INDEX

4K score, 612 determining respiratory versus rheumatoid arthritis, 505 4Ts score, 399 metabolic, 307 systemic lupus erythematosus, 509 5-alpha reductase enzyme, 593–594 metabolic acidosis, 308–309, 309, 310. Acute phase response, 500 See also Metabolic acidosis 5' nucleotidase, 334, 335, 636 Acute type B hepatitis (minicase), 349 metabolic alkalosis, 309, 310. See also 6-mercaptopurine (6-MP), 138 ADAM Questionnaire, 596 Metabolic alkalosis 13C- and 14C-labeled urea, 353 Addison disease, 219 respiratory acidosis, 310, 311 15/15 rule, 208 Adenocarcinoma of lung respiratory alkalosis, 311, 311 17-OHP, 578 anaplastic lymphoma kinase, 526 Acid-base homeostasis, 270–271 21-hydroxylase deficiency, 526 EGFR and, 525 Acid-base homeostasis, regulation of, 99m Tc-sestamibi imaging, 165 306–307, 307 Adenosine, 164 201 TI perfusion imaging, 165 Acid-base physiology, 306 Adenosine diphosphate (ADP), 394, Acidemia, 303 394 A Acid-fast bacilli and stains, 470 Adenoviridae, 456 A1c. See Glycated hemoglobin (A1c) Acidosis. See also Metabolic acidosis ADME (absorption, distribution, metabolism, and excretion), 136 Abacavir, 468–469 defined, 303 Adnexal tumors, hirsutism secondary to Absolute neutropenia, 387 lactic, 308, 309 (minicase), 577 Absorbance optical system, 28 respiratory, 310, 311 Adolescents Absorption, distribution, metabolism, and Activated clotting time (ACT), 408 excretion (ADME), 136 categories of substances abused by, 70 Activated partial thromboplastin time prerequisite drug testing of, 82–83 Accu Check Compact Plus, 200 (aPTT), 406–408, 418 Adrenal disorders, 218–219 Accuracy, 3, 55, 59, 61 Activated protein (APC) resistance, 403 Adrenal glands, 218 Acetaminophen Active metabolites, 99–100, 106 nomogram for, 79 Acute blood loss anemia, 374, 379 Adrenal insufficiency, 210 overview of, 106 Acute coronary syndrome (ACS), 152 ADVIA Centaur, 163 serum concentration of, in poisoning electrocardiographic findings in,154, Afatinib, EGFR and, 140–141, 143 (minicase), 80 154, 154–155 Affinity chromatography in measuring ­ toxicity from, 79 imaging studies and, 163–164 HgbA1c, 57 Acetoacetate, 204, 206, 240 laboratory tests used in evaluation of, Agar dilution, 430, 432–433 Acetone, 204, 206 155 Agarose gel electrophoresis, 27 Acid, defined, 303 biochemical cardiac markers, Agar proportion method, 471 Acid-base chemistry 155–160, 156 Agars, 423, 425 ABG assessments in, 307–308 minicase on, 155 Age-related differences.See also anion gap in, 305 Acute hepatitis, 342, 343, 349 Hematology; Kidney function tests; Liver function tests; Pediatrics arterial bicarbonate in, 304 Acute homeostasis, 271 in laboratory test results, 10–11, 11 arterial blood gas interpretation and, Acute kernicterus, 566 307 Acute liver failure (minicase), 350 in total blood volume, 548–549, 549 arterial oxygen saturation in, 305 Acute lymphoblastic leukemia (ALL), Agglutination, 31–32, 32 arterial partial pressure of carbon 387 Aging Males’ Symptom Scale, 596 dioxide in, 304 Acute myeloblastic leukemia (AML), Agranulocytosis, 387 arterial partial pressure of oxygen in, 387 AHFS Drug Information, 47 304 Acute myocardial infarction (AMI), 152 Alanine aminotransferase (ALT) arterial pH in, 304 Acute pancreatitis, 352 as category of liver function tests, 330, serum lactate in, 305 Acute pharyngitis, 479 330 terminology in, 303 Acute phase reactants (proteins) omega-3 fatty acids and, 187 venous oxygen saturation in, 305 defined, 373 in pediatric patients, 565 venous total carbon dioxide (serum infection and, 484–485 Quickview Chart on, 366 bicarbonate) in, 305 in rheumatic diseases reference range for, in traditional and SI Acid-base disorders juvenile idiopathic arthritis, 507 units, 636 classifications for, 307 overview, 500–501 statins and, 186

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Albumin American College of Cardiology/ Androgen deficiency in aging males as category of liver function tests, 330, American Heart Association (ACC/ (ADAM), 594–595, 595 330 AHA) Androgen Deficiency in Aging Males liver function testing and, 331 Guideline on Treatment of Blood (ADAM) questionnaire, 596 Quickview Chart on, 362 ­Cholesterol, 179, 182 Andropause, 594–595, 595 reference range for, in traditional and SI Guidelines for Assessment Androstenedione, 593 units, 636 of Cardiovascular Risk in Anelloviridae, 456 Asymptomatic Adults, 185 serum, in pediatric patients, 564–565 Anemia(s) guidelines for C-reactive protein in urinalysis, 250 measurement, 501 acute blood loss, 374, 379 Albumin-bound testosterone, 594, 598 lipid guidelines, 208 aplastic, 387 Albuminuria, 250 American College of Chest Physicians causes of, 57, 373 Alcohol Evidence-Based Clinical Practice of chronic disease, 374, 379, 381 driving under influence of, 70 Guidelines, 400, 404, 405, 411 drug-induced hemolytic, 380, 380 HDL and, 179 American Society of Health-System erythrocyte morphology for differential Aldosterone Pharmacists, AHFS Drug Information, diagnosis of, 373, 374 47 potassium and effects of, 263, 269, 270, glucose-6-phosphate dehydrogenase, 272 American Urological Association System 11, 380 Index (AUA-SI), 603–604 sodium and effects of, 264–265 hemolytic, 374, 379–380 Amikacin, 99 Alkalemia, 303 hereditary, 11 Amino acid chains, 493–494, 494 Alkaline phosphatase (ALP) with increased MCV (minicase), 375 Aminoglycosides, 112–113 as category of liver function tests, 330, 330 iron deficiency and, 377–379 Aminophylline, 106–107 evaluation of elevated concentrations iron stores and (minicase), 378 of, 334, 334 Aminotransferases, 330, 338–339 laboratory assessment of, 373–381 liver function and, 334 Amiodarone, 118 low platelet count and (minicase), 379 nonhepatic causes of elevated, 334, 335 Amitriptyline, 122–123 lymphopenia and (minicase), 386 in pediatric patients, 565 Ammonia macrocytic, 373, 375–377 Quickview Chart on, 364 hepatic encephalopathy and, 339–340 macrocytic, megaloblastic, 376 reference range for, in traditional and SI Quickview Chart on, 368 microcytic, 377–379 units, 636 reference range for, in traditional and SI myeloblast crisis (minicase), 382 Alkaline picrate assay, 240 units, 636 myelodysplastic, 387 Alkalosis. See also Metabolic alkalosis Ammonium sulfate precipitation assay, 599 normochromic, normocytic, 379–381 defined, 303 AmpC beta-lactamases, 436 overview of, 373 respiratory, 311, 311 Amperometry, 200 in pediatric patients, 567 ALK inhibitor, 141–142 Amphetamine pernicious, 376 Alpha-fetoprotein (AFP), 518, 523, 535 Quickview Chart on urine drug screen physiologic, of infancy, 568 for, 88 Alpha-glucosidase inhibitors, 224 rheumatologic diseases and, 503 reliability of drug screening (minicase), Altered serum binding, 104–106 juvenile idiopathic arthritis, 507 72 Altitude, laboratory test results and, 12 rheumatoid arthritis, 506 Amphotericin B, 271 Amenorrhea systemic lupus erythematosus, 509 AmpliChip® microarray, 143 defined, 572 sickle cell, 11, 381 Amylase, pancreatitis and, 351–352 differential diagnosis of, 574 signs and symptoms of, 373 Amylin estrogen status and, 577 typical laboratory findings for types of, analog of, 226 functional, 573–574 374 effect of, on glucose concentrations, Angiocardiography, 165 hyperandrogenism and, 576–577 193–194 Angiotensin II, 264 hyperprolactinemia and, 573 levels of, 195–196 Angiotensinogen, 264 hypothyroidism and, 573, 574 Anaerobic bacteria, susceptibility testing ovarian failure and, 574–576 of, 438–439 Angiotension-converting enzyme (ACE) inhibitors, 209 physical examination findings Analgesic/anti-inflammatory drugs,244. associated with, 572–573, 573 See also Acetaminophen Angiotension receptor blockers (ARBs), 209 polycystic ovary syndrome and, 576, Analytes, 3–4, 52 Anion gap, 305 576, 577 Analytical reliability, 144 Anion gap acidosis, 308, 309 primary and secondary, 572 Analytic specificity (interference), 56.See symptoms associated with, 572, 572 also Drug interferences Anisocytosis, 371, 372 uterine outflow obstruction and, 573 Anaplastic lymphoma kinase (ALK), 519, Anterior pituitary dysfunction, 573 American Association of Clinical 526, 543 Antiasthmatics Endocrinologists (AACE), guideline on Anaplastic lymphoma kinase (ALK) caffeine as, 107 LDL, 182 inhibitor, 141–142 theophylline as, 99

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Antibiotic concentration gradient pregabalin as, 112 Antineutrophil cytoplasmic antibodies, methods, 433–434, 434 tiagabine as, 112 498–499, 499 Antibiotics topiramate as, 112 Antinuclear antibodies (ANAs) detecting presence of resistance unbound serum concentrations and characteristics of, 496 mechanisms, 435–439 (minicase), 105 defined, 495 direct measure of activity, 429–435 valproic acid as, 110–111 in juvenile idiopathic arthritis, 507 interaction between sulfonylureas and zonisamide as, 112 in rheumatoid arthritis, 505 sulfa-type, 208 Antifungals in systemic lupus erythematosis, 507 pseudomembranous colitis induced by azole, 115–116 tests for (minicase), 357 data to aid interpretation of, 100 algorithm, 497 tests for bactericidal activity of, 434–435 flucytosine as, 115 overview, 495, 497–498 Antibiotic therapy Antifungal susceptibility testing, qualitative results, 498 empiric, 441 454, 455 quantitative results, 497–498 hospital-acquired pneumonia and Antigen detection Antiphospholipid syndrome (APS), 503, empiric (minicase), 429 for fungi identification, 452 509 using laboratory test results to guide for meningitis identification, 478–479 Antipsychotics, 123–124 choice of, 440 for pneumonia identification, 479–480 Antipsychotics, atypical, 179, 196 Antibody-dependent cell-mediated for streptococcal pharyngitis, 5, 479 Antiretrovirals, 116–117, 468 cytotoxicity (ADCC), 384 for virus identification, 461–462 Anti-Ro/SSA antibodies, 508 Antibody testing Antigen-presenting cells (APC), 384 Anti-Sm antibodies, 508 for chlamydia, 482 Antiglobulin tests, 379, 380 Anti-ssDNA antibodies, 508 for fungi identification, 452–453 Anti-HCV, 344 Antithyroid antibodies, 217 for HIV-1, 463, 465–466 Anti-HER2 therapy, 140 Antiviral susceptibility testing, 462 for virus identification, 462 Antihypertensive agents Anti-Xa, 408, 409, 419 Anticentromere antibody (ACA), 496, 497 safety of, in patients with chronic Apixaban, 396, 396, 400, 404 Anticitrullinated protein antibodies kidney disease, 244 Aplastic anemias, 387 (ACPAs) for secondary lipid disorders, 178 Apo B, 184 in juvenile idiopathic arthritis, 507 that may cause hyperglycemia, 196 Apolipoproteins, 176, 176 in rheumatoid arthritis, 504 Anti-La/SSB antibodies, 508 Apotransferrin, 377 in rheumatological diseases, 494 Antimicrobials Aquaporin-2, 263 Anticoagulants. See also Coagulation; aminoglycosides as, 112–113 Area-under-the-curve (AUC), 102 Warfarin antimycobacterials as, 116 Arenaviridae, 457 mechanisms of, 396, 396 beta-lactams as, 114–115 Argatroban, 399 safety of, in patients with chronic data to aid interpretation of, 99 Arginine vasopressin. See Antidiuretic kidney disease, 245 hormone (ADH) types of, 403 safety of, in patients with chronic kidney disease, 244 Array-based comparative hybridization, Antidepressants, 123 39 testing of combination therapy Antidiabetics, 223–226 - and, 435 Arterial bicarbonate (HCO3 ), 304 Antidiuretic hormone (ADH), 220, vancomycin as, 113–114 Arterial blood gases (ABGs) 262–263 Antimicrobial susceptibility testing for assessment of acid-base status, Antidoping, 83 303–304 additional considerations, 443 Anti-dsDNA antibodies, 507–508 step-wise approach for assessment of, Antiepileptics advantages and disadvantages of 307–308 various types, 430 carbamazepine as, 108 Arterial oxygen saturation (SaO ), 305 detection of antibiotic resistance 2 data to aid interpretation of, 99 mechanisms, 429, 435–439 Arterial partial pressure ethosuximide as, 111 of carbon dioxide (PaCO ), 304, 314 direct measurements of antibiotic 2 felbamate as, 111 activity, 429, 429–435 of oxygen (PaO2), 304 fosphenytoin as, 109–110 methods for reporting results Arterial pH, 304 gabapentin as, 111 hospital cumulative antibiograms, Arthritis lamotrigine as, 111–112 441–443, 442, 442 minicase, 506 levetiracetam as, 112 individual isolate, 439, 439–441 osteoarthritis, 509, 511, 512 overview of, 107–108 overview, 428–429 rheumatoid arthritis, 504–506 oxcarbazepine as, 112 surveillance of large numbers of Arthrocentesis, 502 pentobarbital as, 112 isolates, 443 Aspartate aminotransferase (AST) phenobarbital/primidone as, tests of bactericidal activity of as category of liver function tests, 330, 108–109 antibiotic, 434–435 330 phenytoin as, 109–110 Antimycobacterials, 116 hepatocellular injury and, 338–339

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in pediatric patients, 565 Barbiturates, Quickview Chart on urine production and metabolism of, 335, 336 Quickview Chart on, 365 drug screen for, 88 Quickview Chart on, 367 reference range for, in traditional and SI Baroreceptors, 262 reference range for, in traditional and SI units, 636 Basophilia, 385 units, 636 Aspergillus spp., 446 Basophils, 383 unconjugated hyperbilirubinemia and, Aspirin Bayesian dosage adjustment, 104 336–337 bleeding time (BT) and, 401–402 BCR-ABL, 519, 525, 539 Bilirubinuria, 253 production of PG2 and, 394 Beckman Coulter, 163 Bioavailable testosterone, 598, 598, 599 Assays. See also Enzyme-linked Bedside testing. See Point-of-care testing Biochemical bacterial identification, 425 immunosorbent assay (ELISA); (POCT) Biochemical cardiac markers Immunoassays Bence Jones protein, 387 cardiac-specific troponin I and T, heterogeneous, 31 Benign prostate hyperplasia (BPH) 155–158, 159 readily available, 94 American Urological Association CK-MB isoforms, 159 time-kill, 435 System Score, 603–604 creatine kinase, 158, 159, 172 Asthma BPH Impact Index and, 604, 605 creatine kinase isoenzymes, 156, 158, definitions of airway obstruction defined, 603 159 severity for, 318, 319 digital rectal exam of prostate and, myoglobin, 156, 159 peak flow monitoring in patient with, 604 overview of, 155 322 International Prostate Symptom Score Biochemical markers Astroviridae, 457 instrument, 603 for evaluation of acute coronary Atherosclerotic vascular disease (ASCVD) overview, 603 syndrome emerging lipid risk factors for, 184–185 peak urinary flow rate and, 604–605 B-type natriuretic, 159–160 guidelines for risk assessment of, 179, postvoid residual urine volume and, C-reactive protein, 160 182 605 criteria of ideal marker, 155 transrectal ultrasound of the prostate, overview of, 175 high-sensitivity C-reactive protein, 605 Athletics and drugs. See Sports 160 Benign PSA (BPSA), 609 Atomic absorption spectrophotometry, 23 other markers, 160 Benzodiazepines, Quickview Chart on Atomic emission spectrophotometry, 23 recommendations for measurement, urine drug screen for, 89 Atrial natriuretic peptide, 161, 265 160–161 Benzoylecgonine (cocaine metabolite), Atypical antipsychotics. See for evaluation of heart failure Quickview Chart on urine drug screen Antipsychotics, atypical for, 89 natriuretic peptides, 161–163 Autoantibodies, diabetes-related, 197 other markers, 163 Beta-2 microglobulin (B2M), 518, 523, Autoimmune-type mechanism, of drug- 536 recommendations for measurement, induced antibody formation, 380, Beta-blocking agents, 178 163 380 (1,3)-beta-D-glucan detection, 453 Biological specimens. See Specimen(s) Autoinduction, 101 Beta emitter, 31 Biologic rhythms, as factor in laboratory Automation in the hospital/clinical test results, 11 laboratory, 20–21 Beta-hydroxybutyrate, 204, 206 Biomarkers, 4. See also Tumor markers AxSYM, 163 Beta-lactamase activity, detection of, 435–436 Blastomyces dermatidis, 448 Azathioprine, 138 Beta-lactams, 114–115 Bleeding. See also Hemorrhage Azole antifungals, 115–116 Bias, 55, 59, 61 drugs that effect risk of,399, 401, 403, Azotemia, causes of, 240 - 405 Bicarbonate, arterial (HCO3 ), 304 platelet function and, 401 B Big, big prolactin, 602 Bleeding time (BT), 401–402 Bacteremia, using antibiogram to choose Big prolactin, 602 Blood antibiotic regimen for (minicase), 441 Bile, 333 in chemical analysis of urine, 250, 253 Bacteria. See also Antimicrobial Bile acid sequestrants, 186, 226 susceptiblity testing; Mycobacteria Bilirubin point-of-care analysis of, 52–53, 54 colonization, contamination, or as category of liver function tests, 330, Blood agar, 423, 425 infection, 426–428 330 Blood assay. See Assays defined, 421 conjugated hyperbilirubinemia and, 337 Blood assay for M. tuberculosis (BAMT), identification of delta, 337 472 culture, 423, 425–426 direct, 4, 636 Blood cells, physiology of, 369–371 Gram stain, 422–423 indirect, 4, 336, 636 Blood chemistry analyzer, 53 overview, 421 indirect versus direct, 335–336 Blood clots. See Clots sites of infection and common in kidney function assessment, Blood coagulation tests pathogenic, 428 250, 253 anti-Xa, 419 Bacterial meningitis. See Meningitis in pediatric patients, 565–566 aPTT, 418

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clot degradation, 396 B-type natriuretic peptide (BNP) H. pylori-associated gastric, 353 platelet count, 416 overview of, 159–160, 161–162 leukemias as, 387–388 Blood essay. See Essays prognosis and levels of, 162–163, 163 Candida spp., 446 Blood glucose meters. See Glucose meters Quickview Chart on, 173 Capillary chromatography, 28 Blood pool scintigraphy, 166 sodium homeostasis and, 265 Capillary electrophoresis (CE), 28 Blood pressure values in pediatric Buffers, 306 Capillary gel electrophoresis (CGE), 28 patients, 548 BUN: SCr ratio, 267–268 Capillary puncture, 548 Blood sampling, in pediatric patients, 548 Bunyaviridae, 457 Capillary zone electrophoresis (CZE), 28 Blood urea nitrogen (BUN) Burnett syndrome, 281 Carbamazepine, 99, 101, 108 concomitant, and SCr, 241 Bursa of Fabricius, 386 Carbapenemase enzymes, 436 decreased, 240–241 Carbon dioxide elevated, 240, 240 C arterial partial pressure of (PaCO2), overview of, 240 C3, in diagnosing rheumatic diseases, 500 304, 314 Quickview Chart on, 257–258 C4, in diagnosing rheumatic diseases, 500 reference range for, in traditional and SI ratio of serum creatine (SCr) to, CA 15-3 antigen, 518, 520–521, 531 units, 636 267–268 CA 19-9 antigen, 518, 523, 534 venous total, 305, 313 reference range for, in traditional and SI CA 27.29 antigen, 518, 521, 532 Carbon monoxide breath test, 325–326 units, 637 CA 125 antigen, 518, 521–522, 530 Carbon monoxide diffusion capacity Blood volume, by age group, 548–549, 549 Caffeine, 107 (DLCO), 323 B lymphocytes, 384, 386 CAH spectrum, 578 Carcinoembryonic antigen (CEA), 518, 520, 521, 529 BNP/NT-proBNP, Quickview Chart on, Calcitonin, 279 Cardiac catheterization, 164–165 173 Calcium Cardiac computed tomography (CCT), 166 Body fluids, assessing for infection in, 484, calcitonin and, 279 485 Cardiac C-reactive protein (CRP), 160 in coagulation cascade, 395 Body mass index (BMI), and BNP levels, Cardiac cycle, 151–152, 152 conversion factors to SI units for, 262 162 Cardiac drugs Body plethysmography, 322 disorders of phosphate and (minicase), 284 amiodarone as, 118 Body sites, normally sterile, 426, 426 extracellular, 277–278 data to aid interpretation of, 100 Body surface area, in pediatric patients, hypercalcemia and, 279, 280–281 digoxin as, 117–118 562 hypocalcemia and, 279, 279–280 lidocaine as, 118–119 Bone marrow intracellular, 276–277, 277 procainamide as, 119 dysfunction of, 12 normal range of, 276 quinidine as, 119–120 physiology of, 369–371 normal test ranges for metabolism of, in safety of, in patients with chronic sampling and biopsy of, 370 adults, 281 kidney disease, 244 Bordetella pertussis, 473, 480 parathyroid hormone (PTH) and, 279, Cardiac dysfunction, 152–153 Bornaviridae, 457 279 Cardiac magnetic resonance imaging Borrelia burgdorferi, 473 in pediatric patients, 556 (CMR), 166 BRAF mutation and inhibitor, 142, 519, hypercalcemia, 557, 559 Cardiac output (CO), 152 542 hypocalcemia, 556–557 Cascade reporting, of antibiotic susceptibility, 441 Brain natriuretic peptide (BNP). See measurement, 556 B-type natriuretic peptide (BNP) Casts in urinalysis, 248, 248 phosphate and, 282 Breast cancer Catheterization, cardiac, 164–165 physiology of, 276–279, 277 CA 15-3 antigen and, 518, 520–521 CD4 T-helper cells, 384 Quickview Chart on, 297 CA 27.29 antigen and, 518, 521, 532 CD4+ T lymphocyte count, 384, reference range for, in traditional and SI 467–468 estrogen and progesterone receptors in, units, 636 523–524 CD20 epitope, 388, 388–389 serum calcium correction method and, HER2 in, 524–525 278 C. difficile. See Clostridium difficile Breeze 2, 200 vitamin D and, 278–279 CD molecules, 382 Bronchial provocation test (BPT), Calcium channel blockers, 276–277 Cefoxitin disk diffusion test, 437 323–325 Calcium dobesilate, 199 Cell culture. See Cultures Bronchodilator reversibility test, Caliciviridae, 457 Cell cytotoxicity assay, 355 321–322 Campylobacter-like organism (CLO) test, Cellular casts in urinalysis, 248 Bronchodilators, 99, 106–107 354 Cellulose acetate electrophoresis, 27 Broth macrodilution, 430, 430, 430–431 Cancer. See also Tumor markers; specific Centers for Disease Control and Broth microdilution, 430, 431–432, 432 cancers Prevention (CDC) Broths, 423, 425 Erythrocyte-stimulating agent (ESA) Cholesterol Reference Method Brucella spp., 474 therapy and, 381 Laboratory Network, 57

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resources on waived point-of-care Cholesterol susceptibility testing of aerobic and tests, 52 metabolism of, 175–176, 176 anaerobic bacteria, 428–429 standardized testosterone assays, 597 point-of-care tests for, 57 Clinical Laboratory Improvement Centers for Medicare & Medicaid Services reference range for, in traditional and SI Amendments of 1988 (CLIA-88), 13 (CMS) units, 636 waived point-of-care testing. See Point- of-care testing (POCT) list of waived point-of-care tests, 52 Chromatography Clinical Pharmacogenetics regulation of point-of-care testing, gas, 25, 29, 29–30 51–52 Implementation Consortium (CPIC), high-performance liquid, 25, 30, 30 practice guidelines of, 136, 405 Central diabetes insipidus, 220, 220, overview of, 29 263–264 Clinical predictive power, 144 thin-layer, 29 c-erb B2 gene, 524 Clinistix, 200 Chromium Cerebral salt wasting, 552 Clinitest, 199–200 average range of, 289 Cerebrospinal fluid (CSF), testing of.See Clopidogrel, CYP2C19 gene and, 138, 402 conversion factors to SI units for, 262 Meningitis Clostridium difficile (Pseudomembranous deficiency of, 289–290 Ceruloplasmin, 285 colitis) excess of, 290 Chain-of-custody procedures in antibiotic-induced (minicase), 357 workplace drug testing, 73–74 physiology of, 289 diagnosis of, 355 Challenge. See Bronchial provocation test Quickview Chart on, 302 overview of, 354–355, 474 (BPT) Chromogenic test, 436 Clot degradation tests Checkerboard technique, 435 Chronic disease D-dimer, 410–412, 411 Chemical ionization (CI), 34 anemia of, 374, 379, 381 fibrin degradation products, 410 Chemiluminescence, 22 point-of-care tests for, 52–53, 54 overview, 409–410 Chemiluminescent detection methods, applications, 65 CLO (Campylobacter-like organism) test, 597 determination of appropriateness of 354 Chemokine coreceptor 5 (CCR5), 468 candidates, 63–65 Clots Chemotherapeutic drugs Chronic kidney disease (CKD) degradation of, 396 hyperuricemia and, 512 anemia and, 381 formation of, 393–395, 394 in patients with chronic kidney disease, classification of, 238 Cluster of differentiation (CD) molecules, 245 medication safety in, 244, 244–245 382 Chemstrip, 200 stages of, 242 COAG (Clarification of Optimal Anticoagulation through Genetics) Chest radiography, 163 Chronic Kidney Disease Epidemiology trial, 140, 405 Chlamydia, 474, 482 Collaboration (CKD-EPI) equation, 243 Coagulation. See also Anticoagulants Chloride Chronic lymphocytic leukemia (CLL), characteristics of factors in, 395, 396 conversion factors to SI units for, 262 387, 388 factors that promote, 395, 396 hyperchloremia and, 273–274 Chronic myelogenous leukemia (CML), 387, 388, 525 inhibition of, 396, 396, 397 hypochloremia and, 273–274 Chronic obstructive pulmonary disease Coagulation cascade normal range of, 273 (COPD), 106, 318, 319 physiology of, 395, 395 physiology of, 273 Chronic pelvic pain syndrome, 614–615 vitamin K and, 332, 395 Quickview Chart on, 295 Chronic Prostatitis Symptom Index, 615 Coagulation tests reference range for, in traditional and SI Chvostek sign, 280 activated partial thromboplastin time units, 636 Chylomicrons, 176, 176, 180 (aPTT), 406–408, 418 Chloride resistant metabolic alkalosis, anti-Xa, 408, 409, 419 309, 310 Circadian rhythm, 11 ecarin clotting time, 409, 410 Chloride responsive metabolic alkalosis, Citrate, hypocalcemia and, 557 309, 310 Citrullination, 494 fibrogen assay, 408 Chloridometer, 25 Citrulline antibody, 494 overview, 402–403 point-of-care testing, 412 Chocolate agar, 423, 425 Clarification of Optimal Anticoagulation prothrombin time and international Cholangitis through Genetics (COAG) trial, 140, 405 normalized ratio, 332, 332, 363, hemochromatosis and, 346–347 Classical hemochromatosis, 346 403–406, 417 primary biliary, 346 Clinical and Laboratory Standards thrombin time, 408–409 primary sclerosing, 334 Institute (CLSI) Cobalamin, 373, 375–376 Cholestasis, 333 antimicrobial susceptibility testing, 440 CobasC 4800 BRAF V600 mutation test, extrahepatic, 333, 333–334 automation standards developed by, 21 526 intrahepatic, 333, 333 cumulative antibiogram development, Coccidioides immitis/posadasii, 448 tests associated with, 334–337 442 Cockcroft-Gault equation, 240, 242 Cholestatic liver disease, 330–331, 333 interpretative criteria for MIC results, versus MDRD for drug dosing, 243–244 Cholestech GDX, 199 430 Co-cobalamin, 376

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Codeine, CYP2D6 gene and, 137 Coulter principle, 26, 35 for prostatitis, 481 Colitis, 354 Coumadin. See Warfarin for urinary tract infection, 481 Colitis, pseudomembranous. See Coxiella burnetti, 474 of viruses for identification, 460 Clostridium difficile C-peptide, in diagnosing diabetes Cumulative antibiogram, 441–443, 442, Colloid osmotic pressure (COP), 23, 24 mellitus, 196–197 442 Colloid osmotic pressure (COP) cPSA, 611–612 Current Procedural Terminology (CPT) osmometer, 24 C-reactive protein (CRP) code, 52 Colon cancer, carcinoembryonic antigen in acute coronary syndrome, 160 Cushing syndrome, 218–219, 577 and, 518, 520 elevated, in presence of infection, Cutoff values, 71,71 Colonization, by bacteria, 426–427 484–485 CXC coreceptor (CSCR4), 468 Colorimetry, 200 high-sensitivity, 160, 185, 501 Cyclosporine, 100, 121 Color indicator test strips, 250–251 in rheumatic diseases, 501 CYP2C9 gene, 136, 138, 139, 404, 405 Compensation, 308, 308 Creatine-EDTA clearance, 239 CYP2C19 gene, 136, 138, 402 Complement Creatine kinase (CK) CYP2D6 gene, 136, 137 in diagnosing rheumatic diseases, causes of elevated levels of, 158, 159 CYP3A4 gene, 138 499–500 for diagnosis of acute coronary CYP3A5 gene, 138 in juvenile idiopathic arthritis, 507 syndrome, 156 CYP4F2 gene, 404, 405 in rheumatoid arthritis, 505 isoforms of, 159 Cyproheptadine, 219 in systemic lupus erythematosus, 509 overview of, 158 Cystatin C, 239, 564 Complete blood count (CBC) Quickview Chart on, 172 Cystatin C equations, 243–244 with differential.See White blood cell reference range for, in traditional and SI Cystoscopy, 603 (WBC) count and differential units, 636 Cytochrome P450 Nomenclature elements of, 371–373 Creatine kinase isoenzymes, 156, Committee, 137 minicase on, 382 158–159, 159 Cytochrome P450 system, 136–137 overview of, 371 Creatinine, 239. See also Serum creatinine Cytology reference ranges for typical, 370 Creatinine, Quickview Chart on, defined, 37 258–259 in rheumatology, 503 in identifying viruses, 461 Creatinine clearance (CrCl) Computed tomography (CT), 165–166 Cytometry in assessment of kidney function Conductometry, 26 defined, 35 Confirm MDX, 614 calculating, from a timed urine collection, 241–242 flow, 35–37,36 Conjugated hyperbilirubinemia, 337 measurement, 241–242 image, 37 Contamination, by bacteria, 427 determination of, from urinary in situ hybridization, 37 Continuous glucose monitoring, 200–201 creatinine collection, 562–563 Cytopathic effect (CPE), 460 Contour Next USB, 200 estimating from serum creatinine, 242 Cytopathologic effects (CPEs), 461 COP osmometer, 24 reference range for, in traditional and SI Cytoplasmic antineutrophil cytoplasmic Copper units, 636 antibodies (cANCA), 498, 499 conversion factors to SI units for, 262 standardization of, 562 Cytotoxic drugs, 100, 120–121 hypercupremia and, 286 Crigler-Najjar syndrome, 336, 566 hypocupremia and, 285–286 Criminal justice system, drug screening D normal range of, 284 in, 74 Dabigatran, 396, 396, 400, 403, 404, 406 physiology of, 284–285 Critical value, 6 Dabrafenib, 142 Quickview Chart on, 299 Crizotinib, 141–142 DailyMed, 47 Coreceptor tropism assays, 468 Cryptococcus neoformans, 446 D-dimer, 410–412, 411 Coronary angiography, 165 Cryptosporidium parvum, 474 Dead space, 316 Coronary arteries, 152 Crystals in urinalysis, 249, 249 Dehydration, 12 Coronary artery disease (CAD), 152 C-serotonin release assay, in diagnosing Dehydroepiandrosterone (DHA), 593 Coronary heart disease (CHD), emerging heparin-induced thrombocytopenia Dehydroepiandrosterone sulfate (DHAS), lipid risk factors for, 184–185 (HIT), 399 593 Coronaviridae, 457 Cultures Delta-9-tetrahydrocannabinol-9- Corticosteroid-binding globulin-bound of bacteria, 423, 425–426 carboxylic acid, Quickview Chart on testosterone, 594 false-positive, 427–428 urine drug screen for, 90 Corticosteroids, 219 negative, in patients with infection, Delta bilirubin, 337 Corticotropin-releasing hormone (CRH) 428 Deltavirus, 457 test, 219 for chlamydia, 482 Dematiaceous fungi, 444, 444, 447 Cortisol, 193 of fungi, 445, 450–451 Dendritic cells, 384 Cosyntropin stimulation test, 219 for gonorrhea, 481–482 Dendroaspic natriuretic peptide, 161 Coulometry, 25 of mycobacteria, 470–471 Denileukin diftitox, 389

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Densitometry, 28–29 features of, 7 Direct thrombin inhibitors (DTIs), 396, Depolarization, 153 types of nonprescription in vitro, 14, 14 396, 408, 409, 410 Dermatophytes, 444, 444 Diaphragm, 315 Disease. See Chronic disease; Infectious Des-gamma-carboxy prothrombin (DCP), Diarrhea (minicase), 309 diseases; individual diseases 332 Diastix, 200 Disk diffusion method (Kirby-Bauer), 430, 433, 433 Designer drugs, 74, 84 Diastolic heart failure, 153 Desipramine, 122–123 Disseminated intravascular coagulation DIC syndrome. See Disseminated (DIC) Detoxification, tests associated with, intravascular coagulation (DIC) 339–340 laboratory differential diagnosis of, Diet 411 Dexamethasone suppression test (DST), Atherosclerotic vascular disease minicase on, 407 218–219 (ASCVD) risk and, 179 platelet destruction and, 399 DHEA-S, 576, 577–578 hyperuricemia and, 512–513 Distal tubule, 237 Diabetes Control and Complications Trial laboratory test results and, 12 Diuretics (DCCT), 56, 202 triglycerides and, 180–181 renal potassium wasting and, 271 Diabetes insipidus Dietary Approaches to Stopping central, 220, 220, 263–264 Hypertension (DASH), 182 that may cause hyperglycemia, 196 clinical diagnosis of, 220–221 Diffusion capacity tests, 323 DNA methylation, 614 defined, 219 Digi-Fab, 80, 80 DNA topoisomerase I antibody, 496, 497 drugs that can cause, 265 Digital rectal exam, 600, 603, 604, 615 DOACs (direct oral anticoagulants), 396, nephrogenic, 220, 220, 263–264 Digoxin 396, 403, 410 physiology and, 219–220 concentrations in serum and Dobutamine, 164 of pregnancy, 220–221 myocardium, 118, 118 Done nomogram for salicylate poisoning, data to aid interpretation, 100 water deprivation test in diagnosing, 79 220, 221 overview, 117–118 Dopamine agonists, 226 Diabetes mellitus time course and serum concentrations, Doping, 83 autoantibodies related to, 197 103 Doping control, 83 gestational, 195, 198 toxicities, 117, 118 Doppler echocardiography, 164 insulin therapy for, 202–204 Digoxin immune fragment antibody, 80, Dosage adjustment, use of levels for, 104 laboratory tests for 80 Dihydropyrimidine dehydrogenase, 139 Dose-response relationship, assessment of glucose control, 197– unpredictability of, 94 202. See also Glucose, laboratory Dihydrotestosterone (DHT), 593, 594, Dosing interval, fluctuations within, tests to assess control of 594, 603 101–104 diagnosis, 196–197 Dilute thrombin time (dTT), 409 Double-focusing magnetic sector analyzer, Dilutional hyponatremia, 265, 266, 552 management, 208–209 34 Dilution methods in identifying bacteria secondary causes of, 196, 196 Double-stranded DNA (dsDNA) self-monitoring tests of blood glucose, agar dilution, 430, 432–433 antibodies, 495, 496. See also Anti- 200–202 broth macrodilution, 430, 430, dsDNA antibodies Type 1 (insulin dependent) 430–431 DPP-4 inhibitors, 225 characteristics, 195 broth microdilution, 430, 431–432, Drug abuse. See also Illicit drugs; 432 overview, 194, 195 Substance abuse overview, 429–430 pathophysiology, 195 prescription, 83, 84 Dimorphic fungi, 444, 445 Type 2 (noninsulin dependent) in sports, 83, 83 Dipeptidyl-peptidase 4 (DPP-4), 194 characteristics, 195 Drug concentrations Diploid cell line, 460 chromium deficiency, 289 administration times (minicase), 97 Dipstick tests, urine, 249–254, 250 dyslipidemia and, 178 applications of Dipyridamole, 164 oral agents for management, 204, analgesics, 106 223–226 Direct agglutination, 32 antiepileptics, 107–112 overview, 195 Direct antigen detection in identifying antifungals, 115–116 viruses, 461–462 pathophysiology, 195–196 antimicrobials, 112–115 Direct antiglobulin (Coombs) test (DAT), point-of-care testing (minicase), 65 380 antimycobacterials, 116 Diabetes-related autoantibody testing, 197 Direct bilirubin, 4, 335–336, 636 antiretrovirals, 116–117 Diabetic ketoacidosis (DKA), 204, 240 Direct fluorescent antibody (DFA) test, bronchodilators, 106–107 ketones and, 205, 206 482, 483 cardiac drugs, 117–120 minicase on, 205 Direct hyperbilirubinemia, 337 cytotoxic drugs, 120–121 severe hypophosphatemia and, 283 Direct luminescence immunoassay, 598 immunosuppressants, 121–122 Diagnostic tests Direct oral anticoagulants (DOACs), 396, psychotropics, 122–124 defined, 7, 8 396, 403, 406 appropriate interpretation of, 96

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correlation between efficacy or toxicity fluorescence in situ hybridization Electron microscopy in identifying and, 95 (FISH), 140 viruses, 461 dosage adjustment and, 96, 104 immune checkpoints, 142 Electroosmotic flow, 28 information needed for planning and immunohistochemistry (IHC), 140 Electrophoresis, 26–28 evaluating, 95, 95–96 warfarin, 139–140 Electrospray ionization (ESI), 34 protein binding, active metabolites D test, for clindamycin resistance, 438 Electrostatic force (EOF), 26 and other considerations and, 96, DuBois formula, 562 Elevated platelet count 99–100, 104–106 Dutasteride, 609–610 (thrombocythemia), 398 reasons for illogical, 96, 96 Dyslipidemia(s). See also Lipid disorders ELISA. See Enzyme-linked in saliva, 106 classification of,177, 177–178 immunosorbent assay (ELISA) sample timing and, 96, 100–104 disease-related causes of, 178–179 Emergent care, drug screens and therapeutic range and, 96, 97–99 (minicase), 73 drug induced, 178–179 unbound antiepileptic (minicase), 105 EML4-ALK, 141–142 use of equations to normalize the E Empiric antibiotic therapy, 429, 441 measured total, 105 Ecarin clotting time (ECT), 409, 410 Enantiomers, 106 Drug disposition-related molecular tests Echocardiography (ECG) Endocrine disorders. See also Diabetes clinical significance, 139 mellitus; Thyroid disorders acute coronary syndrome, 154, CYP2C9 gene, 136, 138 154–155 adrenal disorders as, 218–219 CYP2C19 gene, 136, 138 localization of myocardial infarction diabetes insipidus as, 219–221 CYP2D6 gene, 136, 137 and site of leads, 154, 154 diabetic ketoacidosis as, 204, 205, 206 cytochrome P450 system, 136–138 normal conduction, 153, 153–154 glucose homeostasis and, 193–194 dihydropyramidine dehydrogenase, overview, 163–164 hyperosmolar hyperglycemia state as, 139 Edoxaban, 396, 396, 404, 406 206, 207 drug disposition reactions and genetic Effects of Drugs on Clinical Laboratory hypoglycemia as, 193, 206–208 variability, 136, 136 Tests, 45 15/15 rule, 208 other CYP450s, 138 Effects on Clinical Laboratory Tests: Quickview Charts on phases, 136 Drugs, Disease, Herbs, and Natural free T , 232 thiopurine methyltransferase, 138–139 4 Products, 47 plasma glucose, 234 Drug Enforcement Agency, 85 EFGR, 519, 525, 540 total serum T , 230 Drug-gene pairs, 145 EGFR aberrant signaling, 140–141 3 total serum T , 231 Drug-induced hemolytic anemia, 380, EGFR-TKIs (Epidermal growth factor 4 TSH, 233 380 receptor tyrosine kinase inhibitor), Drug interferences 140–141 Endocrine glands, 193 detection of, 45–46 Ehrlichia spp., 475 Endocrine system, 193 incidence of, 44–45 Electrocardiography Endoscopy, upper, 354 literature resources on, 47–48 in acute coronary syndrome, 154, 154, Endpoint, 25, 94 management of, 46–47 154–155 Enrichment media, 423, 425 serum testosterone levels (minicase), 45 defined, 153 Entamoeba histolytica, 475 in vivo and in vitro, 43–44 normal conduction system and, 153, Enzyme immunoassay (EIA). See Enzyme- linked immunosorbent assay (ELISA) Drug metabolism, 162 153–154 Drug resistance, testing for. See Electrochemistry, 24 Enzyme-linked immunosorbent assay Susceptibility testing conductometry and, 26 (ELISA) Drugs. See also Illicit drugs; individual coulometry and, 25 for anti-HCV detection, 344 classes of drugs potentiometry and, 24, 25, 25 for C. difficile detection, 355 as factor in laboratory test results, 12 voltammetry and, 25–26 common tests performed with, 25 half-life of, 101 Electrolytes and minerals. See also in diagnosing heparin-induced medical literature on, 47–48 individual electrolytes thrombocytopenia (HIT), 399 therapeutic ranges of, in traditional and chloride, 273–274 for fungi identification, 452 SI Units, 635–636 conversion factors to SI Units for, 262 for HIV-1 detection, 463, 465 Drug screening. See Toxicological tests; dietary intakes of, 261 overview of, 32 Urine drug screens in intracellular versus extracellular screening antinuclear antibody assay Drug-target-related molecular tests water, 551, 551 (ANA) results with, 498 ALK inhibitors, 141–142 pediatric, 550–557, 559–560. See also T ELISA, 156 anti-HER2 therapy, 140–141 under Pediatric laboratory data Enzyme-multiplied immunoassay BRAF inhibitors, 142 potassium, 268–273 (EMIT), 25, 32, 33 determination of appropriate therapies, sodium, 262–268 Enzyme photometric, 200 140 urinary, 253 Eosinopenia, 385 EFGR TKIs, 140–141 Electron ionization (EI), 33–34 Eosinophilia, 385

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Eosinophils, 383 European Pharmacogenetics of Fibric acid derivatives, 186 Epidermal growth factor receptor (EFGR), Anticoagulant Therapy (EU-PACT) Fibrin, 395 519, 525. See also EGFR study, 140, 405 Fibrin degradation products (FDPs), 410 Epigenetics, 39 Euthyroid sick syndrome, 212 Fibrinogen, 160 Epinephrine, hypoglycemia and, Euvolemic hypernatremia, 268 Fibrinogen assay, 408 206–207 Euvolemic (dilutional) hyponatremia, 265, Fibrinolysis, 396 266, 552 Epsilometer test (Etest) Fibrinopeptide, 160 Everolimus, 121–122 for antimicrobial susceptibility testing, Fibromyalgia, 510 430, 433–434, 434 Exercise, amenorrhea secondary to FilmArray, 426 for antimycobacterial susceptibility (minicase), 574 Filoviridae, 457 testing, 471 Exercise challenge testing, 325 Finasteride, 609–610 Equilibrium dialysis, 598 Exercise stress testing, 164 FISH (Fluorescent in situ hybridization). ERBB2 gene, 140 Exhalation, 315–316 See Fluorescent in situ hybridization Erectile dysfunction Expert Panel on Integrated Guidelines (FISH) causes of organic, 600 for Cardiovascular Health and Risk Reduction in Children and Adolescents, Flame photometry (atomic emission), 23 International Index of Erectile Function 179 Flaviviridae, 457–458 and, 601, 601 Expiratory reserve volume (ERV), 322, 323 Flora bacteria, normal, 426, 427 organic versus psychogenic, 599, 599 Expressed prostate excretion (EPS), Flow cytometry, 35–37, 36 overview, 599–601 614–615 Flow-volume curves, 316–317, 317, 318, prolactin and, 601–603, 602 Extended beta-lactamases (ESBLs), 436 320, 321 Sexual Health Inventory for Men and, External quality assessment (QA), 62 Fluconazole, 116 601, 601 Extracellular water (ECW), 550, 550–551 Flucytosine, 115 specialized diagnostic testing for, 601 Extragonadal estrogen, 575–576 Fluid status, laboratory test results and, 12 Erlotinib, EGFR and, 140–141, 143 Extrahepatic cholestasis, 333, 333–334 Fluorescence, 22 erm gene, 438 Extra-laboratory testing. See Point-of-care Fluorescence-activated cell sorting, 384 Errors. See Laboratory errors testing (POCT) Fluorescent in situ hybridization (FISH) Erythrocyte morphology, for diagnosing Ezetimibe, 186 ALK gene, 142 anemia, 373, 374 HER2, 140, 524 Erythrocytes, age-related differences in, F 566–567. See also Red blood cells overview, 37 Factor VII, 395, 395 Erythrocyte sedimentation rate (ESR) Ph chromosome, 525 Factor VIIa, 395, 395 elevated, in presence of infection, Fluorescent polarization immunoassay 484–485 Factor VIII, 395, 395 (FPIA), 25, 33 overview of, 373 Factor VIIIa, 395, 395 Fluorescent treponemal antibody absorption (FTA-ABS) test, 483 in rheumatologic diseases, 501 Factor V Leiden mutation, 403 Fluorometers, 22–23 Erythrocyte-stimulating agent (ESA) Factor Xa, 395, 395, 409, 410 Fluorometry, 22, 35 therapy, 381 False laboratory value. See Spurious Fluorophore, 22 Estradiol, 575, 582, 588, 594 laboratory value Folate concentration, 377 Estrogen False negatives (FNs), 3 Folic acid amenorrhea and, 577 False positives (FPs) deficiency of,374, 375, 376–377 extragonadal, 575–576 in bacteria identification, 427–428 drugs that interfere with, 375, 377 Estrogen receptor (ER), 519, 523–524, defined, 3 537 in urine drug screens, 75, 75 Follicle-stimulating hormone (FSH) Estrone, 575–576, 594 FANA (immunofluorescence antinuclear in men, 593 Etest antibody) test, 497, 497–498 in women, 571, 572, 574, 575, 575, 581, 581, 586 for antimicrobial susceptibility testing, Faraday law, 25 430, 433–434, 434 Fast atom bombardment (FAB), 34 Follicular phase, 571, 572 for antimycobacterial susceptibility Fastidious bacteria, susceptibility testing Fondaparinux, 396, 396, 399–400 testing, 471 of, 438 Food and Drug Administration (FDA) Ethanol, for treatment of poisoning by Fasting lipid panel, 179–180 list of analytes used in point-of-care methanol, 79 Fasting plasma glucose (FPG), 197–198, testing, 52 Ethanol concentrations 198 list of home-testing kits, 14 medicolegal applications of, 78–79 Fatty liver, 337 regulation of point-of-care testing, 51 toxic effects and, 78,78 Fecal antigen test, for H. pylori, 353–354 Forced expiratory flow (FEF), 318 Ethnicity, as factor in laboratory test Felbamate, 111 Forced expiratory volume in 1 second, 318

results, 11 %FENa test, 254 Forced vital capacity, 317 Ethosuximide, 111 Ferritin, 377–378, 378 Forensic issues, toxicological tests, 81–82

Ethylenediaminetetraacetic acid, 180 FEV1/FVC, 318, 319 Forward-scattered light (FSC), 36

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Fosphenytoin, 109–110 Gender, as factor in laboratory test results, Glucose meters Four-glass versus two-glass method of 11 accuracy of, 201 specimen collection, 615 Gene chips, 39, 143 factors affecting readings of, 201 fPSA, 611, 611 General reporting, of antibiotic features of, 200–201 susceptibility, 440 Fractional excretion of sodium (FENa), frequency of monitoring with, 201–202 267 Genetics, as factor in laboratory test Glucose tolerance factor (GTF), 289 results, 11 Fractional exhaled nitric oxide (FENO) GLUT1, 194 measurement, 326 Genetic testing, pharmacogenetics testing GLUT2, 194 Fraction antigen-binding (FAB) site, 493 versus, 136 Genetic Testing Registry, 143 Glutamic acid decarboxylase Fractions, 3 autoantibodies (GADA), 197 Genitourinary tract infections Free PSA, 611, 611 Glycated hemoglobin (A1c), 197, 198, Freestyle, 200 prostatitis, 481 198–199, 235 Freestyle Lite, 200 urinary tract infection, 480–481 Glycogenesis, 193 Genomics, 39 Free T4, 211, 211–212, 212 Glycogenolysis, 193 Free T index, 214, 214 Genotypic assays. See also GOLD MARK mnemonic, 308 4 Pharmacogenetics Free testosterone, 594, 595, 597–598 Gonadotropin-releasing hormone Freezing-point depression, 23, 24 for antiretroviral drug resistance, 468 (GnRH), 572, 593 Fructosamine, 199 for bacteria identification, 425 Gonorrhea, 481–482 Fulminant hepatitis, 339 Gentamicin, 99 Gout, 510, 512, 512–514 Functional residual capacity (FRC), Geriatric reference ranges, 10 Gram-negative bacteria, 424 322, 323 Gestational diabetes mellitus, 195, 198 Gram-positive bacteria, 424 Fungi Giardia lamblia, 475 Gram stain antifungal susceptibility testing, 454, GIFT study, 405 for bacteria, 422–423 455 Gilbert syndrome, 336, 337, 566 for fungi, 445, 450 categories of, 443–445, 444 Gleason scoring system, 607, 612 for gonorrhea, 481 features used in diagnosis of, 446–449 Glomerular filtration rate (GFR), 238 for meningitis, 478 identification of CKD epidemiology collaboration most commonly identified bacteria antigen detection, 452 creatine equation, 243 based on results of, 424 (1,3)-beta-D-glucan detection, 453 estimating, from serum cystatin C, Gram-variable bacilli, 424 564 culture, 445, 450–451 Granular casts in urinalysis, 248, 248 estimation of (minicase), 245 DNA sequence analysis, 445 Granulocyte-colony stimulating factor MDRD equation for, 242–243 MALDI-TOF mass spectrometry, 454 (G-CSF), 371 in pediatric patients, 561, 561–562 molecular diagnosis, 453–454 Granulocyte-macrophage colony- Glomerulus, 237 overview, 445, 450–452 stimulating factor (GM-CSF), 371 GLP-1 agonists, 224–225 serology, 452–453 Granulocytes, 383–384 Glucagon, 193, 206–207 staining, 445, 450, 450 Granulomatosis with polyangiitis (GPA), Glucagon-like peptide-1 (GLP-1), 194 498–499 nomenclature of, 443 Gluconeogenesis, 204 Graves disease, 217 G Glucose Group A streptococci (GAS), point-of- care testing for, 53, 55, 59, 64 G4 Platinum, 201 in chemical analysis of urine, 250, 253 Growth media G6PD anemia, 380 homeostasis of, 193–194 for bacteria, 423, 425 Gabapentin, 111 laboratory tests to assess control of, 197 for fungi, 450–452, 451 Gamma-emitter, 31 fasting plasma glucose (FPG), 197–198, 198 for mycobacteria, 470 Gamma-glutamyl transpeptidase (GGT), Guardian Real-Time MiniMed 530G, 334, 335, 636 fructosamine, 199 201 Gas chromatography (GC), 25, 29, 29–30, glycated hemoglobin (A1c), 197, 198, 72 198–199 H Gas dilution methods, 322 oral glucose tolerance test (OGTT), 198, 198 Hapten type 1 mechanism, of drug- Gastric cancer, H. pylori-associated, 353 urine glucose, 199–200 induced antibody formation, 380, 380 Gastroenterology tests reference range for, in traditional and SI Harrison’s Principles of Internal Medicine, Clostridium difficile, 354–355 units, 636 331 colitis, 354, 357 self-monitoring tests of, 200–202 Hashimoto thyroiditis, 217 ulcer disease and, 353–354 storage of, in liver, 193 Heart Gaussian (random) value distribution, 5, 5 Glucose-6-phosphate dehydrogenase dysfunction of, 152–153 GC-MS mass spec, 72 (G6PD) deficiency anemia, 11, 380 electrical and mechanical properties Gefitinib, EGFR and, 140–141, 143 Glucose-dependent insulinotropic peptide of, 151 Gel electrophoresis, 27 (GIP), 194 electrocardiography of, 153

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findings in acute coronary syndrome, Hemoglobin electrophoresis, 27 interpretation of common serological 154, 154, 154–155 Hemoglobinopathies, 381 results, 342 normal conduction, 153, 153–154 Hemoglobinuria, 253 molecular assays, 342–343 imaging studies of Hemolysis, 336–337, 380 overview, 341 cardiac catheterization, 164–165 Hemolytic anemia, 374, 379–380 serological profile, 342 chest radiography, 163 Hemolytic complement, total (THC), 500 vaccine for, 343–344 echocardiography, 163–164 Hemolytic-uremic syndrome, 399 type C (HCV) exercise stress testing, 164 Hemorrhage, acute blood loss anemia and, minicase, 349 nuclear imaging, 165–166 379. See also Bleeding overview, 344–345 pharmacologic stress testing, 164 Hemosiderin, 377, 378 point-of-care testing, 54, 58, 58, 65 laboratory tests for Hemostasis type D (HDV), 345, 345–346 evaluation of acute coronary physiological process of type E (HEV), 346 syndrome, 155 clot degradation, 396 Hepatocellular cancer, alpha fetoprotein biochemical cardiac markers, clot formation, 393–395, 394 and, 518, 523 155–160, 160 coagulation cascade, 395, 395 Hepatoxicity, drug-induced (minicase), other biochemical markers, inhibition of coagulation, 396, 396, 350 159–160 397 Hepeviridae, 458 evaluation of heart failure platelets, 393–394 HER2, therapy for, 140 natriuretic peptides, 161–163 tests to evaluate HER2/CEP 17 ratio, 524 other biomarkers, 163 clot degradation tests, 409–410 Hereditary anemias, 11 recommendations for biomarkers, coagulation tests, 402–412 Herpes simplex virus (HSV), 484 163 overview, 397 Herpesviridae, 456 miscellaneous tests, 160 platelet tests, 398–402 Herpes virus, 456, 484 recommendations for biochemical point-of-care testing devices, 412 markers, 160–161 Heteroploid cell line, 460 summary of common tests, 397 physiology of, 151–152, 152 HgbA1C, point-of-care tests for, 56–57, 65 Hemostatic plug, 394 Quickview Charts on High-density lipoprotein Henderson-Hasselbalch equation, 306 BNP/NT-proBNP, 173 characteristics of, 176 Heparin troponins I and T, 172 metabolism of, 177, 177 activated clotting time (ACT) and, Heart failure, 152–153, 162, 246 overview of, 182 408 Heart rate, in pediatric patients, 547 High-level aminoglycoside resistance activated partial thromboplastin time (HLAR), 436–437 Helicobacter pylori, 353–354, 475 (aPTT) and, 406–408 High-performance liquid chromatography Hemadsorption, 460 anti-Xa and, 408 (HPLC), 25, 30, 30 Hematocrit (Htc) minicase on, 410 High-sensitivity C-reactive protein in acute blood loss anemia, 379 prothrombin time (PT) and, 404 (hsCRP), 160, 185, 501 age-related differences in, 566–567 thrombin time (TT) and, 409 High-sensitivity troponin (hsTnI), in CBC count, 370, 372 Heparin-induced platelet activation 157–158 interpretation of (minicase), 379 (HIPA) assay, 399 Hirsutism, 577–579, 578 Hematology, age-related differences in.See Heparin-induced thrombocytopenia Histology, 37 also Blood coagulation tests; Red and (HIT), 399–400, 400 Histone (nucleosome) antibodies, 496, white blood cell tests Hepatic dysfunction, 12 497 erythrocytes, 566–567 Hepatic encephalopathy, 339–340, 348 Histopathologic stains leukocytes, 567–568, 568 Hepatitis for fungi identification, 445 platelets, 568 acute (minicase), 349 for virus identification, 461 Hematology analyzer, 35 algorithm for differential diagnosis of, Histoplasma capsulatum, 447 Hematopoiesis, 369, 369–371 338 HIV. See Human immunodeficiency virus Hematuria, 253 causes of, 337 (HIV) Hemochromatosis, 346–347 defined, 337 HIV DNA PCR, 464, 466–467 Hemoconcentration, 12, 13 drugs implicated in, 333 HIV-RNA concentration (HIV RNA viral Hemoglobin (Hgb). See also HgbA1C fulminant, 339 load), 467 age-related differences in, 566–567 onset of viral, 340 HLA-B*5701 screening, 468–469 in CBC count, 370, 372 type A (HAV), 340–341, 341 HMG-CoA reducatase inhibitors (statins), in chemical analysis of urine, 250, 253 type B (HBV) 185–186 interpretation of (minicase), 379 acute, 342, 343 Hodgkin lymphoma, 388, 388 point-of-care tests for, 57 antigens and their antibodies, 341, Homeostasis reference range for, in traditional and SI 341–342, 342 acid-base, 270–271 units, 636 chronic, 343, 343 acute, 271

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glucose, 193–194 Hyperalbuminemia, 331 Hyperuricemia, 510, 512, 512–514 renal, 263, 269–270, 270, 306–307, 307 Hyperaldosteronism, 272 Hypervolemic hyponatremia, 552–553 sodium, 265 Hyperandrogenism, amenorrhea and, Hyperzincemia, 287–288 water, 262, 263, 264, 264 576–577 Hypoalbuminemia, 331 Home testing, 14, 14 Hyperbilirubinemia Hypocalcemia, 279, 279–280 Hook effect, 603 direct, 337 Hypochloremia, 273–274 Hormones. See also individual hormones indirect, 336–337 Hypochromic cells, 372 female in pediatric patients, 566 Hypocomplementemia, 500 amenorrhea diagnoses and hormone Hypercalcemia, 279, 280–281 Hypocupremia, 285–286 levels, 574 in pediatric patients, 557, 559 Hypogammaglobulinemia, 386 feedback loop, 571, 572 Hyperchloremia, 273–274 Hypoglycemia, 193, 206–208 hormone concentrations in pre-, Hypercortisolism, 218–219 15/15 rule and, 208 post-menopausal women, 576 Hypercupremia, 286 Hypoglycemics, 244 references ranges by age, 575 Hyperglycemia Hypogonadism negative feedback mechanism causes of, 194 regulating, 193, 194 defined, 593 chromium deficiency and, 289 thyroid, 209, 209–210 hormonal changes associated with, 594, diagnosis of 595 Hospital-acquired pneumonia (HAP) diabetes mellitus or prediabetes, incidence of, 593 choosing empiric antibiotic regimen for 202–204 (minicase), 429 late-onset, 594–596, 595 diabetic ketoacidosis, 204–206 detection of, 480 primary, 594, 595 hyperosmolar hyperglycemia state lab test results for choosing empiric secondary, 594, 595 (HHS), 206 antibiotic regimen for (minicase), 429 tertiary, 594, 595 drugs and chemicals that may cause, Hospital susceptibility reports, 441–443, testosterone, physiologic effects and 196 442, 442 production of, 593–594, 594 Hyperkalemia H. pylori, 353–354 tests for causes of, 272, 272–273 Human chorionic gonadotropin (hCG), bioavailable testosterone, 599 clinical diagnosis of, 273 518, 522–523, 533 free testosterone, 597–598 defined, 272 Human epidermal growth factor receptor total testosterone, 596–597, 597 2 (HER2), 519, 524–525, 538 fictitious, 273 Hypokalemia Human immunodeficiency virus (HIV) management of chronic, 273, 274 causes of, 271, 271–272 coreceptor tropism assays, 468 minicase on, 274 defined, 271 drug concentration monitoring for in pediatric patients, 555 in pediatric patients, 554–555 antiretrovirals and, 116–117 Hyperlipidemia, 198 signs and symptoms of, 272, 272 HIV antibody tests, 463, 464, 465–466 Hypermagnesemia, 276, 276, 560 Hypolipemic medications, effects of, HIV testing while on pre-exposure Hypernatremia prophylaxis (minicase), 464 186 euvolemic, 268 HLA-B*5701 screening, 468–469 bile acid sequestrants, 186 minicase on, 269 laboratory tests for HIV-1 infection ezetimibe, 186 overview of, 254, 268 algorithm for laboratory testing, 465 fibric acid derivatives, 186 in pediatric patients, 553–554 CD4+ T lymphocyte count, 384, HMG-CoA reductase inhibitors 467–468 Hyperosmolality, in pediatric patients, 553 (statins), 185–186 HIV DNA PCR, 466–467 Hyperosmolar hyperglycemia state, 206 niacin, 186 HIV-RNA concentration, 467 secondary to type 2 diabetes mellitis omega-3 fatty acids, 186–187 (minicase), 207 overview, 463 proprotein convertase subtilisin/kexin Hyperparathyroidism p24 antigen tests, 466 type 9 inhibitors, 187 primary, 279, 280–281 noninvasive tests, 466 Hypomagnesemia, 275–276, 560 secondary, 279, 280 overview, 462–463 Hyponatremia Hyperphosphatemia, 283–284, 559–560 phenotypic and genotypic assays for dilutional, 265, 266, 552 antiretroviral drug resistance, 468 Hyperprolactinemia, 602 drugs that can cause, 264, 264 point-of-care testing, 53–54, 57–58, 58, Hypertension euvolemic, 265, 266, 552 65, 466 diabetes mellitus and, 208 hypovolemic, 552 rapid screening tests, 465–466 Hyperthyroidism, 210 minicase on, 267 summary of recommended tests, 464 classification of,210 normal total body sodium and, Human leukocyte antigen B27, 501–502 minicase on, 217 265, 266 Hyaline casts in urinalysis, 248, 248 Hypertriglyceridemia, 180–181 overview of, 254, 265 Hyaline hyphomycetes, 444, 444 disorders leading to, 180 seizures and (minicase), 553 Hydrometer, 252 minicase on, 181 signs and symptoms of, 265, 266

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sodium depletion and, 254, 265–266 to detect ALK-positive NSCLC, 142 release of, 197 treatment of, 266–267 to detect estrogen and progesterone treatment of diabetes mellitus or Hypoparathyroidism, 280, 557 receptors, 524 prediabetes with, 202–204, 203 Hypophosphatemia, 282–283, 559 to detect HER2, 140, 524 Insulin autoantibodies (IAA), 197 Hypothalamic-pituitary-gonadal axis, Immunosuppressants Insulinoma, 197 493 cyclosporine, 121 Insulin pump therapy, 203, 203 Hypothalamic-pituitary-thyroid axis, data to aid interpretation of, 100 Interference, 56. See also Drug 209 everolimus, 121–122 interference laboratory diagnosis of dysfunction of, lipid abnormalities, 179 Interleukin-6, 160 217–218 mycophenolic acid, 122 Intermediate-density lipoprotein (IDL), Hypothalamus, secretion of releasing sirolimus, 122 176, 177, 177 hormone by, 194 tacrolimus, 122 International Code of Botanical Hypothyroidism Nomenclature, 443 Increased albumin excretion amenorrhea and, 573, 574 (microalbuminuria), 160, 208 International Index of Erectile Function, 601, 601 classification of,210 Incretin, 193, 194 minicase on, 216 International normalized ratio (INR), 332, Incretin effect, 194, 196 332, 412 overview of, 210 Indirect agglutination, 32 International Olympic Committee, 83 Hypouricemia, 513 Indirect antiglobulin (Coombs) test (IAT), International Prostate Symptom Score Hypovolemic hyponatremia, 552 380 (IPSS), 603 Hypozincemia, 287, 287 Indirect bilirubin, 4, 335–336, 636 International Sensitivity Index (ISI), 404 Hysterosalpingography, 580 Indirect hyperbilirubinemia, 336–337 International System of Units (SI), 7 Infection(s) Intersystem crossing, 22 I acute phase reactants and, 484–485 Intracellular water (ICW), 550, 550–551 Idiopathic thrombocytopenic purpura clinical, laboratory, and radiographic Intrahepatic cholestasis, 333, 333 (ITP), 399 signs of, 427 Intravenous lipid emulsion (ILE) therapy, IgG, 462 common pathogens by site of, 428, 428 77–78 IgM, 340, 341, 341, 462 defined, 427 Intravenous (IV) sodium therapy, 266 IHC (immunohistochemistry), 140, 142 laboratory tests for diagnosis of Inulin, 239 uncommon or miscellaneous, I-Iothalamate, 239 Invasive tests, 4 473–477 Illicit drugs. See also Drug abuse In vitro interference, 43, 44 designer, 74 Infectious diseases. See Bacteria; Fungi; Mycobacteria; Viruses; individual In vivo interference, 43, 44 twelfth-graders’ abuse of, 70,70 infectious diseases Iodine, thyroid function and, 213, 213 use of, 69, 69 point-of-care testing for, 53–54, 54–55 Ion detectors, 34–35 Image cytometry, 37 determination of appropriateness of Ion-selective electrodes (ISEs), 24, 25, 25 Imipramine, 122–123 candidates, 63–64 Ion trap analyzer, 34 Immune checkpoint, 142 patient-specific applications, 65 Irinotecan, 144 Immune complex mechanism, 380 public health applications, 65 Iron Immunoassays Infertility in women, 579–581, 580 intake, loss, and recycling of, 378 agglutination as, 31–32, 32 Inflammatory markers, 185 reference range for, in traditional and SI in drug screenings, 71–72 Influenza A and B, point-of-care testing units, 636 enzyme, 32 for, 53, 59, 60, 63–65 Iron deficiency, 374, 377–379 enzyme-linked immunosorbent assay Informatics, 21 Iron overload. See Hemochromatosis as, 25, 32 Infrared light, 21, 21 Ischemic heart disease (IHD), 152 enzyme-multiplied immunoassay Inhalation, 315–316 Islet cell cytoplasmic autoantibodies technique as, 25, 32, 33 Inhibitory quotient (IQ), 117 (ICA), 197 fluorescent polarization immunoassay Initial drug test, 71–72 Isoenzymes, 3, 4 as, 25, 33 Innocent bystander mechanism, of drug- Isoforms, 3 homogeneous, 31 induced antibody formation, 380, 380 Itraconazole, 115 for measuring HgbA1C, 57 Insensible water loss, 551, 554 overview of, 31 In situ hybridization, 37 J radioimmunoassay as, 31 Inspiratory capacity (IC), 322, 323 Jaffe method, 560, 561 Immunofixation electrophoresis, 27 Inspiratory reserve volume (IRV), 322, Jaundice Immunofluorescence antinuclear antibody 323 in college student (minicase), 348 test (FANA), 497, 497–498 Insulin due to oral contraceptives (minicase), Immunoglobulin M, 340, 341, 341, 462 chromium as cofactor for, 289 347 Immunoglobulins, 493–494, 494 comparison of insulin analogues and neonatal, 566 Immunohistochemistry (IHC) human, 202, 202, 202 pathologic, 566

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Jo-I antibody, 496, 497 urinary electrolytes, 253 low-density lipoprotein cholesterol, Joint Commission of Pharmacy urobilinogen, 250, 252–253 182 Practitioners glucose homeostasis and, 194 non-high-density lipoprotein Pharmacists’ Patient Care Process, 63 hypercalcemia and, 281 cholesterol, 183–184 Junctional potential, 24 lipid disorder secondary to disorder overview, 179–180 Juvenile idiopathic arthritis (JIA), of, 178 total cholesterol, 180 506–507 of newborn, 551 triglycerides, 180–181 phosphate and, 282 rationale for ordering, 7–8 K physiology of, 237, 237–238 in women’s health. See under Women’s Kernicterus, acute, 566 renal homeostasis and, 263, 269–270, health Ketoacidosis. See Diabetic ketoacidosis 270, 306–307, 307 Lactate, 636 (DKA) in sodium regulation, 262 Lactate dehydrogenase (LDH) Ketones, 204, 206, 240, 250 uric acid nephropathy and, 514 isoenzymes of, 4 Ketonuria, 204, 206 Kinky-hair syndrome, 285–286 in pediatric patients, 565 Kidney function tests, age-related KRas gene reference range for, in traditional and SI differences in and resistance to targeted therapy, units, 636 determination of CrCl from urinary 142–143 Lamotrigine, 111–112 creatinine collection, 562–563 as tumor marker, 519, 541 Lap-on-a-chip, 40 estimating CrCl from serum creatinine, La/Sjögren syndrome B (La/SSB) 563–564, 564 L antibody, 496, 497. See also Anti-La/ serum creatinine, 560–561 Laboratory errors, 9 SSB antibodies standardization of creatinine clearance, Late neonatal hypocalcemia, 557 562 Laboratory information system (LIS), 20 Latent syphilis, 482 Kidney(s), 237. See also Chronic kidney Laboratory test results Late-onset hypogonadism, 594–595, disease (CKD) for choosing empiric antibiotic regimen for hospital-acquired pneumonia 595 assessment of function of (minicase), 429 Late/tertiary syphilis, 483 cystatin C, 239 drug interferences with Left shift, 383 cystatin C equations, 243–244 detection, 45–46 Left ventricular ejection fraction (LVEF), endogenous markers, 239–240 incidence, 44–45 153, 164 estimating equations for GFR management, 46–47 Left ventriculography, 165 (minicase), 245 medical literature, 47–48 Legal issues, in toxicological tests, 81 estimation of CrCl, 242 serum testosterone levels (minicase), Legionella pneumophila, 475 estimation of GFR-MDRD equation, 45 Leishmania spp., 476 242–243 in vitro and in vivo interferences, Leptospira spp., 476 estimation of GRF using CKD 43–44 epidemiology collaboration Leukemias, 387–388 creatine equation, 243 warfarin (minicase), 48 Leukocyte disorders, 385, 387–388 exogenous markers, 239 factors that influence, 8, 8 Leukocyte esterase, in urinalysis, 250, 253, I-iothalamate and Cr-EDTA laboratory-specific, 9–10 480–481 clearance, 239 other, 12 Leukocyte phenotype-guided drug inulin clearance, 239 patient-specific, 10–12 therapy, 388, 388–389 measurement of CrCl, 241–242 guidelines for interpreting, 14 Leukocytes, age-related differences in, baseline results, 14–15 567–568, 568. See also White blood overview, 238 cells (WBCs) isolated results versus trends, 15 serum creatinine, 239–240 Leukopenia, in systemic lupus lab value compared to reference urea (blood urea nitrogen), erythematosus, 509 range, 15 240–241 Leuprolide, 46 rate of change, 15 chemical analysis and, 249 Levetiracetam, 112 spurious results, 15 bilirubin, 250, 253 Leydig cells, 593, 595 units used in reporting, 7 blood and hemoglobin, 250, 253 LFT panel. See Liver function tests Laboratory tests. See also Diagnostic tests; %FENa test, 254 (LFTs) Laboratory test results; Point-of-care glucose and ketones, 250, 253 testing (POCT) Lidocaine, 118–119 leukocyte esterase, 250, 253 common, with various assays, 25 Lifestyle nitrate, 250, 253 drug interferences with. See under LDL and, 182 pH, 250, 251–252, 252 Laboratory test results lipids and, 179 potassium, 254 future trends in, 15 Light absorbance and emission, 21, 21 protein, 250, 250–251 for lipids and lipoproteins Light reflectance, and glucose monitoring, sodium, 254 high-density lipoprotein cholesterol, 200 specific gravity, 250, 252 182 Light scatter, in flow cytometry, 35, 36

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Light transmittance aggregometry (LTA), safety of, in patients with chronic characteristics of, 176, 192 402 kidney disease, 245 in HDL metabolism, 177, 177 Limit of detection, 56 Liver overview of, 182 Lipase, 352 anatomy and physiology of, 329–330, Lower urinary tract symptoms (LUTS), Lipid disorders 330 603 effects of hypolipemic medications cholestatic liver disease and Low molecular weight heparins bile acid sequestrants, 186 associated tests, 334–337 (LMWHs), 396, 396, 399, 408. See also ezetimibe, 186 defined, 330–331 Heparin fibric acid derivatives, 186 extrahepatic cholestasis, 333, Low passage cell line, 460 HMG-CoA reductase inhibitors 333–334 Lp(a), 184–185 (statins), 185–186 intrahepatic cholestasis, 333, 333 LSD, urine drug screen for, 90 niacin, 186 glucose storage in, 193 Lungs. See also Pulmonary function tests omega-3 fatty acids, 186–187 hepatocellular injury to. See also (PFTs) overview, 185 Hepatitis anaplastic lymphoma kinase and proprotein convertase subtilisin/ aminotransferases AST and ALT, adenocarcinoma of, 526 kexin type 9 inhibitors, 187 338–339 anatomy and physiology of, 315–316 laboratory tests for lipids and defined, 331 EGFR and adenocarcinoma of, 525 lipoproteins drugs causing injury, 333, 337 Lung volume assessment, 322 high-density lipoprotein cholesterol, lipid disorder secondary to disorder Lung volumes and capacities, 322–323, 182 of, 178 323 low-density lipoprotein cholesterol, minicases on Luteal phase, 572, 572 182 abnormal LFTs, 347 Luteinizing hormone (LH) non-high-density lipoprotein acute hepatitis, 349 in men, 593 cholesterol, 183–184 acute liver failure, 350 in women, 571, 572, 574, 575, 581, 581, overview, 179–180 drug-induced hepatotoxicity, 350 587 point-of-care testing options, 185 hepatic encephalopathy, 348 Lyme disease, 473 total cholesterol, 180 hepatitis type C, 349 Lymphocytes, 384–385, 385, 386–387 triglycerides, 180–181 jaundice due to oral contraceptives, Lymphocytosis, 385 primary, 177, 177–178 347 Lymphomas, 388 primary prevention (minicase), 183 jaundice in college student, 348 Lymphopenia, 385, 386 secondary, 178, 178–179 prolonged PT and low serum secondary prevention (minicase), 184 albumin, 346 M Lipid metabolism, 175–179 primary biliary cholangitis and, 346 Macroamylasemia, 352 Lipid panel, 179–180 Quickview Charts on Macrocytic anemias Lipogenesis, 193 albumin, 362 defined, 373 Lipolysis, 193 ALP (alkaline phosphatase), 364 drugs that cause, 373, 375 Lipoprotein-associated phospholipase A2 ammonia, 368 erythrocyte morphology for differential (Lp-PLA2), 185 and test for ammonia associated with diagnosis of, 374 Lipoproteins hepatic encephalopathy, 339–340 folate concentration and, 377 characteristics of, 176, 176 Liver enzymes in pediatric patients, 565 folic acid deficiency and, 376–377 laboratory tests for Liver function tests (LFTs) megaloblastic, 376 high-density lipoprotein cholesterol, abnormal (minicase), 347 vitamin B deficiency and, 373, 182 12 age-related differences in 375–376 low-density lipoprotein cholesterol, Macrocytic cells, 372 182 bilirubin, 565–566 Macrophages, 383–384 non-high-density lipoprotein liver enzymes, 565 cholesterol, 183–184 serum albumin, 564–565 Macroprolactin, 602 total cholesterol, 180 categories of, 330, 330 Macroprolactinemia, 602 triglycerides, 180–181 of synthetics Magnesium metabolism of, 175–176, 176 albumin, 331 calcium balance and, 280 Liquid chromatography with mass international normalized ratio and conversion factors to SI units for, spectrometry (LC-MS), 597 prothrombin time, 332, 332 262 Liquid junction, 24, 25 overview, 331 hypermagnesemia and, 275–276, 276 Lithium prealbumin (transthyretin), 331–332 hypomagnesemia and, 275 data to aid interpretation of, 100 Lobules, liver, 329, 330 normal range of, 274 nephrogenic diabetes insipidus and, Low-density lipoprotein (LDL) in pediatric patients 220 atherosclerotic vascular disease risk and hypermagnesemia, 560 overview of, 123 particle concentrations of, 184 hypomagnesemia, 560

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physiology of, 274–275 Membrane osmometer, 24 iron deficiency and, 377–379 Quickview Chart on, 296 Meningitis, 474, 478, 478–479 serum ferritin and, 379 reference range for, in traditional and SI Menkes syndrome, 285–286 serum iron, total iron-binding capacity units, 636 Menopause, 574–575 and, 379 Magnetic resonance imaging (MRI), 166 Men’s health. See Benign prostate Microcytic cells, 372 Major histocompatibility complexes, 384 hyperplasia (BPH); Erectile Microhemagglutination T. pallidum Malaria, 476 dysfunction; Hypogonadism; Prostate (MHA-TP) test, 483 MALDI (matrix-assisted laser desorption/ cancer Milk-alkali syndrome, 281 ionization), 34 erectile dysfunction and normal Minerals, dietary intakes of, 261. See MALDI-TOF mass spectrometry, 35 testosterone levels (minicase), 598 also Electrolytes and minerals; specific for bacteria identification, 426 lower urinary tract symptoms and minerals for fungi identification, 454 enlarged prostate (minicase), 606 Minicases MALT (mucosa-associated lymphoid prostate cancer and PSA interpretation abnormal liver function tests (LFTs), 347 tissue), 353 (minicase), 613 abnormal thyroid-stimulating hormone Manganese Menstrual cycle, 571–572, 572 (TSH), 218 conversion factors to SI units for, 262 Metabolic acidosis acetaminophen concentrations, 80 deficiency of, 288–289 anion gap and nonanion gap, 308–309, acute coronary syndrome, 155 309 excess of, 289 acute hepatitis, 349 calcium and, 278, 280 normal range of, 288 acute liver failure, 350 causes of, 308–309, 309 physiology of, 288 acute respiratory depression, 310 Quickview Chart on, 301 minicases on, 309, 310 amenorrhea secondary to weight loss, Mantoux test, 472 potassium and, 270 574 Masimo SpHb device, 57 Metabolic alkalosis anemia and iron stores, 378 Massachusetts Male Aging Survey calcium and, 278 anemia and low platelet count, 379 (MMAS), 596, 599 causes of, 309 anemia and lymphopenia, 386 Mass analyzers, 34 chloride responsive and resistant, 309, anemia with increased MCV, 375 Mass spectrometry (MS) 310 antibiotic therapy for hospital-acquired in confirming drug screenings, 72 minicase on, 311 pneumonia, 429 ion detector in, 34–35 potassium and, 270 anticoagulants, 409 ionization methods in, 33–34 Metabolic syndrome, 181 arthritis, 506 mass analyzers in, 34 Metallothionein, 285 blast (myeloblast) crisis, 382 overview of, 33 Methamphetamine, urine drug screen bleeding disorders, 398 quadrupole, 34 for, 88 bowel obstruction, 311 tandem, 34 Methanol, ethanol in treating poisoning, bronchodilator reversibility study, 321 79 Matrix-assisted laser desorption/ calcium and phosphate disorders, 284 ionization. See MALDI (matrix-assisted Methicillin-resistant Staphylococcus aureus codeine pharmacogenetics, 137 (MRSA), 437 laser desorption/ionization); MALDI- diabetic ketoacidosis, 205 Methotrexate, 100, 120 TOF diarrhea, 309 Methyldopa, 199, 380 MBC test, 434 Disseminated intravascular coagulation Mean corpuscular hemoglobin (MCH), Metrika A1cNow, 199 (DIC), 407 370, 372 Mevalonic acid, conversion of hepatic drug administration times, 97 hydroxymethylglutaryl-coenzyme A Mean corpuscular hemoglobin drug-induced hepatoxicity, 350 concentration (MCHC), 370, 372 to, 176 drug-laboratory test interaction, 48 Mean corpuscular volume (MCV), 370, MIC breakpoints drug screen and cocaine, 77 372, 375 for antimicrobial susceptibility testing, Mean platelet volume (MPV) 430–431 drug screen and heroin, 77 disorders associated with, 400, 401 for susceptibility testing of Candida drug screens for therapy opioids, 84 for distinguishing causes of spp., 454, 455 drug screens and emergent care, 73 thrombocytopenia, 400, 400 Micelle electrokinetic capillary EFGR mutation testing, 141 overview of, 400–401 chromatography, 28 elevated carcinoembryonic antigen range reference for, 370 Michaelis constant, 104 (CEA), 521 Media. See Growth media Michaelis-Menten elimination behavior, erectile dysfunction and normal testosterone levels, 598 Medical literature, 47–48 104 Medical review officer (MRO), workplace Microalbuminuria, 160, 208 estimating equations for GFR, 245 drug testing and, 73, 74 Microcapillary puncture, 548 fever and hypotension, 310 Medications. See Drugs Microcytic anemias heart failure, 162, 246 Membrane attack complex (MAC), 499, erythrocyte morphology for differential hepatic encephalopathy, 348 500 diagnosis of, 374 hepatitis type C, 349

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hirsutism secondary to adnexal tumor, using antibiogram to choose empiric Multiple myeloma, 387, 388 577 antibiotic regimen, 441 Mycobacteria. See also Bacteria HIV testing while on pre-exposure vancomycin dosing based on creatinine blood assay for (M. tuberculosis), prophylaxis, 464 clearance in child, 563 472–473 hyperkalemia, 274 workplace drug screen interpretations, identification of, 469–471 hypernatremia after resection of 76 infections associated with pathogenic, pituitary tumor, 269 MiniMed Paradigm Real-Time Revel, 201 469

hyperosmolar hyperglycemia state Mixed venous oxygen (SvO2), 305 overview of, 469 secondary to type 2 diabetes mellitus, Modification of Diet in Renal Disease skin testing for, 472 207 (MDRD) equation, 240, 242–244 susceptibility testing of, 471–473 hyperthyroidism, 217 Modified Centor Criteria, 59 traits of, effecting identification and hypertriglyceridemia, 181 Molds, 443, 444 treatment, 469–470 hyperuricemia and gout, 513 Molecular absorption spectrophotometry, Mycophenolic acid, 122 hyponatremia, 267 21, 21–22 Mycoplasma hominis, 476 hyponatremia and seizures, 553 Molecular diagnosis Mycoplasma pneumoniae, 476 hypothyroidism, 216 for fungi, 453–454 Myelodysplastic anemia, 387 infertility secondary to male factor, 579 for mycobacteria, 470, 471 Myeloma, multiple, 387, 388 jaundiced college student, 348 for viruses, 460–461 Myeloperoxidase, 160 jaundice due to oral contraceptives, 347 Molecular diagnostics, 37–38 Myocardial infarction (MI), 152 laboratory parameters in dehydration, Molecular emission spectrophotometry, Myocardial perfusion imaging, 165 13 22–23 Myoglobin, 156, 159 laboratory test results to guide choice of Molecular tests Myoglobinuria, 253 antibiotic regimen, 440 drug disposition-related lower urinary tract symptoms and clinical significance, 139 N enlarged prostate, 606 CYP2C9 gene, 136, 138 NA amplification techniques (NAATs) measuring serum testosterone levels for CYP2C19 gene, 136, 138 treatment of erectile dysfunction, 45 for chlamydia, 482 CYP2D6 gene, 136, 137 NASH (nonalcoholic steatohepatitis), for gonorrhea, 482 Cytochrome P450 system, 136–138 356 for virus identification, 455 pancreatitis, 356 dihydropyrimidine dehydrogenase, 139 NA-based bacterial identification perimenopause, 575 methods, 426 drug disposition reactions and point-of-care testing and group A genetic variability, 136, 136 Nanotechnology, 39–40 streptococcal pharyngitis, 64 overview, 136 NASH (nonalcoholic steatohepatitis), 337, point-of-care testing and type 2 356 diabetes and HgbA1C, 65 thiopurine methyltransferase, 138–139 National Academy of Clinical primary prevention of lipid disorders, Biochemistry (NACB), practice drug-target-related 183 guidelines of, 136, 144 ALK inhibitors, 141–142 prolonged PT and low serum albumin, National Collegiate Athletic Association, 346 anti-HER2 therapy, 140–141 83 prostate cancer and PSA interpretation, BRAF inhibitors, 142 National Glycohemoglobin 613 determination of appropriate Standardization Program (NGSP), 56 pseudomembranous colitis, 357 therapies, 140 National Lipid Association pulmonary function tests for interstitial EFGR TKIs, 140–141 Recommendations for Patient-Centered lung disease, 324 fluorescence in situ hybridization Management of Dyslipidemia, 179 rapid streptococcal antigen test (RSAT), (FISH), 140 National Reference System for Cholesterol 5 immune checkpoints, 142 (NRS/CHOL), 57 reliability of drug screening for immunohistochemistry (IHC), 140 Natriuretic peptides, 159–160, 161–163, amphetamines, 72 overview, 139 265 rickets, 558 resistance to targeted therapy, Natural killer (NK) cells, 384, 386–387 sample timing for digoxin, 103 142–143 Near patient testing. See Point-of-care secondary prevention of lipid disorders, warfarin, 139–140 testing (POCT) 184 Monocytes, 383, 384 Necrokinetics, 82 spirometry to diagnose COPD, 319 Monocytosis, 385 Negative percent agreement, 55 synovial fluid assessment, 503 M-protein, 387 Negative predictive value (NPV), 56, 61 thombolytic therapy, 410 Mucosa-associated lymphoid tissue Nelson’s Textbook of Pediatrics, 331 unbound antiepileptic drug (MALT), 353 Neonatal hyperparathyroidism, 557 concentrations, 105 Muddy brown (granular) casts, in Nephelometry, 23 urinary tract infection, 251 urinalysis, 248, 248 Nephrogenic diabetes insipidus, 220, 220, urine drug screen and designer drug, 84 MUDPILES mnemonic, 308 263–264

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Nephron, 237, 238 Omega-3 fatty acids, 186–187 Partial pressure of carbon dioxide

Nernst equation, 24 OneTouch Ultra, 200 (PaCO2), 304, 314 Neuroglycopenia, 208 OneTouch Ultra 2, 200 Particle (indirect) agglutination, 32 Neutropenia, 385, 387 Operational implementation, 144 Parvoviridae, 456 Neutrophilia, 385, 387 Opiates, Quickview Chart on urine drug Passive (indirect) agglutination, 32 Neutrophils, 383 screen for, 91 Patient assessment, 15 Next-generation sequencing (NGS) Oral contraceptives Patient self-management (PSM), for technologies, 143 jaundice due to (minicase), 347 international normalized ratio (INR), 412 Niacin (nicotinic acid) as source of lipid abnormalities, 179 Patient self-testing (PST), for international effects of, on laboratory test results, 186 Oral glucose tolerance test (OGTT), 198, normalized ratio (INR), 412 as urine adulterant, 75 198 PCA3, 612 Nitrate reductase test, 480, 481 Ora-Quick ADVANCE Rapid HIV-1/2 PCP, Quickview Chart on urine drug Nitric oxide (NO), fractional exhaled, 326 Antibody Test, 58, 58 screen for, 91 Nitrite in chemical analysis of urine, 250, Organ function, laboratory test results PCR. See Polymerase chain reaction 253 and, 12 (PCR) Nivolumab, 142 Orthomyxoviridae, 458 PD-1 and PD-L1, 142 Nonalcoholic steatohepatitis (NASH), 337, Osimertinib, 143 Peak, 101, 102 356 Osmometry, 23–24 Peak expiratory flow rate (PEFR), 322 Nonanion gap acidosis, 308, 309, 309 Osmoreceptors, 262 Peak flow meters, 322 Noncentralized laboratory tests. See Point- Osteitis fibrosa cystica, 280 Peak urinary flow rate, 604–605 of-care testing (POCT) Osteoarthritis (OA), 509, 511, 512 Nonfasting lipid panel, 179–180 Pediatric laboratory data. See also Osteomalacia, 279–280 Hematology; Kidney function tests; Non-high-density lipoprotein cholesterol, Ovarian cancer, CA 125 antigen and, 518, Liver function tests, age-related 183–184 521–522 differences in Non-Hodgkin lymphoma (NHL), 388, 388 Ovulation, 571–572, 572, 579–580 physiologic norms and, 547–548 Noninvasive tests, 4 Oxacillin-salt agar screening tests, 437 reference ranges in, 549–550 Nonnucleoside reverse-transcriptase Oxcarbazepine, 112 for serum electrolytes and minerals inhibitors (NNRTIs), 116–117 Oxygen calcium, 556 Non-Q-wave myocardial infarction, 154 arterial oxygen saturation (SaO ) and, Nonradioactive immunoassays, 597 2 intracellular versus extracellular 305 water, 551, 551 Non-small cell lung cancer (NSCLC) arterial partial pressure of (PaO ), magnesium, 560 antibodies and, 142 2 304 phosphorus, 559 EGFR-TKIs and, 140–141 venous oxygen saturation (SvO2) and, potassium, 554 Non-steady-state drug concentrations, 10 305 serum bicarbonate, 555–556 Non-ST-segment elevation MI (NSTEMI), Oxygen-hemoglobin dissociation curve, sodium, 551–552 152, 154 303, 304, 304 Nonthyroid illness, 212 Pediatrics Nontreponemal antibody tests, 483 P blood pressure values in, 548 Nontuberculous mycobacteria (NTM), P24 antigen tests, 466 blood sampling in, 548–549 469, 472 Packed cell volume. See Hematocrit clinical presentation in, 550 definitions of ages in,548 Normal flora, 426,427 Pancreas, 330 heart rates in, 547 Normal ranges. See Reference ranges Pancreatic cancer, CA 19-9 antigen and, Normochromic, normocytic anemias, 374, 518, 523 hyponatremia and seizures (minicase), 553 379–381 Pancreatitis respiratory rates in, 547 Northern blots, 27 acute, 352 rickets in (minicase), 558 Nortriptyline, 122–123 assessment tests for spirometry in, 325 NQO1 gene, 404, 405 amylase, 351–352 total body water in, 550, 550–551 N-terminal-proBNP (NT-proBNP), 161, lipase, 352–353 162, 163, 163, 173 toxicological testing in, 82–83 other tests, 352–353 Nuclear imaging, 165–166 vancomycin dose determination based drugs that may cause, 351 Nucleoside reverse transcriptase on estimated creatinine clearance inhibitors, that may cause minicase on, 356 (minicase), 563 hyperglycemia, 196 overview of, 351 Pembrolizumab, 142 Nutritive media, 423, 425 Papillomaviridae, 456 Pentobarbital, 112 Pap smear, 461 Peptide NA fluorescence in situ O Paramyxoviridae, 458 hybridization (PNA-FISH), 426 Obstructive lung diseases, 316 Parathyroid hormone (PTH), 279, 279 Perfusion, 315 Oligoarthritis, 506–507 Partially treated meningitis, 478 Perimenopause, 575

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Perinuclear antineutrophil cytoplasmic test performance and decision-making, Platelet aggregation, 402 antibodies (pANCAs), 498, 499 144 Platelet count Pernicious anemia, 376 warfarin dosing, 404–405 age-related differences in, 568 Personalized medicine, 136. See also Pharmacogenomics, 135 in CBC count, 370, 372 Pharmacogenetics Pharmacologic stress testing, 164 for evaluating hemostasis, 398–400 pH Pharyngitis, streptococcal, 479 low and anemia (minicase), 379 acid-base homeostasis and, 270–271 Phenobarbital/primidone, 99, 108–109 Quickview Chart on, 416 arterial, 304 Phenothiazines, that may cause Platelet function, 401–402 in chemical analysis of urine, 250, hyperglycemia, 196 Platelets 251–252, 252 Phenotypic assays. See also aggregation of, 402 evaluation of, for arterial blood gas Pharmacogenetics inhibitors of, 396 assessment, 307 for antiretroviral drug resistance, 468 physiology of, 393–394 normal, 303 for bacteria identification, 425 Platelet tests. See also Platelet count Pharmacists’ Patient Care Process, 63 Phenytoin, 99, 104, 109–110 Pharmacogenetics mean platelet volume (MVP), 370, 400, Philadelphia chromosome, 387, 525 400–401, 401 clopidogrel metabolism, 138, 402 pH meter, 25 other tests, 402 commercial genetic tests, 143 Phosphate platelet function, 401–402 costs of testing, 143–144 conversion factors to SI units for, 262 Pleural fluids, 484,485 defined, 135 disorders of calcium and (minicase), Pluripotential (stem) cells, differentiation drug disposition-related molecular 284 of, 369, 370–371 tests, 136 hyperphosphatemia and, 283–284 Pneumocystis carinii (jirovecii), 477 clinical significance, 139 hypocalcemia and, 280 Pneumocystis jirovecii, 449 CYP2C9 gene, 136, 138, 139–140 hypophosphatemia and, 282–283 Pneumonia CYP2C19 gene, 136, 138 normal range of, 281 empiric antibiotic therapy for hospital- CYP2D6 gene, 136, 137 in pediatric patients, 559 acquired (minicase), 429 cytochrome P450 system, 136–138 hyperphosphatemia, 559 laboratory tests for diagnosing, dihydropyrimidine dehydrogenase, hypophosphatemia, 559 479–480 139 physiology of, 281–282 Poikilocytosis, 371, 379 drug disposition reactions and Point-of-care testing (POCT) genetic variability, 136, 136 Quickview Chart on, 298 applications of, 65 other CYP450s, 138 reference range for, in traditional and SI units, 637 for coagulation, 412 thiopurine methyltransferase, 138–139 Phospholipids, 175 common types of, 13 drug-gene pairs, 145 Phosphorescence, 22 for chronic disease management, 52–53, 54 drug-target-related molecular tests, 139 Photometry for infectious disease management ALK inhibitors, 141–142 atomic absorption spectrophotometry and, 23 and screening, 53–54, 54–55 anti-HER2 therapy, 140–141 atomic emission spectrophotometry defined, 13 BRAF inhibitors, 142 and, 23 determining appropriate candidates for, determination of appropriate blood glucose meters and, 200 63–65 therapies, 140 defined, 21 in drug screenings, 72, 81 EFGR TKIs, 140–141 densitometry and, 28–29 future applications for, 66 fluorescence in situ hybridization good laboratory practices of, 61–63 (FISH), 140 molecular absorption spectrophotometers and, 21, 21–22 limitations of, 61 immune checkpoints, 142 molecular emission spectrophotometers immunohistochemistry (IHC), 140 for lipids, 185 and, 22–23 resistance to targeted therapy, minicases on Physicians’ Desk Reference, 47 142–143 Group A streptococcal pharyngitis, Physiologic anemia of infancy, 567 warfarin, 139–140 64 Picobirnaviridae, 458 goals, 135 type 2 diabetes and HbgA1C, 65 Picornaviridae, 458 immune-related genes and adverse overview of, 13–14 effects, 143 Plasma, 7 performance characteristics of, interchange of, with Plasma glucose 55–56 pharmacogenomics, 135 fasting, 197–198, 198 application, 59, 61 limitations of genotyping assays, 143 Quickview Chart on, 234 specific tests, 56–59,58, 60 next-generation sequencing, 143 Plasma (free) Hgb, 379 for platelet function, 402 overview, 135–136 Plasmin, 396 quantitative or qualitative, 55 pharmacogenetics testing versus genetic Plasmodium falciparum, P. vivax, P. ovale, regulatory oversight of, 51–52 testing, 136 P. malariae, 476 resources on, 52

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Poison control centers Pregnancy Prostate Cancer Prevention Trial, 607 poison exposure categories reported diabetes insipidus in, 220–221 Prostate needle biopsy, 605, 612 to, 70 as factor in laboratory test results, 12 Prostate specific antigen (PSA) as source of information on laboratory gestational diabetes mellitus in, 195, 198 age-specific ranges of, 610 tests, 85 Preliminary drug tests, 71–72 benign (BPSA), 609 Poisoning PreproBNP, 161 bounce or flare in, 610 and categories of exposures, 70 Prescription drug abuse, 83 clinical uses of, 518, 609 as leading cause of injury-related death, Prevalence, 4, 4 cPSA and, 611–612 70–71 Primary biliary cholangitis (PBC), 346 diseases, procedures, and drugs that Polyarthritis, RF-positive and RF-negative, Primary cell line, 460 impact, 609 506 Primary hemochromatosis, 346 drug interference with laboratory test Polyclonal antibodies (pABs), 31 Primary hypogonadism, 594, 595 of, 46 Polycystic ovary syndrome (PCOS), 576, drugs that alter, 609–610 576, 577, 578 Primary lipid disorders, 177–178, 178 Primary literature, 47 improving usefulness of, as tumor Polymerase chain reaction (PCR), 25, marker, 610 Primary sclerosing cholangitis (PSC), 334 37–38, 38 interpretation of increased, 609 Primary syphilis, 482 Polymerase chain reaction (PCR) assays in patient with prostate cancer for fungi identification, 453 Primidone. See Phenobarbital/primidone (minicase), 613 for meningitis identification, 479 Procainamide, 119, 380 percentage of free, 611 Polymorphonuclear cells. See Neutrophils Procalcitonin, 485 probability of cancer based on Polyomaviridae, 456 Profile, 8 percentage of, 611 Population pharmacokinetic dosage Progesterone, 575, 582, 582, 589 PSA density and, 610–611 adjustment, 104 Progesterone receptor (PR), 519, 523–524, PSA velocity and, 611 Posaconazole, 100, 115, 116 537 Quickview Chart on, 622 Positive inotropic agents, for stress testing, Programmed cell death ligand (PD-L1), reference range for, 520 142 164 typical actions taken depending on Positive percent agreement, 55 Prolactin results of, 608 Positive predictive value (PPV), 56, 61 in men, 601–603, 602 Prostatitis Positron emission tomography (PET), 166 medication conditions and drugs 4-glass versus 2-glass method of associated with, 602 Postmortem toxicology, 81–82 specimen collection and, 615 in women, 574, 582, 583, 590 Posture, laboratory test results and, 12 categories of types of, 614, 614 Proprotein convertase subtilisin/kexin Postvoid residual urine volume, 605 laboratory tests for diagnosing, 481 type 9 (PCSK9) inhibitors, 187 Potassium overview of, 614–615 ProPSA, 609 Protease inhibitors, 179, 196 acid-base homeostasis and, 270–271 Prostacyclin (PG2), 394 Protein binding, 99–100, 104–106 acute homeostasis and, 270, 271 Prostaglandins (PGs), role in platelet Protein C, 403 in chemical analysis of urine, 254 function, 394, 394 Protein in chemical analysis of urine, 250, conversion factors to SI units for, 262 ProstaScint, 608 250–251 diabetic ketoacidosis and, 204 Prostate Protein S, 403 normal range of, 268 digital rectal eam of, 600, 603, 604, 615 Proteinuria, 208, 250, 250–251 in pediatric patients lower urinary tract symptoms and Proteomics, 39 hyperkalemia, 272, 272–273, 274 enlarged (minicase), 606 Prothrombin G20210A mutation, 403 hypokalemia, 271, 271–272, 272 transrectal ultrasound of, 605 Prothrombin time (PT), 346, 403–404 physiology of, 268–269 Prostate cancer Prothrombin time/international Quickview Chart on, 294 4K score, 612 normalized ratio (PT/INR), 332, 332, reference range for, in traditional and SI clinical tests used to stage, 606 363, 403–406, units, 637 comparison of screenings for, 607 417 renal homeostasis and, 263, 269–270, DNA methylation, 614 ProTime. See Prothrombin time (PT) 270 Gleason scoring, 607, 612 Protirelin. See Thyrotropin-releasing Potentiometry, 24, 25, 25 interpreting PSA in patient with hormone (TRH) Poxviridae, 456 (minicase), 613 Provisional drug test, 71–72 Prealbumin (transthyretin), 331–332 new laboratory tests for management Proximal tubule, 237 Precision, 3, 55, 59, 61 of, 608 PSA bounce, 610 Prediabetes, management of, 202–204 overview, 605, 607–608 PSA density (PSAD), 610–611 Predictive linear regression equations, PCA3, 612 PSA velocity, 611 105–106 prostate needle biopsy, 605, 612 Pseudoheparin resistance, 407 Predictive value, 4, 4 symptoms of, 605 Pseudomembranous colitis. See Pregabalin, 112 TMPRSS2:ERG gene fusion, 612, 614 Clostridium difficile

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Psychotropics ALT (alanine aminotransferase), 366 total serum T3, 230 amitripyline, nortriptyline, imipramine, ammonia, 368 triglycerides, 190 desipramine, 122–123 anti-Xa, 419 Troponins I and T, 172 antidepressants, 123 aPTT, 418 typical contents, 9 antipsychotics, 123–124 arterial partial pressure of carbon urine drug screen, amphetamines, and

data to aid interpretation of, 100 dioxide (PaCO2), 314 methamphetamine, 88 lithium, 123 AST (aspartate aminotransferase), 365 urine drug screen and barbiturates, 88 Pteroylglutamic (folic) acid deficiency, BCR-ABL, 539 urine drug screen and benzodiazepines, 374, 375, 376–377 89 beta-2 microglobulin (B2M), 536 Pulmonary diseases, common pulmonary bilirubin, 367 urine drug screen and benzoylecgonine, function test results and, 317 BNP/NT-proBNP, 173 89 Pulmonary function tests (PFTs). See also BRAF mutation, 542 urine drug screen and delta-9- Spirometry tetrahydrocannabinol-9-carboxylic BUN, 257–258 body plethysmography, 322 acid, 90 CA 15-3, 531 bronchial provocation test (BPT), urine drug screen and LSD, 90 323–325 CA 19-9, 534 urine drug screen and opiates, 91 carbon monoxide breath test, CA 27.29, 532 urine drug screen and PCP, 91 325–326 CA 125, 530 venous total carbon dioxide, 313 clinical uses of, 316, 317 calcium, 297 zinc, 300 diffusion capacity tests, 323 carcinoembryonic antigen (CEA), 529 Quinidine, 119–120, 380 exercise challenge testing, 325 chloride, 295 Quinine, 380 chromium, 302 FEV1/FVC, 318, 319 flow-volume curves, 316–317,317, 318, copper, 299 R 320, 321 creatine kinase MB, 172 Radioactive iodine uptake test, 214, forced expiratory flow, 318 creatinine, 258–259 215–217 forced expiratory volume in 1 second, EGFR mutation (exon 19 and 21), Radioimmunoassay (RIA), 31, 597, 598 318 540 Rapid antigen tests for streptococcus forced vital capacity, 317 estradiol (E2), 588 (RSAT, RADT), 5, 479 fractional exhaled nitric oxide estrogen receptor, 537 Rapid diagnostic tests measurement, 326 follicle-stimulating hormone (FSH), for bacteria, 425 functional residual capacity, 322, 323 586 for HIV, 465–466 inflammatory markers, 185 free T4, 232 for influenza, 462 inspiratory capacity, 322, 323 glycated hemoglobin (A1c), 235 for meningitis, 478 for interstitial lung disease (minicase), human chorionic gonadotropin (hCG), Rapid plasma reagin (RPR) test, 483 324 533 Rapid urease test, 354 overview of, 315 Human epidermal growth factor Rate of change, 15 peak expiratory flow rate, 322 receptor 2 (HER2), 538 Reagent strips, urine, 249–254, 250 serial, 316 KRas mutation, 541 LDL cholesterol, 192 Reagent test strips, 200. See also Glucose six-minute walk test, 325 meters luteinizing hormone (LH), 587 total lung capacity, 322, 323 Recombinant immunoblot assay (RIBA), Pulsed-field electrophoresis (PFGE), 28 magnesium, 296 344 Purified protein derivative (PPD), 472 manganese, 301 Red and white blood cell tests Pyelonephritis, laboratory test results to phosphate, 298 complete blood count, 370, 371 guide choice of an antibiotic regimen plasma glucose, 234 platelet count and mean platelet for (minicase), 440 platelet count, 416 volume, 370, 372, 416 potassium, 294 white blood cell count and differential, Q progesterone, 589 370, 372 Q fever, 474 progesterone receptor, 537 Red blood cell (RBC) count, 370, 371, Quadrupole mass spectrometer, 34 prolactin, 590 566, 567, 567 Qualitative tests, 4 PSA, 622 Red blood cell (RBC) distribution width Quality control (QC), 20–21, 62 PT and INR, 417 (RDW), 370, 372 Quantitative tests, 4 PT/INR (prothrombin time/ Red blood cell (RBC) indices, 370, 372 QuickFISH, 426 international normalized ratio), 363 Red blood cells (RBCs) Quickview sodium, 293 formation of, 369, 369 albumin, 362 testosterone, 591, 620–621 in urinalysis, 248 ALK mutation, 543 thyroid-stimulating hormone (TSH), Redox potential, 24 ALP (alkaline phosphatase), 364 233 Redox potential difference, 24 alpha-fetoprotein (AFP), 535 total cholesterol, 191 Reed-Sternberg cell, 388

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Reference ranges Rheumatologic diseases. See also Seizures, hyponatremia and (minicase), defined, 5 individual rheumatologic diseases 553 factors that influence, 5–6 immunoglobulins and, 493–494, 494 Selective reporting, of antibiotic geriatric, 10 nonrheumatic tests and, 503–504 susceptibility, 440–441 nondrug, for common laboratory tests to diagnose and assess Self-monitoring blood glucose meters. See tests in traditional and SI units, acute-phase reactants, 500–501 Glucose meters 636–637 anticitrullinated protein antibodies Semiquantitative tests, 6 pediatric, 10, 549–550 (ACPAs), 494 S-enantiomer, 404 serum potassium, 5 antineutrophil cytoplasmic Sensitivity Reflectance photometry, 200 antibodies, 498–499, 499 calculation of, 6 Refractometer, 252 antinuclear antibodies, 495, 496, 497, definition and overview of, 6, 61 Refractometry, 23 497–498 of point-of-care tests, 55–56 ReliOn Precision Xtra, 201 C3 and C4, 500 of point-of-care tests for influenza A ReliOn Ultima, 200 complements, 499–500 and B, 63 Re-LY trial, 406 C-reactive protein, 501 test’s predictive value and, 4, 4 Renal blood flow (RBF), 237–238 erythrocyte sedimentation rate, of tumor markers, 518–519 501 Renal dysfunction, 12 Serology human leukocyte antigen B27, in identifying fungi, 452–453 Renal failure 501–502 as cause of abnormally high BUN, 240 for syphilis, 483 qualitative antinuclear antibody assay for virus identification, 462 glomerular filtration rate and, 242 results, 498 Seronegative spondyloarthropathies, 501 uric acid nephropathy as, 514 quantitative antinuclear antibody Renal function, age-related physiologic assay results, 497–498 Serum, 7 development of, 561, 561–562 rheumatoid factor, 494–495 Serum albumin in pediatric patients, 564–565 Renal homeostasis, 263, 269–270, 270, specific and nonspecific tests, 494 Serum amyloid A, 160 306–307, 307 synovial fluid analysis, 502,502, 503 Serum bicarbonate (total carbon dioxide) Renal plasma flow (RPF), 237–238 tests to monitor drug therapy for, 510, Renal tubular function in pediatric 511–512 arterial, 304 patients, 562 Ribonucleoprotein (RNP) antibodies, 495, in pediatric patients, 555–556 R-enantiomer, 404 496, 497 venous, 305, 313 Renin-angiotensin-aldosterone system, Rickets, in children, 280, 557, 558 Serum bicarbonate concentration, 261 264–265 Rickettsia rickettsii, 477 Serum concentrations Reoviridae, 458 Rituximab, 388 common applications in, 78–79 Repolarization, 153 Rivaroxaban, 396, 396, 400, 404, 406 general analytical techniques and, 78 Reproductive cycle, 571–572, 572 Rocky Mountain spotted fever, 477 objectives of analysis of, 77–78 Residual volume (RV), 322, 323 Ro/Sjögren syndrome A (Ro/SSA) use of therapies to treat toxicity guided Resistance, in airways, 316 antibody, 496, 497. See also Anti-Ro/ by, 78 Respiration, regulation of, 306 SSA antibodies Serum creatinine Respiratory acidosis, 310, 311 RT-PCR. See Reverse transcription age-related differences and, 560–561 Respiratory alkalosis, 311, 311 polymerase chain reaction (RT-PCR) assessment of, for renal disease, Respiratory rates in pediatric patients, 547 Rumack-Matthew nomogram, 79 239–240 Reticulocyte count, 370, 372–373 benign prostatic hyperplasia and, 603 S Reticulocytes, 371 BUN: SCr ratio and, 267–268 Retroviridae, 459 Salicylate, Done nomogram for poisoning drug interference with laboratory test by, 79 Reverse T , 209 of, 46 3 Saliva, 106 Reverse transcription polymerase chain estimating creatine clearance from, reaction (RT-PCR) Salt wasting, cerebral, 552 563–564 to detect estrogen and progesterone Sample timing, 100–104 reference range for, in traditional and SI receptors, 524 SBT test, 435 units, 636 for Ph chromosome, 525 Schilling test, 374, 376 Serum electrolytes and minerals. See Electrolytes and minerals for Type C hepatitis, 344 Schlichter’s test, 435 Serum ferritin, 379 Rhabdoviridae, 459 Schwartz equation, 563–564, 564 Screening tests, 7, 7–8 Serum glutamic-oxaloacetic Rheumatoid arthritis (RA), 504–506, 511, transaminase (SGOT). See Aspartate 512 Secondary hypogonadism, 594, 595 aminotransferase (AST) Rheumatoid factor (RF) Secondary lipid disorders, 178, 178–179 Serum glutamic-pyruvic transaminase in juvenile idiopathic arthritis, 506–507 Secondary literature, 47 (SGPT). See Alanine aminotransferase overview of, 494–495 Secondary syphilis, 482 (ALT) in rheumatoid arthritis, 504–505 Segmented neutrophils. See Neutrophils Serum haptoglobin, 380

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Serum iron, 379 hyponatremia, 552–553 Steady-state, 100–101, 101 Serum lactate, 305 overview, 551–552 Steady-state average concentration, 101 Serum protein electrophoresis, 27 physiology of, 262–265 Steady-state maximum concentration, 101 Serum protein electrophoretic (SPEP) Quickview Chart on, 293 Steady-state minimum concentration, 101 gels, 386 reference range for, in traditional and SI Steely-hair syndrome, 285–286

Serum T3 resin uptake, 214, 214 units, 637 Stem cells, differentiation of,369, Serum uric acid, 510, 512–514 renin-angiotensin-aldosterone system 370–371 Serum uric acid, gout and hyperuricemia and, 264–265 Steroids, that may cause hyperglycemia, and, 510, 512–514 tests for assessing fluid status of 196 Sex hormone-binding globulin (SHBG), blood urea nitrogen (BUN): serum Stewart theory, 306 577, 594 creatine (SCr) ratio, 267–268 Streptococcal pharyngitis, 479

drugs that alter concentrations of, 594 fractional excretion of sodium (FENa), Stress testing, noninvasive, 164 late-onset hypogonadism and, 595 267 Strongyloides stercoralis, 477 Sexual Health Inventory for Men, 601, urinary, 254 ST-segment elevation MI (STEMI), 152, 601 Sodium-glucose cotransporter 2 154, 154 Sexually transmitted diseases (STDs) inhibitors, 225 Subforms, 3, 4 chlamydia, 474, 482 Sodium glucose cotransporters (SGLTs), Substance abuse. See also Toxicological 194 gonorrhea, 481–482 tests; Urine drug screens Solid-state electrodes, 24 herpes simplex virus (HSV), 484 overview, 69–71 Southern blots, 27 syphilis, 482–483 prevalence of illicit drug use, 69, 69 Specific gravity, in urinalysis,250, 252 trichomonas, 483–484 sports and drugs, 83, 83 Specificity Shell vial culture, 460 Substance Abuse and Mental Health calculation of, 6 Shunt, 316 Services Administration (SAMHSA) definition and overview of, 6–7, 61 SIADH. See Syndrome of inappropriate Division of Workplace Programs of, 73 secretion of antidiuretic hormone of point-of-care tests, 55, 56 as source of information on drug (SIADH) test’s predictive value and, 4, 4 abuse, 85 Sickle cell anemia, 11, 381 of tumor markers, 518–519 Subtypes, 3 Sickle cell trait/disease, 381 Specimen(s) Sulfonylureas, 208, 223 Sickle crisis, 381 common, for bacteriologic analysis, 422 Supplemental media, 423, 425 Side-scattered light (SSC), 36 defined, 7 Surgical cholestasis. See Extrahepatic Significant bacteriuria, 248 improper handling of, 9–10 cholestasis Single-photon emission CT (SPECT), 165 for point-of-care testing, 52–54 Surveillance susceptibility testing, 443 Single-stranded DNA (ssDNA) antibodies, Spectrophotometry Surviving Sepsis Campaign, 305 495, 496. See also Anti-ssDNS atomic emission and absorption, 23 Susceptibility testing. See also Antimicrobial susceptibility testing; antibodies densitometry as, 28–29 Antiretrovirals, Sirolimus, 122 molecular absorption, 21, 21–22 phenotypic and genotypic assays for Six-minute walk test (6MWT), 325 molecular emission, 22–23 resistance to Sjögren syndrome, 497 SPICE bacteria, 436 antifungal, 454, 455 Skin puncture, 548 Spiral gradient endpoint (SGE) test, 430, antimycobacterial, 471–473 Skin testing, for TB, 472 434 antiviral, 462 Slow vital capacity (SVC), 317, 322, 323 Spirometry on N. gonorrhoeae isolates, 482 Smith (Sm) antibodies, 495, 496. See also definitions of airway obstruction Syndrome of inappropriate secretion of Anti-Sm antibodies severity based on results of, 318, 319 antidiuretic hormone (SIADH), 254, Sodium measurements in, 317–318, 320, 263, 266, 266. See also Hyponatremia antidiuretic hormone (ADH) and, 321–322 Synergy testing of antimicrobial 262–263 overview of, 316–317 combinations, 435 in chemical analysis of urine, 254 in patient with COPD (minicase), 319 Synovial fluid conversion factors to SI units for, 262 pediatric population and, 325 assessment of (minicase), 503 drugs that can alter homeostasis of with reversibility, 321–322 characteristics and classification of, water and, 264, 264 standardization of measurements in, 502 homeostatic mechanism for water and, 321 joint disease and morphology of 262, 263 Sporothrix schenckii, 448 crystals in, 502 hyponatremia and, 254, 265–267, 266 Sports, drug use and, 83, 83 Synovial fluid analysis natriuretic peptides and, 265 Spurious laboratory value, 15 in infection, 484, 485 normal range of, 262 Statins (HMG-CoA reductase inhibitors), in rheumatic diseases, 502, 502, 503 in pediatric patients 185–186, 245 juvenile idiopathic arthritis, 507 hypernatremia, 553–554 Stat urine drug screen, 71–72 rheumatoid arthritis, 505

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Syphilis, 482–483 overview of, 97–99 Quickview Chart on, 233 Systemic lupus erythematosus (SLE), in two patients taking same drug, 98, 98 in thyroidal and nonthyroidal disorders, 507–509, 508, 511, 512 Thiazide diuretics, 178 211 Systolic heart failure, 153 Thiazolidinediones, 224 thyroid disorders and, 214, 215 Thioglycollate broth, 423,425 Thyrotoxicosis, 210 T Thiopurine methyltransferase, 138–139 Thyrotropin.See Thyroid-stimulating hormone (TSH) T3, 209, 210. See also under Thyroid Three-dimensional echocardiography, 164 disorders Thrombin, 394, 395,395 Thyrotropin-releasing hormone (TRH), T , 209, 210. See also under Thyroid 209 4 Thrombin time (TT), 408–409 disorders Thyroxine (T ), 209, 637. See also under Thrombocythemia, 398 4 Tacrolimus, 100, 122 Thyroid disorders Thrombocytopenia Taenia solium, 477 Thyroxine-binding globulin (TBG), 209 causes of, 398–399 Talaromyces marneffei, 449 Tiagabine, 112 drugs associated with, 398–399, 399 Tandem mass spectrometer, 34 Tidal volume (TV), 322–323 heparin-induced (HIT), 399–400, 400 Technetium-99m (99mTc), 165 Time course, as factor in laboratory test in systemic lupus erythematosus, 509 Tertiary hypogonadism, 594, 595 results, 10 Thrombocytosis, in rheumatoid arthritis, Time-kill assays, 435 Tertiary literature, 47–48 506 Tissue factor (TF), 395, 395 Tes-Tape, 200 Thrombolytic therapy (minicase), 410 Testicular cancer, hCG and, 518, 522–523 Tissue factor pathway inhibitor (TFPI), Thromboplastin reagents, 404 396 Testosterone Thrombotic thrombocytopenic purpura T lymphocytes, 384 bioavailable, 598, 598, 599 (TTP), 399 TMPRSS2:ERG gene fusion, 612, 614 bound, 594, 597, 598 Thromboxane A , 394, 394 2 Tobramycin, 99 drug interference and testing levels of, Thyroid Togaviridae, 459 46 anatomy and physiology of, 209–210 Tomography, computed, 165–166 erectile dysfunction and normal levels hormone secretion of, 209, 209 of (minicase), 598 Topiramate, 112 thyroid function tests, 12, 211–217 free, 594, 595, 597–598 Total antibody HAV, 340–341, 341 Thyroid-binding prealbumin.See low serum levels, and erectile Transthyretin Total blood volume, by age group, dysfunction (minicase), 45 548–549, 549 Thyroid-binding protein physiologic effects and production of, Total body water (TBW), 550, 550–551 disease states and drugs that influence, 593–594, 594 214, 214 Total carbon dioxide. See Serum production and physiologic effects of, bicarbonate factors that alter, 212, 212 593–594 Total cholesterol (TC), 180, 191 Thyroid disorders Quickview Chart on, 620–621 Total hemolytic complement (THC), 500 antithyroid antibodies and, 217 supplemental, 596 Total iron-binding capacity (TIBC) of free T and, 211, 211–212, 212, 232 total, 596–597, 597 4 transferrin, 379, 637 free T index and, 214, 214 in women, 574, 582–583, 583, 591 4 Total laboratory automation (TLA), hyperthyroidism as, 210 Test results. See Laboratory test results 20–21 hypothalamic-pituitary-thyroid axis Tetany, 280 Total lung capacity (TLC), 322, 323 dysfunction as, 217–218 Thalassemias, 372, 381 Total serum T3, 214, 214–215 hypothyroidism as, 210, 210 Thallium-201 201( TI), 164, 165 Quickview Chart on, 230 nonthyroid laboratory tests in patients Total serum T Theophylline, 99, 106–107 with, 211, 211 4 Quickview Chart on, 231 Therapeutic drug monitoring, 93–94.See radioactive iodine uptake test and, 214, also Drug concentrations 215–217 thyroid disorders and, 212–214, 214 characteristics of ideal drugs for, 94–95 Total testing process (TTP), 144 serum T3 resin uptake and, 214, 214 defined, 93 thyroid-stimulating hormone (TSH) Toxicity future of, 124 and, 214, 215, 233 dangerous, 94 goal and indications for, 94 thyrotoxicosis as, 210 therapies for treatment of, 78

Therapeutic ranges total serum T3 and, 214, 214–215, 230 Toxicokinetics, 81, 81

defined, 97 total serum T4 and, 212, 212–214, 214, Toxicological tests. See also Urine drug of drugs in traditional and SI units, 231 screens 635–636 Thyroid gland, 209 of athletes, 83 for drugs most commonly monitored, Thyroid hormone-binding ratio, 214 characteristics of selected specimens 99–100 Thyroid-stimulating hormone (TSH), 209 for, 82 factors affecting, 98–99 abnormal test results (minicase), 218 in criminal justice system, 74 of hypothetical drugs, 97 in establishing brain death, 81 inverse relationship between free T4 narrow, 94 and, 209–210 forensic and legal issues in, 81–82

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in pediatrics, 82–83 Tumor markers Unconjugated hyperbilirubinemia, prescription drug abuse and, 83 accessibility, 519–520 336–337 sources of information for, 85 alpha-fetoprotein (AFP), 518, 523, 535 Unfractionated heparin (UFH), 396, 396, Toxicology hold, 81 anaplastic lymphoma kinase (ALK), 399. See also Heparin Toxoplasma gondii, 477 519, 526, 543 United Kingdom Prospective Diabetes Study (UKPDS 33), 202 Toxoplasmosis, 477 BCR-ABL, 519, 525, 539 United States Olympic Committee, 83 Transaminases. See Aminotransferases beta-2 microglobulin, 518, 523, 536 Unstable angine (UA), 152 Transesophageal echocardiography (TEE), CA 15-3 antigen, 518, 520–521, 531 164 CA 19-9 antigen, 518, 523, 534 UPOINT, 615 Transferrin, total iron-binding capacity CA 27.29 antigen, 518, 521, 532 Upper endoscopy, 354 of, 379 CA 125 antigen, 518, 521–522, 530 Urea. See Blood urea nitrogen (BUN) Transthoracic echocardiography, 163 carcinoembryonic antigen (CEA), 518, Urea breath test, 353 Trastuzumab, 140 520, 521, 529 Ureaplasma urealyticum, 477 Treponemal antibody tests, 483 categories, 517 Uric acid Triage BNP, 163 clinical uses defined, 510 Trichomonas, 483–484 markers found in blood, 418, 518 in management of gout and hyperuricemia, 510, 512–514 Triglycerides, 180–181 markers found on tumor cells, 518, reference range for, in traditional and SI metabolism of, 175–176 519 units, 637 Quickview Chart on, 190 mutations impacting drug selection, 518, 519 Uric acid nephropathy, 514 reference range for, in traditional and SI Uridine-rich ribonuclear protein units, 637 overview, 518–520 (U RNP), 495, 496, 497 Triiodothyronine (T ), 209, 210, 637. See cost-effectiveness, 520 1 3 Urinalysis also under Thyroid disorders defined, 517 casts and, 248, 248 Trimethoprim-sulfamethoxazole, epidermal growth factor receptor drug-laboratory test interaction and (EGFR), 519, 525 cells in, 248 (minicase), 48 estrogen receptor (ER), 519, 523–524, chemical (dipstick tests) in, 249–254, Troponin C (TnC), 155–156, 157 537 250 Troponin ELISA, 156 human chorionic gonadotropin (hCG), crystals in, 249, 249 Troponin I (TnI) and cardiac-specific 518, 522–523, 533 macroscopic, 247, 247 TnI human epidermal growth factor microscopic, 247–249 high-sensitivity, 157–158 receptor 2 (HER2), 519, 524–525, overview of, 247 538 interpretative data for, 157 Urinary creatinine collection, progesterone receptor (PR), 519, overview of, 155–158, 156 determination of creatine clearance 523–524, 537 from, 562–563 Quickview Chart on, 172 prostate specific antigen.See Prostate Urinary tract infections (UTIs) recommendations for measurement of, specific antigen (PSA) 160–161 laboratory tests for diagnosing, sensitivity and specificity of, 518–519 480–481 release of, 157 V-Ki-Ras2 Kirsten rat sarcoma viral minicase on, 251 Troponins, causes of detectable levels of, oncogene homolog, 525–526 Urine. See also Kidney(s) 158, 158 V-Raf murine sarcoma viral oncogene adulteration of sample of, 74–75 Troponin T (TnT) and cardiac-specific homolog B1 (BRAF), 526, 542 chemical analysis of. See under TnT Tumors, hirsutism secondary to adnexal Kidney(s) overview of, 155–158, 156 (minicase), 577 collection of, 247 Quickview Chart on, 172 Turbidimetry, 23 Urine drug screens. See also Toxicological recommendations for measurement of, Turbidity, of urine, 247 tests 160–161 Turnaround time, 76 benefits and disadvantages of, 72 release of, 157 Turnaround time (TAT), for point-of-care chain-of-custody in, 73–74 Trough, 101, 102 testing, 13, 52 confirmatory, 72 Trousseau sign, 280 Two-dimensional echocardiography, True negative (TN), 3 163–164 in criminal justice system, 74 True positive (TP), 3 Two-dimensional electrophoresis, 27 cutoff values in, 71,71 Trypticase soy broth (TSB), 423, 425 Types 1 and 2 diabetes. See under Diabetes defined, 71 Tube-dilution method, 430, 430, mellitus detection times and, 75, 75, 76 430–431 Types A-E hepatitis. See under Hepatitis interfering substances giving false Tuberculin skin test (TST), 472 Tzanck smear, 461 positives in, 75, 75 Tuberculosis (TB), 116, 469. See also minicases on Mycobacteria U cocaine, 77 Tubular epithelial cells, in urinalysis, Ulcer disease, 353–354 emergent care, 73 248 Ultraviolet light, 21, 21 heroin, 77

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reliability of testing for categorizations of, 454–455 Wegener granulomatosis. See amphetamines, 72 identification of Granulomatosis with polyangiitis workplace drug screen cell culture, 460 (GPA) interpretations, 76 cytology and histology, 461 Weight loss, amenorrhea secondary to (minicase), 574 negative results, reasons for, 74–75 direct antigen detection, 461–462 preliminary, 71–72 Westergren ESR (erythrocyte electron microscopy, 461 sedimentation rate), 373, 501 purposes of, 72 molecular diagnosis, 460–461 Western blots rates of positive, in workforce, 69, 70 overview, 455, 459–460 for HIV detection, 465 substances often not detected by, 74,74 serology, 462 overview of, 27 waived point-of-care, 52 traits and lab diagnosis of DNA, 456 White blood cell (WBC) count, 370, 371, in workplace, 73–74 traits and lab diagnosis of RNA, 382, 567–568, 568 Urine-free cortisol (UFC) test, 218 457–459 White blood cell (WBC) count and Urine glucose, 199–200 Visible light, 21, 21 differential Urine uric acid, 514 Vitamin B12 deficiency, 373,374, 375, granulocytes and, 383–384 375–376 Urinometer, 252 lymphocytes and plasma cells and, 384, Urobilinogen in chemical analysis of Vitamin D 386–387 urine, 250, 252–253 calcium and, 278–279 normal ranges of, 382 Urodilatin, 161 deficiency of, 279–280 overview of, 381–382 hypocalcemia in pediatric patients and percentages versus numbers of cell V deficiency of, 557 types in (minicase), 382 V600E mutation, 526 Vitamin K, coagulation cascade and, 332, White blood cells (WBCs) 395 V600K mutation, 526 classification of, 381 Vitamin K clotting factors, 404 Vaccines formation of, 369, 369, 371 Vitamin K epoxide reductase, 139–140 for both HAV and HBV, 344 quantitative disorders of, 385 Vitamin K epoxide-reductase complex for hepatitis A virus (HAV), 340 in urinalysis, 248 subunit 1 (VKORC1), 404–405 for hepatitis B virus (HBV), 343–344 Whole blood analysis, point-of-care, V-Ki-Ras2 Kirsten rat sarcoma viral 52–53, 54 Valproic acid, 99, 110–111 oncogene homolog, 525–526 Whooping cough, 473, 480 Vancomycin, 99, 113–114, 563 VKORC1 gene, 139 Wilson disease, 286 Vancomycin intermediate resistant S. Voltammetry, 25–26 aureus (VISA), 437 Wintrobe indices, 371, 372 Volume-time curve, 316, 317 Vancomycin-resistant enterococci (VRE), Wintrobe method, 373 Von Willebrand disease, 38, 397, 401 437–438 Women’s health Von Willebrand factor (vWF), 394 Vasculitis, antineutrophil cytoplasmic amenorrhea, 572–577. See also Voriconazole, 100, 115 antibodies in, 498–499 Amenorrhea V:Q ratio, 316 Vasodilating agents, for stress testing, 164 hirsutism and virilization in, 577–579, Vasopressin. See Antiduretic hormone V-Raf murine sarcoma viral oncogene 578 homolog B1 (BRAF), 526, 542 (ADH) infertility and, 579–581, 580 Vemurafenib, 142, 526 W iron requirements, 377 Venereal Disease Research Laboratory laboratory tests in Warfarin, 144 (VDRL) test, 483 estradiol, 582 aPTT and, 408 Venous oxygen saturation (SvO2), 305 follicle-stimulating hormone (FSH), CYP2C9 gene and, 139–140 Venous total carbon dioxide, 305, 313 581, 581 drug-laboratory test interaction and Ventilation, 315 luteinizing hormone (LH), 581, (minicase), 48 Ventilation:perfusion ratio, 316 581 Heparin-induced thrombocytopenia progesterone, 582, 582 Ventilator-assisted pneumonia (VAP), 480 (HIT) and, 400 VerifyNow P2Y , 402 prolactin, 582, 583 12 mechanism of, 396, 396 testosterone, 582–583, 583 Verigene bacterial identification tests, 426 pharmacogenomics and dosing of, Very low-density lipoprotein (VLDL) 404–405 menstrual cycle and, 571–572, 572 characteristics of, 176 PT/INR and monitoring therapy with, Workplace in HDL metabolism, 176–177, 177 404 drug testing in, 73 in lipid metabolism, 176 Water deprivation test, in diagnosing chain-of-custody procedures, 73–74 Viral hepatitis. See under Hepatitis diabetes insipidus, 220, 221 minicases on, 76, 77 Virilization, 578, 578, 579 Water homeostasis illicit drug use in, 69, 70 Viruses. See also Human drugs that can alter, 264, 264 World Antidoping Agency guidelines, 83 immunodeficiency virus (HIV) mechanism for, 262, 263 antiviral susceptibility testing and, Water loss, insensible, 551, 554 X 462 Waxy casts in urinalysis, 248, 248 XPressFISH, 426

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Y hyperzincemia and, 287–288 Zona fasciculata, 218 Yeasts, 444, 445 hypozincemia and, 287, 287 Zona glomerulosa, 218 normal range of, 286 Zona reticularis, 218 Z physiology of, 286–287 Zonisamide, 112 Zetacrit, 373 Quickview Chart on, 300 Zygomycetes, 443–444, 444, 447 Zeta-sedimentation rate, 373 Zinc conversion factors to SI units for, 262

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