COMMON LAB TESTS

Complete Blood Count

This test, also known as a CBC, is the most common blood test performed. It measures the
types and numbers of cells in the blood, including red and white blood cells and platelets.
This test is used to determine general health status, screen for disorders and evaluate
nutritional status. It can help evaluate symptoms such as weakness, fatigue and bruising,
and can help diagnose conditions such as anemia, leukemia, malaria and infection.

Prothrombin Time
Also known as PT and Pro Time, this test measures how long it takes blood to clot. This
coagulation test measures the presence and activity of five different blood clotting factors.
This test can screen for bleeding abnormalities, and may also be used to monitor medication
treatments that prevent the formation of blood clots.

Basic Metabolic Panel

This test measures glucose, sodium, potassium, calcium, chloride, carbon dioxide, blood
urea nitrogen and creatinine which can help determine blood sugar level, electrolyte and
fluid balance as well as kidney function. The Basic Metabolic Panel can help your doctor
monitor the effects of medications you are taking, such as high blood pressure medicines,
can help diagnose certain conditions, or can be part of a routine health screening. You may
need to fast for up to 12 hours before this test.

Comprehensive Metabolic Panel

Lipid Panel
The lipid panel is a group of tests used to evaluate cardiac risk. It includes cholesterol
and triglyceride levels.

Liver Panel
The liver panel is a combination of tests used to assess liver function and establish
the possible presence of liver tumors.

Thyroid Stimulating Hormone

This test screens and monitors the function of the thyroid.

Hemoglobin A1C
This test is used to diagnose and monitor diabetes.

Urinalysis
Often the first lab test performed, this is a general screening test used to check for
early signs of disease. It may also be used to monitor diabetes or kidney disease.

Cultures
Cultures are used to test for diagnosis and treatment of infections. Illnesses such as
urinary tract infections, pneumonia, strep throat, MRSA and meningitis can be
detected and tested for appropriate antibiotic treatment.
Hematology involves the study of the blood, in particular how blood
can affect overall health or disease. Hematology tests include tests on the
blood, blood proteins and blood-producing organs.
These tests can evaluate a variety of blood conditions including infection,
anemia, inflammation, hemophilia, blood-clotting disorders, leukemia and
the body’s response to chemotherapy treatments. Tests may be routine and
regular, or they may be called upon to diagnose serious conditions in
urgent situations. In many cases, the results of a blood test can give an
accurate assessment of body conditions and how internal or external
influences may affect a patient’s health.
This article will explain some of the more common hematology tests and
what purpose they serve.

Full Blood Count Testing

Full blood count or FBC testing is a routine test that evaluates three major components found in
blood: white blood cells, red blood cells and platelets. There are many reasons for a full blood
count test, but common reasons include infection, anemia and suspected haemato-oncological
diseases.
White Blood Cells (WBC) Testing
White blood cells are responsible for assisting the body’s defenses in fighting illnesses and
disease. Knowing how many white cells are within the blood can prove invaluable for
diagnosing and treating a range of conditions. Increased white blood cells are common in
people fighting infection or suffering from anemia.
Red Blood Cells (RBC) Testing
The number of red blood cells in the body can increase through dehydration, stress and anxiety,
or failure of the bone marrow, to name a few conditions. Decreased blood cells can be the result
of receiving chemotherapy treatments, chronic inflammatory diseases, blood loss and some
types of cancer.
Hemoglobin Testing
Without hemoglobin, oxygen would not be able to travel around the body. This oxygen-rich
protein is essential to life, but it can increase or decrease due to a number of conditions.
Dehydration, congestive heart failure and chronic obstructive pulmonary disease can all cause
an increase in hemoglobin levels, while blood loss, anemia, liver disease and lymphoma can
result in a decrease.
Hematocrit and Platelets
Hematocrit, or HCT as it is commonly known in medical circles, is the ratio of plasma to red
blood cells. Plasma accounts for the fluid component in blood. HCT testing is usually carried
out when hydration levels and anemia are suspected of causing problems. HCT levels can be
affected in the same way as hemoglobin levels.
If anemia is suspected, it is common for doctors to carry out testing on red blood cells,
hemoglobin and hematocrit at the same time.
Platelets are responsible for causing the blood to clot. Without them blood would continue to
flow from a wound and would need immediate medical attention in order to stem the flow.
Increased platelet levels can be the result of inflammatory conditions such as trauma, acute
infection and a number of malignant cancers. Decreases in platelet levels can occur from
anemia, coagulation disorders such as sickle cell anemia, alcohol toxicity and infection.
Mono Screening
Infectious mononucleosis, also known as mono, is caused by the Epstein Barr virus. It can be a
serious condition and is highly contagious. Mononucleosis testing involves looking for the
antibodies the immune system makes as it works to fight the infection.
Vitamin B12 Deficiency Testing
A lack of vitamin B12 can make the patient feel tired, run down and without energy. A simple
blood test can detect whether vitamin B12 levels have decreased. This vitamin is essential for
healthy blood cells, healthy nerves and stable DNA. If a deficiency is detected, this condition is
easy to manage with supplements, changes to the diet and vitamin shots.
Renal Profiling
The kidneys are responsible for a lot of waste management and cleansing in the body. Renal
profiling can provide a unique and valuable snapshot of how the kidneys are functioning. The
blood test will include testing the levels of creatinine and blood urea nitrogen, both responsible
for healthy kidney function.
Cholesterol Testing
High levels of cholesterol have been linked to heart disease and other potentially fatal
conditions for some time. Cholesterol testing can alert a doctor as to whether a patient needs to
take action to lower blood cholesterol and whether further treatment is required. The blood test
itself involves testing the Total Cholesterol, LDL Cholesterol (the bad), HDL Cholesterol (the
good), Triglycerides and the patient’s risk ratio.
Blood Glucose Testing
Blood glucose testing is used to show how well the patient has been able to control his or her
diabetes over the past few months. It is a non-fasting test that shows the level of glucose values
in the blood. It is also known as A1c, Glycohemoglobin or HbA1c testing. While it is a very
accurate test, it should never be used in place of routine daily glucose testing.

White Blood Cells (WBC) differewntials

1. neutrophils
2. lymphocytes

3. monocytes

4. eosinophils

5. basophils

Each of these can be affected in different ways if you have a

particular condition or disease.

A white blood cell (WBC) count measures the number of

white blood cells in your blood, and a WBC differential
determines the percentage of each type of white blood cell
present in your blood. A differential can also detect
immature white blood cells and abnormalities, both of which
are signs of potential issues.

Your doctor may request a WBC count suspect you have one
of several conditions, including:

 anemia

 infection

 Leukemia

A high RBC count may be due to:

 Dehydration
 Stress
 High altitude
 Smoking
 Cardiovascular disease
 Polycythemia vera, which is a disorder of the bone marrow that causes
too many red blood cells to be made
 A type of kidney cancer called renal cell carcinoma and other cancers
that produce erythropoietin

A low RBC count may be caused by a number of conditions, including:

 Anemia
 Malnutrition
 Pregnancy
 Overhydration
 Hemolysis, which is the breakdown of red blood cells
 Chronic kidney failure
 Severe bleeding or hemorrhage
 Failure of normal blood cell production in bone marrow

Increased/breakdown of Platelets

Some conditions can cause your body to use up or destroy platelets faster than
they're produced, leading to a shortage of platelets in your bloodstream.
Examples of such conditions include:
 Pregnancy. Thrombocytopenia caused by pregnancy is usually mild
and improves soon after childbirth.
 Immune thrombocytopenia. Autoimmune diseases, such as lupus and
rheumatoid arthritis, cause this type. The body's immune system
mistakenly attacks and destroys platelets. If the exact cause of this
condition isn't known, it's called idiopathic thrombocytopenic purpura. This
type more often affects children.
 Bacteria in the blood. Severe bacterial infections involving the blood
(bacteremia) can destroy platelets.
 Thrombotic thrombocytopenic purpura. This is a rare condition that
occurs when small blood clots suddenly form throughout your body, using
up large numbers of platelets.
 Hemolytic uremic syndrome. This rare disorder causes a sharp drop
in platelets, destruction of red blood cells and impairs kidney function.
 Medications. Certain medications can reduce the number of platelets in
your blood. Sometimes a drug confuses the immune system and causes it
to destroy platelets. Examples include heparin, quinine, sulfa-containing
antibiotics and anticonvulsants.
CLINICAL PATHOLOGY-
URINE EXAMINATION…..

Visual exam

A lab technician examines the urine's appearance. Urine is typically clear.

Cloudiness or an unusual odor can indicate a problem, such as an infection.
Protein in urine can make it appear foamy.

Blood in the urine can make it look red or brown. Urine color can be influenced
by what you've just eaten or by certain drugs you're taking. For example, beets
or rhubarb might tint your urine red.

Dipstick test

A dipstick — a thin, plastic stick with strips of chemicals on it — is placed in the

urine. The chemical strips change color if certain substances are present or if
their levels are above typical levels. A dipstick test checks for:

 Acidity (pH). The pH level indicates the amount of acid in urine.

The pH level might indicate a kidney or urinary tract disorder.
 Concentration. A measure of concentration shows how concentrated
the particles are in your urine. A higher than normal concentration often is
a result of not drinking enough fluids.
 Protein. Low levels of protein in urine are typical. Small increases in
protein in urine usually aren't a cause for concern, but larger amounts
might indicate a kidney problem.
 Sugar. The amount of sugar (glucose) in urine is typically too low to be
detected. Any detection of sugar on this test usually calls for follow-up
testing for diabetes.
 Ketones. As with sugar, any amount of ketones detected in your urine
could be a sign of diabetes and requires follow-up testing.
 Bilirubin. Bilirubin is a product of red blood cell breakdown. Usually,
bilirubin is carried in the blood and passes into your liver, where it's
removed and becomes part of bile. Bilirubin in your urine might indicate
liver damage or disease.
 Evidence of infection. Either nitrites or leukocyte esterase — a product
of white blood cells — in your urine might indicate a urinary tract infection.
  Blood. Blood in your urine requires additional testing. It may be a sign of
kidney damage, infection, kidney or bladder stones, kidney or bladder
cancer, or blood disorders.
Microscopic exam

Sometimes performed as part of a urinalysis, this test involves viewing drops of

concentrated urine — urine that's been spun in a machine — under a
microscope. If any of the following levels are above average, you might need
more tests:

 White blood cells (leukocytes) might be a sign of an infection.

 Red blood cells (erythrocytes) might be a sign of kidney disease, a
blood disorder or another underlying medical condition, such as bladder
cancer.
 Bacteria, yeast or parasites can indicate an infection.
 Casts — tube-shaped proteins — can be a result of kidney disorders.
 Crystals that form from chemicals in urine might be a sign of kidney
stones.

 IMAGES OF MICROSCPIC EXAMINATION IN URINE ANALYSIS

 PUSS CELLS -
BODY FLUID CULTURES-
What can grow on a nutrient agar plate?
Bacteria: Each distinct circular colony should represent an individual bacterial cell or
group that
has divided repeatedly. Being kept in one place, the resulting cells have accumulated
to form a
visible patch. Most bacterial colonies appear white, cream, or yellow in color, and
fairly circular
in shape. For EX- : Bacillus subtilis, Proteus vulgaris
Staphylococcus aures Streptococcus pyogenes

Yeasts: Yeast colonies generally look similar to bacterial colonies. Some species, such
as
Candida, can grow as white patches with a glossy surface. For example:
Candida Albicans is a type of yeast that
can grow on the surface of skin Round yeast colonies

PINK YEST COLONIES

Molds: Molds are fungi, and they often appear whitish grey, with fuzzy edges. They
usually turn
into a different color, from the center outwards. Two examples of molds:

Green mold (Trichoderma harzianum) Black mold (Aspergillus nidulaus

Other Fungi: Moss green colonies, a white cloud, or a ring of spores can be attributed
to the growth of Aspergillus, which is common in such fungal infections as athlete's
foot. Here is an example of what Aspergillus looks like:
IDENTIFICATION OF BACTERIAS
Top 5 Types of Staining | Microbiology

Staining Type # 1. Simple Staining:

Colouration of microorganisms by applying single dye to a
fixed smear is termed simple staining. One covers the fixed
smear with stain for specific period, after which this solution is
washed off with water and slide blotted dry. Basic dyes like
crystal violet, methylene blue and carbolfuchsin are frequently
used in simple staining to determine the size, shape and
arrangement of prokaryotic cells.
Staining Type # 2. Differential Staining:
These staining procedures are used to distinguish organisms
based on staining properties. They are slightly more elaborate
than simple staining techniques that the cells may be exposed
to more than one dye or stain, for instance use of Gram
staining which divides bacteria into two classes-Gram negative
and Gram positive.

Staining Type # 3. Gram Staining:

It is one of the most important and widely used differential
staining techniques in microbiology. This technique was
introduced in 1884 by Danish Physician Christian Gram.

In the first step the smear is stained with basic dye crystal violet
(Primary stain) followed by treatment with iodine solution
functioning as mordant.

Iodine increases the interaction between cell & dye so that cell
stains strongly. The smear is next decolourized by washing with
ethanol or acetone. This step generates the differential aspect of
Gram stains. Gram positive bacteria retain crystal violet and
become colourless.

Finally smear is counter-stained with a simple basic dye different

in color from Crystal violet. Safranin is the most common
counter stain which colours Gram negative bacteria pink to red
and leaves Gram positive bacteria dark purple.
The differences in staining responses to the Gram stain can be
related to chemical and physical difference of cell walls. The
Gram-negative bacterial cell wall is thin, complex multilayered
structure and contains relatively high lipid contents in addition
to protein and mucopeptide.

The higher amount of lipid is readily dissolved by alcohol,

resulting information of large pore in the cell wall, thus facilitate
leakage of crystal- violet – iodine (CV-I) complex which results in
decolorization of the bacterial cell.

Which later take counter stain and appears red. In contrast the
cell wall of gram+ve bacteria is thick and chemically simple,
composed mainly of mucopeptides. When treated with alcohol,
it causes dehydration and closure of cell wall pore, thereby does
not allow the loss of (CV-I) complex and cell remain purple.

Staining Type # 4. Acid Fast Staining:

It is another important differential staining procedure. It is
most commonly used to identify Mycobacterium spp. These
bacteria have cell wall with high lipid content such as mycolic
acid -a group of branched chain hydroxy lipids, which prevent
dyes from readily binding to cells.
They can be stained by Ziehl-Nulsen method, which uses heat
and phenol to derive basic fuchsin into the cells.
Mycrobacterium spp. were penetrated with basic fuchsin, not
easily decolourized by acidified alcohol (acid alcohol) and thus
are said to be acid fast.
Non arid fast bacteria are decolourized by arid alcohol and
thus are stained blue by methylene blue counter stain.
Staining Type # 5. Endospore Staining:
Spore formation takes place in some bacterial genera to
withstand unfavourable conditions. All bacteria cannot form
spores, only few bacterial genera including Bacillus,
Clostridium, Desulfotomaculum produce sporulating structure
inside vegetative cells called endospore.
Endospore morphology and location vary with species and are
valuable for identification Endospores are not stained well by
most dyes, but once stained, they strongly resist
decolorization.
In the Schaffer-Fulton procedure, endospores are first stained
by heating bacteria with malachite green, which is very strong
stain that can penetrate endospores. After malachite green
treatment, the rest of the cell is washed free of dye with water
and is counter-stained with safranin. This technique yields a
green endospore with red vegetative cell.

ZIEHL-NEELSEN STAIN & PRINCIPLE

Organisms such as Mycobacteria are extremely difficult to stain by ordinary
methods like Gram Stain because of the high lipid content of the cell wall.
The phenolic compound carbol fuchsin is used as the primary stain
because it is lipid soluble and penetrates the waxy cell wall.

Staining by carbol fuchsin is further enhanced by steam heating the

preparation to melt the wax and allow the stain to move into the
cell. Acid is used to decolorize nonacid-fast cells; acid-fast cells resist this
decolorization. The ability of the bacteria to resist decolorization with acid
confers acid -fastness to the bacterium.

Following decolorization, the smear is counterstained with malachite

green or methylene blue which stains the background material, providing
a contrast colour against which the red AFB can be seen.

Acid alcohol can also be used as decolorizing solution, resistant organisms

are referred to as Acid Fast Bacilli (AFB) or Acid Alcohol Fast Bacilli (AAFB).