POCT Flashcards
(185 cards)
1
Q
Other names of POCT
A
- Near-patient testing
- Bedside testing
- Satellite testing
- Peripheral testing
- Decentralized testing
- Ancillary testing
- Alternate site testing
- Patient-focused testing
- Remote testing
- Mobile testing
- Physicians office testing
- Extra-laboratory
- Rapid diagnostics
2
Q
Advantages of POCT
A
- Cheaper and quicker traditional diagnostic methods
- Can be used in resource limited settings.
- Reduced preanalytical and post analytic testing errors.
- Small sample volume for a large test menu
- Easy to use and reduces the need for training.
- Rapid data availability
- Reduced patient’s length of stay and waiting times in the hospital.
- Convenience for clinicians
- Ability to test many types of samples.
3
Q
Disadvantages of POCT
A
- Concerns performance about inaccuracy, imprecision, and performance.
- Bedside laboratory tests performed by poorly trained non-laboratorians.
- Quality of testing is operator-dependent.
- Difficulty in integrating information system (HIS) test or results with hospitallaboratory information system (LIS); lack of connectivity.
- Narrower measuring range for some analytes.
3
Q
Definition of POCT
A
Specimen analysis performed outside of the clinical laboratory setting.
Testing done at any place, where immediate results can be delivered, allowing assessment and management to be given swiftly
- bedside
- physician’s office
- or any alternative site
4
Q
REASSURED criteria by WHO
A
R = real-time connectivity
E = ease of specimen collection
A = affordable
S = sensitive
S = specific
U = user friendly/simple to perform
R = robust and rapid
E = equipment-free
D = delivered to those who need the help
5
Q
3 primary stages in the POCT process
Specimen Requirements and Procedures
A
- pre-analytical
- analytical
- post-analytical
6
Q
occurs before running the POCT on asample; involves collection, transport, preparation,and loading
A
Pre-analytical
7
Q
actual testing sequence of a POCT is conducted
A
Analytical
By the time the machine is clicked to start the process of testing
8
Q
begins when testing is complete,and an obtained result is available
A
Post-analytical
Completed test and obtain results
Two ways of communicating results:
* Results are communicated directly to HIS
* Results are communicated through written or verbal communication (not reliable)
9
Q
Pre-analytical errors
IMPORTANT PRE- AND POST-ANALYTICAL ERRORS IN POCT DIAGNOSTIC TESTING
mistake(s) of MT’s usually commit
A
o Lack of preparation of the patient
o Lack of information about the patient’s condition
o Inappropriate sampling technique
o Wrong or missing additives to blood
o Mishandling and/or mislabeling of patient specimen
o Specimen contamination
o Degradation of specimen due to delays in specimen processing
Mishandling and/or mislabeling of patient specimen
10
Q
Post-analytical errors
IMPORTANT PRE- AND POST-ANALYTICAL ERRORS IN POCT DIAGNOSTIC TESTING
A
o Misreporting patient result
o Recording wrong patient test results
o Lost data
o Delayed reporting of critical results
11
Q
Analytical errors
IMPORTANT PRE- AND POST-ANALYTICAL ERRORS IN POCT DIAGNOSTIC TESTING
A
o Broken device
o Expired
o Wrong test kit
o Contaminated
o Invalid reaction
o Battery deadead
o Error indevi
12
Q
Factors in influencing errors and problems
IMPORTANT PRE- AND POST-ANALYTICAL ERRORS IN POCT DIAGNOSTIC TESTINTESTI
A
o The setting (practice, hospital, etc.) and
o The extent to which the instrument is within a network.
13
Q
Factors irrelevant for POCT
IMPORTANT PRE- AND POST-ANALYTICAL ERRORS IN POCT DIAGNOSTIC TESTING
mostly unnecessary, as whole blood is used.
A
- Transport
- storage
- centrifugation
Evaluation of the test material
14
Q
The greatest importance in the pre-analytical process
IMPORTANT PRE- AND POST-ANALYTICAL ERRORS IN POCT DIAGNOSTIC TESTING
A
correct collection of the sample
15
Q
What results in constant probing of samples
IMPORTANT PRE- AND POST-ANALYTICAL ERRORS IN POCT DIAGNOSTIC TESTING
A
Clotting of sample
16
Q
Where you will input the specimen
A
Test strips
17
Q
POCT is accomplished using
A
portable instruments
18
Q
Many point-of-care test systems are in the form of
A
easy-to-use membrane-based test enclosed by a plastic test cassette
it is to avoid contamination as contamination results to false reactions
19
Q
Parameter of Pregnancy testing
Sample
A
HCG (Human Craionic Gunatrotopin)
Urine & Sebum
20
Q
Parameter of Urine Dipstick Analysis
SSample
A
- Ascorbic acid
- glucose
- bilirubin
- ketone
- SG
- blood pH
- protein
- urobilinogen
- leukocyte
- nitrite
Urine
21
Q
Parameter of Microalbumin screening
Sample
A
Albumin
Urine
22
Q
Parameter of Fecal Occult Blood Test (FOBT)
Sample
A
Hemoglobin
Stool
23
Q
POCT DEVICES
A
- Single-use qualitative strip or cartridge and/or strip devices
- Dipsticks/Urine strips
- Test kits
24
A wide range of devices, including single pad urine test(dipsticks) and test kits
**Single-use qualitative strip or cartridge and/or strip devices**
25
generally dried, porousmatrices with impregnated carrier elements that interactwith the analyte(s) when exposed; chemical reactionusually results in a color change
**Dipsticks/Urine strips**
26
utilizes a layer of supporting materials, suchas porous paper of cellulose fiber filters or wovenmeshes; Example: home pregnancy test
**Test kits**
27
difficult peeing
**anuria**
28
Reaction time of **Ascorbic acid, Glucose, and Bilirubin** in a Dipstick/Urine Strips
30 seconds
29
Reaction time of **Ketones** in a Dipstick/Urine Strips
40 seconds
30
Reaction time of **specific graviin** a Dipstick/Urine Strips
45 seconds
31
Reaction time of **pH, Protein, Blood, Urobilinogen, Nitrite,and Albumin** in a Dipstick/Urine Strips
60 seconds
32
Reaction time of Leukocyte esterase in a Dipstick/Urine Strips
120 seconds
33
utilizes a combination of antibodies including amonoclonal hCG antibody to detect elevated levels of hCG
Test line
34
composed of goat polyclonal antibodies andcolloidal gold particles
Control line
35
Detects hepatitis B surface antigen in human serum or plasma
**HBsAg Test Kit**
36
They include a meter or monitoring device thereby enabling for the detection and quantification of analytes
**Single-use quantitative cartridge and strip test with monitoring devices**
37
What is the **goal** of POCT while treatment is ,ade available immediately after obtaining results.
| **Differences Between Testing Samples Inside The Laboratory and POCT**
**Save time**
38
What devices are being used by POCT
| **Differences Between Testing Samples Inside The Laboratory and POCT**
Portable
## Footnote
you can carry them anywhere and place it in pockets.
39
Why is POCT done
| **Differences Between Testing Samples Inside The Laboratory and POCT**
to make **treatment** **and** **management** **of** **patients** **readily** **available** after results; makes sure results are real-time.
40
Samples tested
## Footnote
Exceptions
1. Urine
2. blood
3. saliva
4. mucus (nasopharyngeal)
5. stool (sometimes)
## Footnote
Any **specimen** collected only by **Physicians** cannot be collected using POCT (e.g. CSF)
41
Parameter of **Infectious agents detection**
## Footnote
Sample
1. Group A Strep
2. Influenza A + B
3. HIC
4. Chlamydia trachomatis antigen
5. MRSA
6. Helicobacter pylori-specific IgG antibody
## Footnote
Swab & serum
42
what is detected after **10 days after conception**
**Human Chorionic Gonadotropin**
43
Sample, although faster, is prone to false increase/decrease: at home
**Urine**
44
Sample that is confirmatory: more accurate: detects hormones: in hospital
**Serum**
44
**Chemical examination** of urine, where analyses also should be in order
**Urine dipstick analyses**
45
big protein; if present in urine, it indicates that the kidney’s filtering ability is damaged (glomerulus
**Albumin**
46
what should be detected to ensure that the filtering capacity of the kidney is well
**Albumin**
47
Urine is bubbly if it has what
**Many protein**
48
contamination in the teeth and tongue; swab sample in tonsils
## Footnote
causes
**Group A Strep**
## Footnote
sore throat and strep throat
49
what does MRSA stand for
**Methicillin-resistant Staphylococcus aureus**
49
can withstand stomach acid; manifests in the formation of ulcers
**Helicobacter pylori-specific IgG antibody**
50
protein; presence of blood in feces may be due to abrasion in GIT like hemorrhoid; defecating first in the morning makit-an ang freshly voided blood
**Hemoglobi**
51
what will be released when RBCs are destroyed
**Hemoglobin**
52
what can result to the expiration of POCT
**False positives**
53
Positive or negative, reactive or nonreactive, invalid
Qualitative
54
Value, unit
**Qualitative**
55
A wide range of devices, including single pad urine test (dipsticks) and test kits
SINGLE-USE QUALITATIVE STRIP OR CARTRIDGE AND/ OR STRIP DEVICES
56
Generally dried, porous matrices with impregnated carrier elements that interact with the analyte(s) when exposed; chemical reaction usually results in a color changchange
## Footnote
Both qualitative and quantitative
Dipstick/urine strips
57
Utilizes a layer of supporting materials, such as porous paper of cellulose fiber filters or woven meshes; Example: home pregnancy testest
TestKits
58
How do we interpret POCT results?
There is a standardized reference to follow qualitatively
## Footnote
(e.g. color reference in urinalysis)
58
Use antibodies to detect **human chorionic gonadotropin (hCG)**, a hormone that can be detected in the urine
Pregnancy Test Kits
58
Ideal **Specimen** for Pregnancy TestKits
**First morning urine** (most concentrated)
59
**Principle** used by regnancy test kits
1. 1. 1. **Lateral flow technology** (capillary motion)
60
Most commonly used; Has the simplest principle
## Footnote
The test kits already have impregnated antibodies
* **HCG - Antigen**
* **Anti-HCG - Antibodies**
* *Red* lines indicate antibody-antigen reaction (positive
**Pregnancy test kits**
61
Once urine passes, it captures analyte (hCG)
Conjugate
62
Where excess of urine antigen goes
Wick
63
Detects **hepatitis B surface antigen** in human serum or plasma
**HBsAg est kit**
64
**Samples** for HBsAg test kit
**SerumPlasma**
65
Principle used by HGsAg test kit
**Sandwich Immunoassay** [Ab-An-Ab]
## Footnote
Called “sandwich” assay because the target antigen is “sandwiched” between two layers of antibodies: a **capture antibody** and a **detection antibody**
66
A lab test used to check **stool samples** for hidden (occult) blood
**Fecal Occult Blood Test**
67
what does **occult blood** does indicate
may indicate **colon cancer** or **polyps** in the colon or rectum
68
Can only detect the presence or absence of blood – it cannot determine what’s causing the bleeding
Fecal Occult Blood Test
69
Principle utilized in Fecal Occult Blood Test
**Sandwich imunnoassay**
70
They include a meter or monitoring device thereby enabling for the detection and quantification of analytes
Single-Use QuantitativeCartridge and Strip Test with Monitoring Devices
71
Has value or number – can quantify or measure the concentration
Single-Use QuantitativeCartridge and Strip Test with Monitoring Devices
## Footnote
Directly tells analyte you are measuring
72
**Hemolyzed** samples are usually due to
1. Alcohol
2. Skin fragments
3. Interstitial fluids
## Footnote
this is why we wipe the first punctured drop of blood
73
Done to evaluate **warfarin** and **heparin therapy** using coagulation POCT analyzer
**Coagulation Monitoring**
74
Common coagulation tests checked
1. Prothrombin time (PT)
2. International normalized ratio (INR)
3. Activated partial thromboplastin time (APTT or PTT)
4. Activated clotting time (ACT)
5. Platelet function
75
Found in the **Hematology section**
**Coagulation Monitoring**
75
Sample from **Coagulation Monitoring** is collected and placed in what tubes
## Footnote
Name and percentage present in tube
**Light Blue Top Tube**
## Footnote
3.2% Sodium Citrate coagulant
76
clotting of the blood
Coagulation
77
monitor abnormal clots inside body
Coagulation devices
78
The medication patients with abnormal clot formation drink to prevent clot formation by dissolving it (“lyse”), especially after surgeries
Blood Thinners
79
What will happen if there is clot inside the body?
**Stroke** - Clot travels towards the brain and blocks supply of oxygen.
If a clot goes to the lungs, you will have a **Pulmonary embolism**.
## Footnote
Other manifestations: **Aneurysm** and **Myocardial infarction**
79
Percentage of Sodium citrate ffor **Blacktube top**
| Color of the tube depends on the type of coagulant present
**3.8%**
80
Our body’s natural coagulant; reason why our blood is in liquid form inside the body
**Heparin**
81
81
82
what does blood do in the absence of Heparin
blood starts to clot
83
What color blood collection tube is Heparin found in
**Green blood collection tube**
84
If you want to have an operation, you have to take this. This is for doctors to determine how much your blood can stand by clotting
| **Coagulation POCT device**
**Cascade POC** - ACT (Activated Clotting Time), APTT, PT/ INR:
84
Coagulation POCT device
1. Cascade POC
2. GEM Premier 4000
3. iSTAT-ACT
4. Verify Now
85
Sample used is anticoagulated sample (Uses 3.2% Sodium Citrate, anticoagulant in light blue top tube)
| **Coagulation POCT device**
**GEM Premier 4000** - ACT, APTT, PT/NR
## Footnote
Not portable, needs to be placed on a table
86
Specific for activated clotting time
| **Coagulation POCT device**
**iSTAT-ACT** - ACT, PT/ INR
87
Only machine for platelet function
| **Coagulation POCT device**
**Verify Now**
88
Performed in **light blue top tube**
**Bleedingtime**
## Footnote
Group of tests performed in the **Hematology section** to determine how long it takes for bleeding to stop
89
A *non-instrumented test* ordered by the physician to evaluate **capillaries** for **platelet plug formation**
**Bleeding time**
## Footnote
No instrument/kit used except for a **timer**. Assess the functionality of platelets to stop bleeding (e.g. cut)
90
Used for pre-surgical screening and detection of problems involving **hemostasis**
**Bleeding time**
## Footnote
Hemostasis = Coagulation.
* Performed before surgeries; gives an idea of the time of bleeding of the patient
* Normal: 2-4 minutes
91
Performed before surgeries; gives an idea of the time of bleeding of the patient
**Bleeding time**
92
Normal time for bleeding time
2-4 minutes
93
Site of collection for the **Duke Method**
**Earlobe** (below the earlob) and **Finger**
## Footnote
* Make sure no hair touches the site of skin or area.
* If in the earlobe, don’t puncture at the site where the earring is
94
When do you start the timer using DukMethode
Start timer after puncture; this is where bleeding starts
95
When do you filter or blot the blood using filter paper using Duke method
Every 30 seconds
## Footnote
Make sure to blot in different areas in the filter paper
96
**Normal value** of bleeding time for Duke method
2 - 4 minutes
## Footnote
more than 4 minutes indicate prolonged bleeding time of patients
97
Indicators of prolonged bleeding time of patients (Duke method)
1.Patient has low platelet count
2. Consider the integrity of the capillary or cardiovascular system
98
Site of puncture for Ivy Method
Forearm (below the antecubital grease)
99
What distance of the lancet punctures for Ivy Method
## Footnote
How many punctures should there be
1.5 cm apart
## Footnote
3
99
Material needed for Ivy method
* BP apparatus
* timer
* lancet
* filter paper
99
How much BP pressure is needed to maintain for Ivy Method
40 mmHg
100
When do we blot for Ivy Method
every 30 seconds
## Footnote
Start blotting with the first puncture until it stops bleeding before proceeding to the next.
100
When do start the timer for Ivy Method
As we get the first puncture
101
Time is noncontinuous for Ivy Method
**False**
| Time is **continuous**
102
do we get the average bleeding time (for all punctures; divide by 3)?
Yes
103
Site of puncture for Copley-Lalitch Immersion Test
**Finger**
104
Materials needed for Copley-Lalitch Immersion Test
1. Beaker with NSS (Normal Saline Solution)
2. Timer
3. Lancet
105
Normal value of bleeding time for Copley-Lalitch
4-10
106
what do temperature do we need to prewarm the Normal Saline Solution
37 degrees in order to imitate the body temptemperature
| Stop once the blood stops flowing.
## Footnote
There should be a distance between the tip of the finger and the bottom of the beaker to avoid covering the puncture; you need to see the flow of blood.
107
Reference method for bleeding time.
Surgicutt MMethod
## Footnote
Makes use of a Surgicutt Device (enclosed in a plastic blister; open only if you use it).
108
What are the specific dimensions made for Surgicutt Device
5mm long x 1 mmdeep
108
Area of puncture for Surgicutt Method
Below antecubital crease
109
Normal value in bleeding time for Surgicutt Method
7-10 minutes
110
How much BP pressure is needed to maintain for Surgicutt Method
40
111
When do we stop the timer for Surgicutt Method
Once there’s no blotting na. Same method as the Ivy Method
112
Drawback for Surgicutt Method
For people who are keloid formers, if you undergo surgical method, the site of punctured will form a keloid scar
113
When do we start the timer for Surgicutt Method
after the second drop of blood produced by the puncture site
114
Can only be performed by a physician or respiratory therapist.
Blood Gas Analyzer
115
Determination of the partial pressure of oxygen and CO2
Blood Gas Analyzer
116
ABG analysis has a prospective influence on patient care than any other laboratory determinants
Blood Gas Analyzer
117
**Important factors** in the management of critically ill patients for **Blood Gas Analyzer**
* Tissue oxygenation
* Ventilation
* cid-base status
118
Parameters for Blood Gas Analyzer
* pH
* p02
* pC02
119
Sample for Blood Gas Analyzer
**Arterial Blood** placed on ice and **held at 0 °C** until analysis
120
Why should Arterial Blood be transorted on ice and held at 0 degreesCelsius
decrease cellular metabolism and oxygen consumption of cells (maintaining partial pressure of oxygen in the sample)
121
The sample of Blood Gas Analyzer should placed on what tube
Placed in a tube with **anticoagulant Heparin (Green stopper blood collection tube)**. *Heparinized blood sample.*
122
what does pH mean
**Power of Hydrogen**
## Footnote
Normal blood pH - **7.35-7.45**. Any deviation can result in **acidosis** or **alkalosis**
123
Refers to the concentration of hydrogen ions in a solution
**pH**
124
An indicator of how well air is exchanged between the blood and lungs; measure of the pressure exerted by dissolved CO2 in the blood plasma in proportion to the PO2 in the alveoli
**PC02**
125
Pressure exerted by dissolved O2 and the ability of the lungs to diffuse oxygen through the alveoli
**P02**
126
Mechanism of person hyperventilation
The presence of CO2 makes our blood acidic. For people hyperventilating which releases lots of CO2, pH increases and is now basic. Hypoventilation: pH lowers (acidic)
127
Sample considertion for Blood Gas Analyzer
When collecting arterial blood, a tourniquet shouldn’t be used because it is pulsating. Instead, 90 degrees angle of needle
128
More portable. Makes use of cartridges. You have to insert cartridge first before loading arterial blood sample. Then select the test you want to choose for the device.
EPOC Critical Care Blood Gas Analyzer
129
Uses arterial blood and cartridge. Sample is to be injected to the device. A more comprehensive testing.
OPTI Critical Care Analyzer
130
Does not only measure parameters, but as well as electrolytes (Na+, Ca+, K+).
One sample needed. Choose any parameter
OPTI Critical Care Analyzer
131
Do POCT devices still need calibration?
Yes
132
A cartridge-based analyzer with all the analytical requirements for the performance of a test contained within an individual cartridge
. i-STAT
133
**“Comprehensive”**; Can perform various tests depending on the cartridge being used. Just feed the sample and choose the type of test. You may choose different tests at the same time.
* The device will be the one to determine what comes first.
* If lab has HIS, all patient results are uploaded in EMR
i-STAT
134
transmitting nerve impulses
Sodium
## Footnote
Where sodium is, water follows. For runners, eat salt for long water retention
Hyponatremia - ↓ Sodium
Hypernatremia - ↑Sodium
135
helps in nerve conduction and muscle function; regulates acid-base balance and osmotic pressure
Potassium
## Footnote
Hypokalemia - ↓ Potassium
Hyperkalemia - ↑ Potassium
136
maintains the integrity of the cells by helping in balancing osmotic pressure and acid-base and water balance of the body
Chloride
## Footnote
Hypochloremia - ↓ Chlorine
Hyperchloremia - ↑ Chlorine
137
helps transport CO2 from the lungs resulting in the reduction of hydrogen ions and increase in blood pH
Bicarbonate ion
## Footnote
↓ CO2 = ↓Bicarbonate ion
138
helps in muscular function cardiac function, blood clotting, nerve transmission function of the body
Ionized calcium
## Footnote
Hypocalcemia - ↓ Calcium
Hypercalcemia - ↑ Calcium
139
For monitoring patient’s **oxygen saturation**
Pulse Oximetry
## Footnote
Measures deoxygenated and oxygenated hemoglobin flowing in the veins and arteries
139
Most common used sites for application are the fingernail and toenail beds
Pulse Oximetry
## Footnote
Placed in index finger, but anywhere is fine (can also be done in toes)
140
The principle of Pulse Oximetry is based on
red and infrared light absorption characteristics of oxygenated and deoxygenated hemoglobin
141
absorbs light at 660 nm
Deoxygenated blood
142
absorbs at 940 nmLow oxygen saturation indicates the need for oxygen
Oxygenated blood
143
# ```
The meter measures the yellowness of the subcutaneous tissue by measuring the difference in the optical density of two wavelengths through the skin
Transcutaneous Measurement of Bilirubin
144
Principle used for Transcutaneous Measurement of Bilirubin
Optical Spectroscopy
## Footnote
* More unconjugated bilirubin present, the more light is transmitted in the analyte
* Bilirubin oxidizes from the presence of light
145
Three factors affecting the Transcutaneous Measurement of Bilirubin
* Gestational (digestive age)
* body weight
* skin color
146
Where are measurements taken for Transcutaneous Measurement of Bilirubin
either on the baby’s forehead or sternum
## Footnote
Intended for babies; measures unconjugated bilirubin
Babies normally have yellowish shade; ma-reduce siya if a baby is exposed to light
Device is not effective for adults because normally, as we grow older, unconjugated bilirubin becomes conjugated
147
A pulse co-oximeter that uses multi-wavelength sensor for spot check and continuous measurement
Non-invasive Hemoglobin Monitors
148
The technology emits multiple wavelengths of light and then calculates the hemoglobin concentration based on the adsorption of light in the blood
Non-invasive Hemoglobin Monitors
149
Principle used for Non-invasive Hemoglobin Monitors
Optical Spectrometry
150
Related to the O2 carrying capability of RBC
Hemoglobin (Hgb)
151
A device that extracts glucose through intact skin via reverse iontophoresis where it is detected by an amperometric biosensor
152
Can provide glucose readings every 20 mins for 12 hours
GlucoWatch Biographer
153
Gauge the effectiveness of the thrombolytic therapy being administered to patients who have suffered from heart attacks
Cardiac Troponin T and Troponin I
153
markers usually increase if a person suffers from a heart attack or Myocardial Infarction (assessed in Clinical Chemistry)
Cardiac Markers
154
parameters for cardiac arrest
* Trop. I
* Trop. B
* Trop. C
155
“lytic”; dissolves unexpected clots formed in the body
Thrombolytic therapy
156
Measures the alanine transferase (ALT) of patients under lipid-lowering medication
Lipid Testing
157
enzyme; for people with high cholesterol (liver enzyme)
alanine transferase (ALT)
## Footnote
High cholesterol = high ALT (direct relationship)
Low ALT = meds effect; if not = change meds
158
Differentiates chronic obstructive pulmonary disease (**COPD**) and congestive heart failure (**CHF**)
B-Type Natriuretic
159
Detects and evaluates infection, tissue injury, and other inflammation disorders.
C-Reactive Protein (CRP)
160
what section does C-Reactive Protein (CRP) belong to
**Immunoserology**
161
**Nonspecific test**: Just a screening test. It states if you have inflammation but does not specify what specific organ is injured or inflamed(Level 1 - Screening Test. Level 2 - Diagnostic/ Confirmatory Test)
C-Reactive Protein (CRP)
162
Analyte (specific test: Confirmatory test)
C-Reactive Protein (CRP)
163
non-specific (screening test)
Tissue injury, inflammation
164
Diagnostic tool for diabetes therapy monitoring
| Other known as
Glycosylated hemoglobin
| HBA1C
165
monitors concentration of glucose for a span of three months
It is different from FPS as this can be measured for 3 months, but this is more accurate
HBA1C
166
Measures the volume of the red blood cells
**Hemaglobin**
## Footnote
Usually high in high altitudes to compensate for the decreased levels O2 consumption
167
Checks the hemoglobin level to manage patients suffering from anemia
Hemoglobin
168
Evaluates the severity of lactic acid disorder and stress response of the patient
Lactate
169
Checks contact with allergens and determines if the body has developed antibodies
Skin test
170
Detects the presence of **group A streptococci**
| Sample tested
## Footnote
Condition
Strep testing
| Swab (tonsils)
## Footnote
Strep throat (bacterial pharyngitis)
