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Dr. Siegel #2 Blood and Urine Test Panel

Dr. Siegel #2 Blood and Urine Test Panel includes Complete Blood Count (CBC) with Differential and Platelets Blood Test, Comprehensive Metabolic Panel (CMP-14) with eGFR Blood Test, Lipid Panel Blood Test, Thyroid #1 Baseline Blood Test Panel, Urinalysis Complete with Microscopic Examination, Hemoglobin (Hb) A1c Blood Test, C-Reactive Protein (CRP) Blood Test, Quantitative, Sedimentation Rate Blood Test, Westergren, Uric Acid Blood Test, Vitamin D 25-Hydroxy Blood Test, Testosterone Total Blood Test, Male Only, and Prostate-specific antigen (PSA).


Test Code: 5010

CPT Code: See Individual Tests

Also Known As:

Methodology:

See Individual Tests.

Preparation:

Patient should be on a stable diet, ideally for two to three weeks prior to collection of blood, and should fast for 12 to 14 hours before collection of the specimen. Stop biotin consumption at least 72 hours prior to the collection.

Test Results:

4-5 days. May take longer based on weather, holiday or lab delays.

Description

Complete Blood Count (CBC) With Differential and Platelets

 

A CBC is a comprehensive screening test that can help diagnose a wide range of illnesses and diseases, including anemia, leukemia, bleeding disorders, and infections. The CBC provides the following information:

 

  • White Blood Cells (WBC) - The body's primary defense against disease and helps to fight infection.
  • Red Blood Cells (RBC) - Responsible for carrying oxygen to and carbon dioxide away from all cells. Iron deficiency will lower the RBC count.
  • Hemoglobin - A chemical compound inside red cells that transports oxygen through the bloodstream to all cells of the body. Hemoglobin gives the red color to blood.
  • Hematocrit - Measures the amount of space red blood cells take up in the blood. It is reported as a percentage.
  • Lymphocytes - This result, along with basophils, eosinophils, monocytes, and neutrophils, deal with white blood cell function.
  • Monocytes - This result, along with basophils, eosinophils, lymphocytes, and neutrophils, deal with white blood cell function. 
  • Neutrophils - This result, along with basophils, eosinophils, lymphocytes, and monocytes, deal with white blood cell function.
  • Mean Corpuscular Hemoglobin (MCH) - The average hemoglobin concentration within a red blood cell.
  • Mean Corpuscular Hemoglobin Concentration (MCHC) - The average hemoglobin concentration percentage within a red blood cell.
  • Mean Corpuscular Volume (MCV) - The average size of red blood cells.
  • Platelets - Blood cell particles associated with the forming of blood clots.
  • Red Cell Distribution Width (RDW) - Measures the amount of red blood cell variation in volume and size.

 

Comprehensive Metabolic Panel (CMP-14) with eGRF 

 

  • Glucose - Blood sugar level, the most direct test to screen for diabetes and also used in diabetes management.

 

  • Kidney Profile
    • Bun or Urea Nitrogen (BUN) - An indicator of kidney function.  
    • Creatinine, Serum - An indicator of kidney function.  
    • Bun/Creatinine Ratio - Calculated by dividing BUN by creatinine. This ratio can suggest conditions including dehydration or intestinal bleeding.
    • Estimated Glomerular Filtration Rate (eGFR) - Measures kidney function to determine kidney disease stage and detect early kidney damage.

 

  • Liver Panel
    • Protein, Total - Assists in determining liver and kidney function and nutritional health.
    • Albumin Serum - One of the major proteins essential for the healthy function of the liver and kidney. 
    • Globulin, Total - One of the major proteins that assist the blood to clot properly and also comprises infection-fighting antibodies. 
    • Albumin/Globulin Ratio - Calculated by dividing albumin by globulin. When paired with other test results, this ratio can assist in the diagnosis of a variety of liver problems. 
    • Bilirubin, Total - Aids in the detection of hepatitis, sickle cell, anemia, cirrhosis, alcohol, and drug abuse. High concentrations may result in jaundice.
    • Alkaline Phosphatase - A protein vital in detecting bone disorders and liver disease.
    • Aspartate Aminotransferase (AST or SGOT) - An enzyme helpful in evaluating liver function. An elevated level is an indication of hepatitis. 
    • Alanine Aminotransferase (ALT or SGPT) - An enzyme helpful in identifying liver damage. Abnormalities may represent liver disease.

 

  • Fluids & Electrolytes
    • Sodium - One of the major salts in body fluid. Sodium is important in water balance and the electrical activity of nerves and muscles.
    • Potassium - Helps to control the nerves and muscles.
    • Chloride - Similar to sodium, it helps to maintain the body's electrolyte balance.
    • Carbon Dioxide, Total - Used to help detect, evaluate, and monitor electrolyte imbalances.
    • Calcium - A mineral essential for the development and maintenance of healthy bones and teeth. It is also important for the normal function of muscles, nerves, and blood clotting.

 

Lipid Panel

 

Lipids are a group of fats and fat-like substances that are important constituents of cells and sources of energy. They contribute to a variety of functions in the body such as the production of hormones which are essential for growth and reproduction, the development of cells in tissues and organs throughout the body, and the absorption of nutrients from the food you eat. Excess lipids can cause the buildup of plaques in the blood vessels. Plaques cause the narrowing or blockage of blood vessels which can lead to heart disease or events such as heart attack or stroke. Monitoring and maintaining healthy lipid levels is vital in staying healthy.

 

Thyroid #1 Baseline Blood Test Panel

 

Thyroid function is critical to your metabolism and affects your energy level, heart rate, weight control, and more. The thyroid-stimulating hormone is produced in the pituitary gland and stimulates the production of thyroid hormones. The TSH helps identify an underactive or overactive thyroid state.

 

Includes:

  • Thyroid Stimulating Hormone (TSH) is produced by the pituitary gland and aids the thyroid gland in producing T4 and T3.
  • T4 is a hormone produced by the thyroid gland which helps maintain the body's metabolism as well as other systems and functions.
  • T3 Uptake helps evaluate the amount of proteins in the blood which carry thyroid hormones throughout the body.
  • Free Thyroxine (T4) Index is a comparison of the amount of T4 which is unbound or free to that which is bound to proteins in the blood.

 

Urinalysis Complete with Microscopic Examination

 

Urinalysis with microscopic exam detects abnormalities of urine and urinary tract infection (UTI); diagnoses and manages renal diseases, urinary tract infection, urinary tract neoplasms, systemic diseases, and inflammatory or neoplastic diseases adjacent to the urinary tract.

 

UA Microscopic includes:

  • Specific Gravity: The concentration of the urine sample. This is used to help evaluate the level of certain substances dissolved in the urine. Low specific gravity can be the result of ingesting large amounts of water prior to urination.
  • pH: This is affected by the acid/base balance in the body. A pH which is too high or low can result in the formation of crystals in the urine which can lead to the development of kidney stones. PH can be adjusted through diet or medication.
  • Color: Darker urine coloration can result from some medications, eating certain foods, blood in the urine, dehydration or fever.
  • Appearance: Cloudy or turbid urine may be caused by bacteria, red blood cells, white blood cells, mucus or contaminants such as lotions or powders.
  • WBC Esterase: White blood cells in the urine is typically a sign of a bacterial urinary tract infection. It may also be caused by inflammation in the kidneys. 
  • Protein: The amount of albumin in the urine. Protein in the urine can be a sign of kidney disease or conditions affecting the urinary tract.
  • Glucose: Glucose in the urine can be a sign of abnormally high blood sugar levels such as those caused by diabetes.
  • Ketones: Ketones are produced when the body metabolizes fat. They can indicate a number of conditions including starvation, a high protein/low carbohydrate diet, diabetes or frequent vomiting.
  • Occult Blood: Blood in the urine can indicate a number of conditions affecting the kidneys or urinary tract. It can also be caused by contamination from sources such as menstruation, hemorrhoids or vaginal bleeding.
  • Bilirubin: Bilirubin is a waste product produced by the liver. Bilirubin in urine can be an early indicator of liver disease.
  • Urobilinogen: Urobilinogen is formed from Bilirubin. Its presence in urine is typically a sign of liver disease.
  • Nitrite: Nitrite in the urine is usually caused by bacteria which can indicate a urinary tract infection.

 

microscopic examination will automatically be performed as well. The microscopic examination may include some or all of the following if results warrant:

 

  • White Blood Cells (WBC): WBC's in the urine usually indicates inflammation or infection of the urinary tract.
  • Red Blood Cells (RBC): RBC's in urine can be caused by inflammation or injury to the kidneys or urinary tract.
  • Epithelial Cells: High concentrations of epithelial cells is typically caused by infection or inflammation of the urinary tract.
  • Crystals: Crystals may be formed by various particles which are dissolved in urine. Crystal formation may be due to an abnormal pH balance or a higher than normal concentration of particles. Crystals formed in the kidneys may lead to the development of kidney stones. 
  • Casts: Casts are cylindrical particles formed from proteins secreted by the kidneys. In people with kidney disease, substances such as RBC's or WBC's may become trapped in the proteins. Examining the casts can help differentiate between types of kidney disorders.
  • Mucus: Mucus in the urine may be the result of a urinary tract infection or conditions affecting the digestive system, certain STD's or kidney disease.
  • Bacteria: Bacteria in the urine is usually indicative of a urinary tract infection. Care should be taken to avoid contaminating the specimen with bacteria from the genital area or hand.

 

Hemoglobin (HB) A1c

 

This test is used to evaluate glucose levels in the blood over the 2 to 3 months previous to the test. This test is crucial in managing one's diabetes. Hemoglobin is stored in red blood cells. When glucose levels are high, the sugar starts to combine with the hemoglobin. It takes the body 8 to 12 weeks to bring hemoglobin A1c levels back to normal. Therefore, if hemoglobin A1c levels are high, that means that there has been a high level of glucose in the blood over the last 2 to 3 months.

 

C-Reactive Protein (CRP) Blood Test

 

In severe cases of inflammation, c-reactive protein increases. Therefore, CRP tests are ordered when a risk of acute inflammation (from an infection after surgery for example) is present, or suspected based on symptoms. This blood test can also be ordered to help evaluate conditions such as lupus and rheumatoid arthritis, and it is often repeated to determine whether treatment is effective (this is helpful for inflammation problems since CRP levels drop as inflammation subsides). CRP blood tests can additionally be used as an early detection system for possible infections in patients who have healing wounds, burns, surgical cuts or incisions, or who have just had an organ transplant. 

 

Sedimentation Rate Blood Test, Westergren

 

Erythrocyte sedimentation rate (ESR) westergren is an easy, inexpensive, nonspecific test that has been used for many years to help diagnose conditions associated with acute and chronic inflammation, including infections, cancers, and autoimmune diseases. ESR is said to be nonspecific because increases do not tell the health provider exactly where the inflammation is or what is causing it, and also because it can be affected by conditions other than inflammation. Because it is nonspecific, ESR is typically used in conjunction with other tests. ESR aids in diagnosing two specific inflammatory diseases, polymyalgia rheumatica, and temporal arteritism, a high ESR being one of the main test results used to support the diagnosis. The test is also used to monitor disease activity and response to therapy in both polymyalgia rheumatica and temporal arteritism.

 

A sed rate test is typically ordered when someone is suspected of having a condition which is causing inflammation or to monitor treatment for various conditions which cause inflammation. A sed rate test isn't a stand-alone diagnostic tool, but it can help your doctor diagnose or monitor the progress of an inflammatory disease. It is used to detect the presence of inflammation caused by one or more conditions such as infections, tumors or autoimmune diseases; to help diagnose and monitor specific conditions such as temporal arteritis, systemic vasculitis, polymyalgia rheumatica, or rheumatoid arthritis.

 

Uric Acid

 

Most of the uric acid is filtered out by the kidneys and passes out of the body in urine. A small amount passes out of the body in stool. But if too much uric acid is being produced or if the kidneys are not able to remove it from the blood normally, the level of uric acid in the blood increases.

 

High levels of uric acid in the blood can cause solid crystals to form within joints. This causes a painful condition called gout. If gout remains untreated, these uric acid crystals can build up in the joints and nearby tissues, forming hard lumpy deposits called tophi. High levels of uric acid may also cause kidney stones or kidney failure. Another cause of hyperuricemia is increased cell death, due to cancer or cancer treatments. This can lead to an accumulation of uric acid in the body.

 

It’s also possible to have too little uric acid in your blood, which is a symptom of liver or kidney disease. It’s also a symptom of Fanconi syndrome, a disorder of the kidney tubules that prevents the absorption of substances such as glucose and uric acid. These substances are then passed in the urine instead.

 

Vitamin D 25-Hydroxy 

 

Vitamin D is essential in the growth and formation of healthy bones and teeth. Without it, children can develop a bone-malformation condition known as rickets, and adults can develop osteomalacia, which is characterized by weakness, softness or fractures of the bones. Vitamin D also helps regulate levels of calcium, phosphorus and magnesium in the blood, and has been shown to influence the growth of other tissues in the body as well as the regulation of the immune system. Vitamin D deficiency has been implicated in the development of conditions such as cancer, heart disease‚ osteoporosis and multiple sclerosis.

 

The body gets vitamin D from two sources: dietary intake through foods and supplements (exogenous), and through production in the skin upon exposure to sunlight (endogenous). Although vitamin D is found naturally in only a few foods, in the United States, many products are supplemented with it, including milk, breakfast cereals and juices. Those at risk of vitamin D deficiency include individuals who are elderly; obese; have dark skin; are institutionalized, homebound or have limited sun exposure; have undergone gastric bypass surgery; and have conditions such as cystic fibrosis and Crohn's disease that interfere with fat absorption.

 

The Vitamin D 25-Hydroxy Blood Test is often ordered for individuals that have symptoms of vitamin D deficiency. It may also be ordered before an individual begins osteoporosis drug therapy. Low levels may indicate a dietary deficiency, malabsorption or lack of exposure to sunlight.

 

Testosterone Total, Male Only

 

Testosterone is the most abundant androgen. It is secreted by the testicular Leydig cells. In addition to its hormonal activity, testosterone is a prohormone that can be converted to dihydrotestosterone, a powerful androgen, and estradiol, an estrogen.

 

Testosterone circulates almost entirely bound to transport proteins: Normally less than 1-2% is free. The principal transport protein for testosterone is known as sex hormone binding globulin (SHBG) or testosterone-estradiol binding globulin (TeBG). Testosterone measurements are used to assess erectile dysfunction, infertility, gynecomastia, and osteoporosis and to assess hormone replacement therapy.

 

Prostate-Specific Antigen (PSA)

Prostate-specific antigen (PSA) is a substance produced by the prostate gland. Elevated PSA levels may indicate prostate cancer, a noncancerous condition such as prostatitis, or an enlarged prostate.

Most men have PSA levels under four (ng/mL) and this has been used as the cutoff for concern about risk of prostate cancer. Men with prostate cancer usually have PSA levels higher than four, although cancer is a possibility at any PSA level. Reports state that men who have a prostate gland that feels normal on examination and a PSA less than four have a 15% chance of having prostate cancer, and those with a PSA between four and 10 have a 25% chance of having prostate cancer and if the PSA is higher than 10, the risk increases to 67%.

It is important to note that not all cases of prostate cancer will show elevated total PSA levels and there are other conditions which may cause higher PSA levels besides cancer.

In general, serum PSA levels increase due to physical changes to prostate architecture caused by trauma, infection, inflammation, prostate manipulation, benign prostatic hypertrophy (BPH) or malignancy.

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