Ideal Laboratory

IDEAL LABORATORY/ DIAGNOSTIC TEST
COMPLETE BLOOD COUNT (CBC)
A complete blood count (CBC) is a test that counts the cells that make up
your blood: red blood cells, white blood cells, and platelets. Your doctor may
order a CBC as part of a routine checkup or to:
 Check for anemia, a condition that causes you to have fewer red blood
cells than usual
 Find out if you have another health issue or to explain symptoms
like weakness, fever, bruising, or feeling tired
 Keep an eye on a blood condition
 See how medications, medical conditions, or treatments
like chemotherapy are affecting your blood
Your part of the test is simple and takes just a few minutes. A nurse or lab
tech will take a sample of blood by putting a needle into a vein in your arm.
Afterward, you can leave and get back to your routine. They’ll send the blood
to a lab for review.
The test can tell your doctor a lot about your overall health. It measures:
 White blood cells (WBCs). These help your body fight germs. If you
have too many of them, it could be a sign of inflammation, infection, a
medical reaction, or another health condition. If it’s low, you could be at
a higher risk for infection. A medication, a viral infection, or a bone
marrow disease could also cause a low count.
 Red blood cells (RBC). These deliver oxygen throughout your body.
They also help carry carbon dioxide. If your RBC count is too low, you
may have anemia or another condition.
 Hemoglobin (Hb or Hgb). This is the protein in your blood that holds
oxygen.
 Hematocrit (Hct). This test tells how much of your blood is made up of
red blood cells. A low score may be a sign that you don’t have enough
iron, the mineral that helps your body make red blood cells. A high
score could mean you’re dehydrated or have another condition.
 Mean corpuscular volume (MCV). This is the average size of your red
blood cells. If they’re bigger than usual, your MCV will be higher. That
could happen if you have low vitamin B12 or folate levels. If your red
blood cells are smaller, you could have a type of anemia.
 Platelets. These help your blood clot.
Each lab has different ways of studying your blood. So the reference range will
depend on the lab that handles your blood tests. It’s also based on things that
can affect your blood like your age, your sex, and how high above sea level you
live.
In general, the reference ranges are:
 White blood cells: 4,500 to 11,000 cells per microliter (cells/mcL)

 Red blood cells: 4.5 million to 5.9 million cells/mcL for men; 4.1 million to
5.1 million cells/mcL for women
 Hemoglobin: 14 to 17.5 grams per deciliter (gm/dL) for men; 12.3 to 15.3
gm/dL for women
 Hematocrit: 41.5% to 50.4% for men; 35.9% to 44.6% for women
 Mean corpuscular volume: 80 to 96
 Platelets: 150,000 to 450,000 platelets/mcL
XRAY
X-ray, electromagnetic radiation of extremely short wavelength and

high frequency, with wavelengths ranging from about 10−8 to 10−12 metre
and corresponding frequencies from about 1016 to 1020 hertz (Hz).
X-rays are commonly produced by accelerating (or decelerating)

charged particles; examples include a beam of electrons striking a metal plate
in an X-ray tube and a circulating beam of electrons in a synchrotron particle
accelerator or storage ring. In addition, highly excited atoms can emit X-rays
with discrete wavelengths characteristic of the energy level spacings in the
atoms. The X-ray region of the electromagnetic spectrum falls far outside the
range of visible wavelengths. However, the passage of X-rays through
materials, including biological tissue, can be recorded with photographic films
and other detectors. The analysis of X-ray images of the body is an extremely
valuable medical diagnostic tool.
X-rays are a form of ionizing radiation—when interacting with matter,

they are energetic enough to cause neutral atoms to eject electrons. Through
this ionization process the energy of the X-rays is deposited in the matter.
When passing through living tissue, X-rays can cause harmful biochemical
changes in genes, chromosomes, and other cell components. The biological
effects of ionizing radiation, which are complex and highly dependent on the
length and intensity of exposure, are still under active study (see radiation
injury). X-ray radiation therapies take advantage of these effects to combat
the growth of malignant tumours.
Antimicrobial Suspectibility Testing
Antimicrobial susceptibility testing (AST) is a laboratory procedure performed

by medical technologists (clinical laboratory scientists) to identify which
antimicrobial regimen is specifically effective for individual patients. On a
larger scale, it aids in the evaluation of treatment services provided by
hospitals, clinics, and national programs for the control and prevention of
infectious diseases. Recently, researchers have had to implement continuous
surveillance activities for resistance patterns due to the mutations in bacterial
DNA.
Clinical laboratories currently employ several methods depending on the

laboratory test menu that they provide. These approaches include the disk
diffusion and minimum inhibitory concentration (MIC) methods. Commercial
systems also became available across health centers and hospital facilities,
utilizing both phenotypic and genotypic characterization of bacterial
resistance. While routine antimicrobial susceptibility testing for gram-positive
(e.g., Staphylococcus aureus) and gram-negative bacteria (e.g.,
Pseudomonas aeruginosa) are commonly available in peripheral laboratories,
drug susceptibility testing (DST) for Mycobacterium tuberculosis are usually
carried out within more complex facilities like reference laboratories. Despite
the differences in the techniques for susceptibility tests, all laboratories must
be critical on each step of the sampling and testing process so that test
results are obtainable with consistently high levels of accuracy and reliability.
URINALYISIS
A urinalysis is a test of your urine. It's used to detect and manage a

wide range of disorders, such as urinary tract infections, kidney disease and
diabetes.
A urinalysis involves checking the appearance, concentration and

content of urine. For example, a urinary tract infection can make urine look
cloudy instead of clear. Increased levels of protein in urine can be a sign of
kidney disease. Unusual urinalysis results often require more testing to find
the source of the problem. You might collect a urine sample at home or at
your health care provider's office. Providers typically give out containers for
urine samples. You might be asked to collect the sample at home first thing in
the morning, when your urine is more concentrated.
You might be instructed to collect the sample midstream, using a clean-catch

method. This method involves the following steps:
 Cleanse the urinary opening. Women should spread the labia and
clean from front to back. Men should wipe the tip of the penis.
 Begin to urinate into the toilet.
 Pass the collection container into your urine stream.
 Urinate at least 1 to 2 ounces (30 to 60 milliliters) into the collection
container.
 Finish urinating into the toilet.
 Deliver the sample as directed by your health care provider.
 If you can't deliver the sample to the designated area within 60 minutes
of collection, refrigerate the sample, unless your provider has told you
otherwise.
 In some cases, if needed, your provider can insert a thin, flexible tube
(catheter) through the urinary tract opening and into the bladder to
collect the urine sample.
BLOOD CHEMISTRY
Electrolyte abnormalities should be identified and corrected. A low

bicarbonate level suggests acidosis and inadequate perfusion. An elevated
anion gap acidosis in the setting of sepsis syndrome commonly represents
lactic acidosis or diabetic ketoacidosis, but other causes need to be ruled out.
An elevated serum creatinine concentration or decreased glomerular filtration
rate signals renal dysfunction or failure, which, if due primarily to sepsis,
indicates organ failure and a worse prognosis. Calcium, magnesium, and
phosphorus levels should be checked.
An elevated lactate level is associated with inadequate perfusion,

shock, and poorer prognosis. One study has shown a progression in mortality
rate with increasing venous lactate level—a lactate level of 0 to 2.5 mg/dL was
associated with a 5% mortality rate, a lactate level of 2.5 to 4.0 mg/dL, 9%
mortality, and a lactate level greater than 4 mg/dL, 28% mortality. An arterial
blood gas assessment may be helpful in identifying and classifying acid-base
disturbances. Metabolic acidosis suggests inadequate tissue perfusion. Liver
function tests can be used to identify liver failure or dysfunction. An elevated
bilirubin level may suggest the gallbladder as a cause of sepsis. An elevated
lipase level may represent pancreatitis as the cause of SIRS.

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IDEAL LABORATORY/ DIAGNOSTIC TEST

COMPLETE BLOOD COUNT (CBC)

In general, the reference ranges are:

 White blood cells: 4,500 to 11,000 cells per microliter (cells/mcL)

X-ray, electromagnetic radiation of extremely short wavelength and

X-rays are commonly produced by accelerating (or decelerating)

X-rays are a form of ionizing radiation—when interacting with matter,

Antimicrobial Suspectibility Testing

Antimicrobial susceptibility testing (AST) is a laboratory procedure performed

Clinical laboratories currently employ several methods depending on the

A urinalysis is a test of your urine. It's used to detect and manage a

A urinalysis involves checking the appearance, concentration and

You might be instructed to collect the sample midstream, using a clean-catch

Electrolyte abnormalities should be identified and corrected. A low

An elevated lactate level is associated with inadequate perfusion,

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