Mariano Marcos State University
College of Health Sciences
Pharmacy Department
City of Batac 2906 Ilocos Norte
PCARE 105: Clinical Pharmacy and Pharmacotherapeutics 1
1st Semester of A.Y. 2023-2024
Title
Clinical Laboratory Tests and Medical Abbreviations
Introduction
The module introduces the basic clinical laboratory tests and the relevant medical
abbreviations. The laboratory tests are performed for multiple purposes such as the
confirmation and classification of a disease, differential diagnosis and monitoring of
effectiveness to therapy. On the other hand, the medical abbreviations are essential
elements in medical documentation to save time and space while evaluating and writing
in the patients' medical records.
Learning Outcomes
At the end of the module, student must have:
1. understood and recognize medical abbreviations and laboratory tests that are
relevant to patient case studies and medical records;
2. analyzed clinical laboratory tests and medical abbreviations that are relevant to a
patient’s case (IO1, IO3, IO4, PO2, PO11, PO12, CO1);
3. interpreted diagnostic and laboratory tests of a patient’s case.
Warm-Up Activity
• Recall the laboratory tests that was conducted from you during your last visit to the
physician. If none, maybe from one of your peers or family members.
Learning Inputs
Clinical Laboratory Tests
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• Laboratory tests are performed for multiple purposes, including to discover a
disease, confirm or differentiate a diagnosis, stage or classify a disease, and monitor
effectiveness of therapy.
• They are classified according to the purpose as for screening or diagnostic.
o Screening tests are used in patients with no signs or symptoms of a disease
(e.g., serum cholesterol for assessing cardiovascular disease risk).
o Diagnostic tests are done in patients with signs and symptoms of disease or
with an abnormal screening test.
Monitoring drug therapy
• Laboratory test results are used to investigate potential problems with a patient’s
anatomy or physiology. Pharmacists usually monitor laboratory tests to:
o Assess the therapeutic and adverse effects of a drug (e.g., monitoring the serum uric
acid level after allopurinol is administered, checking for increased liver function test
values after administration of isoniazid)
o Determine the proper drug dose (e.g., assessment of the serum creatinine or
creatinine clearance value before use of a renally excreted drug)
o Assess the need for additional or alternate drug therapy (e.g., assessment of white
blood cell count after an antibiotic is administered)
o Prevent test misinterpretation resulting from drug interference (e.g., determination
of a false-positive result for a urine glucose test after cephalosporin administration)
• These tests can be expensive, and requests for them must be balanced against
potential benefits for patients and how the laboratory test will affect your decision
regarding therapy.
• Generally, lab tests should be ordered only if the results will affect the decisions
about the management of the patient.
Definition of normal values
• Normal laboratory test results fall within a predetermined range of values, and
abnormal values fall outside that range.
o Normal limits may be defined somewhat arbitrarily; thus, values outside the
normal range may not necessarily indicate disease or the need for treatment (e.g.,
asymptomatic hyperuricemia).
o Many factors (e.g., age, sex, time since last meal) must be taken into account
when evaluating test results.
o Normal values also vary among institutions and may depend on the method used
to perform the test.
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o The goal is not to make all laboratory values normal; resist urges to do something
in a clinically stable patient.
• Laboratory error must always be considered when test results do not correlate with
expected results for a given patient. If necessary, the test should be repeated.
Common sources of laboratory error include spoiled specimens, incomplete
specimens, specimens taken at the wrong time, faulty reagents, technical errors,
incorrect procedures, and failure to take diet or medication into account.
• During hospital admission or routine physical examination, a battery of tests is usually
given to augment the history and physical examination. Basic tests may include an
electrocardiogram (ECG), a chest x-ray, a sequential multiple analyzer (SMA) profile,
electrolyte tests (e.g., Chemistry or Basic Metabolic Panel [BMP]), a complete blood
count (CBC), and urinalysis.
Hematological Tests
• Blood contains three types of formed elements: red blood cells (RBCs), white blood
cells (WBCs), and platelets.
• A CBC typically includes RBC count, total WBC count, hemoglobin (Hb), hematocrit
(Hct), RBC indices (mean cell volume [MCV], mean cell Hb [MCH], mean cell Hb
concentration [MCHC]), reticulocyte count, and platelet count.
Common Serum Enzyme Tests
• Small amounts of enzymes (catalysts) circulate in the blood at all times and are released
into the blood in larger quantities when tissue damage occurs.
• Serum enzyme levels can be used to aid in the diagnosis of certain diseases.
Liver Function Tests
A. Liver enzymes
• Levels of certain enzymes (e.g., LDH, ALP, AST, ALT) increase with liver dysfunction.
• These enzyme tests indicate only that the liver has been damaged. They do not assess
0000 the liver’s ability to function. Other tests provide indications of liver dysfunction.
B. Serum bilirubin
1. Bilirubin, a breakdown product of Hb, is the predominant pigment in bile. Effective
bilirubin conjugation and excretion depend on hepatobiliary function and on the rate of
RBC turnover.
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2. Serum bilirubin levels are reported as total bilirubin (conjugated and unconjugated)
and as direct bilirubin (conjugated only).
o Bilirubin is released by Hb breakdown and is bound to albumin as water-insoluble
indirect bilirubin (unconjugated bilirubin), which is not filtered by the glomerulus.
o Unconjugated bilirubin travels to the liver, where it is separated from albumin,
conjugated with diglucuronide, and then actively secreted into the bile as
conjugated bilirubin (direct bilirubin), which is filtered by the glomerulus.
3. Normal values of total serum bilirubin are 0.1 to 1.0 mg/dL (2 to 18 mmol/L); of direct
00bilirubin, 0.0 to 0.2 mg/dL (0 to 4 mmol/L).
4. An increase in serum bilirubin results in jaundice from bilirubin deposition in the
00tissues. There are three major causes of increased serum bilirubin.
o Hemolysis increases total bilirubin; direct bilirubin (conjugated) is usually normal
or slightly increased. Urine color is normal, and no bilirubin is found in the urine.
o Biliary obstruction, which may be intrahepatic (as with a chlorpromazine
reaction) or extrahepatic (as with a biliary stone), increases total bilirubin and
direct bilirubin; intrahepatic cholestasis (e.g., from chlorpromazine) may increase
direct bilirubin as well. Urine color is dark, and bilirubin is present in the urine.
o Liver cell necrosis, as occurs in viral hepatitis, may cause an increase in both
direct bilirubin (because inflammation causes some bile sinusoid blockage) and
indirect bilirubin (because the liver’s ability to conjugate is altered). Urine color is
dark, and bilirubin is present in the urine.
C. Serum proteins
1. Primary serum proteins measured are albumin and the globulins.
o Albumin (4 to 6 g/dL) maintains serum oncotic pressure and serves as a transport
agent. Because it is primarily manufactured by the liver, liver disease can decrease
albumin levels. Albumin can also be used to assess nutritional status.
o Globulin (23 to 35 g/L) relates to the total measurement of immunoglobins
(antibodies) found in the serum and function as transport agents and play a role in
certain immunological mechanisms. A decrease in albumin levels usually results in a
compensatory increase in globulin production.
2. Normal values for total serum protein levels are 6 to 8 g/dL (60 to 80 g/L).
Urinalysis
• Composed of chemical and microscopic tests of the urine used to provide basic
information regarding renal function, urinary tract disease, and the presence of certain
systemic diseases.
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• Components of a standard urinalysis include physical (color, turbidity, odor, specific
gravity, and osmolality), chemical (pH, Hb, glucose, protein, glucose, ketone, leukocyte
esterase, nitrites, bilirubin) and microscopic examination (RBC, WBC, epithelial cells,
casts, bacteria).
How about renal function tests, electrolytes and minerals?
Comprehensive Pharmacy Review for NAPLEX
Medical Abbreviations
Abbreviation Stands for More information
ABG Arterial blood gases ABG test detects lung diseases.
ACE inhibitors are used to treat
Angiotensin converting
ACE high blood pressure, heart failure,
enzyme
diabetes and kidney diseases.
Commonly injured part of the
ACL Anterior cruciate ligament
knee
Attention deficit hyperactivity
ADHD A behavior disorder
disorder
AFIB Atrial fibrillation A disturbance of the heart rhythm
Acquired immunodeficiency Infection caused by human
AIDS
syndrome immunodeficiency virus
ALP Alkaline phosphatase ALP detects liver or bone disease.
Also known as Lou Gehrig's
ALS Amyotrophic lateral sclerosis.
Disease
ALT Alanine aminotransferase ALP detects liver disease.
Age-related macular
AMD An eye disorder
degeneration
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AMI Acute myocardial infarction Heart attack
AODM Adult onset diabetes mellitus Type 2 diabetes
AST Aspartate aminotransferase ALP detects liver disease.
AVM Arteriovenous malformation Defect in the circulatory system.
Doctor may write this on
BID Twice a day
prescription.
A measure of how one should
BMI Body mass index
weigh based on height
The force of blood pushing against
BP Blood pressure
the walls of arteries
BPH Benign prostatic hypertrophy Enlargement of the prostate gland
People with the gene may be at
BRCA Breast Cancer Gene increased risk for breast or ovarian
cancer.
BUN detects kidney disease
BUN Blood urea nitrogen
problems.
CA Cancer OR Calcium
A blood test for CA-125 A to
CA-125 Cancer antigen 125
measure cancer activity.
CABG Coronary artery bypass graft A type of heart surgery
CAD Coronary artery disease A common type of heart disease
Computerized axial
CAT A type of x-ray
tomography
A blood test that measures many
CBC Complete blood count
properties of the cells in the blood
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CHD Congenital heart disease Heart disease one was born with
The heart can’t pump enough
CHF Congestive heart failure
blood throughout the body.
CMV Cytomegalovirus A common virus
CNS Central nervous system The brain and spinal cord
Chronic obstructive A lung disease that makes it hard
COPD
pulmonary disease to breathe
CPK Creatine phosphokinase CPK detects a heart attack.
An emergency procedure whose
CPR Cardiopulmonary resuscitation heart has stopper or is no longer
breathing
CRF Chronic renal failure Failure of the kidneys
CRP detects inflammation or heart
CRP C-reactive protein
problems.
A fluid that surrounds the brain
CSF Cerebrospinal fluid
and spinal cord
CVA Cerebrovascular accident A stroke or "brain attack"
A diagnostic test that uses
CXR Chest x-ray radiation to make images of the
lungs
A surgical procedure on the uterus
D&C Dilatation and curettage
(womb)
DJD Degenerative joint disease Another name for arthritis
DM Diabetes mellitus
DTP Diphtheria, tetanus, pertussis A vaccine for three diseases
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DVT Deep-vein thrombosis A blood clot
DX Diagnosis
A test that measures electrical
ECG, EKG Electrocardiogram
impulses of the heart
A test that uses sound waves to
ECHO Echocardiogram
look at the heart
A test that measures electrical
EEG Electroencephalogram
impulses of the brain
A test that measures electrical
EMG Electromyography
impulses of muscles
ENT Ear, nose and throat
A way to diagnose problems in the
Endoscopic retrograde
ERCP liver, gallbladder, bile ducts and
cholangiopancreatography
pancreas
Erythrocyte sedimentation
ESR A blood test for inflammation
rate
End-stage renal (kidney)
ESRD
disease
FSH Follicle stimulating hormone FSH evaluates fertility in women.
A problem that happens when
Gastroesophageal reflux
GERD stomach contents leak back into
disease
esophagus
GI Gastrointestinal Another term for digestive system
GFR Glomerular filtration rate A test of kidney damage
GU Genitourinary The urinary and sex organs
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A virus that causes one type of
HAV Hepatitis A virus
liver disease
A virus that causes one type of
HBV Hepatitis B virus
liver disease
HCT Hematocrit A blood test measurement
A virus that causes one type of
HCV Hepatitis C virus
liver disease
A type of cholesterol, also known
HDL High density lipoprotein
as "good" cholesterol
HGB Hemoglobin A blood test measurement
Human immunodeficiency
HIV The virus that causes AIDS
virus
HPV Human papilloma virus A virus that causes cervical cancer
Hormone replacement Hormones supplements that
HRT
therapy women may take
HTN Hypertension High blood pressure
A name for two digestive
IBD Inflammatory bowel disease disorders-- ulcerative colitis and
Crohn's disease
IBS Irritable bowel syndrome A problem with the large intestine
Implantable cardioverter A device that monitors heart
ICD
defibrillator rhythm problems
ICU Intensive care unit Special hospital unit
Insulin-dependent diabetes
IDDM Type 1 diabetes
mellitus
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IM Intramuscular A type of injection
IUD Intrauterine device A type of birth control for women
IV Intravenous A type of injection
IVP Intravenous pyelogram An x-ray test of the urinary system
A type of cholesterol, also known
LDL Low density lipoprotein
as "bad" cholesterol
LFT Liver function tests
MI Myocardial infarction Heart attack
MMR Measles, mumps, and rubella A vaccine for three diseases
MRI Magnetic resonance imaging A type of imaging test
Methicillin-resistant
MRSA A type of infection
Staphylococcus aureus
MS Multiple sclerosis A disease of the nervous system
NG Nasogastric
Non-insulin dependent
NIDDM Type 2 diabetes
diabetes mellitus
NKDA No known drug allergies
Non-steroidal anti-
NSAID Drugs like ibuprofen
inflammatory drug
Obsessive-compulsive
OCD A type of anxiety disorder
disorder
Diseases of the arteries outside
PAD Peripheral arterial disease
the heart
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You may need a PAP test to detect
PAP Papanicolau
cervical cancer.
A disturbance of the rhythm of the
PAT Paroxysmal atrial tachycardia
heart
PET Positron emission tomography A type of x-ray test
PFT Pulmonary function test Tests for lung function
Infection and inflammation of the
PID Pelvic inflammatory disease
female reproductive organs
A group of symptoms that may
PMS Premenstrual syndrome
happen before a woman’s period
PPD Purified protein derivative PPD skin test for tuberculosis.
PRN As needed May be written on prescription.
PSA Prostate specific antigen PSA detects prostate disease.
PT Prothrombin time A measure of blood clotting
PTH Parathyroid hormone PTH to detect parathyroid disease.
Post-traumatic stress An illness caused by traumatic
PTSD
syndrome events
PTT Partial thromboplastin time A measure of blood clotting
PUD Peptic ulcer disease A disease of the stomach
Premature ventricular A disturbance of the rhythm of the
PVC
contraction heart
QID Four times a day May be written on prescription.
RA Rheumatoid arthritis A type of joint disease
RBC Red blood cell A type of blood cell
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A virus that causes infections in
RSV Respiratory syncytial virus
children
Rx Treatment
Depression during seasons with
SAD Seasonal affective disorder
little light
Sudden infant death
SIDS
syndrome
SLE Systemic lupus erythematosus Lupus for short
SOB Shortness of Breath
STD Sexually transmitted disease
Blood test for T3 to detect thyroid
T3 Triiodothyronine
disease.
Blood test for T4 to detect thyroid
T4 Thyroxine
disease.
TB Tuberculosis An infection of the lungs
Surgery to remove a woman's
TAH Total abdominal hysterectomy
uterus (womb)
TIA Transient ischemic attack A small stroke
A test that measures the amount
TIBC Total iron binding capacity
of iron in your blood
TID Three times a day May be written on prescription.
The joint that connects the jaw to
TMJ Temporo mandibular joint
the side of head
Blood test for TSH to detect
TSH Thyroid stimulating hormone
thyroid disease.
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Transurethral resection of An operation to remove parts of
TURP
prostate gland the prostate gland
Another name for the common
URI Upper respiratory infection
cold
Infection of the bladder and
UTI Urinary tract infection
kidneys
Therapy that uses radiation,
XRT Radiotherapy
usually for cancer
WBC White blood cell A type of blood cell
Central Activities
Activity 1: Lecture
• Couse module available for viewing/downloading via mVLE
Activity 2:
• Research for the basic hematological tests, the range of normal values and clinical
implications.
Wrap-Up Activity
Discussion Forum (Open-Ended Questions)
• You are expected to participate in the discussion forum. Please refer to the course guide
for your scheduled time.
• Open-ended questions will be asked randomly among students during the discussion
proper.
• Moreover, you are also given the opportunity to ask/raise any clarifications or questions
during the discussion.
Assessment (Post-assessment)
Quiz
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Course Facilitator
Franklin Viernes Ibana, MSc, CPh, RPh, CIP
Assistant Professor III
Pharmacy Department
09673375038
fvibana@[Link]
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