Test Advice
The Test Advice page is designed as an aid to assist test selection and is not intended to override clinical judgment in individual cases.
It is a support document that underpins Southern.IML Pathology's eOrdering application which is available in Best Practice and Medical Director. For more information about Southern.IML Pathology eOrdering, please contact Customer Services on (02) 4224 7474.
Every effort has been made to ensure the Test Advice page is free from error or omission.
| Clinical Condition or Context | Initial test(s) | As indicated |
|---|---|---|
| Abdominal pain | FBC, E/LFT, Lipase, Urine MCS |
As indicated: Metal exposure - Cadmium, Lead, Urine Arsenic, Urine Mercury As indicated: ? Porphyria - Urine Porphyrins, Beta HCG (females only) |
| Adrenal function: Addison's disease | ACTH, Cortisol AM | Renin/Aldosterone Ratio (recumbent/upright, supine/erect), Synacthen Stimulation |
| Adrenal function: Cushing's syndrome | Dexamethasone Suppression Test | Urinary Free Cortisol (24 hour) |
| Adrenal function: Phaeochromocytoma | Plasma Metanephrines, Chromogranin A | |
| Allergic disorders | IgE, Specific IgE (RAST) | |
| Alopecia | Iron Studies, ANA, TSH | As indicated 1: ENA, ADNA As indicated 2: Skin Scrapings Fungal Culture, Hair Pluck or Skin Biopsy |
| Amenorrhoea | FSH, LH, Oestradiol, Prolactin, Beta HCG, TSH, AMH | As indicated 1: DHEAS, Testosterone, SHBG, Free Testosterone As indicated 2: Blood Chromosomes |
| Anaemia: Haemolytic | Direct Coombs' Test, FBC, Reticulocytes, LDH, Bilirubin, Haptoglobin |
Please consult haematologist (07) 3377 8670 |
| Anaemia: Macrocytic/pernicious | FBC, Reticulocytes, LFT, B12, Serum Folate | As indicated 1: TSH (TFT if indicated) As indicated 2: B12 (Intrinsic Factor Ab, GPC Ab if indicated) |
| Anaemia: Microcytic | FBC, Reticulocytes, E/LFT, Iron Studies | As indicated 1: Thalassaemia Screen (FBC, Hb EPP, Iron Studies) As indicated 2: If iron status is unclear - Soluble Transferrin Receptor |
| Anaemia: Normocytic | FBC, Reticulocytes, E/LFT, Iron Studies, TSH, B12 | As indicated 1: Direct Coombs' Test, Serum EPP, ANA (ADNA, ENA if indicated) As indicated 2: If iron status is unclear - Soluble Transferrin Receptor |
| Antenatal screen (before 20 weeks) | FBC, Group and Antibody Screen, HBsAg, HIV, Rubella (immune status), Syphilis, Hep C, Urine MCS, Glucose, Iron Studies | As indicated 1: Vitamin D (if indicated) As indicated 2: If at risk - CMV, Toxoplasma |
| Antenatal screen (for 26 - 28 Weeks) | FBC, GTT | Rh negative - Antibody Screen (must be prior to anti-D if Rh negative, record dates of recent anti-D) |
| Antenatal screen (for 30 - 36 Weeks) | FBC, Group B Streptococcus Screening, Urate | |
| Antenatal screen: Abnormal pregnancy | Urate, Beta HCG (requires 2 samples more than 2 days apart) | |
| Antenatal screen: Amniotic fluid | Amniotic Fluid AFP, Amniotic Fluid Chromosomes | |
| Antenatal screen: Down syndrome risk screen first trimester | First Trimester Down Syndrome Screen (10-13weeks 6days, also requires ultrasound), PAPP-A, Free Beta HCG | |
| Antenatal screen: Down syndrome risk screen second trimester | Second Trimester Down Syndrome Screen (15-20weeks 0days, includes NTD risk), AFP, Oestradiol, HCG, Free Beta HCG | |
| Antenatal screen: Non-invasive prenatal test | Harmony Non-invasive Prenatal Test (referred on specialised request form only) | |
| Anticoagulant control: IV heparin | APTT | |
| Anticoagulant control: LMW heparin (Fragmin, Clexane) | Monitoring is usually not required, except in certain conditions (e.g. renal impairment, pregnancy, overweight, underweight). | As indicated: Four-hour post-dose specimen required for Anti-Factor Xa Assay |
| Anticoagulant control: Warfarin | INR (doctor control only) | |
| Arthritis: Infectious | Parvovirus, RRV, BFV | As indicated 1: Faeces MCS OCP, Faeces PCR, Urine Chlamydia PCR, Urine Gonorrhoeae PCR, Campylobacter, Yersinia, Streptococcus Group A Serology As indicated 2: Travel dependent - Zika Serology, Sindbis, Dengue, Chikungunya As indicated 3: Rubella IgG and IgM (acute infection) |
| Arthritis: Non-infectious (mono) | FBC, CRP, Urate, HLA B27 | |
| Arthritis: Non-infectious (poly) | FBC, CRP, Rheumatoid Factor, CCP, ANA | ADNA, ENA |
| Bleeding disorders |
Coaguation Screen with PFA* *PFA testing available at Bowen Hills (Brisbane), Townsville, Toowoomba and Gold Coast laboratories. For all other regions, please contact your local laboratory. |
As indicated 1: Clinical history required - Von Willebrand Screen (VIIIc, VWF Ag, RCOF, CBA, Factor IX, Factor XI, Factor XIII) As indicated 2: Obscure - Factor II, Factor V, Factor VII, Factor X |
| Calcium disorders: Hypocalcaemia | E/LFT, Ionised Calcium, PTH, Magnesium | TSH (TFT if indicated), Vitamin D, ACE, Serum EPP, Immunofixation, Free Light Chains |
| Calcium disorders: Hypercalcaemia | E/LFT, Ionised Calcium, PTH | As indicated 1: TSH (TFT if indicated), Vitamin D, ACE, Serum EPP, Immunofixation, Free Light Chains As indicated 2: PTH Related Peptides |
| Cardiac markers | NT ProBNP, Troponin I | |
| Chest pain | FBC, CK, Troponin I | |
| Coeliac disease | TTG Ab, Gliadin Ab | ANCA, ASCA, Faeces Calprotectin |
| Coeliac disease: Genotype | HLA Typing for Coeliac Disease (DQ2, DQ8) | |
| Cough: Persistent <4 weeks | Mycoplasma PCR, Bordetella pertussis PCR, RV PCR | Hospital inpatient with community acquired infection: Legionella pneumophila Urinary Ag, Pneumococcal Urinary Ag, Blood Culture x 3 |
| Cough: Persistent 2-4 weeks | Mycoplasma PCR, Bordetella pertussis PCR, RV PCR, Mycoplasma Ab, Bordetella pertussis Ab, Influenza Ab | As indicated 1: Aspergillus Ab, Bird Fancier's Ab, Farmer's Lung Ab, Meliodosis Ab, Q Fever PCR/Ab As indicated 2: Cryptococcus Ag, Aspergillus Ag, QuantiFERON-TB Hospital inpatient with community-acquired infection: Legionella pneumophila Urinary Ag, Penumococcal Urinary Ag, Blood Culture x 3 |
| Cough: Persistent >4 weeks | Bordetella pertussis Ab, Mycoplasma Ab, Influenza Ab, Legionella Ab | As indicated 1: Aspergillus Ab, Bird Fancier's Ab, Farmer's Lung Ab, Meliodosis Ab, Q Fever PCR/Ab As indicated 2: Cryptococcus Ag, Aspergillus Ag, QuantiFERON-Tb Hospital inpatients with community-acquired infection: Legionella penumophila Urinary Ag, Pneumococcal Urinary Ag, Blood Culture x 3 |
| Crohn's disease | Faeces Calprotectin, Iron Studies, FBC, LFT | ANCA, ASCA, CRP |
| Cross-matching | Blood Group, Cross Match, Antibody Screen | |
| Dementia | B12, E/LFT, HIV, Syphilis, Serum Folate, TSH | As indicated 1: Apolipoprotein E Genotyping, ANA (ADNA, ENA if indicated) As indicated 2: CSF CJD (Creutzfeldt-Jakob Disease) |
| Depression | B12, E/LFT, FBC, Serum Folate, TSH | |
| Diabetes: Annual screen | Urine Albumin (first morning), E/LFT, Fasting Lipids, Cholesterol, Triglycerides, HDL, LDL, HbA1C (monitoring) | |
| Diabetes: 3 monthly screen | E/LFT, Fasting Lipids, Cholesterol, Triglycerides, HDL, LDL, HbA1C (monitoring) | |
| Diarrhoea: Infectious (bacterial) | Faeces MCS OCP x 2, Faeces PCR | As indicated 1: Faeces Clostridium difficile Toxin PCR As indicated 2: Travel/refugee/eosinophilia - Amoeba Ab, Strongyloides Ab, Tropheryma whippelii PCR (biopsy) |
| Diarrhoea: Infectious (viral) | Faeces Viral PCR | |
| Diarrhoea: Non-infectious | Coeliac Screen (TTG Ab, Gliadin Ab), TFT | Vasoactive Intestinal Peptide, Gastrin, Platelet Serotonin, Faeces Calprotectin, Chromogranin A |
| Dysmenorrhoea | FBC, Iron Studies, TSH | Consult genetic pathologist (07) 3377 8534, Blood Chromosomes or Array CGH, MLPA for Microdeletion Syndromes and Sub-telomeric Deletions, FISH |
| Dyspepsia and peptic ulcer disease: Diagnosis | Lipase, Gastrin, Serum H. pylori Ab | Urea Breath Test or Faecal H. pylori Ag Endoscopy: Urease, Tissue MCS, Tissue Histology |
| Dyspepsia and peptic ulcer disease: Treatment | Urea Breath Test or Faecal H. pylori Ag | |
| Dyspepsia and peptic ulcer disease: Treatment failure | Endoscopy: Tissue H. pylori Culture and Susceptibility | |
| Dyspnoea | Arterial Blood Gases, NT ProBNP, Troponin I, D-Dimer | |
| Dysuria | Urine MCS, Urine Chlamydia PCR | Genital Swab MCS, Urine Trichomonas vaginalis PCR, Mycoplasma genitalium PCR |
| Easy bruising |
FBC, Coagulation Screen with PFA* *PFA testing available at Bowen Hills (Brisbane), Townsville, Toowoomba and Gold Coast laboratories. For all other regions, please contact your local laboratory. |
Blood Group, Von Willebrand Screen |
| Eosinophilia | FBC, Allergy Tests (RAST, IgE) | As indicated: Refer to FBC interpretive comment Myeloproliferative: Filariasis Ab, Schistosoma Ab, Strongyloides Ab, Toxocara, Urine Schistosomes x 2, Faeces OCP x 2 (including Schistosomes) |
| Essential elements | Magnesium, Zinc, Copper, Manganese, Nickel, Selenium, Chromium, Iron Studies | |
| Eye: Choroiditis/retinitis/uveitis | Bartonella, CMV, Syphilis, Toxocara, Toxoplasma, Rheumatoid Factor, ACE, Cardiolipin Ab, Beta 2 Glycoprotein Ab, ANCA, HLA B27, ANA (ADNA, ENA if indicated), QuantiFERON-TB, Histoplasma | |
| Eye: Conjunctivitis | Eye Swab MCS | As indicated: Adenovirus PCR, Chlamydia/Gonorrhoeae PCR, HSV PCR, VZV PCR Neonate: Consult Microbiologist (07) 3377 8534, Gonococcal PCR |
| Eye: Keratitis | Adenovirus PCR, Chlamydia/Gonorrhoeae PCR, Corneal Swab MCS including Fungi and AFB, Enterovirus PCR, HSV PCR, VZV PCR, Acanthamoeba Culture, Acanthamoeba PCR | |
| Fatigue | FBC, E/LFT, CRP, TSH, Iron Studies | As indicated 1: CMV, EBV As indicated 2: CK, AChR Ab, ANA (ADNA, ENA if indicated), Cortisol (9am), ACTH As indicated 3: Consult chemical pathologist (07) 3377 8670, Synacthen Stimulation |
| Genital discharge: ? Cervicitis | Cervical Swab MCS, Chlamydia PCR, Gonorrhoeae PCR, CST | |
| Genital discharge: ? Vaginitis | High Vaginal Swab MCS, Trichomonas PCR | |
| Genital ulcer | HSV PCR, VZV PCR, Syphilis PCR, Syphilis | Genital ulcer with or without lymphadenopathy: Consult microbiologist (07) 3377 8534, Chlamydia Ab (LGV), HIV Ag/Ab, Genital Swab MCS including Culture and/or Haemophilus ducreyi PCR As indicated: ? Donovanosis - Consult microbiologist (07) 3377 8534, Giemsa smear of ulcer edge, Klebsiella granulomatis PCR |
| Glandular fever | FBC, LFT, EBV | CMV, Toxoplasma, HIV |
| Gonadal functions: Female | FSH, LH, Oestradiol, Prolactin, Beta HCG | As indicated 1: Free Testosterone, Progesterone, SHBG, Total Testosterone, Inhibin B, AMH As indicated 2: Blood Chromosomes |
| Gonadal functions: Male | FSH, LH, Prolactin, SHBG, Total Testosterone | As indicated 1: Free Testosterone, Progesterone, Inhibin B As indicated 2: Blood Chromosomes |
| Gout | Urate | As indicated 1: Urine Urate As indicated 2: Fluid Microscopy |
| Gynaecomastia | E/LFT, FSH, LH, Oestradiol, SHBG, Testosterone, Prolactin, Beta HCG, TSH | Blood Chromosomes, Urine Drug Screen (Medical) |
| Haematuria | FBC, EUC, Urine MCS | Urine Cytology x 3, Urine Red Cell Morphology, Adenovirus PCR, Polyoma Virus (BK & JC) |
| Haemochromatosis | FBC, Iron Studies, LFT, HFE | |
| Haemoglobinopathy | FBC, Hb EPP, Iron Studies | Sickle Cell Test |
| Haemophilia (A or B) | Coagulation Screen without PFA, Factor IX, Factor VIIIc Assay | |
| Heart failure | FBC, E/LFT, B12, Iron Studies | NT ProBNP |
| Heavy metals: Exposure | Urine Arsenic, Cadmium, Lead, Mercury | |
| Heavy metals: Pre- and post-chelation | Specify heavy metal (pre and post chelation) | |
| Hepatitis: Acute (ALT < 500, atypical lymphocytes >1.0 x 109/L) | CMV, EBV, HIV | Brucella, Dengue, Leptospira, Q Fever PCR/Ab, Rubella, Toxoplasma |
| Hepatitis: Acute (ALT < 500) | E/LFT, HBsAg, Prothrombin Time (PT): Not on anticoagulants, HCV | |
| Hepatitis: Acute (ALT > 500) | HBsAg, HCV, Hep A IgM, Prothrombin Time (PT) | Copper, Paracetamol, HEV |
| Hepatitis B Virus: Treatment monitoring | HBV Viral Load, AFP | HBV Resistance Testing, HBV Genotyping, HDV |
| Hepatitis C Virus: Monitoring | ALT, HCV PCR: Qualitative, HCV Genotyping, HCV Viral Load: Quantitative | |
| Hepatitis: Chronic | E/LFT, HCV, HBsAg | ANA, A1AT, ACE, Serum Copper |
| Hepatitis: Immune status | HBsAb, Hep A IgG | |
| Hepatomegaly | FBC, E/LFT, Iron Studies, CMV, EBV, HBsAg, HCV, Hep A IgM | SMA, AMA, LKM Ab, A1AT, Glucose, HDL, Lipid Studies, ANA (ADNA, ENA if indicated), AFP |
| Hirsutism | Testosterone, SHBG, 17OH Progesterone, Dexamethasone Suppression Test | As indicated 1: DHEAS, FSH, LH, Free Testosterone As indicated 2: Urinary Free Cortisol (24 hour) |
| HIV: New diagnosis | CMV, Toxoplasma, Hep A IgG, HBsAg, HBsAb, HCV, Syphilis, Chlamydia/Gonorrhoeae PCR, HIV Viral Load, Lymphocyte Surface Markers Blood, HIV Genotype, QuantiFERON-TB, Cryptococcus Ag | |
| HIV: Monitoring | HIV Viral Load, Lymphocyte Surface Markers Blood | |
| HPV: Confirmation of treatment | HPV PCR | |
| Hyperlipidaemia | E/LFT, Fasting Lipids, Cholesterol, Triglycerides, HDL, LDL, TSH, Urine Protein/Creatinine Ratio (random) | Apolipoprotein E Genotyping |
| Hypertension | E/LFT, Urine Protein/Creatinine Ratio (random), Urine MCS | Aldosterone, Renin, Plasma Metanephrines, Urinary Free Cortisol (24 hour) x 2 or Dexamethasone Suppression Test |
| Immunodeficiency | FBC, Glucose, IgG, IgA | As indicated 1: Lymphocyte Surface Markers Blood, HIV, IgG Subclasses As indicated 2: Neutrophil Function Tests, Lymphocyte Function |
| Immunosuppressed: Other | Adenovirus PCR, Polyoma Virus (BK & JC), Toxoplasma PCR, EBV Viral Load (PCR), Sputum AFB x 3 | |
| Immunosuppressed: Pneumonia | RV PCR, Aspergillus Ag, Cryptococcus Ag, CMV PCR and Viral Load, Pneumocystis PCR | |
| Impotence | HbA1C, FSH, LH, SHBG, Testosterone, TSH | |
| Inborn errors of metabolism | Please consult chemical pathologist (07) 3377 8670 | |
| Infertility: Female | E/LFT, FSH, LH, Oestradiol, Progesterone, TSH, 17OH Progesterone | Sperm Ab, Blood Chromosomes, AMH |
| Infertility: Male | FSH, LH, SHBG, Testosterone, Prolactin, Semen Analysis: Fertility | Consult genetic pathologist (07) 3377 8534, Blood Chromosomes, Cystic Fibrosis Gene DNA Testing, Y Chromosome Microdeletion, DAZ Gene, Sperm Ab |
| Inflammatory bowel disease | FBC, LFT, Iron Studies, Faeces MCS OCP x 1, Faeces PCR, Faeces Calprotectin | As indicated 1: ANCA, TTG Ab, Gliadin Ab, ASCA As indicated 2: E. coli PCR, C. difficile Toxin PCR, Amoeba Ab |
| Inflammatory process: Non-specific | FBC, CRP, Serum EPP | |
| Intrauterine/neonatal infections | Enterovirus PCR, HSV, Parvovirus, Rubella, Toxoplasma, VZV, CMV (CMV PCR if indicated), Chlamydia/Gonorrhoeae PCR | |
| Iron deficient | FBC, Iron Studies, Faeces Occult Blood x 3, Soluble Transferrin Receptor | |
| Ischaemic heart disease | FBC, Fasting Lipids, Cholesterol, Triglycerides, HDL, LDL, HbA1C | |
| Leukaemia |
FBC, E/LFT, Coagulation Screen with PFA*, Lymphocyte Surface Markers Blood (?Malignancy) *PFA testing available at Bowen Hills (Brisbane), Townsville, Toowoomba and Gold Coast laboratories. For all other regions, please contact your local laboratory. |
Please consult haematologist (07) 3377 8670, D-Dimer |
| LIF pain: Female | FBC, E/LFT, Urine MCS, Beta HCG (females of child bearing age only) | |
| LIF pain: Male | FBC, E/LFT, Urine MCS | |
| LIF pain: Gastro symptoms | Faeces MCS x 1, Faeces OCP x 2, Faeces PCR, Faeces Occult Blood x 3 | |
| Liver disease | A1AT, Iron Studies, Copper, Caeruloplasmin, ANA (ADNA, ENA if indicated), AMA, SMA, LKM Ab, TTG Ab, Gliadin Ab, HBsAg, HCV, Hep A IgM, CMV, EBV, Urine Copper | ELF Score |
| Lower respiratory tract infection <2 weeks | Mycoplasma PCR, Bordetella pertussis PCR, RV PCR | Hospital inpatient with community-acquired infection: Legionella pneumophila Urinary Ag, Pneumococcal Urinary Ag, Blood Culture x 3 |
| Lower respiratory tract infection 2-4 weeks | Mycoplasma PCR, Bordetella pertussis PCR, RV PCR, Mycoplasma Ab, Bordetella pertussis Ab, Influenza Ab | As indicated 1: RSV PCR, Adenovirus PCR, Parainfluenza PCR, Aspergillus Ab, Bird Fancier's Ab, Farmer's Lung Ab, Melioidosis Ab, Q Fever PCR/Ab As indicated 2: Cryptococcus Ag, Aspergillus Ag, QuantiFERON-TB Hospital inpatient with community-acquired infection: Legionella pneumophila Urinary Ag, Pneumococcal Urinary Ag, Blood Culture x 3 |
| Lower respiratory tract infection >4 weeks | Bordetella pertussis Ab, Mycoplasma Ab, Influenza Ab | As indicated 1: RSV PCR, Adenovirus PCR, Parainfluenza PCR, Aspergillus Ab, Bird Fancier's Ab, Farmer's Lung Ab, Melioidosis Ab, Q Fever PCR/Ab As indicated 2: Cryptococcus Ag, Aspergillus Ag, QuantiFERON-TB Hospital inpatient with community-acquired infection: Legionella pneumophila Urinary Ag, Pneumococcal Urinary Ag, Blood Culture x 3 |
| LUQ pain | FBC, E/LFT, Troponin I, Lipase | |
| Lymphadenopathy | FBC, CMV, EBV, Toxoplasma | ACE, HIV Ag/Ab, Streptococcus Group A Serology, Bartonella, HHV6 Ab, Syphilis, AFB Culture, QuantiFERON-TB, Lymphocyte Surface Markers Blood, ANA (ADNA, ENA if indicated), Serum EPP, FNA Cytology and Surface Markers, Bartonella PCR |
| Lymphocytosis | FBC, E/LFT, Lymphocyte Surface Markers Blood (? malignancy) | CMV, EBV, Bordetella pertussis PCR |
| Lymphoma | FBC, LDH, Lymphocyte Surface Markers Blood, Serum EPP, Immunofixation | |
| Malabsorption, failure to thrive | FBC, E/LFT, CRP, Faeces MCS OCP x 1, Faeces PCR, Faeces Amoeba, Urine MCS | Carotene, Iron Studies, Lipase, Zinc, B12, Serum Folate, Vitamin A, Vitamin D, Copper, Caeruloplasmin, Faecal Fat (3 day), Faeces A1AT, Faeces Elastase, Faeces Calprotectin, TTG Ab, Gliadin Ab, Cystic Fibrosis Gene DNA Testing, TSH (TFT if indicated) |
| Menopause | FSH, LH, Oestradiol | AMH, Ovarian Ab, Fragile X Gene DNA Testing, ANA (ADNA, ENA if indicated) |
| Miscarriage, recurrent | Glucose, Cardiolipin Ab, B2GP, TSH, LAC | Urine Chlamydia PCR, Blood Chromosomes |
| Muscle weakness | FBC, CK, E/LFT, CRP, TSH | Vitamin D, AChR Ab, Myositis LIA, ANA (ADNA, ENA if indicated), ANCA |
| Myeloma | FBC, E/LFT, Serum EPP, Free Light Chains, Immunoglobulins | Cryoglobulins, Immunofixation, Myeloma FISH Panel |
| Myositis | FBC, CRP, Myositis LIA | Consult microbiologist (07) 3377 8534, ANA (ADNA, ENA if indicated), Dengue, Leptospira, Toxoplasma, Adenovirus PCR, Respiratory Virus PCR, AChR Ab, ANCA, Enterovirus PCR, Trichinella, Muscle Biopsy |
| Neurological infection | CSF Protein, Glucose and MCS; CSF Cryptococcus Ag | As indicated 1: Blood Culture x 3 As indicated 2: CSF Enterovirus PCR, CSF HSV PCR, CSF Meningococcus PCR, CSF VZV PCR, CSF Syphilis PCR As indicated 3: Creutzfeldt-Jakob Disease As indicated 4: Measles Ab, Japanese B Encephalitis Ab, Kunjin Virus Ab, Cysticercosis Ab, Angiostrongylus Ab (only if eosinophilia), Bat Lyssavirus, CMV, Hendra Virus, HHV6 Ab, Mumps, Mycobacteria, Mycoplasma, Polyoma Virus (BK & JC), Toxoplasma, Flavivirus PCR, Murray Valley Encephalitis PCR |
| Obesity | Glucose, Fasting Lipids (Cholesterol, Triglycerides), HDL, LDL, TSH | As indicated 1: Urinary Free Cortisol (24 hour) As indicated 2: Dexamethasone Suppression Test |
| Parotitis: Infectious | ENT Swab MCS, Ross River PCR, Mumps PCR | |
| Parotitis: Non-infectious | ACE, ANA, Rheumatoid Factor | |
| Pericarditis/myocarditis | ANA (ADNA, ENA if indicated), Cardiolipin Ab, B2GP Ab, Streptococcus Group A Serology, Influenza Ab, Q Fever PCR/Ab, Toxoplasma, Enterovirus PCR, Blood Culture x 3, QuantiFERON-TB, CMV, EBV, Brucella, Mycoplasma, LAC | |
| Peripheral neuropathy | E/LFT, B12, Serum EPP, Free Light Chains, Immunofixation, ANA, ANCA, TSH | Cadmium, Lead, Urine Arsenic, Urine Mercury, Faeces Porphyrins, Urine Porphyrins, Neronal Ab, MAG Ab, Cryoglobulins, Campylobacter, Syphilis, GBM Ab |
| Pharyngitis | FBC, EBV, Throat Swab MCS | |
| Pituitary function | E/LFT, Cortisol (AM), Oestradiol, Prolactin, SHBG, Testosterone, Insulin-Like Growth Factor, FBC, TFT (must have Free T4) | ACTH, FSH, LH |
| Pituitary function: Anterior pituatary function test | Synacthen Stimulation | Insulin Tolerance Test |
| Pituitary function: ? Acromegaly | Insulin-Like Growth Factor | GTT with Growth Hormone |
| Pituitary function: ? Cushing's disease | Dexamethasone Suppression Test, Extended Dexamethasone Suppression Test | |
| Pituitary function: ? Diabetes insipidus | Consult chemical pathologist (07) 3377 8670, Water Deprivation Test | |
| Pituitary function: ? Hypopituitarism ? Pituitary tumour | FBC, E/LFT, TSH, ACTH, Cortisol (AM), FSH, LH, Oestradiol, Prolactin, SHBG, Testosterone, Insulin-Like Growth Factor | |
| Pituitary function: ? Isolated GH deficiency | Growth Hormone (Clonidine Stimulation), Growth Hormone (Exercise Stress Test), Growth Hormone (Arginine/Insulin Stimulation) | |
| Polycystic ovary syndrome | E/LFT (fasting), HbA1C, Prolactin, SHBG, Testosterone, Insulin-Like Growth Factor, Insulin, DHEAS | As indicated 1: Cholesterol, HDL, LDL, 17OH Progesterone, AMH, LH, FSH, Oestradiol, Urinary Free Cortisol (24 hour) As indicated 2: 17OH Progesterone: Synacthen Stimulation |
| Polycythaemia | FBC, E/LFT, JAK2, Erythropoietin | |
| Polyuria | EUC, Glucose, Osmolality (plasma or serum), Urine MCS, Urine Osmolality (random) | Consult chemical pathologist (07) 3377 8670, Water Deprivation Test |
| Pregnancy | Beta HCG | |
| Prostatism | Free PSA, PSA, Urine MCS | Stamey's Test - Urine MCS (pre- and post- prostatic massage) and Prostatic Fluid MCS (post-prostatic massage) |
| Protein abnormalities | FBC, E/LFT, Serum EPP, Immunofixation, Free Light Chains | |
| Pyrexia of Unknown Origin | FBC, CRP, LFT, Urine MCS, Blood Culture x 3 | As indicated 1: ACE, Brucella, CMV, EBV, HIV Ag/Ab, Leptospira, Mycoplasma, Q Fever PCR/Ab, Rickettsia, Syphilis, Toxoplasma, Dengue, Bartonella As indicated 2: Malarial Parasites x 3, Faeces MCS, Faeces PCR, ANCA, ANA, Rheumatoid Factor |
| Rash: Non-vesicular | BFV, RRV, Parvovirus | As indicated 1: CMV, EBV, HIV As indicated 2: Streptococcus Group A Serology, Dengue As indicated 3: Measles, Rubella As indicated 4: Skin Scrapings Fungal Culture, Throat Swab MCS, Measles PCR (throat, urine) As indicated 5: Travel dependent - Chikungunya, Zika Virus |
| Rash: Vesicular | Skin Swab MCS, Enterovirus PCR, HSV PCR, VZV PCR | Sindbis PCR, Blood Culture, Leptospira, Rickettsia |
| Renal disease | FBC, E/LFT, Urine MCS, Urine Albumin (first morning) | Urine Red Cell Morphology, ANCA, GBM Ab, Streptococcus Group A Serology, Complement C3 C4, Serum EPP, Free Light Chains, Immunofixation |
| Renal failure | E/LFT, Urine Albumin (first morning) | As indicated 1: Serum EPP, Free Light Chains, Immunofixation, ANCA, GBM Ab, ANA (ADNA, ENA if indicated) As indicated 2: Complement C3 C4 |
| Renal function | E/LFT, Urine Albumin, Urine Creatinine Clearance (24 hour), Urine Electrolytes, Urine Protein/Creatinine Ratio, Urine Alpha 1 Microglobulin | |
| RIF pain: Female | FBC, E/LFT, Urine MCS, Beta HCG (females of child bearing age only) | |
| RIF pain: Male | FBC, E/LFT, Urine MCS | |
| RIF pain: Gastro symptoms | Faeces MCS x 1, Faeces OCP x 2, Faeces PCR, Faeces Occult Blood x 3 | |
| RUQ pain | FBC, E/LFT, Lipase | |
| Sarcoidosis | FBC, CRP, ACE | Urine Calcium, Ionised/Free Calcium |
| Short stature | E/LFT, Insulin-Like Growth Factor, TSH | As indicated 1: Consult chemical pathologist (07) 3377 8670, Growth Hormone Stimulation Test As indicated 2: Female - Blood Chromosomes |
| Sjogren's syndrome | ANA, Rheumatoid Factor, Complement C3 C4 | |
| Splenomegaly | FBC, LFT, ANA, EBV, CMV | As indicated 1: ACE, HIV, Lymphocyte Surface Markers Blood, Hb EPP, Rheumatoid Factor, CCP, Haemolytic Screen As indicated 2: Malarial Parasites As indicated 3: Toxoplasma, Brucella, Q Fever PCR/Ab, Blood Culture x 3 |
| STI screen | HBsAb, HBsAg, HIV, HCV, Syphilis, Urine Chlamydia/Gonorrhoeae PCR, Genital Swab MCS, Trichomonas vaginalis PCR, HSV | |
| STI screen MSM: 3 monthly | Anal Chlamydia/Gonorrhoeae PCR, Pharyngeal Chlamydia/Gonorrhoeae PCR, Urine Chalmydia/Gonorrhoeae PCR, HIV, Syphilis, HCV | |
| Systemic lupus erythematosis | ANA, Complement C3 C4 | |
| Thalassaemia screen | FBC, Hb EPP, Iron Studies | |
| Therapeutic drug monitoring: Analgesics | Paracetamol, Salicylate | |
| Therapeutic drug monitoring: Antibiotics | Amikacin, Gentamicin, Tobramycin, Vancomycin, Hydroxychloroquine, Beta lactam antibiotics: Ampicillin, Benzyl Penicillin, Ceftriaxone, Cephalothin, Cephazolin, Dicloxacillin, Ertapenem, Flucloxacillin, Meropenem, Piperacillin, Free Ampicillin, Free Benzyl Penicillin, Free Ceftriaxone, Free Cephalothin, Free Chepazolin, Free Dicloxacillin, Free Ertapenem, Free Flucloxacillin, Free Meropenem, Free Piperacillin | Beta lactam antibiotics: Ampicillin, Benzyl Penicillin, Ceftriaxone, Cephalothin, Cephazolin, Dicloxacillin, Ertapenem, Flucloxacillin, Meropenem, Piperacillin, Free Ampicillin, Free Benzyl Penicillin, Free Ceftriaxone, Free Cephalothin, Free Chepazolin, Free Dicloxacillin, Free Ertapenem, Free Flucloxacillin, Free Meropenem, Free Piperacillin |
| Therapeutic drug monitoring: Anticonvulsants | Carbamazepine, Clonazepam, Gabapentin, Lamotrigine, Phenytoin, Primidone, Sulthiame, Topamax, Topiramate, Valproate, Vigabatrin | |
| Therapeutic drug monitoring: Cardiac drugs | Amiodarone, Digoxin, Flecainide, Perhexiline, Procainamide | |
| Therapeutic drug monitoring: Fungal drugs | Fluconazole, Itraconazole, Voriconazole, 5-Fluorocytosine, Posaconazole | |
| Therapeutic drug monitoring: Psychoactive drugs | Clozapine, Fluoxetine, Risperdal, Lithium, Tricyclic Antidepressants | |
| Thrombocytosis | FBC, Iron Studies, CRP | JAK2 |
| Thrombophilia screen/prothrombotic studies for venous thrombosis | FBC, Factor V Leiden, Antithrombin III, Protein C, Protein S, APC Resistance, LAC | B2GP Ab, Cardiolipin Ab, Prothrombin Gene Mutation (20210) |
| Thyroid disease: Graves' disease monitoring | Thyroid Ab | |
| Thyroid disease: Medullary thyroid cancer monitoring | Calcitonin | |
| Thyroid disease: Thyroid carcinoma monitoring | Thyroglobulin | |
| Thyroid disease: ? Medullary cancer of thyroid | Enterovirus PCR, Mumps | |
| Thyroid disease: ? Thyroiditis | TSH Receptor Ab | |
| Toxicology | Urine Drug Screen: Includes therapeutic drugs and drugs of abuse - please note if patient is on a drug-dependence program Serum levels (in particular paracetamol, alcohol and drugs): Refer to Therapeutic drug monitoring Blood and urine for chlorinated hydrocarbons and herbicides (detailed exposure required): Cholinesterase (serum), Cholinesterase (red cell), Urine Arsenic, Blood Cadmium, Blood Lead, Blood Mercury |
|
| Tumour markers: Breast | CA 15.3, CEA | |
| Tumour markers: Colon | CA 19.9, CEA | |
| Tumour markers: Liver | AFP | |
| Tumour markers: Lung | CEA, Mesomark | |
| Tumour markers: Myeloma | Beta 2 Microglobulin, Free Light Chains | |
| Tumour markers: Ovary | CA 125, HE4 | |
| Tumour markers: Stomach, pancreas, bile ducts | CA 19.9, CEA | |
| Tumour markers: Testis | AFP, Beta HCG, LDH Isoenzymes | |
| Ulcerative colitis | Faeces Calprotectin, Iron Studies, FBC, LFT | ANCA, ASCA, CRP |
| Upper abdominal pain | FBC, E/LFT, Lipase, H. pylori Serology | Faeces H. pylori Ag or Urea Breath Test |
| UTI | Urine MCS | |
| Vasculitis | Complement C3 C4, CRP, E/LFT, HBsAg, HIV, HCV, Urine MCS, ANCA | As indicated 1: Cryoglobulins, Serum EPP, Free Light Chains, Immunofixation, ACE As indicated 2: ANA (ADNA, ENA if indicated), CCP, Rheumatoid Factor |
| Von Willebrand disease |
Blood Group, FBC, Coagulation Screen with PFA*, Von Willebrand Screen *PFA testing available at Bowen Hills (Brisbane), Townsville, Toowoomba and Gold Coast laboratories. For all other regions, please contact your local laboratory. |
|
| Weight Loss | FBC, E/LFT (fasting), CRP, TSH | Faeces PCR, Faeces MCS OCP x 2, Synacthen Stimulation |
| Zoonoses: Diagnosis |
Brucella, Leptospira, Q Fever PCR/Ab, Blood Culture x 3 Note: Diagnostic testing protocols differ from prevaccination testing and clinical notes must be clearly stated. |
|
| Q Fever prevaccination | Q Fever IgG Ab, Q Fever Skin Test |