|
If the test
|
has a result of
|
perform additional test:
|
| Serum
Protein Electrophoresis (SPEP) |
monoclonal spike |
Immunofixation
(IFX)
to look for IgG, IgA and IgM monoclonal gammopathies |
| SPEP
(Hematology patients only) |
monoclonal spike |
Immunofixation
for IgG, IgA and IgM |
| ANA |
positive |
Precipitin Panel, anti-dsDNA |
| Urine
Protein Electrophoresis (UPEP) |
monoclonal spike |
Immune electrophoresis |
| CH50 |
less than 150 u/mL |
C1Q, C2,
C3,
C4,
Factor B for BWH and NE Deaconess patients |
| Lyme
Antibodies (ELISA screen) |
positive |
Confirmation by western blot |
| CBC
with automated differential |
2+ left shift, IG or positive flag for blasts |
Manual Differential |
| Urinalysis |
positive for protein, blood or leukocyte esterase |
urine sediment analysis (microscopic urine exam) |
| Paroxysmal Nocturnal Hemoglobinuria (PNH; Sucrose
Lysis) |
positive |
acid
serum |
| Osmotic
Fragility and Coombs
Test |
positive and negative, respectively |
autohemolysis |
| PTT/Lupus
anticoagulant |
positive |
STATCLOT/Lupus
anticoagulant confirmatory |
| von Willebrand Panel and platelet
aggregation studies |
ordered together |
Ristocetin
titration to complete information needed for accurate diagnosis |
| HIV(EIA) |
positive |
confirmation by western blot |
| Fetal
Lung Maturity (FLM) |
All diabetic patients and/or results of 40-59 mg/G |
DSPC assay |
| Activated
protein C resistance (screen) |
positive |
PCR
for Factor V Leiden mutation/Activated Protein C Resistance |
| Anti-thrombin
III functional assay |
abnormal |
Antigenic assay for AT-III |
| Protein
C, functional assay |
abnormal |
Antigenic assay for protein C |
| Hemoglobin
Electrophoresis |
A2 > 3.5% |
A2 Column |
| Antibody
Screen |
Positive |
Antibody Identification (Pregnant women with a clinically significant
antibody will have an antibody titer sent to the Center for Blood Research
(CBR) |
| Direct
Antiglobulin Test |
Positive |
Monospecific Direct Antiglobulin tests with Anti-IgG and Anit-Complement |
| Monospecific
IgG Direct Antiglobulin Test |
Positive |
Eluate |
| RPR |
Positive |
TP-PA confirmation sent to the State Laboratory |
| Bacterial
Culture |
Significant growth |
Antibiotic susceptibility test(s) |
| Bacterial
Culture |
Beta hemolytic streptococci |
Strep Grouping |
| Bacterial
Culture |
Significant growth unidentified by routine methods |
Extended aerobic/anaerobic workup |
| GC
Culture |
Suspected gonococci |
GC confirmation |
| Mycobacterial
Culture |
Acid fast growth |
Genetic probe for AFB |
| Fungal
Culture |
Yeast (not Candida albicans) |
Fungus identification |
| Fungal
Culture |
Fungi (not yeast) |
Extended mycology workup |
| Anaerobic
Culture |
Significant anaerobic growth |
Anaerobic organism ID |
| Viral
Isolations |
Positive CPE |
Confirmation by monoclonal antibody staining |
