicular 2-11 Midcycle 24-103 Luteal : 1-13 Post menopausal : 11-59 Rejection criteria See Management of Laboratory Specimen (CL 7067);

MAGNESIUM Full : MAGNESIUM Short name: MG Blood Specimen - Serum - Plain tube (Red or yellow). - Plasma - Lithium heparin tube Routine : 8 Hrs STAT : 1 Hr Timed endpoint method Unit: mmol/l Age : Female & Male 0-1Y 0.82-1.36 1-5Y 0.78-1.41 5-10Y 0.77-1.46 10-14Y 0.72-1.06 14-20Y 0.72-1.04 20-150Y 0.66-1.07 Rejection criteria See Management of Laboratory Specimen (CL 7067);

METHEMOGLOBIN Full : Methemoglobin Short name: MetHb /Analyzer Rejection criteria Whole blood collected in - Lithium heparin tube or - Blood gas capillary kit Should be in ice STAT / Routine: Sunday Sunday ( 24/7 Days ) STAT: 30 minutes Potentiometry,Amperometry,Conductance Unit: % upto 1.5 % of total Hb Wrong container / Clotted samples Samples not in ice Samples exceeded 60 minutes of collection

Micro-Albumin, Urine Full : Micro-Albumin, Urine Short name: MA Collect urine as 24hrs, timed, or random midstream sample (spot collection) in a clean collection container. 2-30 o C Routine: 8 Hrs Immunoturbidimetric Unit: mg/l Male / Female : Spot urine: 0 20 mg/l Timed urine: 0 30 mg/24hrs Albumin/Creatinine ratio: Male: Female: 0 2.5 mg/mmol creatinine 0 3.5 mg/mmol creatinine Rejection criteria See Management of Laboratory Specimen (CL 7067); - Dilution - Contamination

N TERMINAL PRO B-TYPE NATRIURETIC PEPTIDE Full : N terminal pro B-type natriuretic peptide Short name : NT-ProBNP Whole blood collected in EDTA tubes 2-3 ml blood in 4 ml tube only 18-30 o C STAT: 1 hr Time resolved fluorometry(trf) Unit: pg/ml Male & Female < 249 Rejection criteria See Management of Laboratory Specimen (CL 7067) Clotted samples, Samples with unsuitable anticoagulant.

Parathyroid Hormone (Intact) Full : Parathyroid Hormone (Intact) Short name: PTH Blood Specimen: Serum - Serum - Plain tube (Red or yellow). Plasma - Lithium heparin tube 4 ml tube (Fill until the required mark) STAT / Routine: Sunday - Thursday Routine: 2 Days Chemiluminiscent Immunoassay Unit: pg/ml 12-88 Rejection criteria See Management of Laboratory Specimen (CL 7067);

Phenobarbital Full : Phenobarbital, Phenobarbitone, Phenylethylmalonylurea, Barbita, Luminal. Short name: PHNO Blood Specimen: - Plain tube (red or yellow) - Lithium heparin tube 2-30 o C Routine: 8 Hrs STAT: 1 Hr Immunoturbidimetric Unit: μmol/l Male / Female : 43.1 172.4 Rejection criteria See Management of Laboratory Specimen (CL 7067);

Phenytoin Full : Phenytoin, Epanutin, Dilantin, Diphenylan Sodium, Diphenylhydantoin Short name: PTN 2 ml blood in: -Plain tube (red or yellow) - Lithium heparin tube 2-30 o C Routine: 8 Hrs STAT: 1 Hr Immunoturbidimetric Unit: μmol/l. Male / Female : 40 80 μmol/l. Rejection criteria See Management of Laboratory Specimen (CL 7067);

Phosphorus Full : PHOSPHORUS (Inorganic Phosphorus) Short name: PO4 Blood Specimen - Serum - Plain tube (red or yellow) - Plasma - Lithium heparin tube Routine: 8 Hrs STAT: 1 Hr Timed endpoint method (Phospho-Molybdate) Unit: mmol/l Age : Female : Male : 0 Mint- 1Y 1.53-2.45 1.51-2.62 1-5Y 1.42-2.24 1.41-2.13 5 10Y 1.16-1.99 1.32-2.00 10 14Y 0.95-1.83 1.26-1.94

14 20Y 0.93-1.64 0.89-1.66 20 150Y 0.74-1.52 0.74-1.52 Rejection criteria See Management of Laboratory Specimen (CL 7067); Potassium Full : Potassium, Kalium Short name: K Blood Specimen - Serum - Plain tube ( red or yellow) - Plasma - Lithium heparin tube Routine: 8 Hrs STAT: 1 Hr ISE:INDIRECT Unit: mmol/l Age : Female & Male 0Mint 30D 3.7 5.9 30 D 3Y 4.1 4.7 3 12 Y 3.4 4.7

12-150Y 3.6 5.1 Rejection criteria See Management of Laboratory Specimen (CL 7067); PROGESTERONE Full : PROGESTERONE Short name: PROG Blood Specimen - Serum - Plain tube ( red or yellow) Plasma-Lithium Heparin tube STAT / Routine: Sunday to Thursday Routine: 2 Days Chemiluminiscent Immunoassay Unit: nmol/l Female: <12 Y 0.32-1.06 >12 Y Follicular 0.99-5 Luteal 16 59

PMP <0.25 2.48 Rejection criteria See Management of Laboratory Specimen (CL 7067); PROLACTIN Full : PROLACTIN Short name: PROL Blood specimen: Serum - Plain tube (red or yellow ) Plasma - Lithium heparin tube 4 ml tube (Fill until the required mark) STAT / Routine: Sunday - Thursday Routine: 2 days Chemiluminiscent Immunoassay Unit: miu/l Age Female: Male: 0-2Y 88.2-505 50.7-525

2-5Y 21-367.5 35.7-357 5-10Y 25.2-325.5 14.7-331.8 10-20Y 31.5-409.5 109-557 20-150Y 109-557 73-407 Rejection criteria See Management of Laboratory Specimen (CL 7067); PROSTATE SPECIFIC ANTIGEN (PSA) Full : PROSTATE SPECIFIC ANTIGEN (PSA) HORMON Short name: PSA Serum - Plain tube (red or yellow) Plasma - Lithium heparin tube 4 ml tube (Fill until the required mark) STAT / Routine: Sunday - Thursday Routine: 2 Days Immuno Enzymatic Assay Unit: ng/ml Age : Male:

0-150 0-4 Rejection criteria See Management of Laboratory Specimen (CL 7067); PROTEIN, Total Full : PROTEIN, Total Short name: TP Blood Specimen - Serum - Plain tube (red or yellow) - Plasma - Lithium heparin tube Routine: 8 Hrs STAT: 1 Hr Timed endpoint Biuret method Unit: g/l

Age : Female & Male < 1Y 52-72 1-5Y 61-83 5-10Y 62-91 10-14Y 64-85 14-20Y 63-82 20-150 64-83 Rejection criteria See Management of Laboratory Specimen (CL 7067) Sodium Full : Sodium, Natrium Short name: NA Blood Specimen - Serum - Plain tube (red or yellow) - Plasma - Lithium heparin tube Routine: 8 Hrs STAT: 1 Hr ISE:INDIRECT Unit: mmol/l

Age : Female & Male 0Mint 150Y 135-145 Rejection criteria See Management of Laboratory Specimen (CL 7067) TESTOSTERONE Full : TESTOSTERONE Short name: TESTOS Blood Specimen - Serum - Plain tube (red or yellow) 4 ml tube (Fill until the required mark) - Plasma - Lithium heparin tube STAT / Routine: Sunday - Thursday Routine: 2 Days

Chemiluminiscent Immunoassay Unit: nmol/l Male 6.0-27 Female 0.35-2.6 Rejection criteria See Management of Laboratory Specimen (CL 7067); THEOPHYLLIN Full : Theophylline; Aminophylline, Elixophylline, Slo-phylline, Sustaire, Theo-Dur, Theolair, Theospan. Short name: THEO Blood Specimen - Serum - Plain tube (red or yellow) - Plasma - Lithium heparin tube 2-30 o C Routine: 8 Hrs

STAT: 1 Hr Immunoturbidimetric Unit: umol/l Adult 56-111 umol/l Neonatal Apnea 33-61 umol/l Ped. Asthma 44-111 umol/l Rejection criteria See Management of Laboratory Specimen (CL 7067) Thyroglobulin Full : Thyroglobulin Short name: Tg Blood Specimen - Serum - Plain tube (red or yellow) - Plasma - Lithium heparin tube

4 ml tube (Fill until the required mark) By batch - Every Thursday Routine: 8 Days Chemiluminiscent Immunoassay Unit: ng/ml Athyrotic < 0.1 Intact Thyroid < 33 Rejection criteria Note: Below comment will be attached to all Thyroglobulin outgoing reports Thyroglobulin (Tg) levels must be interpreted in the context of TSH levels, serial Tg measurements and radioiodine ablation status. Tg levels < 0.1 ng/ml in athyrotic individuals on suppressive therapy indicate a minimal risk (<1-2%) of clinically detectable recurrent papillary/follicular thyroid cancer. See Management of Laboratory Specimen (CL 7067); TSH Full : THYROID STIMULATING HORMONE Short name: TSH Serum - Plain tube (red or yellow) Plasma - Lithium heparin tube 4 ml tube (Fill until the required mark)

STAT / Routine: Sunday - Thursday Routine: 2 days /Analyzer Chemiluminiscent Immunoassay Unit: miu/l Male & Female: Age From Age To Sex Reference Range 0 years 12 years <12 years < 19 years Both 0.79 5.85 Both 0.68 3.35 19 years 150years Both 0.38 5.33 For Pregnant : 1 st Trimester 2 nd Trimester 3 rd Trimester Female 0.05 3.7 Female 0.31 4.35 Female 0.41 5.18 Rejection criteria See Management of Laboratory Specimen (CL 7067); Performing Lab Location TRANSFERRIN Full : TRANSFERRIN Short name: TRSF, TRF Blood Specimen - Serum - Plain tube (red or yellow)

- Plasma - Lithium heparin tube Routine: 8 Hrs STAT: 1 Hr Immunoturbidimetric Unit: g/l Age : Female & Male : 0 2 M 1.04 2.24 2-1 Y 1.07 3.24 1-19 Y 2.20 3.37 19-150 Y 2.0 3.6 Rejection criteria See Management of Laboratory Specimen (CL 7067). Triglycerides Full : Triglycerides, Triglycerols.

Short name: TG Blood Specimen - Serum - Plain tube (red or yellow) - Plasma - Lithium heparin tube Routine: 8 Hrs STAT: 1 Hr Timed end point method Unit: mmol/l Male & Female): < 1.70 Normal 1.70-2.2 Borderline high 2.2-5.63 High Rejection criteria See Management of Laboratory Specimen (CL 7067); TROPONIN I Full : Troponin I

Short name:trop I Whole blood collected in EDTA tubes 2-3 ml blood in 4 ml tube only 18-30 o C STAT: 1 hr Rejection criteria Time resolved fluorometry(trf) Unit: ng/ml < 0.02 See Management of Laboratory Specimen (CL 7067); Clotted samples, Samples with unsuitable anticoagulant. TROPONIN T

Full : Troponin T Short name:trop T Whole blood collected in EDTA/Lithium heparin tubes 2-3 ml blood in 4 ml tube only 18-30 o C STAT: 1 hr Rejection criteria Time resolved fluorometry(trf) Unit: ng/l 0-14 See Management of Laboratory Specimen (CL 7067); Clotted samples, Samples with unsuitable anticoagulant.

UREA/BUN Full : UREA / BLOOD UREA NITROGEN Short name: BUN Blood Specimen - Serum - Plain tube (red or yellow) - Plasma - Lithium heparin tube Routine: 8 Hrs STAT: 1 Hr Enzymatic Age : Female : Male : < 1Y 1.2-6.3 1.2-6.3 1-5Y 2.0-7.4 2.0-7.4 5-10Y 2.4-7.0 2.4-7.0 10-14Y 2.2-7.5 2.2-7.5 14-20Y 1.9-6.7 1.9-6.7 20-50Y 2.5-6.7 3.2-7.4 50-150Y 3.5-7.2 3-9.2.0 Rejection criteria See Management of Laboratory Specimen (CL 7067);

Uric Acid Full : URIC ACID,URATE Short name: UA Blood Specimen - Serum - Plain tube (red or yellow) - Plasma - Lithium heparin tube Routine: 8 Hrs STAT: 1 Hr Timed endpoint method Unit: μmol/l Age : Female : Male : 0-150 Y 142-389 202-416 Rejection criteria See Management of Laboratory Specimen (CL 7067);

VALPROIC ACID Full : Depakine, Depakote, Sodium Valporate, Valproic Acid Short name: VALP Blood Specimen - Serum - Plain tube (red or yellow) - Plasma - Lithium heparin tube 2-30 o C Routine: 8 Hrs STAT: 1 Hr Immunoturbidimetric Unit: μmol/l Therapeutic Range Male / Female : 350-690 μmol/l Rejection criteria See Management of Laboratory Specimen (CL 7067);

Vancomycin Collection time Therapeutic Range Full : Vancomycin Short name: Vanco Trough: Just prior to next dose Peak: (not recommended) 1 hour after the end of infusion Blood in: - Plain red tube or yellow - Lithium heparin tube 2-30 o C Routine: 8 Hrs STAT: 1 Hr Immunoturbidimetric Unit: μg/ml. Trough: 15 20 μg/ml. Rejection criteria See Management of Laboratory Specimen (CL 7067);

VITAMIN B-12 Full : VITAMIN B-12 Short name: Vit.B12 Serum - Plain red tube or yellow SST (2 ml - 5 ml) Plasma - Lithium heparin tube 4 ml tube (Fill until the required mark) STAT / Routine: Sunday - Thursday Routine : 2 days Chemiluminiscent Immunoassay Unit: pmol/l Reference Value Female/Male 133-675 Rejection criteria See Management of Laboratory Specimen (CL 7067);

Vitamin D Total Full : Vitamin D Total Short name: VIT.D Serum - Plain red tube or yellow SST (2 ml - 5 ml) Plasma - Lithium heparin tube 4 ml tube (Fill until the required mark) STAT / Routine: Sunday - Thursday Routine: 2 Days Chemiluminiscent Immunoassay Unit: ng/ml Severe deficiency <10 Reference Value Mild to Moderate deficiency 10-30 Optimum values 30-80 Rejection criteria Possible toxicity > 80 See Management of Laboratory Specimen (CL 7067);

Blood Gases Full : BLOOD Gases Short name: ABG,VBG Specimen requirements Arterial or Venous blood collected in heparin syringes Arterial or Venous blood in Lithium heparin tube (Minimum 200 ul in 1 Ml Syringe ) Transport Temperature Days test performed Room temperature within 10 minutes from collection time, not to exceed 30 minutes STAT:24/7, per 7 days a week Turnaround time ( TAT ) /Anal yzer Reference value STAT:30 minutes Potentiometry, Amperometry, Conductance Analyzer :ABL90 Flex ( Radiometer ) Specimen Parameter Type Age From Age To Sex Reference Range Arterial Blood 1 Day 2 Day All 7.29 7.45 >2 Days All All 7.35 7.45 PH Venous Blood All All All 7.32 7.42 Capillary Blood 1 Day 2 Day All 7.29 7.45 Arterial Blood 0 Day 5 day All 27 40 PCO2(mmH 23 g) 6 day Months All 27 41 23 >18 All 35 45

PO2 (mmhg) TCO2 (mmol/l) months Venous Blood All All All 41 51 Capillary Blood 0 Day 5 day All 27 40 23 Months All 27 41 6 day 23 months >18 yrs All 35 45 Arterial Blood 0 Day 1 day All 54 95 02 Day >18 yrs All 83 108 Venous Blood All All All 25 40 Capillary Blood 0 Day 1 day All 54 95 02 day >18 yrs All 83 108 Arterial / 0 days 4 days All 17.0 24.0 Venous / 5 days 12 Yrs All 20.0 28.0 Capillary Blood > 13 yrs All 23.0 27.0 BE (mmol/l) BE(Ecf) (mmol/l) Arterial / Venous / Capillary Blood Arterial / Venous / Capillary Blood All All All -2 2 All All All -2 2 Rejection criteria Performing Lab Location SO2 (%) Arterial / Venous / Capillary Blood See Management of Laboratory Specimen (CL 7067 ) Clotted samples All All All 95% 99%