Test Results Manual

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Test Results Manual

 

Explanation of Laboratory Results and Other Diagnostic Testing

 

It is in your best interest for you to return to see the physician or the physician assistant  for a follow up appointment to review the results of your diagnostic testing in person in order for you to receive the most comprehensive follow up and understanding of your laboratory and diagnostic studies.

Try pressing COMMAND F on your keyboard, then enter the name of the test you want to learn more about. 

 

This Explanation of Results has been developed to help give you a preliminary understanding of your test results and is not meant to be a substitute for the the follow up encounter with the physician or the physician assistant. To help you gain an understanding of your lab results we suggest you look over your lab studies, and than read the sections below that refer to the tests you have had performed. It is than best to come back into the office to speak with the doctor or physician assistant for a more comprehensive understanding and our recommendations.

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In order to help you locate the test or tests you are interested in, we have listed the tests below in alphabetical order. Please scroll down to locate the lab test you are interested in learning more about.

 

CBC (Complete Blood Count)

The complete blood count or CBC test is used as a broad screening test to check for such disorders as anemia, infection, and other illnesses. The CBC is composed of a group of tests that examines different blood components and includes the following.

White Blood Cell Count or WBC is a count of the actual number of white blood cells per volume of blood. There are five different types of white blood cells, each with its own function. The different types of white blood cells include: neutrophils (also known as segs, PMNs, granulocytes, grans), lymphocytes, monocytes, eosinophills and basophils. Although both increases and decreases in your white blood cell count from normal can be important it may also be due to such factors as laboratory inaccuracy, mild infections and even cigarette smoking.  If this is the first time these were found to be abnormal, usually our office will simply want you to repeat the test at a designated time interval.

Red Blood Cell Count or RBC is a count of the actual number of red blood cells per volume of blood. Although both increases and decreases from normal can be important it may also be due to such factors as laboratory inaccuracy and mild anemia.  If this is the first time these were found to be abnormal, usually our office will simply want you to repeat the test at a designated time interval.

Hemoglobin measures the amount of oxygen-carrying protein in the blood. Although both increases and decreases from normal can be important it may also be due to such factors as laboratory inaccuracy and mild anemia. If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy. 

Hematocrit measures the percentage of red blood cells in a given volume of whole blood. If this is the first time these were found to be abnormal, usually our office will simply want you to repeat the test at a designated time interval. Although both increases and decreases from normal can be important it may also be due to such factors as laboratory inaccuracy and mild anemia. If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy.

Platelet Count the number of platelets in a given volume of blood. Platelets are primarily responsible for normal blood clotting. Although increases and decreases can point to abnormal conditions of excessive bleeding or clotting, it may also be due to such factors as laboratory inaccuracy. If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy. 

Mean platelet volume (MPV) is a machine-calculated measurement of the average size of your platelets. New platelets are larger, and an increased MPV occurs when increased numbers of platelets are being produced. MPV gives your doctor information about platelet production in your bone marrow. If this is the first time these were found to be abnormal, usually our office will simply want you to repeat the test at a designated time interval.

Mean corpuscular volume (MCV) is a measurement of the average size of your RBCs. The MCV is elevated when your RBCs are larger than normal, and decreased when your RBCs are smaller than normal. Although increases and decreases can point to abnormal conditions such as vitamin B 12 deficiency or iron deficiency, it may also be due to such factors as laboratory inaccuracy. If this is the first time these were found to be abnormal, usually our office will simply want you to repeat the test at a designated time interval.

Mean corpuscular hemoglobin (MCH) is a calculation of the average amount of oxygen-carrying hemoglobin inside a red blood cell. Large red blood cells tend to have a higher MCH, while small red cells would have a lower MCH. Although increases and decreases can point to abnormal conditions it may also be due to such factors as laboratory inaccuracy. If this is the first time these were found to be abnormal, usually our office will simply want you to repeat the test at a designated time interval.

Mean corpuscular hemoglobin concentration (MCHC) is a calculation of the average concentration of hemoglobin inside a red cell. Decreased MCHC values may be seen in conditions where the hemoglobin is abnormally diluted inside the red cells, conditions such as in iron deficiency anemia and thalassemia. Increased MCHC values are seen in conditions where the hemoglobin is abnormally concentrated inside the red cells, such as in burn patients. Although increases and decreases can point to abnormal conditions it may also be due to such factors as laboratory inaccuracy. If this is the first time these were found to be abnormal, usually our office will simply want you to repeat the test at a designated time interval. 

Red cell distribution width (RDW) is a calculation of the variation in the size of your red blood cells. Although this can be abnormal in anemia it may also be due to such factors as laboratory inaccuracy. If this is the first time these were found to be abnormal, usually our office will simply want you to repeat the test at a designated time interval.

 

Chemistry Profile

A / G Ratio

A/G ratio is the ratio of albumin to globulin in the blood. Normally, albumin is slightly greater than globulin giving a ratio 1.7 to 2.2. In addition to laboratory inaccuracy, low A/G ratio may be due to chronic infections, fatty liver, kidney disease and other conditions. In addition to laboratory inaccuracy, high A/G ratio may be due to liver disease, kidney disease, genetic disorders and other conditions.

Albumin

Albumin is a protein made by the liver. There are numerous causes for abnormal albumin values. Laboratory inaccuracy and dehydration are a couple of the causes of increased albumin. Decreased albumin may also be caused by lab inaccuracy, in addition to other causes such as malnutrition, liver disease, kidney disease, gastro intestinal disorders, hyperthyroidism and various other conditions.

If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy.

Alkaline Phosphatase

Alkaline Phosphatase is an enzyme throughout the body primarily in liver, bone, intestine and placenta. There are numerous causes for elevated and decreased alkaline phosphatase values. Laboratory inaccuracy, hyperparathyroidism, liver disease, chronic inflammatory bowel disease and osteomalacia  are a few of the many causes of increased alkaline phosphatase. Decreased alkaline phosphatase may also be caused by lab inaccuracy and is not of clinical significance.

If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy.

ALT (SGPT)

ALT is an enzyme found primarily in the liver with smaller amounts in muscle and heart. There are numerous causes for elevated AST (SGOT) values. Laboratory inaccuracy and any condition which causes injury to liver cells, heart cells, red blood cells or skeletal muscle cells may cause the ALT to be elevated. Decreased ALT is of no clinical significance.

IIf your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy.

AST (SGOT)

AST is an enzyme found throughout the body including the liver, heart, muscle and brain. There are numerous causes for elevated AST (SGOT) values. Laboratory inaccuracy and any condition which causes injury to liver cells, heart cells or skeletal muscle cells may cause the AST to be elevated. Decreased AST is of no clinical significance.

If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy.

Bilirubin Total

Bilirubin is a reddish yellow pigment found in bile that is produced during the breakdown of red blood cells. There are numerous causes for elevated bilirubin levels. Laboratory inaccuracy and Gilberts syndrome, a condition that causes elevation of Bilirubin and no other symptoms are a couple of frequent causes. Excessive alcohol intake, gallstones and hepatitis are a couple of additional causes of increased Bilirubin. 

Decreased bilirubin is not of any clinical significance.

If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy. 

Below is a partial list of medications that may cause an elevated bilirubin. If you are taking any of the following medications and your bilirubin is elevated, please notify our office immediately.

aminosalicylic acid, androgens, azathioprine, benzodiazepines, carbamazepine, carbarsone, chlorpropamide, propoxyphene, estrogens, penicillin, gold Na thiomalate, imipramine, meprobamate, methimazole, nicotinic acid, progestins, penicillin, phenothiazines, oral contraceptives, sulfonamides, sulfones, erythromycin estolate, acetaminophen, allopurinol, amitriptyline, androgens, asparaginase, aspirin, azathioprine, carbamazepine, chlorambucil, chloramphenicol, chlorpropamide, dantrolene, disulfiram, estrogens, ethanol, ethionamide, halothane, ibuprofen, indomethacin, iron salts, isoniazid, MAO inhibitors, mercaptopurine, methotrexate, methoxyflurane, methyldopa, mithramycin, nicotinic acid, nitrofurantoin, papaverine, paramethadione, phenobarbital, phenazopyridine, phenylbutazone, phenytoin, probenecid, procainamide, propylthiouracil, pyrazinamide, quinidine, sulfonamides, tetracyclines, trimethadione, valproic acid

BUN (Blood Urea Nitrogen)

Urea is a byproduct of protein metabolism. This test detects a level of waste products in your blood. Although increases and decreases from normal can be important and may indicate conditions such as kidney malfunction, it may also be due to such factors as laboratory inaccuracy, mild dehydration, and low protein diets. If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy. 

BUN/ Creatinine Ratio

The BUN / Creatinine Ratio is helpful as a calculation to help doctors determine the reason for abnormal kidney function tests. If this is the first time these were found to be abnormal, usually our office will simply want you to repeat the test at a designated time interval.

Calcium

This test measures the amount of calcium in your blood. Calcium is one of the most important minerals in the body. It is essential for the proper functioning of muscles, nerves, and the heart and is required in blood clotting and in the formation of bones.

Some causes of elevated calcium include the tourniquet used to draw your blood, problems with a gland known as the parathyroid gland, diseases of bone and laboratory inaccuracy. 

Some medications known to cause an elevated calcium include antacids, diuretics, progesterone and estrogens including birth control pills. If you are currently taking any of these medications and your calcium is high please notify our office immediately.

If your calcium is elevated it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy.

Some causes of low calcium include alcoholism, chronic kidney disease, low vitamin D, problems with a gland known as the parathyroid gland and laboratory inaccuracy.

Some of the medications than can cause a low calcium include diuretics, estrogens, insulin methicillin and excessive laxative use. If you are currently taking any of these medications and have a low calcium, please notify our office immediately.

Carbon Dioxide

Carbon Dioxide levels in the blood are influenced by kidney and lung function. Levels of
carbon dioxide below normal may result from diarrhea, kidney disease, various other
conditions and it may also be due to such factors as laboratory inaccuracy. Elevated carbon
dioxide levels can result from breathing disorders, vomiting, many other conditions and
it may also be due to such factors as laboratory inaccuracy.

Chloride

Elevated chloride is seen in dehydration and prolonged diarrhea in addition to other medical conditions and it may also be due to such factors as laboratory inaccuracy.

If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy. 

Below is a partial list of medications that may cause an elevated chloride. If you are taking any of the following medications and your chloride is elevated, please notify our office immediately.

acetazolamide, androgens, corticosteroids, cholestyramine, diazoxide, estrogens, guanethidine, methyldopa, oxyphenbutazone, phenylbutazone, thiazides, and triamterene

Decreased chloride is seen in excessive sweating and prolonged vomiting in addition to other medical conditions and it may also be due to such factors as laboratory inaccuracy.

Below is a partial list of medications that may cause a decreased chloride. If you are taking any of the following medications and your chloride is decreased, please notify our office immediately.

bicarbonate, carbenoxolone, corticosteroids, diuretics, laxatives, and theophylline.

 

Cholesterol

Cholesterol is a fat, produced by the liver, that is essential for many body functions. Levels are impacted by eating foods high in saturated fats (meat, cream, sausage to name a few). Elevated cholesterol can cause narrowing of the arteries, narrowing of the arteries that supply blood to your heart muscle, heart attacks and strokes. Cholesterol is carried through the body by molecules called lipoproteins, LDL and HDL.

If your cholesterol is high you will be placed on a low fat diet with possible recommendation to increase exercise and begin vitamins or medicine. We suggest you come back in to the office to discuss the treatment of your cholesterol.

LDL (Low Density Lipoprotein)

LDL carries cholesterol from the liver to the cells. Elevated LDL increases the risk of coronary heart disease and is often referred to as  “bad cholesterol”.

If your LDL is high you will be placed on a low fat diet with possible recommendation to increase exercise and begin vitamins or medicine. We usually suggest you come back in to the office to discuss the treatment of your LDL.

HDL (High Density Lipoprotein)

HDL takes cholesterol away from the cells, back to the liver, where it is broken down and expelled as waste. HDL prevents arterial disease and is often referred to as “good cholesterol.

Chol / HDLC ratio

The total cholesterol / HDLC ratio value helps predict your risk of developing arterial disease. If the number is high one has a higher chance of developing heart disease.

If your Cholesterol / HDL ratio is high you will be placed on a low fat diet with possible recommendation to increase exercise and begin vitamins or medicine. We usually suggest you come back in to the office to discuss the treatment of your Cholesterol / HDL ratio.

Creatinine

Creatinine is a byproduct of muscle metabolism and is used as a measurement of kidney filtration. Although increases and decreases from normal can be important and may indicate conditions such as kidney malfunction, decreased blood perfusion to the kidneys or urinary obstruction, it may also be due to such factors as laboratory inaccuracy, and adverse effects of medications such as antibiotics and ibuprofen. If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy.

Below is a partial list of medications that may cause an elevated creatinine. If you are taking any of the following medications and your creatinine is elevated, please notify our office immediately.

iron, lithium, mercury, thallium, aminopyrine, ibuprofen, indomethacin, naproxen, fenoprofen, phenylbutazone, phenacetin, Aspirin, Salicylates, aminoglycosides, amphotericin, cephalothin, colistin, cotrimoxazole, erythromycin, ampicillin, methicillin, oxacillin, polymixin, Brifampin, sulfonamides, tetracyclines, vancomycin

benzene, zoxazolamine, tetrachloroethylene, ethylene, glycol, acetazolamide, aminocaproic acid, aminosalicylate, boric acid, cyclophosphamide, cisplatin, dextran (LMW), furosemide, mannitol. methoxyflurane, mithramycin, penicillamine, pentamide, phenindione, quinine, thiazides, carbon, tetrachloride

GGTP

GGT is a liver enzyme. GGT is extremely sensitive to alcohol consumption and is frequently found to be elevated. 

Elevated GGT levels may be found in liver disease, alcoholism, obesity, bile-duct obstruction, cholangitis, and drug abuse. Decreased levels can be found in hypothyroidism, hypothalamic malfunction and very low levels of magnesium. 

If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy. 

Some drugs that may cause an elevated GGT level include phenytoin, carbamazepine, and barbiturates such as phenobarbital. Use of many other prescription and non-prescription drugs, including nonsteroidal anti-inflammatory drugs (NSAIDs), lipid-lowering drugs, antibiotics, histamine receptor blockers (used to treat excess stomach acid production), antifungal agents, antidepressants, and hormones such as testosterone, can increase GGT levels.

If your GGT level is elevated and you are taking any of these medications please notify our office immediately.

Globulin

Globulin is a protein made by the liver. There are numerous causes for elevated and decreased globulin values. Laboratory inaccuracy and chronic inflammation are a couple of the causes of increased globulin. Decreased globulin may also be caused by lab inaccuracy, and liver disease in addition to other uncommon congenital and acquired conditions.

If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy.

Glucose

The blood glucose test is a measurement of the amount of glucose (sugar) in the blood right at the time your blood is taken. It is used to detect hypoglycemia (low blood sugar), hyperglycemia (high blood sugar) and to monitor glucose levels in persons with diabetes.

Sometimes, if the there is a delayed pick up by the laboratory from our office, the blood glucose may be artificially decreased. If your values are out of the normal range you may be asked to return to the office to repeat testing either fasting for 12 hours or at a designated time interval after you have eaten a meal.  If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy. 

Iron

Iron is a mineral that serves many functions in our body. Iron helps in the process of bringing oxygen from our lungs to the rest of our body it is also part of many enzymes that serve different functions in our body. Iron may be checked in our practice as part of a routine blood work up.

Some of the causes of low iron are occult bleeding, pregnancy, decreased intake of iron in the diet, laboratory inaccuracy and menstruation. Increases in iron may be caused by genetic disorders, multiple blood transfusions, high dietary intake, alcoholism, laboratory inaccuracy and other conditions. 

If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy.

Potassium

There are numerous causes for elevated and decreased potassium values. Laboratory inaccuracy, including allowing the specimen to sit too long before being tested or breakage of the red blood cells themselves when the specimen is obtained can are just a couple of causes.  Acute and chronic kidney failure and excessive intake of potassium are a couple of other causes for abnormal potassium and it may also be due to such factors as laboratory inaccuracy. If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy.

Below is a partial list of medications that may cause an elevated potassium. If you are taking any of the following medications and your potassium is elevated, please notify our office immediately.

amiloride, aminocaproic acid, antineoplastic agents, epinephrine, heparin, histamine, indomethacin, isoniazid, lithium, mannitol, methicillin, potassium salts of penicillin, phenformin, propranolol, salt substitutes, spironolactone, succinylcholine, tetracycline, triamterene, and tromethamine.

Decrease in serum potassium is seen commonly in conditions characterized by excess K+ loss, such as in vomiting and diarrhea as well as other conditions that cause potassium loss and it may also be due to such factors as laboratory inaccuracy.

Below is a partial list of medications that may cause a decreased potassium. If you are taking any of the following medications and your potassium is decreased, please notify our office immediately.

amphotericin, carbenicillin, carbenoxolone, corticosteroids, diuretics, licorice, salicylates, and ticarcillin.

If this is the first time your potassium was found to be abnormal, usually our office will simply want you to repeat the test at a designated time interval.

Protein

Proteins are part of every cell, organ and tissue in our body. The protein test is often obtained in our office as part of a general health screening.

Some conditions that cause decreased protein include poor nutrition, malabsorption, diarrhea in addition to laboratory inaccuracy. 

Some conditions that cause increased total protein include viral hepatitis and bone marrow disorders in addition to laboratory inaccuracy.

If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy.

PT / Prothrombin Time INR

PT is a test to determine if someone might have a bleeding disorder or to make sure someone on blood thinners is taking the correct dosage of medication. It is frequently obtained as routine screening prior to someone going for surgery. If your test is elevated it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy.

PTT / Partial Thromboplastin Time

PTT is a test to determine if someone might have a bleeding disorder. It is frequently obtained as routine screening prior to someone going for surgery. If your test is elevated it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy.

Sodium

Sodium is one of the bodies electrolytes and is often checked as part of a routine blood screening in our practice. Elevated sodium can be caused by profuse sweating, severe diarrhea, vomiting, certain medications, inadequate water intake, laboratory inaccuracy and other conditions. Decreased sodium can be caused by diuretics and other medicines, kidney disease, liver disease laboratory inaccuracy and other conditions.

If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy.

Triglycerides

Triglycerides are a type of fat found in the body that is used for energy. However, elevated triglycerides are associated with increased risk of heart disease.

If your Triglycerides are high you will be placed on a low fat diet with possible recommendation to increase exercise and begin vitamins or medicine. We usually suggest you come back in to the office to discuss the treatment of your Triglycerides.

TSH

TSH stands for thyroid stimulating hormone. This test checks the function of your thyroid gland. It’s a bit confusing ,but when this test is high it means your thyroid function is low. If this test is low, it means your thyroid function is high. The test is also used to make sure patients on thyroid medication are on the correct dosage. 

If this test is abnormal, it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy.

Uric Acid

Uric acid is a chemical produced in the body upon breakdown of a substance called purines. Uric acid is primarily used in our practice to diagnose a type of arthritis known as gout or to identify those that might be at risk for developing gout. 

Elevated uric acid can be seen in other conditions such as kidney failure, liver disease etc. Some common drugs such as diuretics can also elevate uric acid. Decreased uric acid is usually of no importance.

A partial list of drugs that can increase levels of uric acid include alcohol, diuretics, ascorbic acid, aspirin, caffeine, levodopa, methyldopa, nicotinic acid and theophylline. If you are taking any of these drugs and your uric acid is elevated, please notify the doctor.

If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy.

Urinalysis

Urinalysis is a test that examines various components and qualities of your urine. It often consists of 3 parts, gross appearance of the urine, results obtained from a urine dip stick and microscopic evaluation of the urine.
Color: normal urine is clear to dark yellow or amber in color. Cloudiness can be a sign of protein in the urine or from the urine sitting in the refrigerator. A reddish color may be due to eating beets, medications and blood in the urine as well as other causes.
Specific gravity: measures the ability of the kidneys to concentrate or dilute the urine.
PH: indicates the acid level of the urine.
Glucose: may be seen in diabetic patients
Bilirubin: bilirubin in the urine may indicate liver dysfunction
Ketones: may be seen in calorie deprivation and uncontrolled diabetics
Occult Blood: may indicate red blood cells in the urine
Protein: detects protein in the urine
Nitrite: suggests bacteria are present in the urine
Leukocyte Esterase: suggests white blood cells are present, sometimes seen with infection
WBC: white blood cells in the urine may come from surrounding tissue such as the vagina but may be an indication of urine infection
RBC: red blood cells in the urine may come from surrounding tissue such as the vagina during menstruation but can sometimes be due to infection or other kidney problems
Squamous Epithelial Cells: are often from surrounding tissues but may result from kidney problems
Bacteria: bacteria may come from surrounding tissue such as the vagina but are often seen in a urinary infection
Hyaline Casts: casts may indicate kidney disease

If your test is abnormal it is best for you to come in to the office and discuss the results with the doctor or physician assistant but often times we will just have to repeat the test to confirm the accuracy. 

 

DISCLAIMER

This transcript is provided "as is" without any express or implied warranties. While reasonable effort has been made to ensure the accuracy of the information, the author assumes no responsibility for errors or omissions, or for damages resulting from use of the information herein.