|
|
|
Section-E
|
|
POWERCHART NAME
|
EAR CULTURE
|
|
MERCY TEST NAME
|
EAR CLT
|
MERCY LAB CODE
|
EARC
|
|
Specimen:
|
Collect sample on a routine culturette. Cleanse the external canal. Collect exudate or scrapings of ear canal.
|
|
Comments:
|
- Susceptibility testing will be performed on significant isolates.
- Haemophilus, Neisseria, & Streptococcus pneumoniae will be screened for penicillin resistance only.
- This order is for INTERNAL ear samples only. If the EXTERNAL portion of the ear is to be cultured, order as a wound culture.
|
|
RL Client Comments:
|
- Write EAR CULTURE on the order form.
- Send specimen at room temperature to Mercy lab.
|
|
Processing:
|
Send at room temperature.
|
|
Performed:
|
Preliminary report: 1,2,3,4 days Final report:5 days
|
|
Reference value:
|
No growth (commensal skin flora may be present).
|
|
Method:
|
Standard culture techniques
|
|
CPT Code:
|
87070
|
|
POWERCHART NAME
|
ELECTROLYTE PANEL
|
|
MERCY TEST NAME
|
ELECTROLYTES
|
MERCY LAB CODE
|
LYTE
|
| Includes: |
Anion Gap, Chloride, CO2, Potassium and Sodium
|
| Specimen: |
- Preferred in house; 0.5 ml lithium heparin plasma from a PST tube.
- Preferred reference lab: 0.5 ml serum from a SST tube.
- Also acceptable: Amm heparin, serum from a plain red top tube.
- Keep tube closed.
|
| Stability: |
8 hours room temperature, 48 hours refrigerated, freeze if >48 hours. |
| Cause for rejection: |
Hemolyzed specimens not acceptable. |
| Performed: |
Within 8 hours of receipt. Available stat. |
| Reference value: |
Please see individual test entries
|
| Method: |
Refer to individual test. |
| CPT Code: |
80051 |
|
POWERCHART NAME
|
ENDOMYSIAL IgA AUTOANTIBODY
|
|
MERCY TEST NAME
|
ENDOMYSIAL ATBY*
|
MERCY LAB CODE
|
ENDA
|
| Specimen: |
2 ml serum from a SST or plain red top tube. Minimum: Adults 1 ml. Pediatric volume 0.5 ml.
|
| Comment: |
Useful for the diagnosis of dermatitis herpetiformis and celiac disease and for monitoring adherence to gluten-free diet in patients with dermatis herpetiforms and celiac disease.
|
| Processing: |
Send refrigerated to Mayo. Ambient or frozen acceptalbe. Mayo #9360. |
| Performed: |
2 days. Test set up at Mayo Monday through Friday. |
| Reference value: |
Report includes presence and titer of circulating anti-endomysial antibodies. Negative in normal individuals, also negative in dermatitis herpetiformis or celiac disease patients adhering to gluten-free diet.
|
| Method: |
Indirect Immunoflourescence (EMA) |
| CPT Code: |
86256 |
|
POWERCHART NAME
|
ENTEROVIRUS RNA DETECTOR
|
|
MERCY TEST NAME
|
ENTEROVIRUS BY PCR*
|
MERCY LAB CODE
|
ENTRPC
|
|
Specimen:
|
Spinal Fluid or Sterile Body Fluid: 0.5 mL collected in a sterile screw-capped container. Minimum 0.3 ml. DO NOT CENTRIFUGE. Respiratory Specimen: 1.5 mL of bronchial washing, bronchoalveolar lavage, nasopharyngeal aspirate or washing, sputum, or tracheal aspirate collected in a sterile screw-capped container. Minimum 1 ml. Dermal/Ocular/Rectal: Collect sample on a routine culturette. The rectal swab should have NO visible stool. Calcium alginate, wood swabs or transport swab containing gel is NOT acceptable.
|
|
Comment:
|
Specimens grossly contaminated with blood may inhibit the PCR and produce false negative results.
|
|
RL Client Comments:
|
- Write ENTEROVIRUS by PCR (Mayo# 80066) on the order form. Indicate the specimen source.
- Send specimens refrigerated to Mercy lab.
|
|
Performed:
|
Monday through Friday; varies. Send specimens refrigerated to Mayo lab. Frozen acceptable. Mayo #80066.
|
|
Reference Value:
|
Negative Positive results will be reported as enterovirus RNA detected.
|
|
Method:
|
Real-Time PCR/RNA Probe Hybridization
|
|
CPT Code:
|
87798
|
|
TEST NAME
|
EOSINOPHIL COUNT TOTAL
|
Included in CBC. Cannot order individually
|
|
POWERCHART NAME
|
EOSINOPHIL SMEAR
|
|
MERCY TEST NAME
|
EOS NASAL SMR
|
MERCY LAB CODE
|
EONS
|
| Specimen: |
Submit a culturette swab or a prepared slide. Reference Lab Clients: Submit a slide that is prepared, unfixed and labeled.
|
| Performed: |
Within 8 hours of receipt. |
| Reference value: |
None seen |
| Method: |
Microscopy, Wright stained smear. |
| CPT Code: |
89190 |
|
POWERCHART NAME
|
SMEAR FOR EOSINOPHIL URINE
|
|
MERCY TEST NAME
|
EOSINOPHIL URINE
|
MERCY LAB CODE
|
EOUA
|
| Specimen: |
10 ml random urine. Deliver to Lab within 1 hour of collection. Refrigerate. Reference Lab Clients: Refrigerate for transport
|
| Stability: |
8 hours refrigerated. |
| Performed: |
Within 8 hours of receipt. |
| Reference value: |
None seen < 1 % may indicate urinary tract infection 1 - 5% is not a good predictor of Acute Interstitial Nephritis > 5 % may be a valuable predictor of Acute Interstitial Nephritis and may indicate Chronic Urinary Tract infection. |
| Method: |
Microscopy, Wright stained smear. |
| CPT Code: |
87205 |
|
POWERCHART NAME
|
EPSTEIN BARR VIRUS PANEL
|
|
MERCY TEST NAME
|
EPSTEIN BARR AB*
|
MERCY LAB CODE
|
EBVA
|
| Comment: |
Includes VCA IgG, VCA IgM, EBNA IgG, and interpretation. |
| Specimen: |
1 ml serum from a SST tube.
|
| Processing: |
Send specimen to Mercy Lab FROZEN. |
| Cause for rejection: |
Grossly hemolyzed or lipemic samples |
| Performed: |
Fridays,Noon |
| Method: |
Enzyme Immunoassay |
| CPT Code: |
86665 x2-VCA, IgG and IgM 86664 EBNA
|
|
POWERCHART NAME
|
ERYTHROPOIETIN LEVEL
|
|
MERCY TEST NAME
|
ERYTHROPOIETIN
|
MERCY LAB CODE
|
EPO
|
| Specimen: |
0.5 ml serum from a SST or plain red top tube. Minimum 0.5 ML.
|
| Comment: |
There are reports of diurnal variation. Recommend that samples be collected at a consistent time of day. Morning samples collected between 7:30 AM and 12:00 noon have been recommended. |
| Processing: |
Stable 24 hours refrigerated. Freeze if test will not be run within 24 hours. Do not store in glass tubes. |
| Turnaround: |
Performed within 8 hours of receipt. |
| Reference value: |
2.6-18.5 mIU/mL.
|
| Method: |
Chemiluminescent immunoassay |
| CPT Code: |
82668 |
|
POWERCHART NAME
|
ESTRADIOL LEVEL
|
|
MERCY TEST NAME
|
ESTRADIOL
|
MERCY LAB CODE
|
ESTD
|
| Specimen: |
- Preferred in house: 0.5 ml serum from a SST tube.
- Preferred reference lab: 0.5 ml serum from a SST tube.
- Also acceptable: serum from a plain red top tube or heparin plasma from a green top tube.
|
| Stability: |
8 hours room temperature, 48 hours refrigerated, freeze if >48 hours. |
|
|
| Processing: |
Regional Lab Clients: Freeze if not received at Mercy Medical Center - North Iowa Laboratory within 48 hours of collection.
|
| Performed: |
Within 8 hours of receipt. |
| Reference value: |
Male: 20 - 47 pg/mL
Female: Estradiol Expected Values for Ovulating non-pregnant females based on the hLH peak as Day 0. Day –6 to –8 Mid-Follicular 27-122 pg/mL Day –1 Peri-Ovulatory 95-433 pg/mL Day +6 to +8 Mid-Luteal 49-291 pg/mL
Post-Menopausal Female 20- 40 pg/mL |
| Method: |
Competitive Binding Immunoassay Chemiluminescence |
| CPT Code: |
82670 |
| |
|
Estradiol Female Tanner Ranges
|
|
Tanner Stage
|
Mean Age
|
Reference Range
|
|
I
|
7.1
|
0-20 pg/ml
|
|
II
|
10.5
|
0-24 pg/ml
|
|
III
|
11.6
|
0-60 pg/ml
|
|
IV
|
12.3
|
15-85 pg/ml
|
|
V
|
14.5
|
15-350 pg/ml
|
|
Puberty onset (transition from Tanner stage I to Tanner stage II) occurs for girls at a median age of 10.2 (+/- 2.0) years. There is evidence that it may occur up to 1 year earlier in obese girls and in African-American girls. Progression through Tanner stages is variable. Tanner stage V (adult) should be reached by age 18.
1-14 days of age: Estradiol levels are very elevated at birth, but will fall to prepubertal levels within a few days.
|
|
Estradiol Male Tanner Ranges
|
|
Tanner Stage
|
Mean Age
|
Reference Range
|
|
I
|
7.1
|
0-13 pg/ml
|
|
II
|
12.1
|
0-16 pg/ml
|
|
III
|
13.6
|
0-26 pg/ml
|
|
IV
|
15.1
|
0-38 pg/ml
|
|
V
|
18
|
10-40 pg/ml
|
|
Puberty onset (transition from Tanner stage I to Tanner stage II) occurs for boys at a median age of 11.5 (+/- 2.0) years. For boys, there is no proven relationship between puberty onset and body weight or ethnic origin. Progression through Tanner stages is variable. Tanner stage V (adult) should be reached by age 18.
1-14 days of age: Estradiol levels are very elevated at birth, but will fall to prepubertal levels within a few days.
|
|
|
TEST NAME
|
ESTROGEN/PROGESTERONE RECEPTOR ASSAY QUANTITATIVE (PARAFFIN BLOCK)
|
|
MERCY TEST NAME
|
ERA/PRA BLOCK
|
MERCY LAB CODE
|
EPRB
|
| Comment: |
Ordered on paraffin block. Routinely ordered on breast carcinoma.
|
| Processing: |
Paraffin Block |
| Performed: |
Test set up Tuesday and Friday. |
| Reference value: |
Included with pathology report. |
| Method: |
Labeled-Streptavidin Biotin Immunoperoxidase stain. |
| CPT Code: |
88342 X2 Immunocytochem+ X2 |
|
TEST NAME
|
ESTROGEN TOTAL SERUM
|
See: Estradiol
|
|
TEST NAME
|
ETHOSUXIMIDE
|
|
MERCY TEST NAME
|
MISC GENERAL LAB
|
MERCY LAB CODE
|
CMIS
|
| Specimen: |
1 ml of serum from plain, red-top tube. Minimum 0.4 ml. |
| Comment: |
Indicate TEST NAME and time last dose in comment field. |
| Processing: |
Remove serum from cells within 2 hours of collection. Send refrigerated. Ambient or frozen acceptable. Mayo #8769. |
| Performed: |
1 day. Test set up Monday through Sunday. |
| Reference value: |
Included with report.
|
| Method: |
Enzyme-Multiplied Immunoassay Technique (EMIT) |
| CPT Code: |
80168 |
|
POWERCHART NAME
|
EYE CULTURE OTHER
|
|
MERCY TEST NAME
|
EYE CLT
|
MERCY LAB CODE
|
EYEC
|
|
Order:
|
Indicate which eye when ordering. See beginning of section for ordering help and codes.
|
|
Specimen:
|
- Conjunctivitis:
Touch the involved area with a sterile swab moistened with sterile saline. Ideally, inoculate directly to the appropriate media (Contact Microbiology). However, the specimen may be transported on a routine culturette to the lab.
- Corneal scrapings:
The cornea may be anesthetized with 0.5% proparacaine hydrochloride, but better results are obtained if the scrapings are collected without the use of a topical anesthetic. A topical anesthetic may have an antimicrobial effect. Scrape the base and margin of the ulcer. Inoculate these scrapings directly to the appropriate media.
|
|
Comment:
|
- Deliver to Lab immediately. The organisms involved in eye infections are often fastidious in nature.
- Susceptibility testing will be performed on significant isolates.
- This order is for INTERNAL eye specimens only. If an external eye culture is needed, order as a wound culture.
|
|
RL Client Comments:
|
- Write EYE CULTURE on the order form. Indicate which eye was cultured.
- Send the specimen room temperature to Mercy lab.
|
|
Performed:
|
Preliminary reports: Days 1 & 2 Final report: 3 days
|
|
Reference value:
|
No growth (commensal skin flora may be present)
|
|
Method:
|
Standard culture techniques.
|
|
CPT Code:
|
87070
|
|
|