Test Information [click for details]

Lipid Panel

 A Lipid Panel is a blood test that measures lipids-fats and fatty substances used as a source of energy by your body. Lipids include cholesterol, triglycerides, high-density lipoprotein (HDL), and low-density lipoprotein (LDL). Lipid panel measures: 

  • Total cholesterol level
  • Triglyceride level
  • HDL cholesterol level. This is the "good" cholesterol
  • LDL cholesterol level. This is the "bad" cholesterol
  • Very-low-density lipoprotein (VLDL) cholesterol level
  • The ratio of total cholesterol to HDL
  • The ratio of LDL to HDL

 

Lipids are found in your blood and are stored in tissues. They are an important part of cells, and they help keep your body working normally. Lipid disorders, such as high cholesterol, may lead to life threatening illnesses, such as coronary artery disease (CAD), heart attack, or stroke.

Complete Blood Count (CBC)

 

Complete Blood Count (CBC)

CBC is a baseline tests used as a broad screening test to check for such disorders as anemia, infection, and many other diseases. CBC is a panel of tests that examines different parts of the blood and includes the following:

White Blood Cell (WBC) count is a count of the actual number of white blood cells per volume of blood. Both increases and decreases can be significant

White Blood Cell Differential looks at the types of white blood cells present. There are five different types of white blood cells, each with its own function in protecting us from infection. The differential classifies a person's white blood cells into each type: neutrophils (also known as segs, PMNs, granulocytes, grans), lymphocytes, monocytes, eosinophils, and basophils

Red Blood Cell (RBC) count is a count of the actual number of red blood cells per volume of blood. Both increases and decreases can point to abnormal conditions

Hemoglobin measures the amount of oxygen-carrying protein in the blood

Hematocrit measures the percentage of red blood cells in a given volume of whole blood

Platelet Count is the number of platelets in a given volume of blood. Both increases and decreases can point to abnormal conditions of excess bleeding or clotting. Mean platelet volume (MPV) is a machine-calculated measurement of the average size of your platelets. New platelets are larger, and an increased MPV occurs when increased numbers of platelets are being produced. MPV gives your doctor information about platelet production in your bone marrow

Mean Corpuscular Volume (MCV) is a measurement of the average size of your RBCs. The MCV is elevated when your RBCs are larger than normal (macrocytic), for example in anemia caused by vitamin B12 deficiency. When the MCV is decreased, your RBCs are smaller than normal (microcytic) as is seen in iron deficiency anemia or thalassemias

Mean Corpuscular Hemoglobin (MCH) is a calculation of the average amount of oxygen-carrying hemoglobin inside a red blood cell. Macrocytic RBCs are large so tend to have a higher MCH, while microcytic red cells would have a lower value

Mean Corpuscular Hemoglobin Concentration (MCHC) is a calculation of the average concentration of hemoglobin inside a red cell. Decreased MCHC values (hypochromia) are seen in conditions where the hemoglobin is abnormally diluted inside the red cells, such as in iron deficiency anemia and in thalassemia. Increased MCHC values (hyperchromia) are seen in conditions where the hemoglobin is abnormally concentrated inside the red cells, such as in burn patients and hereditary spherocytosis, a relatively rare congenital disorder 

 

High Sensitivity CRP

The high sensitivity C-reactive protein (hsCRP) test is a blood assay used to estimate an individual's risk for heart disease and stroke. The test also measures the presence of inflammation or infection.

Knowing one's highly sensitive C-reactive protein levels can help a person manage and lower his or her risk for heart disease. Factors that lower highly sensitive CRP levels include weight loss, regular exercise, a healthy diet, and smoking cessation. Medicines may also be needed.

 

Hemmocult & Urine Analysis

Hemoccult fecal occult blood test (FOBT) is used for detecting hidden blood in stool specimens as an early indication of colorectal cancer.

Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds that pass through the urine.

Urinalysis can reveal diseases that have gone unnoticed because they do not produce striking signs or symptoms. Examples include diabetes mellitus, various forms of glomerulonephritis, and chronic urinary tract infections. 

 

 

History & Physical Exam

Why It Is Done?

A history and physical exam helps your doctor make a diagnosis. They are a routine and important part of any visit to a doctor.

The History portion contains the chronology of what is wrong with the patient and pertinent history about the patient's medical, behavioral, and psycho-social aspects.

The Physical Exam (PE) includes both objective and subjective assessments of the patient's physical being. Documentation of the Physical Exam is typically grouped by body system, such as Head, Eyes, Ears, Nose and Throat (often abbreviated "HEENT"), Respiratory, Genito-Urinary, etc. Objective medical measurements such as blood pressure, pulse rate, temperature, etc. are made and documented. There are also many subjective measurements made during the PE, such as visual observation and palpation, often with "best judgment" assessments as to size, location, and involvement of any abnormal finding.

Results

Your history may reveal risk factors that suggest you have a disease or an increased risk for developing a disease.

Pulmonary Function Test

Pulmonary Function Tests are a group of tests that evaluate how well your lungs work by measuring how well the lungs take in and release air and how well your lungs put oxygen into and remove carbon dioxide from your blood. The tests can diagnose lung diseases, measure the severity of lung problems, and check to see how well treatment for a lung disease is working

Resting Electrocardiogram (EKG or ECG)

An electrocardiogram (ECG or EKG) is a recording of the electrical activity of the heart over time produced by an electrocardiograph, usually in a noninvasive recording via skin electrodes. An EKG or ECG checks for problems with the electrical activity of your heart

An electrocardiogram (EKG or ECG) is done to:

  • Find the cause of unexplained chest pain, which could be caused by a hert attack, inflammation of the sac surrounding the heart or angina or pericarditis 
  • Find the cause of symptoms of heart disease, such as shortness of breath, dizziness, fainting, or rapid, irregular heartbeats (palpitations)
  • Find out if the walls of the heart chambers are too thick (hypertrophied)
  • Check how well medicines are working and whether they are causing side effects that affect the heart
  • Check how well mechanical devices that are implanted in the heart, such as pacemakers, are working to control a normal heartbeat
  • Check the health of the heart when other diseases or conditions are present, such as high blood pressure, high cholesterol, cigarette smoking, diabetes, or a family history of early heart disease

Treadmill Stress Test w/VO2 Max

An exercise electrocardiogram (EKG or ECG) is a test that checks for changes in your heart while you exercise. Sometimes EKG abnormalities can be seen only during exercise or while symptoms are present. This test is sometimes called a "stress test" or a "treadmill test."

This test will help the doctor evaluate your cardiac condition related to: 

  • Irregular heart rhythms 
  • If there is a decreased supply of blood and oxygen to the heart with exercise. 
  • How hard the heart can work before symptoms develop 
  • How quickly the heart recovers after exercise 
  • The patient's overall level of cardiovascular conditioning 
  • What your exercise target heart rate (THR) should be

Vision and Hearing Examination

An eye examination is a series of tests performed to assess vision and ability to focus on and discern objects. Eye examinations may detect potentially treatable blinding eye diseases, ocular manifestations of systemic disease, or signs of tumors or other anomalies of the brain.

A hearing test provides an evaluation of the sensitivity of a person's sense of hearing.

 

BOD POD

BOD POD is a body-composition test that identifies how much of your body is made up of fat, and how much is lean mass (muscles, bones, tendons, etc.). Excess body fat has been found to increase the risk of diabetes, heart disease and some cancers. Lean mass takes up less space, so you'll look better, and muscle burns calories more efficiently.

Chest X-ray

A chest X-ray is a picture of the chest that shows your heart, lungs, airway, blood vessels, and lymph nodes. A chest X-ray also shows the bones of your spine and chest, including your breastbone, ribs, collarbone, and the upper part of your spine. A chest X-ray is the most common imaging test or X-ray used to find problems inside the chest. A chest X-ray can help find some problems with the organs and structures inside the chest. 

Physicians use the examination to help diagnose or monitor treatment for conditions such as:

  • Pneumonia 
  • Heart failure and other heart problems 
  • Emphysema 
  • Lung cancer 

Hepatitis Panel

A hepatitis panel is a blood test used to find markers of hepatitis infection. Hepatitis causes inflammation of the liver.

The tests look for proteins (antibodies) that the body makes to fight the infection, antigens or the genetic material (DNA or RNA) of the viruses that cause hepatitis.

 

Thyroid Stimulating Hormone (TSH)

A thyroid-stimulating hormone (TSH) blood test is used by physicians to diagnose thyroid gland problems or diseases. TSH causes the thyroid gland to make two hormones: triiodothyronine (T3) and thyroxine (T4). T3 and T4 help control your body's metabolism. 

A test for thyroid-stimulating hormone (TSH) is done to find out whether the thyroid gland is working properly:

An underactive thyroid gland (hypothyroidism) can cause symptoms such as weight gain, tiredness, dry skin, constipation, a feeling of being too cold or frequent menstrual periods for women

An overactive thyroid (hyperthyroidism) can cause symptoms such as weight loss, rapid heart rate, nervousness, diarrhea, a feeling of being too hot, or irregular menstrual periods for women

 

Comprehensive Metabolic Panel

A comprehensive metabolic panel is a blood test that measures your sugar (glucose) level, electrolyte and fluid balance, kidney function, and liver function.

The test is used by physicians to check on medical condition, such as high blood pressure, or to help diagnose a medical condition, such as diabetes.

This panel measures the blood levels of sodium, potassium, calcium, chloride, carbon dioxide, glucose, blood urea nitrogen, creatinine, protein serum protein, bilirubin, and liver enzymes.

Sodium - A blood test to check sodium levels is done to:

  • Check the water and electrolyte balance of the body. 
  • Find the cause of symptoms from low or high levels of sodium. 
  • Check the progress of diseases of the kidneys or adrenal glands

Potassium - A blood test to check potassium is done to:

  • Check people with high blood pressure who may have a problem with their kidneys or adrenal glands. 

A potassium level that is too high or too low can be serious. Abnormal potassium levels may cause symptoms such as muscle cramps or weakness, nausea, diarrhea, frequent urination, dehydration, low blood pressure, confusion, irritability, paralysis, and changes in heart rhythm.

Calcium - A test for calcium in the blood checks the calcium level in the body that is not stored in the bones.

A blood calcium test may be done to:

  • To check for problems with the parathyroid glands or kidneys, certain types of cancers and bone problems, inflammation of the pancreas (pancreatitis), and kidney stones. 
  • To see if your symptoms may be caused by a very low calcium level in the blood. Such symptoms may include muscle cramps and twitching, tingling in the fingers and around the mouth, muscle spasms, confusion, or depression. 
  • To see if your symptoms may be caused by a very high calcium level in the blood. Such symptoms may include weakness, lack of energy, not wanting to eat, nausea and vomiting, constipation, urinating a lot, belly pain, or bone pain. 

Chloride - A chloride test measures the level of chloride in your blood or urine

A test for chloride may be done to:

  • Check your chloride level if you are having symptoms, such as muscle twitching or spasms, breathing problems, weakness, or confusion
  • Find out whether you have kidney or adrenal gland problems 
  • Help determine the cause for high blood pH

Carbon Dioxide -  A carbon dioxide test measures the total amount of the three forms of carbon dioxide (bicarbonate, carbonic acid, and dissolved carbon dioxide) in your blood. 

A carbon dioxide test is often done as part of a group of laboratory blood tests to help find the cause of many kinds of symptoms such as breathing problems. 

Blood Glucose -  A blood glucose test measures the amount of a type of sugar, called glucose, in your blood. Fasting blood sugar (FBS) measures blood glucose after you have not eaten for at least 8 hours. It often is the first test done to check for diabetes.

Blood glucose tests are done to:

  • Check for diabetes
  • Monitor treatment of diabetes 

Blood Urea Nitrogen - A blood urea nitrogen (BUN) test measures the amount of nitrogen in your blood that comes from the waste product urea

A BUN test is done to see how well your kidneys are working. If your kidneys are not able to remove urea from the blood normally, your BUN level rises. Heart failure, dehydration, or a diet too high in protein can also make your BUN level higher. Liver disease or damage can lower your BUN level.

Creatinine: Creatinine test measure the level of the waste product creatinine in your blood and urine. This test shows how well your kidneys are working.

A blood creatinine test is done to:

  • See if your kidneys are working normally 
  • See how well the kidneys work in people who take medicines that can cause kidney damage (e.g. Malaria Medicine) 
  • See if severe dehydration is present. Dehydration generally causes BUN levels to rise more than creatinine levels. This causes a high BUN-to-creatinine ratio. Kidney disease or blockage of the flow of urine from your kidney causes both BUN and creatinine levels to rise

Total Serum Protein

A total serum protein test measures the total amount of protein in the blood. It also measures the amounts of two major groups of proteins in the blood: albumin and globulin

Albumin test is done to:

Check how well the liver and kidney are working 

  • Find out if your diet contains enough protein
  • Help determine the cause of swelling of the ankles (edema) or abdomen (ascites) or of fluid collection in the lungs that may cause shortness of breath (pulmonary edema)

Globulin is tested to:

  • Determine your chances of developing an infection
  • See if you have a rare blood disease, such as multiple myeloma

 

Bilirubin test is used to:

  • Check liver function and watch for signs of liver disease, such as hepatitis or cirrhosis, or the effects of medicines that can damage the liver. 
  • Find out if something is blocking the bile ducts. This may occur if gallstones, tumors of the pancreas, or other conditions are present. 

Diagnose conditions that cause increased destruction of red blood cells, such as hemolytic anemia.

Liver Enzyme Tests:  Alkaline phosphates (ALP), Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) tests measures the amount of the enzyme in the blood.

A test for alkaline phosphates (ALP) is done to:

  • Check for liver disease or damage to the liver. Symptoms of liver disease can include jaundice, stomach pain, nausea, and vomiting
  • An ALP test may also be used to check the liver when medicines that can damage the liver are taken 
  • Check bone problems (sometimes found on X-rays), such as rickets, osteomalacia, bone tumors, Paget's disease, or too much of the hormone that controls bone growth (parathyroid hormone) 

An aspartate aminotransferase (AST) test is done to:

  • Check for liver damage
  • Help identify liver disease, especially hepatitis and cirrhosis 
  • Check on the success of treatment for liver disease 
  • Find out whether jaundice was caused by a blood disorder or liver disease 
  • Keep track of the effects of cholesterol-lowering medicines and other medicines that can damage the liver

The alanine aminotransferase (ALT) test is done to:

  • Identify liver disease, especially cirrhosis and hepatitis caused by alcohol, drugs, or viruses
  • Help check for liver damage
  • Find out whether jaundice was caused by a blood disorder or liver disease
  • Keep track of the effects of cholesterol-lowering medicines and other medicines that can damage the liver

Prostate-Specific Antigen (PSA)

Prostate specific antigen (PSA) is a protein produced by the cells of the prostate gland. PSA is present in small quantities in the serum of normal men, and is often elevated in the presence of prostate cancer and in other prostate disorders. The PSA is an effective test currently available for the early detection of prostate cancer particularly for men older than age 50 or for those at high risk for prostate cancer, such as men with a family history of prostate cancer, or for African-American men who have a higher chance of developing cancer than other men. Rising levels of PSA over time are associated with both localized and metastatic prostate cancer (CaP).

Prostate cancer often grows very slowly, without causing major problems. Detecting prostate cancer early and treating it may prevent some health problems and reduce the risk of dying from the cancer.

 

Pap Smear

A Pap Smear (Pap Test) is a way to look at a sample of cells taken from a woman's cervix. The test is used to look for changes in the cells of the cervix that show cervical cancer or conditions that may develop into cancer.

All women who are or who have been sexually active, or who have reached age 21, should have an annual Pap smear. It is your best tool to detect pre-cancerous conditions and hidden, small tumors that may lead to cervical cancer. If detected early, cervical cancer can be cured

 

 

H-pylori

H- pylori infection occurs when a bacteria called Helicobacter pylori (H. pylori) thrives in your stomach or the first part of your small intestine. H-pylori is believed to be responsible for the majority of peptic ulcers and many cases of chronic gastritis (inflammation of the stomach). 

H- pylori does not cause ulcers in every infected person.  Most likely, infection depends on characteristics of the infected person, the type of H- pylori, and other factors.

 

Mammogram

Mammography is an imaging test that uses a low-dose x-ray system to examine breasts. The goal of mammography is the early detection of breast cancer, typically through detection of characteristic masses and/or microcalcifications

Small tumors can be seen on a mammogram before they can be felt by a woman or her health professional. Cancer is most easily treated and cured when it is discovered in an early stage. Mammograms do not prevent breast cancer or reduce a woman's risk of developing cancer. However, regular mammograms can reduce a woman's risk of dying from breast cancer by detecting a cancer when it is more easily treated.

 

Apolipoprotein B/A-I Ratio

Apolipoprotein B/A-I ratio test is used for assessing the levels of apolipoprotein (apo) B, a constituent of atherogenic lipoproteins; apo A-I, a component of antiatherogenic high-density lipoprotein (HDL) cholesterol.

Apo B/A-I ratio provides better prediction of future cardiovascular events than measuring serum low-density lipoprotein (LDL)-cholesterol levels.

 

Homocysteine

Homocysteine is an amino acid that is produced by the body, usually as a byproduct of consuming meat. Amino acids are naturally made products, which are the building blocks of all the proteins in the body.

Elevated levels of homocysteine in the blood may be associated with atherosclerosis (hardening and narrowing of the arteries) as well as an increased risk of heart attacks, strokes, blood clot formation, and possibly Alzheimer's disease.

 

Microalbumin

A microalbumin urine test determines the presence of the albumin in urine. Detectable levels of the protein albumin in the urine signal the beginning of a condition called microalbuminuria, and are typical in disorders such as diabetic nephropathy. The importance of protein in the urine is now becoming recognized as a sensitive, accessible predictor of cardiovascular risk.

The test may show whether you are at risk for developing kidney disease. People with certain chronic diseases such as diabetes, hypertension, and other forms of kidney diseases are at risk for developing microalbuminuria.

Whole Body Scan

The body scan screens for the presence of heart disease, certain cancers, as well as other abnormalities. The purpose of a body scan is to identify abnormalities and diseases at an early stage.

The body scan includes a heart scan and lung scan and following areas of the abdomen: kidneys, spine, liver, pancreas, gall bladder, thoracic aorta, abdominal aorta, adrenal glands, lymph nodes, spleen, and certain pelvic organs.

The body scan may detect early or advanced heart disease, aneurisms of the aorta, vascular disease, lung tumors, kidney tumors and liver tumors, calcified kidney stones, calcified gallstones, and certain abnormalities in the abdominal and pelvic region.

 

Ankle-brachial Index Test

This test is done by measuring blood pressure at the ankle and in the arm while a person is at rest. Measurements are usually repeated at both sites after 5 minutes of walking on a treadmill.

The ankle-brachial index (ABI) result is used to predict the severity of peripheral arterial disease (PAD). A slight drop in your ABI with exercise means that you probably have PAD. This drop may be important because PAD can be linked to a higher risk of heart attack or stroke.

This test is done to screen for peripheral arterial disease of the legs.

 

2D – Echo (2-D Echocardiogram)

Echocardiogram is a test that uses sound waves to create a moving picture of the heart or graphic outline of the heart’s movement. The picture is much more detailed than x-ray image and involves no radiation exposure.

The purpose of this test is to determine the size of your heart, to evaluate how well your heart is functioning or pumping and to assess the structure and function of the valves within the heart. A 2-D (or two-dimensional) echocardiogram is capable of displaying a cross-sectional "slice" of the beating heart, including the chambers, valves and the major blood vessels that exit from the left and right ventricle.

The echocardiogram allows doctors to evaluate heart murmurs, check the pumping function of the heart, and evaluate heart valve disease, cardiomyopathy, effusion and other cardiac abnormalities.

 

Carotid Ultrasound IMT

Intima-media thickness (IMT) also called intimal medial thickness, is a measurement of the thickness of inner layer of the artery walls.

The thickness of the vascular lining indicate genetics and environmental factors (including diet, exposure to carcinogens such as cigarette smoke, and exercise - or the lack of exercise, etc) combine over time to cause inflammation of the inner layers of the artery and the formation of plaque on the inner lining of the arterial wall. 

The thickening of the intima and media layers of the common carotid artery is a predictor of future cardiac and cerebrovascular diseases (i.e. stroke, myocardial infarction, and heart attack).

Carotid IMT will catch more people with disease who may have been shown to be normal on other tests like stress echo, standard lipid panels, and other blood/urine screens. The Carotid Ultrasound test is used to:

  • Predict future cardiac and cerebrovascular diseases
  • Allows early detection and intervention of cardiac and cerebrovascular diseases
  • Distinguish between different types of paque providing further information about stable and unstable plaque

 

 

Heart CT

A Heart CT scan is an imaging test that captures cross-sectional images of the heart at sub-second rates, detects and measures the amount of calcium build-up in your coronary arteries. Calcified plaque is an indicator of heart disease.

Heart disease and heart attacks are caused by a process called atherosclerosis, often referred to as "hardening of the arteries". As we grow older, cholesterol particles deposit themselves in the walls of our blood vessels. This gradual buildup of cholesterol is collectively referred to as "plaque". When plaque gets big enough, it can obstruct blood flow or it can become unstable and the plaque can rupture and cause a heart attack.

Colonoscopy

Colonoscopy is a test that allows your physician to look at the inner lining of your large intestine (rectum and colon). The physician uses a thin, flexible tube called a colonoscope to look at the colon. A colonoscopy helps find ulcers, colon polyps, tumors, and areas of inflammation or bleeding. 

During a colonoscopy, tissue samples can be collected (biopsy) and abnormal growths can be taken out. Colonoscopy can also be used as a screening test to check for cancer or precancerous growths in the colon or rectum (polyps).

 

64 Slice Heart CT (Coronary CT angiography “CTA”)

Cardiac CT is a heart-imaging test that uses CT technology with or without intravenous (IV) contrast (dye) to visualize the heart anatomy, coronary circulation, and great vessels (which includes the aorta, pulmonary veins, and arteries). The 64 slice CT test produces High-resolution, 3-dimensional pictures of the moving heart and great vessels are produced during a coronary CTA to determine if either fatty or calcium deposits (plaques) have built up in the coronary arteries.

References: Healthwise,  Webmd and MedlinePlus, American Heart Association and American Cancer Society