Instructions for using this laboratory test list Tests are ... · Instructions for using this...

Instructions for using this laboratory test listTests are arranged alphabeticallyPlease follow the sample collection, container and volume instructionsFor a more detailed explanation on how to obtain the specimen refer to "Instructions for sample collection" documentIf you are unsure which specimen should be collected, phone the relevant laboratory section for instructionsUnless otherwise stated the specimen requirement is blood, taken into the indicated tube Unless otherwise stated the volume of specimen required is 4 - 5mlSome more specialised tests may not published in this document. Please utelise the phone list and consult a pathologist directly if any test is required that is not available routinelyElectronic version of the Laboratory Test list, contact details and "Instructions for sample collection" available on:DISA Lab (Ward enquiries) www.health.uct.ac.za/departments/cls/about/Please note that this list was last updated 1/3/2012. Some instructions may have changed.Please contact the laboratory with any specific queries

http://www.health.uct.ac.za/departments/cls/about/

NHLS GSH & RXH LABORATORY TEST LISTGSH Speed dial RXH

General results centre 021 404 4129 N/A

Anatomic pathology General: 021 404 3000 General 021 658 5209Consultants: Consultant:On call (Histology) 072 620 6916 Dr Pillay 021 658 5236On call (Cytology) 072 620 6682Prof Wainwright 021 404 5258 76862Dr Duffield 021 404 3381 76893Dr Locketz 021 404 3559 76923Dr Wu 021 404 4252Dr Sookhayi 021 404 5346Dr Learmonth 021 404 3047Dr Malaka 021 404 3463Registrars: Registrar:On call (Histology) 072 620 6537 76937 Room 021 658 5237On call (Cytology) 072 620 8356 76944Room 021 404 4234/2387

Chemical Pathology General 021 404 4129 General: 021 658 5224/6Consultants: Consultant:Dr Berman 021 406 6392 77199 Dr Van der Watt 021 658 5224/6Dr Vreede 021 404 5429 76197Dr Omar 021 404 4118 76350Dr Haarburger 021 404 5040 76349Registrars: Registrar:On call 021 404 4135 77198 On call 021 658 5224/6IMD lab:Chem IMD Molecular 021 404 4449/406 6219Chem IMD Enz 021 406 6392/6102

Non-NHLS LaboratoriesBlood Bank 021 404 4091Lipid Lab 021 406 6208/6125Pharmacology 021 404 5383Porphyria Lab 021 406 6521

Haematology General: 021 404 4129 General: 021 658 5204Consultants: Consultant:Dr Opie 021 404 3082 Dr Shuttleworth 021 658 5228Dr Du Pisani 021 404 3081Dr Ntobongwana 021 404 4244Scientist / Molecular testsDr Karen Shires 021 406 6673Registrars Registrar:Room/Main Bench 021 404 3364/3092 76193 Room 021 658 5248

Microbiology General: 021 404 4129Consultants:Dr Whitelaw 021 404 5282/5137Dr Bamford 021 404 6415/5137Dr Moodley 021 404 5295/5137RegistrarsRoom 021 404 5302/3 76652

Virology General: 021 404 4129Consultants:Dr Korsman 021 4046414 76865Dr Hardie 021 404 5201 76866Dr Hsiao 021 404 5200 76867Registrars: Room 021 404 5302/3

Tissue Immunology General: 021 404 4129Lab Manager:Mr Taljaard 021 404 4420HLA Serology Lab. 021 404 4502HLA Molecular Lab. 021 404 4447

Genetics General: 021 404 4129Cytogenetics 021 4044 509Molecular 021 404 4550

1

Preferred test name Other informationGSH Specimen container

RXH Specimen container

Precautions, comments & volumes Lab

11- deoxycortisol 11DOC yellow gel yellow gel Chem17- hydroxyprogesterone 17OHP yellow gel yellow gel Chem5-hydroxy-indole acetic acid, urine 5HIAA 24 hour urine 24 hour

urine Collect urine in acid (urine pH < 3) Chem

7- dehydrocholesterol Smith-Lemli-Optiz Syndrome purple 2 - 8°C Lipid (Non NHLS)

ABL kinase mutationsGleevec Resistance testing,CASEQ; mutation studies

purple purple At least 2x 5ml. Immediately on ice/ to lab within 24 hrs

C21Molecular haem

ABO blood grouping/phenotyping purple purple Send to blood bank at RXH Haem

ACA (IgG)Anti-cardiolipin antibody IgG; anti-phopspholipid antibody; CLP; APLA; ACLA

yellow gel Immuno

ACA (IgM)Anti-cardiolipin antibody IgM; anti-phopspholipid antibody; CLP; APLA; ACLA

yellow gel Immuno

Acetoacetyl CoA thiolase enzyme β-ketothiolase skin biopsy

and purple

Skin sterile in tissue culture medium or saline. Do not freeze. Arrange with lab beforehand.

Chem IMD

Acetylcholine Receptor Ab ACERA yellow gel yellow gel Chem

Acid base studies, urine contact laboratory

contact laboratory

Test must be arranged with chem path registrar. Deliver to lab immediately on ice. Chem

Acute flaccid paralysis 2x stool 48 hours apart

Requires EPID form. Results available from NICD when processed, but this is meant for surveillance and not diagnostics.

Viro

Actinomyces culture Culture for Actinomyces Pus from infected site Micro

2




Activated protein C resistance APCR blueTo reach lab within 4hrs or contact lab if greater delay. Clinical haematologist authorisation required

Haem

Adenosine deaminase, CSF ADA CSF CSF ChemAdenosine deaminase, fluid fluid fluid ChemAdenovirus 40/41 Rapid test, stool stool Viro

Adrenocorticotrophic hormone ACTH purple purple Deliver to lab immediately on ice. Chem

Alanine transaminase ALT yellow gel green ChemAlbumin yellow gel green ChemAlbumin, CSF plain tube plain tube ChemAlbumin, fluid plain tube plain tube Chem

Albumin, urine (Microalbumin) random or timed urine

random or timed urine Chem

Aldosterone yellow gel yellow gel ChemAlkaline phosphatase ALP yellow gel green ChemAlkaline phosphatase isoenzymes yellow gel green Chem

Allergy Food Screening test - FX5 yellow gel Immuno

Allergy Inhalant Screening test - Phadiatop yellow gel Immuno

Alpha feto protein AFP yellow gel yellow gel ChemAlpha-1 antitrypsin A1AT yellow gel yellow gel Chem

Alpha-1 antitrypsin clearance

timed stool collection into preweighed container

timed stool collection into preweighed container

Minimum 5ml stool. Record weight of empty container on form. Yellow gel top blood sample simultaneously required.

Chem

Alpha-1 antitrypsin point mutation analysis SERPINA 1 purple Do NOT freeze. Must reach lab within 5

days. Chem IMD

Aluminium yellow gel yellow gel Deliver to the lab on ice. Chem

3




Aluminium, urine random urine random urine

Do not collect in a glass or metal container. Deliver to the lab on ice. Chem

Amikacin yellow gel green GSH specimens to be send directly to Pharmacology Chem

Amino Acids (quantitative) yellow gel or green green Minimum 1ml. Deliver to lab immediately. If

delayed, separate and send frozen. Chem

Amino Acids, urine random urine random urine

Minimum 5ml. Deliver to lab immediately. If delayed, send on ice or frozen. Chem

Ammonia, serum NH3 purple green Extremely unstable. Deliver to lab immediately (within 15 min) on ice. Chem

Amoebic IFAT Amoebic serology yellow gel Usually batched. Run weekly. (Test performed at TBH Immunology) Micro

AMP Deaminase point mutation analysis AMP D1 purple Do NOT freeze. Must reach lab within 5

days. Chem IMD

Amylase yellow gel green ChemAmylase, fluid plain tube plain tube Chem

Amylase, urine random urine random urine

Deliver to lab immediately on ice. Serum lipase recommended for acute pancreatitis. Chem

ANA (EliA CTD Screen) Anti-nuclear antibodies; Anti-nuclear factor yellow gel NB- does include anti-dsDNA. Immuno

ANCA Anti-neutrophil cytoplasmic antibody, MPO & PR3 yellow gel Immuno

5-alpha reductase whole gene screen SRDSA2 purple Do NOT freeze. Must reach lab within 5

days. Chem IMD

Androgen receptor whole gene screen AR purple Do NOT freeze. Must reach lab within 5

days. Chem IMD

Androstenedione yellow gel yellow gel Chem

Anti - dsDNA Anti-double stranded DNA antibody yellow gel Immuno

Anti-CCP Ab Anti- cyclic citrullinated peptide antibody; Rheumatoid arthritis yellow gel Immuno

4




AntiDNAse B Streptococcal serology (AntiDNAse B) yellow gel

Daily batches during the day-Mon-Friday. Sat-Sun one batch in the morning. (Test performed at TBH Immunology)

Micro

Anti-Factor Xa Enoxaparin monitoring blue blue Must reach lab within 30 mins of sampling. Performed on weekdays only. At least 5ml Haem - RXH

Anti-Gliadin IgA antibodies Anti-Gliadin (deamidated) IgA antibodies yellow gel Immuno

Anti-Gliadin IgG antibodies Anti-Gliadin (deamidated) IgG antibodies yellow gel Immuno

Anti-IgE receptor Ab yellow gel ImmunoAnti-parietal cell antibody Parietal cell antibody yellow gel Immuno

Anti-thrombin III AT3 blue blueTo reach lab within 4hrs or contact lab if delay. Clinical haematologist authorisation required

Haem

Apolipoprotein B gene Apo B purple Arrange with lipid lab beforehand. Informed consent required

Lipid lab (Non NHLS)

Apolipoprotein E gene Apo E purple Do NOT freeze. Must reach lab within 5 days.

Lipid lab (Non NHLS)

Apoprotein A Apo A yellow gel yellow gel ChemApoprotein B Apo B yellow gel yellow gel ChemArginine succinate lyase enzyme

ASL / ASS complementation assay

skin biopsy and purple

Skin sterile in tissue culture medium or saline. Do not freeze. Arrange with lab Chem IMD

Arginine succinate synthase enzyme

ASL / ASS complementation assay

skin biopsy and purple

Skin sterile in tissue culture medium or saline. Do not freeze. Arrange with lab beforehand.

Chem IMD

Aristaless-related homeobox gene (X-linked mental retardation)

ARXdup24 purple or amniotic fluid

2 to 8 °C (Do not Freeze). At least 10ml blood needed

Genetics (molec)

Arsenic yellow gel yellow gelNo seafood 72 hours before blood test. Keep at room temperature. Arrange with lab beforehand.

Chem

5




Arsenic, hair hair plus roots

hair plus roots

No seafood 72 hours before blood test. At least 100mg hair plus roots - mark root end with a piece of cotton. Arrange with lab beforehand.

Chem

Arsenic, nails nails nails No seafood 72 hours before test. At least 100mg nails. Arrange with lab beforehand. Chem

Arsenic, urine random urine random urine

No seafood 72 hours before test. Requires 25ml urine. Keep at room temperature. Arrange with lab beforehand.

Chem

Aryl sulphatase A, leukocyte green green Requires control sample. Arrange with lab beforehand. NB!! Do NOT centrifuge. Chem

Aryl sulphatase A, plasma green green Requires control sample. Arrange beforehand. Chem

ASOT Streptococcal serology (ASOT) yellow gelDaily batches during the day-Mon-Friday. Sat-Sun one batch in the morning. (Test performed at TBH Immunology)

Micro

Aspartate transaminae AST yellow gel green Chem

Aspergillus precipitins Aspergillus serology yellow gelUsually batched, but urgent tests can be performed by special arrangement. (Test performed at GSH Allergology)

Micro

Aspirate culture

Fluid culture; Sterile fluid culture; Joint, pleural, ascitic, pericardial or peritoneal fluid culture

Sterile screw-top tube or sealed syringe. Purple (if cell count required)

Fluid/aspirate can be submitted on a sterile swab but this is not ideal. Specimens from existing drain sites will not be accepted for culture. Specimens must be collected by direct aspiration or at the time of insertion of the drain. If cell count required please submit a purple-toped tube with this requested (will be performed by Haematology).

Micro

6




Aspirate microscopy

Fluid microscopy; Microscopy (fluid); Joint, pleural, ascitic, pericardial or peritoneal fluid microscopy

Sterile screw-top tube or sealed syringe. Purple (if cell count required)

Fluid/aspirate can be submitted on a sterile swab but this is not ideal. Specimens from existing drain sites will not be accepted for culture. Specimens must be collected by direct aspiration or at the time of insertion of the drain. If cell count required please submit a purple-toped tube with this requested (will be performed by Haematology).

Micro

Bardet-Biedl syndrome (BBS1and 10)

purple or amniotic fluid


Genetics (molec)

BARTH syndrome whole gene screen TAZ1 gene purple Do NOT freeze. Must reach lab within 5

days. Chem IMD

BCR/ABL p190 Qualitative PCR for BCR-ABL - ALL purple purple At least 2x 5ml. Immediately on ice/ to lab

within 24 hrs C21Molecular haem

BCR/ABL p210 Qualitative PCR for BCR-ABL - CML purple purple At least 2x 5ml. Immediately on ice/ to lab

within 24 hrs on ice C21Molecular haem

BCR/ABL quantification Quantitative PCR for BCR-ABL (p210); QRPCR purple purple At least 2x 5ml. Immediately on ice/ to lab

within 24 hrs C21Molecular haem

B2-Glycoprotein IgG Anti-B2-Glycoprotein IgG yellow gel ImmunoB2-Glycoprotein IgM Anti-B2-Glycoprotein IgM yellow gel Immuno

Bence Jones Protein, urine timed urine collection

Collect urine in Bence Jones Protein preservative Chem

Beta-2 microglobulin Microglobulin, beta-2 yellow gel yellow gel Chem

Beta-2 transferrin CSF electrophoresis; CSF rule out test plain tube plain tube Chem

Beta-D-glucan Fungitell yellow gel Sent to NHLS Johannesburg - batched three times a week Micro

Beta-human chorionic gonadotrophin yellow gel yellow gel Chem

7




Bilharzia IFAT Bilharzia serology; Schistosomal serology yellow gel Usually batched. Performed weekly.(Test

performed at TBH Immunology) Micro

Bilirubin, conjugated yellow gel green ChemBilirubin, total yellow gel green ChemBilirubin, total, fluid plain tube plain tube Sample should be protected from light Chem

Bilirubin, urine (qualitative dipstix) random urine random

urine

Protect from light: sample must be wrapped in tin foil or black paper. Deliver to lab within 4 hours.

Chem

Biotinidase whole gene screen purple Do NOT freeze. Must reach lab within 5 days. Chem IMD

Biotinidase enzyme activity yellow gel Arrange with lab in advance. Deliver to lab immediately Chem IMD

BK virus PCR, blood purple ViroBK virus PCR, urine urine Viro

Bleeding timeperformed directly on patient

performed directly on patient.

Please book this procedure by contacting laboratory. Haem

Blood culture Culture (blood). Blood culture bottle

Only aerobic bottles are used. There is no major advantage to include an anaerobic bottle. Three bottles; taken as separate STERILE procedures ; should be submitted from any patient with suspected sepsis.Volume of blood should ideally be the maximum amount indicated on the bottle. Please indicate if patient had infective endocarditis or if fungal culture is required (incubated longer in these clinical situations). DO NOT STICK LABEL UNDERNEATH BOTTOM of BOTTLE.

Micro

Blood gas analysis Acid-base, pH, PO2, pCO2, base excess, standard bicarb

capped heparinised syringe, no air bubble


Deliver on ice within 30 minutes. Chem

8




Blood Group/Red cell Antibody identification Red cell antibodies purple purple Send to blood bank at RXH Haem

Blood Grouping (ABO & Rh) for transplantation cases gold - ACD

2ml purple / 0.5ml pink microtainer/ yellow gel

Blood grouping is only done for transplantation cases.

Tissue Immuno

Bone marrow biopsy Aspirate and trephine Test must be booked in advance Haem

Bordetella PCR Whooping cough PCR Sterile screw-top tube Sputum, tracheal aspirate Micro

Breast cancer BRCA1, BRCA2 purple or amniotic fluid


Genetics (molec)

Brucella ELISA Brucella serology yellow gel Usually batched. Done weekly. (Test performed at TBH Immunology) Micro

C1-esterase inhibitor concentration yellow gel Immuno

C3 Complement yellow gel yellow gel ChemC4 Complement yellow gel yellow gel ChemCA 125 yellow gel yellow gel ChemCA 15-3 yellow gel yellow gel ChemCA 19-9 yellow gel yellow gel ChemCaeruloplasmin yellow gel yellow gel ChemCalcitonin yellow gel yellow gel Chem

Calcium, ionised



Deliver on ice within 30 minutes. RXH: arrange with lab beforehand. Chem

Calcium, total yellow gel green Chem

Calcium, urine random or timed urine

random or timed urine Collect urine in acid (urine pH <3) Chem

Calculus analysis Stone analysis clinical specimen

clinical specimen Chem

9




Carboxyhaemoglobin green greenNB!! Completely filled tube (5ml). No air. Deliver to lab immediately on ice. Arrange with lab beforehand.

Chem

Carcinoembryonic antigen CEA yellow gel yellow gel Chem

Carnitine profile green or yellow gel

green or yellow gel

Arrange with chem path registrar. Deliver to lab immediately. Chem

CD34 CD34 collection; CD34 stem cells

purple / apheresis bag collection

Haem

CD4 PLG CD4; CD4 for ARV purple HaemCD64 CD64 PMN; marker for sepsis purple HaemCell count, ascitic purple purple HaemCell count, CSF sterile tube sterile tube Haem

Cell count, CSF Sterile screw-top tube

Submit in sterile screw-topped tube. DO NOT SUBMIT IN CLOT-ACTIVATING TUBES OR TUBES WITH ANY OTHER ADDITIVES.

Micro

Cell count, pleural purple purple HaemCentromere Ab yellow gel ImmunoCerebrotendinous Xanthomatosis CTX; CYP27A1 purple/dry

blood spotDo NOT freeze. Must reach lab within 5 days. Chem IMD

CF (Cystic fibrosis) genetic analysis

Delta F508; 3120+1 G-A; CF 30 gene screen purple Do NOT freeze. Reach lab within 5 days Chem IMD

CFTR whole gene screen CF purple Do NOT freeze. Reach lab within 5 days Chem IMDCharcot-Marie Tooth Syndrome

Hereditary Motor Sensory Neuropathy (HMSN)

purple or fresh frozen tumour


Genetics (molec)

Chimerism analysis genotyping, Bone marrow engraftment, STR purple purple 1X 5ml peripheral blood. To reach lab

within 3 days C21Molecular haem

Chlamydia antibody testing Chlamydia pneumoniae, C. psittaci and C. trachomatis Yellow gel Tranport at 4 °C. Turn-around time 7 days.

Test performed at STIRC, NICD, Jhb. Micro

10




Chlamydia antigen detection Chlamydia DFATPus swab from infected site

Micro

Chloride yellow gel green ChemChloride, CSF plain tube plain tube ChemChloride, stool watery stool watery stool Chem

Chloride, urine random urine random urine Chem

Cholera Culture for Vibrio cholerae faeces (stool)Please indicate this request on the form as this is NOT part of the routine culture for stool.

Micro

Cholesterol, total yellow gel green ChemCholinesterase Pseudocholinesterase yellow gel yellow gel Chem

Chromogranin A CGA purple purple Rest for 30min pre-test. Deliver to lab on ice. Arrange with lab. Chem

Chromosome analysis (constitutional disorders)

Karyotype (constitutional disorders)

green tube or green neonatal tube; amniotic fluid: sterile containers supplied by lab

green tube or green neonatal tube

CVS and Skin to be sent in transport medium or sterile saline. Please alert lab in advance for CVS and skin samples. Do NOT freeze samples and transport immediately / urgently to the lab.

Genetics (cyto)

Chylomicrons, fluid plain tube plain tube Chem

Citrate, urine random or timed urine

random or timed urine Collect urine in acid (urine pH < 3). Chem

Citrulline yellow gel Chem IMD

Clostridium difficile toxin pseudomembranous colitis watery stool Stool must reach the laboratory within 3 hours of collection Micro

CMV IgG Cytomegalovirus IgG yellow gel ViroCMV IgM Cytomegalovirus IgM yellow gel ViroCMV PCR, aspirate Cytomegalovirus PCR aspirate Viro

11




CMV PCR, biopsy material Cytomegalovirus PCR biopsy in saline Never in formalin for virological testing Viro

CMV PCR, CSF Cytomegalovirus PCR CSF ViroCMV PCR, urine Cytomegalovirus PCR urine ViroCMV viral load, CSF CSF ViroCMV viral load, blood purple Viro

CO2 total Bicarbonate yellow gel green Tube must be filled completely. Separate tube. Chem

Cold agglutinin titre Cold Agglutinin screen purple purple Arrange with lab in advance. Blood to be taken and kept at 37 degrees celcius Haem

Complement, Total total haemolytic complement yellow gel Deliver to lab on ice. Immuno

Connexin 26 genetic deafness purple or amniotic fluid


Genetics (molec)

Copper Cu yellow gel yellow gel Deliver to lab on ice. Chem

Copper, liver Wilson's disease liver biopsy No additive. Deliver to lab at room temperature. Chem IMD

Copper, urine random urine random urine

Do not collect in a glass or metal container. Deliver to lab on ice. Chem

Corneal scrapings

2 slides labelled on frosted edge, 1 BHI plate and broth

Micro

Cortisol yellow gel yellow gel Chem

Cortisol, saliva salivette salivette Saliva to be collected in a salivette (obtainable from lab) only. Chem

Cortisol, urine 24 hour urine 24 hour urine Chem

Coxiella IFAT Q Fever serology yellow gel Usually batched. Performed weekly. (Test performed at TBH Immunology) Micro

Coxsackie B antibody titre yellow gel Viro

12




CPEO (Chronic progressive external ophthalmaplegia) mtDNA deletions

muscle biopsy preferred

Frozen Chem IMD

C-peptide yellow gel yellow gel ChemCPT2 (Carnitine palmitoyltransferase II) enzyme activity

myopathy, liver disease skin biopsy Sterile in tissue culture medium or saline. Do not freeze. Arrange with lab beforehand. Chem IMD

CPT2 (Carnitine palmitoyltransferase II) gene screen

CPTase purple Do NOT freeze. Reach lab within 5 days Chem IMD

C-reactive protein CRP yellow gel green ChemCreatine kinase CK yellow gel green ChemCreatine kinase MB CKMB yellow gel green ChemCreatinine yellow gel green Chem

Creatinine clearance24 hour urine and yellow gel

24 hour urine and green

Submit blood sample taken within collection period Chem

Creatinine, fluid plain tube plain tube Chem

Creatinine, urine random or timed urine


Crigler-Najjar (UGT1A gene screen)

Hyperbilirubinemia / Gilbert syndrome purple Do NOT freeze. Must reach lab within 5

days. Chem IMD

Cryoglobulins yellow gel yellow gel Collect and deliver specimen at 37°C. ChemCryptococcus antigen detection, blood

CLAT; Cryptococcal latex agglutination test yellow gel Micro

Cryptococcus antigen detection, CSF

CLAT; Cryptococcal latex agglutination test

Sterile screw-top tube Micro

Crystals Urate crystals joint fluid Micro

13




CSF culture Cerebrospinal fluid culture; Culture (CSF)

Sterile screw-top tube

Cryptococcal detection methods are performed on all HIV+ patients (if this information is provided), otherwise only if indicated by request and/or cell counts and history provided. TB culture will be performed if indicated by request and/or cell counts and history provided.

Micro

CSF microscopy Cerebrospinal fluid microscopy; Microscopy (CSF)

Sterile screw-top tube

A Gram stain is performed on all CSFs. Microscopy for cryptococcus is performed on all HIV positive patients (if this information is provided) otherwise only if indicated by the cell count result and history provided. TB microscopy is performed only on request or when indicated by the cell count and history provided.

Micro

Cyclosporine purple purple ChemCystathionine β synthase CBS purple Discuss with lab first. Do not freeze Chem IMD

Cysticercus ELISA Cysticercus serology yellow gel Usually batched. Performed weekly. (Test performed at TBH Immunology) Micro

Cystine, leukocytes green green Minimum 4ml required. Do not freeze Chem

Cystine, urinetimed urine collection or random urine

timed urine collection or random urine

Refrigerate specimen during collection. Deliver to lab on ice. Chem

Cystinosis whole gene screen CTNS purple Do NOT freeze. Reach lab within 5 days Chem IMD

Cytochrome C oxidase skin biopsySkin sterile in tissue culture medium or saline. Do not freeze. Deliver blood to lab on ice. Arrange with lab beforehand.

Chem IMD

Cytogenetics/chromosome analysis (haematological cancer)

Karyotyping

green, bone marrow in transport medium

green, bone marrow in transport medium

Pre book and to be delivered <1hr. Blood can be send in green tube

Genetics (cyto)

14




Cytomegalovirus 48hr culture and immunofluorescence (IF) CMV Shell Vial Culture

clinical specimen (eg respiratory secretions)

CMV PCR is the preferred test. Discuss with lab if CMV culture is required. Viro

Cytomegalovirus isolation CMV isolation clinical specimen

CMV PCR is the preferred test. Discuss with lab if CMV culture is required. Viro

Cytomegalovirus pp65 antigenaemia assay PP65 N/A N/A No longer available. See CMV viral load. Viro

Cytospin, ascitic fluid purple or sterile

purple or sterile Sample as fresh as possible. >2ml needed Haem

Cytospin, CSF CSF Cytospin purple or sterile


Cytospin, pleural fluid purple or sterile


D-dimers blue blue To be delivered within 6hrs Haem

Dentatorubral palidolyusian atrophy DRPLA purple or

amniotic fluid3 to 8 °C (Do not Freeze). At least 10ml blood needed

Genetics (molec)

Deoxypyridinoline, urine random urine random urine Chem

DHEAS yellow gel yellow gel Chem

Differential count White Cell differential purple purple Deliver immediately to the laboratory. Do NOT refrigerate. Haem

Direct Coombs test Coombs, DAGT purple purple Haem

Disputed Paternity Testing Please contact laboratory for further information

Tissue Immuno

DNA extraction purple Do not freeze Chem IMD

Duchenne/Becker Muscular Dystrophy (DMD)

Testing for exonic deletions/duplications


2 to 8 °C (Do not Freeze). At least 10ml blood needed.

Genetics (molec)

15




Duchenne/Becker Muscular Dystrophy (DMD): microsatellite linkage analysis


2 to 8 °C (Do not Freeze). At least 10ml blood needed. Microsatellite markers for gene tracking.

Genetics (molec)

Dystonia DYT1 purple or amniotic fluid


Genetics (molec)

EBV EBNA IgG Epstein Barr Virus Nuclear Antigen IgG; EBNA IgG yellow gel Viro

EBV Monospot Epstein Barr Virus Monospot; Monospot yellow gel Viro

EBV PCR, blood Epstein Barr Virus PCR purple ViroEBV VCA IgM Epstein Barr Virus VCA IgM yellow gel ViroEBV Viral load, blood purple ViroEBV Viral load, CSF CSF Viro

Echinococcus ELISA Hydatid serology yellow gel Usually batched(Tuesdays). (Test performed at TBH Immunology) Micro

Elastase, stool random stool sample

random stool sample Minimum 5ml Chem

ENA

Extractable nuclear antigen; consists of anti-Sm (Smith) antibody & anti-RNP70 (ribonucleoprotein) antibody

yellow gel Immuno

Enterovirus PCR, CSF CSF ViroEnterovirus PCR, stool stool ViroEnterovirus PCR, throat throat swab Viro

Erythrocyte Sedimentation rate ESR, Westergren black or purple purple Haem

Erythropoietin yellow gel yellow gel ChemEstradiol yellow gel yellow gel Chem

Factor II blue To reach lab within 4hrs - contact lab if delay. Haem

16




Factor inhibitor assay Inhibitor assay blue blue To reach lab within 4hrs - contact lab if delay. At least 8ml blood Haem

Factor inhibitor screen blue blue To reach lab within 4hrs - contact lab if delay. At least 8ml blood Haem

Factor IX blue blue To reach lab within 4hrs - contact lab if delay. At least 8ml blood Haem

Factor V blue blue To reach lab within 4hrs - contact lab if delay. At least 8ml blood Haem

Factor V Leiden PCR Factor V; FV mutation purple purple 1X5ml tube. To reach lab within 3 days. C21Molecular haem

Factor VII blue blue To reach lab within 4hrs - contact lab if delay. At least 8ml blood Haem

Factor VIII blue blue To reach lab within 4hrs - contact lab if delay. At least 8ml blood Haem

Factor X blue blue To reach lab within 4hrs - contact lab if delay. At least 8ml blood Haem

Factor XI blue blue To reach lab within 4hrs - contact lab if delay. At least 8ml blood Haem

Factor XII blue blue To reach lab within 4hrs - contact lab if delay. At least 8ml blood Haem

Factor XIII Urea clot lysis time blue blue Haem

Fanconi's anaemia Chromosomal breakage analysis heparin heparin Fresh sample. At least 8ml blood needed Genetics

(cyto)

Fatty acid oxidation defects skin biopsy Sterile in tissue culture medium or saline. Do not freeze. Arrange with lab beforehand. Chem IMD

Ferritin yellow gel yellow gel Chem

Fibrinogen blue blue To reach lab within 4hrs - contact lab if delay. Haem

Fibroblasts Tissue culture skin biopsy Sterile in tissue culture medium or saline. Do not freeze. Arrange with lab beforehand. Chem IMD

17




FISH (Aneuploidy)Down Syndrome, Edward & Patau syndrome, Turner syndrome, Klinefelter syndrome



Discuss with lab in advance. At least 4ml amniotic fluid in sterile tube needed

Genetics (cyto)

FISH (haematological cancer)

green, bone marrow in transport medium or bone marrow slides

green, bone marrow in transport medium or bone marrow slides

Discuss with lab/haematologist in advance. Blood can be send in green tube

Genetics (cyto)

FISH (microdeletions)

Di George, Prader Willi, Angelman, Williams Beuren, Smith-Magenis, Miller-Dieker, Phelan-McDermid



At least 4ml amniotic fluid needed in sterile tube

Genetics (cyto)

Flow cytometry/ immunophenotyping, bone marrow or blood

purple purple Must be booked in advance - keep sample at room temp Haem

FLT3 ITD mutation FLT3 ITD purple purple 1X 5ml peripheral blood or bone marrow aspirate (preferred sample). To reach lab within 3 days

C21Molecular haem

FLT3 mutations (ITD and AL) FLT3 mutations purple purple1X 5ml peripheral blood or bone marrow aspirate (preferred sample). To reach lab within 3 days

C21Molecular haem

18




FLT3 AL mutation FLT3 TK ; FLT3 D835; FLT3 AL purple purple 1X 5ml peripheral blood or bone marrow aspirate (preferred sample). To reach lab within 3 days

C21Molecular haem

FNA Fine needle aspirates

Prior booking required and should be arranged with lab at RXH or GSH depending on location. Arrange with lab staff to perform smears.

Cytology

Folate, red cell Red cell folate purple purpleRequires minimum 2x5ml blood. Deliver to lab on ice. Must be separate specimen from other tests.

Chem

Folate, serum yellow gel yellow gel ChemFollicle stimulating hormone FSH yellow gel yellow gel Chem

Fragile X syndrome FRAXA purple or amniotic fluid


Genetics (molec)

Free fatty acids FFA yellow gel or grey or green

yellow gel or grey or green

Deliver to lab immediately on ice. Chem

Free light chains yellow gel yellow gel Arrange with chem path registrar. Deliver to lab immediately. Chem

Free T3 FT3; thyroid hormone (free T3), triidothyronine yellow gel yellow gel Chem

Free T4 FT4; thyroxine; tetraiodothyronine yellow gel green or

yellow gel Chem

Friedreich’s Ataxia FRDA purple or amniotic fluid


Genetics (molec)

Frozen sections

Fresh, unfixed, clearly marked.

Book with lab in advance. Histology

Fructosamine yellow gel yellow gel Chem

19




FTA, CSF Syphilis serology (FTA)

CSF (serum FTA has been replaced by the TP - see syphilis serology)

Usually batched, but urgent tests can be performed by special arrangement. Micro

Full Blood Count FBC; CBC; Complete Blood Count; Blood count purple purple Haem

Fungal culture Culture (fungal) Sample from infected site Micro

Fungal microscopy Microscopy (fungal) Sample from infected site Micro

G6PD Screen and AssayGlucose-6-phosphate dehydrogenase deficiency screening

purple purple Fresh sample Haem - RXH

GALT (Galactosemia) enzyme activity

Galactose-1 phosphate uridyl transferase deficiency green green Minimum 4ml. Requires control sample.

Arrange with lab. NB!! Do NOT centrifuge. Chem

GALT (Galactosemia) point mutation analysis

Galactose-1 phosphate uridyl transferase deficiency purple Do NOT freeze. Reach lab within 5 days Chem IMD

Gamma glutamyl transferase GGT yellow gel green Chem

Gastrin yellow gel yellow gel Fresh blood (less than 1 hour old) required. Chem

Gaucher's Disease purple or amniotic fluid


Genetics (molec)

GBM Ab Anti - glomerular basement membrane yellow gel Immuno

Gentamicin yellow gel green GSH specimens to be send directly to Pharmacology Chem

Glucose grey green or grey Chem

20




Glucose, CSF grey plain tube Recommended simultaneous blood glucose measurement. Chem

Glucose, fluid grey plain tube Chem

Glucose, urine (dipstix) random urine random urine

Deliver immediately to lab on ice within 4 hours. Chem

Glutamate hydrogenase (overactive) purple Chem IMD

Glutaric Acidemia Type 1 common mutation

Glutaric Aciduria / GA1/ GAT1/GCDH gene purple Do NOT freeze. Reach lab within 5 days Chem IMD

Glutaric Acidemia Type 1 whole gene screen

Glutaric Aciduria / GA1/ GAT1/GCDH gene purple Do NOT freeze. Reach lab within 5 days Chem IMD

Glutaryl CoA dehydrogenase activity skin biopsy

Skin sterile in tissue culture medium or saline. Do not freeze. Deliver blood to lab on ice. Arrange with lab beforehand.

Chem IMD

Glutathione synthetase whole gene screen GSS purple Do NOT freeze. Reach lab within 5 days Chem IMD

Glutathione & glutathione synthase activity GSH synthase deficiency skin biopsy

and purple

Skin sterile in tissue culture medium or saline. Do not freeze. Deliver blood to lab on ice. Arrange with lab beforehand.

Chem IMD

Glycated haemoglobin HbA1c purple purple Chem

Glycine, CSFplain tube CSF and yellow gel

plain tube CSF and green

Submit simultaneous yellow gel or green top blood sample. Chem

Glycogen Storage Disease Type 1- glucose-6-phosphatase enzyme activity

liver biopsy Snap-frozen. No additive. Arrange with lab beforehand. Chem IMD

Glycogen Storage Disease Type 4 Branching enzyme defect 5ml green Discuss with lab beforehand. Deliver to lab

on ice. Chem IMD

Growth hormone GH yellow gel yellow gel ChemHaemoglobin Hb; Hemoglobin purple purple Haem

Haemoglobin A2 Thalassaemia testing/haemoglobin studies purple purple Clinical haematologist authorisation

required Haem

Haemoglobin electrophoresis/HPLC

Thalassaemia testing/haemoglobin studies purple purple Clinical haematologist authorisation

required Haem

21




Haemoglobin F Thalassaemia testing/haemoglobin studies purple purple Clinical haematologist authorisation

required Haem

Haemoglobin H inclusion bodies Hb H purple purple Haem

Hain test TB PCR

Sputum, tracheal aspirate and other respiratory samples.

The Hain test can be performed directly on AFB positive sputum if requested. The result can confirm the presence of M. tuberculosis and provide rifampicin and INH sensitivity results.

Micro

Ham's test see PNH flow see PNH flow Discontinued Haem

Haptoglobin yellow gel yellow gel ChemHDL cholesterol yellow gel yellow gel Chem

Heamachromatosis HFE purple or amniotic fluid


Genetics (molec)

Heinz Bodies purple purple Fresh sample HaemHeparin Induced Thrombocytopenia HIT yellow gel Fresh specimen. Arrange with lab in

advance. Haem

Hepatitis A IgG yellow gel ViroHepatitis A IgM yellow gel ViroHepatitis B Core IgM yellow gel ViroHepatitis B Core Total yellow gel ViroHepatitis B drug resistance testing (Lamivudine)

yellow / purple

Only performed if Hepatitis B viral load is detectable Viro

Hepatitis B e Ab yellow gel ViroHepatitis B e Ag yellow gel Viro

Hepatitis B PCR yellow / purple Viro

Hepatitis B s Ab yellow gel ViroHepatitis B s Ag yellow gel Viro

Hepatitis B Viral load yellow / purple Viro

22




Hepatitis C Antibody yellow gel ViroHepatitis C PCR purple Viro

Hepatitis C Viral genotyping purple Only performed if Hepatitis C PCR positive Viro

Hepatitis C Viral load purple ViroHerpes simplex virus IgG HSV IgG yellow gel ViroHerpes simplex virus IgM HSV IgM yellow gel ViroHerpes simplex virus PCR, aspirate HSV PCR aspirate Viro

Herpes simplex virus PCR, biopsy material HSV PCR biopsy in

saline Never in formalin for virological testing Viro

Herpes simplex virus PCR, CSF HSV PCR CSF Viro

Herpes simplex virus PCR, swab HSV PCR swab Viro

HHV6 IgG Human Herpes Virus 6 IgG N/A No longer available. See HHV6 PCR. ViroHHV6 IgM Human Herpes Virus 6 IgM N/A No longer available. See HHV6 PCR. ViroHHV6 PCR, blood purple ViroHHV6 PCR, CSF CSF ViroHHV8 PCR, aspirate aspirate Viro

HHV8 PCR, biopsy material biopsy in saline Never in formalin for virological testing Viro

Histology (routine)

Blue / Lilac lid container in 10 % formalin

Histology

Histoplasma serology yellow gelUsually batched, but urgent tests can be performed by special arrangement. (Test performed at GSH Allergology)

Micro

HIV 1&2 ELISA yellow gel ViroHIV 2 Western Blot yellow gel ViroHIV-1 drug resistance testing purple ViroHIV-1 PCR purple Viro

23




HIV-1 p24 Antigen yellow gel Only performed if indicated by routine serology Viro

HIV-1 Viral Load

purple / plasma separation tube

Viro

HIV 1/2 rapid test (antibody) yellow gel purple Only done after hours on occupational exposure cases Viro

HLA – Class I Serological Typing HLA-AB Tissue Typing gold - ACD

Please contact the laboratory to discuss volume of blood to be taken

Mix tube thoroughly to prevent clotting. Sample not to be more than 24 hours old on arrival in lab. At least 10ml sample taken at GSH

Tissue Immuno

HLA antibody screening and identification

HLA Serum Screening. HLA Cytotoxic Antibodies Lymphocytoxic Antibodies

yellow gel Tissue Immuno

HLA Crossmatching – Class I Crossmatch

patient: yellow gel and golden (ACD) . potential donor: golden (ACD)


Mix yellow tubes without gel thoroughly to prevent clotting. Sample not to be more than 24 hours old on arrival in lab.

Tissue Immuno

HLA Typing – DNA-PCR – High Resolution per allele purple


If other DNA typing is requested no further samples are needed. At least 25ml blood needed (5 tubes)

Tissue Immuno

24




HLA Typing Class I – DNA-PCR – Low Resolution per locus

HLA-A or B or Cw DNA Typing. HLA Class I DNA typing purple


Mix thoroughly to prevent clotting. At least 25ml blood needed (5 tubes)

Tissue Immuno

HLA Typing Class II – DNA-PCR – Low Resolution per locus

HLA Class II DNA typing. HLA-DRB1, DQB1 typing purple


If other DNA typing is requested no further samples are needed. At least 25ml blood needed (5 tubes)

Tissue Immuno

HLA-B27 or other test for a specific HLA antigen purple Mix tube thoroughly to prevent clotting. At

least 10ml blood needed (2 tubes)Tissue Immuno

HNPCC (Hereditary Non-poliposis Colon Cancer)

purple, fresh or parrafin embedded tumour tissue

Blood: 2 to 8 °C (Do not Freeze). At least 10ml blood needed

Genetics (molec)

Homocysteine purple purple Recommend fasting and 6h post methionine load. Deliver to lab on ice. Chem

Homovanillic acid, urine HVA 24 hour urine

3 spot urines collected in tube containing HCl

Collect urine in acid (urine pH < 3) Chem

HPV PCR, biopsy material biopsy in saline Never in formalin for virological testing Viro

HTLV-1 PCR, CSF CSF Viro

25




Huntington and Huntington-like Disease HD and HDL2 purple or

amniotic fluid3 to 8 °C (Do not Freeze). At least 10ml blood needed

Genetics (molec)

Hyperlipidaemia type 1 gene Lipoprotein lipase purple/dry blood spot

Do NOT freeze. Must reach lab within 5 days. Chem IMD

Hypoxanthine phosphoribose tranferase enzyme activity assay

HPRT; Lesch-Nyhan green or purple

Discuss with lab beforehand. Do not freeze. At least 10ml Chem IMD

Hypoxanthine phosphoribose tranferase whole gene screen HPRT; Lesch-Nyhan purple Discuss with lab beforehand. Do not freeze Chem IMD

IgA yellow gel yellow gel ChemIgG yellow gel yellow gel Chem

IgG index, CSFplain tube CSF and yellow gel

plain tube CSF and yellow gel

Submit simultaneous yellow gel blood sample. Chem

IgM yellow gel yellow gel ChemImmunofixation Serum protein immunofixation yellow gel yellow gel Chem

INR Prothrombin time; Warfarin monitoring blue blue To reach lab within 4hrs Haem

Insulin yellow gel yellow gel ChemInsulin - like growth factor 1 IGF 1 yellow gel yellow gel ChemIron Fe yellow gel yellow gel Must reach lab within 30 minutes ChemIsopropanol stability test purple Haem

JAK2 V617F JAK2 purple purple 1X 5ml peripheral blood. To reach lab within 3 days

C21Molecular haem

HTLV-1 PCR, blood purple ViroJC virus PCR, CSF CSF ViroJo Ab Anti Jo antibody yellow gel ImmunoKetones (qualitative) yellow gel green Chem

Ketones, acetoacetate grey, green or yellow gel

grey, green or yellow gel

NB Arrange with chem path registrar. Minimum 1ml blood. Deliver on ice within 30 minutes.

Chem

26




Ketones, beta-hydroxybutyrate grey, green or yellow gel

grey, green or yellow gel

NB Arrange with chem path registrar. Minimum 1ml blood. Deliver on ice within 30 minutes.

Chem

Ketones, urine (dipstix) random urine random urine


KIR genotyping purple Consult laboratory At least 15ml blood needed (3 tubes) Tissue

ImmunoKleihauer Test purple purple Fresh sample. Maternal blood Haem

KSS (Kearn-Sayers Syndrome) mtDNA deletionsMuscle biopsy preferred

Frozen Chem IMD

La Ab & Ro Ab Anti-La antibody & Anti-Ro antibody yellow gel Immuno

Lactate grey grey Deliver on ice. ChemLactate dehydrogenase LDH yellow gel green ChemLactate dehydrogenase isoenzymes LDH isoenzymes yellow gel yellow gel Chem

Lactate dehydrogenase, fluid LDH plain tube plain tube ChemLactate, CSF grey grey Deliver on ice. ChemLead Pb purple purple ChemLegionella antigen detection Legionella urinary antigen test Urine Micro

Legionella IFAT Legionella serology yellow gel Usually batched. Performed weekly. (Test performed at TBH Immunology) Micro

LEIGHS (mitochondrial DNA) purple Do NOT freeze. Reach lab within 5 days Chem IMD

LEIGHS (mitochondrial DNA) skin biopsy 2 to 8 °C. DO NOT FREEZE. Deliver to lab immediately. Chem IMD

LEIGHS (mitochondrial DNA) muscle biopsy Frozen. Deliver to lab immediately. Chem IMD

Leprosy microscopy Sample from infected site

Clearly indicate request for Leprosy microscopy Micro

Leptospira ELISA Leptospira serology yellow gel Test performed weekly. (Test performed at TBH Immunology) Micro

27




Leukocyte alkaline phosphatase

Neutrophil alkaline phosphatase, NAP; LAP purple

Must be done on fresh finger prick sample - blood applied to slide

Arrange with lab in advance. <30min old specimen Haem

LHON (Lebers Hereditary Optic Neuropathy) purple Do NOT freeze. Reach lab within 5 days Chem IMD

LHON (Lebers Hereditary Optic Neuropathy) skin biopsy 2 to 8 °C. DO NOT FREEZE. Deliver to lab

immediately. Chem IMD

LHON (Lebers Hereditary Optic Neuropathy)

muscle biopsy Frozen. Deliver to lab immediately. Chem IMD

Lipase yellow gel yellow gel ChemLipid electrophoresis yellow gel yellow gel Fasting blood. ChemLipoprotein (a) yellow gel yellow gel ChemLithium yellow gel yellow gel NB! Lithium-free tube. Chem

LKM Ab Anti-liver, kidney, microsomal antibody yellow gel Immuno

Lupus AnticoagulantLAC Screen and Confirm; DRVVT; Dilute Russel's Viper Venom Time

blue To reach lab within 4hrs - contact lab if delay. >15ml blood needed Haem

Luteinizing hormone LH yellow gel yellow gel Chem

Lymphoblasts Lymphs green Do not freeze. Arrange with lab in advance. At least 10ml Chem IMD

Lymphocyte subset analysisT-cell subsets; CD3/CD4/CD8/CD45 (CD16,CD56 if indicated)

purple purple Room temp. DO NOT FREEZE. Reach lab within 24 hours. Haem

MA Ab Anti-mitochondrial antibody yellow gel ImmunoMagnesium Mg yellow gel green Chem

28




Magnesium, urinetimed urine collection or random urine

random urine Collect urine in acid (urine pH < 3) Chem

Malaria investigation Thin and thick film; Malaria antigen test purple purple Haem

Maple Syrup Urine Diseasebranched chain αketo acid dehydrogenase; leucine decarboxylase

skin biopsy Sterile in tissue culture medium or saline. Do not freeze. Arrange with lab beforehand. Chem IMD

McArdle’s disease point mutation analysis

Glycogen phosphorylase; PYGM

purple/dry blood spot Do not freeze Chem IMD

Measles IgG yellow gel ViroMeasles IgM yellow gel Send with urine and EPID form ViroMeasles PCR, CSF CSF ViroMeasles PCR, throat throat swab ViroMeasles PCR, urine urine Viro

Measles notificationurine + yellow top blood

Requires EPID form. Results available from NICD when processed, but this is meant for surveillance and not diagnostics.

Viro

Medium chain Acyl Coenzyme A dehydrogenase point mutation analysis

MCAD; ACADM purple Do not freeze Chem IMD

MELAS purple Room temp. DO NOT FREEZE. Reach lab within 5 days. Chem IMD

MELASMuscle biopsy preferred

Frozen. Send to lab immediately. Chem IMD

Mercury Hg purple purple Chem

MERRF purple DO NOT FREEZE. Reach lab within 5 days. Chem IMD

MERRFMuscle biopsy preferred

Frozen. Send to lab immediately. Chem IMD

29




Metabolic screen, urine random urine random urine

Minimum 10ml. Deliver immediately to lab on ice. Chem

Metanephrines fractionated, urine

Individual normetanephrine and metanephrine levels 24 hour urine 24 hour

urineCollect urine in acid (urine pH < 3). Please supply patient height and weight. Chem

Methaemoglobin MHb green greenNB!! Completely filled tube (5ml). No air. Deliver to lab immediately on ice. Arrange with lab beforehand.

Chem

Methotrexate yellow gel yellow gel Chem

Methyltetrahydrofolate reductase mutation PCR MTHFR mutation PCR purple purple 1X 5ml peripheral blood. To reach lab

within 3 days C21Molecular haem

Microfilaria purple Arrange with lab in advance. Haem

Minor H genotyping mH antigens purple Consult laboratory At least 10ml blood needed (2 tubes) Tissue

ImmunoMitochondrially encoded non-syndromic deafness MT RNR-1 / MT TS-1 purple DO NOT FREEZE. Reach lab within 5

days. Chem IMD

Mitochondrial Polymerase G (POLG) gene POLG purple Do NOT freeze. Must reach lab within 5

days. Chem IMD

Mo cofactor deficiency (hypoxanthine, xanthine, urate levels)

random urine Arrange with lab beforehand. Chem IMD

Mt DNA mutations screen for MERRF, MELAS, NARP, Leighs

purple DO NOT FREEZE. Reach lab within 5 days. Chem IMD


skin biopsy 2 to 8 °C DO NOT FREEZE. Send to lab immediately. Chem IMD



muscle biopsy Frozen. Send to lab immediately. Chem IMD

Mucopolysaccharides Glycosaminoglycans random urine random urine

Minimum 5ml urine. Deliver to lab immediately on ice. Arrange with lab. Chem

30




Multiple carboxylase (pyruvate, propionyl CoA, methylcrotonyl CoA) enzyme activity

skin biopsy Sterile in tissue culture medium or saline. Do not freeze. Arrange with lab beforehand. Chem IMD

Mumps IgG yellow gel ViroMumps IgM yellow gel ViroMumps virus isolation, CSF CSF ViroMumps virus isolation, saliva saliva ViroMumps virus isolation, urine urine ViroMuramidase, serum Discontinued HaemMuramidase, urine Discontinued Haem

Muscle biopsiesUnfixed, wrapped in gauze

Dampened in saline if delayed. Prior booking required.

Histology (Red Cross)

Mycobacterium Tuberculosis PCR, vitreous fluid vitreous fluid

Only done as part of a panel on vitreous fluid. See Microbiology for other MTB PCRs.

Viro

Mycoplasma IFAT Mycoplasma serology yellow gelBeing an IgM test, specimens are assayed on the day after arrival of specimen. (Test performed at TBH Immunology)

Micro

Myoglobin green green Arrange with lab. Deliver to laboratory immediately. Chem

Myoglobin, urine (qualitative) random urine random urine

Minimum 10ml. Deliver immediately to lab on ice. Chem

Myotonic Dystrophy (MYD) purple or amniotic fluid


Genetics (molec)

NARP purple Do NOT freeze. Reach lab within 5 days Chem IMD

NARP skin biopsy 2 to 8 °C DO NOT FREEZE. Send to lab immediately. Chem IMD

NARP muscle biopsy Frozen. Send to lab immediately. Chem IMD

31




Nocardia culture Culture for Nocardia Sample from infected site

Indicate request for Nocardia culture clearly on request form. Micro

NT- ProBNP green green Arrange with lab. Deliver to laboratory immediately. Chem

NTX, urine N-telopeptide, bone resorption marker random urine random

urineSecond morning urine. Protect from light (wrap in foil). Chem

Occult blood, stool random stool random stool

NB!!Deliver to lab immediately (within 8 hours). Chem

Oligoclonal bands, CSFplain tube CSF and yellow gel

plain tube CSF and yellow gel

Send simultaneous blood sample in yellow gel. Chem

Organic acids, urine random urine random urine Minimum 5ml. Deliver to lab immediately. Chem

Ornithine transcarbamylase gene screen OTC gene purple Do NOT freeze. Reach lab within 5 days Chem IMD

Orotic acid Urea cycle disorder Random urine Arrange with lab beforehand. Chem IMD

Osmolality yellow gel green Separate specimen. Deliver to lab immediately on ice. Chem

Osmolality, stool watery stool watery stool Deliver to lab on ice. Chem

Osmolality, urine random urine random urine Chem

Osmotic Fragility Hereditary Spherocytosis purple purple Arrange with lab in advance HaemOsteocalcin yellow gel yellow gel Chem

Oxalate timed urine collection

timed urine collection Acidified urine. Chem

Paracetamol Acetaminophen yellow gel green ChemParathyroid hormone PTH purple purple Chem

Parechovirus, CSF CSF If parechovirus is requested, it will be done together with enterovirus PCR. Viro

Parvovirus IgG yellow gel ViroParvovirus IgM yellow gel Viro

Parvovirus PCR, amniotic fluid amniotic fluid Viro

32




Parvovirus PCR, blood yellow gel Viro

Parvovirus PCR, bone marrow bone marrow Viro

PCP antigen detection PCP DFAT; Pneumocystis jirovecii

screw-top tube

Induced sputum or bronchoalveolar (BAL) washings in a firmly closed screw-top container

Micro

PDH E1a gene (Pyruvate dehydrogenase E 1a)

PDCD / congenital infantile lactic acidosis / intermittent ataxia with lactic acidosis / x-linked Leigh syndrome / PDH A1

purple Do NOT freeze. Must reach lab within 5 days. Chem IMD

Pearson’s disease mtDNA deletions purple Do NOT freeze. Must reach lab within 5 days. Chem IMD

Phosphate, inorganic Phosphate, Pi yellow gel green Chem

Phosphate, urine Phosphate, Pi random or timed urine

random or timed urine

Collect urine in acid (urine pH < 3). For tubular reabsorption of phosphate: require yellow gel / green tube blood taken simultaneously.

Chem

Platelet Aggregation Platelet function test Patient (not sample only) to be referred to Tygerberg Hospital Haem

Platelet count PLT purple purple Haem

PML/RARα APL PCR molecular testing; PML/Raralpha; PML purple purple 1x 5ml BM aspirate - Immediately on ice

and to lab within 24 hrs on ice C21Molecular haem

PNH screen CDPNH purple Must be booked in advance Haem

Porphyria screen (acute or chronic)

urine, stool and EDTA blood

urine, stool and EDTA blood

Protect samples from light Chem

Potassium K yellow gel green ChemPotassium, stool watery stool watery stool Chem

Potassium, urine random or timed urine


33




Prader-Willi/Angelman's Syndrome (PW)



Genetics (molec)

Primary hyperoxaluria - alanin-glyoxylate aminotransferase enzyme activity

liver biopsy Snap-frozen. No additive. Arrange with lab beforehand. Chem IMD

Primary hyperoxaluria (AGXT gene)

alanine-glyoxylate aminotransferase / Primary hyperoxaluria type 1 / Glycolicaciduria

purple Do NOT freeze. Must reach lab within 5 days. Chem IMD

Procalcitonin PCT yellow gel green ChemProgesterone yellow gel yellow gel ChemProlactin yellow gel yellow gel Chem

Propionyl Coa carboxylase enzyme activity skin biopsy Sterile in tissue culture medium or saline.

Do not freeze. Arrange with lab beforehand. Chem IMD

Proprionyl CoA carboxylase whole gene screen HLCS purple Do NOT freeze. Must reach lab within 5

days. Chem IMD

Prostatic specific antigen (total) PSA, Total yellow gel Chem

Prostatic specific antigen,free ratio F-PSA ratio yellow gel Chem

Protein C blueTo reach lab within 4hrs - contact lab if delay. Clinical haematologist authorisation required

Haem

Protein electrophoresis, serum SPE yellow gel yellow gel Chem

Protein S blueTo reach lab within 4hrs - contact lab if delay. Clinical haematologist authorisation required

Haem

Protein, CSF plain tube plain tube Chem

34




Prothrombin mutation PCR Thrombin gene mutation purple purple C21Molecular haem

PTT Partial thromboplastin time; Heparin monitoring blue blue To reach lab within 4hrs - contact lab if

delay Haem

Pus culture Culture (pus)

Pus: sterile swab, screw-top tube or sealed syringe.

Please indicate site as selective media may be required. Micro

Pus microscopy Microscopy (pus)

Pus: sterile swab, screw-top tube or sealed syringe.

Micro

Pyrimidine 5'nucleotidase green Arrange with lab in advance. Chem IMD

Pyruvate grey grey NB. Arrange with chem path registrar. Deliver on ice within 10 minutes. Chem

Pyruvate carboxylase enzyme activity PC skin biopsy Sterile in tissue culture medium or saline.


Pyruvate Dehydrogenase enzyme activity PDH, lactic acidosis skin biopsy Sterile in tissue culture medium or saline.


Pyruvate kinase enzyme activity haemolytic anaemia green or

purpleArrange with lab in advance. Deliver to lab immediately. Chem IMD

Rapid HIV HIV, Rapid yellow gel

Performed on behalf of the Virology lab in cases of sharps injury after 16h00 and before 08h00. Other reasons for testing must be motivated with the Virology consultant on call

Micro

RDD (Retinal Degenerative Disorders)



Genetics (molec)

35




Rectal biopsiesIn 10% formalin as routine

Deliver to lab as soon as possible. Histology (Red Cross)

Red Cell Membrane studiesHereditary red cell membrane disorders eg Hereditary Spherocytosis

gold Arrange with haematologist or registrar on call. 2x ACD tubes (patient) 1x ACD normal control

Haem

Reducing Substances, stool Benedicts qualitative glucose stool stool Minimum 5ml. Deliver to lab on ice. Chem

Reducing Substances, urine Benedicts qualitative glucose random urine random urine Minimum 5ml. Deliver to lab on ice. Chem

Renal biopsies Prior notification required, then contact lab 5-10 minutes in advance for collection. Histology

Renin, active purple purple Transport at room temperature - Do NOT refrigerate. Chem

Respiratory Virus PCR, respiratory secretions

respiratory secretions

Mulitplex PCR for Adenovirus, influenza A and B, RSV, Rhinovirus A, Metapneumovirus, Parainfluenza1/2/3

Viro

Reticulocyte count purple purple Haem

Rett's Syndrome purple or amniotic fluid


Genetics (molec)

RF Rheumatoid factor yellow gel yellow gel ChemRhesus grouping Rh purple purple RXH - send to blood bank Haem

Rickettsia IFAT

Rickettsia serology; Weil Felix (Note: The Weil Felix has been replaced by the more specific Rickettsial serology)

yellow gel Tests are performed weekly.(Test performed at TBH Immunology) Micro

Ro Ab & La Ab Anti-Ro & Anti-La antibody yellow gel ImmunoRotavirus Rapid test, stool stool Viro

RPR Syphilis serology (RPR) yellow gelPositive tests will be confirmed by a specific syphilis test, usually available the next day

Micro

Rubella IgG yellow gel ViroRubella IgM yellow gel Viro

36




Rubella PCR, amniotic fluid amniotic fluid Viro

Rubella PCR, urine urine ViroRyanadine receptor mutation screen RYR1 mutations purple Do NOT freeze. Must reach lab within 5

days. Chem IMD

SACE Serum angiotensin converting enzyme yellow gel yellow gel Deliver directly to Pharmacology. Chem

Salicylate yellow gel green Chem

Schistosoma microscopy Bilharzia microscopy urinePlease indicate this request on the form as this is NOT part of the routine and specifically request a CONCENTRATION.

Micro

SCID point mutation analysis IL-2 gamma chain Receptor; IL2RA purple Do NOT freeze. Must reach lab within 5

days. Chem IMD

SCL70 Ab Anti-scleroderma antibody yellow gel ImmunoSex hormone binding globulin SHBG yellow gel yellow gel Chem

Short Tandem Repeats genotyping, engraftment purple purple C21Molecular haem

Sickling test Sickle cell Anaemia purple purple Fresh sample HaemSMA (Spinal Muscular Atrophy) genetic test 5ml purple Do NOT freeze. Must reach lab within 5

days. Chem IMD

SMA Ab Anti - smooth muscle antibody yellow gel ImmunoSodium Na yellow gel green ChemSodium, fluid plain tube plain tube ChemSodium, stool watery stool watery stool Chem

Sodium, urine random or timed urine


Specific gravity, urine Specific gravity random urine random urine Deliver to lab on ice within 4 hours. Chem

Specific IgE (RAST) yellow gel Give relevant antigen being investigated. ImmunoSpecific IgG - Aspergillus fumigatus yellow gel Immuno

Specific IgG - budgerigar yellow gel Immuno

37




Specific IgG - parrot yellow gel ImmunoSpecific IgG - pigeon yellow gel Immuno

Spinocerebellar Ataxias SCA 1, 2, 3, 6, 7, 12 & 17 purple or amniotic fluid


Genetics (molec)

Sputum culture Culture (sputum) screw-top tube

Sputum, NOT saliva, submitted in a firmly closed screw-top container. If routine, fungal and TB culture required, please indicate order of preference of testing in the event that specimen volume is insufficient for all tests.

Micro

Sputum microscopy Microscopy (sputum) screw-top tube

Sputum, NOT saliva, submitted in a firmly closed screw-top container. Microscopy for pneumocystis must be specifically requested. Pneumocystis microscopy is only performed on INDUCED sputum.

Micro

Steatocrit, stool random stool random stool Minimum 5ml. Chem

Steroid profile, urine timed urine collection

timed urine collection Minimum 200ml. Collect in boric acid. Chem

Steroid-resistant Nephrotic syndrome (NPHS2) gene screen

Congenital nephrotic syndrome / SRN / Podocin gene purple Do NOT freeze. Must reach lab within 5

days. Chem IMD

Stool culture Culture (stool) screw-top tube

Routine culture includes salmonella, shigella and campylobacter. Culture for Vibrio cholerae, enterohaemorrhagic E. coli and any other stool pathogen is only performed on request.

Micro

38




Stool microscopy Microscopy (stool) screw-top tube

Microscopy for cryptosporidium is performed on all children <2, HIV positive patients with chronic diarrhoea (if this information is provided) and patients on chemotherapy, otherwise on request only. Microscopy for microsporidium on request only. If a CONCENTRATION is required to look for specific parasites, please indicate clearly on request form. Please indicate if patient is HIV-positive or has a travel history.

Micro

Succinyl CoA – 3 oxoacid CoA transferase

SCOT; ketothiolase; ketoacidosis

skin biopsy and purple blood

Skin sterile in tissue culture medium or saline. Arrange with lab beforehand. Do not freeze.

Chem IMD

Succinylacetone Tyrosinaemia type 1 Random urine Arrange with lab in advance. Chem IMD

Sulfonylurea purple purple

Requires 10ml blood (2x5ml tubes). Separate red blood cells from plasma and transport both separately. Wrap the plasma in foil

Chem

SURF 1 gene (exon 1- 10) Surfeit locus protein purple Do NOT freeze. Must reach lab within 5 days. Chem IMD

Sweat testsweat collected at lab or ward

Pre-arrange with laborarory Chem

Syphilis - specific antibody test Syphilis TP yellow gelThis specific test has replaced the FTA as a confirmatory test for positive RPRs or as a diagnostic test in early primary syphilis.

Micro

T-cell subsets only (3 antibodies) CD4; CD8 purple purple Fresh sample. Must be booked in advance Haem

Testosterone yellow gel yellow gel Chem

Theophylline yellow gel yellow gel or green Chem

39




Thrombin Time blue blue To reach lab within 4 hrs - contact lab if delay Haem

Thrombophilia ScreenINR, PTT, ProtC, ProtS, ATIII, APCR, LAC, FVLeiden, Prothrombin Gene mutation

purple and blue

To reach lab within 4 hours - contact lab/haematologist if delay. NB genetic testing (FVL, PT mutation) generally not appropirate in African patients. 5ml purple & 15ml blue

Haem

Thrombophilia Screen (FV,PRO and MTHFR)

Thrombophilia mutations; Thrombotic screen purple purple 1X 5ml peripheral blood. To reach lab

within 3 daysC21Molecular haem

Thymidine Kinase 2 TK2 purple Do NOT freeze. Must reach lab within 5 days. Chem IMD

Thyroglobulin Ab & Thyroid peroxidase Ab

Anti thyroglobulin antibodies & Anti thyroid peroxidase antibodies; thyroid antibodies

yellow gel Immuno

Thyroid stimulating hormone TSH yellow gel yellow gel or green Chem

Tissue culture sterile screw-top container

Tissue should be submitted in saline. A small piece of tissue from the infected site should be submitted. DO NOT SENT THE WHOLE SURGICAL SPECIMEN.

Micro

Tissue Typing - Cardiac Transplantion Work-up

yellow - no gel, golden (ACD) and purple

Contact Laboratory

To reach the laboratory within 24-48 hours. At least 5ml clotted blood with gel and 5ml in golden tube (ACD). At least 10ml purple EDTA blood

Tissue Immuno

Tissue Typing - Renal Transplantion Work-up

golden (ACD), yellow gel and purple

Contact Laboratory


Tissue Immuno

Tissue Typing - Bone Marrow Transplantion Work-up

golden (ACD), yellow gel and purple

Contact Laboratory


Tissue Immuno

Total IgE yellow gel Immuno

40




Total protein yellow gel green ChemTotal protein, CSF plain tube plain tube ChemTotal protein, fluid plain tube plain tube Chem

Total protein, urine random or timed urine


Toxocara ELISA Toxocara serology yellow gel Usually batched, performed weekly. Micro

Toxoplasma ELISA Toxoplasma serology yellow gel Usually batched(Mondays).(Test performed at TBH Immunology) Micro

Toxoplasma gondii IgG yellow ViroToxoplasma gondii IgM yellow ViroToxoplasma gondii PCR, amniotic fluid amniotic fluid Viro

Toxoplasma gondii PCR, aspirate aspirate Viro

Toxoplasma gondii PCR, CSF CSF Viro

TPMT (Thiopurine S-Methyltransferase deficiency) genotyping

Risk for thiopurine / azathioprine side effects purple Do NOT freeze. Must reach lab within 5

days. Chem IMD

TPO Ab Anti thyroid peroxidase antibodies; thyroid antibodies yellow gel Immuno

Transferrin Total iron binding capacity; TIBC yellow gel yellow gel Chem

Triglyceride TRIG yellow gel yellow gel Fasting blood. ChemTroponin T Trop T green green ChemTrypanosomes Sleeping sickness purple Fresh sample. CSF and blood Haem

Tryptase, mast cell yellow gelSamples needed: Basal, within 30 min of anaphylaxis & 4 hours after. 15ml blood needed

Immuno

TTG Ab (IgA) Tissue transglutaminase IgA Ab; Coeliac disease yellow gel Immuno

TTG Ab (IgG) Tissue transglutaminase IgG Ab; Coeliac disease yellow gel Immuno

41




Tuberculosis culture Mycobacterial culture; Culture (mycobacterial)

Sample from infected site. TB blood culture bottles are available on request from the microbiology laboratory.

Micro

Tuberculosis microscopy Mycobacterial microscopy; Microscopy (tuberculsosis)

Sample from infected site Micro

Typhoid Culture for TyphoidBlood culture, stool or urine

Micro

Unstable Hb purple purple Sample must be < 24 hours old HaemUrea yellow gel green ChemUrea, fluid plain tube plain tube Chem

Urea, urine random or timed urine


Uric acid Urate yellow gel green ChemUric acid, fluid plain tube plain tube Chem

Uric acid, urine random or timed urine

random or timed urine Urine must be alkalinised (urine pH > 7) Chem

Urinalysis Urine dipstix random urine random urine


Urine culture MSU culture; Culture (urine) screw-top tube

Collect a mid-stream specimen from a properly prepared patient. For patients who are catheterised, collect urine from port above the clamped catheter and NOT from the drainage bag

Micro

42




Urine microscopy MSU microscopy; Microscopy (urine)

screw-top tube

Collect a mid-stream specimen from a properly prepared patient. For patients who are catheterised, collect urine from port above the clamped catheter and NOT from the drainage bag

Micro

Vancomycin yellow gel green GSH specimens to be send directly to Pharmacology Chem

Varicella-Zoster IgG yellow gel Viro

Varicella-Zoster IgM yellow gel Aspirate/swab for VZV PCR preferred test to diagnose chickenpox/shingles Viro

Varicella-Zoster PCR, aspirate V-Z VIRUS PCR aspirate Viro

Varicella-Zoster PCR, biopsy material V-Z VIRUS PCR biopsy in

saline Never in formalin for virological testing Viro

Varicella-Zoster PCR, CSF V-Z VIRUS PCR CSF ViroVaricella-Zoster PCR, swab V-Z VIRUS PCR swab Viro

VDRL, CSF Syphilis serology (VDRL) CSF VDRLs are now only performed on CSF. The RPR has replaced the serum VDRL. Micro

Very long chain fatty acids Adrenoleukodystrophy yellow gel green Deliver to lab immediately. Chem

Vitamin A yellow gel purple Sample must be wrapped in tin foil or black paper Chem

Vitamin B1 Thiamine purple purple ChemVitamin B12 Cobalamin yellow gel yellow gel Chem

Vitamin C Ascorbic acid contact laboratory

contact laboratory

Arrange with chem path registrar. Deliver immediately on ice. Chem

Vitamin D, 1,25 dihydroxy Calcitriol yellow gel yellow gel Deliver to lab immediately. ChemVitamin D, 25 hydroxy yellow gel yellow gel Deliver to lab immediately. ChemVitamin E yellow gel purple Chem

Von Willebrands Factor VWF; Factor VIII related antigen blue blue Arrange with haematologist or registrar on call. Fresh sample. 10ml blood required Haem

White cell count WCC; WBC; Leukocyte count purple purple Sample must be < 24 hours old Haem

43




Widal Typhoid serology; Salmonella serology yellow gel

The diagnosis of typhoid fever is best made by culture of blood, bone marrow, stool or urine. Serological tests are imprecise and difficult to interpret. Available Monday-Friday. Daily batches assayed. (Test performed at TBH Immunology)

Micro

Xylose absorption test contact laboratory

contact laboratory Arrange with lab in advance. Chem

Yersinia serology yellow gelAvailable Monday-Friday. Daily batches assayed. (Test performed at TBH immunology)

Micro

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