Laboratory Test Preparation

Leptospira Agglutination Test

Not applicable

Used in the diagnosis of leptospirosis

Agglutination

Special Test

No patient preparation necessary.

• Note Date and Time of collection

• Need requesting physician

• Patient Diagnosis

• License No. of Physician

Red or Gold Tube

3 mL Serum

Not Applicable

48 Hours

7 Days

30 Days

Transport specimen at 2 – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Batch Running

4:00 PM

After 1 week (excluding Saturdays, Sundays and Holidays)

• NEGATIVE

• POSITIVE

Significant titer: ≥ 1: 1600

None specified.

Not applicable

Leptospirosis

Leptospira IgG/IgM (Qualitative test)

• Leptospira IgG
• Leptospira IgM

Used for the qualitative and differential detection of IgG and/or IgM antibody to Leptospira interrogans

Immunochromatography

Serology

No patient preparation necessary.

Red or Gold tube

1-2mL Serum

1-2mL Plasma (EDTA, Heparin, Na Citrate)

Not Specified

7 Days

>2 Weeks

Transport specimen at 2 – 10 °C (with cold packs)

• Improperly labeled specimens
• Hemolyzed specimens
• Lipemic specimens
• Quantity not sufficient
• Specimen transported outside the required temperature.

Daily

NEGATIVE

None identified.

Not Applicable

Leptospirosis, Leptospira interrogans.

• LD
• Lactate Dehydrogenase

Not applicable

• LDH test is a non-specific test that may be used in the evaluation of a number of diseases and conditions.
• May be used as a general indicator of the existence and severity of acute or chronic tissue damage
• May be used to detect and monitor progressive conditions such as anemia, including hemolytic anemia and megaoloblastic anemia, or severe infections
• Help stage, determine prognosis, and/or monitor treatment of cancers, such as germ cell tumors, lymphoma, leukemia, melanoma, and neuroblastoma

Kinetic UV assay

Chemistry

• No patient preparation necessary.
• Separate serum from red cells within 2 hours of collection. 
• Do not refrigerate samples prior to centrifugation.

Red or Gold tube

1-3 mL Serum

1-3mL Plasma (Li-heparin)

7 Days

Note:SERUM MUST BE SEPARATED FROM GEL SEPARATOR

4 Days

Note:

SERUM MUST BE SEPARATED FROM GEL SEPARATOR

In connection with certain diseases (e.g. hepatopathy, diseases of skeletal muscle, malignant tumors), the LDH?4 and LDH?5 isoenzyme portions are increased and unstable in cooled and frozen samples; this may lead to an incorrect LDH value in samples collected from patients suffering from such diseases.

6 Weeks

Note:

SERUM MUST BE SEPARATED FROM GEL SEPARATOR

In connection with certain diseases (e.g. hepatopathy, diseases of skeletal muscle, malignant tumors), the LDH?4 and LDH?5 isoenzyme portions are increased and unstable in cooled and frozen samples; this may lead to an incorrect LDH value in samples collected from patients suffering from such diseases.

• Uncentrifuged sample: Room temperature (15°C – 25°C)

NOTE:

Sample must be separated from serum within 2 hours of collection

• Centrifuged sample:  Refrigerated Temperature (2°C – 8 °C) (with cold packs)

1. Specimens that failed the serum index criteria
2. Specimens with any sign of hemolysis
3. Exceeded sample stability requirement
4. Quantity not sufficient
5. Improperly labeled specimen
6. Improper collection tube used
7. EDTA plasma

Daily

Monday to Saturday:6:00 PM

Sunday:4:00PM

ROUTINE
• 4 hours after receipt of specimen/ arrival of messenger
STAT
• After 2½ hours from extraction/messenger arrival

0-16Y (MALE/FEMALE): 150.00-300.00 U/L
16Y & 1 Day - 999Y MALE: 135.00-225.00 U/L
16Y & 1 Day - 999Y FEMALE: 135.00-214.00 U/L

• In very rare cases, gammopathy, in particular type IgM (Waldenstrom’s macroglobulinemia), may cause unreliable results.

Not applicable

Tissue damage, Comprehensive Metabolic Panel, Haptoglobin, Liver Panel, CSF Analysis, Body Fluid Analysis, Pleural Fluid Analysis, Pericardial Fluid Analysis, Peritoneal Fluid Analysis, Tumor Markers

Not Applicable

1. ANA Immunofluorescent
2. Anti DsDNA
3. Anti-ENA Antibodies
   • Anti snRNP
   • Anti Sm
   • Anti SSA / Ro
   • Anti SSB / La
   • Anti Jo-1

NOTE:Only contents of Anti-ENA test are not ordered separately.

• To aid in diagnosis of Systemic Lupus Erythematosus.
• Helps in confirming and/or excluding the presence of Lupus-like anticoagulants.

Serology:

• Anti-SnRNP, Anti-SSA, Anti-SSB, Anti-Smith, Anti Jo-1–  Enzyme-linked  Immunoassay

• Anti- DsDNA– Enzyme immunoassay (EIA)

• ANA (IMF)- Indirect Immunofluorescence

Special Test: U1RNP

Serology:

• Anti-SnRNP
• Anti Sm
• Anti SSA
• Anti SSB
• Anti Jo-1
• Anti- DsDNA
• ANA(IMF)

No patient preparation necessary.

Anti-DsDNA:1 Red top

ANA (IMF):1 Gold or 1 Red top tube

Anti-ENA Panel :1 Gold tube

Serology:2-3 mL serum

Not applicable.

Serology :

• Anti-ENA Panel -Not Specified

• Anti-DsDNA -2 days

• ANA (IMF) -Not Specified

Serology :

•  Anti-ENA Panel -4 days

• Anti-DsDNA -5 days

• ANA (IMF) - 7 days

Serology :

•  Anti-ENA Panel - >4 days

• Anti-DsDNA - >5days

• ANA (IMF) - 30 days

Transport specimen at 2 – 10 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Serology:

Anti-ENA Panel – Thursdays

Anti-DsDNA – Mondays

ANA (IMF) – Thursday

Serology:

Anti-ENA Panel – Wednesday 9:00PM

Anti-DsDNA - Sunday 5:00PM

ANA (IMF) – Wednesday 6:00PM

Serology:

Anti-ENA Panel – Friday 9:00 AM

Anti-DsDNA – Tuesday, 4:00PM

ANA (IMF) – Friday 4:00PM

Serology:

Anti-ENA Panel

<12.00 AU/ml:NEGATIVE

12.00~18.00 AU/ml:EQUIVOCAL

>18.00 AU/ml:POSITIVE

Anti-DsDNA

NEGATIVE: <25 IU

BORDERLINE POSITIVE: 25 – 30 IU

LOW POSITIVE: 30 – 60 IU

POSITIVE: 60 – 200 IU

STRONG POSITIVE: >200 IU

ANA (IMF)

NO PATTERN:

Adult :

Negative               :  <80

Children <17 y/o :

Negative               :  <40

• HOMOGENOUS, SPECKLED, NUCLEOLAR, CENTROMERE, CYTOPLASMIC

Adult :

Positive threshold  :  80

Low Titer                  : 160-320

High Titer                 : >320

Children <17 y/o:

Titer of 40 may be significant

Heat-inactivation can rise to erroneous results. The quality of the sample can be seriously affected by microbial contamination which leads to erroneous results. Strongly lipemic, icteric, hemolyzed or contaminated samples cannot be used.

Not applicable

Systemic Lupus Erythematosus, SLE, Disseminated Lupus Erythematosus, Lupus Erythematosus, LE, Discoid Lupus, Subacute Cutaneous Lupus, Drug-induced Lupus, Neonatal Lupus

• Blood Lead Level Test
• Blood Lead Test

Not applicable

For the determination of lead concentration in whole blood

Inductively Coupled Plasma - Mass Spectrometry (ICPMS)

Trace Metals

• No special instructions
• No fasting or special diet requirement

4 ml EDTA Tube

2 pcs. of 4 ml EDTA (Whole Blood)

2 pcs. of 2 ml EDTA (Whole Blood)

Not applicable

10 weeks

Not applicable

Store and transport specimen at 2 – 10 °C (with cold packs)

• Clotted sample

• Insufficient volume 

• Incorrect storage temperature of specimen

• Only One (1) K2 EDTA tube submitted 

• Exceeded sample stability requirement

• Improperly labeled specimens

Batch Running

Friday, 4:00 PM

15 working days (excluding Saturdays, Sundays and Holidays)

Children <6 yrs old and Pregnant women: <5 ug/dL

>6 yrs. old: <10 ug/dL

Exposed individuals: <25 ug/dL

Not Applicable

Q :What are the products that may contain lead?

A :Products that contain lead are paints, ceramics, car batteries, pipes, e;ectronic parts, scrap metals, pvc, jewelry, brass objects and plastics.

Q :How do people get exposed to lead?

A :Contact with surfaces contaminated with lead dust and transferring to your mouth. Inhaling dust in lead contaminated areas. Occupational lead exposure like in construction, scrap metal recycling shops, electrician work, firing range workers, auto repair workers, printing press workers and fuel station workers.

• Heavy metals
• Lead Toxicity
• Lead Poisoning
• Zinc Protoporphyrin
• Neurodegeneration

Not applicable

Not applicable

Elevated urinary lead concentration is indicative of chronic lead toxicity. Urinary lead concentrations may be used to monitor detoxification therapy.

Inductively Coupled Plasma/Mass Spectrometry (ICP/MS)

Special Test

Request Container to Special test section (Acid Washed Container)

Acid Washed Container

60 mL Random Urine

Not Applicable

48 Hours

5 Days

14 Days

Transport specimen at 2 – 8 °C (with cold packs)

• Quantity not sufficient
• Received room temperature
• Improperly labeled specimen
• Improper urine collection
• If specimen submitted in a non-acid washed container.

Batch Running

Monday, 12:00 PM

2 weeks after cut-off (excluding Saturdays, Sundays and Holidays)

Available upon request

None specified.

Not applicable

Increased urine lead excretion

Not applicable

Not applicable

• A hormone secreted by adipose tissue which acts on the systems controlling satiety, energy metabolism, thermoregulation and reproductive function.

Electrochemiluminescence (ECL)

Special Test

No patient preparation necessary.

Red or Gold Tube

3 mL Serum

Not Applicable

8 Hours

14 Days

35 Days

Transport specimen at 2 – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Batch Running

Monday, 12:00 PM

2 weeks after cut-off (excluding Saturdays, Sundays and Holidays)

Not Applicable

None specified.

Not applicable

Lymphocyte Antibody Test

Not applicable

This test is done to measure if you produce blocking antibodies to stop the immune system from attacking and rejecting the fetus.

Special Test

• 6 hrs fasting
• Need Requesting Physician
• Patient Diagnosis
• License No. of Physician

Red or Gold Tube

3 mL Serum

Not Applicable

24 Hours

7 Days

Not applicable

Transport specimen at 2 – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Batch Running

7:00 AM

After 1 month (excluding Saturdays, Sundays and Holidays)

Available upon request

None specified.

Not applicable

Tissue Typing, HLA Typing, Histocompatibility Testing, HLA Crossmatching, HLA Antibody Testing/Screening/Identification, Human Leukocyte Antigen, HLA Oligotyping, HLA Sequence-based Typing

• Luteinizing Hormone
• Lutropin
• ICSH
• Interstitial Cell Stimulating Hormone

Not applicable

• Aids in diagnosis and management of pituitary and gonadal disorders.
• In women and men, LH (and FSH) tests are ordered as part of the workup of infertility, suspected pituitary problems, or gonadal disorders when a woman is having trouble getting pregnant or when pituitary, ovary, or gonadal disorders are suspected.
• The test may be ordered along with an FSH test when a woman is having irregular menstrual periods, especially at the beginning of menopause.
• LH and FSH may be ordered when a boy or girl does not appear to be entering puberty at an appropriate age (either too late or too soon). Irregular timing of puberty may be an indication of a more serious problem involving the hypothalamus, the pituitary gland, the gonads (ovaries or testes), or other systems. The measurement of LH and FSH may differentiate between benign symptoms and true disease. Once it is established that symptoms are a result of true disease, further testing can be done to discern the underlying cause.

Electrochemiluminescence Immunoassay (ECLIA)

Immunology

No patient preparation necessary.
•Samples should not be taken from patients receiving therapy with high biotin doses (i.e. > 5 mg/day) until at least 8 hours following the last biotin administration.

Red or Gold tube

1-3mL Serum

1-3 mL Plasma (Li-, Na-, Ammonium heparin/ K3-EDTA/ sodium fluoride/ potassium oxalate)

Not specified

2 Weeks

6 Months (Freeze only once)

Transport specimen at 2°C – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Monday, Wednesday, Friday

Monday to Saturday:10:00 PM

Sunday:6:00PM

ROUTINE (on running days)
• 4 hours after receipt of specimen/ arrival of messenger
STAT (on running days only)
• 2½ hours from extraction/messenger arrival

Female:
Folicular phase: 2.40-12.60 mIU/mL
Ovulation phase: 14.00 - 95.60 mIU/mL
Luteal phase: 1.00 - 11.40 mIU/mL
Post menopause: 7.70 - 58.50 mIU/mL

Male: 1.70-8.60 mIU/mL

•Samples should not be taken from patients receiving therapy with high biotin doses (i.e. > 5 mg/day) until at least 8 hours following the last biotin administration.

Not applicable

Fertility Testing, FSH,Testosterone, Progesterone, Estrogens, Androstenedione, Semen Analysis, Anti-Mullerian Hormone, Prolactin, SHBG

Leuteinizing Hormone

Not applicable

This test is useful in the differential diagnosis of pituitary and gonadal insufficiency and in children with precocious puberty.

Radio Immuno Assay (RIA)

Special Test

No patient preparation necessary.

Red or Gold Tube

3 mL Serum

Not Applicable

48 Hours

7 Days

28 Days

Transport specimen at 2 – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Improperly labeled specimen
• Improper collection tube used

Wednesday

Tuesday, 7:00 AM

3 days after running day (excluding Saturdays, Sundays and Holidays)

Available upon request

None specified.

Not applicable

Menopause, Infertility or Lowered sex drive

Not applicable

Not applicable

Aids in the diagnosis of acute and chronic pancreatitis

Enzymatic (Quinone Dye)

Chemistry

• No patient preparation necessary.

Red or Gold tube
 

1-3 mL Serum

1-3 Plasma (Lithium heparin and Sodium heparin)

7 Days

7 Days

1 Year ( Freeze only once)

Transport specimen at 2 – 8 °C (with cold packs)

• Failed serum index samples
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Daily

Monday to Saturday:10:00 PM

Sunday:6:00PM

ROUTINE
• 4 hours after receipt of specimen/ arrival of messenger
STAT
• After 2½ HOURS from extraction/messenger arrival

8.00~78.00 U/L

Interferences from medications or endogenous substances such as Acetaminophen, Dipyrone, N-Acetyl-L-Cysteine, N-Acetyl-4-benzoquinone Imine (NAPQI) may affect results.

Not applicable

Amylase, Trypsin, Trypsinogen

• Lipid Panel

1. Cholesterol
2. Triglycerides
3. HDL
4. LDL
5. VLDL
6. CHOL/HDL

Used as part of cardiac risk assessment to help determine an individual's risk of heart disease and to help make decisions about what treatment may be best if there is borderline or high risk.

Cholesterol: CHOD-PAP
Triglycerides: Enzymatic
HDL: Direct Measure - PEG
LDL: Calculated
VLDL: Calculated
CHOL/HDL: Calculated

Chemistry

10-14 hours fasting.
Note:
• Prolonged fasting is highly discouraged since various metabolic changes associated with starvation may begin to develop. Water intake is acceptable.
• Note in clinical info if patient drank more than 4 glasses of water during fasting period, ask patient for medical history as this is rather unusual.
• Note in clinical info in case patient overfasts and insists on proceeding test.

Red or Gold tube

1-3 mL Serum

1-3mL Plasma (Li-heparin)

Not Specified

7 Days

30 Days

Transport specimen at 2 – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Daily

Monday to Saturday:10:00 PM

Sunday:6:00PM

RUNNING TIME: 6:00 AM onwards

RELEASING TIME: ROUTINE
• 4 hours after receipt of specimen/ arrival of messenger
RELEASING TIME: STAT
• After 2½ hours from extraction/messenger arrival

Cholesterol:
NCEP Recommendations:
Desirable: <5.20 mmol/L (<200.00 mg/dL)
Borderline High: 5.20-6.20 mmol/L (200.00-239.38 mg/dL)
High: >/= 6.20 mmol/L (>/= 239.38 mg/dL)

Triglycerides:
NCEP Recommendations:
Borderline High: 1.69-2.25 mmol/L(149.57-199.12 mg/dL)
High: 2.26-5.64 mmol/L (200.01-499.14 mg/dL)
Very High: >/= 5.65 mmol/L (>/= 500.02 mg/dL)

HDL (mmol/L):
MALE: >1.45:No risk for CHD,based on HDL value
0.90-1.45:Moderate risk for CHD
<0.90:High risk for CHD
FEMALE: >1.68:No risk for CHD,based on HDL value
1.15-1.68:Moderate risk for CHD
<1.15:High risk for CHD

LDL:
MALE:1.27-4.47 mmol/L (49.03-172.59 mg/dL)
FEMALE:1.64-4.34 mmol/L (63.32-167.57 mg/dL)

VLDL: < 0.78 mmol/L (<30.00 mg/dL)

CHOL/HDL:
MALE:< 5.70
FEMALE:< 4.52

• Elevated concentrations of free fatty acids and denatured proteins may cause falsely elevated HDL-cholesterol results.
• In rare cases, elevated immunoglobulin concentrations can lead to artificially increased HDL-cholesterol results.
• Abnormal liver function affects lipid metabolism; consequently, HDL and LDL results are of limited diagnostic value. In some patients with abnormal liver function, the HDL-cholesterol result may significantly differ from the DCM (designated comparison method) result.
• Endogenous unesterified glycerol in the sample will falsely elevate serum triglycerides.
• Dicynone (Etamsylate) at therapeutic concentrations may lead to false-low results.
• Ascorbic acid and calcium dobesilate cause artificially low triglyceride results. Intralipid is directly measured as analyte in this assay and leads to high triglyceride results.
• Acetaminophen intoxications are frequently treated with N-Acetylcysteine. N-Acetylcysteine at the therapeutic concentration when used as an antidote and the Acetaminophen metabolite N-acetyl-p-benzoquinone imine (NAPQI) independently may cause falsely low results.
• Venipuncture should be performed prior to the administration of Metamizole. Venipuncture immediately after or during the administration of Metamizole may lead to falsely low results.
• In very rare cases, gammopathy, in particular type IgM (Waldenstrom’s macroglobulinemia), may cause unreliable results.

Q: When should testing for cholesterol/lipid profile be done?
A: In all adults aged 20 years or older, a fasting Lipid Profile should be obtained once every 5 years.

Q: Can cholesterol be done on non-fasting samples?
A: If the testing opportunity is nonfasting, only the values for total cholesterol and HDL cholesterol will be usable.

Cholesterol, HDL Cholesterol, LDL Cholesterol, Triglycerides, Direct LDL Cholesterol, VLDL Cholesterol, Cardiac Risk Assessment , Lp-PLA2, Apo A-I, Apo B; Lp(a), LDL Particle Testing

Not Available

• HDL Particle Size
• HDL Size NMR
• LDL Particle Size NMR
• Large HDL Particle number NMR
• HDL Particle number NMR
• Large VLDL Particle number NMR

Used in Appropriate high risk patients (eg Diabetes Mellitus) in whom LDL particle number is being used to guide the therapy

• Quantitative Nuclear Magnetic Resonance
• Spectroscopy

Special Test

12hrs Fasting is Required

Blood sample will be drawn every Monday - Tuesday from 8am-12pm.

Plain Red Tube

4 ml serum

Not Applicable

2 days

30 days

Not Available

Transport specimen at 15°C ~25 °C (room temperature)

• Not properly labeled specimen
• Non Fasting
• Lipemic Sample

Batch Running

Monday, 12:00 PM

3 working weeks except Saturdays Sundays and Holidays

Not Applicable

Not Applicable

Not Applicable

Not Applicable

Not Applicable

• Total Cholestero
• Triglycerides
• HDL Cholesterol
• LDL Cholesterol Calc.
• HDL Particle size NMR
• VLDL Particle size NMR
• LDL Particle size NMR
• Large HDL Particle number NMR
• HDL Particle number NMR
• Large VLDL Particle number NMR
• Small LDL Particle number NMR
• LDL Particle number NMR
• EER LipoFit by NMR

Use in appropriate high risk patients (eg, type 2 diabetes mellitus)in whom LDL particle number is being used to guide therapy.

• Quantitative Nuclear Magnetic Resonance
• Spectroscopy
• Quantitative Enzymatic
• Detergent Solubilization

Special Test

• With 12hrs Fasting
• Not recommended for cardiovascular disease risk assessment in most individuals.
• Blood sample will be drawn every Monday - Tuesday from 8am-12pm.

Plain Tube

4 ML Serum 

Not Applicable

24 Hours

5 Days

Not Available

Transport specimen at 15°C ~25 °C (room temperature)

• not properly labeled specimen
• non fasting specimen
• QNS Sample
• Lipemic Sample
• Exceeded sample stability requirement

Batch Running

Monday, 12:00 PM

3 working weeks except Saturday, sundays and Holidays

Not Applicable

Not Applicable

Not Applicable

Not Applicable