Biochemistry (MC2 L)

Laboratory Activity #5
BLOOD LABORATORY TESTS

Name:__________________________________ Group:_______
Section:___________ Date:_______________

Regular blood testing is one of the most important ways to keep track of your overall physical well-being. Getting tested
at routine intervals can allow you to see the way your body changes over time and empower you to make informed
decisions about your health.

Some blood tests can help your doctor determine how different organs in your body are working. Examples of organs
whose malfunctions can be visible in a blood test include your thyroid, liver, or kidneys.
Your doctor can also use blood tests to search for markers of diseases and health conditions such as: diabetes, HIV,
anemia, cancer, coronary heart disease, etc.
Even if a person does not have heart disease, a blood test can show whether they may be at risk of developing the
condition. Other blood tests can indicate whether the medications you’re taking are working properly, or assess how
well your blood is clotting.

Below are some of the common blood tests requested.

1. Complete blood count
A routine complete blood count (CBC) checks for levels of 10 different components of every major cell in your blood:
white blood cells, red blood cells, and platelets.
Important components this test measures include red blood cell count, hemoglobin, and hematocrit.
Here’s the typical range of results, although every laboratory may have its own range that varies slightly:

Abnormal levels of these components may indicate:

 nutritional deficiencies, such as vitamin B6 or B12  blood cancer
 anemia (iron deficiency)  infection
 clotting problems  immune system disorders
Based on your results, your doctor will order follow-up tests to confirm abnormal levels and a possible diagnosis.

2. Basic metabolic panel

A basic metabolic panel (BMP) usually checks for levels of eight compounds in the blood:
 calcium  potassium  blood urea nitrogen (BUN)
 glucose  bicarbonate  creatinine
 sodium  chloride

Whether you’re going to see your doctor for a routine checkup or you’re admitted to the hospital, your doctor needs
information about how your body is functioning. A basic metabolic panel is a combination of tests that helps them
assess important functions in your body.
The tests that make up the basic metabolic panel are blood (serum) tests for:
 BUN (blood urea nitrogen), which measures the amount of nitrogen in the blood in order to determine your
kidney function

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  creatinine, which can tell your doctor how your kidneys are functioning
 glucose, which checks your blood sugar levels — abnormally high or low glucose levels could indicate a range of
issues
 albumin, which is a protein that can change with kidney and liver disease
 CO2 (carbon dioxide or bicarbonate), which references lung and kidney function
 calcium, which can help determine if there is a kidney bone or parathyroid problem (a gland in the neck)
 sodium, one of the salts in the body that reflects more the body’s water balance than salt
 potassium, another salt in the body
 chloride

Your sodium, potassium, and chloride levels will be tested as part of your electrolyte panel. Electrolyte balance is
essential to the normal functioning of the muscular, cardiovascular, and nervous systems.
This test may require you to fast for at least 8 hours before your blood is drawn, depending on the instructions of your
doctor and what the test is measuring.

The basic metabolic panel can give your doctor a good idea as to whether you have any serious problems with:
 blood filtration  blood sugar levels
 acid/base balance of your blood  electrolyte levels

This can help uncover a variety of medical issues, including:

 kidney problems
 lung problems
 problems with your pancreas or insulin metabolism

More detailed tests will be ordered if any of these basic indicators are abnormal. One advantage of a panel of tests is
that many tests can be done with just one blood sample. It’s then divided up in a lab.

Normal Results for a Basic Metabolic Panel

Normal ranges will vary slightly for adults over the age of 60 years.

Abnormal results may indicate:

 kidney disease  diabetes  hormone imbalances
Your doctor will perform follow-up tests to confirm a diagnosis.

3. Comprehensive metabolic panel

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A comprehensive metabolic panel (CMP) includes all the measurements of a BMP as well as additional proteins and
substances related to liver function, such as:
 albumin
 total protein
 alkaline phosphatase (ALP), an enzyme mostly found in the bones and liver that’s involved in several bodily
processes
 alanine aminotransferase (ALT), an enzyme found in the liver
 aspartate aminotransferase (AST), an enzyme found in the liver and other tissues within the body
 bilirubin, which is waste resulting from the breakdown of red blood cells that the liver filters out

The same conclusions can be drawn from a CMP as from a BMP for the same substances that a BMP covers. Other
abnormal levels can also indicate underlying conditions, such as:

4. Lipid panel
This test checks levels of two types of cholesterol:
 high-density lipoprotein (HDL), or “good” cholesterol
 low-density lipoprotein (LDL), or “bad” cholesterol

HDL is “good” because it removes harmful substances from your blood and helps the liver break them down into waste.
LDL is “bad” because it can cause plaque to develop in your arteries, increasing your risk of heart disease.

You may need to fast for at least 8 hours before this test. Here are the ranges for each type:

Normal levels can also vary by age.

5. Thyroid panel
A thyroid panel, or thyroid function test, checks how well your thyroid is producing and reacting to certain hormones,
such as:
 Triiodothyronine (T3). Along with T4, this regulates your heart rate and body temperature.
 Thyroxine (T4). Along with T3, this regulates your metabolism and how you grow.
 Thyroid-stimulating hormone (TSH). This helps regulate the levels of hormones your thyroid releases.
Your thyroid is a tiny gland in your neck. It helps regulate bodily functions like your mood, energy level, and overall
metabolism.
Here are normal results:
T3: 80–180 nanograms per deciliter of blood (ng/dL)
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T4: 0.8–1.8 ng/dL in adults.
TSH: 0.5–4 milli-international units per liter of blood (mIU/L)

Abnormal levels of these hormones can indicate numerous conditions, such as:
 low protein levels
 thyroid growth disorders
 abnormal levels of testosterone or estrogen

6. Cardiac biomarkers
Enzymes are proteins that help your body accomplish certain chemical processes, such as breaking down food and
clotting blood. They’re used throughout your body for many vital functions.
Abnormal enzyme levels can indicate many conditions.

Common enzymes tested include:

 Creatine kinase (CK). This is an enzyme primarily located in the brain, heart, and skeletal muscle. When muscle
damage happens, CK seeps into the blood in growing amounts.
 Creatine kinase-MB (CK-MB). These enzymes are found in your heart. They often increase in your blood after a
heart attack or other heart injury.
 Troponin. This is a heart enzyme that can leak into your blood and results from heart injury.

Here are the normal ranges for the enzyme listed above:
CK: 30–200 U/L CK-MB: 0–12 IU/L troponin: <1 ng/mL

7. Sexually transmitted infection tests

Many sexually transmitted infections (STIs) can be diagnosed using a blood sample. These tests are often combined with
urine samples or swabs of infected tissue for more accurate diagnoses.

The following STIs can be diagnosed with blood tests:

 chlamydia  herpes  syphilis
 gonorrhea  HIV

Blood tests aren’t always accurate right after contracting an infection. For an HIV infection, for example, you may need
to wait at least a month before a blood test can detect the virus.

8. Coagulation Panel
Coagulation tests measure how well your blood clots and how long it takes for your blood to clot. Examples include the
prothrombin time (PT) test and fibrinogen activity test.

Clotting is a crucial process that helps you stop bleeding after a cut or wound. But a clot in a vein or artery can be deadly
since it can block blood flow to your brain, heart, or lungs. This can cause a heart attack or stroke.

Coagulation test results vary based on your health and any underlying conditions that may affect clotting.

Results from this test can be used to diagnose:

 leukemia  liver conditions
 excessive bleeding (hemophilia)  vitamin K deficiency
 thrombosis

9. DHEA-sulfate serum test

The dehydroepiandrosterone (DHEA) hormone comes from your adrenal glands. This test measures whether it’s too high
or too low.
In men, DHEA helps develop traits like body hair growth, so low levels are considered abnormal. In women, high levels
can cause typically male traits, like excess body hair, to develop, so low levels are normal.

Low levels may be caused by:

 Addison’s disease  adrenal dysfunction  hypopituitarism

High levels in men or women can result from:

 congenital adrenal hyperplasia  polycystic ovary syndrome (PCOS)
 benign or malignant tumor on the adrenal gland  ovarian tumor
10. C-reactive protein test

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C-reactive protein (CRP) is made by your liver when tissues in your body are inflamed. High CRP levels indicate
inflammation from a variety of causes, including:
 bacterial or viral infection
 autoimmune diseases, such Lupus or rheumatoid arthritis
 inflammation related to diabetes
 inflammation related to physical trauma or from habits like smoking
 cancer

The higher the level, the higher the risk of heart disease:
 <0.3 mg/dL: normal
 0.3 to 1.0 mg/dL: minor elevation can be associated with a person’s sex, body mass index (BMI), or with
conditions like depression or insomnia
 to 10.0 mg/dL: moderate elevation usually caused by systemic inflammation, such as from an autoimmune
disease, bronchitis, heart attack, or cancer
 >10.0 mg/dL: marked elevation typically caused by a serious bacterial or viral infection, major trauma, or
systemic vasculitis
 >50.0 mg/dL: severe elevation usually caused by an acute bacterial infection

11. Blood Tests for Sexually Transmitted Diseases.

Sexually transmitted diseases (STDs) are infections spread from person to person during sex (vaginal, oral, or anal) or
close sexual contact. STDs are also called sexually transmitted infections, or STIs.
Blood Tests for STD’s include:
 Human immunodeficiency virus (HIV)
 Genital herpes (no symptoms): Blood test (ask for a type-specific IgG test, not an IgM test)
 Syphilis
 Hepatitis

12. Blood Culture

A blood culture test helps your doctor figure out if you have a kind of infection that is in your bloodstream and can affect
your entire body. Doctors call this a systemic infection. The test checks a sample of your blood for bacteria or yeast that
might be causing the infection.

If your doctor orders this test, it’s because they think you might have a systemic infection and they want to check for
certain kinds of germs in your blood. It can help them come up with the best treatment for you.

Your doctor might order the test if you have symptoms that may include:
 Fever or chills  Nausea
 Fatigue  Confusion
 Peeing less often than normal  Faster heart rate or breathing

If your infection is more severe, you might have:

 Inflammation in different areas of your body  A serious drop in your blood pressure
 Small blood clots forming in your small blood  Organ failure
vessels
Why do some blood tests require fasting?
Everything you eat and drink contains vitamins, proteins, and other nutrients that can cause the related levels in your
blood to temporarily spike or drop.
Fasting for 8 to 12 hours helps ensure that blood test results are free from these variables, making your test results as
accurate as possible.

Some common tests that may require fasting include:

 cholesterol tests  kidney function tests
 blood sugar tests  basic metabolic panel
 liver function tests  glucose tests

Laboratory Activity. Testing Random Blood Glucose using a Glucometer (50 points)

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Materials Needed.
o Disposable latex-free o 70% isopropyl alcohol o 2 x 2 gauze
gloves o Lancet or automatic o Reagent strips
o Alcohol swab/ cotton balls lancing device o Blood glucose meter
Procedure:
1. Assess patient’s sites for skin puncture. Skin integrity at the puncture site minimizes the risk of infection and
promotes healing.
2. Perform hand hygiene. Hand hygiene prevents the transfer of microorganisms.
3. Have patient wash hands with soap and warm water, and position the patient comfortably in a semi-upright
position in bed or upright in a chair. Encourage patient to keep hands warm. Washing reduces transmission of
microorganisms and increases blood flow to the puncture site.
4. Remove a reagent strip from the container and reseal the container cap. Do not touch the test pad portion of
the reagent strip. Tight closure of the container keeps strips from damage due to environmental factors. Follow
the manufacturer’s instructions to prepare the meter for measurement. This prepares meter for accurate
readings.
5. Place the unused reagent strip in the glucometer or on a clean, dry surface (e.g., paper towel) with the test pad
facing up. This step is dependent on the manufacturer’s instructions. Moisture may alter the test results.
6. Apply non-sterile gloves. Gloves protect health care provider from contamination by blood.
7. Keep area to be punctured in a dependent position. Do not milk or massage finger site. Dependent position will
increase blood flow to the area. Milking or massaging the finger may introduce excess tissue fluid and hemolyze
the specimen.
8. Avoid having the patient stand during the procedure to reduce the risk of fainting.
9. Select appropriate puncture site and perform skin puncture.
10. Gently squeeze above the site to produce a large droplet of blood. Do not contaminate the site by touching it.
The droplet of blood needs to be large enough to cover the test pad on the reagent strip.
11. Transfer the first drop of blood (or second drop if indicated by agency policy or manufacturer’s instructions) to
the reagent strip and apply following the manufacturer’s instructions. The test pad must absorb the droplet of
blood for accurate results. Smearing the blood will alter results.
12. Immediately press the timer on the meter (unless it starts automatically with insertion of reagent strip). Timing
is critical to produce accurate results. Always check the manufacturer’s instructions because the technique
varies between meters.
13. Apply pressure, or ask patient to apply pressure, to the puncture site using a 2 x 2 gauze pad or clean tissue. This
will stop the bleeding at the site.
14. Read the results on the unit display. Each meter has a specified time for the reading to occur.
15. Turn off the meter and dispose of the test strip, 2 x 2 gauze, and lancet according to agency policy. This reduces
contamination by blood to other individuals.
16. Remove non-sterile gloves and place them in the appropriate receptacle. This reduces transmission of
microorganisms.
17. Perform hand hygiene. This reduces the transmission of microorganisms.
18. Review test results with the patient. This promotes patient participation in health care. Note down results.

Questions to answer. Write answers legibly at the back of

this page.
1. What is the oral glucose tolerance test (OGTT) and
hemoglobin A1c (HbA1c)? Briefly describe each. (20 points)
2. Discuss the differences of Fasting Blood Sugar, OGTT and
hemoglobin A1c. (30 points)

Results: Normal values Interpretation

1. Patient A:_____________________ _____________________ __________________________

2. Patient B:_____________________ _____________________ __________________________

2. Patient B:_____________________ _____________________ __________________________