Laboratory Test Preparation

• Red Blood Cell Folate

• RBC Folic

• Erythrocyte Folic Acid

Not Applicable

• Folate deficiency is associated with systemic (asthenia and anorexia), psychiatric and neurological symptoms. A variety of different causes are possible: inadequate intake or absorption, increased need, drug interactions, genetic abnormality and excessive loss. Serum levels reflect recent folate intake and erythrocyte levels are a measure of reserves.

Immunoassay

Special Test

No patient preparation

EDTA

3 pcs of 4mL EDTA

72 Hours

72 Hours

30 Days

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

• Improperly labeled specimens
• Clotted specimens
• Over-filled or Under-filled tube
• Quantity not sufficient
• Specimen stored and transported outside the required temperature

Batch Running

Monday, 12:00 PM

14 days after cut-off (excluding Saturdays, Sundays and Holidays)

• RBC appearance in urine
• RBC size/shape in urine
• Red Blood Cell Morphology

Not applicable

Aids in determining the site of renal bleeding (to differentiate if bleeding is associated primarily with glomerular bleeding, or due to non-glomerular haematuria).

Direct Microscopic Examination

Clinical Microscopy

No patient preparation necessary.

Clean, leak-proof container

10-15 mL Urine

NOTE: For pediatric and geriatric patients, minimun of 5 mL is acceptable.

Not applicable

2 Hours

2 hours

Unacceptable

Transport specimen to HPD laboratory at 2 – 8 °C (with cold packs) within 2 hours

NOTE: Do not delay transport of samples.

• Quantity not sufficient (QNS): Samples less than 10mL
NOTE: For pediatric and geriatric patients, minimun of 5 mL is acceptable.
• Specimen with fecal contamination
• Decomposition or bacterial overgrowth due to delayed transport of urine
• Improperly labeled sample
• Patient collected urine sample during menstruation OR less than 3 days of last menstruation.

Daily

Monday to Saturday
• 6:00 PM

Sunday
• 3:00 PM

ROUTINE
• 3 hours after receipt of specimen/ arrival of messenger
STAT
• After 1½ hours from receipt of specimen/ arrival of messenger

RBC Morphology (Urine):
• Normal = 70%
• Crenated = 5%
• Dysmorphic = 25%

Presence of menstrual blood may interfere with the result of RBC morphology.

Not applicable

Creatinine, Kidney Function

• Random Blood Sugar
• Random Blood Glucose

Not applicable

RBS is a test that determines how much sugar is in a blood sample at anytime without fasting.

Hexokinase

Chemistry

No patient preparation necessary.
Note:
• Samples without preservatives (NaF) must be separated from red cells within 30 mins of blood extraction.

Red or Gold tube

1-3 mL Serum

1-3mL Plasma (Li-heparin and K2-EDTA, NaF/Na2 EDTA, KF/Na2 EDTA, NaF/K?Oxalate and NaF/citrate/Na2?EDTA)

Serum (no hemolysis): 8 hours
Plasma (fluoride): 3 days

72 Hours

Not specified

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

3.89~7.79 mmol/L (70.73~139.90 mg/dL)

ADA Recommendations 2015:
Pre-diabetics: 7.8-11.0 mmol/L(140-199 mg/dL)
Diabetics: >/=11.10 mmol/L(>/=200.00 mg/dL)

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

Not applicable

HbA1c, Urinalysis, Insulin, C-peptide, Urine Albumin, Comprehensive Metabolic Panel, Basic Metabolic Panel, Fructosamine

Renin-angiotensin system activity

Renin activity

RAP

Not Applicable

A proteolytic enzyme synthesized by renal juxtaglomerular cells which converts angiotensinogen into angiotensin I. Useful in the diagnosis of renovascular hypertension. Increased levels seen in high blood pressure and in response to certain drugs (diuretics and calcium inhibitors). Reduced levels are associated with primary hyperaldosteronism (Conn's syndrome) and hyperadrenocorticism (e.g. Cushing's syndrome).
The measured activity of the renin-angiotensin-aldosterone system (RAAS) depends on many different factors, including:
- the (position) posture of the subject: during sampling
* lying down: the subject should have been lying down and at rest for at least 3 hours without having so much as put a foot on the ground (blood to be drawn at the patient's home with a third party opening the door)
* standing up: slowly walking for at least one hour; both renin and aldosterone levels double in an erect posture;

- age: levels decrease with age . The concentration in 50 year-olds is about one half that observed in those of under 30 years of age
- sodium intake: RAAS activity is inversely related to sodium intake so it is essential to make sure the subject is not on any special diet with respect to sodium;
- drugs: most antihypertensive drugs interfere with RAAS activity. All diuretics, beta-blockers and converting enzyme inhibitors should have been discontinued at least two weeks before the test and aldosterone antagonists (e.g. spironolactone) should be discontinued a full month beforehand. Courses of prazosin (e.g. Minipress and Alpress LP) and of centrally acting antihypertensive drugs (e.g. methyldopa) can be continued.

Radio Immunoassay

Special Test

• DIET INFORMATION: our reference ranges are only valid for a normal salt intake (80-250mEq/24hrs natriuresis )
• Specify upright or reclined (Sampling in upright position after 1 hr of walking : REND
  sampling in the reclined position after 1 hr in supine position : RENC

EDTA or Violet Tube

3 mL Plasma

Not Applicable

24 Hours

24 Hours

28 Days

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

• Quantity not sufficient
• Received room temperature
• Improperly labeled specimen
• Hemolyzed sample

Batch running

Friday 12:00 PM

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

Available upon request

None specified

Not Applicable

Not applicable

• To assess the function of the bone marrow and to help monitor progress after chemotherapy, bone marrow transplants, or after treatment for iron deficiency anemia.
• To evaluate erythropoietic activity in hemorrhage and hemolytic anemias and also to evaluate response to therapy of various anemias.

Direct Microscopic Examination- Brilliant Cresyl Blue stain

Hematology

No patient preparation necessary.

EDTA (purple top)

• 2mL EDTA whole blood
Note: 0.250- 0.500 mL EDTA whole blood if microtainer is used

Not applicable

Not applicable

24 Hours

Not applicable

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

• Improperly labeled specimens
• Clotted
• Under-filled or over-filled tube
• Specimen transported outside the required temperature.
• Exceeded sample stability requirement

Daily

Monday to Saturday
• 6:00 PM

Sunday
• 3:00 PM

ROUTINE
• 3 hours after receipt of specimen/ arrival of messenger
STAT
• After 1½ HOURS from extraction/messenger arrival

0.50%-1.50%

• In transfused patients, reticulocytes may decrease on a dilutional basis

Not applicable

Complete Blood Count, CBC, Red Blood Cell Count, Hemoglobin, Hematocrit, Blood Smear, Erythropoietin, Vitamin B12 and Folate, Haptoglobin, G6PD, Iron Tests, Bone Marrow Aspiration and Biopsy, Anemia, Bone Marrow Disorders, Myeloproliferative Neoplasms.

RF (Rheumatoid Factor) / Reumatoid Factor Qualitative

Reumatoid Factor with dilution / Reumatoid Factor Quantitative

Not Applicable

Used for diagnosis of rheumatoid arthritis but can also be found in other inflammatory-rheumatic diseases and in various non-rheumatic diseases.

Diagnosis of rheumatoid arthritis in patients with inflammatory arthritis.

Turbidimetry

Chemistry

No patient preparation necessary.

Red or Gold tube

1-3 mL Serum

Not Applicable

Not Specified

2 days

Indefinite

• Sample must be sent to laboratory immediately after collection.
• Serum should be stored and transported at 2?C to 8?C (with cold packs).

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

Daily

Monday to Saturday
• 6:00 PM

 

ROUTINE
• 4 hours after receipt of specimen/ arrival of messenger

• Negative:< 30.00 IU/mL
• Weak positive: 30.00-50.00 IU/mL
• Positive: >50.00 IU/mL

Not applicable

Not Applicable

Rheumatoid Arthritis, RA

Risk of Ovarian Malignancy Algorithm

1. HE-4
2. CA-125
3. ROMA

By measuring both markers together, the strengths of both markers can be combined to ensure optimized sensitivity and specificity for primary diagnosis- especially for patients with pelvic mass and detection of recurrence during follow-up. The dual marker combination CA 125 and HE 4 is a more accurate predictor of malignancy than either alone. Measured values of HE 4 and CA 125 can be combined in an algorithm called ROMA.

Electrochemiluminescence Immunoassay (ECLIA)

Immunology

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

1-3 mL Serum

1-3 mL Plasma (Li-heparin, K2, K3-EDTA)

HE4 :5 hours
CA 125: Not specified

HE4: 48 Hours
CA 125: 5 Days

HE4: 12 Weeks (Sample may be frozen twice)
CA 125: 3 Months

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

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

Batch Running: 7 Days

6:00 PM

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

CA125: 0.00-35.00 U/mL

HE4:
<40Y: <60.50 pmol/L
40Y & 1 Day – 49Y: <76.20 pmol/L
49Y & 1 Day– 59Y: <74.30 pmol/L
59Y & 1 Day – 69Y: <82.90 pmol/L
69Y & 1 Day - 999Y: <104.00 pmol/L

ROMA:
Premenopausal:
>/= 11.40%: High Risk
< 11.40%: Low risk

Postmenopausal:
>/= 29.90%: High Risk
< 29.90%: Low risk

Note:
ROMA score result must be interpreted in conjunction with other methods in accordance with standard clinical management guidelines.

• 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.
• In rare cases, interference due to extremely high titers of antibodies to analyte?specific antibodies, streptavidin or ruthenium can occur.

Not applicable

Tumor Markers, BRCA-1 and BRCA-2, CA 125, HE4

Rotavirus Antigen

Not Applicable

Rotaviruses cause epidemics or outbreaks of acute infantile gastroenteritis, especially in the winter months. Such infections are a common reason for the hospitalization of babies.

Massive numbers of viral particles are excreted in the feces and they can be directly detected for rapid diagnosis.

Serological analysis is relatively insensitive and of very limited value.

Rapid Enzyme Immunoassay

Special Test

• Collection should be done at DEL MONTE BRANCH ONLY
• No patient preparation necessary.
• Inform laboratory 1 day before extraction for schedule.
• For schedule special trip

NOTE: Stool specimen should not be contaminated with urine or other water contaminant.

Sterile Leak-proof container

Pea size of Stool/Feces (Freshly Collected)

Not Applicable

Not Applicable

1 Hour

Not Applicable

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

• Quantity not sufficient or less than pea size
• Contaminated stool (e.g) with urine or other fluids
• Improperly labeled samples 
• Sample that contains formalin and other preservatives and collected with transport media.
• Exceeded sample stability requirement 

Monday to Friday

Monday to Friday, 7:00 AM 

3 days after cut-off (excluding Saturdays, Sundays and Holidays)

Available upon request

None Specified.

Not Applicable

Diarrhoeal disease

Stool Exam

Physical Exam
• Color
• Consistency

Microscopic Examination
• White Blood Cell
• Red Blood Cell
• Fat Globules (if present)
• Ova/Parasite
• Yeast Cells (if present)

Aids in the early detection of parasitic infection and assess worm burden of a patient

Direct Fecal Smear (NSS and Lugol's)

Clinical Microscopy

No patient preparation necessary.
*Fresh specimens are necessary for the recovery of motile protozoa.
The following recommendations should be considered in accepting fresh specimens:
1. Liquid and Soft : Must be examined within 30 minutes of passage
2. Semi-formed: Must be examined within 1 hour of passage
3. Formed: Must be examined within 24 hours of passage

Clean, leak-proof container

Pea sized or size of 25 centavo coin stool

Not applicable

Liquid: 30 Minutes
Soft: 30 Minutes
Semi-formed: 1 Hour
Formed: 24 Hours

Not specified

Unacceptable

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

• Improperly labeled specimen container
• Exceeded abovementioned stability requirements
• Quantity of stool sample not sufficient
• Contaminated stool sample (E.g. water, urine or any other fluids.)

Daily

Monday to Saturday
• 6:00 PM

Sunday
• 3:00 PM

ROUTINE
• 3 hours after receipt of specimen/ arrival of messenger
STAT
• After 1½ hours from receipt of specimen/ arrival of messenger

NO INTERTINAL PARASITE SEEN

Samples which exceeded sample stability prior to examination may produce erroneous results.

Q: Is specimen collected in diaper be acceptable?
A: It is advised not to proceed with stool analysis, because the stool specimen may be contaminated with urine, and the characteristics morphology of the parasite maybe affected but agree to accept if patient/physician insisted to proceed with the test due to difficulty in sample collection.

Diarrhea

• Rapid Plasma Reagin
 

Not Applicable

Used for screening of Syphilis, a venereal disease caused by the microorganism Treponema pallidum. It is also requested as part of pre-natal check-up, usually during the first trimester of pregnancy.

 

Flocculation

Serology

No patient preparation necessary.

Red tube (DO NOT USE GOLD TUBE or any other type of tube with gel separator)

1-2mL Serum

1-2mL Serum

Not Specified

5 Days

4 Weeks

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

• Gold Top (Collection tube WITH gel separator)
• With signs of bacterial contamination
• Markedly lipemic serum
• Improperly labeled specimens
• Hemolyzed specimens
• Quantity not sufficient
• Specimens exceeded sample stability requirement

Monday - Saturday
Batch Running:
• 9:00 AM
• 12:00 NOON
• 3:00 PM
• 6:00 PM
• 8:00 PM
 
Sundays
Batch Running:
• 9:00 AM
• 12:00 NOON
• 4:00 PM

Monday to Saturday
• 8:00 PM

Sunday
• 4:00 PM

ROUTINE
• 4 hours after receipt of specimen/ arrival of messenger

No STAT Requests

<1:1 NONREACTIVE

Diseases such as leprosy, lupus erythematosus, infectious mononucleosis, malaria, vaccina and viral pneumonia may give false positive results. All reactive samples should undergo further serological test (i.e. TPPA)

Not Applicable

Syphilis Screening, Fluorescent Treponemal Antibody Absorption Test, FTA-ABS, Treponema pallidum Particle Agglutination Assay, TPPA, Microhemagglutination Assay, MHA-TP, Darkfield Microscopy, Automated Immunoassays for Syphilis Antibodies, Treponema pallidum by PCR, Syphilis Detection Tests

IgG Antibodies to Rubella virus

Not Applicable

Rubella is a viral exanthematous infectious disease caused by rubella virus. This test is intended for the determination of:

• IgG-class antibodies to Rubella virus in human serum.
• past infection with Rubella Virus.

Chemiluminescent Microparticle Immuassay (CMIA)

Immunology

No patient preparation necessary.

Red or Gold top tube

1-3 mL Serum

1-3 mL Plasma (Li-, Na-, Ammonium heparin, EDTA, Na Citrate)

Not applicable

14 days

1 month

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

• Markedly lipemic specimens
• Hemolyzed specimens
• Specimens showing bacterial contamination
• Improperly labeled specimens
• Quantity not sufficient
• Specimen stored exceeded outside required stability

Monday-Friday 

6:00 PM

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

NEGATIVE: 0.0 to 4.9 IU/mL

EQUIVOCAL: 5.0 to 9.9 IU/mL

POSITIVE: >10.0 IU/mL

Heterophilic antibodies, Mouse monoclonal antibodies and human anti-mouse antibodies (HAMA)

Not Applicable

TORCH, Measles and Mumps, CSF Analysis, Toxoplasmosis, CMV, Rubella Antibodies, Rubella IgM, German Measles,
Three (3)-day Measles

IgGMAntibodies to Rubella virus

Not Applicable

:

Rubella is a viral exanthematous infectious disease caused by rubella virus. This test is intended for the determination of:

• IgM-class antibodies to Rubella virus in human serum.
• current infection with Rubella Virus

Chemiluminescent Microparticle Immuassay (CMIA)

Immunology

No patient preparation necessary.

Red or Gold top tube

1-3 mL Serum

1-3 mL Plasma (Li-, Na-, Ammonium heparin, EDTA, Na Citrate)

Not specified

14 days

1 month (not more than 6 freeze/ thaw cycles)

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

• Improperly labeled specimens
• Hemolyzed specimens
• Lipemic specimens
• Quantity not sufficient
• Specimen storage and transport exceeded required temperature

Every Friday

6:00 pm

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

 NEGATIVE:     <1.20  S/CO

 EQUIVOCAL:  1.20 ~ 1.59 S/CO

 POSITIVE:       >/= 1.60 S/CO

Heterophilic antibodies, Mouse monoclonal antibodies and human anti-mouse antibodies (HAMA)

Not Applicable

TORCH, Measles and Mumps, CSF Analysis, Toxoplasmosis, CMV, Rubella Antibodies, Rubella IgM, German Measles,
Three (3)-day Measles

Not Applicable

Not Applicable

Used for Qualitative detection and screening of IgM antibodies to Rubella

Immunochromatography

Serology

No patient preparation necessary.

Red or Gold tube

1-2mL Serum

1-2mL Plasma (EDTA)

Not Specified

3 Days

>3 Days

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

• Improperly labeled specimens
• Hemolyzed specimens
• Lipemic specimens
• Quantity not sufficient
• Specimen storage and transport exceeded required temperature

Daily

Monday to Saturday
• 8:00 PM

Sunday
• 3:00 PM

ROUTINE
• 3 hours after receipt of specimen/ arrival of messenger
STAT
• 1½ hours from extraction/messenger arrival

NEGATIVE

None identified.

Not Applicable

Newborn Infection, German Measles; Three-day Measles; 3-day Measles, Rubella Antibodies, IgM and IgG

Anti-Morbillivirus antibodies - IgG/IgM

Not applicable

Used in diagnosis of infection with measles in a non vaccinated patient and to establish immunity subsequent to vaccination.

A highly contagious disease which causes fever and skin eruption in children and which can give rise to complications in the form of pneumonia or severe panencephalitis. It is becoming rare in the industrialized world because of effective immunization programs but it remains a public health problem in under-developed countries. Diagnosis depends on detecting viral antigens in nasopharyngeal or conjunctival material. The virus can be isolated but it usually grows very slowly. Serological analysis can be used to demonstrate seroconversion and the presence of specific IgM antibodies. IgG antibodies are persistent and their level gives a measure of protection (either after immunization or following natural infection).

Chemiluminescence

Special Test

No patient preparation necessary.

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

Batch Running

Friday, 4:00 PM

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

Available upon request

None specified.

Not applicable

Rubeola, Parotitis, Measles Immunity Test, Mumps Immunity Test, Measles Blood Test, Mumps Blood Test, Measles Antibody, IgM and IgG, Measles Viral Culture, Measles by RT-PCR, Mumps Antibody, IgM and IgG, Mumps Viral Culture, Mumps by RT-PCR

•Rubeola IgG
•Measles IgG

•Measles Antibody IgG

Not Applicable

For the determination of IgG-Class antibodies to Measles virus in human serum.

ENZYME LINKED IMMUNOSORBET ASSAY (ELISA)

Serology

No patient preparation necessary.

Red or Gold top tube

2mL Serum

Not Applicable

Not Specified

4 Days

> 4 Days

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

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Specimen is stored and transported outside the required temperature
• Quantity not sufficient
• Improperly labeled specimens

Monday

Sunday 5:00PM

Monday, 6:00PM

NEGATIVE: <0.80 Index

EQUIVOCAL: between 0.80 and 1.20 Index

POSITIVE: >1.2 Index

Not Applicable

Not Applicable

Measles Immunity Test; Mumps Immunity Test; Measles Blood Test; Mumps Blood Test, Measles Antibody, IgM and IgG; Measles Viral Culture; Measles by RT-PCR; Mumps Antibody, IgM and IgG; Mumps Viral Culture; Mumps by RT-PCR