BLOOD INVESTIGATIONS-matyie

BLOOD INVESTIGATIONS:

BLOOD INVESTIGATIONS Prepared by : Matyiestenia Gravis MEMo80005

TYPES:

TYPES Baselines : FBC, RFT, LFT, CP Specifics : tumour markers, anti- sDNA , TIBC, serum ferritin

BASELINES:

BASELINES Mandatory Fx : pre-operative assessment + monitor progress of patient + assess complications of disease

Full Blood Count:

Full Blood Count Hb level = anemia MCV, MCH = types of anemia WCC = raised in bacterial infection , low in viral infection Platelet : low ( suspected coagulation problems ) Lymphocytosis : viral Eosinophils : blood parasitism / allergic reactions ESR – raised in chronic infection / disease / malignancy/ autoimmune …such as TB..non-specific CRP – acute inflammation / acute infections

Renal Function Test:

Renal Function Test U & E Electrolyte imbalances – Na , K , CI Urea : raised in renal failure… Uric acid : raised in pre- eclampsia Creatinine : reflects GFR Ca is measured in suspected paraneoplastic lung tumour ( PTH –like substances )

Liver Fx Test:

Liver Fx Test 3 important proteins : Albumin , Globulin, Fibrinogen Albumin : 60 % of total protein.. Reflects productivity of hepatocytes --- goes down in chronic liver disease ALP – secreted by billiary tree cells ..non –specific..produced by bones and prostate too AST & ALT – raised in hepatocyes injury ..AST / ALT > 1 : alcoholic liver disease GGT – Cholestasis & alcoholism ( enzyme-induction ) – alcoholic liver disease + ALP

Clotting Profile:

Clotting Profile Assess if got any bleeding problems If all increased : DIC

SPECIFICS:

SPECIFICS CANCER MARKERS - progress HEPATITIS SEROLOGY PERIPHERAL BLOOD FILM – definitive causes SEROLOGY - rheumatoid factors , anti- dsDna VDRL & RPR – maternal check up HIV SCREENING – hi risk RBS , FBS , OGTT – DM Dengue Serology – HIT, Igm , NS1 , PCR PSA – PROSTATE ISSUE

TUMOUR MARKERS:

TUMOUR MARKERS AFP – HEPATITIS, CIRROCHIS, HCC ( continous ) CEA – colorectal ca CA 125 – ovarian ca ( screening ) CA 19.9 – PANCREATIC CA & GI malignancies B-HCG - choriocarcinoma

DM specific tests:

DM specific tests RBS – > 11.1 mmol /l FBS  7.1 mmol /l OGTT – 75 g/ 300 ml ( 2-hr pp) HbA1c – glycaemic control for the past 3 months > 6.5 % RFT – diabetic nephropathy Urine Dipstick – proteinuria ( 24 hr Protein collections ) p/s : DM is diagnosed by one of tree : OGTT, RBS + symptoms of DM , FBS > 1 occasions…OGTT is rarely done as diagnostic test as it’s costly.

Serum amylase :

Serum amylase Normal : 250 IU/L Markers for acute pancreatitis ( > 1000 IU/L ) Indication : acute abdominal pain Also raised in parotid gland diseases , messentric ischemia , PUD , acute cholecytitis Fx : assess progress of acute pancreatitis ( remain high in pancreatic pseudocyst ) Lipase is more sensitive ( exclusively raised n last longer  good for long term prognosis )

CAUSES OF LIVER CIRROCHIS:

CAUSES OF LIVER CIRROCHIS Chronic viral hepatitis – viral hepatitis serology Copper Overload / Wilson Disease – increase urinary copper excretion , reduced serum copper and caeruloplasmin Hemochromatosis - transferrin , TIBC , serum iron Alcoholic liver cirrochis – GGT, ALP, AST A-1 antitrypsin deficiency – measure it la !

OTHERS…:

OTHERS… Emphysema – a-1 antitrypsin level SLE – anti dsDNA , ANA MI – cardiac enzymes Uric acid – Gout , PIH RA – rheumatoid factor