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General Diagnostics Information

Source: uuhsc.utah.edu/hlalab/Mission.html

Biological fluids and secretions such as those shown in table 1 below are commonly analyzed in the clinical laboratory. Testing purposes may vary from simple drug screenings to determining whether or not a patient may have cancer. A summary of the many types of routine tests is shown in Table 2

Table 1 Body fluids and excrements analyzed in medical laboratories

Whole blood (EDTA) from arteries, veins, blood capillaries

plasma (EDTA, heparin, citrate)

serum

urine

cerebrospinal fluid (CSF)

synovial fluid

ejaculate

stool

saliva

sputum

amnion fluid

ascites etc.

(Source: Schleicher, 2006)

Table 2 Analytes from blood or urine currently determined in routine clinical chemistry laboratories (analytes may vary depending on the specialization and size of the hospital)

a) blood cells ① haemoglobin ① (Hb)	erythrocyte-, leukocyte-, thrombocyte count, differential leukocyte count, erythrocyte sedimentation rate ⑧, Hb content, Hb A1c, HbA2, HbF
b) electrolytes ② ③ ④ ⑥ blood gas analysis ④ ⑦	Na^+, K^+, Ca^2+, free Ca^2+, Mg^2+, Cl^−, PO4 ^3−, pH, pCO2, pO2 ⑦
c) substrates / lipids ② ③	ammonia ④ ⑦ (NH4 ^+), bilirubin, creatinine, ethanol, glucose⑦, lactate⑦, urea, uric acid, total cholesterol, triglyceride, HDL- and LDL-cholesterol, free fatty acids
d) enzymes ② ③	alkaline phosphatase (AP) amylase, lipase cholinesterase (CHE), creatine kinase (CK), glutamate oxaloacetic transaminase (GOT), glutamate pyruvate transaminase (GPT), γ-glutamyl transferase (γ-GT), lactate dehydrogenase (LDH)
e) coagulation parameters ⑤	prothrombin time (PT) (Quick), partial thromboplastin time (PTT), antithrombin-III, APC-resistance, D-Dimer, factor II, V, VII, VIII, IX, X, XI, XII, XIII, heparin (antiXa), fibrin degradation products, fibrin monomers, protein-S/-C, thrombocyte antibodies, complement C3, C4, C1 esterase-inhibitor
f) hormones ② ③	free thyroxine (fT4), free triiodothyronine (fT3), thyreoidea-stimulating hormone (TSH), cortisol and other steroid hormones, corticotrophin (ACTH) ⑦, insulin, C-peptide, proinsulin, insulin-like growth factor (IGF)−1, erythropoetin, follitropin (FSH), lutropin (LH), gastrin, glucagon, growth hormone, prolactin, renin
g) inflammation markers, cytokines ② ③	C-reactive protein (CRP), interleukins (IL)–1β, –6,–8,–10, tumour necrosis factor (TNF) α
h) plasma proteins ② ③	albumin immunoglobulin G, –A, –M, –E, transferrin, ceruloplasmin, fibrinogen, Apo-protein A, Apo-protein B, carbohydrate deficient transferrin (CDT), ferritin, myoglobin, troponin, haptoglobin, hemoglobin, α1-fetoprotein (AFP), α1-antitrypsin, α1-orosomucoid, β2-microglobulin
i) autoantibodies ② ③	Autoantibodies against: glutamic-acid-decarboxylase (GAD), cardiolipin, phospholipid, anti-mitochondrial (AMA), anti-cytoplasmatic-(ANCA), anti-nuclear-(ANA), anti-thyreoglobulin-anti-thyreoideaperoxidase antibodies, thyreotropine receptor antibodies, rheuma factors
j) drugs	drug screening ② ③ ⑥: barbiturate, tricyclic antidepressants, opiates, benzodiazepine, tetrahydrocannabinol
	therapeutic drug monitoring (TDM) ② ③: acetylsalicylate, carbamazepine, coffein, digoxin, digitoxin, disopyramide, ethosuximid, immunosuppressants (e.g. cyclosporin①, tacrolimus①), methotrexate, paracetamol, phenobarbital, phenytoin, primidone, theophylline, valproate, etc.
k) electrophoresis	serum protein electrophoresis ③, immune electrophoresis ③, urine electrophoresis ⑥, haemoglobin electrophoresis ①
l) tumour markers ② ③	carcino-embryonic antigen (CEA), CA 125, CA 15–3, CA 19–9, CA 72–4, CYFRA 21–1, neuron-specific enolase (NSE), prostata specific antigen (PSA), chromogranine
m) trace elements, vitamins ② ③	Cu, Fe, Zn, Se, Pb, etc. vitamin A, B1, B2, B6, B12, C, D, E, K, folate
n) special analytes in plasma ② ⑦ or in urine ⑥ ⑦	catecholamines (adrenaline, noradrenaline, dopamine) and degradation products (metanephrines, vanillyl-mandelic acid (VMA), homo-vanillyl-mandelic acid (HVA)), porphyrins, 5-hydroxyindol acetic acid (HAA), osmolarity ③
o) neonatal screening ⑦	TSH, galactose, phenylalanine, etc.

Specimens from CSF, saliva, ascites or from other sources are not included

Indices indicate the sample species used for each analysis:

① - EDTA - blood

② - heparin plasma

③ - serum

④ - capillary blood (heparin-coated)

⑤ - citrate plasma

⑥ - urine

⑦ - special sampling and/or pretreatment

⑧ - citrate blood (Source: Schleicher, 2006)

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