1. LIST OF TESTS

HORMONES & TUMOR MARKERS
 
 

TDM
 
 

Notes: B : Blood

U : Urine

CSF: Cerebrospinal Fluid

F: Other Fluids (pleural, peritoneal,ascitic etc.).
 
 
 
 
 
 

FUNCTION/PROFILE TESTS
 
 

3. COMMUNICATION

For any inquiry of the service or tests provided, kindly  ring :

         2119 - Laboratory
         2123 - Biochemist
         2120 - Specimen reception counter
 

4. REQUEST FORMS

5. SPECIMEN COLLECTION

6.     SPECIMEN CONTAINERS

Types of specimen containers for biochemical tests:
(The following containers are supplied by Laboratory receiving Counter)

                i .   Serum Seperation Tubes / SST     -  for blood sample-serum
                ii    Plain Plastic tubes -

               iii .   Heparin Tubes
               iv.    Flouride Oxalate Tubes                 --  for  blood samples – plasma or whole blood
               v.     Potassium Oxalate Tubes

               vi.   EDTA Tubes                                   } for blood sample – whole blood
               vii.   Micro tubes/bullet                         } for peadiatric use)
               viii.   Universal Bottle                            } for urin,PD fluid, other body fluids
               ix.      24h urine bottle                             } for 24h urine collection
 

7. DESPATCH OF SPECIMEN

All specimens should be sent to the Reception Counter, Department of Pathology,HKT

Any incomplete forms, labels, wrong containers, inadequate samples and inappropriate specimen will
be rejected.

8. REPORTING OF RESULTS

As soon as a batch of tests results is completed, they are screened by biochemist. All laboratory results
must pass quality control criteria before they are reported.

All the reports will be placed in the ‘pigeon holes’ located at the Reception Counter, Department of
Pathology,HKT. The results are despatched to the pigeon holes for collection several times in a day.

Ward and clinic staff should come to the laboratory to collect results regularly, preferably once in the morning and once in the afternoon or even more frequently..

Results for polyclinics and distric hospitals will be posted 1-2 times a week.

9. INQUIRY OF RESULTS

Inquiry of urgent results by telephone is permitted but should be kept to minimum so as not to
interrupt work in the laboratory unnecessarily.

10. URGENT REQUEST AFTER OFFICE HOURS

Specimen with completed request forms should be brought to the Biochemistry Laboratory by the ward
staff.

Results will be telephoned back to the ward as soon as the test is completed and all the reports are
despatched to the pigeon holes for collection by the wards.

SECTION B

TABLE OF TEST OFFERED, SPECIMEN REQUIRED AND CHARGE

              1.    ROUTINE CHEMISTRY

 

TESTS	SPECIMEN	CONTAINER	SAMPLE VOLUME	CHARGE
BUSE – BUN - Na/K/Cl	Blood Urine – random - 24hr collection	SST/Plain/heparin tube Universal bottle 24hr urine container	5ml (neonates: 1.5ml) 10ml 24 volume	G – each test G x 4 – BUSE
Glucose – Fasting/Random/HPPS - GTT (fasting, 1hr, 2hr)	Blood Blood Urine	Flouride oxalate tube Flouride oxalate tube Universal bottle	3ml (neonates: 1.5ml) 3ml each 10ml	G – each test C – GTT
Total Protein, Albumin, ALP, ALT, Bilirubin-total & direct, Uric Acid, Creatinine, Calcium, AST, CK, LDH, Phosphate, Cholesterol, Triglyserides, HDL-Cholesterol, Amylase, Magnesium, ACP	Blood (Lipid-fasting sample)	Plain plastic tube/SST	3ml (<10tests) 5ml (>10test)	G – each test C- LFT D – Lipid
Iron, TIBC	Blood	Plain plastic tube/SST	5ml	G – each test
Total Protein, Uric Acid, Calcium, Phosphate, Creatinine Creatinine Clearence	Urin – Random - 24hr  Urine  Blood	Universal bottle 24hr urine bottle 24hr urine bottle Plain plastic tube/SST	10ml 24hr volume 24hr volume 3ml	G – each test
LDH	Other body fluids	Universal bottle	10ml	G
Amylase	Urine - Random - 24hr Other body fluids	Universal bottle  24hr urine bottle Universal bottle	10ml 24hr volume 10ml	G
Ammonia (appointment must be made)	Blood	Heparin Tube	5ml (3ml: children)	G
Bilirubin (capillary method)- neonatal jaundice cases	Blood	Heparinised capillary tube	>3/4 capillary tubes volume	G
Fibrinogen	Blood	Potassium Oxalate tube	5ml	G
FEME	CSF Other body fluids	Sterile bijou bottle Universal bottle	2ml 10ml	F

            2.   HORMONES, TUMOR MARKERS ETC.

              1.  Routine Chemistries

 

TEST	BLOOD/SERUM/PLASMA	URINE
Acid Phosphatase/ACP	Total:        0 - 9 U/L Prostatic: 0 - 3 U/L
Albumin	35 - 50 g/l
Alkaline Phosphatase	Adult: 39 - 117 U/L Children:
ALT/SGPT	Up to 37 U/L
Ammonia	45 - 115 ug/dl
Amylase	Up to 220 U/L	Up to 1000 U/L
AST/SGPT	Up to 37 U/L
Bilirubin – total - Direct	Adult: up to 18.8umol/l Neonates: <171.1 umol/l Up to 4.3 umol/l
Calcium	2.02 - 2.60 mmol/l	2.50 - 8.0 mmol/24h
Chloride	99 - 114 mmol/l	85 - 170 mmol/l
Cholesterol	Low risk: < 5.7 mmol/l Suspect Range: 5.7 - 6.7mmol/l High Risk: > 6.7 mmol/l
Creatinine	Up to 124 umol/l	5 - 18mmol/24h (5000 - 18000umol/24h)
Creatinine Clearence	70 - 140ml/min
CK/CPK	Up to 190 U/L
Fibrinogen	1.5 - 4.5 g/l
FEME / Biochemistry	CSF Appearance: Clear & colorless Cell Count: < 5 WBC Protein, Total: 1.5 - 4.5 g/l Globulin: Negative Glucose: 2.2 - 3.89 mmol/l Chloride: 120 - 130 mmol/l
Glucose	Fasting: 4.1 - 6.3 mmol/l Random: 4.4 - 6.6 mmol/l
HDL-Cholesterol	MaleFemale Low Risk: > 1.4 >1.7 mmol/l Suspect Range: 0.9 – 1.4 1.2 - 1.7 mmol/l High Risk: < 0.9 <1.2 mmol/l
Iron	Male: 10.6 - 2.3 umol/l Female: 6.6 - 26.0 umol/l
LD/LDH	200 - 480 U/L
LDL-Cholesterol	Low Risk: <5.7 mmol/l Suspect Range: 5.7 - 6.7 mmol/l High Risk: >6.7 mmol/l
Magnesium	0.7 - 1.1 mmol/l	2.1 - 8.22 mmol24h
Phosphorus	Adult: 0.9 - 1.5 mmol/l	11 - 32 mmol/24h
Potassium	3.5 - 5.3 mmol/l	35 - 80 mmol/l
Protein, Total	66 - 87 mmol/l	<0.2 g 24h
Sodium	137 - 151 mmol/l	30 - 300 mmol/24h
TIBC	Male: 52.1 - 77.0 umol/l Female: 49.1 - 88.5 umol/l
Triglyserides	Low Risk: <1.7 mmol/l Suspect Range: 1.7 - 2.3 mmol/l High Risk: >2.3 mmol/l
Urea	2.5 - 6.4 mmol/l
Uric Acid	Male: 202 - 416 umol/l Female : 142 - 339 umol/l	1.5    - 4.5 mmol/24h (1500 - 4500 umol/l)

              2.  IMMUNOASSAY - Hormon & Tumor Markers

 

TEST	BLOOD/PLASMA/SERUM	URINE
AFP (Alpha Fetoprotein)	<17 ng.ml
BHCG (Human Chorionic Ganadotrophin)	< 5 mIU/ml
CEA (Carcinoembrionic antigen)	< 10 ng/ml
Cortisol	Am: 165.6 - 828.0 umol/l Pm: 82.8 - 441.6 umol/l	1159.2 - 6016.8 umol/24h
Ferritine	Male: 16.4 - 323.0 umol/l Female: 6.9 - 282.5 umol/l
Glycated Hb (HbA1)	4.4 - 6.4%
FSH	Follicular: 4 - 13 mIU/ml Mid Cycle: 5 - 22 mIU/ml Luteal: 2 - 13 mIU/ml Postmenopausal: 20 - 138 mIU/ml Male: 1 - 8 mIU/ml
LH	Follicular: 4 - 13 mIU/ml Mid Cycle: 5 - 22 mIU/ml Luteal: 2 - 13 mIU/ml Postmenopausal: 20 - 138 mIU/ml Male: 1 - 8 mIU/ml
Prolactin	Female: 0.30 - 27.3 ng/ml Male: 1.58 - 23.12 ng/ml
Progesterone	13 - 80 nmol/l (Day 21)
T4-Free (Thyroxine)	9.2 - 23.8 pmol/l
T3-total	0.9 - 2.67 nmol/l
TSH	0.40 - 4.67uIU/ml

3.        IMMUNOASSAY – TDM
 

DRUG LABORATORY

SECTION A

1. INTRODUCTION

1. To carry out analysis of drugs of abuse in urine

• Sreening and confirmation tests for MORPHINE.
• Sreening and confirmation tests for CANNABINOIDS.

1. To provide consultation services the area of drugs testing.
2. To carry out research in the relevant field.

1. REQUEST FORM FOR DRUG ANALYSIS

1. All requests for drug analysis should be accompanied with a drug analysis request form (Annex )
2. All requests form should be completed by an authorised officer requesting the drug analysis.
3. Personnal authorised to request for drug analysis – where possible this should be a qualified Medical Officer. Others who may be authorised are Senior Police Officers, Senior Army Officers and those who are gazetted as Drug Rehabilaization Officers.
4. Completed form should be signed and stamped with departmental stamp.
5. Name and Identity Card (IC) number of the suspect should be clearly printed as on his/her identity card.
6. Name and IC number of the officer supervicing the collection and the person despatching the specimen should be printed clearly.

1. URINE COLLECTION

1. The collection of specimens is normally carried out by medical assistant or nurses. Collection ca also be carried out at other sites and done by authorised personnel as follows:

• Police lock-up – Police
• Drug Rehabilization Centre – Officers

1. Suitable toilet facilities must be available before collection of urine is considered.
2. The toilet must be surveyed for any contraband which can be used to invalidate the sample. Toilet facilities can be set up without soap dipenser or cleaning agents.
3. If adultration by changing the pH of urine is suspected, the laboratory should be notified and request to check the pH.
4. The volume of urine samples should be at least 25ml . This is to ensure that further analysis ca be carried out to confirm the presence of drugs in the urine.
5. The person supervising the collection should stand close enough to drug user suspectto see that the urine is genuinly passed out from the person and to see that there is no attempt to falsify the specimens.
6. After the urine is collected, the bottles should be securely stoppered and labeled as follows:
7. 
    

    
    
    
    
    

   Name:
   IC Number:
   Date and time of collection:
   Signature of person supervising the collection:
   Drug Suspected:
   Labelling of bottles should be made in front of the suspect.

8. The stopper of the bottle should be sealed with sealing wax duly stamped with departmental seal.

1. SECURITY OF THE SPECIMEN

1. The security of samples as well as empty cups, request forms, labels and other packing materials is critical.
2. Suspect should not be allowed to have any involvement in the collection, labelling and packing or transporting of samples to the laboratory.
3. It is important that the suspect witness tha sealing of the bottle and sign or initial tha seal.
4. Accurate and complete records of all individuals involved in the urine collection, storage and transport should be maintained.
5. Specimen label should be afixed to the urine container not to the lid . This will prevent accidental or intentional switching of specimens and identifing labels.

1. TRANSPORT OF SAMPLES TO DRUG DETECTION LABORATORY

1. After the request form has been completed, the samples with the forms are given to the despatch person to be sent to the drug detection laboratory.
2. 
    

    
    
    
    
    

   Reminder: ‘Suspect’ should never be permitted to transport samples to the laboratory.

3. In the laboratory, the Medical Laboratory Technologists receive, check the samples against the forms to confirm that all the specimen are received and sign the despatch book.
4. After examining the samples and request forms, slips found at the bottom of every form should be handed to the person to acknowledge receipt of specimens.
5. Urine specimen should be stored at 4⁰C and locked if analysis is delayed.
6. Specimens collected by police /outside personnel should be sent to the laboratory immediately.

6. REPORTING OF RESULTS

All batch of test results that are completed will be screened by a biochemist before they are reported.

  e-mails are welcome at sehomar@spkb.net.my