Basic Skills in

Interpreting
Laboratory Data
Fifth Edition

Mary Lee, PharmD, BCPS, FCCP

Vice President
Chief Academic Officer
Pharmacy, Optometry, and Health Science Education
Midwestern University
Professor, Pharmacy Practice
Midwestern University Chicago College of Pharmacy
Downers Grove, Illinois

American Society of Health-System Pharmacists®

Any correspondence regarding this publication should be sent to the publisher, American Society of
Health-System Pharmacists, 7272 Wisconsin Avenue, Bethesda, MD 20814, attention: Special Publishing.

The information presented herein reflects the opinions of the contributors and advisors. It should not be
interpreted as an official policy of ASHP or as an endorsement of any product.

Because of ongoing research and improvements in technology, the information and its applications
contained in this text are constantly evolving and are subject to the professional judgment and interpretation
of the practitioner due to the uniqueness of a clinical situation. The editors, contributors, and ASHP have
made reasonable efforts to ensure the accuracy and appropriateness of the information presented in this
document. However, any user of this information is advised that the editors, contributors, advisors, and
ASHP are not responsible for the continued currency of the information, for any errors or omissions,
and/or for any consequences arising from the use of the information in the document in any and all
practice settings. Any reader of this document is cautioned that ASHP makes no representation, guarantee,
or warranty, express or implied, as to the accuracy and appropriateness of the information contained in
this document and specifically disclaims any liability to any party for the accuracy and/or completeness
of the material or for any damages arising out of the use or non-use of any of the information contained
in this document.

Director, Special Publishing: Jack Bruggeman

Acquisitions Editor: Robin Coleman
Editorial Project Manager: Ruth Bloom
Production Editor: Kristin Eckles
Cover and Page Design: Carol Barrer

Library of Congress Cataloging-in-Publication Data

Basic skills in interpreting laboratory data / [edited by] Mary Lee. -- 5th ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-58528-343-9
I. Lee, Mary (Mary Wu-Len) II. American Society of Health-System Pharmacists.
[DNLM: 1. Clinical Laboratory Techniques. 2. Reference Values. QY 25]
616.07’5--dc23

2012040827

©2013, American Society of Health-System Pharmacists, Inc. All rights reserved.

No part of this publication may be reproduced or transmitted in any form or by any means, electronic
or mechanical, including photocopying, microfilming, and recording, or by any information storage and
retrieval system, without written permission from the American Society of Health-System Pharmacists.

ASHP is a service mark of the American Society of Health-System Pharmacists, Inc.; registered in the U.S.
Patent and Trademark Office.

ISBN 978-1-58528-343-9
 D e d i c at i o n
T his book is dedicated to Scott Traub, the originator
of Basic Skills in Interpreting Laboratory Data. He saw
the need for this textbook, had the vision to create the first
edition, and edited the second edition.
 Mary Lee

iii

contents
acknowledgments���������������������������������������������������������������������������� vi
preface ���������������������������������������������������������������������������������������vii
Contributors�������������������������������������������������������������������������������������� ix
Reviewers ���������������������������������������������������������������������������������������xii
aBBREVIATIONS������������������������������������������������������������������������������������xiv
CHAPTER 1. DEFINITIONS AND CONCEPTS........................................... 1
Karen J. Tietze

CHAPTER 2. INTRODUCTION TO COMMON LABORATORY ASSAYS

AND TECHNOLOGY........................................................ 17
Philip F. DuPont

CHAPTER 3. PRIMER ON DRUG INTERFERENCES WITH TEST RESULTS.... 39

Mary Lee

CHAPTER 4. SUBSTANCE ABUSE AND TOXICOLOGICAL TESTS............ 47

Peter A. Chyka

CHAPTER 5. INTERPRETATION OF SERUM DRUG CONCENTRATIONS.... 71

Janis J. MacKichan

CHAPTER 6. ELECTROLYTES, OTHER MINERALS, AND

TRACE ELEMENTS.......................................................... 119
Alan Lau, Lingtak-Neander Chan

CHAPTER 7. Pharmacogenomics and Molecular Testing...... 161

Amber L. Beitelshees, Rosane Charlab

CHAPTER 8. THE KIDNEYS................................................................ 175

Dominick P. Trombetta

CHAPTER 9. ARTERIAL BLOOD GASES AND ACID–BASE BALANCE.... 193

Anastasia L. Roberts

CHAPTER 10. PULMONARY FUNCTION AND RELATED TESTS............... 207

Lori A. Wilken, Min J. Joo

CHAPTER 11. THE HEART: LABORATORY TESTS AND

DIAGNOSTIC PROCEDURES........................................... 223
Wafa Y. Dahdal, Samir Y. Dahdal

iv
 v
C onten t s

CHAPTER 12. LIVER AND GASTROENTEROLOGY TESTS....................... 247

Paul Farkas, Joanna Sampson, Barry Slitzky, Brian Altman

CHAPTER 13. ENDOCRINE DISORDERS............................................... 283

Eva M. Vivian, Brady Blackorbay

CHAPTER 14. LIPID DISORDERS.......................................................... 331

Jill S. Borchert, Kathy E. Komperda

CHAPTER 15. HEMATOLOGY: RED AND WHITE

BLOOD CELL TESTS....................................................... 351
Paul R. Hutson, Ashley M. Johnson

CHAPTER 16. HEMATOLOGY: BLOOD COAGULATION TESTS.............. 373

Lea E. Dela Peña

CHAPTER 17. INFECTIOUS DISEASES.................................................. 401

Sharon M. Erdman, Rodrigo M. Burgos, Keith A. Rodvold

CHAPTER 18. RHEUMATIC DISEASES .................................................. 469

Terry L. Schwinghammer

CHAPTER 19. CANCERS AND TUMOR MARKERS.................................. 493

Patrick J. Medina, Val Adams

CHAPTER 20. INTERPRETING PEDIATRIC LABORATORY DATA................ 521

Donna M. Kraus

CHAPTER 21. Women’s Health....................................................... 545

Michelle J. Washington, Candace S. Brown

CHAPTER 22. Common Medical Disorders of Aging Males—

Clinical and Laboratory Test Monitoring.......... 567
Mary Lee, Roohollah Sharifi

Glossary .................................................................................... 593

Appendix A. Therapeutic Ranges of Drugs in Traditional and
SI Units......................................................................... 603
Appendix B. Nondrug Reference Ranges for Common Laboratory
Tests in Traditional and SI Units.................................... 604
Appendix C. Blood Collection Tubes: Color Codes, Additives,
and Appropriate Sample Volumes............................... 605
INDEX .................................................................................... 607
 acknowledgments
T he authors and I would like to acknowledge all of the careful and selfless work of
the many chapter reviewers; Dr. John Kennedy, our clinical laboratory/pathologist
expert reviewer of the entire book; and the Special Publishing staff at ASHP, including
Jack Bruggeman, Robin Coleman, Ruth Bloom, and Kristin Eckles, for their technical
assistance. We also express our gratitude to our families who supported us through
this project.

  Mary Lee

vi
p r e fac e
I n January 2011, the American Society of Health-System Pharmacists (ASHP) invited me
to serve as editor for the third time for Basic Skills in Interpreting Laboratory Data. Based
on the revisions to the fourth edition, the book was well received and was becoming a popu-
lar educational tool among colleges of pharmacy in the United States and at international
programs. What an honor for me to work on this project again!

The authors, many of whom have traveled along with me on my professional path, are expe-
rienced pharmacists and/or faculty at prestigious colleges of pharmacy and medicine. They
participate in medication therapy management in their practices, supervise residents and
other postdoctoral students in training, and publish widely. They know how to teach, and
how to teach well. As you use this book, their depth of experience shows in the clarity of the
content and the practical examples in the cases that demonstrate how to apply a laboratory
test result to a particular patient’s diagnosis, treatment, or drug therapy monitoring plan.
A few new authors have joined the team, and we are grateful for their fresh approach, in-
sights, and expertise.

The fifth edition includes several enhancements over previous editions. We have revised the
template for the Quickview tables at the end of each chapter to make the content easier to
understand. This table format is the same as that used in ASHP’s Interpreting Laboratory
Data: A Point-of-Care Guide. In addition, all of the abbreviations used throughout the book
have been consolidated into one master list in the front; this should increase the convenience
of finding the explanation of each abbreviation. Our eagle-eye pathologist consultant, Dr.
John Kennedy, has standardized all the normal value ranges for the laboratory test results
to mirror those used in Harrison’s Principles of Internal Medicine, which reduces some of
the variation in normal lab value ranges between this book and other textbooks. Finally, in
many of the chapters the cases have been updated or changed.

What has been preserved in the fifth edition are the same chapter topics; discussion of com-
monly used laboratory tests for each major organ system and how they are used for screen-
ing, diagnosis, treatment, or monitoring response to treat; patient cases that highlight ap-
plication of test results; and learning points that summarize important concepts at the end
of each chapter. This book is designed to be a companion to commonly used pharmaco-
therapeutic textbooks; therefore, the emphasis is on covering laboratory tests that are used
for management of diseases discussed in those textbooks.

When using this book, readers should be aware of the following guidelines:

• All laboratory tests are organized into one of three sections: Concepts (chapters 1–6),
Body Systems (chapters 7–18), and Special Populations (chapters 19–21).
• Readers can find the most appropriate chapter by checking the Table of Contents or the
Index.
• To look up a specific laboratory test, it is most efficient to check the Index.
• For each laboratory test, we have included a short description of how measurement of
this laboratory test is related to normal physiologic processes or the pathophysiology of
the disease, common diseases or medications that might increase or decrease laboratory
test results, and how to interpret an abnormal laboratory result.
• We have minimized redundancy in the descriptions of laboratory tests where appropri-
ate. For example, prostate specific antigen is covered in Chapter 22: Common Medical
Disorders of Aging Males—Clinical and Laboratory Test Monitoring, but it is not covered
in Chapter 19: Cancers and Tumor Markers.

vii

viii b a s ic s k ills i n i nterpreti ng l ab or ator y data

• For certain diseases, other types of tests—including radiographs, scans, and electrocar-
diograms—are used. We have described how these other tests are used for diagnosis,
management, and monitoring of selected diseases as appropriate.

This book differs from many classic textbooks on clinical laboratory tests in that the focus is
on clinical interpretation of laboratory test results as they apply to individual patients. If the
reader is seeking an in-depth description of the assay methodology of a particular laboratory
test, rare disease or medication-related causes of abnormal laboratory test results, or causes
of in vitro interferences with a particular laboratory test, then this is not the appropriate
resource to use. Chapter 3: Primer on Drug Interferences with Test Results includes a listing
of alternative reference resources that would be best for those purposes.

As you use this book, the authors’ and reviewers’ commitment to ensure that this book
provides accurate, clinically pertinent, and up-to-date information will be clearly evident.

 Mary Lee
 May 2013
Contributors
Editor
Mary Lee, PharmD, BCPS, FCCP
Vice President, Chief Academic Officer
Pharmacy, Optometry, and Health Science
Education
Midwestern University
Professor, Pharmacy Practice
Midwestern University Chicago College of
Pharmacy
Downers Grove, Illinois

Contributors
Val Adams, PharmD, FCCP, BCOP Lingtak-Neander Chan, PharmD, BCNSP
Associate Professor of Pharmacy Associate Professor
College of Pharmacy School of Pharmacy
University of Kentucky University of Washington
Lexington, Kentucky  Seattle, Washington

Brian Altman, PharmD Rosane Charlab, PhD

Albany College of Pharmacy and Health Genomics Group, Office of Clinical
Sciences, 2012 Pharmacology
Longmeadow, Massachusetts Office of Translational Sciences
Center for Drug Evaluation and Research
Amber L. Beitelshees, PharmD, MPH, FAHA U.S. Food and Drug Administration
Assistant Professor Silver Spring, Maryland
Department of Medicine
University of Maryland, Baltimore Peter A. Chyka, PharmD
Baltimore, Maryland Professor and Executive Associate Dean
College of Pharmacy, Knoxville Campus
Brady Blackorbay The University of Tennessee Health Science
Doctor of Pharmacy Candidate Center
School of Pharmacy Knoxville, Tennessee
University of Wisconsin-Madison
Madison, Wisconsin Samir Y. Dahdal, MD, FACC
Clinical Assistant Professor of Medicine
Jill S. Borchert, PharmD, BCPS, FCCP Medical Director, General Cardiology Practice
Professor and Vice-Chair, Pharmacy Practice The University of Arizona Medical Center
Midwestern University Chicago College of Tucson, Arizona
Pharmacy
Downers Grove, Illinois Wafa Y. Dahdal, PharmD, BCPS
(AQ Cardiology)
Candace S. Brown, MSN, PharmD Director of International Programs
Professor of Clinical Pharmacy, Obstetrics & Associate Director of Professional Development
Gynecology, and Psychiatry American College of Clinical Pharmacy
University of Tennessee Health Science Center Lenexa, Kansas
Memphis, Tennessee Adjunct Clinical Professor
Department of Pharmacy Practice
Rodrigo M. Burgos, PharmD College of Pharmacy
Clinical Assistant Professor University of Illinois at Chicago
College of Pharmacy Chicago, Illinois
University of Illinois at Chicago
Chicago, Illinois  Lea E. Dela Peña, PharmD, BCPS
Associate Professor, Pharmacy Practice
Midwestern University Chicago College of
Pharmacy
Downers Grove, Illinois

ix

x b a s ic s k ills i n i nterpreti ng l ab or ator y data

Philip F. DuPont, MD, PhD Alan Lau, PharmD, FCCP

Adjunct Professor Professor and Director, International Clinical
Department of Pathology Pharmacy Education
Chicago College of Osteopathic Medicine College of Pharmacy
Midwestern University University of Illinois at Chicago
Downers Grove, Illinois Chicago, Illinois
Department of Biology
Benedictine University Mary Lee, PharmD, BCPS, FCCP
Lisle, Illinois Vice President, Chief Academic Officer
Pharmacy, Optometry, and Health Science
Sharon M. Erdman, PharmD Education
Clinical Professor of Pharmacy Practice Midwestern University
Purdue University School of Pharmacy Professor, Pharmacy Practice
Wishard Health Services Midwestern University Chicago College of
Indianapolis, Indiana Pharmacy
Downers Grove, Illinois
Paul Farkas, MD, FACP, AGAF
Chief of Gastroenterology Janis J. MacKichan, PharmD, FAPhA
Mercy Hospital Professor and Vice Chair
Assistant Clinical Professor of Medicine Department of Pharmacy Practice
Tufts University School of Medicine Northeast Ohio Medical University
Springfield, Massachusetts Rootstown, Ohio 

Paul R. Hutson, PharmD, BCOP Patrick J. Medina, PharmD, BCOP

Associate Professor, Pharmacy Practice Associate Professor of Pharmacy
School of Pharmacy University of Oklahoma College of Pharmacy
University of Wisconsin Oklahoma City, Oklahoma
Madison, Wisconsin
Anastasia L. Roberts, PharmD, BCPS
Ashley M. Johnson, PharmD Assistant Professor of Pharmacy Practice
Clinical Pharmacist St. Louis College of Pharmacy
St. Mary’s Hospital St. Louis, Missouri 
Madison, Wisconsin
Keith A. Rodvold, PharmD, FCCP, FIDSA
Min J. Joo, MD, MPH, FCCP Professor of Pharmacy Practice and Medicine
Assistant Professor of Medicine College of Pharmacy
Department of Medicine University of Illinois at Chicago
University of Illinois at Chicago Chicago, Illinois
Chicago, Illinois
Joanna Sampson, MD
Kathy E. Komperda, PharmD, BCPS Baystate Medical Center
Associate Professor, Pharmacy Practice Springfield, Massachusetts
Midwestern University Chicago College of
Pharmacy Terry L. Schwinghammer, PharmD, FCCP,
Downers Grove, Illinois FASHP, FAPhA, BCPS
Professor and Chair
Donna M. Kraus, PharmD, FAPhA, Department of Clinical Pharmacy
FPPAG, FCCP School of Pharmacy
Associate Professor of Pharmacy Practice West Virginia University
Departments of Pharmacy Practice and Morgantown, West Virginia
Pediatrics
Colleges of Pharmacy and Medicine Roohollah Sharifi, MD, FACS
University of Illinois at Chicago Section Chief of Urology
Chicago, Illinois University of Illinois College of Medicine
Chicago, Illinois
 xi
C ontr ibuto rs

Barry Slitzky, MD
Senior Clinical Instructor
Tufts University School of Medicine
Springfield, Massachusetts

Karen J. Tietze, PharmD

Professor of Clinical Pharmacy
Department of Pharmacy Practice and
Pharmacy Administration
Philadelphia College of Pharmacy
Philadelphia, Pennsylvania

Dominick P. Trombetta, PharmD, BCPS,

CGP, FASCP
Associate Professor, Pharmacy Practice
Wilkes University
Wilkes-Barre, Pennsylvania

Eva M. Vivian, PharmD, MS, CDE,

BC-ADM, FAADE
Clinical Associate Professor
School of Pharmacy
University of Wisconsin-Madison
Madison, Wisconsin

Michelle J. Washington, BS, PharmD

Clinical Pharmacist
ExcelleRx, Inc.
Memphis, Tennessee

Lori A. Wilken, PharmD, BCACP, TT-S,

AE-C
Clinical Assistant Professor, Ambulatory Care
Department of Pharmacy Practice
University of Illinois at Chicago
Chicago, Illinois
 Reviewers
Eric G. Boyce, PharmD Arthur I. Jacknowitz, MSc, PharmD
Associate Dean for Academic Affairs & Professor Professor and Distinguished Chair Emeritus
of Pharmacy Practice School of Pharmacy
Thomas J. Long School of Pharmacy & Health Robert C. Byrd Health Sciences Center
Sciences West Virginia University
University of the Pacific Morgantown, West Virginia
Stockton, California
Samantha Karr, PharmD, BCPS, BCACP
Joseph Bubalo, PharmD, BCPS, BCOP Assistant Professor of Pharmacy Practice
Oncology Clinical Pharmacy Specialist College of Pharmacy–Glendale
Assistant Professor of Medicine Midwestern University
Oregon Health & Science Hospital & Clinics Glendale, Arizona
Portland, Oregon
John L. Kennedy, MD
Katie S. Buehler, PharmD, BCPS Lead Pathologist
Assistant Professor of Pharmacy Practice Pathology and Laboratory Medicine Service
St. Louis College of Pharmacy Jesse Brown VA Medical Center
St. Louis, Missouri Clinical Associate Professor
Department of Pathology
Vince Colucci, PharmD, BCPS(AQ-Card), University of Illinois at Chicago
CPP Chicago, Illinois
Professor, Department of Pharmacy Practice
The University of Montana, CHPBS Lisa J. Killam-Worrall, PharmD, BCPS
Missoula, Montana Director of Experiential Education
Associate Professor of Pharmacotherapy
Susan Cornell, BS, PharmD, CDE, FAPhA, University of North Texas System College of
FAADE Pharmacy
Assistant Director of Experiential Education University of North Texas Health Science Center
Associate Professor of Pharmacy Practice Fort Worth, Texas
Midwestern University Chicago College of
Pharmacy Julie M. Koehler, PharmD, FCCP
Downers Grove, Illinois Associate Dean for Clinical Education &
External Affiliations
Emily R. Hajjar, PharmD, BCPS, Professor of Pharmacy Practice
College of Pharmacy & Health Sciences
BCACP, CGP Butler University
Associate Professor
Ambulatory Care Clinical Pharmacist
Jefferson School of Pharmacy
Methodist Hospital of Indiana University Health
Thomas Jefferson University
Indianapolis, Indiana
Philadelphia, Pennsylvania
Taimour Langaee, MSPH, PhD
Evelyn R. Hermes-DeSantis, PharmD, Research Associate Professor
BCPS Graduate Coordinator
Clinical Professor Director, Center for Pharmacogenomics
Pharmacy Practice & Administration Genotyping Core Lab
Rutgers, The State University of New Jersey College of Pharmacy
Director Drug Information Service University of Florida
Robert Wood Johnson University Hospital Gainesville, Florida
New Brunswick, New Jersey
Catherine M. Oliphant, PharmD
Tudy Hodgman, PharmD, FCCM, BCPS Associate Professor of Pharmacy Practice
Clinical Coordinator/Critical Care Specialist College of Pharmacy
Northwest Community Hospital Idaho State University
Associate Professor, Pharmacy Practice Meridian, Idaho
Critical Care Residency Director
Midwestern University Chicago College of
Pharmacy
Downers Grove, Illinois

xii
 xiii
Reviewe rs

Nancy D. Ordonez, PharmD, BCPS

Assistant Dean for Experiential Programs
College of Pharmacy
University of Houston
Houston, Texas

Frank P. Paloucek, BS, PharmD, DABAT,

FASHP
Director, Residency Programs
Clinical Associate Professor in Pharmacy
Practice
Department of Pharmacy Practice
College of Pharmacy
University of Illinois at Chicago
Chicago, Illinois

Tracy Pettinger, PharmD, BCPS

Clinical Assistant Professor
College of Pharmacy
Idaho State University
Pocatello, Idaho

Theresa Prosser, PharmD, BCPS, AE-C,

FCCP
Professor of Pharmacy Practice
St. Louis College of Pharmacy
St. Louis, Missouri

William Spruill, PharmD, FASHP, FCCP

Professor
Clinical and Administrative Pharmacy
College of Pharmacy
University of Georgia
Athens, Georgia

Holli Temple, PharmD, BCPS, CGP

Clinical Assistant Professor
College of Pharmacy
University of Texas at Austin
Austin, Texas

Timothy J. Todd, PharmD

Associate Professor of Pharmacy Practice
Midwestern University Chicago College of
Pharmacy
Downers Grove, Illinois
 a BBREVIATIONS
1,25-DHCC 1,25-dihydroxycholecalciferol
17-OHP 17 alpha-hydroxyprogesterone
2,3 DPG 2,3-diphosphoglycerate
25-HCC 25-hydroxycholecalciferol
3SR self-sustained sequence replication
5-HT serotonin
6-AM 6-acetylmorphine
6MWT 6-minute walk test
A-G6PD glucose-6 phosphate dehydrogenase variant
A1c glycosylated hemoglobin
A2M alpha 2-macroglobulin
ABG arterial blood gas
ACA anticentromere antibody
ACC American College of Cardiology
ACCF American College of Cardiology Foundation
ACCP American College of Clinical Pharmacy
ACCP anticyclic citrullinated peptide
ACE angiotensin-converting enzyme
ACE-I angiotensin-converting enzyme inhibitor
ACPA anticitrullinated protein antibody
ACR American College of Rheumatology
ACS acute coronary syndrome
ACT activated clotting time
ACT alpha 1-antichymotrypsin
ACTH adrenocorticotropic hormone (corticotropin)
ADA American Diabetes Association
ADAM androgen deficiency in aging males
ADCC antibody-dependent cellular cytotoxicity
ADH antidiuretic hormone
ADME absorption, distribution, metabolism, excretion
ADP adenosine diphosphate
AFB acid-fast bacilli
AFP alpha fetoprotein
AHA American Heart Association
AIDS acquired immunodeficiency syndrome
ALK anaplastic lymphoma kinase
ALL acute lymphoblastic leukemia
ALP alkaline phosphatase
ALT alanine aminotransferase
AMA antimitochondrial antibody
AMI acute myocardial infarction
AML acute myelogenous leukemia
ANA antinuclear antibody
ANCA antineutrophil cytoplasmic antibody
ANF atrial natriuretic factor
ANP atrial natriuretic peptide
anti-CCP anti-cyclic citrullinated peptide
anti-HAV IgG IgG antibody against hepatitis A virus
anti-HAV IgM IgM antibody against hepatitis A virus
anti-HBc antibody to hepatitis B core antigen
anti-HbeAg antibody to hepatitis B extracellular antigen
anti-HBs antibody to hepatitis B surface antigen

xiv
 xv
Abbr eviation s

anti-HCV antibody against HCV antigen

anti-HD antibody against hepatitis D
APC activated protein C
APC antigen-presenting cell
ApoB apolipoprotein B
APS antiphospholipid antibody syndrome
aPTT activated partial thromboplastin time
ARB angiotensin receptor blocker
ASA aspirin
ASCO American Society of Clinical Oncology
AST aspartate aminotransferase
AT antithrombin
ATP adenosine triphosphate
ATP-K adenosine triphosphate potassium
ATP Adult Treatment Panel
ATP III Adult Treatment Panel III
ATS American Thoracic Society
AUA American Urological Association
AUC area under the (serum concentration time) curve
AV atrioventricular
AVP arginine vasopressin
B&B Brown and Brenn
B2M beta-2-microglobulin
BAL bronchial alveolar lavage; bronchoalveolar lavage
BAMT blood assay for Mycobacterium tuberculosis
BBT basal body temperature
BCG Bacille Calmette-Guérin
bDNA branched-chain DNA
BGMK-hDAF buffalo green monkey kidney cell line
BHI brain heart infusion
BHR bronchial hyper-responsiveness
BID twice daily
BMI body mass index
BMP basic metabolic panel
BNP brain natriuretic peptide
BP blood pressure
BPH benign prostatic hyperplasia
BPSA benign prostate-specific antigen
BPT bronchial provocation testing
BRAF v-Raf murine sarcoma viral oncogene homolog B1
BSA body surface area
BSL biosafety level
BT bleeding time
BUN blood urea nitrogen
C. difficile Clostridium difficile
C3 complement protein 3
C4 complement protein 4
CA cancer antigen
CA carbonic anhydrase
CABG coronary artery bypass graft
CAcorr corrected serum calcium level
CAD coronary artery disease
xvi b a s ic s k ills i n i nterpreti ng l ab or ator y data

CAH congenital adrenal hyperplasia

CAN2 ChromID Candida agar
cANCA cytoplasmic antineutrophil cytoplasmic antibody
CAP College of Pathologists
CAP community-acquired pneumonia
CAT computerized axial tomography
CAuncorr uncorrected serum calcium level (or actual measured total serum calcium)
CBC complete blood count
CCFA cycloserine cefoxitin fructose agar
CCNA cell cytotoxicity neutralization assay
CCP cyclic citrullinated peptide
CCR5 chemokine coreceptor 5
cCRP cardiac C-reactive protein
CCT cardiac computed tomography
cd candela
CD clusters of differentiation
CDC Centers for Disease Control and Prevention
CDR complementarity-determining regions
CE capillary electrophoresis
CEA carcinoembryonic antigen
CEDIA cloned enzyme donor immunoassay
CF complement fixation
CFTR cystic fibrosis transmembrane conductance regulator
CFU, cfu colony-forming units
CFW calcofluor white
CH50 complement hemolytic 50%
CHD coronary heart disease
CHF congestive heart failure
CI chemical ionization
CIS combined intracavernous injection and stimulation
CK creatine kinase
CK-MB creatine kinase isoenzyme MB
CK1 creatine kinase isoenzyme 1
CK2 creatine kinase isoenzyme 2
CK3 creatine kinase isoenzyme 3
CKD chronic kidney disease
CLIA-88 Clinical Laboratory Improvement Amendments of 1988
CLIA Clinical Laboratory Improvement Amendments
CLL chronic lymphocytic leukemia
CLSI Clinical and Laboratory Standards Institute
cm centimeter
CMA cornmeal agar
CML chronic myelogenous leukemia
CMP comprehensive metabolic panel
CMR cardiac magnetic resonance
CMV cytomegalovirus
CNA colistin-nalidixic acid
Cnormalized normalized total concentration
CNP c-type natriuretic peptide
CNS central nervous system
CO carbon monoxide
CO cardiac output
 xvii
Abbr eviation s

CO2 carbon dioxide

CO-Hgb carboxyhemoglobin
COP colloid osmotic pressure
COPD chronic obstructive pulmonary disease
CPE cytopathic effect
CPK creatine phosphokinase
CPPD calcium pyrophosphate dihydrate
cPSA complexed PSA
CrCl creatinine clearance
CREST syndrome characterized by calcinosis, Raynaud disease, esophageal
motility disorder, sclerodactyly, and telangiectasias
CRH corticotrophin-releasing hormone
CRP C-reactive protein
CSF cerebrospinal fluid
Css, avg average steady-state concentration
CT computed tomography
cTnC cardiac-specific troponin C
cTnI cardiac-specific troponin I
CX circumflex
CXCR4 CXC chemokine coreceptor
CYP cytochrome P450 drug metabolizing enzymes
CYP2C19 cytochrome P450 2C19 enzyme
CYP2D6 cytochrome P450 2D6 enzyme
CYP3A4 cytochrome P450 3A4 enzyme
CYP450 cytochrome P450 enzyme
CZE capillary zone electrophoresis
D5W 5% dextrose in water
DAT direct agglutination test
DAT direct antibody test
DCCT Diabetes Control and Complications Trial
DCP des-gamma-carboxyprothrombin
DDAVP desmopressin
DDT dichlorodiphenyltrichloroethane
DFA direct fluorescent antibody
DHA docosahexaenoic acid
DHEA dehydroepiandrostenedione
DHEAS dehydroepiandrosterone sulfate
DI diabetes insipidus
DIC disseminated intravascular coagulation
DIM dermatophyte identification medium
DKA diabetic ketoacidosis
dL deciliter
DLCO diffusing capacity of the lung for carbon monoxide
DM diabetes mellitus
DNA deoxyribonucleic acid
DNP dendroaspis natriuretic peptide
DO2 oxygen delivery
DPD dihydropyrimidine dehydrogenase
DPP-4 dipeptidyl peptidase-4
dsDNA double-stranded DNA
DST dexamethasone suppression test
DTI direct thrombin inhibitor
xviii b a s ic s k ills i n i nterpreti ng l ab or ator y data

DTM dermatophyte test medium

EBM esculin base medium
EBV Epstein-Barr virus
ECD energy coupled dye
ECG electrocardiogram
ECMO extracorporeal membrane oxygenation
ECT ecarin clotting time
ECW extracellular water
ED emergency department
EDTA ethylenediaminetetraacetic acid
EGFR epidermal growth factor receptor
eGFR estimated glomerular filtration rate
EI electron ionization
EIA enzyme immunoassay
EIB exercise- or exertion-induced bronchospasm
EKG electrocardiogram
ELISA enzyme-linked immunosorbent assay
ELVIS enzyme-linked virus-inducible system
EM electron microscopy
EMB eosin methylene blue
EMIT enzyme-multiplied immunoassay technique
EOF electroosmotic force
EPA eicosapentaenoic acid
EPS expressed prostatic secretions
ER estrogen receptor
ERS European Respiratory Society
ERV expiratory reserve volume
ESA erythrocyte-stimulating agent
ESBL extended-spectrum beta-lactamase
ESC European Society of Cardiology
ESI electrospray ionization
ESR erythrocyte sedimentation rate
Etest® epsilometer test
ETIB enzyme-linked immunoelectrotransfer blot
EU ELISA units
EUCAST European Committee on Antimicrobial Susceptibility Testing
EULAR European League Against Rheumatism
FA fluorescent antibody
Fab fraction antigen-binding
FAB fast atom bombardment
FAB French-American-British
FACS fluorescence-activated cell sorting
FALS forward-angle light scattering
FANA fluorescent antinuclear antibody
FDA Food and Drug Administration
FDP fibrin degradation product
FEF25–75 forced expiratory flow at 25% to 75% of vital capacity
FEF forced expiratory flow
FENa fractional excretion of sodium
FENO fractional exhaled nitric oxide
FEV0.5 forced expiratory volume in 0.5 second
FEV1 forced expiratory volume in 1 second
 xix
Abbr eviation s

FISH fluorescence in situ hybridization

FITC fluorescein isothiocyanate
fL femtoliter
FM Fontana-Masson
FN false negative
FP false positive
FPG fasting plasma glucose
FPIA fluorescence polarization immunoassay
fPSA free prostate specific antigen
FRC functional residual capacity
FSH follicle-stimulating hormone
FTA-ABS fluorescent treponemal antibody absorption
FVC forced vital capacity
FWR framework regions
g gram
G-CSF granulocyte colony–stimulating factor
G6PD glucose-6 phosphate dehydrogenase
GA gestational age
GADA glutamic acid decarboxylase autoantibodies
GC gas chromatography
GC-MS gas chromatography and mass spectrometry
GERD gastroesophageal reflux disease
GF Gridley fungus
GFR glomerular filtration rate
GGT, GGTP gamma-glutamyl transferase; gamma-glutamyl transpeptidase
GHB gamma-hydroxybutyrate
GI gastrointestinal
GIP glucose-dependent insulinotropic peptide
GLC gas liquid chromatography
GLP-1 incretin hormones glucagon-like peptide-1
GLUT glucose transporter
GM-CSF granulocyte/macrophage colony-stimulating factor
GMS Gomori methenamine silver
GnRH gonadotropin-releasing hormone
GOLD Global Initiative for Chronic Obstructive Lung Disease
gp glycoprotein
GTF glucose tolerance factor
H&E hematoxylin and eosin
H. Pylori Helicobacter pylori
HAAg hepatitis A antigen
HAP hospital-acquired pneumonia
HAV hepatitis A virus
Hb hemoglobin
HbA1c glycosylated hemoglobin
HBcAg hepatitis B core antigen
HBeAg hepatitis B extracellular antigen
HBsAg hepatitis B surface antigen
HBV hepatitis B virus
HCG, hCG human chorionic gonadotropin
HCO3– bicarbonate
HCT, Hct hematocrit
HCV hepatitis C virus
xx b a s ic s k ills i n i nterpreti ng l ab or ator y data

HDAg hepatitis D antigen

HDL high-density lipoprotein
HDL-C high-density lipoprotein cholesterol
HDV hepatitis D virus
HER-1 human epidermal growth factor receptor 1
HER-2 human epidermal growth factor receptor 2
HEV hepatitis E virus
HGA human granulocytic anaplasmosis
Hg, Hgb hemoglobin
HHS hyperosmolar hyperglycemia state
HIPA heparin-induced platelet activation
HIT heparin-induced thrombocytopenia
HIV human immunodeficiency virus
HIV-1 human immunodeficiency virus type 1
HLA human leukocyte antigen
HLAR high-level aminoglycoside resistance
HME human monocytic ehrlichiosis
HMG-CoA hydroxymethylglutaryl-coenzyme A
HMWK high-molecular weight kininogen
HPA hypothalamic pituitary axis
HPF high-power field
HPLC high-performance (or pressure) liquid chromatography
HPV human papillomavirus
HR heart rate
hr hour
hs-CRP high-sensitivity C-reactive protein
HSG hysterosalpingogram, hysterosalpingography
hsTnI high-sensitivity troponin I
hsTnT high-sensitivity troponin T
HSV herpes simplex virus
Ht height
I intermediate
IA immunoassay
IA-2A insulinoma-associated-2 autoantibodies
IAA insulin autoantibodies
IAT indirect antibody test
IBW ideal body weight
IC inspiratory capacity
IC50 inhibitory concentration 50%
ICA immunochromatographic assay
ICA islet cell cytoplasmic autoantibodies
ICTV International Committee on Taxonomy of Viruses
ICU intensive care unit
ICW intracellular water
ID immunodiffusion
IDC International Diabetes Center
IDL intermediate-density lipoproteins
IDMS isotope dilution mass spectrometry
IFA immunofluorescence assay; indirect fluorescent antibody
IFN-γ interferon gamma
IgA immunoglobulin A
IgD immunoglobulin D
 xxi
Abbr eviation s

IgE immunoglobulin E
IgG immunoglobulin G
IgM immunoglobulin M
IHC immunohistochemistry
IHD ischemic heart disease
IIEF International Index of Erectile Function
IIM idiopathic inflammatory myopathy
IMA inhibitory mold agar
INR international normalized ratio
IP interphalangeal
iPSA inactive PSA
IPSS International Prostate Symptom Score
IRMA immunoradiometric assay
IRV inspiratory reserve volume
ISE ion-selective electrode
ISI International Sensitivity Index
ITP idiopathic thrombocytopenic purpura
IV intravenous
JIA juvenile idiopathic arthritis
JRA juvenile rheumatoid arthritis
k constant of proportionality
K kelvin
Kcorr corrected serum potassium level
KDOQI Kidney Disease Outcome Quality Initiative
kg kilogram
KIMS kinetic interaction of microparticles in solution
Km Michaelis constant
KOH potassium hydroxide
KRas V-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog
Kuncorr uncorrected serum potassium level (or actual measured serum potassium)
L liter
LA latex agglutination
La/SSB La/Sjögren syndrome B
LAD left anterior descending
LBBB left bundle branch block
LC liquid chromatography
LCR ligase chain reaction
LDH lactate dehydrogenase
LDH1 lactate dehydrogenase isoenzyme 1
LDH2 lactate dehydrogenase isoenzyme 2
LDH3 lactate dehydrogenase isoenzyme 3
LDH4 lactate dehydrogenase isoenzyme 4
LDH5 lactate dehydrogenase isoenzyme 5
LDL low-density lipoprotein
LDL-C low-density lipoprotein cholesterol
LE lupus erythematosus
LFT liver function test
LH luteinizing hormone
LHRH luteinizing hormone–releasing hormone
LMP last menstrual period
LMWH low molecular weight heparin
Lp-PLA2 lipoprotein-associated phospholipase A2
xxii b a s ic s k ills i n i nterpreti ng l ab or ator y data

LSD lysergic acid diethylamide

LTA light transmittance aggregometry
LUTS lower urinary tract symptoms
LVEF left ventricular ejection fraction
m meter
m2 meters squared
MAbs monoclonal antibodies
Mac MacConkey
MAC membrane attack complex
MAC Mycobacterium avium complex
MALDI matrix-assisted laser desorption/ionization
MALDI-TOF matrix-assisted laser desorption ionization time-of-flight
MAP mitogen-activated protein
MAT microscopic agglutination
MBC minimum bactericidal concentration
MBP mannose-binding protein
mcg microgram
MCH mean corpuscular hemoglobin
MCHC mean corpuscular hemoglobin concentration
MCP metacarpophalangeal
MCT medium chain triglycerides
MCTD mixed connective tissue disease
MCV mean corpuscular volume
MDMA 3,4-methylenedioxy-N-methamphetamine (Ecstasy)
MDR multidrug resistant
MDRD Modification of Diet in Renal Disease
MDx molecular diagnostics
mEq milliequivalent
mg milligram
MHA Mueller-Hinton agar
MHA-TP microhemagglutination Treponema pallidum
MHC major histocompatibility complex
MI myocardial infarction
MIC minimum inhibitory concentration
MIC50 MIC value representing 50% of a bacterial population
MIC90 MIC value representing 90% of a bacterial population
MIF microimmunofluorescence
min minute
mL milliliter
mm millimeter
mm3 cubic millimeter
mmol millimole
MoAB monoclonal antibody
mol mole
MOTT mycobacteria other than tuberculosis
MPO myeloperoxidase
MPV mean platelet volume
MRI magnetic resonance imaging 
mRNA messenger ribonucleic acid
MRO medical review officer
MRSA methicillin-resistant Staphylococcus aureus
MS mass spectrometry
 xxiii
Abbr eviation s

MSSA methicillin-susceptible Staphylococcus aureus

MTP metatarsophalangeal
NA nucleic acid
NAAT nucleic acid amplification test
NACB National Academy of Clinical Biochemistry
NAEPP National Asthma Education Prevention Program
NASBA nucleic acid sequence-based amplification
NASH nonalcoholic steatohepatitis
NCCB nondihydropyridine calcium channel blocker
NCEP National Cholesterol Education Program
ng nanogram
NHL Non-Hodgkin lymphoma
NK cells natural killer (T) lymphocytes
NNRTI non-nucleoside reverse transcriptase inhibitor
NNS number needed to screen
NQMI non Q-wave myocardial infarction
NRTI nucleoside reverse transcriptase inhibitor
NSAID nonsteroidal anti-inflammatory drug
NSCLC non-small-cell lung cancer
NSTEMI non-ST-segment elevation myocardial infarction
NT-proBNP N-terminal-proBNP
NTM nontuberculous mycobacteria
NYHA New York Heart Association
OA osteoarthritis
OAT organic anion transport
OCT organic cation transport
OGTT oral glucose tolerance test
OSHA Occupational Safety and Health Administration
P serum creatinine concentration
P1G1O1 one live birth, one pregnancy, no spontaneous or elective abortions
P-gp P-glycoprotein
PaCO2 arterial partial pressure of carbon dioxide
PAI1 plasminogen activator inhibitor 1
pANCA perinuclear antineutrophil cytoplasmic antibody
PaO2 arterial partial pressure of oxygen
PAS periodic acid-Schiff
PBC primary biliary cirrhosis
PBMC peripheral blood mononuclear cell
PBP penicillin-binding protein
PC20FEV1 provocation concentration of the bronchoconstrictor agent that produces
a 20% reduction in FEV1
PCA postconceptional age
PCI percutaneous coronary intervention
pCO2 partial pressure of carbon dioxide (in an arterial blood gas)
PCOS polycystic ovary syndrome
PCP phencyclidine
PCR polymerase chain reaction
PDA potato dextrose agar
PE phycoerythrin
PEA phenylethyl alcohol
PEFR peak expiratory flow rate
PET positron emission tomography
xxiv b a s ic s k ills i n i nterpreti ng l ab or ator y data

PF3 platelet factor 3

PF4 platelet factor 4
PFA potato flake agar
PFT pulmonary function test
pg picogram
PG prostaglandin
PG2 prostacyclin
pH power of hydrogen or hydrogen ion concentration
Ph Philadelphia
PICU pediatric intensive care unit
PID pelvic inflammatory disease
PIP proximal interphalangeal
PKU phenylketonuria
PMA postmenstrual age
PMN polymorphonuclear leukocyte
PNA postnatal age
PO per os (by mouth)
pO2 partial pressure of oxygen
POC point-of-care
POCT point-of-care testing
PPAR peroxisome proliferator-activated receptor
PPD purified protein derivative
PPG postprandial glucose
PPI proton pump inhibitor
PR progesterone receptor
PR3 proteinase 3
PRN as needed
PSA prostate specific antigen
PSAD prostate specific antigen density
PSB protected specimen brush
PSM patient self-management
PST patient self-testing
PT prothrombin time
PTCA percutaneous transluminal coronary angioplasty
PTH parathyroid hormone
q every
Q perfusion
QC quality control
QID four times daily
qPCR real-time polymerase chain reaction
QRS electrocardiograph wave; represents ventricular depolarization
QwMI Q-wave myocardial infarction
R resistant
R-CVA right cerebral vascular accident
RA rheumatoid arthritis
RAAS renin-angiotensin-aldosterone system
RADT rapid antigen detection test
RAEB refractory anemia with excess blasts
RAIU radioactive iodine uptake test
RALS right-angle light scattering
RBC red blood cell
RBF renal blood flow
 xxv
Abbr eviation s

RCA right coronary artery

RDW red cell distribution width
RF rheumatoid factor
RhMK rhesus monkey kidney
RI reticulocyte index
RIA radioimmunoassay
RIBA recombinant immunoblot assay
RIDTs rapid influenza diagnostic tests
RNA ribonucleic acid
RNP ribonucleoprotein
Ro/SSA Ro/Sjögren syndrome A antibody
RPF renal plasma flow
RPR rapid plasma reagin
RR respiratory rate
RSA rapid sporulation agar
RSV respiratory syncytial virus
RT reverse transcriptase; reverse transcription
RT-PCR reverse-transcriptase polymerase chain reaction
RV residual volume
S susceptible
S:P ratio saliva:plasma concentration ratio
SA sinoatrial
SAMHSA Substance Abuse and Mental Health Services Administration
SAT serum agglutination test
SBA sheep blood agar
SBT serum bactericidal test
Scl70 scleroderma-70 or DNA topoisomerase I antibody
SCr serum creatinine
SD standard deviation
SDA Sabouraud dextrose agar
SDA strand displacement amplification
sec second
SGE spiral gradient endpoint
SGLT sodium glucose cotransporters
SHBG sex hormone-binding globulin
SI International System of Units
SIADH syndrome of inappropriate antidiuretic hormone
SLE systemic lupus erythematosus
Sm Smith antibody
SMBG self-monitoring blood glucose
SNP single nucleotide polymorphism
SnRNP small nuclear ribonucleoprotein particle
SPECT single-photon emission computed tomography
SPEP serum protein electrophoresis
SRA C-serotonin release assay
ssDNA single-stranded DNA
SSRI selective serotonin reuptake inhibitor
STD sexually transmitted disease
STEMI ST segment elevation myocardial infarction
SV stroke volume
SVC slow vital capacity
SvO2 mixed venous partial pressure of oxygen
xxvi b a s ic s k ills i n i nterpreti ng l ab or ator y data

T3 triiodothyronine
T4 thyroxine
TAT turnaround time
TB tuberculosis
TBG thyroxine-binding globulin
TBI total body irradiation
TBPA thyroid-binding prealbumin
TBW total body water
TBW total body weight
TC total cholesterol
TCA tricyclic antidepressant
TDM therapeutic drug monitoring
TEE transesophageal echocardiography
TF tissue factor
TFPI tissue factor pathway inhibitor
TG triglyceride
TIBC total iron-binding capacity
TID three times daily
TJC The Joint Commission
TK tyrosine kinase
TKI tyrosine kinase inhibitor
TLA total laboratory automation
TLC therapeutic lifestyle changes
TLC thin layer chromatography
TLC total lung capacity
TMA transcription mediated amplification
TN true negative
TnC troponin C
TNF tumor necrosis factor
TnI troponin I
TnT troponin T
TP true positive
TP tube precipitin
tPA tissue plasminogen activator
TPMT thiopurine methyltransferase
TR therapeutic range
TRH thyrotropin-releasing hormone
TRUS transrectal ultrasound of the prostate
TSB trypticase soy broth
TSH thyroid-stimulating hormone
TST tuberculin skin test
TT thrombin time
TTE transthoracic echocardiography
TTP thrombotic thrombocytopenic purpura
TTP total testing process
TV tidal volume
TXA2 thromboxane A2
type 1 DM type 1 diabetes mellitus
type 2 DM type 2 diabetes mellitus
U urinary creatinine concentration
U1RNP uridine-rich ribonuclear protein
UA unstable angina
 xxvii
Abbr eviation s

UCr urine creatinine

UFC urine-free cortisol
UFH unfractionated heparin
UGT1A1 uridine diphosphate glucuronyl transferase
UKPDS United Kingdom Prospective Diabetes Study
ULN upper limit of normal
uNGAL urine neutrophil gelatinase associated lipocalcin
uPA urokinase plasminogen activator
UTI urinary tract infection
V total urine volume collected
V ventilation
V volt
VAP ventilator-associated pneumonia
VC vital capacity
Vd volume of distribution
VDRL Venereal Disease Research Laboratory
VKORC1 vitamin K epoxide reductase complex subunit 1
VLDL very low-density lipoprotein
Vmax maximum rate of metabolism
VO2 oxygen consumption
VRE vancomycin-resistant enterococci
VTE venous thromboembolism
vWF von Willebrand factor
VZV varicella zoster virus
WB western blot
WBC white blood cell
WHO World Health Organization
WNL within normal limits
Wt weight
WT wild type
yr year