Note: Page numbers followed by f refer to figures; those followed by t refer to tables; those followed by b refer to boxes.

%FENa test, 220

(1,3)-β-D-glucan assay, detection of yeasts by, 459

4K score, definition of, 647

4Ts score, probability of heparin-induced thrombocytopenia, 382

5′-nucleotidase, definition and normal range of, 320t, 321

5α-reductase enzymes, types of, 626

6MWT. See Six-minute walk test


α-fetoprotein (AFP)

 definition and normal range of, 520

 use of tumor marker, 516t

A1c. See Glycosylated hemoglobin

ABCB1 gene, 389

Abdominal pain, acid-base disorder with, 295b

ABG. See Arterial blood gases

Absorbance optical system, 29

Absorption transition vector, 22

ABW. See Average body weight

ACC. See American College of Cardiology


 CLIA-waived POC tests variables that affect, 53

 definition and calculation of, 3

 laboratory request form needs completeness and, 77

 qualitative CLIA-waived POC test and definition of, 53


 delay in toxicity symptoms with, 554

 hepatotoxicity after overdose of, 554f

 poisoning from multiple-ingredient drugs containing, 548b

 Rumack-Matthew nomogram for, 554

 therapeutic range, clinical considerations, sample timing, 90

See also Serum acetaminophen

ACI. See Acute kidney injury

Acid, definition of, 287

Acid-base chemistry, 287

Acid-base disorders

 classifications of, 291, 292t

 types and causes of, 292–294

Acid-base homeostasis, 239–240, 290–291

Acid-base physiology, 290

Acidemia, definition of, 287

Acid-fast bacilli (AFB), timing of lab test for, 11

Acid-fast stain, for Mycobacterium, 4

Acidosis, definition of, 287

ACPA. See Anticitrullinated protein antibodies

Acquired immunodeficiency syndrome (AIDS), HIV as cause of, 474

ACR. See Albumin-to-creatinine ratio

ACS. See Acute coronary syndrome

ACT. See Activated clotting time

ACTH. See Adrenocorticotropic hormone

Activated clotting time (ACT)

 definition and normal range, 390

 monitor anticoagulation therapy with, 385

Activated partial thromboplastin time (aPTT)

 causes of decreased level of, 390

 causes of prolonged, 389

 definition and normal range, 389

 effect of warfarin on, 390

 monitor anticoagulation therapy with, 385, 389–390

Activated protein C (APC), factor V Leiden mutation and, 386, 387

Acute coronary syndrome (ACS), 139, 141b, 142b

Acute dyspnea, BNP levels in, 144t

Acute kidney injury (AKI), 203

Acute-phase reactants, definition and diseases associated with, 498, 503, 504–505

ADA. See American Diabetes Association

ADAM. See Androgen deficiency in aging men

Addison disease, cause and symptoms of, 188

ADH. See Antidiuretic hormone

Adnexal tumor, hirsutism secondary to, 612b

Adolescent, definition of age group, 574t

Adrenal disorders, 186–188

Adrenal gland, anatomy and physiology, hormone production of, 186, 625

Adrenal insufficiency, cause and symptoms of, 188

Adrenocorticotropic hormone (ACTH)

 pregnancy affects, 13

 test adrenal insufficiency with, 188

 timing of lab test for, 11

Adult, definition of age group, 574t

AEDs. See Antiepileptic drugs

AFB. See Acid-fast bacilli

Affinity separation method, description/advantage of HgbA1c test using, 57

AFP. See α-fetoprotein

AG. See Anion gap

Agar, bacterial growth medium and types of, 407t

Agar dilution susceptibility testing, procedure for, 415


 laboratory test results affected patient’s, 11

 number/affinities of drug receptors change with, 81

Age groups, definitions and terminology used for, 574t

Agglutination immunoassay, description and use of, 32, 32f

Agglutination reaction, types of, 32


 laboratory test results affected by, 12t

 physiologic changes associated with, 11

Aging Male’s Symptoms (AMS) scale, 628

Agranulocytosis, 372

AHA. See American Heart Association

AHFS Drug Information, description of, 47

AIDS. See Acquired immunodeficiency syndrome

Alanine aminotransferase (ALT, SGPT)

 definition and normal range of, 316, 324–325

 pediatric and adult normal ranges, 592


 description and normal range of, 317

 prolonged INR and low serum, 333b

See also Serum albumin

Albumin-to-creatinine ratio (ACR), kidney function and, 202

Albuminuria, ADA recommendations for, 176–177

ALK. See Anaplastic lymphoma kinase

Alkalemia, definition of, 287

Alkaline phosphatase (ALP)

 definition and normal range of, 316, 320, 320t, 321t

 pediatric and adult normal ranges, 592

Alkalosis, definition of, 287


 definition of, 120t

 no-function, 124

Allele function, standardized by CPIC, 123

ALP. See Alkaline phosphatase

ALT. See Alanine aminotransferase

Altitude, lab tests affected by, 13–14

AMA. See Antimitochondrial antibodies


 definition, causes, symptoms of, 605–607, 606t, 607t

 exercise and weight loss as cause of, 608b

 laboratory tests and diagnosis of, 608t

American College of Cardiology (ACC)

 ASCVD prevention guidelines of, 59

 dyslipidemia guidelines, 153

American College of Emergency Physicians, 546

American College of Rheumatology (ACR), 501

American Diabetes Association (ADA)

 recommends diabetes tests be NGSP certified, 57

 screening schedule for high-risk persons, 169

American Heart Association (AHA)

 ASCVD prevention guidelines of, 59

 cholesterol guidelines by, 149

 dyslipidemia guidelines, 153

American Society of Andrology, 629

American Thoracic Society (ATS), 307

American Urological Association Symptom Index (AUA-SI), 636–637

American Urological Association/Society of Urologic Oncology, 5b


 importance of sample timing with, 87

 therapeutic range for, 96–97

Aminotransferases, types of, 316, 324–325

Amiodarone, therapeutic range and clinical considerations, 103

Ammonia, definition, normal range, causes of increased, 325–326

AmpC, bacterial hyperproduction of, 418

Amperometry, description of, 170

Amphetamine abuse, reliability of amphetamine results to show, 547b

AMS. See Aging Male’s Symptoms

Amylase, description and normal range of blood and urine, 339–340

ANA. See Antinuclear antibodies

Anaerobic bacteria, tests to identify, 420–421

Analyte, definition, reference ranges vary for different forms, 3

Analyzers, components/functions of automated, 20

Anaplastic lymphoma kinase (ALK)

 description of fusion gene, 523

 personalized cancer treatment with tumor marker, 516t

ANCA. See Antineutrophil cytoplasmic antibodies

Androgen deficiency in aging men (ADAM), definition, causes of, questionnaire for, 626, 628

Andropause, definition of, 626


 acute blood loss and, 365–366

 chronic diseases that cause, 367

 definition and causes of, 5, 359

 identifying candidates for CLIA-waived POC test, 58

 increased mean cell volume with, 361–362b

 iron stores and, 364b

 low platelet count and, 366b

 pediatric causes of, 595

 types and diagnosis of, 360f, 360t

ANF. See Atrial natriuretic factor

Angiotensin receptor neprilysin inhibitor (ARNI), 145

Anion gap (AG)

 definition and normal range of, 289

 causes of, 289, 292, 293t

Anode stripping voltammetry, 26

Antagonism, definition of, 417


 choosing antibiotic therapy using a cumulative, 431b

 CLSI recommendations for developing, 430t

 hospital, 428, 429, 430f

Antibiotic activity, dilution methods to measure, against particular bacterium, 412

Antibiotic concentration gradient methods, 416

Antibiotic resistance mechanisms, methods of detecting, 418


 agglutination reaction, avidity and affinity of, 32

 structure of an, 492f

Antibody tests, detect pathogens and infection, 55

Anticitrullinated protein antibodies (ACPA)

 description of, 493

 JIA and presence of, 504

 quantitative and qualitative assay of, 493

 in rheumatoid arthritis, 502

Anticoagulant drug therapy, coagulation tests to monitor, 381t

Anticoagulant medications, action of, 380t

Antidiuretic hormone (ADH)

 diabetes insipidus and, 188–189

 water/sodium regulation by, 231, 232

Anti-double-stranded DNA (anti-dsDNA) test, SLE and presence of, 505

Antidoping, control of doping by, 558

Antiepileptic drugs (AEDs)

 applications and indications for monitoring, 82t, 91–96

CYP3A5 gene and, 125

 interpreting drug concentrations of, 82t

 trough level used as therapeutic confirmation for, 86

 unbound serum concentration of, 89b

Antifungal drugs

 applications and therapeutic range for, 84t, 99–100

 interpreting drug concentrations of, 84t

Antifungal susceptibility testing, 461

Antigen, definition of, 491

Antigen-detection test, molecular CLIA-waived POC test higher sensitivity than, 66

Antigen tests

 CLIA-waived POC test for influenza A and B, 63–64, 65t

 description and advantages/disadvantages of, 55

 detect pathogens and infection with, 55

Anti-histone (nucleosome) antibodies, definition and normal range of, 495

Antikinetochore antibody, test for, 495

Anti-La/SSB antibodies, SLE and presence of, 505

Antimicrobial drugs

 applications for, 96–99

 interpreting drug concentrations of, 83t

Antimicrobial combination test (synergy test), description of, 417

Antimicrobial susceptibility tests

 advantages and disadvantages of, 413t

 quantitative/qualitative methods for, 411–412, 412t

Antimicrobial therapy, benefits of combination, 417

Antimitochondrial antibodies (AMA), 331

Antimycobacterial drugs, for tuberculosis, 100

Antineutrophil cytoplasmic antibodies (ANCA), definition of, 496–497

Antinuclear antibodies (ANA)

 definition of, 493–494

 drugs that affect test for, 13

 JIA and presence of, 504

 SLE and presence of, 505

 test for rheumatoid arthritis, 502–503

 titer for, 496

Antinuclear cytoplasmic antibodies, rheumatic disease and, 497t

Antiphospholipid antibody syndrome (APS), 386, 506

Antiretroviral drugs, applications, therapeutic range, clinical considerations, 100–101

Antiretroviral drug resistance, phenotypic and genotypic assays for, 480–481

Anti-Ro/SSA antibodies, SLE and presence of, 505

Anti-Sm antibodies, SLE and presence of, 505

Antithrombin (AT), coagulation inhibited by, 379

Antithrombotic medications, action of, 380t

Antithyroid antibodies, diseases with high level of, 186

Antitopoisomerase I antibody, test for, 495

Antiviral susceptibility testing, description of, 474

Anti-Xa, definition, use, and normal range of, 391

APC. See Activated protein C

Apolipoproteins, function of, 150, 150f

Apparent strong ion difference (aSID), 290

APS. See Antiphospholipid antibody syndrome

aPTT. See Activated partial thromboplastin time

Area under the curve (AUC), steady-state average concentration and, 87

ARNI. See Angiotensin receptor neprilysin inhibitor

Array-based comparative hybridization, definition of, 40

Arrhythmia, definition of, 139

Arterial bicarbonate, definition and normal range of, 288–298

Arterial blood gas (ABG)

 interpretation of, 291

 steps for assessment of, 291–292

 definition and use of, 287–289

Arterial oxygen content (CaO2), 289

Arterial oxygen saturation (SaO2), definition and normal range of, 289

Arterial partial pressure of carbon dioxide (PaCO2), definition and normal range of, 288

Arterial partial pressure of oxygen (PaO2), normal range and factors that affect, 288

Arterial pH, definition and normal range of, 288

Arthritis, differential diagnosis for, 504b

ASCVD. See Atherosclerotic cardiovascular disease

aSID. See Apparent strong ion difference

Aspartate aminotransferase (AST, SGOT)

 definition and normal range of, 316, 324–325

 pediatric and adult normal ranges, 592


 digoxin, 6

 total bound and unbound substance measured by, 3

See also Specific names of assays

Association for Molecular Pathology PGx Working Group, 123

Association for Molecular Pathology, 124

AST. See Aspartate aminotransferase

Asthma, spirometry to diagnose, 304, 305b

Atherosclerotic cardiovascular disease (ASCVD)

 community/corporate health programs screen for, 58

 risk factors for, 149

 U.S. deaths due to, 58

Atomic absorption (AA) spectrophotometer, uses for, 22–23

Atomic emission spectrophotometer, 22

Atoms, clinical laboratory use and classes of, 32

Atrial natriuretic factor (ANF), 233

Atrial natriuretic hormone, pregnancy affects, 13

AUA-SI. See American Urological Association Symptom Index

AUC. See Area under the curve

Autoantibody testing, for diabetes mellitus, 167

Autoinduction, example of, 85–86

Automation, definition and characteristics of lab test, 19–20

Automation, hospital/clinical laboratory, 20–21

Average body weight (ABW), creatinine clearance and, 206

Azotemia, causes of, 204t


B lymphocytes, types and functions of, 372

β-ketone test, ketones in blood, 175

β-lactam drugs, therapeutic range and clinical considerations, 98–99

β-lactamase activity, antibiotic resistance and detection of, 418

β-thromboglobulin, definition and normal range of, 385

β-trace protein (BTP), description and normal range for, 203

β2, β-2 microglobulin (B2M, B2M)

 definition and normal range of, 520

 description and normal range for, 203

 use as tumor marker, 516t

B2M, B2M. See β-2 microglobulin

Back-extrapolated volume (BEV), 307


 biochemical tests and rapid diagnostic tests to detect, 407–408

 characteristics of, 403

 culture and identification of, 406

 genotypic and phenotypic testing of, 406–407

 growth requirements for aerobic and anaerobic, 406

 laboratory tests for detecting miscellaneous, 422–427t, 428f

 specimen collection and identification of, 403–404

Bacterial meningitis, laboratory tests to diagnose, 431–433, 432t

Bacterial pneumonia, laboratory tests to diagnose, 433–434

Bacteriuria, definition of, 213

BAMT. See Blood assay for Mycobacterium tuberculosis

Bariatric surgery, copper deficiency after, 255

Baroreceptors, function of, 231

Basal body temperature (BBT), infertility and charting of, 613

Base, definition of a, 287

Baseline laboratory tests, obtained prior to therapy, 15

Basic metabolic panel (BMP), example of lab test profile, 8

Basophils, definition, function, and normal range of, 369

Bayesian method, dosage adjustment method, 88, 97, 98

BBT. See Basal body temperature

BCR-ABL fusion gene, Philadelphia chromosome and, 521

BCT. See Bronchial challenge test

Benign prostatic hyperplasia (BPH), definition, symptoms, and causes, 636

BEV. See Back-extrapolated volume

Bias, quantitative CLIA-waived POC test and definition of, 53

Bicarbonate (HCO3), 288

Bicarbonate/carbonic acid system, extracellular buffer, 290


 conjugated versus unconjugated subforms verses bound to albumin, 3–4

 definition, production, and normal range of, 321, 322f

 description and normal range for urine, 217

 direct versus indirect, 4

 pediatric and adult normal ranges, 593

See also Total bilirubin

Bioavailability, grapefruit juice enzyme and drug, 13

Bioavailable testosterone

 laboratory tests for, 631

 pediatric and adult normal range, 630, 630t

Bioelectrical impedance analysis, to evaluate malnutrition, 281

Biologic rhythms, characteristics and types of, 12

Biologic specimens, types of, 404t

Biological marker. See Biomarker

Biological rhythm. See Biologic rhythm

Biomarker, FDA definition of, 4

Biotin nutritional supplement, elevated thyroid hormones caused by, 46b

Bladder urothelial carcinoma recurrence surveillance, 5b

Bleeding disorders, coagulation tests to diagnose, 386

Bleeding time (BT), definition and normal range of, 385


 components of whole, 7

 description and normal range for urine, 217

 laboratory tests for HIV for screening donor, 475t

Blood assay for Mycobacterium tuberculosis (BAMT), 485

Blood chemistries

 CLIA-waived POC tests for, 59

 identifying patients for CLIA-waived POC tests, 59

 pharmacist monitors renal/liver function by, 59

Blood chemistry analyzer, types of analytes measured by, 59

Blood coagulation, screening test for, 8

Blood culture, example of diagnostic test, 8

Blood ethanol, toxic effects and medicolegal problems from, 553, 553t

Blood sampling, methods, sites, and volume for pediatric patients, 574–575

Blood urea nitrogen (BUN)

 causes of elevated, 204, 204t

 description and normal range for, 204

 example of lab test profile, 8

 relationship to serum creatinine SCr, 204–205, 206f

 causes of deceased, 204

Blood urea nitrogen:serum creatinine ratio (BUN:SCr), description, normal range, 236–237

Blood volume, age group and total, 575t

BMI. See Body mass index

BMP. See Basic metabolic panel

BNP. See B-type natriuretic peptide;

 Brain natriuretic peptide

Body mass index (BMI), 144

Body plethysmography, definition and use of, 309

Body sites

 examples of normally sterile, 408t

 normal colonizing bacteria flora in, 409t

Body surface area (BSA)

 Dubois-Dubois and Mostellar equations for, 206

 pediatric patients and estimating, 589

Bone marrow, description and physiology of, 355

Bone marrow biopsy, reason for and sites of, 356–357

Bone marrow suppressant drugs, lab tests affected by, 13

Bound substance, effect of unbound substance versus, 3

Boyle’s law, 309–310

BPH. See Benign prostatic hyperplasia

BPH Impact Index score, 637


 description of viral oncogene, 522–523

 personalized cancer treatment with tumor maker, 516t

Brain natriuretic peptide (BNP), 233–234

Branched DNA amplification, 38

Breast cancer, use of tumor markers in, 518b

Breath alcohol test, 553–554

Brief Male Sexual Function Inventory, 634, 634t

Bronchial challenge test (BCT), 311–312

Bronchodilator drugs

 applications of, 82t, 90–91

 interpreting drug concentration of, 82t

Bronchodilator responsiveness test, 307

Broth, bacteria growth medium and types of, 407t

Broth macrodilution susceptibility testing, 413f, 414

Broth microdilution susceptibility testing, 414–415, 414f, 420

BSA. See Body surface area

BTP. See β-trace protein

B-type natriuretic peptide (BNP), diagnostic test for, 8

Buffers, acid-base imbalance and role of, 290

BUN. See Blood urea nitrogen


C3, definition and normal range of complement protein, 498

C4, definition and normal range of complement protein, 498

C-peptide, to differentiate between Type 1 and Type 2 DM, 167

C-reactive protein

 correlation with serum albumin, 278f

 definition and normal range of, 499

 not clinical marker for nutritional status, 280–281

C-serotonin release assay, 383

C-urea breath test, drugs that affect, 13

CA 15-3, definition and normal range of cancer antigen and tumor marker, 515t, 517

CA 19-9, definition and normal range of cancer antigen and tumor marker, 515t, 519–520

CA 27.29, definition and normal range of cancer antigen and tumor marker, 515t, 517

CA-125, definition and normal range of cancer antigen and tumor marker, 515t, 517–519

CAC. See Coronary artery calcium


 therapeutic range and clinical consideration, 91

 treatment of neonatal apnea, 90

CAH. See Congenital adrenal hyperplasia


 body regulation of, 582

 description, physiology, normal range, 245–248, 246f

 effect of vitamin D, calcitonin, parathyroid hormone on, 248

 EKG and intracellular potential for, 247f

 measurement of pediatric and adult, 583

 pediatric and adult normal ranges, 582

See also Serum calcium

Calcium channel blockers, effect on calcium of, 247

Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER), 576

Candida, MIC breakpoint for genus and species of, 462t

CaO2. See Arterial oxygen content

CAP. See College of Pathologists;

 Community-acquired pneumonia

Capillary electrophoresis (CE), components, uses, advantages of, 26–28

Capillary gel electrophoresis (CGE), uses of, 28–29

Capillary lateral flow design, CLIA-waived POC tests for HIV, 62

Capillary puncture, blood sampling method/sites for pediatric patients, 574–575

Capillary zone electrophoresis (CZE), components and use of, 27–28

Carbapenemase enzymes, chromosomal or plasmid-mediated, 418–419

Carbon monoxide (CO) breath test, 312–313

Carbonic acid (H2CO3), 290

Carbonic acid-bicarbonate buffering system, 290

Carcinoembryonic antigen (CEA)

 definition, normal range, tumor marker, 515t, 517

 elevated level of, 518b

Carcinoma, nonmuscle-invasive (NMIBC), 5b

Cardiac drugs, interpreting drug concentrations of, 84t, 101–104

Cardiac enzymes, types of, 142

Cardiac output (CO), equation for, 140

Cardiac physiology, 139–140

Cardiac-specific troponin (cTn)

 I and T diagnostic test of serum, 8

 subunit biomarker for myocardial infarction, 140–141

Cardiovascular disease, incidence in U.S. of, 149

Cardiovascular pharmacogenetics, 126b

Casts, types of urinary, 213–214, 213t

CBC. See Complete blood count

CBC with differential, meaning of, 357

CC. See Capillary electrophoresis

CD4+ T lymphocyte count, test for HIV, 480

CDC. See Centers for Disease Control and Prevention

CDTM. See Collaborative drug therapy management

CE. See Capillary electrophoresis

CEA. See Carcinoembryonic antigen

Cefoxitin disk diffusion test, 419

Centers for Disease Control and Prevention (CDC)

 algorithm to interpret CLIA-waived POC tests for influenza A and B, 63

 annual number of cases of HCV, 60

 pharmacist training for CLIA-waived POC tests, 68

 pharmacy training for HIV testing, 62

 recommend testing sequence for HCV, 60

 standardized testosterone assays, 629

 technical info on CLIA and POC from, 51

 website for CLIA-waived POC tests, 52t

Centers for Medicare and Medicaid Services (CMS)

 oversee CLIA, 51

 regulate facilities doing lab tests/POCT, 52

 website for CLIA-waived tests, 52t

Central venous oxygen saturation (ScvO2), taken from central venous catheter, 289–290

Cerebrospinal fluid, antigen testing for fungi in, 457

Ceruloplasmin, indicator of copper status, 255

CESI gene, 389

CGE. See Capillary gel electrophoresis

CGM. See Continuous glucose monitoring

Chain of custody, SAMHSA guidelines for drug specimen, 547

Checkerboard technique, description of, 418

Chemical analysis, semiquantitative tests and urine dipsticks, 214–220

Chemical ionization (CI), principles, components, uses of, 34

Chemiluminescence, description and components of, 22

Chemiluminescent detection method, 629

Chemistry analyzers, laboratory, 20

Child, definition of age group, 574t

Chlamydia, laboratory tests to diagnose, 436

Chlamydia trachomatis, cause of chlamydia, 436

Chloride, definition and physiology of, 242

Chloridometer, 25


 symptoms and diagnosis of, 333b

 types of, 319

Cholestatic liver disease, description of, 316–317, 318–320, 319t


 AHA guidelines for, 149

 combined enzymatic method CLIA-waived POC test for, 59

 elevated level as cause of ASCVD, 58

 identifying candidates for CLIA-waived POC test for, 58

 variants that affect CLIA-waived POC test for, 59

See also Total cholesterol

Cholesterol Reference Method Laboratory Network, NRS/CHOL standards and, 58

Chromatography, components, types, and use of, 29–30

Chromium, physiology, normal range, deficiency/excess of, 259–260

Chromogen, serum creatinine level not accurate due to noncreatine, 203

Chromophores, 59

Chronic disease, CLIA-waived POC testing and medication adjustment for, 53

Chronic kidney disease (CKD)

 anemia associated with, 367–368

 definition and classification of, 202

 KDIGO guidelines for, 591

 stages of, 207t

Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, 202, 205b, 207–208

Chronic myelogenous leukemia (CML)

 cytogenetic and molecular response of, 522t

 Philadelphia chromosome in, 521

Chronic obstructive pulmonary disease (COPD)

 postbronchodilator airflow limitation, 305

 spirometry to diagnose, 305b

Chronic pain, guidelines/testing to prevent abuse from drugs for, 558, 559t

Chronic Prostatitis Symptom Index, from NIH, 648

Chronic renal failure, calcium and phosphate disorders in, 253–254b

Chronotropic effect, management of arrhythmia with digoxin, 102

Chvostek sign, hypocalcemia and, 250

Chylomicron, description of, 150, 150f, 151t

CI. See Chemical ionization

Circadian rhythm, description and lab test results affected by, 12

CK. See Creatine kinase

CK-MB. See Creatine kinase-myocardial band

CKD. See Chronic kidney disease

CKD-EPI. See Chronic Kidney Disease Epidemiology Collaboration

Clarification of Optimal Anticoagulation Through Genetics (COAG), 129–130

CLIA Certificate of Waiver, issued by CMS, 52

CLIA-88. See also Clinical Laboratory Improvement Amendments

CLIA-waived POC tests and testing

 CDC website for professional education/information for, 52t

 CMS website list by CPT of, 52t

 government websites with information on, 52t

 legal and regulatory barriers to pharmacists doing, 69

 lipid types, 158

 outpatient pharmacies use of, 51

 performance characteristics/applications, 53–54

 pharmacy degree programs do not include infectious disease, 69–70

 qualitative and quantitative, 53

 shortage of primary care providers so pharmacists will do more, 70

 steps to take before offering, 68–69

 uses and applications of, 56–67

See also Clinical Laboratory Improvement Amendments; Point-of-care testing

Clinical and Laboratory Standards Institute (CLSI)

 criteria for MIC results, 412

 standards for cholesterol tests, 59

 standards set by, 20

Clinical drug trials, FDA looks at drug concentration versus response relationship in, 79

Clinical Laboratory Improvement Amendments of 1988, 14, 51

Clinical Pharmacogenetics Implementation Consortium (CPIC)

 clinical practice guidelines for genotype, 132

 guidelines from, 120

 standardized terms for allele function and phenotype, 123

Clostridium difficile, diagnosis, tests, and treatment for, 344

Clot degradation test, definition and use of, 392

CLSI (Clinical and Laboratory Standards Institute)

 Performance Standards and Guidelines for Antimicrobial Susceptibility Testing, 428

CML. See Chronic myelogenous leukemia

CMP. See Comprehensive metabolic panel

CMS. See Centers for Medicare and Medicaid Services

CO. See Cardiac output

Coagulation, factors that inhibit or promote, 377–378

Coagulation cascade, function of, 378, 378f

Coagulation studies, factors that interfere with, 387

Coagulation tests, lack of standardization of most common types of, 385–386

Cocaine, interpretation of workplace testing for, 552b

Cockcroft Gault equation, 14b

Cockcroft-Gault equation, estimation of creatinine clearance, 206

Cockcroft-Gault equation, glomerular filtration rate equation versus, 208

Codeine, CYP2D6 gene and, 124, 125b

Colitis, description, causes, diagnosis of, 343–344

Collaborative drug therapy management (CDTM), CLIA-waived POC testing with, 56

Collaborative practice agreement (CPA), CLIA-waived POC testing with, 56

College of Pathologists (CAP), 132

Colligative properties, 23

Colloid osmotic pressure (COP), definition of, 23

Colloid osmotic pressure (COP) osmometer, components of, 23–24

Colonization, in a biologic specimen, 408

Colony-stimulating factors, 357

Colorimetry, description of, 170–171

Combined enzymatic method, CLIA-waived POC test for cholesterol, 59

Community-acquired pneumonia (CAP), 411

Community/corporate health screenings, for ASCVD by pharmacist at, 58

Community screenings, pharmacists and CLIA-waived POC tests for diabetes of, 56


 definition and pathways to activate the system of, 497–498

 JIA and presence of, 504

 SLE and presence of, 505

 test for rheumatoid arthritis, 503

Complete blood count (CBC)

 normal range dependent on age, 11

 tests included in, 356t, 357–359

Complexity, FDA classifies POC tests by, 51

Comprehensive metabolic panel (CMP), lab tests included in, 8

Conductometic method, CLIA-waived POC test for hemoglobin using, 58

Conductometry, definition and uses of, 26

Congenital adrenal hyperplasia (CAH), definition and cause of, 611–612

Conjugated bilirubin, pediatric and adult normal ranges, 593

Contamination, definition and occurrence of, 409

Continuous glucose monitoring (CGM)

 FDA accuracy requirement for, 172

 Smartphone app for, 171

 subcutaneous sensor for, 171

Continuous pulse oximetry, 312

Coomassie dye, 27

COP. See Colloid osmotic pressure

COPD. See Chronic obstructive pulmonary disease

Copper, description, physiology, normal range of, 254

Coronary artery calcium (CAC), recommended by ACC/AHA, 157–158

Corporate health/wellness programs, CLIA-waived POC tests for diabetes for, 56

Corticotropin. See Adrenocorticotropic hormone

Corticotropin-releasing hormone (CRH), pregnancy affects, 13

Cost efficiency, automation as driver in clinical laboratory, 20

Cosyntropin, timing of lab test for, 11

Cosyntropin stimulation test, for adrenal insufficiency, 188

Cosyntropin test, example of diagnostic test, 8

Coulometry, principles, components, uses of, 24–25

Coulter principle, basis of cell counting/sizing, 35


 identifying candidates for POC tests for, 67

 novel SARS-CoV-2 virus causes, 66

 performance characteristics of, 67

 use of antigen detection and molecular tests for, 67

COVID-19 POC tests, not CLIA-waived, 67

CPA. See Collaborative practice agreement

CPA/CDTM agreement

 pharmacist adjusts drug doses, schedules testing/physician follow-up under, 56

 pharmacist authorization from patient’s primary care provider, 69

 pharmacist can screen/manage ASCVD, 58

 pharmacist monitors renal/liver function with blood chemistries, 59

 pharmacist prescribes antibiotic for urinary tract infection, 59

CPE. See Cytopathologic effect

CrCl. See Creatinine clearance

Creatine kinase (CK)

 isoforms of, 4

 location, and function of isoenzymes of, 142

 timing of postmyocardial infarction level of, 9, 11

Creatine kinase-myocardial band (CK-MB), estimate size of infarction with, 141


 description and normal range for serum, 203

 drugs that affect, 13

 normal range dependent on age, 11

See also Serum creatinine

Creatinine clearance (CrCl)

 determined from urinary creatinine, 589

 estimated from glomerular filtration rate, 589

 kidney function and, 202

 measurement/equations for, 205–206

 standardization of basis for, 589

CREST (mnemonic for several diseases), 495

CRH. See Corticotropin-releasing hormone

Criminal justice system, purpose of drug screening in, 548

Critical value, definition of, 6

Crohn disease

 copper deficiency and, 255

 malnutrition risk for, 282b


 morphology of synovial fluid, 500t

 types of urinary, 214, 215f

cTn. See Cardiac-specific troponin

Culture, identifying fungi by, 455

Culture media, types of nutritive, differential, and selective, 406

Cuproproteins, copper and, 255

Cushing syndrome, causes and symptoms of, 186–187

Cutoff value, sensitivity of quantitative test and threshold or predefined, 53

Cuvette, analytical or sample, 21, 21f, 22

Cyclic voltammetry, 26

Cyclooxygenase, platelet, 378

CYP2C9 gene, 124–125, 127f, 388

CYP2C19 gene

 clopidogrel metabolism and effect of, 385

 no-function alleles in, 124

CYP2D6 gene, codeine pharmacogenetics and, 124, 125b

CYP3A4 gene, 389. See also Cytochrome P450 3A4 enzyme

CYP3A5 gene, 125

CYP4F2 gene, definition of, 388

CYP450. See Cytochrome P450

Cystatin C

 description and normal range for, 202–203

 equation for, 207–208

 kidney function and, 202

Cystoscopy, recurrence surveillance of bladder urothelial carcinoma by, 5b

Cytochrome P450 3A4 enzyme, in grapefruit juice, 13

Cytochrome P450 family, isoenzymes, 12

Cytochrome P450 system, description of, 123

Cytometry, definition and types of, 35–37

Cytomics, definition of, 35

Cytopathologic effect (CPE), viruses produce, on cells, 472

Cytoplasmic antineutrophil cytoplasmic antibody (cANCA), test for, 496

Cytotoxic drugs, 84t, 104–105

Cytotoxicity assay, for pseudomembranous colitis, 344

CZE. See Capillary zone electrophoresis


D-Dimer, definition, uses, and normal range of, 393, 394, 394f

DailyMed (National Institutes of Health), description of, 47, 49b

DAT. See Direct agglutination test

DCCT. See Diabetes Control and Complications Trial

DEA. See Desethylamiodarone

Dehydration, interpretation of lab tests in, 14b

Dehydroepiandrosterone (DHEA), 626

Delayed-release drug, lowest concentration versus peak concentration for, 86f

Densitometry, description, components, and uses of, 27, 29

Deoxyribonucleic acid (DNA), screening test for, 8

Desethylamiodarone (DEA), metabolite of amiodarone, 103

Designer drugs, not detected on routine drug screening, 548, 549t, 560b

Detoxification, laboratory tests associated with, 325

DFA. See Direct fluorescent antibody test

DHEA. See Dehydroepiandrosterone

DHT. See Dihydrotestosterone


 as cause of secondary dyslipidemia, 151

 CLIA-waived POC test for detection/management of, 56

 CLIA-waived POC urinalysis to monitor, 59

 identifying candidates for CLIA-waived POC test for, 56

 number of Americans with undiagnosed, prediabetes, or, 56

See also Diabetes mellitus; Diabetes insipidus; Gestational diabetes

Diabetes Control and Complications Trial (DCCT), HgbA1c correlated with complications, 56

Diabetes insipidus (DI)

 drugs that cause, 232, 233t

 physiology, causes, types of, 188–189

Diabetes mellitus (DM)

 cardiovascular disease leading cause of death in, 176

 laboratory tests to diagnose, 167, 168t, 169–170

 type 1 characteristics of, 166, 166t

 type 2 characteristics of, 166–167, 166t

 type 2 HgbA1c and, 57b

 types of, 166–167

Diabetic ketoacidosis (DKA), causes and symptoms of, 172–174, 173–174b

Diagnostic tests, definition, features, purpose, examples of, 8, 8t

Diastolic heart failure, definition of, 142

DIC. See Disseminated intravascular coagulation

Diet, serum glucose and lipid profiles affected by, 13

Diffusion capacity tests, definition and types of lung, 310–311

Digital rectal examination, of prostate gland, 638


 importance of sample timing with, 87, 87b

 inappropriate timing of blood sample, 102

 serum concentrations versus myocardial tissue concentrations, 102f

 therapeutic range and clinical considerations, 101–103

 timing of laboratory test and serum concentrations of, 9

 toxicities from, 102t

Digoxin assay, 6

Digoxin immune fragment antibody, digoxin toxicity treated with, 555, 555f

Dihydropyrimidine dehydrogenase (DPD), deficiency of, 128

Dihydrotestosterone (DHT), physiologic effect of, 626t

Dilute thrombin time (dTT), definition of, 392

Diplotype, definition of, 120t

Direct agglutination test (DAT), description and uses of, 32, 366

Direct agglutination, description and uses of, 32

Direct antigen detection, of a virus, 473

Direct bilirubin

 definition of, 4

 normal range of conjugated/soluble, 321–322, 322f

Direct Coombs test, 13, 366

Direct fluorescent antibody test (DFA), 436

Direct oral anticoagulant (DOAC), 380, 387t

Direct thrombin inhibitor (DTI), 380, 381t

Disease genetic testing, versus pharmacogenetic testing, 120

Disk diffusion susceptibility testing, Kirby-Bauer method of, 415–416, 415f

Disseminated intravascular coagulation (DIC)

 formation of D-dimers in, 394f

 laboratory differential diagnosis of, 391b, 395t

Diuretic drugs, lab tests affected by, 13

Diurnal variability, effect on lab test results of, 12

DKA. See Diabetic ketoacidosis

DLCO, definition of, 311

DM. See Diabetes mellitus

DNA. See Deoxyribonucleic acid

DO2. See Oxygen delivery

DOAC. See Direct oral anticoagulant

Dome nomogram, categories for salicylate poisoning on, 554

Doping, definition of, 558

Dosage adjustments, for linear and nonlinear drug behavior, 88

Dose rate, influenced by dosing interval and amount of dose, 88

Dosing interval

 factors that affect, 86

 factors that determine fluctuation within, 86

Double-stranded DNA antibodies, definition and normal values of, 494–495

Driving under the influence, number of Americans reporting, 543

Drug, interpretation of result of non-steady-state concentration of, 11

Drug-laboratory test interaction

 medical literature can confirm, 46–47

 categories/examples of, 12–13

Drug abuse, high school seniors and type of drug used in, 546t

Drug administration, importance of documenting time of, 80b

Drug concentration

 appropriate interpretation of, 77, 79t

 information to request/evaluate, 77

 measure at steady state, 81, 82–85t, 85

 prompt-release versus sustained-release formation and, 86f

 reasons when and why results do not make sense, 79t

 sample not drawn at desired time and how to interpret, 88

Drug concentration monitoring, goals/indications for, 76

Drug databases, website to access, 49b

Drug disposition reactions, phases of, 123

Drug interference

 identifying, 44–45

 reasons for and when to suspect, 45, 46b

 steps to take in managing, 46

Drug metabolism, enzyme polymorphism and, 11–12

Drug monitoring

 future of therapeutic, 108–109

 overuse or underuse debate about, 75

Drug screening, purpose in criminal justice system, 548

Drug test, role of medical review officer in reviewing results of, 547–548

Drug therapy, rheumatic diseases and tests to monitor, 506–507, 507–508t, online drug database, 47

DTI. See Direct thrombin inhibitor

dTT. See Dilute thrombin time

Dual-energy absorptiometry, to evaluate malnutrition, 281

DuBois formula, equation for body surface area, 589

DynaMed Plus, online drug database, 47, 49b


 definition, classification of primary and secondary, 151, 152t, 153t

 risk factor for ASCVD, 149

Dysrhythmia, definition of, 139

D-Zone test, for clindamycin resistance, 420


Ecarin clotting time (ECT), definition and use of, 392

ECT. See Ecarin clotting time

ECW. See Extracellular water

Effective strong ion difference (eSID), 290

eGFR. See Estimated glomerular filtration rate

EGFR. See Epidermal growth factor receptor

EI. See Electron ionization

EIA. See Enzyme immunoassay

Electrochemistry, definition and types of, 24

Electrodes, types of, 24


 CLIA-waived POC test for, 59

 intracellular water versus extracellular water composition of, 577

 recommended dietary intake of, 230t

 traditional units converted to SI units, 230t

 types of, 229–235

 urine, 218–219

Electromotive force, 26

Electron ionization (EI), principles, components, uses of, 34

Electron microscopy (EM), detection of viruses by, 473

Electronic medical record (EMR), combining biorepositories with, 123

Electronic Medical Records and Genomics (eMERGE) description of, 123

Electroosmotic flow (EOF), 28

Electrophoresis, principles, components, types, uses of, 26–29

Electrospray ionization (ESI), principles, components, uses of, 34

ELISA. See Enzyme-linked immunosorbent assay

eMERGE. See Electronic Medical Records and Genomics

Emergency Use Authorization (EUA)

 definition for COVID-19 of, 67

 from FDA for POC tests, 51–52

EMIT. See Enzyme-multiplied immunoassay

EMR. See Electronic medical record


 activity and pharmacokinetic behavior of, 77

 pharmacokinetics affected by racemic mixture of, 81

Enantiomeric drug pairs, racemic mixture of, 90

Endpoint, definition of, 24

Enzyme Immunoassay (EIA)

 components and advantages of, 32–33

 detection of fungi by, 458

 molecular absorption spectrophotometer and, 23

Enzyme polymorphism, drug metabolism and examples, 11–12

Enzyme-linked immunosorbent assay (ELISA)

 anti-HCV, 330

C. difficile infection, 344

 heparin-induced thrombocytopenia, 383

 principles, components, uses of, 25t, 33

 quantitative assay for ACPA by, 493

 viral infectious diseases, 56

Enzyme-multiplied immunoassay (EMIT), description and use of, 25t, 33, 33f

EOF. See Electroosmotic flow

Eosinophils, definition, function, and normal range of, 369

Epidermal growth factor receptor (EGFR), 130, 516t


 definition and use of, 38–39

 personalized medicine and, 19

Epitope, definition of, 31

Epsilometer test (Etest), description of, 416, 416f


 CKD-EPI Collaboration creatinine, 207–208

 CKD-EPI Collaboration cystatin C, 207–208

 Cockcroft Gault, 14b

 creatinine clearance, 589

 Dubois-Dubois body surface area, 206, 589

 glomerular filtrate rate (GFR), 208

 Haidukewych, 94

 nitrogen balance, 280

 Modification of Diet in Renal Disease (MDRD) for glomerular filtration rate, 204, 206b, 207

 Mostellar body surface area, 206, 589

 Nernst, 24

 predictive linear regression, 90

 Schwartz bedside glomerular filtration rate, 590

 Sheiner, 89

 Tozer, 89–90

 Winter-Tozer, 94

Erectile dysfunction

 comparison of organic and psychogenic, 632t

 definition, symptoms, and causes, 631–633, 631–632t

 diagnostic tests for, 633t

 low serum testosterone and, 630b

Erection Hardness Scale, 634, 634t

Error limits, manufacturer’s package insert for CLIA-waived POC test has, 53

ERS. See European Respiratory Society (ERS), 307

ERV. See Expiratory reserve volume

Erythrocyte sedimentation rate (ESR), definition and normal range of, 357, 359, 498–499

Erythrocytes (RBCs), pediatric and adult normal ranges, 594

Erythropoietin, source of, 357

ESBL. See Extended-spectrum-β-lactamase

ESI. See Electrospray ionization

eSID. See Effective strong ion difference

ESR. See Erythrocyte sedimentation rate

Estimated glomerular filtration rate (eGFR), kidney function and, 202

Estradiol, pediatric, adult, and female normal ranges, 603–604, 610t

Estrogen receptor (ER)

 personalized cancer treatment with tumor marker, 516t

 response to treatment predicted by, 513

 use of assay, 520

Estrogen status, progesterone challenge test, 610

Ethanol, methanol and ethylene glycol poisonings treated with, 554

Ethnicity, laboratory test results affected by, 11

EUA. See Emergency Use Authorization

Euglycemic diabetic ketoacidosis, 172

European Association of Andrology, 629

European Association of Urology, 629

European Committee on Antimicrobial Susceptibility Testing (EUCAST), 461

European League Against Rheumatism (EULAR), 501

Euthyroid state, definition of, 178

Exercise challenge test, purpose of, 312

Expiratory reserve volume (ERV), definition of, 310, 310f

Extended-spectrum-β-lactamase (ESBL), 418

Extracellular water (ECW), pediatric versus adult, 576–577, 577f

Extrahepatic cholestasis, definition, causes, and laboratory tests for, 320


Facts and Comparisons, online drug database, 47, 49b

False negative (FN), 3, 4t

False positive (FP), 3, 4t

FANA. See Fluorescent antinuclear antibody

Faraday constant, 24

Faraday law, 24–25

Fast atom bombardment, ionization technique of, 34

Fasting, glucose and lipid levels after, 13

Fasting blood glucose (FBG)

 normal range dependent on age, 11

 screening test for, 8

Fasting plasma glucose (FPG), to assess glucose control, 168

Fatty liver, causes of, 323

FBG. See Fasting blood glucose

FDA. See Food and Drug Administration

FDP. See Fibrin degradation product

Fecal antigen test, for H. pylori, 342

Fecal occult blood (FOB), screening test for, 8

Fecal transplantation, for C. difficile infection, 344

Federal Bureau of Investigation Laboratory, 556

FDA (U.S. Food and Drug Administration)

 accuracy requirement for glucose tests/monitors, 172

 analytes in POC tests and EUAs from, 52t

 classifies POC tests by complexity and public health risk, 51

 determines drug concentration response early in clinical trials, 79

 Emergency Use Authorization for POCT, 51–52

 regulates POC test manufacturers, 51

 Table of Pharmacogenetic Associations from, 120

 Table of Pharmacogenomic Biomarkers in Drug Labeling from, 120

FeNO, FENO. See Fractional exhaled nitric oxide

Ferritin, definition of, 364

FEV1. See Forced vital capacity in 1 second

FEV1/FVC, definition of ratio of, 303, 304

Fibrin degradation product (FDPs)

 clot degradation and, 380

 definition and normal range of, 393

 thrombolytic therapy and elevated, 393

Fibrinogen assay, definition, use, and normal range of, 391–392

Fibrinolysis, definition, 380

Fibromyalgia, definition, symptoms, and laboratory tests for, 506

Film Array multiplex PCR system, for rapid identification of bacteria by, 408

FiO2. See Fraction of inspired oxygen

First Databank, online drug database, 47

FISH. See Fluorescent in situ hybridization

Flame emission photometer, also known as atomic emission spectrophotometer, 21

Flow cytometry, principles, components, use of, 35, 36, 37f

Flow-volume curve or loop

 obstructive and restrictive pulmonary disease and, 306f

 spirometry and, 302, 304f, 305

Fluid status, tests for assessing, 235–244

Fluorescence, description and components of, 22

Fluorescence-activated sorting, 370

 assay of blood or bone marrow, 520

 components and uses of, 37

Fluorescence polarization immunoassay (FPIA), components and use of, 25t, 33–34

Fluorescent antinuclear antibody (FANA) test, indirect, 496

Fluorescent in situ hybridization (FISH)

Fluorescent polarization, 22

Fluorescent treponemal antibody absorption (FTA-ABS) test, 437


 also known as molecular emission spectrophotometry, 22

 principle of, 36

Fluorophore, definition of, 22

FN. See False negative

FOB. See Fecal occult blood

Folate concentration, definition and normal range of, 363

Folic acid, sources, absorption, and tests for, 363

Folic acid deficiency, causes of, 363

Follicle-stimulating hormone (FSH)

 drugs affecting lab value of, 603t

 pediatric and adult normal range, 602–603

 pediatric and female normal range, 610t

Follicular phase, hormone levels during, 601

Fomepizole, ethylene glycol poisoning treated with, 554

Food and Drug Administration (FDA)

 biomarker definition by, 4

 home-testing kits approved by, 15

Forced vital capacity (FVC), definition of, 303

Forced vital capacity in 1 second (FEV1), definition of, 303, 304

Forensic issues, urine drug screens and serum drug concentrations, 556

Forward-scattered light (FSC), 36

FP. See False positive

FPG. See Fasting plasma glucose

FPIA. See Fluorescence polarization immunoassay

Fraction antigen-binding (Fab) site, on immunoglobulins, 491

Fraction of inspired oxygen (FiO2), 288

Fractional excretion of sodium (FENa), description and normal range, 235–236

Fractional exhaled nitric oxide (FeNO, FENO), 5, 8, 313

Framingham Study, HDL level protective against cardiovascular risk, 156

FRC. See Functional residual capacity

Free T4

 availability and performance of assay of, 181t

 laboratory test for thyroid disease, 179

 thyroid and nonthyroid disease levels of, 180t

Free T4 index, laboratory test for thyroid disease, 183

Free testosterone, pediatric and adult normal ranges, 629

Freezing-point depression osmometer, 23

Fructosamine, laboratory test for diabetes, 170

FSC. See Forward-scattered light

FTA-ABS. See Fluorescent treponemal antibody absorption

Full-term neonate, definition of age group, 574t

Functional residual capacity (FRC), definition of lung, 309–310, 310f

Fungi, antigen testing and detection of, 457


 description and categories of, 445–447

 genus and species names of medically important, 446t

 laboratory tests for identification of, 447, 448–453t

 molecular diagnostic tests to identify, 459–460

 stains to enhance microscopic detection of, 454–455t

Fungitell assay, 459

FVC. See Forced vital capacity


G6PD. See Glucose-6-phosphate dehydrogenase

G6PD deficiency, definition and causes of hemolysis from, 367

GAD. See Glutamic acid decarboxylase

GADA. See Glutamic acid decarboxylase autoantibodies

Gallstone disease, abdominal pain and, 341b

Gamma-glutamyl transferase (GGT), definition and normal range of, 321

Gamma-glutamyl transpeptidase (GGTP), definition and normal range of, 321

Gas chromatography (GC), principles and use of, 29–30, 25t, 30f

Gas chromatography with mass spectrometry (GC-MS), to confirm result of urine drug screen, 545

GAS. See Group A streptococcus

Gastric cancer, Helicobacter pylori-associated, 342

Gaussian (random) value distribution, reference population to have, 5–6, 6f

GC. See Gas chromatography

GDM. See Gestational diabetes mellitus

Gel electrophoresis, components of, 26–27

Gender, laboratory test results affected by, 11

Gene, definition of, 120t

“Gene chips,” 40

Genetic disease, PCR used to identify, 38

Genetic polymorphism, examples of, 12

Genetic testing, future trends in, 16

Genetics, laboratory test results affected by, 11

Geneva score, probability of venous thromboembolism, 393


 definition and use of, 38–39

 key terms for, 120t

 personalized medicine and, 19


 definition of, 120t

 response to certain drugs determined by, 81

Genotyping, definition of preemptive, 119

Genotyping platforms, tests for pharmacogenetic-related genes, 131–132

Geriatric reference range, laboratory test results and, 11, 12t

Germline mutations, definition of heritable, 129

Germline variant, definition of, 120t

Germline variation

 CPIC guidelines for drugs with, 121–122t, 132

 genotype-guided therapy and, 129

Gestational age (GA), definition of, 574t

Gestational diabetes mellitus (GDM), pregnancy and 166, 167

GFR. See Glomerular filtration rate

Gleason score, of prostate gland tumor, 639, 647–648

Global Initiative for Asthma, 2020 guidelines, 90

Global Initiative for Chronic Obstructive Lung Disease (GOLD), 90, 302–303, 304

Global Lung Function Initiative (GLI), spirometry reference values from, 302

Glomerular filtration rate (GFR)

 age-related development of, 588–589

 equations for estimating, 205b

 piperacillin-tazobactam dose based on, 590–591b

 serum cystatin C used to estimate, 591–592

Glucagon, functions of, 165

Gluconeogenesis, definition of, 165

Glucose, description and normal range for urine, 218

Glucose-6-phosphate dehydrogenase (G6PD), erythrocytes and, 128

Glucose-6-phosphate dehydrogenase deficiency (G6PD), gender/ethnicity and, 11

Glucose homeostasis, process of, 165–166

Glucose meters, website for list and features of, 171

Glucose monitors, for children and visually impaired, 171

Glucose test

 environmental factors affecting, 171–172

 FDA accuracy requirement for, 172

Glucose tolerance factor (GTF), definition of, 259

Glutamic acid decarboxylase (GAD), 167

Glutamic acid decarboxylase autoantibodies (GADA) test, 167

Glycated hemoglobin. See Glycosylated hemoglobin

Glycogen, glucose stored in the liver, 165

Glycogenesis, definition of, 165

Glycogenolysis, definition of, 165

Glycosuria, diabetes mellitus and, 219b

Glycosylated hemoglobin (A1c, HbA1c)

 biomarker for blood sugar level, 4

 CLIA-waived POC test for, 56

 diabetic patient compliance and, 168–170

GOLD MARK, mnemonic for causes of anion gap acidosis, 292

Gonadotropin-releasing hormone (GnRH), 625

Gonorrhea, laboratory tests to diagnose, 435–436

Gout, hyperuricemia and, 510b

GPA. See Granulomatosis with polyangiitis

Gram stain

 bacteria identified with, 405–406t

 identification of fungi by, 454, 454t

 microorganisms that cannot be identified with, 404

 steps in procedure of, 404

Granulocytes, definition of, 368–369

Granulomatosis with polyangiitis (GPA), quantitative and qualitative assays for, 496–497

Grapefruit juice, bioavailability of drugs altered by, 13

Gridley stain, for identification of fungus, 454, 454t

Group A streptococci (GAS)

 CLIA-waived POC tests for, 55

 diagnosing viral sore throat versus, 64

 identifying candidates for CLIA-waived POC test, 64

 performance characteristics of CLIA-waived POC test, 64, 66

 types of antigen detection methods in CLIA-waived POC tests, 66

Growth media, used to identify fungi, 456–457t

GTF. See Glucose tolerance factor


H2CO3. See Carbonic acid

Haidukewych equation, total phenytoin concentration, 94

Hair, drug toxicity strengths and weaknesses of specimen, 557t


 constant infusion versus intermittent infusion and, 85f

 prolonged at higher concentrations for phenytoin, 88

HAP. See Hospital-acquired pneumonia

Haplotype, definition of, 120t

Hapten type 1, hemolysis from, 367

Hartford method, aminoglycoside dosing and, 97

HAV. See Hepatitis A virus

HbA1c. See Glycosylated hemoglobin

HBcAg. See Hepatitis B core antigen

HBeAg. See Hepatitis B extracellular antigen

HBsAg. See Hepatitis B surface antigen

HBV. See Hepatitis B virus

HCG. See Human chorionic gonadotropin

hCG, HCG. See Human chorionic gonadotropin

HCO3. See Bicarbonate

Hct/HCT. See Hematocrit

HCV. See Hepatitis C virus

HDLs. See High-density lipoproteins

HDV. See Hepatitis D virus

Health Insurance Portability and Accountability Act, federal privacy law, 68

Healthy People 2020, goal for total cholesterol (TC), 149

Heart disease, leading cause of death in U.S., 58

Heart failure

 definition and etiology of, 142–143, 143b

 kidney function in, 211b

 laboratory tests for, 143–145

Helicobacter pylori, tests for, 342

Hematocrit (Hct, HCT)

 definition and normal range of, 356t, 358

 pediatric and adult normal ranges, 594–595

Hematologic tests, age-related differences in, 594–596

Hematology analyzer, principles of, 20, 35–36


 definition and sites of, 355–356, 355f

 inhibitors of, 357

Hemochromatosis, definition, types, symptoms, tests for, 331–332

Hemoconcentration, lab tests affected by, 13

Hemodilution, laboratory test results affected by, 13, 14t

Hemoglobin (Hgb)

 definition and normal range of, 356t, 358

 description and normal range for urine, 217

 pediatric and adult normal ranges, 594

 performance characteristics of CLIA-waived POC test, 58

 physiologic factors affecting measurement of, 58

 structure of normal adult, 27

Hemoglobin (Hgb) and hematocrit (Hct), CLIA-waived POC tests for, 57

Hemoglobin electrophoresis, use of, 27

Hemoglobin molecule, CLIA-waived POC tests based on structural differences in, 57

Hemoglobin S disease, hemoglobin electrophoresis and, 27

Hemoglobinopathy, definition and causes of, 368

Hemoglobinuria, 217

Hemolysis, drug-induced autoimmune type, 366–367

Hemolytic anemia, definition and causes of, 366, 367t

Hemolytic-uremic syndrome, 382

Hemophilia A and B, definition of, 386

Hemorrhagic disorders, coagulation tests to monitor, 381t

Hemosiderin, definition of, 364


 laboratory tests to evaluate, 380–385

 physiology of clot formation and, 377–380

Henderson-Hasselbalch physiologic approach to acid-base, 290

Heparin-induced platelet activation assay, 383

Heparin-induced thrombocytopenia (HIT)

 definition and incidence of, 382, 383t

 tests to diagnose, 383

Hepatic cirrhosis, description of, 317

Hepatic dysfunction, lab tests affected by, 13

Hepatic encephalopathy, 325, 335b


 definition, types, causes, diagnosis, of, 323, 324f

 laboratory diagnosis of acute, 336b

Hepatitis A virus (HAV)

 symptoms, persons at risk, tests for, 326–327, 326t, 327f

 vaccine for, 327

Hepatitis B virus (HBV)

 serological markers and tests for, 328t, 329f

 types, symptoms, persons at risk for, 326t, 327–330, 328f

 vaccine for, 330

Hepatitis B core antigen (HBcAg), 327

Hepatitis B extracellular antigen (HBeAg), 327

Hepatitis B surface antigen (HBsAg), 327

Hepatitis C virus (HCV)

 CLIA-waived POC test and public health efforts for, 60

 identifying candidates for CLIA-waived POC test for, 60

 laboratory diagnosis of, 336–337b

 names of CLIA-waived POC tests for, 61t

 number of Americans with, 60

 number of genotypes and subtypes of, 331

 RNA test for, 4

 symptoms and tests for, 326t, 330–331

 whole blood specimen for CLIA-waited POC test, 55

Hepatitis D virus (HDV), symptoms and tests for, 326t, 331, 332f

Hepatitis E virus (HEV), 326t, 331

Hepatocellular injury, 323

Hepatocellular liver disease, description of, 317, 319t


 after acetaminophen overdose, 554f

 drug induced, 338b

Hepcidin, iron transport by hepatic, 363

HER-2, HER. See Human epidermal growth factor receptor 2

Herbal products, in vitro interference by, 44

Heritability, genetic basis of drug variability, 119

Heroin, workplace accident with abuse of, 551b

HEV. See Hepatitis E virus

Hgb. See Hemoglobin


 enhanced pharmacy services with CPA/CDTM and POC test for, 56

 type 2 diabetes mellitus and, 57b

See also Glycosylated hemoglobin

HHS. See Hyperosmolar hyperglycemia state

High specificity test, examples of, 7

High-density lipoproteins (HDLs)

 function and characteristics of, 150, 151t, 151f

 lipid panel component and values for, 156

 protect against atherosclerosis, 150

High-level aminoglycoside resistance (HLAR), 419

High-performance liquid chromatography (HPLC), components and use of, 25t, 30, 31f

High-pressure liquid chromatography (HPLC), drugs interfere with, 44

Hirsutism, definition, causes, laboratory findings, 611–612, 612t

Histology, another name for image cytometry, 36

HIT. See Heparin-induced thrombocytopenia

HIV. See Human immunodeficiency virus

HLA. See Human leukocyte antigen

HLAR. See High-level aminoglycoside resistance

Hodgkin lymphoma, 374

Home testing, definition, advantages/disadvantages of, 15

Home-testing kits, types of and list of FDA approved, 15

Homeostasis, types of, 238–240

Homeostatic mechanisms, water and sodium regulation, 230–232, 231f

Hospital-acquired pneumonia (HAP), 411b, 433

HPLC. See High-performance liquid chromatography

HPV. See Human papillomavirus

Human chorionic gonadotropin (hCG, HCG)

 definition and normal range of, 519

 examples of diagnostic test, 8

 use as tumor marker, 515t

Human epidermal growth factor (EGFR), definition of, 522

Human epidermal growth factor receptor 2 (HER, HER-2)

 use of, 520

 personalized cancer treatment with tumor marker, 516t

Human Genome Project, 40

Human immunodeficiency virus (HIV)

 antibody/antigen screening test, 8

 antibody tests for, 476–477

 description and serotypes of, 474

 identifying candidates for CLIA-waived POC test, 62

 laboratory tests for, 474–480, 477f

 names of CLIA-waved POC tests for, 61t

 number of American with, 62

 oral mucosal transudate specimen for CLIA-waived POC test, 55

 performance characteristics of CLIA-waived POC test for, 61t, 62

 pre-exposure prophylaxis testing for, 476b

 structure of, 28f

 viral load test, 479

 whole blood specimen for CLIA-waived POC test, 55

Human leukocyte antigen (HLA), drug-induced adverse events and, 131

Human leukocyte antigen (HLA-B27), definition and test for, 499

Human Metabolome Database Project, description of, 40

Human papillomavirus, screening test for, 8

Hyperalbuminemia, 317–318

Hyperandrogenism, definition and causes of, 610


 causes of indirect and direct, 322–323, 323t

 definition of, 594


 causes and symptoms of, 250–251

 definition and causes in pediatrics, 584

Hyperchloremia, causes of, 243–244

Hypercortisolism, steroid-induced, 187b

Hypercupremia, definition and causes, 256


 definition of, 165–166

 diagnosis, categories, therapy goals for, 172


 definition and causes in pediatrics, 581–582

 definition, causes, symptoms of, 241–242, 242t, 243b


 CLIA-waived POC test for detection/management of, 56

 definition of, 58


 definition and causes in pediatrics, 587

 definition, causes, symptoms of, 245, 245t


 after resection of pituitary tumor, 238b

 definition and causes in pediatrics, 580

 definition and symptoms of, 237

 description of, 220

Hyperosmolar hyperglycemia state (HHS), diabetes and, 175, 176b

Hyperparathyroidism, definition and causes in pediatrics, 584


 definition and causes in pediatrics, 586

 definition and causes of, 253

Hyperprolactinemia, definition and causes of, 607


 classification by etiology, 179t

 laboratory tests for, 179t

 patient with, 184b

Hypertriglyceridemia, 155b

Hyperuricemia, definition and laboratory tests for, 508–509, 510b

Hyperzincemia, definition of, 257

Hypoalbuminemia, definition of, 277–278, 317


 definition and causes in pediatrics, 582–584

 definition and causes of, 249

Hypochloremia, causes of, 243

Hypocupremia, definition, causes, and symptoms of, 255


 blood glucose range for, 172, 175

 classification of, 175

 release of hormones in, 165


 comparison of menopause (women) and late-onset (male), 628t

 definition, types, and causes of, 625–628, 627t

 hormonal changes in male, 626

 hormonal changes with late-onset, 627


 definition and causes in pediatrics, 581

 definition, causes, symptoms of, 240–241, 240t

Hypolipemic medications, effects on lipoproteins of various, 159–160, 159t


 definition and causes in pediatrics, 586–587

 definition and causes of, 245


 definition and causes in pediatrics, 578–580, 579b

 definition and symptoms of, 234–235, 234t

 description of, 219

 drugs that cause, 233t

 symptoms and diagnosis of, 236b


 causes of, 250

 definition and causes in pediatrics, 583


 definition and causes in pediatrics, 584–586

 definition and causes of, 252–253

Hypothalamic-pituitary-ovarian axis, 602f

Hypothalamic-pituitary-thyroid axis, 177f, 186


 releasing hormone from, 166f

 thyroid-releasing hormone (TRH) from, 177f


 case of possible, 185b

 cause, classification, symptoms of, 178, 178t

 definition and causes in women of, 607

 laboratory tests for, 179t

Hypouricemia, definition of, 509

Hypovolemia, lab tests affected by, 13

Hypozincemia, definition and causes of, 256–257, 257t, 258t


I-Iothalamate, urine clearance of, 202

IA-2A. See Insulinoma-associated-2 autoantibodies

IAA. See Insulin autoantibodies

IAT. See Indirect antiglobulin test

IBW. See Ideal body weight

ICA. See Islet cell cytoplasmic autoantibodies

ICD. See International Classification of Diseases

ICI. See Intracavernosal injection

ICW. See Intracellular water

Ideal body weight (IBW), creatinine clearance and, 206

Idiopathic thrombocytopenic purpura (ITP), 381t

IDLs. See Intermediate-density lipoproteins

IDMS. See Isotope dilution mass spectrometry

IDSA. See Infectious Diseases Society of America

IEF. See Isoelectric focusing

IFE. See Immunofixation electrophoresis

IFG. See Impaired fasting glucose

IgE. See Immunoglobulin E

IGNITE. See Implementing GeNomics In PracTicE

IGT. See Impaired glucose tolerance

IHC. See Immunohistochemistry

IIEF. See International Index of Erectile Dysfunction

ILE. See Intravenous lipid emulsion therapy

Illicit drug use, number of Americans reporting, 543, 544t

IM-ADR. See Immune-mediated adverse drug reaction, 131

Image cytometry, components and uses of, 36–37

Immune-mediated adverse drug reaction (IM-ADR), HLA associated, 131


 competitive, 22

 description of HgbA1c test using, 57

 drug concentration measurement done in clinic office by, 75

 heterogenous and homogeneous categories of, 31

 principles, detection methods, use for, 30–34

Immunofixation electrophoresis (IFE)

 drugs that affect, 13

 use of, 27

Immunoglobulin antibodies, serological tests show, 56

Immunoglobulin E (IgE), drugs that affect, 13


 classes of, 492

 definition, structure, and physiology of, 491–492

 function of fraction crystallizable (Fn) portion, 492

Immunohistochemistry (IHC), measurement of proteins by, 520

Immunosuppressant drugs, 84–85t, 105–107

Immunosuppressant pharmacogenetics, TPMT phenotyping and, 127b

Impaired fasting glucose (IFG), 168

Impaired glucose tolerance (IGT), 168

Implementing GeNomics In PracTicE, Pragmatic Clinical Trials Network, 123

In situ hybridization, image cytometry and, 37

In vitro drug interference

 definition, examples, reasons for, 43–44

 incidence of with new lab methods, 44–45

 substances in test tubes cause, 44

In vivo drug interference

 definition, examples, reasons for, 43

 incidence of, 44–45

 simultaneous in vitro drug interference and, 44

Inactive ingredients, in vitro interference by, 44

Indicator electrode, 24

Indifference, definition of, 417

Indirect agglutination, description and uses of, 32

Indirect antiglobulin test (IAT), 13, 366

Indirect bilirubin

 definition of, 4

 normal range of unconjugated/insoluble, 321–322, 322f

Indirect Coombs test, 13, 366

Indirect lateral flow immunoassay, CLIA-waived POC and FDA approved for HCV, 60, 61t

Infant, definition of age group, 574t


 acute phase reactants and, 438–439

 assessing sterile body fluids for, 438, 438t, 439t

 common pathogens by site of, 410t

 definition, symptoms, and laboratory/radiologic signs of, 409, 409t

Infectious diseases

 CLIA-waived POC tests diagnose, 53

 CLIA-waived POC tests qualitative for, 53

 concern of overtesting for, 70

 ELISA detects immunoglobulins in viral, 56

 pharmacy degree programs do not include POC tests, 69–70

 types of CLIA-waived POC tests for, 55–56

 types of specimens for CLIA-waived POC tests for, 55–56

Infectious Diseases Society of America (IDSA), POC test for influenza recommended by, 64


 definition, incidence of, cause of female, 613–614, 615t

 history and physical exam in female, 614t

 male factors in female, 614b


 as component of malnutrition, 276

 effect on serum albumin and prealbumin, 278

Influenza A and B

 annual number of Americans with, 63

 CLIA-waived POC tests for, 55

 identifying candidates for CLIA-waived POC test, 63

 performance characteristics of CLIA-waived POC tests, 63, 65t

 physician-pharmacist management model from CDC for, 63

Informatics, laboratory automation and, 20–21

Infradian rhythm, description of, 12

Inhibitor quotient (IQ), 101

Innocent bystander, immune complex of antibodies and RBCs, 367

Inotropic effect, management of heart failure with digoxin’s, 102

INR. See International Normalized Ratio

Insensible water loss, definition and comparison by body weight, 578

Inspiratory capacity, definition of lung, 310

Inspiratory reserve volume (IRV), definition of, 310, 310f

Insulin, β cells of pancreas secrete, 165

Insulin autoantibodies (IAA), 167

Insulin clearance, chronic kidney disease and, 202

Insulinoma, 167

Insulinoma-associated-2 autoantibodies (IA-2A), test, 167


 definition and examples of for qualitative and quantitative tests, 54

 manufacturer’s package insert gives information on, 54

Intermediate-density lipoproteins (IDLs), function and characteristics of, 150, 150f, 151t

International Classification of Diseases (ICD), codes for malnutrition in, 275, 276t

International Code of Botanical Nomenclature for Fungi, 445

International Committee on Taxonomy of Viruses (ICTV), 461

International Index of Erectile Dysfunction (IIEF), domains and score for, 634t

International normalized ratio (INR)

 calculation of, 388

 definition and normal range of, 387

 monitors anticoagulation therapy, 385

 normal range and use of, 318

International Prostate Symptom Score (IPSS), 636–637

International Sensitivity Index (ISI), definition of, 9, 388

International Society for the Study of the Aging Male, 629

International Society of Andrology, 629

International System of Units (SI), 7, 229

Internet, laboratory/healthcare system use of, 21

Intersystem crossing, 22

Intracavernosal injection (ICI) test, 633t

Intracellular water (ICW), pediatric versus adult, 576–577, 577f

Intrahepatic cholestasis, definition of, 319

Intrauterine drug exposure, 556

Intravenous lipid emulsion (ILE) therapy, rescue therapy for toxicity, 552

Invasive test, noninvasive test versus, 4

Ion detector, component of mass spectrometer, 35

Ion trap analyzer, 34–35

Ionization methods, mass spectrometry and, 34

Ion-selective electrodes (ISEs)

 advantage over flame photometry for, 24

 components, advantage, uses of, 24, 25t

Ion-selective glass membrane electrodes, 24, 25f

IPSS. See International Prostate Symptom Score

IQ. See Inhibitor quotient

Iron, storage and recycling of body, 365f

Iron deficiency, causes of, 363–364

IRV. See Inspiratory reserve volume

ISEs. See Ion-selective electrodes

ISI. See International Sensitivity Index

Islet cell cytoplasmic autoantibodies (ICA) test, 167

Isoelectric focusing (IEF), electrophoresis technique of, 26

Isoenzymes, cytochrome P450 (CYP450) family of, 12

Isothermal amplification, 38

Isothermal nucleic acid amplification method, CLIA-waived POC test for influenza A and B, 64

Isotope dilution mass spectrometry (IDMS)

 definition, 204

 serum creatinine measured by, 587, 588

ITP. See Idiopathic thrombocytopenic purpura


Jaffe method, serum creatinine measured by, 44, 587


 causes of icterus and, 322

 Gilbert syndrome and, 335b

 oral contraceptives cause, 334b

JIA. See Juvenile idiopathic arthritis

Jo-1 antibody (anti-Jo), 495–496

Joint Commission, standards for nutritional screening/assessment, 275

Junctional potential, redux potential versus, 24

Juvenile idiopathic arthritis (JIA)

 definition and laboratory tests for, 503–504

 nonrheumatic tests for, 505


KDIGO. See Kidney Disease Improving Global Outcomes

KDOQI. See Kidney Disease Outcomes Quality Initiative


 description and normal range for urine, 218

 DKA and presence of blood and urine, 174

Ketonuria, diabetes mellitus and, 174, 219b

Kidney biopsy, example of diagnostic test, 8

Kidney disease, medication safety and dosage adjustment in, 208

Kidney Disease Improving Global Outcomes (KDIGO)

 guidelines for CKD, 591

 urine testing recommendations, 214

Kidney Disease Outcomes Quality Initiative (KDOQI), guidelines for CKD, 207

Kidney function

 age groups and changes in, 578

 assessment of, 202–205

 exogenous and endogenous markers of, 202

Kidney function tests, age-related differences in, 587–592


 anatomy and physiology of, 201–202, 232

 retention and excretion of sodium/water by, 231–232

Koch-Weser, variations in steady-state serum drug concentrations, 75


 description of, viral oncogene, 522

 personalized cancer treatment with tumor marker, 516t

Kwashiorkor, definition of, 275


La/Sjögren syndrome B antibody (anti-La/SSB), test for, 495

LABA. See Long-acting β2-agonist

“Lab-on-a-chip,” microarray technology and, 40

Laboratory, areas of a centralized laboratory, 20

Laboratory information system (LIS), link to electronic medical records, 20

Laboratory practices, policies and procedures for good, 67–69, 68f

Laboratory tests

 acute coronary syndrome (ACS), 140–142

 adrenal disorders, 187–188

 biologic rhythms affect, 12

 calcium, 251t

 definition of spurious result, 16

 diabetes mellitus, 167, 168t, 169–170

 disease diagnosis and role of, 19–20

 factors that influence results of, 8–13, 9t, 10f

 glucose control, 168–172

 ketones in blood and urine, 174–175

 lipids and lipoproteins, 153–156

 noncentralized, 14–15

 nutritional status, 275–281

 OIG projected savings for Medicare, 20

 pediatric reference ranges for, 575

 performed with assays, 25t

 purpose of, 3

 questions to ask before ordering, 8

 rationale for ordering, 7

 reasons for errors in results of, 9

 reproductive cycle and hormone, 602–605

 result of isolated abnormal value versus series of, 15

 screening versus diagnostic, 8, 8t

 thyroid disease, 178–181, 179t

 thyroid disorders and drug effects on, 183t

See Specific name of test

Laboratory test-drug interactions, categories/examples of, 12–13

Laboratory test results

 guidelines for interpreting, 15–16

 in vivo/in vitro drug interference with, 43

 isolated abnormal value versus series of, 15

 reasons for errors in of, 9

Laboratory value, information needed to order/interpret, 78t

Lactate dehydrogenase (LDH)

 isoenzymes of, 4

 pediatric and adult normal ranges, 593

 timing of postmyocardial infarction level of, 11

Lactic acidosis, classifications of, 292, 293t

LADA. See Latent autoimmune diabetes mellitus

Last menstrual period (LMP), 603

Latent autoimmune diabetes mellitus (LADA), characteristics of, 167

Latent tuberculosis infection (LTBI), skin testing for, 484

Latex agglutination (LA) method, detection of fungi by, 458

Latex agglutination immunoassay, advantages/disadvantages of, 32 32f

LBW. See Lean body weight

LDH. See Lactate dehydrogenase

LDLs. See Low-density lipoproteins

Lean body weight (LBW), creatinine clearance and, 206

Left ventricular ejection fraction (LVEF), 142

Legal issues, urine drug screens and serum drug concentrations, 556

Leukemia, definition and types of, 372–374

Leukocyte esterase, description and normal range for urine, 217

Leukocytes (WBCs)

 pediatric and adult normal ranges, 594

 types of disorders of, 372

Lexicomp, online drug database, 47, 49b

Leydig cells, in testes, 625

LFTs. See Liver function tests

Lidocaine, therapeutic range and clinical considerations, 103

Lifestyle modifications, effect on lipoprotein concentrations, 153

Ligase chain reaction, 38

Light, wavelength characteristics of, 21t

Limit of detection, definition of, 53

Linear potential sweep polarography, 26

Lipase, description and normal range of, 340

Lipid disorders, definition and causes of primary and secondary, 151

Lipid level, effect of drugs on, 152

Lipid metabolism, physiology of, 149–153

Lipid panel/panel

 no longer need fasting specimen, 154, 157b

 other risk-enhancing factors to include in, 157–158

 screening test for, 8

 standard tests included in, 153

Lipolysis, definition of, 165

Lipoprotein lipase (LPL), function and characteristics of, 150, 150f

Lipoproteins, characteristics, origins, major classes of, 150, 151t

Liquid chromatography

 confirm result of urine drug screen, 545

 tandem mass spectrometry (LC-MS), 629

Liquid ion-exchange membrane electrodes, 24

LIS. See Laboratory information system

Lithium, importance of sample timing with, 87

Liver, anatomy and physiology of, 315, 316f

Liver disease, classification of, 319t

Liver enzymes, pediatric and adult normal ranges, 592

Liver failure, acute, 337b

Liver function tests (LFTs

 categories of, 316t, 317–318

 age-related differences in, 592–594

 abnormal, 334b

LLN. See Lower limit of normal

LMP. See Last menstrual period

LMWH. See Low molecular weight heparin

Loading dose, steady-state concentration with and without, 85f, 86

Long-acting β2-agonist (LABA), 307

Low molecular weight heparin (LMWH), 379–380

Low-density lipoproteins (LDLs)

 focus of dyslipidemia management, 150

 function and characteristics of, 150, 150f, 151t

 lipid panel component and values for, 156

Lower limit of normal (LLN), 302, 304

Lower respiratory tract, sputum specimen not used for CLIA-waived POC test, 55

Lower urinary tract symptoms (LUTS), benign prostatic hypertrophy and, 636, 637b

LPL. See Lipoprotein lipase

LTBI. See Latent tuberculosis infection

Lungs, anatomy and physiology of, 301

Luteal phase, hormone levels during, 602

Luteinizing hormone (LH)

 definition of, 625

 drugs affecting lab value of, 603t

 pediatric and adult normal range, 603

 pediatric and female normal range, 610t

Luteinizing hormone-releasing hormone (LHRH), chemotherapy for prostate cancer, 629

LUTS. See Lower urinary tract symptoms

LVEF. See Left ventricular ejection fraction

Lymphocyte count, not clinical marker for nutritional status, 280

Lymphocytes, definition, types, function, and normal ranges for, 370–372

Lymphoma, definition and types of, 374

Lymphopenia, anemia and, 373b


m/z ratio, description of, 34

MAC. See Membrane attack complex;

Mycobacterium avium complex

Macroalbuminuria, 176

Macroamylasemia, 340

Macro-AST, definition of, 325

Macrocyte, definition and causes of, 358

Macrocytic anemia

 drug-induced, 361t

 types of, 361–363

Macrocytic, megaloblastic anemia, 362

Macrophages, definition and normal range for, 370

Macroprolactinemia, definition of, 636


 description and normal range, 244–245

 pediatric and adult normal ranges, 586

Major histocompatibility complexes (MHC), 370

MALDI. See Matrix-assisted laser desorption/ionization

MALDI-TOF (matrix-assisted laser desorption-ionization time-of-flight)

MALDI-TOF mass spectrometry (MS), identify fungi and bacteria by, 408, 447, 460–461


 cardiac surgery and risk of, 282b

 complications of, 275

 definition of, 276

 factors for increased risk of, 281t

 phenotypic or etiologic criteria for, 281


 deficiency and excess of, 258

 description, physiology, normal range of, 257

Mantoux test, for tuberculosis, 484–485

Manufacturer’s instructions, pharmacist must follow POC test’s, 69

Manufacturer’s literature, performance characteristics of CLIA-waived POC test in, 53

Marasmus, definition of, 275

Mass analyzers, component in mass spectrometer, 34

Mass spectrometer

 Fourier transform, 35

 time-of-flight, 35

Mass spectrometry (MS)

 gold standard for unknown substances, 41

 ionization methods for, 34

 principles, components, types of, 28, 34

 types of mass analyzers for, 34

Massachusetts Male Aging Survey, 628

Matrix-assisted laser desorption/ionization (MALDI), 34

Matrix-assisted laser desorption/ionization time of flight system (MALDI-TOF), 35

MBC. See Minimum bactericidal concentration

MCH. See Mean corpuscular hemoglobin

MCHC. See Mean corpuscular hemoglobin concentration

MCTD. See Mixed connective tissue disease

MCV. See Mean corpuscular volume

MDRD. See Modification in Diet of Renal Disease

MDx. See Molecular diagnostics

Mean corpuscular hemoglobin (MCH), definition and normal range of, 356t, 358

Mean corpuscular hemoglobin concentration (MCHC), definition and normal range of, 356t, 358

Mean corpuscular volume (MCV), definition and normal range of, 356t

Mean k value, by age group, 590

Mean platelet volume (MPV), definition and normal range of, 356t, 384

Mechanization, definition and characteristics of lab test, 19–20

Medical mycology, definition of, 445

Medicare laboratory test reimbursement, cost of, 20

Medication safety, kidney disease and, 208, 209–210t

Melanoma, BRAF mutation with, 130–131

Membrane attack complex (MAC), 497

Membrane osmometer, components of, 23–24

Menkes syndrome, definition of, 255

Menstrual cycle, hormone levels during, 601, 602f

Metabolic acidosis

 cause of, 292, 293t

 chronic kidney disease and, 250

 classified by anion gap, 292, 293t

 compensatory response to, 292t

Metabolic alkalosis

 cause of, 292–293, 294t

 chloride resistant versus chloride responsive, 292, 294, 294t

 compensatory response to, 292t

 diuretic therapy as cause of, 294

Metabolic syndrome, characteristics of, 155

Metabolite, therapeutic range affected by active drug, 80, 81f

Metabolites, therapeutic response or toxicity, affected by active, 90

Metabolizer status, levels of, 123–124


 definition of, 38–40

 personalized medicine and, 19

Methadone treatment program, 558

Methicillin-resistant Staphylococcus aureus, tests to detect, 97–98, 419–420

Methotrexate, importance of sample timing with, 87–88

Methyldopa, fructosamine false test result caused by, 170

Mexiletine, therapeutic range and clinical considerations, 103

MHA-TP. See Microhemagglutination T pallidum

MHT. See Modified Hodge test

MIC. See Minimum inhibitory concentration

Michaelis-Menton, drug elimination, 88


 CLIA-waived POC test for, 60

 screening tests for, 175

Microbial identification systems, laboratory, 20

Microcytic anemia, types of, 363–365

Microhemagglutination T pallidum (MHA-TP) test, 437

Micromedex Solutions, online drug database, 47, 49b

Microorganisms, PCR better than cultures to identify, 38

Micro-satellite instability (MSI), definition of, 523

Milk-alkali syndrome (Burnett syndrome), 250

Minerals, recommended dietary intake of, 230t

Mini Nutritional Assessment, 281

Minimum bactericidal concentration (MBC)

 CLSI standardization of method for, 417

 definition of, 414

Minimum inhibitory concentration (MIC)

 antibiotic and bacteria breakpoints for, 412–414

 bactericidal activity and, 96

Mismatch repair (MMR) system, genomic alterations and, 523

Mixed connective tissue disease (MCTD), presence of ANA and RF in, 492

MMR. See Mismatch repair

moAbs. See Monoclonal antibodies

Model for End-stage Liver Disease score, 317

Modification of Diet in Renal Disease (MDRD)

 description of, 202

 equation for creatinine clearance, 205b

 equation for glomerular filtration rate, 207

Modified Centor Criteria Score, GAS diagnosed with, 64, 66b, 67t

Modified Hodge test (MHT), 418

Molds, genus and species names of medically important, 446t

Molecular absorption spectrophotometer, nephelometry and EIA, 21–23

Molecular diagnostics (MDx)

 automation and types of, 37–38

 components and uses of, 29

Molecular emission spectrophotometry, also known as fluorometry, 22

Molecular tests

 description and technology of, 55, 56

 drug disposition-related, 123–129

 drug target-related, 129–131

Monoamine oxidase inhibitors, therapeutic range, 107


 excitation and emission, 22

 types of, 21, 21f

Monoclonal antibodies (moAbs), development of, 31

Monoclonal antibody drugs, lab test results and effect of, 13

Monocytes, definition, function, and normal range of, 370

mOsm. See Serum osmolality

Mosteller formula, equation for body surface area, 589

Motor vehicle accident, acid-base disorder after, 293b

MPV. See Mean platelet volume

MRP. See Multidrug resistant gene associated protein

MRSA. See Methicillin-resistant Staphylococcus aureus

MS. See Mass spectrometry

MSI. See Micro-satellite instability

MUDPILES, mnemonic for causes of anion gap acidosis, 292

Multidrug resistant gene associated proteins (MRP1, MRP2, MRP3), 12

Multiplexed point-of-care (xPOCT) testing, definition of, 14

Multistix, types of tests with urine dipstick, 216t


 description, groups, and identification of, 481–483

 infections associated with, 482t

 speciation of, 476b

 susceptibility testing guidelines for, 483

Mycobacterium avium complex (MAC), acid-fast stain for, 4

Myelodysplastic anemia, 372

Myeloproliferative disorders, types of, 372–373

Myocardial infarction (MI)

 complications from, 140

 diagnosis by ECG and biomarkers, 140

 timing of testing enzyme levels after, 9, 11


NAAT. See Nucleic acid amplification test

NAFLD. See Nonalcoholic fatty liver disease

Nanobiosensor-based technology, future in POC testing, 16

Nanoequivalent, unit of measure for hydrogen ions, 287

Nanometer (nm), measurement of wavelength of light, 21, 21t

Nanoscale devices, size of, 40

Nanotechnology, description of, 40

Narcotic drugs, lab tests affected by, 13

NASH. See Nonalcoholic steatohepatitis

National Academy of Clinical Biochemistry (NACB), phenotyping guidelines, 120, 132

National Center for Biotechnology Information (NCBI), SNP database, 124

National Cholesterol Education Program, goal of, 58

National Comprehensive Cancer Network (NCCN), guidelines for prostate cancer, 644

National Glycohemoglobin Standardization program (NGSP)

 manufacturer certification by, 57

 standardized HgbA1c test results, 56–57, 170

National Health and Nutrition Examination Survey (NHANES III), 6, 302

National Highway Traffic and Safety Administration, list of breath alcohol test devices, 554

National Institutes of Health (NIH)

 categories/types of prostatitis, 648, 649t

 Pharmacogenomics Knowledge Database, 122

National Kidney Disease Education Program (NKDEP), SCr measurement and, 203, 588–589

National Kidney Foundation (NKF), clinical practice guidelines for CKD, 207

National Reference System for Cholesterol (NRS/CHOL), test methods for cholesterol, 58–59

National Survey on Drug Use and Health (NSDUH), 543

Natriuretic peptides

 cardiac specific B-type, 143

 water/sodium regulation by, 231, 233–234

Natural killer (NK) cells, definition and function of, 372

NCBI. See National Center for Biotechnology Information

NCCN. See National Comprehensive Cancer Network

Necrokinetics, definition of, 556

Negative predictive value (NPV)

 definition of, 5, 53

 dependent on population tested/disease prevalence, 54

 qualitative CLIA-waived POC test and, 54

Neisseria gonorrhoeae, gonorrhea caused by, 435

Neonate, definition of age group, 574t


 definition, uses, and advantages of, 23

 molecular absorption spectrophotometer used with, 21, 23

Nephrogenic diabetes insipidus, 189

Nephrology Practice and Research Network, algorithm of, 208

Nephrotoxicity, vancomycin, 97

Nernst equation, 24

Neutropenia, definition of absolute, 372


 definition, types, function, and normal range of, 369, 369t

 other names for, 369, 369t

New York Heart Association Classification, of heart failure symptoms, 143

Newborn baby, toxicological testing of, 556

Next-generation sequencing (NGS), DNA sequencing method of, 132, 523

NGS. See Next-generation sequencing

NGSP. See National Glycohemoglobin Standardization Program

NHANES III. See National Health and Nutrition Examination Survey

Nicotine detection test, 60

NIH. See National Institutes of Health

Nitrite, description and normal range for urine, 218

Nitrogen balance, description and equation for, 280

NK. See Natural killer cells

NKF. See National Kidney Foundation

NMIBC. See Carcinoma, nonmuscle-invasive

NNRTIs. See Non-nucleoside reverse-transcriptase inhibitors

NNS. See Number needed to screen

Nocturnal penile tumescence and rigidity test, 633t

Nonalcoholic fatty liver disease (NAFLD), 319

Nonalcoholic steatohepatitis (NASH), 323–324, 338b

Non–high-density lipoprotein cholesterol, lipid panel component and values for, 156–157

Non-Hodgkin lymphoma, 374

Nonion gap, causes of, 292, 293t

Nonlinearity, definition of, 88

Non-nucleoside reverse-transcriptase inhibitors (NNRTIs), 101

Nonradioactive immunoassay, 629

Non-small cell lung (NSCL) cancer, EGFR and, 522

Non-small-cell lung cancer (NSCLC), EGFR mutation with, 130

Non–ST-segment myocardial infarction (NSTEMI), 140

Normal flora, definition of, 408

Normalization of measured total concentration, use of equations and literature to, 89–90

Normochromic, normocytic anemia, causes of, 365

Northern blot electrophoresis, methods and use for, 27

NPV. See Negative predictive value

NRS/CHOL. See National Reference System for Cholesterol

NSCL. See Non-small cell lung cancer

NSCLC. See Non-small-cell lung cancer

NSTEMI. See Non-ST-segment elevation myocardial infarction

Nuclear/cytoplasmic antigens, characteristics of antibodies to, 493–494t

Nucleic acid amplification, types of, 38

Nucleic acid amplification test (NAAT), fungi and viruses identified by, 435, 447, 472

Nucleic acid methods, detection of viruses by, 472

Nucleic acid sequence-based amplification, 38

Nudix hydrolase 15 (NUDT15) enzyme, 128

Number needed to screen (NNS), definition of, 8

Nutritional assessment, purpose of, 281

Nutritional status

 Joint Commission standards for, 275

 laboratory tests for, 275–281


OATP. See Organic anion transporting peptide

Obstructive and restrictive lung diseases, types of, 302, 303t

Occupational Safety and Health Administration (OSHA), work place safety standards, 68

Occupational Safety and Health Administration, for HPLC, 30

Office of In Vitro Diagnostics and Radiological Health, FDA, 15

Office of the Inspector General (OIG), cost of Medicare lab tests, 20

OGTT. See Oral glucose tolerance test

OIG. See Office of the Inspector General

OIR. See Office of In Vitro Diagnostics and Radiological Health

“One dose fits all” strategy, avoiding, 119

Opioid analgesics, monitoring chronic therapy with, 559b

Oral glucose tolerance test (OGTT), types of, 168, 169

Oral mucosal transudate, CLIA-waived POC test for HIV, 55

Organic anion transporting peptide (OATP), 12

OSHA. See Occupational Safety and Health Administration


 definition of osmolarity versus, 230

 definition of, 23

 formula for serum, 174

Osmolarity, definition of, 23


 colloid osmotic pressure or membrane, 23–24

 types and uses for, 23

Osmometry, principles of, 23

Osmoreceptors, function of, 231

Osteoarthritis (OA), definition and laboratory tests for, 503

Ototoxicity, vancomycin toxicity, 97

Outpatient pharmacy, common CLIA-waived tests in, 56

Ovarian failure, definition and causes of, 607–608

Overweight, diabetes testing for asymptomatic persons who are, 168

Ovulation, hormone levels during, 601–602

Oxacillin-salt agar screening test, 419

Oxygen delivery (DO2), definition and equation for, 289

Oxygen saturation, definition of, 288

Oxyhemoglobin dissociation curve, definition and factors that affect, 288, 288f


P-glycoprotein (P-gp), drug transporter, 12

p24, first viral protein detected after HIV infection, 62

p24 antigen test, identification of HIV with, 479

pAbs. See Polyclonal antibodies

PaCO2. See Arterial partial pressure of carbon dioxide

PAE. See Postantibiotic effect

Pancreas, anatomy and physiology of, 316


 causes, symptoms, and tests for, 333, 339–340, 341b

 drugs that cause, 339t

 malnutrition risk for acute, 283b

PaO2. See Arterial partial pressure of oxygen

Papanicolaou smear, as a screening test, 8

Parasites, laboratory tests for detecting, 427t

Parathyroid hormone (PTH), effect on calcium of, 248, 249f

Passive (or particle) agglutination, also known as indirect agglutination, 32


 sites of infection by common, 410t

 tests to detect, 55

Patient access portal, lab data accessed via, 21

Patient self-management (PSM), for INR, 395

Patient self-testing (PST), for INR, 395

Patient-centered care, pharmacist’s role in wellness and, 51

Patient-specific factors, laboratory test results influenced by, 9

PBC. See Primary biliary cholangitis

PBP. See Penicillin-binding protein

PCA3 assay score, definition of, 648

PCOS. See Polycystic ovarian syndrome

PCR. See Polymerase chain reaction

PD-L1. See Programmed death-ligand 1

Peak, definition and reasons to use drug level, 86–87

Peak expiratory flow (PEF), definition of, 307

Peak expiratory flow rate (PEFR), 307

Peak flow meter, how to use, 307, 309

Peak time, package insert gives, for different formations of a drug, 88

Pediatric body composition, fluid compartments and, 576

Pediatric clinical presentation, adult symptoms different from, 576

Pediatric patients

 age and variations in heart/respiratory rate and blood pressure, 573–574

 physiologic differences that influence lab data, 573

Pediatric reference ranges, laboratory test and results, 11, 575

PEF. See Peak expiratory flow

PEFR. See Peak expiratory flow rate

Pelvic inflammatory disease (PID), 435

Penicillin-binding protein (PBP), 419

Penile duplex ultrasonography, 633t

Performance characteristics, manufacturer’s literature has CLIA-waived POC test, 53

Performance-enhancing drugs, detection of athletic, 558, 558t

Perfusion (P), definition of, 301–302

Perimenopause, symptoms of, 608–609, 609b

Perinuclear antineutrophil cytoplasmic antibody (pANCA), test for, 496

Periodic acid-Schiff stain, for identification of fungi, 454, 455t

Pernicious anemia, causes of, 362–363

Personalized medicine, advances in genetics and, 19

PF ratio, definition and normal value of, 288

PF4 platelet test, definition and normal range of, 385

PFGE. See Pulsed-field electrophoresis

PFT. See Pulmonary function test

PGI2. See Prostacyclin

PGs. See Prostaglandins

PGx. See Pharmacogenetic (test)


 acidemia and alkalemia refer to abnormal, 287

 consequences of abnormal, 288

 description and normal range for urine, 214–215

 drug alters specimen, 44

 factors affecting urine, 218t

 normal range of, 287

pH meter, use of ISE in, 25f


 authorized by Department of Health and Human Services to give COVID-19 POC tests, 66

 CDC says training needed on CLIA-waived POC tests for, 52t, 68

 CLIA-waived POC test for ASCVD used by, 58

 CPA/CDTM agreement for enhanced pharmacy services by, 56, 59

 role change from product focused to patient-oriented, 51

 therapeutic drug monitoring and importance of, 75

Pharmacodynamics, definition of, 79

Pharmacogene Variation Consortium, nomenclature for polymorphisms, 122

Pharmacogenetic genotyping, limitations of cost and time, 132

Pharmacogenetic test and testing (PGx)

 risks and ethical issues for, 122

 types of, 120t

 versus disease genetic testing, 120


 cardiovascular, 126b

 codeine, 125b

 description and goals of, 119 120t

 personalized/precision medicine and, 122

 resources for, 122, 123t

Pharmacogenomic information, online resources for, 123


 clinical implementation of, 132

 description and key terms, 119, 120t

Pharmacogenomics Knowledge Database (PharmGKB), description of, 122


 circadian rhythm affects aminoglycoside, 12

 description of, 123

 laboratory test and change in physiology and, 11

 racemic mixture of enantiomers and effect on, 81


 definition of, 120t

 standardized by CPIC, 123

Phenylalanine hydroxylase deficiency, test for, 6

Phenylketonuria (PKU), test for, 6, 7


 effect on T3 and T4, 181

 methods for dose adjustments for, 88

 unbound serum concentration of, 89b

PHI. See Prostate Health Index

Philadelphia chromosome, BCR-ABL fusion gene, 521

Phosphate, description, physiology, normal range of, 251

Phosphate buffer system, intra- and extracellular buffer, 290

Phospholipids, function of, 149

Phosphorescence, description and components of, 22

Phosphorus, pediatric and adult normal ranges, 584

Photodetector, 22

Photoluminescence, techniques for, 22

Photometry, definition/types of instruments, 21–23

Photomultiplier tube, 21, 21f

Physicians’ Desk Reference, description of, 47

PI. See Protease inhibitors

PID. See Pelvic inflammatory disease

Pituitary gland

 stimulating/inhibitory hormone from anterior, 166f

 thyroid-stimulating hormone (TSH) from anterior, 177, 177f

PKU. See Phenylketonuria

Plasma, definition and components of, 7

Plasminogen, factors that activate or inhibit, 381f

Platelet aggregation, definition and tests for, 385

Platelet count

 definition and normal range of, 356t, 359, 380, 382

 pediatric and adult normal ranges, 596

Platelet factor 3 (PF), 378

Platelet function, drugs that cause abnormal, 385t

Platelet function test, diseases associated with increased and decreased, 384, 384t

Platelet survival time, test of, 385


 definition and function of, 377–378

 relationship between clotting cascade and, 378f

 types of tests for, 380–385

Pleural fluid, interpretation of findings of, 438t

Pluripotential cells, definition and CD34 surface marker on, 356

PMA. See Postmenstrual age

PMN. See Neutrophil (polymorphonuclear), 369

PNA. See Postnatal age

PNA-FISH, nonamplified bacterial identification method, 408

POC (Point-of-care)

POCT. See Point-of-care testing

Point-of-care test and testing (POCT)

 advantages/disadvantages of, 14

 alternative names and apps for, 14

 breath alcohol determination, 556

 coagulation tests available as, 394

 future trends in, 16

 limitations of, 69

 miniaturization of analyzers for, 21

 personnel performing and location of, 14

 urine drug screens and, 544

 waived for pharmacists under CLIA-88, 51

Poison Control Center

 categories of poison exposure reported to, 545t

 information from clinical toxicologists in, 559


 number of annual unintentional and intentional, 543

 SAMHSA or DEA website information on, 559

Polarography, types of, 26

Policies and procedures, before offering CLIA-waived POC tests, 68

Polyclonal antibodies (pAbs), early immunoassays used, 31

Polycystic ovary syndrome (PCOS), definition, symptoms, diagnosis of, 603, 609–610, 611t

Polymerase chain reaction (PCR)

 advantages/disadvantages of, 29, 38

 description, steps of cycle, use of, 25t, 38, 39f


 factors in significance of drug metabolism, 129

 Pharmacogene Variation Consortium nomenclature for, 122

Population pharmacokinetic dosage adjustment method, 88

Positive predictive value (PPV)

 definition of, 53

 dependent on population tested/disease prevalence, 54

 qualitative CLIA-waived POC test and, 54

Postantibiotic effect (PAC), aminoglycosides, 97

Postmenopausal women, steroid hormone levels in, 610t

Postmenstrual age (PMA), definition of, 574t

Postnatal age (PNA), definition of, 574t

Postoophorectomy women, steroid hormone levels in, 610t

Postprandial glucose (PPG), two-hour readings for, 172

Posture, lab tests affected by, 13

Postvoid residual urine volume, normal range, 638–639


 description and normal range, 237–238

 description and normal range for urine, 220

 pediatric and adult normal ranges, 580–581

See also Serum potassium

Potentiometer, use of, 24

Potentiometry, description and use of, 24

PPD. See Purified protein derivative

PPG. See Postprandial glucose

PPIs. See Proton pump inhibitors

Prealbumin (transthyretin), definition, normal range, and uses of, 318


 characterized by standard deviation for quantitative CLIA-waived POC tests, 53

 CLIA-waived POC test and definition of, 53

 definition of, 3

Precision medicine, pharmacogenetics and personalized, 122

Precursor blood cells, developmental stages of, 357

Predictive linear regression equation, 90

Predictive value, definition and use of, 4, 4t


 diabetes insipidus in, 189

 gestational diabetes mellitus (GDM), 166, 167

 lab tests affected by, 13

Premature neonate, definition of age group, 574t

Premenopausal women, steroid hormone levels in, 610t

Prevalence, predictive value derived from disease, 4, 4t

Primary biliary cholangitis (PBC), symptoms and tests for, 331

Primary care physicians, pharmacists and CLIA-waived testing due to shortage of, 70

Primary care provider, value of screening lipid profile by, 157b, 158b

Primary medical literature, description and examples of, 49

Pro Time test. See Prothrombin time

Procainamide, therapeutic range and clinical considerations, 103–104

Productivity, automation as driver in clinical laboratory, 20


 benefits and drawbacks of laboratory test, 8

 definition and examples of laboratory test, 8


 drugs affecting lab value of, 604t

 pediatric and adult normal ranges, 604

 pediatric and female reproductive normal range, 610t

Progesterone challenge test, estrogen status and, 610

Progesterone receptor (PR)

 personalized cancer treatment with tumor maker, 516t

 response to treatment predicted by, 513

Progesterone receptor (PR) assay, use of, 520

Programmed death-ligand 1 (PD-L1), description of, 523

Proinsulin, precursor of insulin, 167


 adult men normal range, 634

 conditions associated with increased/decreased, 635t

 drugs affecting lab value of, 605t

 pediatric and adult normal ranges, 604

Prostacyclin (PGI2), platelet aggregation inhibited by, 378

Prostaglandins (PGs), platelet function and role of, 378

Prostate cancer

 clinical tests to stage, 639–640, 639t

 definition, symptoms, causes of, 639–640

 free PSA and probability of, 647t

 National Comprehensive Cancer Network risk-stratification guideline for, 644

 professional organizations screening recommendations for, 641t

 tissue and urine lab tests for management of, 642–643t

Prostate gland, digital rectal exam of, 638

Prostate Health Index (PHI), 647

Prostate-specific antigen (PSA)

 definition and normal range of, 517

 factors and drugs that affect level of, 645, 646t

 forms of and normal range, 640

 men (various ages/races) normal range of, 643t

 prostate cancer and interpreting level of, 645b

 use of as tumor marker, 514, 515t

 uses of, 644

 velocity of, 646

Prostate-specific antigen density (PSAD), 646

Prostate-specific antigen doubling time (PSADT), definition of, 646


 definition, cause, symptoms of, 648

 four-glass method to diagnose chronic, 650

 laboratory tests to diagnose, 435

 NIH categories/types of, 648, 649t

Protease inhibitors (PIs), 101


 causes of increased urine, 217t

 description and normal range for urine, 214

Protein binding

 bound and unbound portions of drug, 88–90

 drug concentrations with bound and unbound drug, 81

Protein C, function and deficiency of, 380, 386

Protein S, function and deficiency of, 380, 386

Protein synthesis, liver function test of, 317

Proteinuria, 60

Proteome, more complex than genome, 40


 definition of, 38–40

 personalized medicine and, 19

Prothrombin time (PT)

 definition and normal range of, 387

 monitors anticoagulation therapy, 385

 normal range and use of, 318

Proton pump inhibitors (PPIs), 342

Protozoa, laboratory tests for detecting, 423–427t

PSA. See Prostate-specific antigen

PSAD. See Prostate-specific antigen density

PSADT. See Prostate-specific antigen doubling time

Pseudoheparin resistance, definition of, 390

Pseudomembranous colitis, causes and diagnosis of, 343–344

PSM. See Patient self-management

PST. See Patient self-testing

Psychotropic drugs, 85t, 107–108

PT. See Prothrombin time

PT/INR, evaluation of prolonged, 318, 318f

Pteroylglutamic acid. See Folic acid

PTH. See Parathyroid hormone

Public health risk

 CLIA-88 categories of tests based on, 14

 FDA classifies POC tests by, 51

Public Readiness and Emergency Preparedness Act, 66

PubMed, indexing and abstracting service, 49

Pulmonary function test (PFT)

 clinical use of, 302

 evaluation of interstitial lung disease with, 311b

 pulmonary diseases and results of, 303t

 types and measurements of, 302–313

 uses of, 304t

Pulse polarography, 26

Pulsed-field electrophoresis, (PFGE), components and uses of, 29

Purified protein derivative (PPD), of tuberculosis, 484

Pyelonephritis, antibiotic regimen based on laboratory tests to treat, 429b


QC. See Quality control

Quadrupole mass spectrometer, 34–35

Qualitative antinuclear antibody (ANA) assay, definition and immunofluorescent patterns in, 496

Qualitative test

 definition and examples of, 4, 5

 examples of, 5

 lacks reference range, 5

 positive or negative result from, 5

Quality control (QC) process, laboratory, 20

Quantitative antinuclear antibody (ANA) assay, definition and normal range of, 496

Quantitative assay

 calculation of accuracy in, 3

 definition of, 552

Quantitative test, definition and examples of, 5

Quickview chart, contents of typical, 10f

Quinidine, therapeutic range and clinical considerations, 104


RA. See Rheumatoid arthritis

Radioactive iodine uptake test, diseases diagnosed with, 185–186

Radioimmunoassay (RIA)

 history, advantages/disadvantages of, 32, 629

 in vitro drug interference seen with, 44

RADT. See Rapid antigen detection test

Rapid antigen detection test (RADT), 433

Rapid plasma reagin (RPR) test, 437

Rapid urease test, for H. pylori, 342–343

Rate of change, of lab test result and, 15

RBC. See Red blood cell

RBF. See Renal blood flow

RDW. See Red cell distribution width

Reagent blank, of spectrophotometer, 21

Real-time reverse transcription polymerase chain reaction (rtRT-PCR), molecular test, 55–56

Recurrence surveillance, bladder urothelial carcinoma and, 5b

Red blood cell (RBC), 356t

Red blood cell (RBC) count

 definition and normal range of, 357–358

 pediatric and adult normal ranges, 594

Red blood cell indices

 definition and normal range of, 356t, 358

 pediatric and adult normal ranges, 595t

Red cell distribution width (RDW), definition and normal range of, 356t, 358–359

Red man syndrome, vancomycin toxicity, 97

Redox potential difference, definition, 24

Redox process, 24

Reed-Sternberg cell, 374

Reference electrode, 24

Reference population, Gaussian (random) value distribution of, 5–6, 6f

Reference range

 also known as reference interval or reference value, 5

 calculation of, 5

 definition of, 5, 6f

 different values for total and free substances, 3

 factors that influence/change, 5–6

 inaccurate if calculated from non-Gaussian test results, 6

 lab test value compared to, 15

 pediatric and geriatric lab test, 11, 12t

 preferred over normal range, 5

Reflectance photometry, CLIA-waived POC test for cholesterol using, 59

Refractometer, measure urine specific gravity, 216

Refractometry, principles and uses of, 23

Relative standard deviation, coefficient of variance and, 53

Renal blood flow (RBF), 202

Renal dysfunction, lab tests affected by, 13

Renal function, age-related development of, 588–589

Renal homeostasis, role of potassium in, 238–239, 239f

Renal plasma flow (RPF), equation for, 202

Renal system, regulation of acid-base by, 290–291

Renin-angiotensin-aldosterone system, water/sodium regulation by, 231, 232–233

Reproductive cycle, anatomy and physiology and phases of, 601

Reserve volume (RV), definition of lung, 310, 310f

Respiratory acidosis

 causes of, 294, 296t

 compensatory response to, 292t

Respiratory alkalosis

 characterized by, 294, 296t

 compensatory response to, 292t

Respiratory depression, acid-base disorder with acute, 294b

Respiratory system, regulation of acid-base by, 290

Reticulocyte count, definition and normal range of, 356t, 359

Reticulocyte index (RI), equation for, 359

Retinol-binding protein, 277t, 279

Reverse transcriptase polymerase chain reaction (RT-PCR)

 assay, 330

 molecular monitoring with, 521

Reverse transcription-loop-mediated isothermal amplification (RT-LAMP), 56

RFs. See Rheumatoid factors

Rheumatic arthritis (RA), nonrheumatic tests for, 503

Rheumatic disease

 laboratory tests to diagnose and assess, 492–493

 nonrheumatic tests and diseases associated with, 500–501

 presence of antinuclear cytoplasmic antibodies in, 497

 tests to monitor drug therapy for, 506–507, 507–508t

Rheumatoid arthritis (RA)

 ACR/EULAR classification criteria for, 502

 laboratory tests and diagnosis of, 501–503

 presence of rheumatoid factor in, 492

Rheumatoid factor (RF)

 definition of, 492–493

 JIA and presence of, 504

 quantitative and qualitative assay of, 492–493

 test for rheumatoid arthritis, 502

RI. See Reticulocyte index

RIA. See Radioimmunoassay

Ribonucleic acid (RNA) test, for hepatitis C virus, 4

Ribonucleoprotein antibodies (anti-RNP), definition and normal range of, 495

Rickets, pediatric, 585b

RNA. See Ribonucleic acid

Ro/Sjögren syndrome A antibody (anti-Ro/SSA), test for, 495

RPF. See Renal plasma flow

RPR. See Rapid plasma reagin

RT-LAMP. See Reverse transcription-loop-mediated isothermal amplification

RT-PCR assay, for C. difficile infection, 344

RT-PCR. See Reverse transcriptase polymerase chain reaction

rtRT-PCR. See Real-time reverse transcription polymerase chain reaction

Rumack-Matthew nomogram, for acetaminophen poisoning, 554

RV. See Reserve volume


SABA. See Short-acting β2-agonists

Salicylate poisoning, Dome nomogram categories for, 554


 drug toxicity strengths and weaknesses of specimen, 557t

 substitute for unbound drug concentration, 90, 94

SAMHSA. See Substance Abuse and Mental Health Services Administration

Sample timing

 digoxin and importance of, 87, 87b

 peak, trough, or “random” drawing, 77, 81–85

SaO2. See Arterial oxygen saturation


 focus of current malnutrition research, 275

 prevalence in population by age, 276t

SARS-CoV-2. See Severe acute respiratory syndrome coronavirus 2

SBT. See Serum bactericidal test

Schilling test, for vitamin B12, 362

Schlichter test, 417

Schwartz bedside equation, for glomerular filtration rate, 590

Scleroderma, presence of RF in, 492

SCr. See Serum creatinine

Screening test

 characteristics of, 8

 definition, features, and examples of, 8, 8t

ScvO2. See Central venous oxygen saturation

SDD. See Susceptible-dose dependent

Secondary medical literature, description of, 49

SEGA. See Subependymal giant cell astrocytoma

Seizures, hyponatremia and, 579b

Selective serotonin reuptake inhibitors, therapeutic range, 107


 deficiency and excess of, 259

 description, physiology, and normal range of, 258

Self-monitoring blood glucose (SMBG) monitors, 171

Self-monitoring tests, blood glucose, 170–171

Semiquantitative test, definition and examples of, 6


 definition of positive percent agreement or, 53

 definition, examples, calculation of, 6, 7t

 performance characteristic independent of population tested, 53

 predictive value derived from, 4, 4t

Serological tests, for chronic diseases and public health surveillance, 56

Serology tests

 to detect antibody response to a virus, 473–474

 to detect fungi, 458

Serotonin norepinephrine reuptake inhibitors, therapeutic range, 107

Sertoli cells, in testes, 625, 626

Serum, definition and components of, 7

Serum acetaminophen

 overdose and, 554, 555b

See also Acetaminophen

Serum albumin

 correlation with C-reactive protein, 278f

 not clinical marker for nutritional status, 277

 pediatric and adult normal ranges, 592

 physiologic functions of, 276–277, 277t

See also Albumin

Serum antinuclear antibody titer, 5

Serum bactericidal test (SBT, Schlichter’s test), description of, 417

Serum bicarbonate

 pediatric and adult normal ranges, 582

 total CO2 content and, 288

 venous total carbon dioxide and, 289

See also Bicarbonate

Serum binding, altered drug, 88

Serum calcium

 also known as ionized calcium, 3

 causes of abnormal concentration of, 249

See also Calcium

Serum concentrations, objectives and types of analysis for toxin, 552–553

Serum creatinine (SCr)

 description and normal range for, 203

 factors that influence pediatric, 587

 Jaffe method and IDMS method to measure, 587

 kidney function and, 202

 laboratory methods to measure, 203

 pediatric and adult normal ranges, 587

See also Creatinine

Serum Cystatin C, glomerular filtration rate estimated from, 591–592

Serum digoxin concentration, toxicity and, 555

Serum drug concentrations, therapeutic effect or toxicity predicted by, 75

Serum ferritin, definition and normal range of, 365

Serum iron, definition and normal range of, 365

Serum lactate, definition and normal range of, 289

Serum osmolality (mOsm)

 formula for, 174

 normal range and equation for, 229–230

Serum potassium

 Gaussian (random) value distribution of, 6f

See also Potassium

Serum prealbumin, functions of, 278

Serum protein electrophoresis (SPE)

 drugs that affect, 13

 uses of, 26

Serum retinol-binding protein, not clinical marker for nutritional status, 279

Serum sodium

 description and normal range for urine, 219–220

 description and physiology of, 229

 pediatric and adult normal ranges, 578

See also Sodium

Serum testosterone

 erectile dysfunction and low, 630b

 guidelines for treatment of low, 629

See also Testosterone

Serum transferrin, function of, 279

Serum uric acid, definition and normal range of, 508

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), CLIA-waived POC tests for, 55

Sex hormone-binding globulin (SHBG), 611, 625–626, 626t

Sexual Health Inventory for Men (SHIM), questionnaire, 634, 634t

Sexually transmitted diseases (STDs), laboratory tests to diagnose, 435–438

SHBG. See Sex hormone-binding globulin

Sheiner equation, normalize measure total concentration, 89

SHIM. See Sexual Health Inventory for Men

Short-acting β2-agonists (SABA), 307

Shortness of breath, acid-base disorder with fever and, 295b

SI. See International Systems of Units

SIADH. See Syndrome of inappropriate antidiuretic hormone

Sickle cell, screening test for, 8

Sickle cell disease, hemoglobin CLIA-waived POC test, 58

Sickle cell trait, 368

SID. See Strong ion difference

Side-scattered light (SSC), 36

SIHD. See Stable ischemic heart disease

Single nucleotide polymorphism (SNP)

 definition of, 120t

 NCBI numbers for, 124

Single-stranded DNA antibodies, definition of, 495

Singlet state, 22

SIRS. See Systemic inflammatory response syndrome

Six-minute walk test (6MWT), purpose of, 312, 308–309b

Sjögren syndrome, presence of RF and ANA in, 495, 492

SLCO1B1. See Solute carrier organic anion transporter family member 1B1

SLE. See Systemic lupus erythematosus

Slow vital capacity (SVC), definition of lung, 303, 310

SMBG. See Self-monitoring blood glucose

Smith antibodies (anti-Sm), definition of, 495

SNP. See Single nucleotide polymorphism


 description and normal range for urine, 219–220

 description and physiology of, 229

 pediatric and adult normal ranges, 578

See also Serum sodium

Solid-phase technology, CLIA-waived POC test for cholesterol using, 59

Solid-state electrodes, 24

Solute carrier organic anion transporter family member 1B1 (SLCO1B1), 126–127

Somatic mutations, definition of, 129

Somatic variant, definition of, 120t

Southern blot electrophoresis, methods and use for, 27

SPE. See Serum protein electrophoresis

Specific gravity, description and normal range for urine, 216


 definition of negative percent agreement or, 53

 definition, examples, calculation of, 7, 7t

 performance characteristic independent of population tested, 53

 predictive value derived from 4, 4t

 quantitative laboratory tests and definition of, 7


 CLIA-waived POC tests and common types of, 54

 CLIA-waived POC tests require unprocessed, 54

 definition and types of, 7

 inaccurate laboratory test result due to, 9

Specimen collection and timing, manufacturer’s guidelines for CLIA-waived POC test, 55

Specimen collection techniques, before offering CLIA-waived POC tests, 68


 molecular absorption, 21–22

 types and components of, 21–23, 21f

Spectrophotometric method, CLIA-waived POC test for hemoglobin using, 58

SPICE bacteria (mnemonic for specific genus and species gram-negative bacteria), 418

Spirochetes, laboratory tests for detecting, 422t, 425t


 ATS and ERS standards for, 307

 definition and use of, 302, 304

 procedure for, 305, 307

 standardization of measurements for, 305

SpO2, lowest arterial oxygen saturation, 312

Sports, drug testing in, 557–558

Spurious laboratory test value, definition of, 16

Sputum smear, timing of laboratory sample for, 11

SSC. See Side-scattered light

Stable ischemic heart disease (SIHD), 140

Stable isotope dilution liquid chromatography, 629

Standard deviation, precision of quantitative CLIA-waived POC tests by, 53

Standard error of mean, precision of quantitative CLIA-waived POC tests by, 53

Star allele, definition of, 120t

STD. See Sexually transmitted disease

Steady state

 definition of, 81

 drug half-life can predict time to, 85

 not reached faster with loading dose, 86

Steady-state average concentration, definition of, 86–87

Steady-state maximum concentration, definition of, 86

Steady-state minimum concentration, definition of, 86

STEMI. See ST-segment elevation myocardial infarction

Stewart approach, acid-base and, 290

Stokes shift, definition of, 22, 36

Streptococcal pharyngitis, laboratory tests to diagnose, 433

Stroke volume (SV), definition of cardiac, 140

Strong ion, definition of, 290

Strong ion difference (SID), 290

ST-segment elevation myocardial infarction (STEMI), 140

Subependymal giant cell astrocytoma (SEGA), drugs for, 106

Subjective Global Assessment, of nutrition, 281

Substance Abuse and Mental Health Services Administration (SAMHSA)

 drug testing rules from, 544, 547

 cutoff drug concentrations for urine drug tests, 546t

 website poisoning information, 559

Substance use disorders, symptoms of, 558–559

SULTA1A gene, 389

Surveillance susceptibility testing, definition and use of, 431

Susceptibility testing

 for anaerobic or fastidious bacteria, 420

 methods for reporting results of, 421, 427–431

Susceptible-dose dependent (SDD), CLSI interpretive criterion for bacteria, 412

SV. See Stroke volume

SVC. See Slow vital capacity

SvO2. See Venous oxygen saturation

Sweat, drug toxicity strengths and weakness of specimen, 557t

Syndrome of inappropriate antidiuretic hormone (SIADH), causes of, 232, 235f

Syndromic panels, 38

Synergy testing, antimicrobial combination and definition of, 417–418

Synovial fluid analysis for rheumatoid arthritis and, 503

 arthrocentesis, characteristics, and assessment of, 499, 500t, 500b

 interpretation of findings of, 439t

 JIA and analysis of, 505

Syphilis, symptoms, stages, and laboratory tests to diagnose, 436–437

Systemic inflammatory response syndrome (SIRS), 333, 339

Systemic lupus erythematosus (SLE)

 EULAR/ACR classification of, 505

 laboratory tests for, 494–496, 505

 nonrheumatic tests for, 506

 presence of ANA and RF in, 492

Systolic heart failure, definition of, 142


T lymphocytes, types and functions of, 370

T3. See Triiodothyronine

T3 resin uptake, laboratory test for thyroid disease, 181–182

T4. See Thyroxine

Tandem mass spectrometer, use of, 35

Targeted therapy, resistance to, 131

TAT. See Turnaround time

TB. See Tuberculosis

TBG. See Thyroxine-binding globulin

TBW. See Total body water;

 Total body weight

TC. See Total cholesterol

TCAs. See Tricyclic antidepressants

Tertiary medical literature, description and examples of, 47, 48b

Tests. See Laboratory tests. See also Specific names of tests


 drugs affecting lab value of, 606t

 laboratory methods to determine level of, 629

 pediatric and adult normal ranges, 604–605

 physiologic effect of, 626t

 production and effects of, 625

See also Bioavailable testosterone; Free testosterone; Serum testosterone; Total testosterone

Tetany, symptom of hypocalcemia, 250

TFPI. See Tissue factor pathway inhibitor

TG. See Triglycerides

Thalassemia, 368

THC. See Total hemolytic complement

Therapeutic drug monitoring

 characteristics of ideal drugs for, 76

 definition of, 75

 use of total drug concentration (unbound and bound), 88–89

Therapeutic range

 age-related changes affect, 81

 definition and other names for, 77

 how determined for older antiepileptic drugs, 79

 pharmacodynamics of drug affect, 79

 population-based average for, 77, 80f

Thin layer chromatography (TLC), components and use of, 29

Thiopurine methyltransferase (TPMT), phenotype, 127b, 128

Third International Consensus Definition for Sepsis and Septic Shock (Sepsis-3), 289

Three-dimensional test, 418

Threshold value, sensitivity of quantitative test and cutoff value or, 53

Thrombaxane A2, platelet aggregation and, 378

Thrombin time (TT), definition, use, and normal range of, 392

Thrombocythemia, definition and causes of, 382

Thrombocytopenia, definition and causes of, 382, 382t

Thrombocytosis, definition and causes of, 382

Thromboplastin, ISI versus INR lab results for, 9

Thrombotic disorders, tests to diagnose, 386

Thrombus, processes involved in formation of arterial, 378

Thyroid disease, laboratory tests for, 178–181

Thyroid disorders, 151, 178

Thyroid function tests (TFTs)

 categories of, 178–181

 drugs that affect, 13, 185

Thyroid gland, anatomy and physiology of, 177

Thyroid-binding protein, factors/diseases that increase/decrease, 181t

Thyroid hormone-binding ratio, 182

Thyroid-stimulating hormone (TSH)

 function of, 177

 subunits of, 183–184

 thyroid and nonthyroid disease levels of, 180t

Thyrotoxicosis, cause and symptoms of, 178

Thyrotropin, 177

Thyrotropin-releasing hormone (TRH), function of, 177

Thyroxine (T4), function of thyroid hormone, 177

Thyroxine-binding globulin (TBG), 177

TIBC. See Total iron-binding capacity

Tidal volume (TV), definition of, 310, 310f

Time of sample draw, versus phlebotomist’s time of intended draw, 77

Time-kill studies, description of, 417


 considerations for accurate sample, 82

 frequent source of error from sample collection, 81

 misleading results from incorrect laboratory test, 9

Tissue factor pathway inhibitor (TFPI), 379

TLA. See Total laboratory automation

TLC. See Thin layer chromatography

TMB. See Tumor mutation burden

TN. See True negative

Total bilirubin

 normal range of, 321

 pediatric and adult normal ranges, 593

See also Bilirubin

Total body water (TBW), pediatric versus adult, 576–577

Total body weight (TBW), creatinine clearance and, 206

Total carbon dioxide, equivalent to serum bicarbonate, 229

Total cholesterol (TC)

 exogenous and synthesized sources of, 149, 150f

 function of, 149

 Healthy People 2020, goal for, 149

 lipid panel component and values for, 154

Total CO2 content, serum bicarbonate and, 288, 289

Total hemolytic complement (THC), definition and normal range of, 498

Total iron-binding capacity (TIBC), definition and normal range of, 365

Total laboratory automation (TLA), goal, scope, and motivation for, 20

Total lung capacity (TLC), tests included in, 310, 310f

Total serum T3, laboratory test for thyroid disease, 183

Total serum T4, laboratory test for thyroid disease, 179–180

Total testosterone

 causes of increased, 629

 pediatric and adult normal ranges, 628

Tourniquet time, hemoconcentrate analytes changed by prolonged, 9

Toxicity, serum contractions guide therapies to treat, 553t

Toxicokinetics, definition of, 556

Toxicological analysis, characteristics of specimens for, 557t

Toxicology, postmortem, 556

Toxicology hold, definition of, 556

Toxicology screen (tox screen), urine drug test as, 544

Tozer equation, 89–90

TP. See True positive

Trace elements, descriptions and functions of, 254–260

Transcription mediated amplification, 38

Transferrin iron saturation, 332

Transrectal ultrasound of the prostate (TRUS), 638, 639

Transtubular potassium gradient (TTKG), 220

Treponema pallidum, syphilis caused by, 436

TRH. See Thyrotropin-releasing hormone

Trichomonas, laboratory tests to diagnose, 437–438

Tricyclic antidepressants (TCAs), therapeutic range and clinical considerations, 107

Triglycerides (TG)

 effects of diet, exercise, and drugs on, 149

 exogenous and synthesized sources of, 149, 150f

 function of, 149

 lipid panel component and values for, 154–155

 pregnancy affects, 13

Triiodothyronine (T3), function of thyroid hormone, 177

Triplet state, 22


 causes for elevated, 141t

 high-sensitivity, 141

 timing of postmyocardial infarction level of, 11

Trough, definition and reasons to use, 86

Trousseau sign, hypocalcemia and, 250

True negative (TN), 3, 4t

True positive (TP), 3, 4t

TRUS. See Transrectal ultrasound of the prostate

TSH. See Thyroid-stimulating hormone

TST. See Tuberculin skin test

TTKG. See Transtubular potassium gradient

Tuberculin skin test (TST), for tuberculosis, 8, 484–485

Tuberculosis, antimycobacterial four-drug regimen for, 100

Tumor cells, array-based comparative hybridization profiling of, 40

Tumor marker

 clinical use of different, 515–516t

 definition, categories, and uses of, 513

 personalized treatment of cancer with different, 516t

 type of biomarker, 4

Tumor marker tests

 accessibility and cost-effectiveness of, 514–515

 sensitivity and specificity of, 514

Tumor molecular testing, oncology guided by, 130

Tumor mutation burden (TMB), definition of, 523

Turbidimetry, definition, uses, advantages/disadvantages of, 23

Turn-around time (TAT)

 CLIA-waived POCT test has quick, 54–55

 POC testing and decreased, 14

TV. See Tidal volume

Type 1 and type 2 diabetes mellitus. See Diabetes mellitus


U.S. Department of Health and Human Services, Medicare costs and, 20

U.S. Drug Enforcement Administration (DEA), website poisoning information, 559

U.S. Food and Drug Administration (FDA). See FDA

Ubiquitous Pharmacogenomics Consortium (U-PGx), pre-emptive genotyping by, 123

UCr. See Urine creatinine

UFC. See Urine-free cortisol

UFH. See Unfractionated heparin

Ulcer disease, description, cause, and tests for, 342–343

ULN. See Upper limit of normal

Ultradian rhythm, description of, 12

Unbound drug, measurement of, 89

Unfractionated heparin (UFH), 380

Units, laboratory test results and types of, 7

U-PGx, See Ubiquitous Pharmacogenomics Consortium

UPOINT, classification for symptoms of chronic pelvic pain, 649

Upper limit of normal (ULN), lab test result of, 15

Upper respiratory tract, types of specimens for CLIA-waived POC test of, 55

Urea breath test, for H. pylori, 342

Uridine diphosphate glucuronosyltransferase (UGTIA), elimination of bilirubin by, 128

Uridine-rich ribonucleoprotein antibodies (anti-U1RNP), definition and normal range of, 495


 identifying candidates for CLIA-waived POC, 60

 macroscopic and microscopic and uses of, 208, 212–214

 pharmacist monitors diabetes with CLIA-waived POC, 59

 types of CLIA-waived POC tests for, 59

Urinary tract infection (UTI)

 bacteriuria and, 213

 laboratory tests to diagnose, 434–435

Urinary urea nitrogen (UUN), 280


 causes of coloration of, 212t

 dipstick or tablet reagent for CLIA-waived POC test of, 54

 toxicological strengths and weaknesses of specimen, 557t

Urine creatinine (UCr), kidney function and, 202

Urine dipstick, CLIA-waived POC urinalysis by, 59

Urine drug screen

 list of immunoassays for doing, 544

 preliminary, stat, or provisional, 544

 qualitative result from, 544

 reasons for, 546

 substances and rate of workforce positive, 545t

 substances interfering with immunoassay, 550t

Urine-free cortisol (UFC), test for Cushing syndrome, 187–188

Urine glucose, diabetes and, 170

Urine specimen, intentional or unintentional altering of, 549

Urine uric acid concentration, definition and normal range of, 509–510

Urinometer, measure urine specific gravity, 216

Urobilinogen, description and normal range for urine, 217

Uroflowmetry testing, limitation of, 638

Uterine outflow obstruction, definition and causes of, 607

UTI. See Urinary tract infection

UUN. See Urinary urea nitrogen


V:Q ratio. See Ventilation: perfusion ratio

Validity, use of accuracy/bias/precision to evaluate CLIA-waived POC test, 53

Vancomycin, toxicities associated with, 97

Vancomycin intermediate Staphylococcus aureus (VISA), tests to detect, 97, 420

Vancomycin-resistant enterococci (VRE), tests to detect, 420

Vancomycin-resistant Staphylococcus aureus (VRSA), tests to detect, 420

VAP. See Ventilator-associated pneumonia

Vapor pressure osmometry, 23

Vasculitis, patterns of ANCAs in, 496

Vasopressin, water/sodium regulation by, 231, 232

VDRL. See Venereal Disease Research Laboratory

Venereal Disease Research Laboratory (VDRL), 5, 437

Venous oxygen saturation (SvO2)

 definition and normal range, 289–290

 taken from pulmonary artery catheter, 289–290

Venous thromboembolism (VTE), Wells or Geneva score for probability of, 386, 386b, 393

Venous total carbon dioxide, definition and normal range of, 289

Ventilation (V), definition of, 301–302

Ventilation: perfusion ratio (V:Q), ways to normalize, 302

Ventilator-associated pneumonia (VAP), 433

Verigene Gram-Positive Bloodstream Infection Test, 408

Very low-density lipoproteins (VLDLs), function and characteristics of, 150, 150f, 151t

Viral hepatitis, types of, 326

Viral load, CLIA-waived POC tests for influenza A and B depend on, 63

Virilization, definition, causes, and symptoms of, 611, 613t


 description and classification of, 461

 laboratory tests for medically important DNA, 463–465t

 laboratory tests for medically important RNA, 466–470t

 laboratory tests to identify, 461–462, 471–474

VISA. See Vancomycin intermediate Staphylococcus aureus

Visceral proteins, definition, types of, physiologic function of, 276, 277t

Vitamin B12 (cobalamin)

 anemia and symptoms from, 361, 361t, 362

 sources and absorption of, 362

Vitamin D, cause of deficiency in pediatrics, 584

Vitamin K, definition and reasons for low level of, 318

Vitamin K epoxide reductase (VKOR), definition and use of, 388

VKOR. See Vitamin K epoxide reductase

VLDLs. See Very low-density lipoproteins

Voltammetry, description, components, types of, 25–26

Volume-time curve, spirometry and, 302, 304f

von Willebrand disease, 386

von Willebrand disease, coagulation test for, 381t

von Willebrand factor (vWF), 378

VRE. See Vancomycin-resistant enterococci

VRSA. See Vancomycin-resistant Staphylococcus aureus

VTE. See Venous thromboembolism

vWF. See von Willebrand factor


Waived laboratories, definition of, 52

Waived point-of-care tests, definition of, 51

Waived test status, definition of, 14


 factors that influence dose and pharmacokinetics of, 388, 389t

 tests to monitor therapy with, 388

Warfarin pharmacogenetics, 129–130

Water deprivation test, diabetes insipidus and, 189–190, 189t

Wavelength of light, measured in nanometers (nm), 21

WBC. See White blood cell

Weak ions, definition of, 290

Wellness, patient-centered care and pharmacist focus on, 51

Wells score, probability of venous thromboembolism, 393

Western blot electrophoresis, with ELISA to confirm HIV, 27, 28f

White blood cell (WBC), 356t

White blood cell (WBC) count

 classification, function, and normal range of, 368, 369t

 definition and normal range of, 358

 and differential (types of), 368

 pediatric and adult normal ranges, 596, 596t

White blood cell (WBC), disorders, 371t

WHO. See World Health Organization

Whole blood, finger stick specimen for CLIA-waived POC test of, 54

Wilson disease, genetic copper deficiency, 255–256

Winter-Tozer equation, normalize phenytoin concentration, 94

Workplace drug screening, interpretation of, 551b

World Health Organization (WHO), G6PD phenotyping from, 128


xPOCT. See Multiplexed point-of-care testing

Yeasts, genus and species names of medically important, 446t

Zinc, description, physiology, normal range of, 256

Zinc trafficking, definition of, 256

Zone of inhibition, CLSI interpretive criteria for diameter of, 416

Z-potential, definition of, 32