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Author Topic: crash course on Medical Lab tests  (Read 12657 times)

Bonerskinners

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crash course on Medical Lab tests
« on: January 18, 2009, 07:48:08 pm »
Laboratory exams are requested by your doctor so he could confirm what’s wrong with you.  Knowing these tests would be very helpful for you to understand what you’re doctor is thinking about.

1. Urinalysis - probably one of the most abused tests because it’s cheap.  Coined from “urine analysis“, it can tell your doctor certain things that could be helpful, like if you have a significant amount of pus cells in your urine (plus you have symptoms of difficulty in urinating, fever, chills), you most likely have a urinary tract infection, and you’d probably need antibiotics. Red cells in urine could be anything (think kidney stones, kidney inflammation, menstrual contamination, etc), but if you’re male, it shouldn’t be there.  Proteins (like albumin) and Sugar (Glucose) should never be detected in you’re urine as well.  If you’re diabetic and you have protein in your urine, consult a nephrologist (kidney specialist) right away. It might mean that your Diabetes is destroying your kidneys. Other things the urinalysis could tell you?  Urine pH, specific gravity, urine color, casts.

    Tip : Make sure you “produce” the specimen an hour before you submit it to the lab.  And it should be a mid-stream clean catch, meaning, during specimen collection, clean your privates first then allow some urine to spill before getting the specimen.

2. BUN and Creatinine - BUN stands for Blood Urea nitrogen, and together with creatinine, these two exams could tell if your kidneys are functioning properly.  You don’t want them to be elevated, because elevation almost always means that you have some form of kidney failure (or renal failure).  Your kidneys usually filter out these substances from you’re body, so if your kidneys are busted, your blood levels of these substances would rise.  Simply put- creatinine and BUN reflects the level of crap in your blood that is supposed to be filtered by functioning kidneys. Your doctor could get an idea of why you have renal failure if these two are done (whether it’s due to dehydration, or an intrinsic kidney defect), so it’s best to let him interpret these tests for you.  Some patients with extremely high levels would need dialysis.

    Another thing : You only need one kidney to live, and one kidney could efficiently clear out unwanted toxins from your body.  So if your BUN and creatinine is high, it means that BOTH kidneys are not functioning well.

3. Cultures - anything with the word “culture” means that the doctors would want to know what organism would grow in the specimen (the more common ones are blood, urine, sputum cultures).  This is usually requested so you’re doctor could be guided as to what antibiotic he would give you.  In cultures, you could know and brag about the name of the bacteria that grew in your sample, and what antibiotics would kill it.

    Organisms might not grow in cultures but this doesn’t mean that it’s not there.

4. CBC - Complete Blood Count. This is again, one of the most abused tests.  The CBC could be very informative, and sometimes, it’s so informative that it could confuse your doctor.  Your CBC should indicate at least the following : Hemoglobin, Hematocrit, White Blood Cell Count, Differential Count, Platelet Count. In some laboratories, they don’t include the platelet count, so sometimes the doctor specifies “CBC with PC” in their order.  The hemoglobin and hematocrit (H&H) are parameters for your doctor to know if you have enough red blood cells or not (I’m assuming that you have heard of red blood cells in your biology class.  Yes, it’s that portion of blood that makes it red).  Males have slightly higher values than females.  If this is decreased, you have anemia, and you might need blood transfusion.  Anemia is not a diagnosis itself, but rather a sign of a disease. If you have problems with your H&H, you need to have this investigated further by your doctor (preferably, a blood disease specialist or hematologist).

« Last Edit: December 17, 2009, 01:57:34 pm by neckromancer »


IWM

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Re: crash course on Medical Lab tests
« Reply #1 on: January 18, 2009, 07:57:57 pm »
Doc, regarding tests for kidney function, which is more reliable - BUN or creatinine?
NAWAWALA YUNG SIG KO... ='(   NAWAWALA YUNG SIG KO... ='(   NAWAWALA YUNG SIG KO... ='(   NAWAWALA YUNG SIG KO... ='(   NAWAWALA YUNG SIG KO... ='( 
"Without evil, there can be no good. So it must be good to be evil sometimes." ;D

Bonerskinners

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Re: crash course on Medical Lab tests
« Reply #2 on: January 18, 2009, 08:27:29 pm »
Good Question...
strictly speaking Creatinine is a more specific tests for the kidneys

Creatinine is a break-down product of creatine phosphate in muscle, and is usually produced at a fairly constant rate by the body (depending on muscle mass). Creatinine is chiefly filtered by the kidneys and not reabsorbed in the blood. Hence, Creatinine is used to calculate the filtration rate and the renal clearance.

BUN or blood urea nitrogen measures the amount of nitrogen in the blood in the form of urea. The liver produces urea in our body (via the urea cycle) as a waste product of the digestion of protein. The kidneys in turn remove urea from the blood.
So, simply put, an elevated BUN has a many causes... whether its due to increase formation of your urea or a decrease in excretion via kidneys and other many causes

That's the reason why doctors usually order BOTH BUN and creatinine. The ratio of BUN and creatinine will usually reflect the cause of the renal problem. A high BUN with a normal creatinine will reflect dehydration as a cause. And a high BUN with high creatinine will reflect an intrinsic renal damage.


IWM

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Re: crash course on Medical Lab tests
« Reply #3 on: January 18, 2009, 08:33:22 pm »
Thank you for that doc. So to sum it up, both tests (BUN and Crea) can be used to test renal function but creatinine is more specific to renal function than BUN.
NAWAWALA YUNG SIG KO... ='(   NAWAWALA YUNG SIG KO... ='(   NAWAWALA YUNG SIG KO... ='(   NAWAWALA YUNG SIG KO... ='(   NAWAWALA YUNG SIG KO... ='( 
"Without evil, there can be no good. So it must be good to be evil sometimes." ;D

Bonerskinners

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Re: crash course on Medical Lab tests
« Reply #4 on: January 18, 2009, 08:46:33 pm »
yup. you got it.  toast::


ugat

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Re: crash course on Medical Lab tests
« Reply #5 on: January 18, 2009, 08:56:33 pm »
i recommend CREATININE... it's easy & very much relaible.. & accurate to know your kidney's condition..
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sixty9

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Re: crash course on Medical Lab tests
« Reply #6 on: January 19, 2009, 03:14:19 am »
Question: blood test ba ang creatinine or urine exam?? doc, san ka nagpapractice?
padiscuss naman ALT and AST,. is it right na pag elevated SGPT, usually liver problem, tpos pag SGOT, heart problem naman? tama po ba?

Bonerskinners

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Re: crash course on Medical Lab tests
« Reply #7 on: January 19, 2009, 03:43:53 pm »
Yup its the blood test, to simply answer your question, SGPT or Serum glutamic pyruvic transaminase, (also known as ALT) and SGOT or serum glutamic oxaloacetic transaminase (also known as AST) are enzymes that are normally present in liver and in heart cells. Their difference:

AST (or SGOT) is normally found in a diversity of tissues including liver, heart, muscle, kidney, and brain. It is released into serum when any one of these tissues is damaged. For example, its level in serum rises with heart attacks and with muscle disorders. It is therefore, neither a highly specific indicator of liver injury nor for heart injuries. So an elevated SGOT doesn't mean that you automatically have a heart problem. A different enzyme is used for that which is more specific for the heart which I would discuss here in this forum one of these days.

ALT (or SGPT) is, by contrast, normally found largely in the liver. This is not to say that it is exclusively located in liver, but that is where it is most concentrated. It is released into the bloodstream as the result of liver injury. It therefore serves as a fairly specific indicator of liver status.

In liver cirrhosis (fatty degenration of liver), ALT/AST ratio is also commonly used by doctors to fairly evaluate the reason for the cirrhosis. A high AST/ALT ratio reflects alcoholic cirrhosis and a a high ALT/AST ratio would reflect a different reason.

Therefore, AST (SGOT) and ALT (SGPT) are sensitive indicators of liver damage or injury from different types of disease. But it must be emphasized that higher-than-normal levels of these liver enzymes should not be automatically equated with liver disease. They may mean liver problems or they may not. For example, elevations of these enzymes can occur with muscle damage or medication induced. The interpretation of elevated AST and ALT levels depends upon the entire clinical evaluation of a patient, and so it is best done by doctors experienced in evaluating liver disease.


sixty9

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Re: crash course on Medical Lab tests
« Reply #8 on: January 21, 2009, 10:22:22 pm »
how about d 24 hour urine collection? pang test din po ba ng crea un? and tanong ko lang, doc, di ba nakakabaog daw ang xray? wat if kelangan kang i xray, may possibility bang mabaog ka? tnx..

sixty9

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Re: crash course on Medical Lab tests
« Reply #9 on: January 25, 2009, 06:48:31 am »
dok, ttanong ko lang din kung nasa magkano ang "skin biopsy" sa ust? sana po pareply sa mga questions.. tnx boner

Bonerskinners

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Re: crash course on Medical Lab tests
« Reply #10 on: January 26, 2009, 03:11:42 am »
how about d 24 hour urine collection? pang test din po ba ng crea un? and tanong ko lang, doc, di ba nakakabaog daw ang xray? wat if kelangan kang i xray, may possibility bang mabaog ka? tnx..

a 24 hour urine collection can also be used to test creatinine levels... actually it is used alongside with serum creatinine to calculate the creatinine clearance of the kidneys.

X-Rays... hmmm... actually I asked one of my radio resident friend and he said that X-ray or the radiation of x-rays has certain harmful side effects but these side effects are  usually evident after prolonged exposures or several exposures. he didn't say how much though but I'm probably sure that its more that 100 exposures... and a single exposure (few seconds worth) is probably harmless... so wag ka matakot magpa XRay...

dok, ttanong ko lang din kung nasa magkano ang "skin biopsy" sa ust? sana po pareply sa mga questions.. tnx boner
sorry don't know this one... I'll ask na lang derma the residents about this... but I think di naman lalagpas ng 300 pesos... hiwalay pa bayad sa histopath.



sixty9

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Re: crash course on Medical Lab tests
« Reply #11 on: January 30, 2009, 09:13:15 am »
tnx dok.. pa update nalang kung magkano presyo nun jan sa inyo,.. dahil jan e2 po ang sa inyo dok..  finger4u