Laboratory Test Preparation

Strongyloidiasis Serology

Not applicable

A tropical infection due to the parasite Strongyloides stercoralis. Sometimes occurs in humid temperate regions. This test is usually performed when a subject who has recently visited an endemic area presents with recurrent gastrointestinal problems associated with pruritis and eosinophilia. Diagnosis relies on the identification of larvae in fresh stools. Serological results are often difficult to interpret because of the many possible cross reactions, mostly with other nematodes.

Enzyme Immunoassay (EIA)

Special Test

No patient preparation necessary.

Red or Gold Tube

3 mL Serum

Not Applicable

24 Hours

7 Days

28 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

Friday, 4:00 PM

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

Available upon request

None specified.

Not applicable

Strongyloides stercoralis, infective filariform larva in warm, moist soil

Sucrose Hemolysis Test

Not Applicable

The Sucrose Hemolysis Test is useful in screening for paroxysmal nocturnal hemoglobinuria (PNH). PNH describes erythrocytic destruction with the appearance of dark urine in the morning. PNH is an acquired disorder that is characterized by hemolytic anemia, large vessel thrombosis, or a deficiency of hematopoiesis.

Hemolysis

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

Citrated or Blue Top

2 pcs of 4mL Citrated whole blood

Not Applicable

2 Hours

Not Applicable

Not Applicable

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

• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used
• Clotted Sample
• Over-filled or Under-filled tube

Monday to Friday

Monday to Friday, 7:00 AM

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

Available upon request

None Specified.

Not Applicable

Carbohydrate, Sugar

• Histopath

• Not applicable

• For the examination of surgical specimens or tissues removed from living patients for the purpose of diagnosis of disease and guidance in the care of patients.
• Differentiates specimens between benign (non-cancerous) and malignant (cancerous) and identifies infectious agents in body tissues.

• Routine Histopathology (Tissue Processing)

• Histopathology

• Fresh tissue specimen must be immersed in adequate fixative preferably 10% Neutral Buffered Formalin
• Fix tissue for a minimum of 6 hours to a maximum of 48 hours.
• Container must be properly labeled with at least two identifying marker (e.g. Patient’s name, type of specimen)
• Specimens brought to the laboratory should have its corresponding request form filled with complete patient demographics and information

• Tightly sealed, wide mouthed specimen containers

• Volume ratio of tissue sample to fixative should be 1:10

• Not applicable

• Indefinite if fixed with 10% neutral buffered formalin

• Not applicable

• Not applicable

• Transport speciments at 15°C to 30°C

• Improperly fixed specimen
• Incomplete information in the Histopathology Request Form (HPD_F_258), Histopathology Service Request Form (HPD_F_259)
• Unlabeled samples
• NOTE: In general, anatomic pathology specimens are not rejected for testing because they are irreplaceable and/or cannot be easily recollected. Instead, any problems encountered that may affect proper diagnosis will be documented and reported.
• Inform the attending physician, client, branch and/or pathologist at once if problems are encountered.

• Daily

• 7:00 PM

• 3 to 5 days after receipt of specimen (with reading/interpretation)
• 1 day for Metro Manila clients and 2 days for Provincial clients (processing only)
• Note: Additional 2 days may be necessary if specimen needs further evaluation and confirmation by another Pathologist.

• Not applicable

• Not applicable

• Not applicable

• Histopath

Not applicable

Not applicable

It is used to differentiate carcinoid from carcinoma; merkel cell carcinoma vs. basal cell carcinoma; small cell carcinoma of lung vs. lymphoma

Precipitation Indirect Reaction

Special Test

No patient preparation necessary.

Slide holders or mailers for microscope slides; FFPE tissue blocks can either be wrapped in paper or placed in a box.

• Formalin-fixed paraffin-embedded (FFPE) tissue block
• 1 H&E stained slide representative of the submitted tissue block.
• Histopathology report for the submitted tissue block

Not Applicable

Indefinite

Not applicable

Not applicable

• Microscope slides should be placed in slide holders or mailers and should be adequately padded before placing in a shipping/packaging container to prevent breakage.
• FFPE tissue blocks must be placed in a box and avoid direct sunlight to prevent melting and disorientation during transport or shipping.
• Transport specimen at 15°C ~25 °C (room temperature)

• Incomplete information in the Request Form
• Improper or insufficient labeling of tissue blocks or slides
• Inadequate tissue available on the tissue block

Tuesday , Thursday and Saturday

Monday, Wednesday and Friday 3:00 P.M

After 7 days (excluding Saturdays, Sundays and Holidays)

Not Applicable

None specified.

Not applicable

Major synaptic vesicle protein p38

• Joint Fluid Analysis

1. Macroscopic
2. Microscopic
3. Differential Count
4. Synovial Fluid Glucose
5. Synovial Fluid Protein

• Cell Count and Differential Count: Cell count and identification of types of cells present are used in determining the cause of an effusion, especially when used in combination with an individual's medical history, physical examination and other tests performed.
• Body Fluid Protein and Glucose: Differentiates Transudates from Exudates. It helps identify the cause of fluid accumulation.

• WBC count- Fluorescent Cytometry
• RBC count- Hydrodynamic Focusing
• Differential Count- Fluorescence Cytometry/ Microscopic Examination
• Body Fluid Protein - Colorimetric (Biuret)
• Body Fluid Glucose - Enzymatic Colorimetric(Hexokinase)

• Cell Count/Differential Count: Hematology
• Body Fluid Protein and Glucose: Chemistry

• Cell Count/Diff Count: No patient preparation necessary
• Protein and Glucose: Preferably 8 hours fasting
• Send to Laboratory within 24 hours of collection.

Glucose and Protein:
• Bottle #1 placed on a plain tube (Red Top with no additive)

Cell Count/Diff Count:
• Bottle #2 placed on an EDTA Tube

• Cell Count/Diff Count: 3-5 mL
• Glucose and Protein: 3-5 mL

Not applicable

Glucose and Protein: 1 Day

Cell Count/Diff Count: 1 Day

Glucose and Protein: 6 Days

Cell Count/Diff Count: Not specified

Unacceptable

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

• Quantity not sufficient
• Clotted sample (for Cell Count and Diff Count)
• Incorrect storage temperature of specimen
• Incorrect collection tube used
• Specimen stored exceeded required sample stability
• Highly viscous specimen
• Hemolyzed samples

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

Glucose:
Transudate: Exudate: Lower than whole blood levels

Total Protein:
Transudate: 10.00~30.00 g/L
Exudate: >30.00 g/L

Specific Gravity:
Transudate: <1.016
Exudate: >/=1.016

White Blood Cells:
Transudate: <100.00 x 10^3/uL
Exudate: >1000.00 x 10^3/uL

None specified

Not applicable

Uric Acid, Gram Stain, Susceptibility Testing, AFB Testing, Body Fluid Analysis, Rheumatoid Factor, Cyclic Citrullinated Peptide Antibody

• Total Calcium
• Calcium
• Ca

Not applicable

• Used to screen for, diagnose, and monitor a range of conditions relating to the bones, heart, nerves, kidneys, and teeth.
• Often measured as part of a routine health screening to diagnose or monitor a variety of conditions.

Colorimetric

Chemistry

• 8-12 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

1-3 mL Plasma (Li-Heparin)

7 Days

3 Weeks

8 Months

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

• Specimens that failed serum index requirement
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used
• EDTA Plasma

Daily

Monday to Saturday:6:00 PM

Sunday: 4:00PM

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

2.10-2.55 mmol/L (8.40-10.20 mg/dL)

• Blood from patients receiving Hypaque radiographic contrast agent cannot be used.
• Blood from patients on EDTA therapy cause false results.

Not applicable

Phosphorus, Vitamin D Tests, PTH, Magnesium, Albumin, Comprehensive Metabolic Panel, Basic Metabolic Panel, Kidney Stone Analysis, Kidney Stone Risk Panel

Toxoplasma gondii Quali IgM

Not Applicable

Used for Qualitative detection of IgM antibodies to Toxoplasma gondii, used as screening for toxoplasmosis.

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, Toxoplasmosis, Toxoplasma gondii Antibodies, IgG, IgM; Toxoplasma gondii Molecular Detection by PCR

• TP
• Total Protein

Not applicable

• May be used for evaluation of nutritional status and protein altering diseases like kidney disease or liver disease

Colorimetric

Chemistry

• No patient preparation necessary.

Red or Gold tube

1-3 mL Serum

1-3 mL Plasma (Li- or Na-Heparin)

1 Week

34 Days

2 Months

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

1. Failed serum index samples
2. Specimen stored/transported outside the temperature range
3. Quantity not sufficient
4. Improperly labeled specimen
5. Improper collection tube used
6. EDTA plasma

Daily

Monday to Saturday:  6:00 PM

Sunday: 4:00PM

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

0-3Y: 59.00-70.00 g/L (5.90-7.00 g/dL)
3Y & 1 Day - 6Y: 59.00-78.00 g/L (5.90-7.80 g/dL)
6Y & 1 Day - 9Y: 62.00-81.00 g/L (6.20-8.10 g/dL)
9Y & 1 Day - 11Y : 63.00-86.00 g/L (6.30-8.60 g/dL)
11Y & 1 Day - 999Y: 64.00-87.00 g/L (6.40-8.70 g/dL)

Interferences from medications or endogenous substances may affect results.

Not applicable

Albumin, Liver Panel, Protein Electrophoresis, Comprehensive Metabolic Panel, BUN, Creatinine, Urine Protein, Body Fluid Analysis

• Triiodothyronine
• Total T3

Not applicable

The determination of T3 is utilized in the diagnosis of T3-hyperthyoridism , the detection of early stages of hyperthyroidism and for indicating a diagnosis of thyrotoxicosis factitia.

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-, Na-, NH4 -heparin, K3-EDTA, Sodium Citrate, Sodium Fluoride, Potassium Oxalate)

Not specified

7 Days

1 Month (Freeze only once)

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

Monday, Tuesday, Wednesday, Thursday, Friday, Saturday

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

1.30-3.10 nmol/L

• 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.
• Therapy with amiodarone can lead to depressed T3 values.
• Phenytoin, phenylbutazone, and salicylates cause release of T3 from the binding proteins, thus leading to a reduction in the total T3 hormone level at normal fT3 levels.
• Autoantibodies to thyroid hormones can interfere with the assay.
• Binding protein anomalies seen with FDH (familial dysalbuminemic hyperthyroxinemia), for example, may cause values which, while characteristic of the condition, deviate from the expected results.
• Pathological concentrations of binding proteins (TBG, albumin) can lead to total T3 values outside the normal range being found despite a euthyroid metabolic state (e.g. in NTI-patients, pregnancy, use of oral contraceptives). In such cases an fT3 or fT4 determination is indicated.

Not applicable

Thyroid Function Test, TSH; Free T4; Thyroid Panel; Thyroid Antibodies

• Reverse T3
• Reverse triiodothyronine
• rT3

Not applicable

The assay may be useful in the diagnosis of nonthyroidal illness (NTI). Patients with NTI have low T3 concentrations and increased concentrations of rT3. RT3 may be useful in neonates to distinguish euthyroid sick syndrome from central hypothyroidism.

Mainly produced by the deiodination of thyroxine (T4) in peripheral tissue.

Radioimmunoassay (RIA)

Special Test

No patient preparation necessary.

Red or Gold Tube

3 mL Serum

Not Applicable

24 Hours

7 Days

28 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

Friday, 4:00 PM

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

Available upon request

None specified.

Not applicable

Isomer of triiodothyronine

• Thyroxine
• Total T4

Not applicable

The determination of T4 can be utilized for the detection of primary and secondary hypothyroidism and for monitoring of TSH-supression therapy.

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.
• Patients treated with lipid-lowering agents (D-T4) should be discontinued 4-6 weeks of therapy prior to collection (please consult your doctor before following this preparation).

Red or Gold tube

1-3 mL Serum

1-3 mL Plasma (Li-, Na?heparin and  K3?EDTA)

Not specified

7 Days

1 Month (Freeze only once)

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

Monday, Tuesday, Wednesday, Thursday, Friday, Saturday

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

66.00-181.00 nmol/L

• 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.
• The test cannot be used in patients receiving treatment with lipid-lowering agents containing D?T4. If the thyroid function is to be checked in such patients, the therapy should first be discontinued for 4?6 weeks to allow the physiological state to become re-established.
• Autoantibodies to thyroid hormones can interfere with the assay.
• Binding protein anomalies seen with FDH (familial dysalbuminemic hyperthyroxinemia), for example, may cause values which, while characteristic of the condition, deviate from the expected results.

Not applicable

Thyroid Function Test, TSH, Free T3 or Total T3, Thyroid Panel, Thyroid Antibodies, Calcitonin, Free T4

• Tacro
• FK506
• Fujimycin
• Prograf

Not applicable

To monitor the adequacy of drug dosage levels in management of immunosuppression for organ transplant recipients.

Electrochemiluminescence Immunoassay (ECLIA)

Immunology

• Collect as 12-hour trough specimen (12 hours after last intake of Tacrolimus medication)
• Provide date and time of last Tacrolimus intake, dosage and date and time of sample collection. This information is important to help requesting clinicians interpret the result.
• An interaction with Itraconazole (INN international nonproprietary name) was found. Samples from patients under Itraconazole treatment cannot be tested.
• Sample 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.

EDTA

2mL EDTA whole blood (K2- or K3- EDTA only)

Not Applicable

5 Days

7 Days

6 Months

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

• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used
• Clotted sample
• Over-filled or Under-filled tube

Monday to Saturday: 12:00 PM

Monday to Saturday: 6:00 PM

 

ROUTINE (on running days)

• 4 hours after receipt of specimen/ arrival of messenger

STAT (on running days only)

• 2 1/2 hours from extraction or messenger arrival

5.00~20.00 ng/mL

NOTE: No firm therapeutic range exists for tacrolimus in whole blood. The complexity of the clinical state, individual differences in sensitivity to immunosuppressive and nephrotoxic effects of tacrolimus, coadministration of other immunosuppressants, type of transplant, time post-transplant, and a number of other factors contribute to different requirements for optimal blood levels of tacrolimus. Individual tacrolimus values cannot be used as the sole indicator for making changes in the treatment regimen. Each patient should be thoroughly evaluated clinically before treatment adjustments are made, and each assay user must establish his or her ranges based on clinical experience.

• Sample 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.
• An interaction with Itraconazole (INN international nonproprietary name) was found. Do not use samples from patients under Itraconazole treatment.
• In rare cases, interference due to extremely high titers of antibodies to analyte-specific antibodies, streptavidin or ruthenium can occur.

Not applicable

Organ Transplant, Immuno suppressant, Immuno suppressant agent

• Mycobacterium Tuberculosis
• MTB c/s

Not Applicable

Tuberculosis is a chronic, granulomatous disease caused by M. tuberculosis. Identification, and, if appropriate, antibiotic sensitivity, is required to initiate necessary therapy.

TB is an infectious bacterial disease caused by mycobacterium tuberculosis, which most commonly affects the lungs.

Bactec MGIT

Special Test

Note:

• Indicate Diagnosis and Medications
• Culture and Sensitivity of Sputum samples (expectorated/induced)
• Sample should be sputum not saliva. In case sample submitted does not fit the criteria of a sputum specimen, a repeat collection will be requested.
• Sample must be properly packed (trtiple packaging)
• For Sputum Samplemust be at Laboratory, Monday to Friday before 7:00 AM., sample must be collected Monday to Thursday, on or before 3:00 PM and need to be send to MAIN branch within that day.

A. Sputum Collection
The most productive sputum can be collected in the morning.

1. Expectorated Sputum

• Rinse the mouth and gargle with water. Do not brush teeth prior to collection.
• Take a deep breath and make a deep cough. Good quality sputum should not contain saliva. Specimen should be collected in a sterile leak-proof container and delivered to the laboratory without delay.
•  Properly close and wipe dry the container. Label sample container with patient's complete name, with date and time of collection.

2. Induced Sputum

• Rinse the mouth and gargle with water. Do not brush teeth prior to collection.
• Take a deep breath and make a deep cough. Collect the induced sputum into a sterile leak-proof container and deliver to the laboratory without delay.
• Properly close and wipe the container dry. Label sample container with patient's complete name, with date and time of collection.

B. Endotracheal Aspirate Collection

• Aspirate the specimen into a sterile Luken trap and aseptically transfer sample to a sterile screw-cap container.
• Label the sterile container or the catheter cover properly and submit to the laboratory.

C. Pleural Effusion

• Aspirate the specimen into a sterile Luken trap and aseptically transfer sample to a sterile screw-cap container.
• Label the sterile container and cover properly, always indicate the site of collection If RIGHT or LEFT LUNG, then submit to the laboratory.

D. Urine

• Indicate patient’s diagnosis, medical history and sample type on request forms.
• Clean-voided midstream urine collection
• Before starting the procedure, wash hands thoroughly with soap and water.
• Cleanse the genital area before collection.

Plastic leak proof sterile container (screw cap) 

NOTE:Sample must be properly packed (trtiple packaging)

• 2 mL Sputum/ETA/Pleural Fluid
• 100 mL Urine

Not Applicable

24 Hours

SPUTUM- 24 Hours

URINE- 24 Hours

OTHER BODY FLUIDS- 7 Days

Not applicable

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

• Quantity Not sufficient
• Improperly labeled specimen
• Specimen stored and transported outside the required temperature
• Wrong container

Monday to Friday

Monday to Friday, 7:00 AM

For Sputum Samplemust be at Laboratory, Monday to Friday before 7:00 AM., sample must be collected Monday to Thursday, on or before 3:00 PM and need to be send to MAIN branch within that day.

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

Not Applicable

None specified.

Not applicable

Bacteria or fungi that are causing an infection of the lungs

Not applicable

Not applicable

Used to aid the physician in the rapid diagnosis and treatment of a possible tuberculosis infection.

Polymerase Chain Reaction (PCR)

Special Test

• No patient preparation necessary.
• Call Special Test Section (By Appointment/Schedule).
• Sample must be properly packed (trtiple packaging)

NOTE: Do not collect specimen without approval of Special Test Section

Plastic leak proof sterile container (screw cap) 

NOTE: Sample must be properly packed (trtiple packaging)

Atleast 2 mL Sputum

Atleast 2 mL Any body fluids or 60 mL Random Urine

24 Hours

5 Days

Not applicable

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

• Quantity Not sufficient
• Improperly labeled specimen
• Specimen stored and transported outside the required temperature
• Improper collection container

Wednesday

Tuesday, 7:00 AM

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

Not Applicable

None specified.

Not applicable

Confirm an infection of Tuberculosis