Download 6. Chemical Pathology and Haematology

Chemical Pathology & Haematology
VI Chemical Pathology & Haematology
1 Contact information
Address Clinical Pathology Laboratory Centre
5/F & 6/F, Lek Yuen Health Centre, 9, Lek Yuen Street, Shatin, N.T. Opening hours
Monday – Friday Saturday 9:00am – 5:00pm
9:00am – 1:00pm
Telephone no.
General enquiries
2687 4961
Chemical Pathology Laboratory (CPL)
Haematology & Serology Laboratory (HSL)
2687 4957
2687 4953
Senior Medical Technologist (CPL)
Senior Medical Technologist (HSL)
Senior Medical Technologist (CPL)
2687 4975 2687 4979 2687 4974 Scientific Officer (Medical) (CPL) Scientific Officer (Medical) (HSL) 2687 4994
2687 4995
Senior Medical & Health Officer Consultant Pathologist 2687 4977
2687 4984
2687 4949 2687 4954 Facsimile no.
General enquiries
Request for laboratory report
2699 4221 2694 7949 Suggestions and feedback
Quality Manager 2687 4994 / 2687 4995
2 Specimen containers
(a) Bar-coded collection tubes and containers:
For DH users : Blood and spot urine tests are required to be collected in tubes with bar code
labels (Table 1). The main portion of the label is firmly stuck to the tube and the oval portion
is designed for peeling off and sticking on to the request form for identification & matching.
For HA GCRS e-ordering users : GCRS specimen labels printed at blood collection /
submission of spot urine specimen should be affixed to corresponding tubes provided
(Table 1).
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Chemical Pathology & Haematology
Table 1: Tubes with or wihout bar codes for collection of blood and spot urine
Tube
with bar code
Colour Volume after filling Major Tests
of cap to the mark on tube (Please refer to Appendices 1 & 2)
Gel tube
Yellow 3.5 mL
LFT, RFT, iron, TIBC, lipid profile,
fructosamine, amylase, etc.
Plain tube
Red
4 mL
-
Fluoride tube
Grey
2 mL
Glucose
EDTA tube
Purple 3 mL
CBC, ESR, haemoglobin pattern,
haemoglobin A1c, lead, etc.
Citrate tube
Blue
2.7 mL
Coagulation study
3 mL
ACR, protein / creatinine ratio
Plain spot urine tube White
Hormones including thyroid hormones
Tumour marker e.g. PSA, AFP
Immunochemistry e.g. C3, C4, RF
Drugs, vitamin B12, serum folate
Antibody detection: Antinuclear
antibodies, etc.
(b) Collection tubes & containers without bar codes:
Tube/Container
without bar code
Feature
Sample type
Test
(Please refer to Appendices 1 & 2)
EDTA tube
Purple cap
3 mL of blood Blood groups (ABO, Rh(D) ) only
Plastic container
No preservative Semen
Semen analysis
Plastic container
No preservative Stool
Occult blood
Plain bottle
No preservative; Urine, body
Size ~ 25 mL
fluid
Body fluid for chemistry test
Spot urine for chemistry test e.g. chyle,
porphyrins
24-h urine bottle
Size of 4 L
24-hour urine for chemistry test
24-hour urine
(c) Specimen tubes/containers can be obtained as described in section VII of this handbook and
preferably on monthly basis. The quantity requested should be based on the usual
consumption of the unit. Keep the tubes/containers in a cool and dry place before use.
3 Request form
For users of GCRS and CIMS (the ordering system in Hospital Authority (HA) and Department
of Health (DH) respectively), please follow the guidelines issued by HA and DH accordingly, in
sending laboratory requests to Clinical Pathology Laboratory Centre (CPLC).
(a) Types:
No.
Use for
DH2456 *
Tests of Haematology & Serology, Chemical Pathology; except Blood Grouping.
DH2457
Blood Grouping only
* (rev.16) is the latest version. Sep 2016
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(b) Enter all the fields in the request form:
Field
Requirement
Note
Surname
Block letters, clear & legible
Shown on the report
Other Names
Block letters, clear & legible
Shown on the report
HKID No.
Legible, including check digit
Shown on the report
Sex@
Male (or M); Female (or F)
Shown on the report
Date of birth is desirable; DO NOT enter
“adult”, “child”
Age shown on the report
Clinical Diagnosis
Diagnosis and/or history
Maximum 50 characters
Useful information
Dr
Block letters, clear & legible
Shown on the report
Signature
MUST be provided
Report to
Clinic/Institution
Clinic code
Clinic name and LIS code
(Chop is preferred)
Clinic/Institution
reference
As a reference for clinic staff, such as AN Shown on the report for
no., room no. etc. to facilitate sorting/filing. clinic use if it is provided
Maximum 14 characters
on the request form.
Age/DOB
@
Date Requested
Date & Time Sample
Collected
Clinic name shown on the
report
Necessary information
State clearly & legibly BOTH date and Shown on the report
time.
@
If sex / age is not indicated, sex / age-dependent reference ranges will not be shown on the
report.
For the above-collected patient information, CPLC adopts Department of Health’s ‘Policy and
Guidelines on the Handling of Personal Data under the Personal Data (Privacy) Ordinance’.
(c) Tick the boxes to order the test(s); write other test(s) at the lower left corner.
Tests included in the profile tests:
Profiles
Tests included
Liver function test
Total protein, Albumin, Total bilirubin, Alk. Phosphatase, ALT
Renal function test
Sodium, Potassium, Urea, Creatinine
Lipid profile
Cholesterol, Triglycerides, HDL-cholesterol, calculated LDLcholesterol
Thyroid function test
TSH (Refer to Table 2 for Laboratory Investigation Protocol)
CBC
Haemoglobin, RBC, Hct, red cell indices, WBC, Platelet count
CBC & Diff
Haemoglobin, RBC, Hct, red cell indices, WBC, Platelet count,
differential count on white cell
(d) Prepare the appropriate tubes/containers for sampling as indicated in Appendices 1 & 2.
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(e) A patient’s demographic data (name, sex, ID number, date of birth) must be the same in each
request. If the current data is different from the previous one (as checked by the DH
Laboratory Information System), the request form will be faxed to the clinic for clarification.
Clinic staff has to sign and date for amendments made on the request form. The report will be
withheld until the data concerned are clarified.
(f) The Laboratory staff will not change or enter any data/information obtained over the phone
on behalf of clinic staff.
4 Specimen
(a) Safety practice in specimen collection:
 Collect specimen using safety precautions and personal protective equipment in
accordance with infection control guidelines of your institution.
 Dispose of any potentially contaminated materials used for specimen collection in
accordance with infection control guidelines of your institution and Code of Practice
promulgated by the Environmental Protection Department.
(b) Each sample must be collected in an appropriate tube/container; the specimens have to be
treated appropriately according to the requirement listed in this Handbook.
(c) Fresh samples are recommended for analysis; accuracy of the results may be affected if the
specimens are stored overnight. Presence of haemoglobin, lipoprotein and bilirubin in serum
and plasma may have interfering effect on some laboratory tests. Details are provided on
laboratory reports.
(d) Blood and semen specimens for the following tests require same day delivery to CPLC for
immediate processing:
Chemical Pathology
Haematology & Serology
Ceruloplasmin
Creatine kinase (CK)
Lactate dehydrogenase (LD)
Magnesium
Osmolality
Phosphate, inorganic
Potassium
Serum folate
Vitamin B12
Antenatal Screening for MCV
Coagulation studies (e.g. PT, APTT)
(Send to CPLC within 2 hours
after collection)
ESR
Semen analysis
(Send to CPLC within 1 hour
after collection)
Anti-dsDNA
(e) Other specimens may be stored overnight at 4oC if same day delivery to the laboratory is
not possible.
(f) Blood must be filled to the mark of the tube (gel / plain / EDTA / fluoride / citrate).
(g) For 24-urine specimen collection, the bladder should be emptied at the start time, without
collecting the urine. Thereafter and within the next 24 hours, all urine passed should be
collected, including the urine voided at the end of the 24-hour period. The start and end time
of urine collection should be clearly written on the specimen container.
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(h) Label the specimens clearly, legibly and correctly:
﹣ Check that the entry/entries on the tube/container is/are correct and identical to that
of the request form. Entries of “Name” should be in the same language, otherwise, are
not treated as identical.
﹣ Peel off the oval bar code from each specimen and stick it on the lower right corner of
the request form. One oval sticker corresponds to one specimen tube.
For DH clinics:
Type of Tube/Container
Label required
Remarks
Tube with bar code
HKID number (or other ID
(gel/plain/EDTA/fluoride/citrate/ number) **
plain urine)
DO NOT write over/mask
the bar codes
EDTA tube without bar code:
For Blood Grouping only
Name, HKID no. (or other ID *Blood grouping
no.), Clinic name/code &
specimens must be
Clinic’s reference no.
labelled with 4 entries
Citrate tube without bar code
Name and HKID number
2 entries are required for
non bar-coded tube
Plastic container / bottle and other Name and HKID number
special container
2 entries are required for
non bar-coded tube
* Specimen for Blood Grouping using EDTA tube with or without bar code: the label
requirement is the same - Name, HKID no. (or other ID no.), clinic name/code & clinic’s
reference no.
** Guidelines for sticking gum label on collection tubes with bar code:1. Stick the gum label along the collection tube, exposing BOTH bar code and number,
and leaving a window for inspection of the sample. (Please refer to the picture below)
2. DO NOT use scotch tape to stick the gum label.
3. DO NOT write over / mask the bar code and the number.
4. The length of the gum label shall not cover the round end or the cap of the tubes.
Leave a window
for inspection
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For HA GCRS e-ordering clinics, GCRS specimen labels should be used.
Guidelines for sticking GCRS barcode label on specimen collection tube:
1. Stick the top margin of the label just below the ‘LOT’ number information
2. Stick the right margin of the label close to but not beyond the round bottom of the
tube.
1. below the ‘LOT’ number information
2. close to the round bottom

3.
Pay attention to the orientation of the label. (see diagram)
 4.
Roll the label along the surface of the tube as shown. Crease on label is not acceptable.
Roll the label along the surface of the tube
Crease on label is NOT acceptable
5.
Keep a clear window for sample inspection.
Keep a clear window for inspection
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6.
To ensure effective barcode reading by CPLC analysers, the first alphabet of HKID
should be fully and clearly shown on the GCRS label.

5

Packing and dispatch
(a) With effect from September 2016, no request forms are required for HA GCRS users, while
request forms are still in use for DH and other users.
(b) Check that the specimens match with the tests ordered.
(c) Fold the request form twice without creasing the bar code(s) on the form.
(d) Place the specimen(s) of the client together with the folded request form in one mediumsized plastic zip-bag.
(e) Firmly seal the zip-bag to hold the request form and the corresponding specimen(s) in one
pack.
(f) Gather all the medium-sized zip-bags in one large plastic bag, which bears a green “CPLC”
label, and dispatch it to Clinical Pathology Laboratory Centre at Lek Yuen Health Centre,
Shatin. Stamp clinic name on the green “CPLC” label for identification of sender.
(g) Ensure that the “CPLC” bag does not contain specimens for Virology, Bacteriology, VDRL,
Cytology, TB tests - they are tested in Public Health Laboratory Centre, Shek Kip Mei.
(h) In case there is unavoidable delayed delivery of specimens, e.g. suspension of service due to
Typhoon signal no. 8, keep these specimens in one single pack and label date of collection
clearly on the green “CPLC” label before dispatch upon resumption of service.
(i) Do not insert ice-chilled specimen in the bag that contains other specimens i.e. the icechilled device should not be allowed to come in direct contact with other specimens
otherwise cell lysis may be induced. There shall be a sturdy outer carrier for the ice-chilled
specimen during transportation, e.g. a small size cooler or a plastic carrier. With proper
labelling, the carriers will be returned, if necessary, to clinics for re-use.
6 Reports
(a) The users who receive the laboratory reports at their fax machine via our Laboratory
Information System (LIS) should note the followings:
(1) The fax machine is ON and there is adequate paper in the machine to receive the fax
reports in batches after office hours (scheduled LIS-fax).
(2) Urgent/critical results will be sent by fax as soon as possible.
(3) Turnaround time (TAT) of report depends on the mix of tests requested. The TAT in
Appendices 1 and 2 refers to the specific test(s) only.
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(b) Clinics/units will receive the LIS-reports in batches within the turnaround time. If the
clinic/unit wants the report before or after the LIS-fax schedule, the staff responsible should
complete a “Urgent Request for Laboratory Report” form and fax to Reception Section (Fax
no.: 2694 7949; Tel no.: 2687 4920) for arrangement.
(c) Biological reference intervals of tests requested are provided on laboratory reports for
interpretation of laboratory results. The reference intervals may be revised as needed. The
information will be indicated on the laboratory report.
7 Additional notes for sending specimens
(a) Generally, one request form (DH2456) is for ordering multiple tests of Chemical Pathology,
Haematology & Serology, which are packed together with the specimens in one mediumsized zip-bag.
However, 2 request forms are required for ordering Antenatal Screening
DH2456 for [Antenatal / MCV Screening]; and
DH2457 for [ABO, Rh(D)]
Use separate DH2456 request form for
Tests that require ice-chilled specimen, e.g. PTH
Specimen other than blood, e.g. urine, faeces
(b) 2 EDTA-specimens are required when:
-
Sep 2016
HbA1c and Hb pattern are requested
Lead analysis and CBC are requested
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Appendix 1 - Chemical Pathology - List of tests and notes
TEST
(Blood)
Volume of
blood
Specimen
container
Alanine aminotransferase (ALT)
Albumin
Alkaline phosphatase
Alkaline phosphatase, heat stable
isoenzyme
Alpha-fetoprotein (AFP)
Amylase
^Antitrypsin, alpha-1
Aspartate aminotransferase (AST)
Bilirubin, direct
Bilirubin, total
^ Ceruloplasmin
3.5 mL
3.5 mL
3.5 mL
3.5 mL
GT
GT
GT
GT
2
2
2
7
4 mL
3.5 mL
4 mL
3.5 mL
3.5 mL
3.5 mL
4 mL
P
GT
P
GT
GT
GT
P
4
2
12
2
2
2
12
Calcium
Carbamazepine (Tegretol)
3.5 mL
4 mL
GT
P
Carbon dioxide (CO2) content
Carcinoembryonic antigen (CEA)
Chloride
Cholesterol (total)
3.5 mL
4 mL
3.5 mL
3.5 mL
GT
P
GT
GT
Cholesterol, high density lipoprotein
(HDL-cholesterol)
Cholesterol, low density lipoprotein
(LDL-cholesterol)
3.5 mL
GT
Pseudocholinesterase
Complement C3
Complement C4
Cortisol
3.5 ml
4 mL
4 mL
4 mL
GT
P
P
P
Creatine kinase (CK)
C-Reactive protein (CRP)
Creatinine
^ Digoxin
3.5 mL
4 mL
3.5 mL
4 mL
GT
P
GT
P
Ferritin
3.5 or 4 mL
Folate (serum)
4 mL
^ Follicle stimulating hormone (FSH)
4 mL
Fructosamine
3.5 mL
Gamma-glutamyl transferase (GGT)
GT: Gel Tube
Sep 2016
P: Plain Tube
3.5 mL
GT / P
P
P
GT
Notes on collection & storage, remarks (if any)
T/T
(day)
Prolonged storage at room temperature leads to
decreased levels.
Take blood immediately before next dose.
State the collection time (e.g. 10:30 am) on the
request form.
2
7
2
7
2
2
12-hour fasting is required if LDL-C is
requested.
12-hour fasting is required if LDL-C is
requested.
2
12-hour fasting is required.
Calculated LDL-cholesterol = Total cholesterol Triglycerides x 0.45 - (HDL-cholesterol).
Not applicable with triglycerides > 4.5 mmol/L and in
the presence of chylomicrons.
2
For insecticide (organophosphates) poisoning.
Fasting blood sample is required.
Fasting blood sample is required.
Take blood at 07:00 - 09:00 hour, 16:00 - 18:00
hour.
State the collection time (e.g. 10:30 am) on the
request form.
2
10
10
7
Fasting blood sample is required.
Take blood > 6 hours post dose.
State the collection time (e.g. 10:30 am) on the
request form.
Fasting blood preferable. Protect from light.
Should be interpreted with care when there is
abnormal serum protein concentration.
GT
2
10
2
7
7
7
12
2
2
^:Referral test
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Chemical Pathology & Haematology
TEST
(Blood)
Volume of
blood
Specimen
container
Notes on collection & storage, remarks (if any)
T/T
(day)
Glucose
2 mL
F
2
Glucose tolerance test (GTT)
(75 g anhydrous glucose (MW 180)
or 82.5 g monohydrate glucose (MW
198))
^ Growth hormone
2 mL
F
4 mL
P
If the blood is drawn after fasting overnight,
indicate “fasting” on the form; if not, mark the
time (hours postprandial) on the form.
Take normal diet for 3-4 days and then fast
overnight before blood taking/glucose loading.
State the collection time (e.g. 10:30 am) on the
request form.
Random samples are of little value. It should be
requested as part of a stimulation or suppression
test.
^ Haptoglobin
^ Human chorionic gonadotrophin
(HCG)
Immunoglobulin A (Ig A)
^ Immunoglobulin E (IgE)
Immunoglobulin G (Ig G)
Immunoglobulin M (Ig M)
Immunoglobulin pattern
(IgA, IgG, IgM)
Iron & total iron binding capacity
(TIBC)
4 mL
4 mL
P
P
4 mL
4 mL
4 mL
4 mL
4 mL
P
P
P
P
P
3.5 mL
GT
Iron saturation
Lactate dehydrogenase (LD)
Lead
3.5 mL
3.5 mL
3 mL
GT
GT
EDTA
Lithium
Liver function test (LFT)
(Includes total protein, albumin, total
bilirubin,
alkaline
phosphatase,
alanine aminotransferase)
^ Luteinizing hormone (LH)
Magnesium
4 mL
3.5 mL
P
GT
4 mL
3.5 mL
P
GT
^ Oestradiol (Estradiol)
Osmolality
4 mL
4 mL
P
P
^ Parathyroid Hormone, PTH
3 mL
EDTA
^ Phenobarbital (Luminal)
4 mL
P
Phenytoin (Dilantin)
4 mL
P
GT: Gel Tube
Sep 2016
P: Plain Tube
F: Fluoride Tube
2
12
12
12
Fasting blood sample is required.
10
21
10
10
10
Fasting blood sample is required.
Fasting blood sample is required.
Fasting blood sample is required.
Collect morning sample for the test. State the
collection time (e.g. 10:30 am) on the request
form.
Calculated iron saturation=(Iron / TIBC)*100%
Use only EDTA tube provided by PHLC. One
EDTA-blood solely for Lead; not shared with
other tests.
Take blood at 12 hours post dose.
State the collection time (e.g. 10:30 am) on the
request form.
Avoid contamination of blood with ethanol or
propanol.
The specimen should be wrapped in a plastic
bag and kept in an ice-chilled box / container
during transportation.
See additional
information in section 5(h) on ‘Packing and
Dispatch’.
Take blood immediately before next dose.
State the collection time (e.g. 10:30 am) on the
request form.
Take blood immediately before next dose.
State the collection time (e.g. 10:30 am) on the
request form.
2
2
2
12
7
2
12
2
12
2
21
7
7
^:Referral test
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Chemical Pathology & Haematology
TEST
(Blood)
Volume of
blood
Specimen
container
Notes on collection & storage, remarks (if any)
T/T
(day)
Phosphate, inorganic
3.5 mL
GT
2
Potassium
3.5 mL
GT
State the collection time (e.g. 10:30 am) on the
request form.
State the collection time (e.g. 10:30 am) on the
request form.
^ Progesterone
^ Prolactin
Prostate specific antigen (PSA)
^ Protein electrophoresis pattern
Protein, total
Renal function test (Includes sodium,
potassium, urea, creatinine)
Rheumatoid factor (RF)
Sodium
^ Testosterone
^ Theophylline
4 mL
4 mL
4 mL
3.5 mL
3.5 mL
3.5 mL
P
P
P
GT
GT
GT
4 mL
3.5 mL
4 mL
4 mL
P
GT
P
P
Thyroid function test
4 mL
P
Thyroxine, free (FT4)
4 mL
P
Triiodothyronine, free (FT3)
4 mL
P
Thyroid stimulating hormone (TSH)
4 mL
P
Triglycerides
3.5 mL
GT
Urate (Uric acid)
Urea
Valproate (Valproic acid)
3.5 mL
3.5 mL
4 mL
GT
GT
P
4 mL
P
Vitamin B12
GT: Gel Tube
P: Plain Tube
2
12
12
4
14
2
2
Qualitative test
Fasting blood sample is required.
Take blood immediately before next dose. State
the collection time (e.g. 10:30 am) on the
request form.
Laboratory Investigation Protocol :
* please refer to Table 2
Laboratory Investigation Protocol :
* please refer to Table 2
Laboratory Investigation Protocol :
* please refer to Table 2
Laboratory Investigation Protocol :
* please refer to Table 2
A fasting sample, for at least 12 hours, is
required. This should be indicated on the
request form.
Take blood immediately before next dose.
State the collection time (e.g. 10:30 am) on the
request form.
Fasting blood preferable. Protect from light.
10
2
12
7
4
4
4
4
2
2
2
7
7
^:Referral test
* Table 2
Clinical Information
Suspected hyperthyroidism
Initial Test
TSH
Hyperthyroidism on treatment
Suspected hypothyroidism
TSH, FT4
TSH
1 hypothyroidism or post thyroid surgery on thyroxine
2 hypothyroidism on thyroxine
TSH, FT4
FT4
Sep 2016
Further Test
FT4 if TSH result
abnormal
FT3 if indicated
FT4 if TSH result
abnormal
VI - 11 of 18
Chemical Pathology & Haematology
TEST
(Urine – fresh sample required)
Albumin
^ Bence Jones protein
^ Calcium
Catecholamines
^ Cortisol
Creatinine
Creatinine clearance test
(Blood and urine creatinine)
Chyle
^ 5-Hydroxyindoleacetic acid
(5-HIAA)
^ Lead
Osmolality
^ Phosphate, inorganic
^ Porphobilinogen
^ Porphyrins
Potassium
Protein, total
^ Reducing substances
PU: Plain Urine Bottle
24B: 24-hours Urine Bottle
Sep 2016
Minimum Specimen
T/T
volume of container Notes on collection & storage, remarks (if any) (day)
urine
@
24B
Use first morning sample where practicable.
5
24 hr
@
@
( or 3 mL ) ( or PUB ) Same day delivery unless kept refrigerated.
Do not collect specimen after exertion, in the
presence of urinary tract infection, during acute
illness, immediately after surgery, during
menstruation, or after an acute fluid load.
20 mL
PU
Qualitative test. Send urine to laboratory 14
immediately.
24 hr
24B (A)
5
24 hr
24B (A) Avoid patient stress, exercise, smoking, pain 14
and caffeine products. The patient should not
be subjected to hypoglycaemia or exertion.
Some drugs (e.g. labetalol) may interfere the
assay.
24 hr
24B
12
24 hr
24B
Same day delivery unless kept refrigerated.
5
24 hr
24B
Same day delivery unless kept refrigerated.
5
Provide height and weight of the patient for
calculation.
10mL
PU
Qualitative test
7
24 hr
24B(A) Bananas, pineapples, egg plant, tomatoes, 14
plums, and walnuts must be excluded from diet
1 day prior to and during specimen collection.
Phenothiazines should likewise be discontinued.
Protect the specimen bottle from light.
24 hr
24B
For known lead poisoning case only.
14
Acid-washed container is required. Call 2687
4920 for arrangement.
3 mL
PU
Keep refrigerated
2
.
24 hr
24B (A)
5
10 mL
PU
Qualitative test. Wrap the specimen bottle in
dark paper to protect from light; send it to
laboratory immediately.
20 mL
PU
Qualitative test. Wrap the specimen bottle in
dark paper to protect from light; send it to
laboratory immediately.
@
24B
Random urine potassium is useful ONLY
24 hr
( or 3 mL@ ) (or PU@ ) when serum potassium is also performed at the
same time.
For calculation of transtubular potassium
gradient (TTKG), paired urine and blood
specimens are required.
24 hr
24B
Same day delivery unless kept refrigerated.
( or 3 mL) ( or PUB )
10 mL
PU
Qualitative test. Send urine to laboratory
immediately. Large quantities of salicylates,
penicillin, ascorbic acid, nalidixic acid,
cephalosporins,
creatinine,
uric
acid,
probenecid may cause false positive results.
This test is of limited clinical utility in adults.
12
12
5
5
7
PUB: Plain Urine Bottle with barcode
^: Referral test
24B(A): 24-hours Urine Bottle (Addition of preservative)
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Chemical Pathology & Haematology
TEST
(Urine – fresh sample required)
Sodium
Vanillylmandelic acid (VMA)
PU: Plain Urine Bottle
24B: 24-hours Urine Bottle
Minimum Specimen
T/T
volume of container Notes on collection & storage, remarks (if any) (day)
urine
@
24B
Random urine sodium is useful ONLY when
5
24 hr
( or 3 mL@ ) (or PU@ ) serum sodium is also performed at the same
time.
24 hr
24B (A) Monoamine oxidase inhibitors and methyldopa 14
may
decrease
VMA
output.
L-dopa,
phenothiazines and tricyclic antidepressant may
have a variable effect on VMA production.
PUB: Plain Urine Bottle with barcode 24B(A): 24-hours Urine Bottle (Addition of preservative) TEST
(Other body fluids)
Minimum Specimen
volume of container Notes on collection & storage, remarks (if any)
fluid
Send fresh body fluid to laboratory immediately after collection.
Amylase
4 mL
P / PB
Chloride
4 mL
P / PB
Creatinine
4 mL
P / PB
Glucose
2 mL
F
Lactate dehydrogenase (LD)
4 mL
P / PB
Potassium
4 mL
P / PB
Protein, total
4 mL
P / PB
Sodium
4 mL
P / PB
Urate (Uric acid)
4 mL
P / PB
Urea
4 mL
P / PB
P: Plain Tube
PB: Plain Bottle
TEST
(Miscellaneous)
^ Calculus
PB: Plain Bottle
Sep 2016
T/T
(day)
2
2
2
2
2
2
2
2
2
2
F: Fluoride Tube
Volume
Whole
portion
Px: Plastic container
Specimen
container
PB / Px
Notes on collection & storage, remarks (if any)
T/T
(day)
12
^: Referral test
VI - 13 of 18
Chemical Pathology & Haematology
TEST
(Faeces)
Occult blood
Minimum
volume of
faeces
5g
Specimen
Notes on collection & storage, remarks (if any)
container
Px
Same day delivery to CPLC is recommended. If
not possible, store at 2-8oC before delivery on
the next day. Do not submit more than one
specimen per bowel motion. Do not collect
specimen during menstruation or diarrhoea.
Qualitative test –
It is recommended that the patient be placed
on a high residue diet starting 2 days before
the test period.
DIET MAY INCLUDE:
Meats:
Only small amounts of well-cooked
chicken, turkey and tuna.
Vegetables:
Generous amounts of vegetables including
lettuce, corn, spinach, carrots and celery.
Fruits: Plenty, especially prunes & apples.
Cereals: Bran and bran-containing cereals
AVOID:
Meat:
Diet should not include any red or rare meat
e.g. beef, lamb
Fruits & vegetables:Restriction of peroxidase rich fruits and
vegetables such as broccoli, cauliflower,
turnip, horseradish, parsnip, red radishes,
and cantaloupe.
OTHER FACTORS which affect the test:
Medications:
For 7 days prior to test and during the
testing, do not ingest aspirin or other antiinflammatory medicines. For 2 days prior to
and during testing, do not use rectal
medicines or tonics or vitamin preparations
which contain Vitamin C (ascorbic acid) in
excess of 250 mg per day.
T/T
(day)
4
Px: Plastic Container
Sep 2016
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Chemical Pathology & Haematology
Appendix 2 - Haematology & Serology - List of tests and notes
Volume of
blood
Specimen
container
Complete Blood Count
[CBC (+ Diff / Retic / RBC
Morphology)]
3 mL
EDTA
Antenatal Screening (CBC)
Excluding Blood Grouping
3 mL
EDTA
Erythrocyte Sedimentation Rate
[ESR]
3 mL
EDTA
Prothrombin Time (with or without
International Normalized Ratio)
[PT (+ INR)]
3 mL
Citrate
Blood for coagulation studies must be freshly
drawn, filled exactly to the mark of the tube.
State the collection time (e.g. 10:30 am) on the
request form.
Send to CPLC within 2 hours.
2
Activated Partial
Time [APTT]
3 mL
Citrate
Blood for coagulation studies must be freshly
drawn, filled exactly to the mark of the tube.
State the collection time (e.g. 10:30 am) on the
request form.
Send to CPLC within 2 hours.
2
EDTA
All blood grouping—use only DH2457
1 EDTA blood + DH2457 in one medium-sized
zip-bag.
DO NOT use this request form for Antenatal /
MCV screening.
3*
TEST
Notes on collection & storage, remarks
T/T
(day)
Blood Counts:
2
CBC will be reported when a stamp of “MCV
Screening in MCHC” is marked; no need to tick
any box of DH2456.
2
2
Coagulation Studies:
Thromboplastin
Immunohaematology & Serology:
ABO Grouping & Rh (D) Typing
3 mL
(no bar code)
^ Direct Antiglobulin Test
3 mL
EDTA
Call Laboratory Staff at 2687 4924 for
arrangement.
5
^ Indirect Antiglobulin Test
4 mL
Plain
Call Laboratory Staff at 2687 4924 for
arrangement.
5
*6 days when blood grouping investigation is required
^: Referral test
Sep 2016
VI - 15 of 18
Chemical Pathology & Haematology
Volume of
blood
Specimen
container
Haemoglobin Pattern:
Hb electrophoresis,
HbA2 level, HbF level,
HbH inclusion demonstration.
3 mL
EDTA
Haemoglobin A1c level
3 mL
EDTA
TEST
Notes on collection & storage, remarks
T/T
(day)
Haemoglobin Studies:
Haemoglobin Pattern test is for cases of “low
MCV” or clients with family history of
haemoglobinopathy. Contact laboratory if there
is any other special indication.
8*
4#
*16 days for abnormal haemoglobin pattern
#
8 days if sample interference is detected
Immunology:
Anti-thyroid antibodies:
Anti-microsomal (TPO) antibodies &
Anti-thyroglobulin antibodies
4 mL
Plain
8
Anti-nuclear Antibody [ANA]
+ Anti-dsDNA
4 mL
Plain
8
Miscellaneous:
Semen analysis
(include: sperm count, motility,
morphology and blood cell density)
Whole
Clean bottle Sample should be collected after a minimum of
stream of
48 hours and no longer than 7 days of sexual
ejaculation
abstinence.
The sample should be protected from extremes
of temperatures (not less than 20oC and not
more than 40oC) during transport to CPLC.
State the collection time (e.g. 10:30 am) on the
request form.
Deliver sample to CPLC within 1 hour after
collection.
Prior arrangement with CPLC at 2687 4954 is
required.
Specimen
without
prior
arrangement will not be entertained.
Whole
Sperm count
Clean bottle
(sperm motility, morphology and stream of
blood cell density will not be ejaculation
performed)
Sep 2016
Sample should be collected after a minimum of
48 hours and no longer than 7 days of sexual
abstinence.
The sample should be protected from extremes
of temperatures (not less than 20oC and not
more than 40oC) during transport to CPLC.
State the collection time (e.g. 10:30 am) on the
request form.
Deliver sample to CPLC within 1 hour after
collection.
Prior arrangement with CPLC at 2687 4954 is
required.
Specimens
without
prior
arrangement will not be entertained.
1
1
VI - 16 of 18
Chemical Pathology & Haematology
Appendix 3 - Abbreviations on request form (DH2456)
Abbreviation
HKID No.
DOB
Dr.
For
Hong Kong Identity Card Number
Date of birth
Doctor’s name
Abbreviation
(Test)
ALT
ANA
APTT
CBC
CBC & Diff
ESR
OGTT
PT/INR
Retics
RF
TSH
FT4
FT3
VMA
Description
(Test)
Alanine aminotransferase
Antinuclear antibodies
Activated Partial Thromboplastin Time
Complete Blood Count
Complete Blood Count & Differential Count
Erythrocyte Sedimentation Rate
Oral Glucose Tolerance Test
Prothrombin Time/International Normalized Ratio
Reticulocytes
Rheumatoid Factor
Thyroid Stimulating Hormone
Free thyroxine
Free triiodothyronine
Vanillylmandelic acid
Sep 2016
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Chemical Pathology & Haematology
Appendix 4 - Abbreviations on laboratory report
Abbreviation
Description
Ab
Antibody/antibodies
APTT
Activated Partial Thromboplastin Time
BASO
Basophil
EOS
Eosinophil
ESR
Erythrocyte Sedimentation Rate
Gamma GT
Gamma Glutamyl Transferase
ALT
Alanine aminotransferase
HCT
Haematocrit
HDL
High Density Lipoprotein
HGB
Haemoglobin
HPLC
High Performance Liquid Chromatography
INR
International Normalized Ratio
LDL
Low Density Lipoprotein
LYMPH
Lymphocyte
MCH
Mean Cell Haemoglobin
MCHC
Mean Cell Haemoglobin Concentration
MCV
Mean Cell Volume
MONO
Monocyte
MPV
Mean Platelet Volume
NEUT
Neutrophil
NRBC
Nucleated Red Blood Cell
PLT
Platelet
RBC
Red Blood Cell
RDW
Red Cell Distribution Width
RETIC
Reticulocyte
WBC
White Blood Cell (Leukocyte)
Sep 2016
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