Pre Sampling Instruction for Biochemical parameters

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Information about Pre Sampling Instruction for Biochemical parameters
Science-Technology

Published on February 23, 2014

Author: jaya85

Source: authorstream.com

Pre sampling instructions for Clinical Biochemistry : Pre sampling instructions for Clinical Biochemistry Dr JAYAGANDAN J Vijaya Diagnostic Centre Hyderabad What is sample ?: What is sample ? S mile A ssure M edications P ast history L ast meal eaten E xplain the procedure. What is fasting?: What is fasting? Abstain from F OOD A LCOHOL S MOKING T IME (for particular duration) Synopsis: Synopsis OGTT Lipid Profile Hormones Vitamins Therapeutic drugs Special tests Urine OGTT: OGTT Unrestricted diet rich in carbohydrates for 3 days. Limit alcohol intake. Eat regular evening meal, then fast for 12 hours. Children may be asked to fast for a shorter time. DO NOT Eat, chew gum, smoke, drink anything except water. until the test is completed. Avoid walking or exercise the day before and the morning of the test. OGTT contd…: OGTT contd… OGTT for adults, non-pregnant women & children Withdraw fasting sample. Glucose 75 g dissolved in 250-300 mL water. Time frame to drink - 5 minutes. Collect second sample after 2 hours. NOTE: Half hour (or) first hour (or) 3 hour s samples can be collected on Doctor’s request. Take a copy of Doctor’s request. OGTT contd…: OGTT contd… OGTT for Gestational Diabetes Withdraw fasting sample. Glucose 75 g dissolved in 250-300 mL water. Time frame to drink - 5 minutes. Collect two samples after 1hour & 2 hours. Note: Donot insist fasting for >10 hours. Take a copy of Doctor’s request. OGTT cont…: OGTT cont… Glucose Challenge test No Fasting required Glucose 50 g dissolved in 200 mL water Time frame to drink - 5 minutes. Collect second sample after 1 hour. Note: Any change in glucose load is allowed only on clinician’s request. Lipid Profile: Lipid Profile Abstain from alcohol for 24 hours. Fasting for 12 hours before the test. Water is not restricted. It is also recommended that drugs that may alter triglyceride levels be withheld for 24 hours Hormones: Hormones Thyroid hormones (T3,T4,TSH,FT3,FT4,TG,aTPO,aTG ) Before noon samples preferably with fasting. Fertility hormones (FSH,LH,Prog,E2,HCG) Menstrual cycle details mandatory. Request patient to follow clinician’s advice. ACTH ( HMNR only ) Time of collection preferably 6 to 8 A.M. No sample should be collected after 10 A.M for ACTH without clinician’s advice. Pre-cooled EDTA tubes & temperature controlled centrifugation is mandatory. Hormones: Hormones Cortisol Fasting for at least 8 hours. Time of collection 8 A.M (or) 4 P.M. Details of medications should be obtained. Gastrin Fasting for at least 8 hours. Vitamins: Vitamins Vitamin B12 & Folate Fasting for at least 6 - 8 hours is required. Details of vitamin supplementation should be obtained. Total 25 – OH Vitamin D No preparation required. Therapeutic Drug Monitoring : Therapeutic Drug Monitoring Carbamazepine - Trough Phenytoin - Trough Valproic acid - Trough Lithium - Trough Trough ( Just before the next dose) Digoxin – 8 hours after taking the dose. Never ever advice patient to skip the drug for testing. Special Tests: Special Tests Plasma Amino acid screen Fasting for at least 8 hours required Minimum of 2 hours fasting from last feed for infants & young children. Heparin plasma should be collected. Urine Amino acid screen Spot collection is sufficient. Obtain clinical details and copy of doctor’s request. Urine Tests: Urine Tests 24 hours urinary VMA & Metanephrines The following foods are restricted: Artificial flavored or colored foods, bananas, candy, carbonated beverages, cereals, coffee, cheese, chocolate, chewing gum, citrus fruits, grains, gelatin foods, jelly, licorice, nuts, vanilla, salad dressing and tea. Details of Medication. To be on safer side get treating doctor’s advice. PowerPoint Presentation: THANK YOU

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