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LAB

 

The most common blood tests doctors order are listed below. Please access the links to learn about the blood test, why it may have been ordered, and what the lab tests results may mean. Prior to arrival to MISH Hospital and Clinics, please ensure we already have your doctor's lab orders or that you have them with you. Some lab tests require preparation. Please ask your doctor if any preparation is required or call 913-322-7408 for help.

 

 

BLOOD COUNT TESTS


Complete Blood Count with Differential (CBC)
Series of blood tests that provides information about the components of blood including red blood cells, white blood cells, and platelets. CBC test results can help diagnose diseases and determine their severity.


Hemoglobin
Normal range:
  • Male: 13.5 - 17.5 g/dL
  • Female: 12.0 - 16.0 g/dL
Hematocrit
Percent of total blood volume that is made up of red cells.
Normal range:
  • Male: 40 - 55%
  • Female: 36 - 48%
Platelet count
Normal range adult: 150,000 - 400,000/mL
White blood cell (WBC) count
Normal range adult: 5,000-10,000/mL

 

 

BLOOD SUGAR TESTS


A blood test that measures your blood sugar levels

 

Fasting Blood Sugar (FBS or Fasting Glucose)

Elevated levels are associated with diabetes and insulin resistance, in which the body cannot properly handle sugar (e.g. obesity). Eating and digesting foods called carbohydrates forms glucose (blood sugar). Glucose is needed by your body to provide energy to carry out your normal activities. Insulin is needed by the body to allow glucose to go into the cells and be used as energy. Without insulin, the levels of glucose in the blood will rise. Diabetes is a disease that occurs when either the pancreas (an organ in your body) is not able to produce insulin or the pancreas makes insulin, but it does not work as it should. Fasting blood sugar is a part of diabetic evaluation and management. An FBS greater than 126 mg/dL on more than one occasion usually indicates diabetes.

GOAL VALUES:
  • Less than 100 mg/dL = normal
  • Between 110–125 mg/dL = impaired fasting glucose (i.e., prediabetes)
  • Greater than 126 mg/dL on two or more samples = diabetes
PREPARATION:
This test requires a 12-hour fast. You should wait to eat and/or take a hypoglycemic agent (insulin or oral medication) until after test has been drawn, unless told otherwise.


Glycosylated Hemoglobin or Hemoglobin A1C (HbA1C)
Reflects average blood sugar levels over the preceding 90-day period. Elevated levels are associated with prediabetes and diabetes.
Individuals with diabetes have an increased risk of a cardiac event. A diabetic person's risk for heart attack is the same as a non-diabetic person, who has experienced one heart attack, having a second heart attack. Aggressive global preventive risk reduction efforts, such as lower LDL targets, diet, exercise and blood pressure control, are recommended.

GOAL VALUES (per American Diabetes Association guidelines):
  • A range of 5.7-6.4 percent indicates an increased risk for development of diabetes (i.e., prediabetes), and lifestyle interventions may be beneficial.
  • A value equal or greater than 6.5 percent is considered diabetic.
PREPARATION:
This test may be measured any time of the day without fasting.
Glycosylated hemoglobin is blood glucose attached to hemoglobin (a component of blood). This test is often called the "diabetic report card." It reflects the average blood sugar for the two to three month period before the test.
To calculate the average blood glucose level from the HbA1C:
HbA1C level x (multiplied by) 33.3 – 86 = average blood glucose level for the past 90 days. HbA1C can be helpful to track diabetic control over time.

 

 

BLOOD TESTS FOR THOSE TAKING ANTICOAGULANTS (Blood Thinners)


When taking an anticoagulant, it is important to have your blood tested for bleeding times to ensure you are taking your medications safely and not at increased risk for bleeding


Prothrombin Time (PT)
PT is a test to determine how fast it takes for your blood to clot. Usually when taking a "blood thinner," such as warfarin (Coumadin), the desired PT is about one and a half times the normal PT. When checking PT, your doctor will receive the results and let you know if you are taking the correct amount of blood thinner medication.
Normal range for an adult:
  • 9.9-13 seconds
PREPARATION:
This test may be measured any time of the day without fasting.


International Normalized Ratio (INR)
INR is tested for those on anticoagulant medications to prevent stroke, embolism and heart attack.
Normal level for an adult:
  • 0.9 – 1.2. Your doctor will determine your therapeutic range.
PREPARATION:
This test may be measured any time of the day without fasting.

 

 

BLOOD TESTS TO DETERMINE RISK OF CORONARY ARTERY DISEASE


These blood tests help to determine your risk for coronary artery disease and heart attack and guide your treatment.


Lipoprotein a (Lp(a))
“Non-traditional” blood protein associated with higher risk of heart attack and stroke. Lp(a) is LDL (low density lipoprotein) attached to a protein called apo (a). It is not fully known what Lp(a) does, but if Lp(a) is greater than 30 mg/dL, it is related to an increased risk for heart attack and stroke. It is also related to development of fatty matter in vein grafts after bypass surgery, coronary artery narrowing after angioplasty and increased risk for the development of blood clots. If Lp(a) is high, it is even more important to bring the LDL levels down to an acceptable level. Lp(a) is higher in African Americans. The causes of high Lp(a) are kidney disease and certain family (genetic) lipid disorders.
GOAL VALUES:
  • Desirable level for adults: less than 30 mg/dL
PREPARATION:
Blood should be collected after a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check this blood level.

 

Apolipoprotein A1 (Apo A1)
Apo A1 is the major protein of HDL. Low levels of Apo A1 is associated with increased risk of early cardiovascular disease, and may be seen more often in patients with a high-fat diet, inactivity and central obesity.
GOAL VALUES:
  • Desirable level for adults: more than 123 mg/dL
PREPARATION:
Blood should be collected after a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check this blood level.


Apolipoprotein B (ApoB)
A major protein found in cholesterol particles. New research suggests ApoB may be a better overall marker of risk than LDL alone.
GOAL VALUES:
  • Less than 100 mg/dL for those with low/intermediate risk
  • Less than 80 mg/dL for high-risk individuals, such as those with cardiovascular disease or diabetes
PREPARATION:
Blood should be collected after a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check this blood level.

 

Fibrinogen
A protein found in the blood. Encourages blood clotting, but high levels are linked to an increased risk for heart attack and vascular disease. Higher blood pressure, body weight, LDL and age are related to higher levels of fibrinogen. On the other hand, alcohol use and exercise are related to lower fibrinogen levels. Higher fibrinogen levels are also seen with African Americans, and a rise is seen with menopaus
GOAL VALUES:
  • Less than 300 mg/dL
PREPARATION:
Blood should be collected after a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check this blood level.

 

N-terminal-pro-B-type Natriuretic Peptide (NT-proBNP)
"Non-traditional" blood protein made in the heart and found in the blood. High levels are associated with increased risks of cardiovascular disease, heart attack and heart failure development. Elevated levels are associated with development of heart failure and worse prognosis.
GOAL VALUES:
  • Less than 125 pg/mL
PREPARATION:
This test may be performed any time in the day without fasting.

 

LDL-associated PLA2 (PLAC)
This blood test measures the level of lipoprotein associated-phospholipase A2 (Lp-PLA2), an enzyme associated with inflammation, stroke and heart attack risk. However, elevated levels also may be due to non-arterial causes.
GOAL VALUES:
  • Less than 200 ng/mL (normal value) for low relative risk of CVD
  • Between 200-235 ng/mL for intermediate relative risk of CVD
  • More than 235 ng/mL for high relative risk of CVD
PREPARATION:
A 12-hour fast (no food or drink, except water) is required for this blood test. Wait at least two months after a heart attack, surgery, infection, injury or pregnancy for best results.

 

Urine Albumin/Creatinine Ratio (Ualb/Cr)
Albumin is a protein found in urine that can be a sign of increased risk for kidney disease, diabetes complications and cardiovascular risks. If elevated levels of Ualb/CR are present, close attention to blood pressure control, including use of specific blood pressure medications that help protect the kidney, may be recommended. Aggressive global preventive risk reduction efforts, such as closer attention to lipid levels, blood pressure control and diabetes control, are suggested.
GOAL VALUES:
  • More than 30 mg/g indicates increased risk for CVD and diabetic nephropathy
  • More than 300 mg/g indicates clinical nephropathy
PREPARATION:
A clean catch spot urine test can be performed any time in the day and does not require fasting.

 

Ultra Sensitive C-Reactive Protein (HS-CRP)
High Sensitivity (also called Ultra-sensitive) C-reactive protein is known as HS-CRP, US-CRP or CRP for short. It is a protein found in the blood and what we call a "marker" for inflammation, meaning its presence indicates a heightened state of inflammation in the body.
Inflammation is a normal response to many physical states including fever, injury and infection. Inflammation plays a role in the initiation and progression of cardiovascular disease. HS-CRP, combined with a global risk evaluation can provide an overall view of cardiovascular risk. This information is important to develop a plan to improve your cardiovascular health.
In studies involving large numbers of patients, CRP levels seem to be correlated with levels of cardiac risk. In fact, CRP seems to be at least as predictive of cardiac risk as cholesterol levels. The Physicians Health Study, a clinical trial involving 18,000 apparently healthy physicians, was the first large study to show that elevated levels of CRP were associated with a threefold increase in the risk of heart attack.
While elevated cholesterol, LDL and triglycerides and low HDL are all independent risk factors for heart disease and cholesterol build-up, HS-CRP provides additional information about inflammation in the arteries – something not determined by lipid testing alone.
RESULTS:
  • Less than 1.0 mg/L = Low Risk for CVD
  • 1.0 – 2.9 mg/L = Intermediate Risk for CVD
  • Greater than 3.0 mg/L High Risk for CVD
Therefore, testing should not occur while ill or injured. The HS-CRP should be ordered to evaluate CVD risk in apparently healthy individuals who have not had recent infection or other serious illness. Those who have levels of higher than 10 should be evaluated for other sources of inflammation.
PREPARATION:
This test may be measured any time of the day without fasting.

 

Myeloperoxidase (MPO)
MPO is short for myeloperoxidase. MPO is an enzyme. Enzymes are special types of protein found in the body that cause chemical changes. MPO is usually stored in a certain type of white blood cell. These cells release MPO when blood vessels are injured or become inflamed. Your MPO level is a way to assess your risk of heart attack. Research shows that when arteries get inflamed on the inside, it can lead to a heart attack. As cholesterol and fat (plaque) collect and build up in the artery walls, the artery wall becomes inflamed. Eventually, the inflammation gets bad enough that the plaque bursts through the artery wall and into the blood, causing a clot to form. When a clot completely blocks blood flow to the heart, it causes a heart attack. Measuring the level of MPO in your body can help your doctor identify inflammation in your arteries. If you have inflammation, it means you are at a higher risk of having a heart attack.
PREPARE:
Your MPO level will be checked with a simple blood test. You do not need to follow any special instructions for the test. It can be done at any time of the day. You do not need to fast or stop taking any medications. But, if you are having blood drawn for other tests, you may need to follow special instructions not related to the MPO test.
RESULTS:
  • Goal: Low risk: 400 - 480 pmol/L
  • High risk: ≥480 pmol/L

 

 

B-TYPE NATRIURETIC PEPTIDE (BNP) BLOOD TEST


BNP is a substance secreted from the ventricles or lower chambers of the heart in response to changes in pressure that occur when heart failure develops and worsens.
BNP is a substance secreted from the ventricles or lower chambers of the heart in response to changes in pressure that occur when heart failure develops and worsens. The level of BNP in the blood increases when heart failure symptoms worsen, and decreases when the heart failure condition is stable. The BNP level in a person with heart failure – even someone whose condition is stable – is higher than in a person with normal heart function.
PREPARATION:
To test the BNP level, a small amount of blood is taken and placed in a machine that detects the level of BNP in your blood. The test takes about 15 minutes. The BNP level helps to determine if you have heart failure, rather than another condition that may cause similar symptoms. In addition, BNP help the physician make decisions about hospitalizations, aggressive treatments, and future prognosis.
RESULTS:
  • BNP levels below 100 pg/mL indicate no heart failure.
  • BNP levels of 100-300 pg/mL suggest heart failure is present.
  • BNP levels above 300 pg/mL indicate mild heart failure.
  • BNP levels above 600 pg/mL indicate moderate heart failure.
  • BNP levels above 900 pg/mL indicate severe heart failure.

 

 

ELECTROLYTES


Electrolyte levels are useful in detecting kidney, heart and liver disease, and the effects of certain medications (such as diuretics or some heart pills). These substances in the blood that help regulate the proper balance of body fluids. Electrolyte levels are useful in detecting kidney, heart and liver disease, and the effects of certain medications (such as diuretics or some heart pills).


Sodium
Normal range:
  • Male: 135-146 mmol/L
  • Female: 132-148 mmol/L

 

Magnesium
Normal range adult: 1.6-2.4 mg/dL

 

Potassium
Normal range adult: 3.5-5.0 mmol/L

 

 

ENZYME & PROTEIN BLOOD TESTS


A series of blood tests that measure enzymes that are released into the bloodstream when cells are damaged. When cells are damaged, enzymes are released into the bloodstream.

 

Alanine Aminotransferase (ALT; also called SGPT)
A liver enzyme. May increase when using cholesterol-lowering medications.
GOAL VALUE:
  • 5 – 50 U/L
PREPARATION:
This test may be measured any time of the day without fasting.
ALT is an enzyme that is measured to detect liver disease, hepatitis. It may increase with use of some medications.

 

Aspartate Aminotransferase (AST; also called SGOT)
A liver enzyme that is released into the bloodstream following injury or death of cells. Increased AST is seen with liver disease, myocardial infarction (MI) and some medications. May increase when using cholesterol-lowering medications.
GOAL VALUE:
  • 7 – 40 U/L
PREPARATION:
This test may be measured any time of the day without fasting.


Creatinine (Cr)
Creatinine becomes elevated with illness, kidney disease, muscle injury and some medications.
GOAL VALUE:
  • 0.7 – 1.4 mg/dL
PREPARATION:
This test may be measured any time of the day without fasting.

 

Creatine Kinase (CK)
A muscle enzyme found in the heart and muscles. Increased CK-MB is seen with heart muscle damage. Increased CK-MM is noted with skeletal muscle injury. Strenuous exercise, weight lifting, surgical procedures, high doses of aspirin and other medications can elevate CK. May increase when using cholesterol-lowering medications.
GOAL VALUE:
  • 30 – 220 U/L.
CK may also be reported as percentages: CKBB: 0%; CKMB: 0 - 4% ;CKMM: 96 - 100%
PREPARATION:
This test may be measured any time of the day without fasting.

 

Lactate dehydrogenase (LDH)
LDH is an enzyme released in the blood with cell injury. It is often used as a late marker to detect a heart attack. It is also elevated with liver and kidney disease, pernicious and megaloblastic anemias, malignancy, progressive muscular dystrophy, and pulmonary emboli.
GOAL VALUE:
  • 100 - 220 U/L
PREPARATION:
This test may be measured any time of the day without fasting.


Myoglobin (Mb)
Myoglobin is a protein found in certain types of muscle. Elevated myoglobin may indicate muscle injury or inflammation.
GOAL VALUE:
  • 30 – 90 µg/mL
PREPARATION:
This test may be measured any time of the day without fasting. Vigorous exercise right before the test may raise myoglobin levels.

 

Troponin T (cTNT)
Troponin T is a protein found in the blood and is related to contraction of the heart muscle. Troponin T is valuable for detecting heart muscle damage and risk.
GOAL VALUE:
  • 0.0 - 0.10 µg/mL
PREPARATION:
This test may be measured any time of the day without fasting.

 

 

LIPID BLOOD TESTS


Blood tests that provide information about the amount of cholesterol levels in your blood.


Total Cholesterol (TC)
Directly linked to risk of heart and blood vessel disease. Cholesterol is a type of fat, found in your blood. It is produced by your body and also comes from the foods you eat (animal products). Cholesterol is needed by your body to maintain the health of your cells. Too much cholesterol leads to coronary artery disease. Your blood cholesterol level is related to the foods you eat or to genetic conditions (passed down from other generations of family members).
GOAL VALUES:
  • 75-169 mg/dL for those age 20 and younger
  • 100-199 mg/dL for those over age 21
PREPARATION:
This test may be measured any time of the day without fasting. However, if the test is drawn as part of a total lipid profile, it requires a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check cholesterol levels.

 

High Density Lipoprotein (HDL) “Good cholesterol”
High levels linked to a reduced risk of heart and blood vessel disease. The higher your HDL level, the better. HDL is a lipoprotein (a combination of fat and protein) found in the blood. It is called "good" cholesterol because it removes excess cholesterol from the blood and takes it to the liver. A high HDL level is related to lower risk of heart and blood vessel disease.
GOAL VALUE:
  • Greater than 40 mg/dL
PREPARATION:
This test may be measured any time of the day without fasting. However, if the test is drawn as part of a total lipid profile, it requires a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check HDL levels.


Low Density Lipoprotein (LDL) “Bad cholesterol”
High levels are linked to an increased risk of heart and blood vessel disease, including coronary artery disease, heart attack and death. Reducing LDL levels is a major treatment target for cholesterol-lowering medications. LDL is a lipoprotein (a combination of fat and protein) found in the blood. It is called "bad" cholesterol because it picks up cholesterol from the blood and takes it to the cells. A high LDL level is related to a higher risk of heart and blood vessel disease.
GOAL VALUES:
  • Less than 70 mg/dL for those with heart or blood vessel disease and for other patients at very high risk of heart disease (those with metabolic syndrome)
  • Less than 100 mg/dL for high risk patients (e.g., some patients who have multiple heart disease risk factors)
  • Less than 130 mg/dL for individuals who are at low risk for coronary artery disease
PREPARATION:
Blood should be collected after a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check LDL levels.

 

Triglycerides (TG)
Elevated in obese or diabetic patients. Level increases from eating simple sugars or drinking alcohol. Associated with heart and blood vessel disease. Triglycerides are a type of fat found in the blood. The blood level of this type of fat is most affected by the foods you eat (such as sugar, fat or alcohol) but can also be high due to being overweight, having thyroid or liver disease and genetic conditions. High levels of triglycerides are related to a higher risk of heart and blood vessel disease.
GOAL VALUE:
  • Less than 150 mg/dl
PREPARATION:
Blood should be collected after a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check triglyceride levels.

 

 

THYROID BLOOD TESTS


A series of blood tests that provides information about the function of your thyroid gland. The thyroid is a gland located in the neck. It’s job is to take iodine from the blood and combine it with an amino acid (one of the building blocks of protein) to form thyroid hormones. One of the hormones, thyroxine, is responsible for your metabolism. Thyroid function tests help to determine if your thyroid is not working correctly:
hyperthyroid – an over-working thyroid; hypothyroid – poor thyroid function. Abnormal thyroid function is common. It is seen in two to three percent of the entire population. When the thyroid is not working properly, it can cause changes in other blood tests as well


Thyroid Stimulating Hormone (TSH)
An indicator of thyroid function.
  • Normal range for an adult: 0.4 – 5.5 mU/mL
PREPARATION:
This test may be measured any time of the day without fasting.
The brain regulates the amount of thyroid hormones in the blood.
When the hormone levels are low, the brain sends a message to send out TSH. This causes the thyroid gland to send out more hormones.
If blood levels of thyroid hormone are high, the brain senses this and sends a message to stop producing TSH. TSH is a very good test to check for hypothyroidism. TSH is increased with hypothyroid and decreased with hyperthyroid.
Values may be lowered with use of aspirin, corticosteroids and heparin therapy.
Values may be raised with use of lithium, potassium, iodide and TSH injections.


Thyroxine (T4)
Thyroxine is a hormone produced by the thyroid. It is drawn to assess thyroid function. Low T4 is seen with hypothyroidism. High T4 is seen with hyperthyroidism. The T4 blood test can also be used to monitor the effectiveness of medications used to treat thyroid disease.
Estrogen, anticonvulsants, aspirin use and anticoagulants may affect T4 levels. They are increased with pregnancy.

  • Normal range for an adult: 5 – 11 µg/dL
PREPARATION:
This test may be measured any time of the day without fasting.


Microsomal Thyroid Antibodies (TPO)
Thyroid antibodies are present if hypothyroid is related to thyroiditis. Hypothyroid can be caused by primary thyroid disease. It also can be related to other health problems, such as glucocorticoid or amiodarone use, osteoporosis, pregnancy, insulin dependent diabetes and liver disease.
Desirable level for an adult: 0.0 - 5.0 IU/mL
PREPARATION:
This test may be measured any time of the day without fasting.

 

 

WASTE PRODUCTS IN THE BLOOD


Tests that provide information about the waste products in the blood excreted by the kidneys. Waste products are usually excreted by the kidneys. High levels of waste products in the blood may mean that the kidneys are not working as they should.


Blood Urea Nitrogen (BUN):
High levels of BUN can also be found in those on high-protein diets and/or with strenuous exercise.
GOAL VALUES:
  • Male: 10 – 25 mg/dL
  • Female: 8 – 25 mg/dL

 

Serum Creatinine (CR): An indicator of kidney function
GOAL VALUE:
  • 0.7 – 1.4 mg/dL

 

Uric Acid:
High levels of uric acid are also found in those with gout, arthritis and some metabolic disorders.
GOAL VALUES:
  • Male: 3 – 8 mg/dL
  • Female: 2 – 7 mg/dL

 

Urine Albumin Creatinine Ratio (U Alb:Cr):
Measures whether there is any protein in the urine. A small amount of protein in the urine is a risk factor for heart and blood vessel disease.
GOAL VALUES:
  • Less than 30 mg/g

MISSION, VISION, AND GOAL

Our Mission: MISH Hospital and Clinics provides high-quality care and programs that set community standards and exceed patient expectations. Services are provided in a caring, convenient, cost-effective and accessible environment.

Our Vision: MISH Hospital and Clinics strives to be recognized as a leader in patient care. We are people working together to do the right thing every day to improve the health and well-being of every person we serve. 

Our Goal: The goal of MISH Hospital and Clinics is to provide excellent and innovative patient care in a supportive and approachable care environment.