Medical Terminology/Transcription On-Line Course
Facilitator: Carrie Stein, CMT
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COMPLETE BLOOD COUNT (CBC)
hemoglobin (Hgb)
hematocrit (Hct)
The H&H results give different measures of red blood cell volume. Low levels indicate anemia. Hgb is reported in g or g/dL; Hct is reported in %.
white blood cells (WBCs)
White cells (leukocytes) fight infection, and high levels can indicate infection. Low levels can be due to medication or even bone marrow suppression.
red blood cells (RBCs)
Red cells are erythrocytes, and this is a measure of red blood cells in a certain volume of blood.
Platelets
Platelets are components essential for coagulation (clotting).
MCV, MCH, MCHC
Known as the red blood cell indices, the MCH, MCV, and MCHC describe the size of the red blood cells and the amount of hemoglobin in the red cells. For example, iron deficiency anemia and pernicious anemia would have different indices. The initials stand for mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC).
Segmented neutrophils (segs), basophils, (basos), eosinophils (eos), bands, lymphocytes (lymphs), and monocytes (monos) represent different types of white blood cells. Counting the types of WBCs is known as the white blood cell differential count, often dictated as the �diff.� Analyzing the patterns of the differential can give information about many diseases. A �shift to the left� indicates an increase in the percentage of unsegmented (immature) neutrophils, also called band cells or bands. A "shift to the right" indicates an increase in the percentage of multisegmented (mature) neutrophils, also called segs.
URINALYSIS (UA)
Testing some chemical reactions in the urine and looking at centrifuged debris (sediment) under the microscope gives information about different diseases, including those of the kidney and urinary bladder.
glucose (sugar)
The presence of glucose may indicate diabetes mellitus.
protein
The presence of protein may indicate kidney disease but is also seen with recent exercise, dehydration,heart failure, and multiple myeloma.
specific gravity
This is a measurement of the concentration of urine, being low after consuming abundant fluids and being high with dehydration.
pH
This measures the acidity of urine, always transcribed pH.
MICROSCOPIC URINALYSIS
White blood cells (WBCs) in urine seen under a microscope can be due to infection in the kidney or in the urinary bladder.
Red blood cells (RBCs) in urine seen in under a microscope may be due to infection, stones, or even a malignancy.
The presence of bacteria in urine seen under a microscope may indicate a urinary tract infection. If a specimen has been sitting out for a time before being tested, however, bacteria could be present from just sitting too long with no true urinary tract infection present.
PROTHROMBIN TIME with INR and the PARTIAL THROMBOPLASTIN TIME
The PT/PTT blood tests are used to track anticoagulation, and the results are often dictated together. The prothrombin time or pro time (PT) can be used to keep track of Coumadin levels. The partial thromboplastin time (PTT) can be used to keep track of heparin levels. Coumadin and heparin are both blood thinners. PT/PTT results can be abnormal with blood abnormalities, liver disease, in hemophilia, etc.
The PT and INR results (International Normalized Ratio) may be dictated without the PTT. (Example, PT is 16.5 seconds with an INR of 2%.) The INR is a method of improving prothrombin time tests despite variations in the properties of different batches of thromboplastin used in the test.
SEDIMENTATION RATE (SED RATE)
A nonspecific test that indicates inflammation anywhere in the body, the sed rate may be elevated in the presence of infection, malignancy, trauma, and/or certain types of rheumatism. Like an elevated temperature, the sedimentation rate indicates a problem but defines neither the location nor the type of problem. This test is also known as the ESR (erythrocyte sedimentation rate).
THYROID FUNCTION TESTS (TFTs)
T3, T4 (sometimes transcribed with subscripted "3" and "4)), and TSH are the usual screening tests for thyroid disease.
T3 (triiodothyronine) is an organic, iodine-containing hormone compound secreted in small amounts by the thyroid gland.
T4 (thyroxine) is the principal hormone manufactured by the thyroid gland. If elevated, it may indicate an overactive thyroid (hyperthyroidism). If low, underactive thyroid disease (hypothyroidism) may be the cause.
TSH (thyroid stimulating hormone) is manufactured by the pituitary gland and directs the thyroid gland to either increase or decrease production of thyroxine (T4). In the usual form of hypothyroidism, the T4 is low. and the TSH is high. Low T4 and TSH levels may indicate hypothyroidism secondary to pituitary disease. T3, T4, and TSH may be decreased by either an acute or a chronic illness, by fasting, or by severe stress.
PROSTATE SPECIFIC ANTIGEN (PSA)
Prostate specific antigen is a substance produced in the prostate gland. Normal levels are between 0 and 4. The most common cause of an elevated PSA (>4) is prostate enlargement, known as benign prostatic hyperplasia (BPH). An elevated PSA, however, can also indicate prostatic cancer. Being a nonspecific test, a diagnosis may require additional studies, including ultrasound and/or needle biopsy of the prostate.
CHEMISTRY PROFILE (CHEM PROFILE)
A chemistry profile is a group of blood studies that provide information about internal bodily function and disease. It is an effective and economical study using a small blood sample and performed on a machine (sometimes called a SMAC or a Coulter) that runs the tests simultaneously. A chemistry profile is known as a �screening procedure� and is designed to uncover common diseases that might be missed on physical examination. It usually provides no definite answers, since most diagnoses require more specific tests and correlation with the physician�s history and physical exam. The blood tests and their significance are discussed below.
glucose
Sugar in the blood, high levels of which can indicate diabetes mellitus.
cholesterol, cholesterol/HDL, triglycerides, cholesterol/LDL
Known as the lipid (fat) profile, the pattern of results provides information about fat metabolism. Abnormal patterns can indicate a tendency for coronary artery disease. Generally, lower levels of cholesterol, HDL, triglycerides, and LDL are ideal. With HDL, the �good� cholesterol, however, higher levels are better than lower levels.
blood urea nitrogen and creatinine
The BUN and creatinine measure kidney function; their results are usually dictated together.
uric acid
Commonly high with gout, the uric acid level is abnormal in kidney disease, with tissue breakdown, dehydration, and in other disease conditions.
calcium and phosphorus
Abnormal levels can indicate disease of the bone, parathyroid gland, kidneys, and other diseases.
bilirubin, alkaline phosphatase, AST (SGOT), ALT ( SGPT), LDH, and GGPT
The above group of chemistry tests is commonly referred to as a liver function panel or the liver function tests (LFTs). The bilirubin is a yellow pigment and can be abnormal with liver and gallbladder disease plus certain blood diseases. The alkaline phosphatase (often dictated alk phos) is an enzyme that indicates bone disease, cancer, or other disease. AST, ALT, and LDH are enzymes that can be abnormal with liver, muscle, or heart disease. (AST and ALT are preferred usage over SGOT and SGPT.) GGPT distinguishes liver disease from other disease.
protein and albumin-globulin ratio
These provide a picture of general nutrition, liver function, and acute or chronic inflammation.
sodium, potassium, chloride, and bicarbonate (electrolytes)
The above group of four chemistry tests is known as the electrolytes (often dictated "lytes"). They can be abnormal with kidney disease, liver or respiratory failure, dehydration, and diuretic therapy (water pills).
Chemistry terminology also heard on dictation includes the following:
BMP (basic metabolic profile)
CMP (complete metabolic profile)
SMAC-8 (eight chemistry tests)
SMAC-21 (21 chemistry tests)
NOTE: Each of the above descriptions is meant to provide some basic information about the many tests done in the clinical laboratory. Normal results do not always assure good health; abnormal results do not always indicate disease. The human body is very complex, and different results in different people can have different meanings. Therefore, interpretation and/or evaluation by your physician is essential.