Name of Test
Test Type
Normal Adult Findings
Indications for Test
Interfering Factors & Contraindications
Clinical Significance of Findings
RBC, WBC, Platelet, Hgb, Hct, CBC with differentials, Platelets
See Basic Diagnostic Test Grid
See Basic Diagnostic Test Grid
See Basic Diagnostic Test Grid
See Basic Diagnostic Test Grid
See Basic Diagnostic Test Grid
Erythrocyte Sedimentation Rate (ESR)
Blood Test
Peripheral Blood Smear
Blood Test
Normal quantity of red blood cells (RBCs), white blood cells (WBCs), and platelets. Normal size, shape, and color of RBCs. Normal WBC differential count
Can identify concerning drugs and diseases that affect the RBCs, WBCs, or platelets. Some congenital and acquired diseases can be diagnosed by an examination of the peripheral blood smear. Infection, infestation, leukemia, and other diseases can be identified with special stains.
The smear being delayed after the blood is collected can alter the results. Not enough or too large amount of blood collected. Failure to apply to blood correctly to the slide.
Red Blood Cell (RBC) size, shape, color and intracellular structure abnormalities- can help identify causes of anemia and the presence of other diseases.
White blood cell (WBC) examination- increased numbers can indicate leukemia or infection.
Platelet examination- can determine platelet numbers that help to promote clotting.
Coombs Test, Direct
Blood Test
Normal, no agglutination
To identify immune hemolysis or to investigate hemolytic transfusion reactions
Antiphospholipid antibodies and some drugs can cause a false positive
Will identify hemolytic anemia, blood transfusion reactions, infectious mononucleosis, or blood transfusion reactions
Sickle Cell Screen
Blood Study
Negative, no sickle cells present
To screen for sickle cell disease or trait
Blood transfusions within 3-4 months, polycythemia, or certain drugs can alter results
Will identify if a patient has the sickle cell trait or sickle cell anemia. Sickle cell anemia more than 25% of the Hgb is the S variation
Folic Acid
Blood Test
Ferritin
Blood Test
Iron
Blood Test
Vitamin B12
Blood Test
160-950 pg/mL
Used to identify the cause of megaloblastic anemia
Certain drugs can decrease Vit B12 levels
Measures the amount of Vitamin B12 in the blood. Decreased levels are a sign of anemia. Increased levels (as well as decreased levels) are signs of other conditions
Erythropoietin
Blood Test
5-35 international units/L
Used to assist in differentiating the cause of anemia or polycythemia
Pregnancy can cause elevated levels. Transfused blood decreases levels. Certain drugs (SCTH, birth control pills and steroids) can increase levels.
Increased levels- Iron- deficiency, hemolytic or megaloblastic anemia, AIDS, renal cell or adrenal carcinoma.
Decreased levels- Polycythemia vera:
Prothrombin Time/International Normalized Ratio (PT/INR)
Blood Test
Partial Thromboplastin Time (PTT)
Blood Test
Blood Typing
Blood test
Compatibility
Used to determine the blood type of the patient before receiving blood or the expectant mother to assess the risks of Rh incompatibility between mother and newborn.
Non-ABO or non-Rh minor antibodies can interfere with obtaining an adequate crossmatch.
Can determine ABO type (A, B, AB or O), Rh Type (positive or negative) and Crossmatch compatibility.
D-Dimer
Blood Test
<0.4 mcg/mL
Used to identify intravascular clotting
Patients with high lipid levels or high levels of rheumatoid factor may alter results
Increased levels may indicate the patient has DIC, or a thromboembolism.
May also be elevated with surgery, cancer, or pregnancy
Fibrinogen
Blood test
60-100 mg/dL
To help aid in the diagnosis of suspected bleeding disorders. It is also used for monitoring severity and treatment of disseminated intravascular coagulation and fibrinolysis.
Blood transfusions within the past month, diets rich in omega-3 and omega-6 fatty acids, drugs that alter the levels
Increased levels: Acute inflammatory reactions (RA), acute infection pneumonia), coronary heart disease, stroke, peripheral vascular disease, pregnancy, smoking
Decreased levels: Liver disease (hepatitis, cirrhosis), advanced carcinoma, malnutrition (severe protein depletion), large- volume blood transfusion
DIC Screening
Blood test
No evidence of DIC
For patients who are suspected of having DIC, have chronic DIC, or are at risk for DIC
N/A
Should be evaluated for patients with a coagulopathy or patients with a diagnosis of sepsis or advanced cancer
Bone Marrow Biopsy
Procedural needle biopsy
Active erythroid cell line, myeloid and lymphoid cell lines, and megakaryocyte (platelet) production
To evaluate anemias, leukopenia, or thrombocytopenia. To diagnose leukemia and myelodysplastic syndromes. Used to assess abnormal iron states and to stage lymphomas or other cancers.
Contraindicated in patients that can’t comprehend an informed consent, can’t cooperate and remain still for the procedure or have acute coagulation disorders.
Can determine types of infections (Bacterial, viral or fungal), Multiple myelomas, Hodgkin’s disease, lymphoma, leukemia, anemia and rheumatic fever
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