“Testing Time: Make the laboratory your friend!” - Key Messages

 

 

Contacts

Specimen reception                                          01782 554638

Pathology Office                                               01782 554648

Biochemistry Helpdesk                                     01782 554676

Duty Biochemist                                               Contact via

                                                                          Hospital switchboard

Immunology                                                      01782 554041

Haematology                                                     01782 554623

Microbiology                                                    01782 554666

Virology                                                           01782 554682

IT issues                                                             01782 554489

 

 

Request Cards

 

Always provide

 

Ensure handwriting is legible

Encourage dates and times on the samples bottles

 

Common issues

 

Wrong samples being taken - pathology handbooks are available on the internet

 

www.uhns.nhs.uk

            Healthcare professional section

            Pathology

            Pathology Handbooks

 

 

Biochemistry:

 

Most useful tests are the most common

       Renal, liver, bone, thyroid, glucose

       LFTs are most commonly requested pathology tests

       Utility of biochemical tests depends on clinical question

       Please contact to discuss individual cases

 

Hyperkalaemia:

       Need to exclude artefacts

       ? On cells/EDTA/difficult venepuncture

       Interpret in light of renal function

       Lithium heparin sample in difficult cases

       Drug history

       ACE/NSAIDs/heparin/LoSalt

 

Magnesium

       Often neglected test but can be useful in investigation of:

       Hypocalcaemia

       Hypokalaemia

       Low magnesium also potentiates digoxin toxicity

 

Urinalysis:

       Investigation of ? Myeloma

       BJP

       Investigation of hyponatraemiaRheumatoid factor is of more value in prognosis than diagnosis in RA

       Presence of ANA does not equate with Autoimmune disease however, ANA is useful when negative to virtually exclude a diagnosis of SLE.

       interpretation of positive ANA depends on titre of result, age & sex of patient as autoantibodies increase in elderly females in the absence of disease.

  

Least Useful Tests:

       Random cortisol/growth hormone

       Generic “hormone profiles” or “tumour markers” requests

       B12/folate

       Useful in macrocytic anaemia/neuropsychiatric symptoms

 

 

Immunology

Auto-immune disease

Rheumatoid factor is of more value in prognosis than diagnosis in RA

        Presence of ANA does not equate with Autoimmune disease however, ANA is useful when negative to virtually exclude a diagnosis of SLE.

        interpretation of positive ANA depends on titre of result, age & sex of patient as autoantibodies increase in elderly females in the absence of disease.

 

 

Allergy

        Immediate type-1 hypersensitivity, IgE – mediated.

        Most helpful part is clinical history – seasonal, perennial, animals, food type, occupation, bee, wasp, drugs

 Please be specific about your IgE !

 

Immunology NBs:

Where possible, please request specific tests

Please give clinical details

Any queries or comments, please contact us

Lab  tel no. 01782 554140

Lead BMS: Karen Sneade 01782 554245

karen.sneade@uhns.nhs.uk