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Test DIRECTORY

Explore our comprehensive menu of laboratory tests designed to support accurate, reliable results across every specialty.

APG LAB's test directory provides a comprehensive list of specialty and general laboratory testing services.

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There are currently 17 names in this directory beginning with the letter O.

Occult Blood, Fecal, Immunoassay

Synonyms FIT iFOBT Expected Turnaround Time 1 - 3 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Routine Microbiology Related Documents For more information, please view the literature below. Immunochemical Colorectal Cancer Screening: An Improved Fecal Occult Blood Test Microbiology Specimen Collection and Transport Guide Sample Report Specimen Requirements Specimen Stool in Polymedco OC-Auto Sampling Bottle Volume One Polymedco OC-Auto Sampling Bottle with stool Container Polymedco OC-Auto Sampling Bottle Collection Enter patient identification and date of collection on sampling bottle label. Place collection paper inside toilet bowl on top of water. Deposit fecal sample on top of collection paper. Do not allow fecal sample to contact toilet water until after specimen has been collected. Open the green cap on the sampling bottle by twisting and pulling upwards. Scrape the surface of the fecal sample with the sampling probe. Cover the grooved portion of the sampling probe completely with the fecal sample. Close the sampling bottle by inserting the sampling probe and snap the green cap on tight. Do not reopen. Flush remaining stool and used collection paper. Return the sampling bottle to the physician or laboratory. Only one stool specimen collected from one bowel movement is required. Storage Instructions Specimen in sampling bottle can be stored for 15 days at ambient temperature. Patient Preparation No special drug or dietary restrictions are required. Results of this test are not affected by dietary peroxidases, animal blood, or vitamin C. Causes for Rejection Collection tube or sampling device other than the Polymedco OC-Auto Sampling Bottle; specimens with obvious blood (which may be due to menstrual bleeding, bleeding hemorrhoids, constipation bleeding, or urinary bleeding); raw stool submitted in a container; unlabeled specimen or name discrepancy between specimen and test request label; specimen received after prolonged delay (more than 15 days at room temperature since collection); specimen received frozen; expired sampling bottle; leaking sampling bottle, sampling bottle overfilled, or without adequate liquid. Test Details Use Qualitative detection of fecal occult blood Limitations This test is intended only for the detection of human hemoglobin in fecal specimens. It is not for use in testing urine, gastric specimens, or other bodily fluids. Results cannot be considered conclusive evidence of the presence or absence of gastrointestinal bleeding or pathology. This test is designed for preliminary screening. A positive result should be followed up with additional diagnostic procedures, such as colonoscopy or sigmoidoscopy, to determine the exact cause and source of the occult blood in the feces. A negative result can be obtained even when a gastrointestinal disorder is present. For example, some polyps and colorectal cancers may bleed intermittently or not at all during certain stages of disease. False-negative results may occur when occult blood is not uniformly distributed throughout the stool. Repeat testing is recommended if a pathological condition is suspected. Urine and excessive dilution of specimens with water from the toilet bowl may cause erroneous results. For best results, use the collection paper in the collection kit. Patients with menstrual bleeding, bleeding hemorrhoids, constipation bleeding, and urinary bleeding should not be considered for testing as these conditions may interfere with test results. These patients may be considered for testing after such bleeding ceases. Alcohol and certain medications, such as aspirin, indomethacin, reserpine, phenylbutazone, corticosteroids, and nonsteroidal anti-inflammatory drugs, may cause gastrointestinal irritation and subsequent bleeding in some patients. Methodology Immunoassay (IA) Additional Information A screening test for colorectal cancer, diverticulitis, colitis, polyps, and adenomas should be highly sensitive and highly specific for bleeding in the lower gastrointestinal tract, and should encourage patient compliance with obtaining a proper specimen. Guaiac-based tests for occult blood in stool suffer from a number of drawbacks, leading to a reduction in their sensitivity as well as production of false-positive results. These drawbacks include: • Detection of heme present in the stool, which can originate from bleeding anywhere in the gastrointestinal tract • Inability to distinguish human heme from heme present in many foods, such as dietary meats • Indiscriminate detection of peroxidase activity, which is present in a wide range of fruits and vegetables • Reaction with drugs and other substances that can cause false-negative results Detection of fecal occult blood by immunoassay eliminates the drawbacks seen with guaiac-based tests, and provides a sensitivity and specificity that is superior to guaiac. Immunochemical fecal occult blood tests utilize antihuman hemoglobin antibodies to detect the globin portion of undegraded human hemoglobin in stool. While hemoglobin from the upper gastrointestinal tract is mostly degraded by bacterial and digestive enzymes before reaching the large intestine, hemoglobin from lower gastrointestinal tract bleeding undergoes less degradation and remains immunochemically reactive. Thus, these tests are specific for lower gastrointestinal tract bleeding. Additionally, immunochemical fecal occult blood tests do not react with animal hemoglobin; peroxidase compounds; or with drugs, vitamins, or other substances that can produce false results, thereby eliminating the need for dietary or drug restrictions prior to patient specimen collection. The Polymedco OC-Auto Micro 80 immunochemical fecal occult blood test is capable of detection of as little as 100 ng of human hemoglobin per mL of feces, making it a much more sensitive assay than guaiac-based tests for detecting low levels of human fecal occult blood. It requires only one stool specimen collected from one bowel movement.

Olanzapine, Serum or Plasma

Synonyms Zyprexa® Expected Turnaround Time 5 - 10 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Serum or plasma Volume 2 mL Minimum Volume 0.5 mL Container Red-top tube or green-top (heparin) tube. Gel-barrier tubes are not recommended. Collection Serum or plasma should be separated from cells within two hours of venipuncture. Submit serum or plasma in a plastic transport tube. Storage Instructions Submission/transport (<3 days): Room temperature. For storage beyond three days, specimen should be refrigerated or frozen. Patient Preparation Trough levels are most reproducible. Causes for Rejection Gel-barrier tubes Test Details Use Therapeutic drug management Methodology Liquid chromatography/tandem mass spectrometry (LC/MS-MS)

Opiate Confirmation (Four Drugs), Urine

Test Includes Codeine; hydrocodone; hydromorphone; morphine Special Instructions Chain-of-custody documentation is required for samples submitted for preëmployment, random employee testing, and forensic purposes. For other applications, use the standard test request form. Please mark chain-of-custody test number on the test request form. Expected Turnaround Time 3 - 5 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Urine Volume 20 mL Container Use plastic urine drug container and tamper-evident seal for forensic specimen. Collection kits are available by request from the laboratory. Collection Urine temperature monitoring is recommended for samples to be tested for medicolegal purposes. Storage Instructions Maintain specimen at room temperature. If arrival at lab will extend beyond seven days, refrigerate specimen. Causes for Rejection Quantity not sufficient for analysis; improper specimen (serum, plasma, blood); incomplete chain-of-custody documentation; incomplete specimen identification Test Details Use Detect the presence of opiates Methodology Mass spectrometry (MS)

Opiate Confirmation, Urine

Test Includes Codeine; morphine Expected Turnaround Time 2 - 4 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Urine Volume 20 mL Container Use plastic urine drug bottle and evidence tape or tamper-evident container for forensic specimen. Collection kits are available by request from the laboratory. Collection Urine temperature monitoring is recommended for samples to be tested for medicolegal purposes. Storage Instructions Maintain specimen at room temperature. If arrival extends beyond seven days, then refrigerate. Test Details Use Detect the presence of opiates Methodology Mass spectrometry (MS)

Opiates, Screen and Confirmation, Urine (Codeine/Morphine)

Test Includes Codeine and morphine only; confirmation is performed at an additional charge. Special Instructions Chain-of-custody documentation is required for samples submitted for preëmployment, random employee testing, and forensic purposes. For other applications, use the standard test request form. Please mark chain-of-custody test number on the test request form. Expected Turnaround Time 1 - 5 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Urine Volume 20 mL Container Use plastic urine drug bottle and evidence tape or tamper-evident container for forensic specimen. Collection kits are available by request from the laboratory. Collection Urine temperature monitoring is recommended for samples to be tested for medicolegal purposes. Storage Instructions Maintain specimen at room temperature. If arrival extends beyond seven days, then refrigerate. Stability Requirements Temperature Period Room temperature 14 days Refrigerated 14 days Frozen 14 days Test Details Use Evaluate drug abuse Limitations In most immunoassays a number of narcotic drugs can cross react to give a positive result. Every effort should be made to confirm, by an analytically different and more sensitive method, all presumptive, positive opiate tests. Methodology Immunoassay (IA); confirmation: mass spectrometry (MS) Additional Information A qualitative urine test for opiates is performed in suspected overdose cases or as part of a drug of abuse program. The test is most sensitive for morphine and codeine, but other drugs will cross react in an immunoassay and give positive results (eg, hydrocodone, hydromorphone). All presumptive positive assays should be confirmed, preferably by MS. Morphine is a prescribed drug for pain relief, a metabolite of heroin, a metabolite of codeine, and a constituent of poppy seeds. Its presence in urine, even after confirmation, must be interpreted very carefully. Ingestion of poppy seeds (bagels, Danish) can cause positive opiate tests at a 300 ng/mL cutoff.1 The intake of heroin by the user can only be proved by the detection of 6-O-acetyl morphine. Opiates in general are a group of drugs (commonly referred to as narcotics) that are used medically to relieve pain, but that also have a high potential for abuse. Morphine and codeine are found in the resin collected from the opium poppy. Other opiates are synthesized or manufactured (eg, heroin). Opium appears as dark brown chunks or as a powder and is usually smoked or eaten. Heroin can be a white or brownish powder that is usually dissolved in water and injected. Opiates tend to relax the user. When the opiates are injected, the user feels an immediate “rush.” Other initial and unpleasant effects include restlessness, nausea, and vomiting. The user may go “on the nod,” going back and forth from feeling alert to drowsy. With very large doses, the user cannot be awakened, pupils become smaller, and the skin becomes cold, moist, and bluish in color. Furthermore, breathing slows down and death may occur. Clearance may be slower in geriatric patients.

Opiates, Screen and Confirmation, Urine (Pain Management)

Test Includes Confirmation of positive screen includes codeine, hydrocodone, hydromorphone, and morphine. Special Instructions This assay is designed for pain management. It is not intended for workplace testing and does not comply with state regulatory workplace testing programs. Expected Turnaround Time 3 - 5 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Urine Volume 20 mL Container Plastic urine container Storage Instructions Maintain specimen at room temperature. If arrival at lab will extend beyond seven days, refrigerate. Test Details Use Detect and confirm presence of opiates Methodology Initial testing by immunoassay (IA); confirmation of positives by mass spectrometry (MS)

Opiates, Screen Only, Urine

Special Instructions This assay is designed for pain management. It is not intended for workplace testing and does not comply with state regulatory workplace testing programs. Expected Turnaround Time 1 - 4 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Urine Volume 20 mL Container Plastic urine container Storage Instructions Maintain specimen at room temperature. If arrival at lab will extend beyond seven days, refrigerate. Test Details Use Opiates detection Methodology Immunoassay (IA)

Organic Acid Analysis, Urine

Expected Turnaround Time 3 - 7 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Urine (random), frozen Volume 10 mL Minimum Volume 3 mL Container Plastic urine container, no preservative Storage Instructions Freeze Stability Requirements Temperature Period Frozen 12 months Causes for Rejection Urine too dilute; quantity not sufficient for analysis Test Details Use Urine organic acid testing is useful in the diagnosis and monitoring of patients with inborn errors of organic acid metabolism, inborn errors of amino acid metabolism, urea cycle defects, and defects of the mitochondrial respiratory chain. Limitations Organic acid analysis may fail to detect certain disorders that are characterized by minimal or intermittent metabolite excretion. This test was developed, and its performance characteristics determined, by LabCorp. It has not been cleared or approved by the US Food and Drug Administration (FDA). Methodology Gas chromatography/mass spectrometry (GC/MS)

Orotic Acid, Urine

Expected Turnaround Time 2 - 5 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Urine, frozen Volume 3 mL Minimum Volume 0.5 mL (Note: This volume does not allow for repeat testing.) Container Plastic urine container, no preservative Storage Instructions Freeze. Stability Requirements Temperature Period Room temperature Unstable Refrigerated Unstable Frozen 14 days Causes for Rejection Specimen not frozen Test Details Use Elevated levels of orotic acid help lead to positive diagnoses of specific urea cycle disorders, including ornithine transcarbamylase deficiency (OTC), citrullinemia, and arginosuccinic aciduria. Rare hereditary disorders may also be diagnosed via elevation of orotic acid, namely orotic aciduria and uridine monophosphate synthase deficiency, which may be physiologically characterized by megaloblastic anemia and crystalluria. Normal levels of orotic acid assist in the accurate differential diagnoses of patients with elevated plasma ammonia and low plasma citrulline and arginine levels caused by liver infections, carbamoylphosphate synthetase I deficiency (CPSI), or N-acetyl glutamate synthetase deficiency (NAGS). Limitations This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration. Methodology Liquid chromatography/tandem mass spectrometry (LC/MS-MS) Additional Information Orotic acid is an intermediary in the metabolism of the nucleotide pyrimidine, immediately following the conversion of carbamoyl phosphate to dihydroorotate in the human mitochondria. Orotic acid is then converted into orotate monophosphate by the activated form of ribose 5-phosphate, 5-phosphoribosyl-1-pyrophosphate, which is delivered in to the urea cycle. The urea cycle is of vital importance to the functions of the body, as it clears unused ammonia and its precursor metabolites through urinary excretions. Ammonia buildup (hyperammonemia) may rapidly develop, manifesting initially as lethargy and vomiting, eventually leading to cerebral edema, coma, and death. Other symptoms urea cycle disorders present include hyper- or hypoventilation, anorexia, hypothermia caused by a lack of thermoregulation, seizures, sleep disorders, delusions (in adult-onset hyperammonemia), and abnormal posturing of the body caused by swelling of the brain and pressure on the brain stem. Urea cycle disorders normally become apparent in early childhood, often a few days after birth, though late-onset variants of these disorders exist. Likewise, female carriers of the X-linked disorder ornithine transcarbamylase (OTC) deficiency may be symptomatic with a variable age of onset. Symptoms in late-onset forms are often triggered by excess stress and/or illness. Many children leave hospital care before defects of the urea cycle become apparent, emphasizing the need for diagnostic tools that provide clinically-relevant information before physical symptoms can present and cause irreversible damage. References Analytical Validation Report. Quantification of Orotic Acid in Urine by LC-MS/MS Analysis.. Unpublished LabCorp Internal Document Number VR-NOQS-BN-2008-10. Soldin SJ, Hicks JM, eds. Pediatric Reference Ranges. Washington DC: AACC Press;1995.

Osmolality, Urine

Synonyms Urine Osmolality Special Instructions If 24-hour urine is collected, record total urine volume on the request form. Expected Turnaround Time 1 - 3 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Urine Specimens Related Documents Sample Report Specimen Requirements Specimen Urine (random or 24-hour) Volume 2 mL Minimum Volume 0.2 mL (Note: This volume does not allow for repeat testing.) Container Plastic urine container, no preservative Collection Centrifuge urine sample after collection for five minutes at 4°C to 25°C to remove gross particulate matter. Storage Instructions Refrigerate Stability Requirements Temperature Period Room temperature 14 days Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x3 Test Details Use Evaluate concentrating ability of the kidneys (eg, in acute and chronic renal failure); evaluate electrolyte and water balance; used in work-up for renal disease, syndrome of inappropriate antidiuretic hormone secretion (SIADH), and diabetes insipidus; may be used with urinalysis when patient has had radiopaque substances, has glycosuria or proteinuria;1 evaluate dehydration, amyloidosis. Osmolality is desirable in examination of neonatal urine when protein or glucose are present.2 Methodology Freezing point depression Reference Interval • 24-hour urine: 300−900 mOsm/kg • Random urine: 50−1400 mOsm/kg • After 12-hour fluid restriction: >850 mOsm/kg Additional Information Osmolality is a better measurement than specific gravity. Osmolality is a measure of renal tubular concentration, depending on the state of hydration. Simultaneous determination of urine and serum osmolalities facilitates interpretation of results. High urinary:plasma ratio is seen in concentrated urine. Normal ranges for the U:P ratio are given by Weisberg as approximately 0.2−4.7, and >3.0 with overnight dehydration.1 With poor concentrating ability the ratio is low but still ≥1.0. In SIADH urine sodium and urine osmolality are high for plasma osmolality.3 Low birthweight infants have been reported to have increased serum osmolality with normal urine osmolality.4 The urine osmolar gap is described as the sum of urinary concentrations of sodium, potassium, bicarbonate, chloride, glucose, and urea compared to measured urine osmolality. The gap is normally 80−100 mOsm/kg (SI: 80−100 mmol/kg) H2O. Determination of the urine osmolal gap is used to characterize metabolic acidosis.

Osteocalcin

Synonyms Bone GLA Protein Expected Turnaround Time 2 - 4 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Serum, frozen Volume 0.8 mL Minimum Volume 0.4 mL (Note: This volume does not allow for repeat testing.) Container Red-top tube or gel-barrier tube Collection Transfer the serum into a LabCorp PP transpak frozen purple tube with screw cap (LabCorp No 49482). Freeze immediately and maintain frozen until tested. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit separate frozen specimens for each test requested. Storage Instructions Freeze. Test Details Use Evaluate bone disease. Increased levels of osteocalcin are found in bone diseases characterized by increased bone turnover. Osteocalcin has been found to be elevated in Paget disease of the bone, cancer accompanied by bone metastases, primary hyperparathyroidism and renal osteodystrophy. Osteocalcin levels may serve as useful index in evaluating the therapeutic management of the patient. Methodology Enzyme-linked immunosorbent assay (ELISA) Reference Interval • Male: 3.2−39.6 ng/mL • Female: − Premenopausal: 4.9−30.9 ng/mL − Postmenopausal: 9.4−47.4 ng/mL Additional Information Osteocalcin, or bone Gla protein (BGP), is the major noncollagenous protein of bone matrix. It has a molecular weight of approximately 5.8 kilodaltons and consists of 49 amino acids, including three residues of γ-carboxyglutamic acid. Osteocalcin is synthesized in bone by osteoblasts. After production, it is partly incorporated into the bone matrix and partly delivered to the circulatory system. The precise physiological function of osteocalcin is still unclear. A large number of studies have shown that the circulating level of osteocalcin reflects the rate of bone formation. Determination of serum osteocalcin has proven to be valuable as an aid in identifying women at risk of developing osteoporosis, for monitoring bone metabolism during perimenopause and postmenopause, and during antiresorptive therapy.

Ovarian Cancer Monitor

Test Includes Human Epididymis Protein 4 [081700]; Cancer Antigen 125 [002303]. See individual test descriptions for complete information. Special Instructions This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample. Expected Turnaround Time 1 - 3 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents For more information, please view the literature below. Human Epididymis Protein 4 (HE4): Monitoring Patients With Epithelial Ovarian Carcinoma Sample Report Specimen Requirements Specimen Serum Volume 1 mL Minimum Volume 0.8 mL (Note: This volume does not allow for repeat testing.) Container Red-top tube or gel-barrier tube Collection If red-top tube is used, transfer separated serum to a plastic transport tube. Storage Instructions Refrigerate Stability Requirements Temperature Period Room temperature 5 days Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x3 Test Details Use Use of HE4 in combination with CA 125 provides a more accurate predictor of malignancy than either marker alone. Methodology HE4: enzyme-linked immunosorbent assay (ELISA); CA 125: electrochemiluminescence immunoassay (ECLIA)

Oxalate, Quantitative, 24-Hour Urine

Synonyms Oxalic Acid Special Instructions State patient's age, sex, and total 24-hour urine volume on the test request form and specimen. Specimens submitted without preservative should be acidified after receipt to pH ≤3 with 6N HCl prior to aliquoting. Expected Turnaround Time 2 - 5 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Urine Specimens Related Documents Sample Report Specimen Requirements Specimen Urine (24-hour) Volume 10 mL aliquot Minimum Volume 2.5 mL aliquot Container Plastic LabCorp 24-hour urine container with 30 mL 6N HCl preservative (LabCorp N° 21584). Collection Instruct patient to void at 8 AM (or 8 PM) and discard the specimen. Then collect all urine including the final specimen voided at the end of the 24-hour collection period (ie, 8 AM [or 8 PM] the following day). Label container with patient's name and date and time collection started and finished. Measure and record total urine volume. Mix well. pH must be ≤3. Preservative not necessary during collection but should be added to urine collection within 24 hours. Storage Instructions Maintain acidified urine at room temperature. Acid prevents crystallization and conversion of ascorbate (vitamin C) to oxalate. Stability Requirements Temperature Period Room temperature 7 days Refrigerated 7 days Frozen 14 days Freeze/thaw cycles Stable x3 Patient Preparation Avoid vitamin C supplements and vitamin C-rich foods (eg, citrus fruits like oranges, orange juice; vegetables like broccoli, tomatoes, peppers, potatoes) for 48 hours prior to collection. Causes for Rejection Urine sample received with a pH not ≤3 from a patient on high doses of vitamin C Test Details Use Patients who form calcium oxalate kidney stones appear to absorb and excrete a higher portion of dietary oxalate in urine than do normals. Hyperoxaluria is not uncommon in subjects with malabsorption. Twenty-four hour urine collections for oxalate are indicated in patients with surgical loss of distal small intestine, especially those with Crohn's disease. The incidence of nephrolithiasis in patients who have inflammatory bowel disease is 2.6% to 10%.1 Hyperoxaluria is regularly present after jejunoileal bypass for morbid obesity; such patients may develop nephrolithiasis. Used to work up nephrolithiasis. Methodology Enzymatic Reference Interval • Children: − <7 years: not established − 7 to 14 years: 13−38 mg/24 hours • Adults: − Male: 7−44 mg/24 hours − Female: 4−31 mg/24 hours Additional Information Oxaluria is characteristic of ethylene glycol intoxication. Oxalic acid excretion is increased with methoxyflurane. Serum calcium and urinary calcium excretion are also commonly needed; calcium oxalate renal stones are common. Hyperoxaluria may occur with high intake of animal protein, purines, gelatin, calcium, strawberries, pepper, rhubarb, beans, beets, spinach, tomatoes, chocolate, cocoa, and tea. Hyperoxaluria is described with pyridoxine deficiency. Urinary oxalate derives from the metabolism of glycine and ascorbic acid more than from dietary ingestion. Oxalate excretion is increased in vegetarians, despite low animal protein ingestion.2 Vitamin C increases oxalate excretion and may be a risk factor for calcium oxalate nephrolithiasis in individuals consuming “megadose” vitamin C. Such ingestion can usually be determined by the history. If a vitamin C using stone former is found to have high urine oxalate excretion, the habit should be stopped. If oxalate excretion drops to normal, additional therapy to prevent stones may not be required. Hyperoxaluria can result from intestinal hyperabsorption related to low calcium intake or high calcium enteric binding. Unabsorbed fat can bind calcium. Increased urinary uric acid excretion is frequently found in subjects who have calcium oxalate nephrolithiasis. Calcium nephrolithiasis in patients with hyperuricosuria has been related to urate-induced crystallization of calcium oxalate.3 Urinary oxalate concentrations have been found to be increased in very low birth weight infants receiving parenteral amino acid solutions.4 Rare genetic disorders increase endogenous oxalate production; there are two types of primary hyperoxaluria. They are characterized by elevated urinary oxalate excretion and recurrent oxalate nephrocalcinosis. In type I, a defect in glyoxalate metabolism is found, leading to increased oxalate synthesis. Excessive quantities of glyoxylic and glycolic acid urinary excretion occur. Type II is rare; it is characterized by excessive urinary excretion of oxalic and L-glyceric acids with normal excretion of glycolic acid.5

Oxcarbazepine, Serum or Plasma

Synonyms GP 47680 Trileptal® Test Includes Analysis of active metabolite, 10-hydroxy carbamazepine (MHD) Expected Turnaround Time 2 - 4 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Serum or plasma Volume 1 mL Minimum Volume 0.3 mL Container Red-top tube or plastic transport tube. Do not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug by the gel. Depending on the specimen volume and storage time, the decrease in drug level due to absorption may be clinically significant. Collection Transfer separated serum or plasma to a plastic transport tube. Draw trough levels immediately prior to next dose. Steady-state levels are reached within two to three days in patients taking oxcarbazepine twice daily. Storage Instructions Room temperature Stability Requirements Temperature Period Room temperature 14 days Refrigerated 14 days Frozen 105 days Freeze/thaw cycles Stable x3 Causes for Rejection Gross lipemia; hemolysis; icteric specimen; gel-barrier tube Test Details Use Oxcarbazepine is an antiepileptic drug, indicated for use as monotherapy or adjunctive therapy in the treatment of partial seizures in adults with epilepsy. It is used in adjunctive therapy in epileptic children between the ages of four and 16. Limitations Clinically significant hyponatremia (sodium <125 mmol/L) can develop during oxcarbazepine use. This generally occurs during the first three months of treatment. This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration. Methodology Liquid chromatography/tandem mass spectrometry (LC/MS-MS) Reference Interval 10−35 μg/mL Additional Information Oxcarbazepine is the prodrug for its active metabolite, 10-hydroxy-carbamazepine (MHD). MHD reaches maximal serum concentrations in three to five hours after oral ingestion and is 40% bound to protein. The elimination half-life is 8 to 15 hours.1 Co-administration of other antiepileptic drugs (eg, carbamazepine, phenytoin, phenobarbital, primidone) causes decreases in MHD serum levels.2

Oxycodone and Metabolite

Synonyms Free Oxycodone and Metabolite Oxycontin® Roxicodone® Expected Turnaround Time 4 - 7 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Serum, plasma, or whole blood Volume 0.3 mL Minimum Volume 0.1 mL Container Red-top tube, lavender-top (EDTA) tube, or green-top (heparin) tube. Do not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug by the gel. Depending on the specimen volume and storage time, the decrease in drug level due to absorption may be clinically significant. Collection Separate serum or plasma within one hour of collection and transfer to a plastic transport tube. Storage Instructions Refrigerate. Stable at room temperature, refrigerated, or frozen for 14 days. Causes for Rejection Gel-barrier tube Test Details Limitations Opioids is a general term applied to all substances with morphine-like properties and describes naturally occurring or semisynthetic analgesic alkaloids derived from opium. Some important semisynthetic derivatives of morphine include heroin and its metabolite 6-acetyl morphine, oxycodone, codeine, hydrocodone, oxymorphone, dihydrocodeine, and hydromorphone. Opiates are used clinically because of their analgesic properties, also causing sedation, euphoria, respiratory depression, orthostatic hypotension, diminished intestinal motility, nausea, and vomiting. Because of these properties, opioids have a high abuse potential, whereby chronic use leads to tolerance and dependence. Clinical monitoring of compliance is effected through measurement of these analytes. This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration. Methodology Liquid chromatography/tandem mass spectrometry (LC/MS-MS)

Oxycodone/Oxymorphone Confirmation (LabCorp MedWatch®)

Synonyms Numorphan® Opana® Oxycontin® Special Instructions This assay is intended for pain management. It is not intended for workplace testing and does not comply with state regulatory workplace testing programs. Expected Turnaround Time 4 - 5 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Urine (random) Volume 20 mL Storage Instructions Maintain specimen at room temperature. If arrival at lab will extend beyond seven days, refrigerate. Causes for Rejection Quantity not sufficient for analysis; incorrect specimen Test Details Use Drug analysis/clinical drug monitoring Methodology Mass spectrometry (MS)

Oxycodone/Oxymorphone, Screen and Confirmation, Urine

Synonyms Numorphin® Opana® Oxycontin® Special Instructions This assay is designed for pain management. It is not intended for workplace testing and does not comply with state regulatory workplace testing programs. Expected Turnaround Time 3 - 5 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Urine Volume 20 mL Container Plastic urine container Storage Instructions Maintain specimen at room temperature. If arrival at lab will extend beyond seven days, refrigerate. Test Details Use Detect and confirm the presence of oxycodone or oxymorphone Methodology Initial testing by immunoassay (IA); confirmation of positives by mass spectrometry (MS)

Common Lab Tests

Complete Blood Count

This test, also known as a CBC, is the most common blood test performed. It measures the types and numbers of cells in the blood, including red and white blood cells and platelets. This test is used to determine general health status, screen for disorders and evaluate nutritional status. It can help evaluate symptoms such as weakness, fatigue and bruising, and can help diagnose conditions such as anemia, leukemia, malaria and infection.

Prothrombin Time

Also known as PT and Pro Time, this test measures how long it takes blood to clot. This coagulation test measures the presence and activity of five different blood clotting factors. This test can screen for bleeding abnormalities, and may also be used to monitor medication treatments that prevent the formation of blood clots.

Basic Metabolic Panel

This test measures glucose, sodium, potassium, calcium, chloride, carbon dioxide, blood urea nitrogen and creatinine which can help determine blood sugar level, electrolyte and fluid balance as well as kidney function. The Basic Metabolic Panel can help your doctor monitor the effects of medications you are taking, such as high blood pressure medicines, can help diagnose certain conditions, or can be part of a routine health screening. You may need to fast for up to 12 hours before this test.

Lipid

Panel

The lipid panel is a group of tests used to evaluate cardiac risk. It includes cholesterol and triglyceride levels.

Liver Panel

The liver panel is a combination of tests used to assess liver function and establish the possible presence of liver tumors.

Hemoglobin A1C

This test is used to diagnose and monitor diabetes.

Urinalysis

Often the first lab test performed, this is a general screening test used to check for early signs of disease. It may also be used to monitor diabetes or kidney disease.

Cultures

Cultures are used to test for diagnosis and treatment of infections. Illnesses such as urinary tract infections, pneumonia, strep throat, MRSA and meningitis can be detected and tested for appropriate antibiotic treatment.

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