Maryland State Department of Education Academy of Health

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Maryland State Department of Education
Academy of Health Professions
Course 1: Foundations of Medicine and Health Science
Unit 2: Medical Assessment
Section 2: Diagnostic Techniques
ANSWER KEY AND RUBRIC
Contents
2.1 Diagnostic Techniques
2.1.1 Understanding Common Medical Abbreviations
2.1.2 Body Imaging Techniques
Part I: Survey of Images Techniques
Part II: Analysis of Body Images
2.1.3 Medical Laboratory Screening
Part I: Clinical Laboratory Tests
Part II: Total White Blood Cell Count
Part III: Toxicology Testing
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Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
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Name:_______________________________
2.1.1 WORKSHEET 3: MEDICAL ABBREVIATIONS – ANSWER KEY
ACRONYM
ā
abd
ac
ad lib
ADL’s
ax
FULL NAME
Before
Abdomen
Before meals
As desired
Activities of daily living
Axillary
BB
Technologist in Blood Banking
BM
Bowel Movement
BMP
Basic Metabolic Panel
BP
Blood Pressure
BR
Bed rest
BRP
Bathroom privileges
_
C
CBC
With
Complete Blood Count
©
EXPLANATION OF TERM OR ITS CLINICAL USE
Earlier in time
Part of the body between the thorax (chest) and pelvis.
Meals consumed earlier in time
Having a strong longing for
Activities performed on an every-day basis.
An anatomical term derived from axilla, the armpit.
Performs independently in various laboratory sections of the
Pathology and research Departments.
The discharge of waste matter from the large intestine; defecation.
Blood test that measures your sugar (glucose) level, electrolyte and
fluid balance, and kidney function.
The force exerted by circulating blood on the walls of blood
vessels, and constitutes one of the principal vital signs.
Confinement to bed continuously.
An advantage, immunity, permission, right, or benefit granted to
use the bathroom.
Used as a function word to indicate accompanying detail or
condition.
A test that gives important information about the kinds and
numbers of cells in the blood, especially red blood cells, white
blood cells, and platelets.
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CC
C-collar
CCU
CLT
CMA
CMP
CNS
c/o
COPD
CPR
CRNA
Statement describing the symptom, problem, condition, diagnosis,
Chief Complaint
physician recommended return, or other factor that is the reason
for a medical encounter.
An orthopedic piece of medical equipment used to support a
Cervical collar (neck brace)
patient's spinal cord and head. A cervical collar can help realign
one's spinal cord and relieve pain.
Intensive Care Unit that provides care to patients with a variety of
Cardiac Care Unit
cardiac illnesses and other critical medical issues.
Health care workers responsible for maintaining and operating
lab equipment, setting up and supervising experiments, monitoring
Certified Lab Technician
and recording the results and many other chores.
Health care workers who perform the administrative and clinical
Certified Medical Assistant
tasks that keep the offices of health practitioners running smoothly.
Blood test that measures your sugar (glucose) level, electrolyte and
Comprehensive Metabolic Panel
fluid balance, kidney function, and liver function.
Part of the nervous system that functions to coordinate the activity
Central Nervous System
of all parts of the bodies of multicellular organisms.
Complains of
Feelings of pain, dissatisfaction, or resentment.
Disease of the lungs in which the airways become narrowed. This
Chronic Obstructive Pulmonary Disease leads to a limitation of the flow of air to and from the lungs causing
shortness of breath.
Emergency medical procedure for a victim of cardiac arrest or, in
Cardiopulmonary resuscitation
some circumstances, respiratory arrest.
Licensed professional nurse who provides the same anesthesia
Certified registered nurse anesthetist
services as an anesthesiologist.
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CRT
CRTT
C-spine
CT/CAT
CVA
DA
DM
DMD/DDM
DNR
DO/OD
DSD
DP
Deliver respiratory care therapeutic treatments to patients who
have breathing or other cardiopulmonary disorders.
Responsible for the delivery of Respiratory Therapy services and its
Certified respiratory therapy technician subdivisions to provide a level of patient care equivalent to the
level of care available throughout the institution.
X-rays used in conjunction with the clinical examination to "clear"
Cervical spine
the cervical spine in patients who present with multiple trauma and
head injuries with neck pain.
Medical imaging method employing tomography. Digital geometry
Computed tomography/Computed axial processing is used to generate a three-dimensional image of the
tomography
inside of an object from a large series of two-dimensional X-ray
images taken around a single axis of rotation.
Loss of brain functions due to a disturbance in the blood vessels
Cerebrovascular accident (stroke)
supplying blood to the brain.
Help the dental operator (dentist or other treating dental auxiliary)
Dental Assistant
provide more efficient dental treatment.
Syndrome of disordered metabolism, usually due to a combination
Diabetes mellitus
of hereditary and environmental causes, resulting in abnormally
high blood sugar levels.
A doctor's degree in dental medicine.
Doctor of dental medicine
Do not resuscitate
Prohibition to restore consciousness, vigor, or life.
Primary health care professionals for the eye.
Doctor of Optometry
An adjunct used by a person for application to a wound in order to
Dry sterile dressing
promote healing and/or prevent further harm.
Professional degree for pharmacists similar to the doctor of
Doctor of Pharmacy
medicine (MD) for physicians.
Certified respiratory therapist
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DVT
DVM
dx
ECG/EKG
EEG
EMT
ER/ED
FUO
fx
GI
GU
Deep venous thrombosis
Doctor of Veterinary Medicine
The formation of a blood clot ("thrombus") in a deep vein.
Degree of the highest study in Veterinary Medicine.
The identification of the nature of anything, either by process of
Diagnosis
elimination or other analytical methods.
A recording of the electrical activity of the heart over time
Electrocardiogram
produced by an electrocardiograph, usually in a noninvasive
recording via skin electrodes.
Measurement of electrical activity produced by the brain as
Electroencephalogram
recorded from electrodes placed on the scalp.
Assess the nature of the patient’s condition while trying to
determine whether the patient has any pre-existing medical
Emergency Medical Technician
conditions. Following medical protocols and guidelines, they
(Paramedic)
provide appropriate emergency care and, when necessary,
transport the patient.
Hospital or primary care department that provides initial treatment
Emergency room/emergency department to patients with a broad spectrum of illnesses and injuries, some of
which may be life-threatening and requiring immediate attention.
Condition in which the patient has an elevated temperature but
Fever of unknown origin
despite investigations by a physician no explanation has been
found.
Separation of a bone or material into two, or more, pieces under
Fracture
the action of stress.
Adjective referring collectively to the stomach and small and large
Gastrointestinal
intestines.
Genitourinary
Organ system of the reproductive organs and the urinary system.
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Hgb
Hemoglobin
Hct
h/o
HOB
HR
hs
Hematocrit
History of
Head of bed
Heart rate
At bedtime
HTN
Hypertension
ICU
Intensive Care Unit
I&O
Intake and output
IDDM
Insulin dependent diabetes mellitus
IM
IV
KVO
Intramuscular
Intravenous
Keep vein open
LFT
Liver function test
LOC
Level of consciousness
LP
Lumbar puncture
©
Iron-containing oxygen-transport metalloprotein in the red blood
cells of vertebrates.
The proportion of blood volume that is occupied by red blood cells.
Information obtained to enable the physician to form a diagnosis.
Part of the bed consisting of two bedposts and a headboard.
The number of heart beats per unit time, usually per minute.
At the time at which one goes to bed.
Medical condition in which the blood pressure is chronically
elevated.
A specialized section of a hospital that provides comprehensive and
continuous care for persons who are critically ill and who can
benefit from treatment.
Fluids balance that give valuable information about the patient's
condition.
A medical term that describes diabetes mellitus that requires
insulin therapy to avoid ketoacidosis.
The injection of a substance directly into a muscle.
The giving of liquid substances directly into a vein.
To keep a vein with no protective or concealing cover.
Groups of clinical biochemistry laboratory blood assays designed
to give information about the state of a patient's liver.
Measurement of a person's arousability and responsiveness to
stimuli from the environment.
A diagnostic/therapeutic procedure that is performed in order to
collect a sample of cerebrospinal fluid (CSF).
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L-spine
MI
Lumbar spine
Myocardial infarction (heart attack)
MLT
Medical laboratory technician
MD
Medical Doctor
MT
Medical technologist
MRI
Magnetic resonance imaging
NCT
Nuclear Cardiology Technologist
NPO
Nothing by mouth
NSAID’s
O2
OOB
Non-steroidal anti-inflammatory drugs
Oxygen
Out of bed
OT
Occupational therapy
OR
Operating room
©
X-rays used in conjunction with the clinical examination to "clear"
the lumbar spine in patients who present with multiple trauma and
head injuries with neck pain.
Occurs when the blood supply to part of the heart is interrupted.
Conduct laboratory tests that aid in the detection, diagnosis, and
treatment of disease.
A doctoral degree for physicians (medical doctors).
A healthcare professional who performs diagnostic analytic tests
on body fluids such as blood, urine, sputum, stool, cerebrospinal
fluid (CSF), peritoneal fluid, pericardial fluid, and synovial fluid,
as well as other specimens.
A medical imaging technique most commonly used in radiology to
visualize the structure and function of the body. It provides detailed
images of the body in any plane.
Applies methods and techniques to optimize image quality and
overall efficiency of the nuclear cardiology laboratory.
Prohibition to consume food/drinks through the mouth.
Anti-inflammatory drugs that may increase the chance of a heart
attack or stroke that can lead to death.
The element with atomic number 8 and represented by the symbol
O.
To get up from bed.
Incorporates meaningful and purposeful occupation to enable
people with limitations or impairments to participate in everyday
life
A facility equipped for performing surgery.
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PA
Physician Assistant
PC
After meals
PCP
Primary care physician
PCU
Progressive care unit
PE
Pulmonary embolism
PMH
Past medical history
PO
prn
pt
By mouth
As needed
Patient
PT
Physical Therapist
RT
Radiology Technologist
©
Advanced practice clinician licensed to practice medicine with the
supervision of a licensed physician.
To be consumed subsequently in time or place.
Is a physician/medical doctor who provides both the first contact
for a person with an undiagnosed health concern as well as
continuing care of varied medical conditions, not limited by cause,
organ system, or diagnosis.
Unit for those patients who do not need intensive care, but who do
need more nursing care than what is usually provided on general
nursing units.
A blockage of the pulmonary artery or one of its branches, usually
occurring when a venous thrombus (blood clot from a vein)
becomes dislodged from its site of formation and embolizes to the
arterial blood supply of one of the lungs.
Medical questionnaire that assesses history and dates of past
illnesses.
To be ingested by mouth.
To take as needed for “pain”.
Any person who receives medical attention, care, or treatment.
Health care profession which provides services to individuals and
populations to develop, maintain and restore maximum movement
and functional ability throughout life.
Healthcare professional who creates medical images of the body to
help health care providers diagnose and treat illness and injury.
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RBC
Red blood cell
RDA
Registered Dental Assistant
RMA
Registered Medical Assistant
RN
Registered Nurse
R/O
Rule out
r/t
_
Related to
The most common type of blood cell and the vertebrate body's
principal means of delivering oxygen to the body tissues via the
blood.
Assists dentist at chair side, employing the latest concept of fourhanded dentistry.
Health care workers who perform the administrative and clinical
tasks that keep the offices of health practitioners running smoothly.
Health care professional responsible for implementing the practice
of nursing through the use of the nursing process in concert with
other health care professionals.
To prevent or preclude.
Being connected either logically or causally or by shared
characteristics.
Without
With something absent or lacking.
Sub-Q
Subcutaneous
Implies just under the skin.
sl/SL
SOB
Sublingual
Shortness of breath
Implies under the tongue.
Perceived to be difficulty of breathing or painful breathing.
STAT
Immediately
Without delay.
S
sx
Symptoms
TB
Tuberculosis
TPR
Temperature, pulse, respirations
©
A departure from normal function or feeling which is noticed by a
patient, indicating the presence of disease or abnormality.
A common and often deadly infectious disease caused by
mycobacteria, mainly Mycobacterium tuberculosis.
Vital signs that are measurements of the body's most basic
functions.
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T-spine
UA
Up ad lib
VS
Thoracic spine
Urinalysis
Up as desired
Vital signs
WBC
White blood cell
WNL
Within normal limits
wt
weight
X-rays used in conjunction with the clinical examination to "clear"
the thoracic spine in patients who present with multiple trauma and
head injuries.
An array of tests performed on urine and one of the most common
methods of medical diagnosis.
To be up as much as a patient wants to.
Measures of various physiological statistics often taken by health
professionals in order to assess the most basic body functions.
Cell of the immune system defending the body against both
infectious disease and foreign materials.
Regarding to as having no significant changes, such as an x-ray
and/or an MRI scan.
A measurement of the gravitational force acting on an object.
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Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
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Name____________________
2.1.2 WORKSHEET 4: BODY IMAGING TECHNIQUES – ANSWER KEY
Type of
Scan
X-ray
CT
What does it
stand for?
When is it used?
Most useful for imaging skeletal
system. Generally not good for
imaging soft tissue, although is
used to identify soft tissue
abnormalities such as lung
disease.
X-ray
Used to quickly identify injuries
to the lungs, heart and vessels,
liver, spleen, kidneys or other
internal organs in cases of
trauma. Also used to guide
biopsies and other procedures
such as abscess drainage and
minimally invasive tumor
treatments, and to measure bone
mineral density for the detection
of osteoporosis.
Computed
Tomography
©
What information does it
convey?
X-rays can pass through a human
body. Hard tissue blocks x-ray
penetration more than soft
tissue. When an image receptor is
placed behind a body part exposed
to x-rays, a “shadow” of the
internal structures is produced
with the soft tissue appearing
dark, and the hard tissue
appearing relatively light due to
blockage of x-rays.
Two-dimensional x-ray images are
converted to a three-dimensional
image by digital geometry
processing. Provides detailed
cross-sectional views of tissue
sections.
Healthcare Professional
Radiologist
Diagnostic Radiologist
Radiologic Technologist
Mammographer
Computed Tomography
Technologist
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Type of
Scan
MRI
What does it
stand for?
When is it used?
This is the most commonly used
technique to visualize the
structure and function of the
body. It provides detailed images
of the body in any plane. MRI
provides much greater contrast
between the different soft tissues
of the body than (CT scans) does,
making it especially useful in
neurological (brain),
musculoskeletal, cardiovascular,
and oncological (cancer)
imaging.
Ultrasound waves pass easily
through fluids and soft tissues,
making the procedure especially
useful for examining fluid-filled
organs such as the uterus in
pregnancy, as well as the
gallbladder, and soft organs like
the liver.
Ultrasound waves are unable to
penetrate bone or gas, so
ultrasound is of limited use for
examining regions surrounded by
bone, or areas that contain gas or
Magnetic
Resonance
Imaging
Ultrasound
©
What information does it
convey?
Healthcare Professional
Measures the magnetic field
produced by ions in the body cells.
Radio frequencies are used to
change the electronic pulses of the
hydrogen nucleus in cells to one
polarity. The speed of realignment
when the radio frequencies are
changed determines the type of
image that is produced to
represent the tissue. No exposure
to radiation occurs.
Magnetic Resonance
Technologist
Ultrasound imaging uses sound to
produce images. During the
ultrasound examination, a
machine called a transducer emits
sound and detects the returning
echoes when it is placed on or
over the body part being studied.
When the emitted sound
encounters a border between two
tissues that conduct sound
differently, some of the sound
waves bounce back to the
transducer, creating an echo...The
Sonographer
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air. Even so, ultrasound has been
used to examine most parts of the
body.
The technology is relatively
inexpensive and portable,
especially when compared with
magnetic resonance imaging
(MRI) and computed
tomography (CT). Ultrasound
poses no known risks to the
patient because it does not use
ionizing radiation.
©
echoes are analyzed by a computer
in the ultrasound machine and
transformed into moving pictures
of the organ or tissue being
examined.
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Name:___________________________
2.1.2 WORKSHEET 5: ANALYSIS OF BODY IMAGES – ANSWER KEY
Type of Scan
What Body
Quadrants/Regions
can you identify?
What
Anterior/Posterior
Surface Body
Landmarks can you
see?
X-ray
Right Upper
Quadrant, Left Upper
Quadrant & Pectoral
Region.
What Body Cavity is
this?
Organs Found
Anterior: sternal,
pectoral, deltoid,
axillary, brachial &
cervical landmarks.
Thoracic Cavity.
Bones: clavicle,
sternum, ribs,
vertebrae &
humerus.
CT
Part of all 4
Quadrants is visible.
Anterior: abdominal
& pelvic landmarks.
Abdominal Cavity &
Pelvic Cavity.
Kidneys and ureters,
bladder, part of the
ribs, spine & pelvis.
MRI
Part of all 4
Quadrants is visible.
Surface Body
Landmarks cannot be
seen.
Abdominal Cavity &
Pelvic Cavity.
Liver, kidneys and
ureters & spine.
©
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2.1.3 Medical Laboratory Screening
Part I: Clinical Laboratory Tests: Peer Grading Rubric of PowerPoint
Presentations
The students will assess each other’s presentation using the rubric below. For each
group, use the criteria in the rubric to assess the quality of each presentation.
Table 1. Content
Each of the content categories should be rated on a 0-2 scale as follows:
2 = Very good: covered all information with sufficient detail.
1 = Okay: Information but not in sufficient detail, or some information was
missing.
0 = Poor: Did not cover the required information.
Table 1. Required Content:
Did the students give the full name of the clinical test and explain any
abbreviations?
Did the students define and explain assigned clinical test?
Did the students identify the type of specimen collected, and if any special
patient preparation was required?
Was the purpose of the test, and the type of information provided adequately
explained?
Were the normal ranges for the test, including units stated?
Did the presentation include illustrations and/or animations?
SUBTOTAL
/12
Table 2. Presentation Skills
Each of the presentation skill categories should be rated on a 0-1 scale as follows:
Yes = 1
No = 0
Table 2. Presentation Skills:
Was the presentation interesting?
Was the presentation well organized?
Were the slides neat and easily read by the audience?
Did the student avoid reading his/her presentation?
Did the student make eye contact with the audience?
Was the student able to answer questions clearly?
SUBTOTAL
PRESENTATION TOTAL = __________________
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2.1.3 Medical Laboratory Screening
Part I: Clinical Laboratory Tests
Rubric for Grading Patient Brochure of Clinical Test
Table 1. Content
Each of the content categories should be rated on a 0-2 scale as follows:
2 = exceeds standards: covered more than the minimum required information
1 = meets standards: covered the required information
0 = standards not met: did not cover the required information
Table 1. Required Content:
Did the brochure contain a description of the test in laymans terms?
Did the brochure explain why a physician might order this test and describe the
type of information that it would provide?
Was the procedure described in such a way so as not to cause anxiety to the
patient?
Was the length of the test procedure included in its description, and
information on typical wait time for results?
Were any special patient preparation requirements clearly explained?
Did the presentation include illustrations and/or animations?
SUBTOTAL
/12
Table 2. Presentation Skills
Each of the presentation skill categories should be rated on a 0-1 scale as follows:
Yes = 1
No = 0
Table 2. Presentation Skills:
Was the presentation interesting?
Was the presentation well organized?
Were the slides neat and easily read by the audience?
Did the student avoid reading his/her presentation?
Did the student make eye contact with the audience?
Was the student able to answer questions clearly?
SUBTOTAL
PRESENTATION TOTAL = __________________
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Name:___________________________
2.1.3 WORKSHEET 6: SUMMARY OF CLINICAL LABORATORY TESTS – ANSWER KEY
Test
Name
Blood Type
and
Screen:
ABO
antigen
typing,
RhD typing
Alternative
Names and
Abbreviatio
ns
ABO Grouping
and Rh Typing
Type of
Specimen,
and How it
is Collected
From
Patient
Blood is drawn
from a vein in
the arm or
from the tip of
the finger
(fingerstick). In
newborns,
blood from the
umbilical cord
or a small
amount of
blood from a
heelstick may
be used for
testing.
©
Any Special
Preparation
For the Test
(e.g. fasting)
None
What is Being
Tested?
Red blood cells
(RBCs) have
markers or antigens
on the surface of the
cells. The two major
antigens or surface
identifiers on human
RBCs are the A and
B antigens. Your
blood is grouped
according to the
presence or absence
of these antigens.
People whose red
blood cells have A
antigens are
considered to be
blood group A;
those with B
antigens are group
B; those with both A
and B antigens are
group AB; and
those who do not
Why is this Test
Performed?
How Will the Result
Help the Patient?
To determine a patient’s
blood type.
This will identify the type
of blood they can safely
receive.
It is important to ensure
that there is compatibility
between a patient who
requires a transfusion of
blood or blood
components and the ABO
and Rh type of the unit of
blood that will be
transfused. A potentially
fatal transfusion reaction
can occur if a unit of
blood containing an ABO
antigen to which a patient
has an antibody is
transfused to that patient.
For example, people with
blood group O have both
anti-A and anti-B
antibodies in their blood.
If a unit of blood that is
group A, B, or AB is
ABO grouping and Rh
typing are performed on all
donated blood. They are
also performed for all
patients requiring a blood
transfusion.
Cases in which blood or
blood products are needed
for treatment may include:
- Severe anemia and
conditions causing anemia
such as sickle-cell disease
and thalassemia
- surgical patients with
intra-operative or postoperative bleeding
- injury or trauma patients
with excessive blood loss
- cancer and the effects of
chemotherapy
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What is a
Normal Result
or Range of
Values?
Blood groups can be
As follows:
Type A, Type B,
Type AB, and Type
O
Rh positive, or Rh
negative
have either of these
markers are
considered to have
blood group O.
Another important
surface antigen is
called Rh factor. If
it is present on your
red blood cells, your
blood type is Rh+
(positive); if it is
absent, your blood
is type Rh(negative).
©
- bleeding disorders such as
hemophilia
transfused to this patient,
the antibodies in the
patient’s blood will react
with the red cells,
destroying them and
causing potentially
serious complications.
Rh typing is especially
important during
pregnancy because a
mother and her fetus
could be incompatible. If
the mother is Rh-negative
but the father is Rhpositive, the fetus may be
positive for the Rh
antigen. As a result, the
mother’s body could
develop antibodies
against the Rh antigen.
The antibodies may cross
the placenta and cause
destruction of the baby’s
red blood cells, resulting
in a condition known as
hemolytic disease of the
fetus and newborn. To
prevent development of Rh
antibodies, an Rhnegative mother is treated
with an injection of Rh
immune globulin during
her pregnancy and again
after delivery if the baby
is Rh-positive. The Rh
immune globulin “masks”
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any Rh antigen from the
fetus that the mother may
be exposed to during her
pregnancy and delivery
and prevents her from
becoming sensitized and
developing antibodies
against the Rh antigen.
©
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Test Name
Comprehensive
Metabolic Panel:
Glucose
Alternative
Names and
Abbreviations
Blood sugar,
Fasting blood
sugar, FBS, blood
glucose, Oral
Glucose Tolerance
Test (OGTT or
GTT), Urine
glucose
©
Type of
Specimen,
and How it
is Collected
From
Patient
Any
Special
Preparati
on For the
Test (e.g.
fasting)
A blood sample
drawn from a
vein in your arm
or, for a self
check, a drop of
blood from a
skin prick;
sometimes a
random urine
sample is used.
It is
generally
recommende
d that you
fast at least 8
hours before
a blood
glucose test.
What is
Being
Tested?
Why is this
Test
Performed?
Glucose is a
simple sugar that
serves as the
main source of
energy for the
body. The
carbohydrates we
eat are broken
down into
glucose (and a
few other simple
sugars), absorbed
by the small
intestine, and
circulated
throughout the
body. Most of the
body’s cells
require glucose
for energy
production; brain
and nervous
system cells not
only rely on
glucose for
energy, they can
only function
To determine if
your blood
glucose level is
within healthy
ranges; to screen
for, diagnose, and
monitor
hyperglycemia,
hypoglycemia,
diabetes, and prediabetes
How Will the Result
Help the Patient?
Detects both hyperglycemia
and hypoglycemia, to help
diagnose diabetes, and to
monitor glucose levels in
persons with diabetes.
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What is a
Normal Result
or Range of
Values?
Fasting Blood
Glucose: From 70 to
99 mg/dL (3.9 to 5.5
mmol/L)
Oral Glucose
Tolarance Test: Less
than 140 mg/dL (7.8
mmol/L)
Test Name
Alternative
Names and
Abbreviations
Comprehensive
Metabolic Panel:
Total Protein
TP,
Albumin/Globulin
ratio,
Albumin/Globulin
ratio
©
Type of
Specimen, and
How it is
Collected From
Patient
Blood is drawn
from a vein in
the arm or from
the tip of the
finger
(fingerstick). In
newborns, blood
from the
umbilical cord
or a small
amount of blood
from a heelstick
may be used for
testing
Any Special
Preparation
For the Test
(e.g. fasting)
None
when glucose
levels in the blood
remain above a
certain level.
What is Being
Tested?
The total protein
test is a rough
measure of all of
the proteins in the
plasma portion of
your blood.
Proteins are
important
building blocks of
all cells and
tissues; they are
important for
body growth and
health. Total
protein measures
the combined
amount of two
classes of
proteins, albumin
and globulin.
Albumin is a
carrier of many
small molecules,
but its main
purpose is to keep
fluid from leaking
out of blood
Why is this Test
Performed?
How Will the Result Help
the Patient?
What is a Normal
Result or Range of
Values?
Total protein
measurements can
reflect nutritional
status, kidney
disease, liver
disease, and many
other conditions.
Low total protein levels can
suggest a liver disorder, a
kidney disorder, or a
disorder in which protein is
not digested or absorbed
properly. If total protein is
abnormal, further tests must
be performed to identify
which protein fraction is
abnormal, so that a specific
diagnosis can be made.
6.1 - 7.9 g/dL 15 - 45
mg/dL
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Test Name
Alternative
Names and
Abbreviations
Comprehensive
Metabolic Panel:
Albumin
ALB
Type of
Specimen, and
How it is
Collected From
Patient
A blood sample
drawn from a
vein in the arm
©
Any Special
Preparation
For the Test
(e.g. fasting)
None
vessels, while
globulin proteins
include enzymes,
antibodies, and
more than 500
other proteins.
The ratio of
albumin to
globulin (A/G
ratio) is
calculated from
values obtained
by direct
measurement of
total protein and
albumin. It
represents the
relative amounts
of albumin and
globulins.
What is Being
Tested?
Albumin, the
most abundant
protein in the
blood plasma.
Why is this Test
Performed?
How Will the Result Help
the Patient?
What is a Normal
Result or Range of
Values?
Albumin is the
most abundant
protein in the
blood plasma. It
keeps fluid from
leaking out of
blood vessels;
nourishes tissues;
and transports
hormones,
vitamins,
Albumin testing is used in a
variety of settings to help
diagnose disease, to monitor
changes in health status with
treatment or with disease
progression, and as a screen
that may serve as an
indicator for other kinds of
testing.
A physician orders a blood
albumin test (usually along
3.5 - 4.8 g/dL
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
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Test Name
Alternative
Names and
Abbreviations
Comprehensive
Metabolic Panel:
Blood Urea
Nitrogen
BUN, Urea
nitrogen, Urea
Type of
Specimen, and
How it is
Collected From
Patient
A blood sample
drawn from a
vein in the arm
©
Any Special
Preparation
For the Test
(e.g. fasting)
What is Being
Tested?
drugs, and ions
like calcium
throughout the
body. Albumin is
made in the liver
and is extremely
sensitive to liver
damage. The
concentration of
albumin drops
when the liver is
damaged, with
kidney disease,
when a person is
malnourished, if
experiences
inflammation in
the body, or with
shock. Albumin
increases when a
person is
dehydrated.
Why is this Test
Performed?
None
This test
measures the
amount of urea
nitrogen in the
blood. Nitrogen,
in the form of
ammonia, is
produced in the
liver when
Most diseases or
conditions that
affect the kidneys
or liver have the
potential to affect
the amount of
urea present in
the blood. If
increased
with several other tests) if a
person seems to have
symptoms of a liver disorder
or nephrotic syndrome.
How Will the Result Help
the Patient?
What is a Normal
Result or Range of
Values?
Evaluates kidney function
and monitors the
effectiveness of dialysis and
other treatments related to
kidney disease or damage
7 - 18 mg/dl 12 - 20
gm/24 hrs
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Test Name
Alternative
Names and
Abbreviations
Comprehensive
Metabolic Panel:
Creatinine
Creat
Type of
Specimen, and
How it is
Collected From
Patient
A blood sample
drawn from a
vein in the arm
and possibly a
24-hour urine
sample
©
Any Special
Preparation
For the Test
(e.g. fasting)
None
protein is broken
into component
parts (amino
acids) and
metabolized. The
nitrogen
combines with
other molecules
in the liver to
form the waste
product urea,
which is then
released into the
bloodstream and
carried to the
kidneys, where it
is filtered out of
the blood and
excreted in the
urine.
What is Being
Tested?
amounts of urea
are produced by
the liver or
decreased
amounts are
excreted by the
kidneys, then urea
concentrations
will rise. If
significant liver
damage or disease
inhibits the
production of
urea, then BUN
concentrations
may fall.
Why is this Test
Performed?
How Will the Result Help
the Patient?
What is a Normal
Result or Range of
Values?
This test
measures the
amount of
creatinine in your
blood and/or
urine. Creatinine
is a waste product
produced in your
muscles from the
breakdown of a
compound called
To determine if
your kidneys are
functioning
normally and to
monitor treatment
for kidney disease
Increased creatinine levels in
the blood suggest diseases or
conditions that affect kidney
function. These can include:
Serum:
Male: 0.6- 1.3mg/dL
Urine:
Male: 8002000mg/24hrs
Female: 600-1800
mg/24 hrs
blood vessels in the kidneys
(glomerulonephritis) caused
by, for example, infection or
autoimmune diseases;
kidneys (pyelonephritis);
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 24
Test Name
Alternative
Names and
Abbreviations
Comprehensive
Metabolic Panel:
Electrolytes
Lytes
Type of
Specimen, and
How it is
Collected From
Patient
A blood sample
drawn from a
vein in the arm
©
Any Special
Preparation
For the Test
(e.g. fasting)
None
creatine. Creatine
is part of the
cycle that
produces energy
needed to
contract your
muscles and it as
well as creatinine
are produced at a
relatively
constant rate.
Almost all
creatinine is
excreted by the
kidneys, so blood
levels are a good
measure of how
well your kidneys
are working.
What is Being
Tested?
Why is this Test
Performed?
How Will the Result Help
the Patient?
What is a Normal
Result or Range of
Values?
Electrolytes are
electrically
charged minerals
that are found in
body tissues and
blood in the form
of dissolved salts.
They help move
nutrients into and
wastes out of the
body’s cells,
maintain a
The electrolyte
panel is frequently
ordered as part of
a routine physical,
either by itself or
as components of
a basic metabolic
panel or
comprehensive
metabolic panel.
It is used to screen
for an electrolyte
Knowing which electrolytes
are out of balance can help
your doctor to determine the
cause and treatment to
restore proper balance. If left
untreated, electrolyte
imbalance can lead to
dizziness, cramps, irregular
heartbeat, and possibly
death.
A Normal blood
sodium level is 135 145
milliEquivalents/liter
(mEq/L), or in
international units,
135 - 145
millimoles/liter
(mmol/L).
kidneys’ small tubes (acute
tubular necrosis) caused, for
example, by drugs or toxins;
stone, or other causes of
urinary tract obstruction; or
kidney due to shock,
dehydration, congestive heart
failure, atherosclerosis, or
complications of diabetes.
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 25
The normal blood
potassium level is
healthy water
balance, and help
stabilize the
body’s pH level.
The electrolyte
panel measures
the main
electrolytes in the
body: sodium
(Na+), potassium
(K+), chloride
(Cl-), and
bicarbonate
(sometimes
reported as total
CO2).
Test Name
Alternative
Names and
Abbreviations
Comprehensive
Metabolic Panel:
CO2
Total CO2, TCO2,
Bicarb,
Bicarbonate
©
Type of
Specimen, and
How it is
Collected From
Patient
A blood sample
drawn from a
vein in the arm
Any Special
Preparation
For the Test
(e.g. fasting)
What is Being
Tested?
or acid-base
imbalance and to
monitor the effect
of treatment on a
known imbalance
that is affecting
bodily organ
function. Since
electrolyte and
acid-base
imbalances can be
present with a
wide variety of
acute and chronic
illnesses, the
electrolyte panel
is frequently
ordered for
hospitalized
patients and those
who come to the
emergency room.
Why is this Test
Performed?
None
The total CO2
test measures the
total amount of
carbon dioxide in
the blood, mostly
in the form of
bicarbonate
(HCO3-); in
many
Measuring
bicarbonate (or
total CO2) as part
of an electrolyte
or metabolic
panel may help
diagnose an
electrolyte
imbalance,
3.5 - 5.0
milliEquivalents/liter
(mEq/L), or in
international units,
3.5 - 5.0
millimoles/liter
(mmol/L).
The normal serum
range for chloride is
98 - 108 mmol/L.
How Will the Result Help
the Patient?
What is a Normal
Result or Range of
Values?
When bicarbonate levels are
higher or lower than normal,
it suggests that your body is
having trouble maintaining
its acid-base balance or that
you have upset your
electrolyte balance, perhaps
by losing or retaining fluid.
Both of these imbalances may
1 day-1 yr: 16-28
mmol/L Adult: 21-32
mmol/L
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Test Name
Alternative
Names and
Abbreviations
Comprehensive
Metabolic Panel:
Total Bilirubin
TBIL, Neonatal
bilirubin, Direct
bilirubin
(conjugated
bilirubin), Indirect
bilirubin
(unconjugated
bilirubin)
©
Type of
Specimen, and
How it is
Collected From
Patient
In adults, a
blood sample
from a vein in
the arm; in
newborns, a
blood sample
from a heelstick;
non-invasive
technology is
available in
some health care
facilities that
will measure
bilirubin by
using an
instrument
placed on the
skin
(transcutaneous
bilirubin meter)
Any Special
Preparation
For the Test
(e.g. fasting)
None
laboratories,
bicarbonate is
now measured
directly.
Bicarbonate is a
negatively
charged
electrolyte that is
excreted and
reabsorbed by the
kidneys
What is Being
Tested?
acidosis or
alkalosis as the
result of a disease
process or
condition.
be due to a wide range of
dysfunctions.
Why is this Test
Performed?
How Will the Result Help
the Patient?
What is a Normal
Result or Range of
Values?
Bilirubin is an
orange-yellow
pigment found in
bile. Red blood
cells (RBCs)
normally degrade
after 120 days in
the circulation. At
this time, a
component of the
RBCs,
hemoglobin (the
red-colored
pigment of red
blood cells that
carries oxygen to
tissues), breaks
down into
unconjugated
bilirubin.
When bilirubin
levels are high, a
condition called
jaundice occurs,
and further testing
is needed to
determine the
cause. Too much
bilirubin may
mean that too
much is being
produced (usually
due to increased
hemolysis) or that
the liver is
incapable of
adequately
removing
bilirubin in a
timely manner due
Adults and children:
Bilirubin levels can be used
to identify liver
damage/disease or to
monitor the progression of
jaundice.
1 wk-1 mo: <0.7
mg/dL 1 mo - 18 yrs:
<2.0 mg/dl Adult:
0.4-2.0 mg/dL
Newborns: Excessive
bilirubin damages
developing brain cells in
infants (kernicterus) and may
cause mental retardation,
learning and developmental
disabilities, hearing loss, or
eye movement problems. It is
important that bilirubin in
newborns does not get too
high
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Page 27
Test Name
Comprehensive
Metabolic Panel:
Aspartate
aminotransferase
Alternative
Names and
Abbreviations
AST
©
Type of
Specimen,
and How it
is Collected
From
Patient
Any
Special
Preparati
on For the
Test (e.g.
fasting)
A sample is
taken by needle
from a vein in
the arm.
The
physician
may require
discontinuati
on of any
drugs that
might affect
the test,
including
antihypertens
ives
(treatment of
high blood
pressure),
Approximately
250 to 350 mg of
bilirubin is
produced daily in
a normal, healthy
adult, of which
85% is derived
from damaged or
old red cells that
have died, with
the remaining
amount from the
bone marrow or
liver.
to blockage of bile
ducts, liver
diseases such as
cirrhosis, acute
hepatitis, or
inherited
problems with
bilirubin
processing.
What is
Being
Tested?
Why is this
Test
Performed?
AST is an enzyme
found mostly in
the heart and
liver, and to a
lesser extent in
other muscles.
When liver or
muscle cells are
injured, they
release AST into
the blood.
An AST test is
ordered along
with several other
tests to evaluate a
patient who seems
to have symptoms
of a liver disorder.
Some of these
symptoms include
jaundice
(yellowing of the
eyes and skin),
dark urine,
nausea, vomiting,
How Will the Result
Help the Patient?
What is a
Normal Result
or Range of
Values?
This test will help to
determine if the patient is
suffering from liver disease,
and can help to assess the
proper diagnosis for
treatment.
Normal ranges for
the AST are
laboratory-specific,
but can range from
3-45 units/L (units
per liter).
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Page 28
coumarintype
anticoagulan
ts (bloodthinning
drugs),digital
is,
erythromycin
(antibiotic),
oral
contraceptive
s, and
opiates,
among
others. The
patient may
also need to
cut back on
strenuous
activities
temporarily,
because
exercise can
also elevate
AST for a
day or two.
©
abdominal
swelling, unusual
weight gain, and
abdominal pain.
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Page 29
Test Name
Alternative
Names and
Abbreviations
Type of
Specimen,
and How it
is Collected
From
Patient
Any
Special
Preparati
on For the
Test (e.g.
fasting)
Comprehensive
Metabolic Panel:
Alanine
aminotransferase
ALT, Serum
glutamic-pyruvic
transaminase,
SGPT
A blood sample
drawn from a
vein in your arm
None
Complete Blood
count:
Platelet Count
Platelet
A sample is
taken by needle
from a vein in
the arm.
There is no
preparation
needed for
this test.
©
What is
Being
Tested?
Why is this
Test
Performed?
ALT is an enzyme
found mostly in
the liver; smaller
amounts of it are
also in the
kidneys, heart,
and muscles.
Under normal
conditions, ALT
levels in the blood
are low. When the
liver is damaged,
ALT is released
into the blood
stream, usually
before more
obvious symptoms
of liver damage
occur, such as
jaundice
(yellowing of the
eyes and skin).
Platelets
(thrombocytes)
are tiny fragments
of cells called
megakaryocytes
The ALT test
detects liver
injury. ALT values
are usually
compared to the
levels of other
enzymes, such as
alkaline
phosphatase
(ALP) and
aspartate
aminotransferase
(AST), to help
determine which
form of liver
disease is present.
Screens for liver damage
A platelet count is
often ordered as a
part of a complete
blood count,
which may be
This test will help to
determine if the patient has a
bleeding disorder or a bone
marrow disease, such as
leukemia. This is determined
How Will the Result
Help the Patient?
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Page 30
What is a
Normal Result
or Range of
Values?
Male: 30 - 65
IU/L Female: 14
- 54 IU/L
In an adult, a
normal count is
about 150,000 to
450,000 platelets per
microliter (x 10–
that are made in
the bone marrow.
These fragments
(about 2-3
microns in
diameter) are
released from the
bone marrow to
circulate in the
blood. They are
the first
components to be
activated when
there has been an
injury to a blood
vessel or tissue.
Because they are
very "sticky," they
begin the
formation of a
blood clot. The
platelet count is a
test that
determines the
number of
platelets in your
blood.
©
done at an annual
physical
examination. It is
almost always
ordered when a
patient has
unexplained
bruises or takes
what appears to
be an unusually
long time to stop
bleeding from a
small cut or
wound.
by the number of platelets
present and/or their ability to
function correctly.
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 31
6/Liter)
of blood.
Test Name
Complete Blood
Count:
Hematocrit
Alternative
Names and
Abbreviations
Hct, Crit, Packed
cell volume (PCV)
©
Type of
Specimen,
and How it
is Collected
From
Patient
A blood sample
drawn from a
vein in your arm
or by a
fingerstick
(children and
adults) or
heelstick
(newborns)
Any
Special
Preparati
on For the
Test (e.g.
fasting)
None
What is
Being
Tested?
Why is this
Test
Performed?
Hematocrit is a
measurement of
the proportion of
blood that is
made up of red
blood cells. The
value is expressed
as a percentage
or fraction of
cells in blood.
For example, a
hematocrit value
of 40% means
that there are 40
milliliters of red
blood cells in 100
milliliters of
blood.
The hematocrit
rises when the
number of red
blood cells
increases or when
the plasma volume
is reduced, as in
dehydration. The
hematocrit falls to
less than normal,
indicating anemia,
when your body
decreases its
production of red
blood cells or
increases its
destruction of red
blood cells or if
blood is lost due
to bleeding.
The hematocrit
reflects both the
number of red
cells and their
volume (mean
corpuscular
volume or MCV).
How Will the Result
Help the Patient?
This test is used to evaluate:






anemia,
polycythemia,
response to
treatment of
anemia or
polycythemias,
dehydration,
blood transfusion
decisions for severe
symptomatic
anemias, and
the effectiveness of
those transfusions.
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What is a
Normal Result
or Range of
Values?
39 - 55 %
Test Name
Complete Blood
Count:
Hemoglobin
Alternative
Names and
Abbreviations
Type of
Specimen, and
How it is
Collected From
Patient
A blood sample
is obtained by
inserting a
needle into a
vein in your arm
or by a
fingerstick (for
children and
adults) or
heelstick (for
newborns).
Hgb
©
Any Special
Preparation
For the Test
(e.g. fasting)
None
What is Being
Tested?
This test
measures the
amount of
hemoglobin, a
protein found in
red blood cells, in
a blood sample,
which is a good
indication of the
blood’s ability to
deliver oxygen to
tissues and
organs and to
transport the
waste product
carbon dioxide to
the lungs, where
it is exhaled. If
your hemoglobin
levels are low,
you may have
anemia, a
condition in
which your body
is not getting
enough oxygen,
If the size of the
red cell decreases,
so will the
hematocrit and
vice versa.
Why is this Test
Performed?
The hemoglobin
test is an integral
part of your
health evaluation.
The test is used to:
-measure the
severity of anemia
or polycythemia
-monitor the
response to
treatment of
anemia or
polycythemia
-help make
decisions about
blood transfusions
if the anemia is
severe.
How Will the Result Help
the Patient?
This test can provide the
patient with their
hemoglobin level.
Above-normal hemoglobin
levels may be the result of:
-dehydration
-excess production of red
blood cells in the bone
marrow
-severe lung disease
-several other conditions.
Below-normal hemoglobin
levels may lead to anemia
that can be the result of:
-iron deficiency or other
deficiencies, such as B12 and
folate
-inherited hemoglobin
defects, such as sickle cell
anemia or thalassemias
-other inherited conditions,
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Page 33
What is a Normal
Result or Range of
Values?
Normal values in an
adult are 12 to 18
grams per deciliter
(100 milliliters) of
blood.
causing fatigue
and weakness.
Test Name
Complete Blood
Count:
Red Blood Cell
Count
Alternative
Names and
Abbreviations
RBC count,
Erythrocyte count,
Red count
©
Type of
Specimen, and
How it is
Collected From
Patient
The test is
performed on a
blood sample
taken by a
needle placed in
a vein in the arm
or by a
fingerstick (for
Any Special
Preparation
For the Test
(e.g. fasting)
None
such as enzyme defects
-cirrhosis of the liver
-excessive bleeding
-excessive destruction of red
blood cells
-kidney disease
-other chronic illnesses
-bone marrow failure or
aplastic anemia
-cancers that affect the bone
marrow
The hemoglobin
rises when the
number of red
blood cells
increases. The
hemoglobin falls
to less than
normal,
indicating
anemia, when
your body
decreases its
production of red
blood cells,
increases its
destruction of red
blood cells, or if
blood is lost due
to bleeding.
What is Being
Tested?
Why is this Test
Performed?
How Will the Result Help
the Patient?
What is a Normal
Result or Range of
Values?
This test counts
the number of red
blood cells (RBC)
in a sample of
whole blood. Red
blood cells, which
are made in the
bone marrow,
A RBC count is
ordered as a part
of the complete
blood count
(CBC), often as
part of a routine
physical, presurgical
This test will help the patient
to determine the amount of
Red Blood Cells that are
being produced by their
body. A decreased number of
RBCs results from either
acute or chronic blood loss.
Acute blood loss is a rapid
Normal range varies
slightly between
laboratories but is
generally between
4.2 to 5.9 million
cells/cmm. This can
also be referred to
as the erythrocyte
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Page 34
children and
adults) or
heelstick (for
newborns).
©
carry oxygen
from the lungs to
the cells of
organs in the
body and
transport carbon
dioxide from
those cells back
to the lungs.
Changes in the
RBC count are
usually
associated with
changes in
hemoglobin
levels. When the
values of the RBC
count and
hemoglobin
decrease below
the established
reference range,
the patient is said
to be anemic.
When the values
increase above
this range, the
patient is said to
be polycythemic.
procedure, or for
other clinical
reasons. The test
is also repeated in
patients who have
hematologic
disorders,
bleeding
problems, chronic
anemias,
polycythemia,
and/or patients
undergoing
chemotherapy or
radiation therapy.
depletion of blood volume.
Chronic blood loss stems
from various conditions that
often results in some form of
an anemia. Chronic anemias
are due to loss of small
amounts of blood over a long
period of time (bleeding),
mechanical destruction of the
RBCs, or some physiologic
problem such as decreased
RBC production. Increased
number of RBCs can result
from a number of conditions
that include dehydration,
congenital heart disease,
pulmonary diseases, and
situations involving tissue
hypoxia.
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 35
count and can be
expressed in
international units
as 4.2 to 5.9 x 1012
cells per liter.
Test Name
Complete Blood
Count:
White Blood Cell
Count
Alternative
Names and
Abbreviations
WBC count,
Leukocyte count,
White count
Type of
Specimen,
and How it
is Collected
From
Patient
The blood
sample is
obtained by a
needle placed in
a vein in the arm
or a fingerstick
(for children and
adults) or
heelstick (for
newborns).
©
Any
Special
Preparati
on For the
Test (e.g.
fasting)
None
What is
Being
Tested?
Why is this
Test
Performed?
The white blood
cell (WBC) count
numerates the
number of white
blood cells in a
sample of blood.
An abnormal high
or low count may
suggest the
presence of
illness. White
blood cells are
made in the bone
marrow and
protect the body
against infection
and aid in the
immune response.
If there is an
infection, white
blood cells will
attack and
destroy the
bacteria, fungus,
or virus causing
the infection.
A WBC count is
normally ordered
as part of the
complete blood
count (CBC). In
some
circumstances, a
WBC count may
be ordered to
monitor recovery
from illness.
How Will the Result
Help the Patient?
Conditions or medications
that weaken the immune
system, such as HIV
infection, chemotherapy, or
radiation therapy cause a
decrease in white blood cells.
The WBC count detects
dangerously low numbers of
these cells.
The WBC count is used to
determine the presence of an
infection or leukemia. It is
also used to help monitor the
body’s response to various
treatments and to monitor
bone marrow function.
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 36
What is a
Normal Result
or Range of
Values?
The normal range
for WBC count is
4,300 to 10,800
cells per cubic
millimeter (cmm)
or 4.3 to 10.8 x
109 cells per liter.
Complete Blood
Count:
White Blood Cell
Differential
Leukocyte
differential count,
Peripheral
differential, White
blood cell
morphology, WBC
differential, Diff
©
The test is
performed on a
blood sample
drawn from a
vein in the arm
or from a
fingerstick (for
children and
adults) or
heelstick (for
infants).
None
This test
measures the
differential in the:
neutrophils,
lymphocytes,
monocytes,
eosinophils and
basophils and
reveals if these
cells are present
in normal
proportion to one
another, if one
cell type is
increased or
decreased, or if
immature cells
are present. This
information is
helpful in
diagnosing
specific types of
illnesses that
affect the immune
system. White
blood cells
protect your body
against infection
and aid your
immune system by
attacking and
destroying the
microorganism
causing the
infection.
The white blood
cell differential is
normally run as
part of the
complete blood
count (CBC),
which is ordered
for many different
reasons.
The white blood cell
differential assesses the
ability of the body to respond
to and eliminate infection. It
also detects the severity of
allergic and drug reactions
plus the response to parasitic
and other types of infection.
It is essential in evaluating
the reaction to viral
infections and response to
chemotherapy. It can also
identify various stages of
leukemia.
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 37
Total WBC: 4,500 10,000
Bands or stabs: 3 - 5
%
Granulocytes
(polymorphonuclear
s) Neutrophils (or
segs): 50 - 70%
relative value (25007000 absolute value)
Eosinophils: 1 - 3%
relative value (100300 absolute value)
Basophils: 0.4% 1% relative value
(40-100 absolute
value)
Agranulocytes (or
mononuclears)
Lymphocytes: 25 35% relative value
(1700-3500 absolute
value)
Moncytes: 4 - 6%
relative value (200600 absolute value)
Test Name
Complete Blood
Count:
Red Blood Cell
Indices (MCV,
MCH, MCHC)
Alternative
Names and
Abbreviations
Red Cell Indices,
RRC Indices
Type of
Specimen,
and How it
is Collected
From
Patient
The test is
performed on a
blood sample
drawn from a
vein in the arm
or from a
fingerstick (for
children and
adults) or
heelstick (for
infants).
©
Any
Special
Preparati
on For the
Test (e.g.
fasting)
None
What is
Being
Tested?
Why is this
Test
Performed?
The indices
include these
measurements:
mean corpuscular
volume (MCV);
mean corpuscular
hemoglobin
(MCH); mean
corpuscular
hemoglobin
concentration
(MCHC); and red
cell distribution
width (RDW).
They are usually
calculated by an
automated
instrument as
part of a
complete blood
count (CBC).
Indices are
covered by
insurance when
medically
necessary. Results
are available the
same day that the
Anemia includes a
variety of
conditions with
the same outcome:
a person's blood
cannot carry as
much oxygen as it
should. A healthy
person has an
adequate number
of correctly sized
red blood cells
that contain
enough
hemoglobin to
carry sufficient
oxygen to all the
body's tissues. An
anemic person has
red blood cells
that are either too
small or too few in
number. As a
result, the heart
and lungs must
work harder to
make up for the
lack of oxygen
How Will the Result
Help the Patient?
This test will help to
determine if a patient has
anemia, and if so what type.
Anemia has several general
causes: blood loss; a drop in
production of red blood cells;
or a rise in the number of red
blood cells destroyed. Blood
loss can result from severe
hemorrhage or a chronic
slow bleed, such as the result
of an accident or an ulcer.
Lack of iron, vitamin B12, or
folic acid in the diet, as well
as certain chronic diseases,
lower the number of red
blood cells produced by the
bone marrow. Inherited
disorders affecting
hemoglobin; severe
reactions to blood
transfusions; prescription
medications; or poisons can
cause red blood cells to burst
(hemolyze) well before the
end of their usual 120-day
lifespan.
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 38
What is a
Normal Result
or Range of
Values?
Normal results for
red blood cell
indices are as
follows:
-MCV 82-98 fl
(femtoliters)
-MCHC 31-37 g/dl
-MCH 26-34 pg
(picograms)
-RDW 11.5-14.5%.
blood is drawn or
the following day.
Mean
corpuscular
volume (MCV)
MCV is the index
most often used. It
measures the
average volume
of a red blood cell
by dividing the
hematocrit by the
RBC. The MCV
categorizes red
blood cells by
size. Cells of
normal size are
called
normocytic,
smaller cells are
microcytic, and
larger cells are
macrocytic. These
size categories
are used to
classify anemias.
Normocytic
anemias have
normal-sized cells
and a normal
MCV; microcytic
anemias have
small cells and a
©
delivered to the
tissues by the
blood.
Anemia is caused
by many different
diseases or
disorders. The
first step in
finding the cause
is to determine
what type of
anemia the person
has. Red blood
cell indices help
to classify the
anemias.
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 39
decreased MCV;
and macrocytic
anemias have
large cells and an
increased MCV.
Under a
microscope,
stained red blood
cells with a high
MCV appear
larger than cells
with a normal or
low MCV.
Mean
corpuscular
hemoglobin
concentration
(MCHC)
The MCHC
measures the
average
concentration of
hemoglobin in a
red blood cell.
This index is
calculated by
dividing the
hemoglobin by
the hematocrit.
The MCHC
categorizes red
blood cells
according to their
©
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 40
concentration of
hemoglobin.
Cells with a
normal
concentration of
hemoglobin are
called
normochromic;
cells with a lower
than normal
concentration are
called
hypochromic.
Because there is a
physical limit to
the amount of
hemoglobin that
can fit in a cell,
there is no
hyperchromic
category.
Just as MCV
relates to the size
of the cells,
MCHC relates to
the color of the
cells.
Hemoglobin
contains iron,
which gives blood
its characteristic
red color. When
examined under a
microscope,
normal red blood
©
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 41
cells that contain
a normal amount
of hemoglobin
stain pinkish red
with a paler area
in the center.
These
normochromic
cells have a
normal MCHC.
Cells with too
little hemoglobin
are lighter in
color with a
larger pale area
in the center.
These
hypochromic cells
have a low
MCHC. Anemias
are categorized
as hypochromic
or normochromic
according to the
MCHC index.
Mean
corpuscular
hemoglobin
(MCH)
The average
weight of
hemoglobin in a
red blood cell is
©
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 42
measured by the
MCH. The
formula for this
index is the sum
of the
hemoglobin
multiplied by 10
and divided by
the RBC. MCH
values usually
rise or fall as the
MCV is increased
or decreased.
Red cell
distribution width
(RDW)
The RDW
measures the
variation in size
of the red blood
cells. Usually red
blood cells are a
standard size.
Certain
disorders,
however, cause a
significant
variation in cell
size.
©
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 43
Test Name
Urinalysis
Alternative
Names and
Abbreviations
UA
Type of
Specimen,
and How it
is Collected
From
Patient
Specimen is
collected in a
plastic
container.
©
Any
Special
Preparati
on For the
Test (e.g.
fasting)
There is no
preparation
needed for
this test.
What is
Being
Tested?
Why is this
Test
Performed?
A urinalysis is a
group of tests that
detect and semiquantitatively
measure various
compounds that
are eliminated in
the urine,
including the
byproducts of
normal and
abnormal
metabolism as
well as cells,
including
bacteria, and
cellular
fragments. Urine
is produced by
the kidneys,
located on either
side of the spine
at the bottom of
the ribcage. The
kidneys filter
wastes and
metabolic
A routine
urinalysis may be
done when you
are admitted to
the hospital. It
may also be part
of a wellness
exam, a new
pregnancy
evaluation, or a
work-up for a
planned surgery.
A urinalysis will
most likely be
performed if you
see your health
care provider
complaining of
abdominal pain,
back pain, painful
or frequent
urination, or
blood in the urine,
symptoms of a
UTI.
How Will the Result
Help the Patient?
The urinalysis test will help
to detect substances or
cellular material in the urine
associated with different
metabolic and kidney
disorders.
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 44
What is a
Normal Result
or Range of
Values?
This test has no
single number that
identifies an
abnormal result.
Your lab report
should include a
range of numbers
(reference range)
that identifies what
is expected for you
based on your age,
sex, and the method
used in that
laboratory.
byproducts out of
the blood, help
regulate the
amount of water
in the body, and
conserve
proteins,
electrolytes, and
other compounds
that the body can
reuse. Anything
that is not needed
is excreted in the
urine and travels
from the kidneys
to the bladder,
through the
urethra, and out
of the body. Urine
is generally
yellow and
relatively clear,
but every time
someone urinates,
the color,
quantity,
concentration,
and content of the
urine will be
slightly different
because of
varying
constituents.
A complete
urinalysis
©
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 45
consists of three
distinct testing
phases:
The physical
examination,
which evaluates
the urine's color,
clarity, and
concentration;
The chemical
examination,
which tests
chemically for 9
substances that
provide valuable
information about
health and
disease.
The microscopic
examination,
which identifies
and counts the
type of cells,
casts, crystals,
and other
components
(bacteria, mucus )
that can be
present in urine.
Usually, a routine
urinalysis
©
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 46
consists of the
physical and the
chemical
examinations.
These two phases
can be completed
in just a few
minutes in the
laboratory or
doctor’s office. A
microscopic
examination is
then performed if
there is an
abnormal finding
on the physical or
chemical
examination, or if
the doctor
specifically
orders it.
©
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 47
Name:_________________________
2.1.3 WORKSHEET 7: TOTAL WHITE BLOOD CELL COUNT
SLIDE 1
1. Enter your white blood cell counts for 10 different microscopic fields in Table 4.
Table 4. White Blood Cell Counts From a Peripheral Blood Smear for Slide 1
Field Number
WBC Number
1
2
3
4
5
7
8
9
10
2. Calculate the average number of WBC per microscopic field (hpf).
The average number of WBC/hpf for slide 1 = ___________________
3. Use that number to estimate the total white blood cell (WBC) count/mm3 using the
conversion chart below:
Average No. of WBCs /hpf
Estimated Total WBC/mm3
2-4
4-6
6-10
10-20
4,000-7,000
7,000-10,000
10,000-13,000
13,000-18,000
The white blood cell (WBC) count/mm3 for Slide 1 = _________________
SLIDE 2
1. Repeat the white blood cell (WBC) counts for 10 different microscopic fields on slide.
2. Enter your counts in Table 5.
©
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 48
Table 5. White Blood Cell Counts from a Peripheral Blood Smear for Slide 2
Field Number
WBC Number
1
2
3
4
5
7
8
9
10
2. Calculate the average number of WBC per microscopic field (hpf).
The average number of WBC/hpf = ___________________
3. Use that number to estimate the total white blood cell (WBC) count/mm3 using the
conversion chart below:
Average No. of WBCs /hpf
Estimated Total WBC/mm3
2-5
4-7
6-11
10-21
4,000-7,000
7,000-10,000
10,000-13,000
13,000-18,000
The white blood cell (WBC) count/mm3 for slide 2 = _________________
Study Questions
1. Where do the cells classified as white blood cells originate from?
White blood cells originate from stem cells in bone marrow.
2. What is the normal reference range for total WBC count?
The normal range for WBC count is 4,300 to 10,800 cells per cubic millimeter
(cmm) or 4.3 to 10.8 x 109 cells per liter.
©
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 49
3. Does the normal range differ depending on age or gender? If yes, why?
Yes, normal values do vary with:
 Age and gender.
 Pregnancy in the final month and labor may be associated with increased
WBC levels.
 If you have had your spleen removed, you may have a persistent mild to
moderate increased WBC count.
 The WBC count tends to be lower in the morning and higher in the late
afternoon. WBC counts are age-related.
 On average, normal newborns and infants have higher WBC counts than
adults. It is not uncommon for the elderly to fail to develop leukocytosis as a
response to infection.
 There are many drugs that cause both increased and decreased WBC counts
 Smoking may also cause an increased WBC count.
4. What is the medical term for an increased WBC count? What is the term for a
decreased count?


Increased WBC count- leukocytosis
Decreased WBC count- leukopenia
5. What diseases/patient conditions will cause an increase in the total number of WBCs?
What could cause a decrease?
An elevated number of white blood cells can result from bacterial infections,
inflammation, leukemia, trauma, intense exercise, or stress.
A decreased WBC count can result from many different situations, such as chemotherapy,
radiation therapy, or diseases of the immune system.
6. What do the units (mm3 or cmm) mean?
The unit cmm (cubic millimeter) is the volume or capacity; mm3 is the cubic area.
[For example 1 cubic meter (cm) = 1.0 x 109 mm3.]
7. How is 4,300 = 4.3 X 109?
These two values have different units of measurement.
4,300 cubic decimeters (cdm) = 4.3 x 109 cubic millimeters (cmm)
©
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 50
Name:___________________________
2.1.3 WORKSHEET 8: SUMMARY OF LABORATORY TOXICOLOGY TESTS – ANSWER KEY
Drug Category
Amphetamines
Common
Names of
Drugs
Detected
Test Type
(including
acronym)
Adderall,
Vyvanse,
Dexedrine,
Speed, and
Meth
One step
competitive
immunoassay
©
Type of
Specimen
Required
Urine or
hair
Chemicals
Detected
Amphetamin
e and
Methamphet
amine
How Long
Substances
Remain in
the Body
1-3 days –
urine
90 days - hair
Physical and
Psychological
Changes
CNS stimulant.
Anxiety and/or
general nervousness,
creative or
philosophical
thinking, perception
of increased energy,
increased sense of
well being, increase
of goal-orientated
thoughts or organized
behavior, repetitive
behavior, increased
concentration and
mental sharpness,
increased alertness,
feeling of power or
superiority,
emotional lability,
excitability,
talkativeness, and
increased expression
of aggression or
paranoia
Interesting
Facts
Originally
marketed as a
decongestant
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 51
Test
Appropriate
for Jake,
Rebecca, or
Marylou?
Barbiturates
Phenobarbital
(Luminol),
Secobarbital
(Seconal),
pentobarbital
(Nembutal),
butalbital
(Fiorinal),
amobarbital
(Amytal)
Immunoassay
(EIA) provides a cost
effective,
sensitive
method for
detection.
Reacts with a
number of
barbiturates.
Gas
chromatograph
y/mass
spectrometry
(GC/MS) is
used to further
identify the
presence of a
particular
barbiturate.
©
Urine
Barbiturate
metabolites
1-21 days
CNS depressants.
Produce a wide
spectrum of effects,
from mild sedation to
anesthesia. They are
also effective as
anxiolytics, hypnotics
and as
anticonvulsants. They
have addiction
potential, both
physical and
psychological.
The precursor
of
barbiturates,
barbituric
acid was first
synthesized
urea with
diethyl
malonate (an
ester derived
from the acid
of apples).
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 52
Benzodiazepines Diazepam
(Valium),
chlordiazepoxi
de (Librium),
oxazepam
(Serax),
lorazepam
(Ativan),
alprazolam
(Xanax),
clonazepam
(Clonopin),
and others.
Some, such as
flurazepam
(Dalmane),
alprazolam
(Xanax) and
triazolam
(Halcion)
Immunoassays
(EIA) are
utilized to
detect
benzodiazepine
s in urine. All
positives are
confirmed by
GC/MS.
Urine – to
identify
presence of
benzodiaze
pine group
Follow-up
blood
testing is
required to
identify
specific
drug.
Benzodiazep
ines
1-42 days
Benzodiazepines both
depress and stimulate
the CNS by
modulating the
GABAA receptor, the
most prevalent
inhibitory receptor
within the brain.
This produces
hypnotic, sedative
and anti-anxiety
effects, as well as
muscle-relaxing
and, amnesic
properties.
Benzodiazepi
nes are used
before certain
medical
procedures
such as
endoscopies
or dental
work to
remove
tension and
anxiety, and
are also used
prior to some
unpleasant
medical
procedures in
order to
induce
sedation and
amnesia.
©
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 53
Marylou
Cannabinoids
Cannabis,
Marijuana,
Hash
Immunoassays
are used to
initially screen
specimens for
cannabinoids
(THC).
Confirmation of
positives is by
GC/MS.
©
Urine,
blood, hair,
and saliva
9-carboxy11-nordelta-9Tetrahydroc
annabinol
(THC) – a
metabolite
of
Tetrahydroc
annabinol
produced
when
cannabinoid
s are
smoked.
Urine: single
use = 1–6
days.
Weekly = 39 days.
Daily = 7-30
days.
Hair: up to
90 days
Blood: 2-3
days
infrequent
use. Up to 2
weeks
frequent use.
Increased heart rate
and decreased blood
pressure. Impairment
of short term memory
and concentration,
mood changes such
as euphoria, altered
perception of time,
and hunger. At higher
doses, interferes with
motor coordination
and complex task
functioning.
In Kanas and
Nebraska
wild cannabis
"ditch weed"
grows in great
abundance.
These plants
have escaped
from
cultivation,
which was
encouraged
during World
War II. They
produce very
little THC,
and are not
valued for
recreational
use.
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 54
Cocaine
Cocaine,
Crack
Immunoassays
for initial
screening with
confirmation of
positives by gas
chromatograph
y/mass
spectrometry
(GC/MS).
Saliva ,
urine, or
hair
Cocaine and
its
metabolite
benzoylecgo
nine.
Saliva-1 day
Urine 4-5
days
Hair – up to
90 days
Ethanol
Alcohol
Ethanol is
screened in
urine using an
automated
ethanol
dehydrogenase
enzymatic
assay, and
confirmed by
quantitative gas
chromatograph
y.
Urine,
Blood, and
Saliva
Ethanol,
Methanol,
Isopropanol,
and Acetone
Urine – 6-24
hours
Blood – 12
hours
Saliva – 6-12
hours
©
CNS stimulant and
appetite suppressant.
The initial signs of
stimulation are
hyperactivity,
restlessness,
increased blood
pressure and
increased heart rate
and euphoria. The
euphoria is
sometimes followed
by feelings of
discomfort and
depression and a
craving to experience
the drug again.
Euphoria,
talkativeness,
relaxation, CNS
depression, impaired
cognition.
Cocaine is
used in
medicine as a
topical
anesthetic
even in
children,
specifically in
eye, nose and
throat
surgery.
Many
hospitals and
clinics test
only the
"blood
serum,"
resulting in a
blood alcohol
content figure
that can be
25% - 33%
higher than a
"whole blood"
test result.
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 55
Marylou, Jake
Hydrocodone
Lortab,
Vicodin
Immunoassays
for initial
screening with
confirmation of
positives by gas
chromatograph
y/mass
spectrometry
(GC/MS).
©
Urine
Hydrocodon
e
1-6 days
Hydrocodone is
prescribed for the
relief of moderate to
moderately severe
pain. It is taken orally
as an active narcotic
analgesic (pain
killer) and an anti
tussive (cough
suppresant). The pain
relief by
hydrocodone is
thought to involve
peripheral and
central actions but
the exact
mechanism(s)
remains unknown.
Because the drug acts
on the brain, its
major side effects are
central and include
dizziness, drowsiness,
nausea, vomiting,
euphoria,
lighheadedness and
confusion.
Hydrocodone
was until
recently the
active
antitussive in
more than 200
formulations
of cough
syrups and
tablets sold in
the United
States. In late
2006, the
FDA began
forcing the
recall of many
of these
formulations
due to reports
of deaths in
infants and
children
under the age
of six.
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 56
Marylou
MDMA
Ecstasy, 3-4Methylenediox
ymethampheta
mine
One step
competitive
immunoassay.
©
Urine
MDMA
4 days
MDMA affects the
chemistry of the
brain, in particular
by releasing a high
level of serotonin.
Serotonin is a
chemical in the brain
that plays an
important role in the
regulation of mood,
energy level and
appetite, among other
things. Technically
classified as a
hallucinogenic
amphetamine, ecstasy
has similar physical
effects as other
amphetamines:
euphoria, excitability,
nervousness, fast
heartbeat, sweating,
dizziness,
restlessness,
insomnia, etc. In
short, it produces
every sign of a
heavily
overstimulated brain
and nervous system.
The larger
danger of
ecstasy is that
it can make
the user lose
touch with his
or her body's
basic needs.
Users in allnight dances
and raves
have been
known to die
of
hyperthermia
(overheating),
caused by
overexertion
with no rest
and not
enough water.
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 57
Methaquelone
Qualuudes,
Ludes,
Mandrax
Gas
chromatograph
y/mass
spectrometry
(GC/MS).
Urine
Methaquelo
ne
2-4 days
Opiates
heroin, opium,
codeine,
morphine
Immunoassay,
confirmed by
gas
chromatograph
y/mass
spectrometry
(GC/MS).
Blood 1-3
days
Urine – 3-5
days
Hair –up to
90 days
Morphine,
Codeine, 6MAM [6monoacetylmorphine.
6-MAM- 8-10
hours
Codeine &
Morphine: 2-3 days
©
Effects include
relaxation, euphoria,
and drowsiness,
reduced heart rate,
respiration, increased
sexual arousal and
numbness of the
fingers and toes.
Larger doses can
cause depression,
slurred speech,
headache, and pain
in the eyes when
exposed to light.
The major effects are
on the central
nervous system (CNS)
and the bowel. These
include analgesia,
drowsiness
(nodding), changes in
mood, respiratory
depression, and
decreased
gastrointestinal
motility. Pupils are
constricted and not
responsive to light
stimulus.
Opiates are
found in
poppy
flowers.
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 58
Phencylidine
PCP, Angel
Dust
Immunoassay,
confirmed by
gas
chromatograph
y/mass
spectrometry
(GC/MS).
©
Blood,
Saliva,
Urine, and
Hair
PCP and it
metabolites
hydroxylate
and
glucuronide
Blood – 1-3
days
Saliva – 3
days
Urine -3-4
days
Hair up to 90
days
Phencyclidine is
rapidly absorbed
from the lung and
easily crosses the
blood/brain barrier.
PCP inhibits
depolarization of
neurons and
interferes with
cognitive and other
functions of the
nervous system.
Symptoms progress
from barely
perceptible to
comatose.
Observable symptoms
include "ether"
breath, nystagmus
(vertical and
horizontal)
movements of the eye,
"moon walk", and a
diverse variety of
behavior including
hallucinations,
catatonic rigidity,
"superhuman"
strength, lack of
stimulus to pain, time
distortions, and lack
of memory and events
while under the
influence.
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 59
Propoxyphene
Methadone
Immunoassay,
confirmed by
gas
chromatograph
y/mass
spectrometry
(GC/MS).
©
Urine
Propoxyphe
ne
2-4 days
Propoxyphene
depresses the CNS,
and respiraratory
system, and also has
gastrointestinal
effects. It may also
have mood and
thought altering
effects. It can also
act as local
anesthetic.
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 60
2.1.3 Medical Laboratory Screening
Part III: Toxicology Testing
Peer Grading Rubric of PowerPoint Presentations
The students will assess each other’s presentation using the rubric below. For each group, use
the criteria in the rubric to assess the quality of each presentation.
Table 1. Content
Each of the content categories should be rated on a 0-2 scale as follows:
2 = Very good: covered all information with sufficient detail.
1 = Okay: Information but not in sufficient detail, or some information was missing.
0 = Poor: Did not cover the required information.
Table 1. Required Content:
Was a title slide included?
Did the students define and explain the toxicology screening test?
Were the physical changes in the urine and/or blood described?
Were the chemicals usually found in the body described?
Were additional interesting facts about this screening test included?
Did the presentation include illustrations and/or animations?
Was a list of references included?
SUBTOTAL
/14
Table 2. Presentation Skills
Each of the presentation skill categories should be rated on a 0-1 scale as follows:
Yes = 1
No = 0
Table 2. Presentation Skills:
Was the presentation interesting?
Was the presentation well organized?
Were the slides neat and easily read by the audience?
Did the student avoid reading his/her presentation?
Did the student make eye contact with the audience?
Was the student able to answer questions clearly?
SUBTOTAL
/6
PRESENTATION TOTAL = __________________
©
Copyright, Stevenson University, 2009; AHP Course 1_Unit 2: Section 1_Teacher Version 2
Page 61
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