“Testing Time: Make the laboratory your friend!” - Key Messages

Contacts

Specimen reception                                          01782 554638

Pathology Office                                               01782 554648

Biochemistry Helpdesk                                     01782 554676

Duty Biochemist                                               Contact via

                                                                          Hospital switchboard

Immunology                                                      01782 554041

Haematology                                                     01782 554623

Microbiology                                                    01782 554666

Virology                                                           01782 554682

IT issues                                                             01782 554489

Request Cards

Always provide

• An identifying patient number - either Unit or NHS No.
• Full Name
• Date of birth
• Address and post code
• Tests filled in clearly
• Clinical Details
• Any medication information you think is relevant
• Risk status if applicable

Ensure handwriting is legible

Encourage dates and times on the samples bottles

Common issues

Wrong samples being taken - pathology handbooks are available on the internet

www.uhns.nhs.uk

            Healthcare professional section

            Pathology

            Pathology Handbooks

Biochemistry:

Most useful tests are the most common

–       Renal, liver, bone, thyroid, glucose

•       LFTs are most commonly requested pathology tests

•       Utility of biochemical tests depends on clinical question

•       Please contact to discuss individual cases

Hyperkalaemia:

•       Need to exclude artefacts

–       ? On cells/EDTA/difficult venepuncture

•       Interpret in light of renal function

•       Lithium heparin sample in difficult cases

•       Drug history

–       ACE/NSAIDs/heparin/LoSalt

Magnesium

•       Often neglected test but can be useful in investigation of:

–       Hypocalcaemia

–       Hypokalaemia

–       Low magnesium also potentiates digoxin toxicity

Urinalysis:

•       Investigation of ? Myeloma

–       BJP

•       Investigation of hyponatraemiaRheumatoid factor is of more value in prognosis than diagnosis in RA

•       Presence of ANA does not equate with Autoimmune disease however, ANA is useful when negative to virtually exclude a diagnosis of SLE.

•       interpretation of positive ANA depends on titre of result, age & sex of patient as autoantibodies increase in elderly females in the absence of disease.

Least Useful Tests:

•       Random cortisol/growth hormone

•       Generic “hormone profiles” or “tumour markers” requests

•       B12/folate

–       Useful in macrocytic anaemia/neuropsychiatric symptoms

Immunology

Auto-immune disease

Rheumatoid factor is of more value in prognosis than diagnosis in RA

•        Presence of ANA does not equate with Autoimmune disease however, ANA is useful when negative to virtually exclude a diagnosis of SLE.

•        interpretation of positive ANA depends on titre of result, age & sex of patient as autoantibodies increase in elderly females in the absence of disease.

Allergy

•        Immediate type-1 hypersensitivity, IgE – mediated.

•        Most helpful part is clinical history – seasonal, perennial, animals, food type, occupation, bee, wasp, drugs

 Please be specific about your IgE !

Immunology NBs:

Where possible, please request specific tests

Please give clinical details

Any queries or comments, please contact us

Lab  tel no. 01782 554140

Lead BMS: Karen Sneade 01782 554245

karen.sneade@uhns.nhs.uk