Guide To The Most Common Hematology Tests

October 25, 2023

Hematology refers to the study of blood and the impact it has on disease and overall health. Hematologists study various blood disorders and conduct research to understand what roles blood plays in the body. Hematology covers issues with not only white and red blood cells, but also with platelets, bone marrow, blood vessels, spleen, lymph nodes, and all the proteins involved in clotting and bleeding.

Hematology tests are common when treating blood conditions. Patients who require anemia treatment as well as treatment of blood cancer, will need regular hematology tests. Hemophilia treatment also involves these tests. Hematology tests can be used both as a diagnostic tool and measure of effectiveness for these treatments. Of course, it starts with understanding the most common hematology tests.

Complete Blood Count

A complete blood count (CBC) is a hematology test that evaluates a patient's overall health. It can be used to detect multiple different disorders, including leukemia, infection, and anemia. These tests review several different aspects of blood. This includes measuring the amount of white blood cells, red blood cells, hemoglobin, and platelets in the makeup of a patient's blood. In addition, they measure the proportion of plasma to red blood cells. If any of these readings are unusual, the hematologist will have a better sense of the underlying condition with which a patient may be dealing.

Complete blood counts are used for multiple different reasons. In addition to being a diagnostic tool, they can be used to review overall health during a routine examination, monitor a chronic medical condition, or monitor ongoing medical treatment. If a patient is recovering from a medical condition like cancer, their doctor may order complete blood counts periodically to make sure they have not had any relapses. Complete blood counts are not fasting blood tests. However, patients may need to fast if their doctor needs additional information from the sample.

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Blood Chemistry Test

A blood chemistry test is another hematology test that measures chemicals found in a blood sample. They help find abnormalities in chemical levels and determine how well an individual's organs are functioning. These tests are also sometimes interchangeably called chemistry panels. Multiple types of chemistry tests are available, and the one a doctor uses will vary depending on the patient's circumstances. The doctor may measure minerals, vitamins, proteins, sugars, hormones, lipids, electrolytes, enzymes, or any combination of them.

Electrolyte panels measure minerals, including bicarbonate, phosphate, magnesium, potassium, sodium, and chloride. Renal panels measure the function of the kidneys by seeing how much creatinine and blood urea nitrogen are in the patient's blood. Basic metabolic panels take both electrolyte and kidney readings, and also measure the patient's calcium and glucose. Comprehensive metabolic panels take all of these measurements and also include a liver function test. Blood chemistry tests are used to diagnose conditions, monitor ongoing treatment, and measure the function of organs like the thyroid, liver, and kidneys.

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Blood Enzyme Test

A blood enzyme test can be a vital diagnostic tool during a medical emergency. Cardiac enzyme tests are used to determine if a patient has had or is currently having a heart attack. The test may also be administered for individuals who have artery blockage symptoms. These include chest pain, shortness of breath, weakness and tiredness, dizziness, cool and clammy skin, sweating, and nausea or vomiting. When the heart undergoes severe stress, the muscle can become damaged. The damaged muscle releases enzymes into the bloodstream. Following a heart attack, these enzymes can reach high levels.

If a doctor finds high enzyme levels in the patient's blood, they know there is a serious issue. Cardiac tests often measure the enzyme troponin. Even after the other released enzymes return to normal, troponin will continue to be in high concentrations in the blood. The results from these tests tend to come in quickly since they are a response to an urgent medical condition. Doctors may repeat the test a few times to monitor how the patient's enzyme levels change.

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Blood Glucose Test

Blood glucose tests measure the glucose levels in the blood. Glucose is a simple sugar that cells use for energy. When individuals eat carbohydrates, their body converts them into glucose. These tests are most commonly ordered for individuals with a form of diabetes, such as gestational diabetes, type 1 diabetes, and type 2 diabetes. The test may also be used to diagnose or check for the presence of diabetes. Diabetes causes high blood glucose levels, which can damage a patient's internal organs and cause death if untreated. The body controls blood sugar with the hormone insulin.

With diabetes, the patient's body either does not create enough insulin or does not create properly working insulin. Since the insulin is not converting carbohydrates to usable energy, they build up in the blood and cause toxic reactions. Some patients may also have a blood glucose test done to determine if they have hypoglycemia, which occurs when their blood glucose is low. After a diabetes diagnosis, patients may have regular glucose tests to monitor their blood sugar and make sure their treatment is working.

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Cholesterol Test

A lipid profile, lipid panel, or complete cholesterol test measures how many triglycerides and how much cholesterol is in an individual's blood. Cholesterol tests are used to determine the extent of a patient's risk of heart disease. High cholesterol can cause plaques to build up in the arteries, which can lead to a narrowing or blockage that could be life-threatening. Individuals with high cholesterol readings tend to have significantly higher risks of developing coronary artery disease.

A complete cholesterol panel measures four lipids found in the blood. Patients will get a total cholesterol reading that measures their blood's cholesterol content. This is broken down further into high-density lipoprotein (HDL) cholesterol readings, low-density lipoprotein (LDL) cholesterol readings, and triglyceride readings. LDL cholesterol leads to plaque buildup in the arteries. However, HDL cholesterol carries LDL cholesterol away and keeps arteries unblocked.

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Hemoglobin Testing

Hemoglobin is a vital protein in red blood cells. It is responsible for carrying oxygen to organs and other tissues and bringing carbon dioxide back to the lungs. Hemoglobin testing involves measuring the amount of hemoglobin an individual has in their blood. In most cases, individuals will undergo hemoglobin testing as part of a complete blood count. However, this test can be isolated as well.

Doctors will often order a hemoglobin test if the patient is dealing with abnormal fatigue, dizziness, weakness, or shortness of breath. These symptoms may indicate that a patient has an underlying medical condition, such as anemia or polycythemia vera. A patient's hemoglobin will be low if they have anemia. It will be elevated for polycythemia vera. Hemoglobin testing is also helpful when patients are undergoing treatment for both conditions, as it allows doctors to assess the effectiveness of their treatment.

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Renal Profiling

Renal profiling, sometimes referred to as a renal panel, is a type of blood chemistry test. This hematology test examines the levels of blood urea nitrogen and creatinine, both of which are crucial in kidney function. Renal profiling will provide doctors with an accurate idea of how well a patient's kidneys are functioning.

This test is typically performed when doctors are concerned that their patients may have a condition that is affecting their kidneys. For instance, patients with elevated blood urea nitrogen may have kidney damage, kidney disease, or kidney failure. Elevated levels can also indicate dehydration, kidney stones, stroke, or heart attack. Patients may be asked to fast for eight to twelve hours before renal profiling. It is also common to require more than one test if levels are only slightly out of the normal range.

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Bone Marrow Biopsy

Overall, a bone marrow biopsy is not a common test in that most individuals never get one. However, it is a common test for hematologists, as they conduct them fairly frequently. This test involves taking a sample of the patient's bone marrow for examination. In it, a healthcare professional will insert a small needle into a large bone and draw bone marrow into the needle. They will give this sample to the lab, where it is thoroughly analyzed.

Bone marrow biopsies can confirm various diseases, including anemia, abnormal clotting or bleeding issues, and various forms of cancer. The types of cancer this test can help diagnose include multiple myeloma, leukemia, and lymphoma. A bone marrow biopsy can also detect if another type of cancer has spread to the patient's bone marrow from another part of their body.

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Prothrombin Time Test

Prothrombin, a protein in the blood, is a vital factor in helping blood clot normally. The liver is responsible for producing it. Thus, a prothrombin time test is a hematology test to evaluate blood clotting time in a patient. Doctors will order regular prothrombin time tests for their patients who are taking warfarin, a common anticoagulant. The tests can be ordered for patients on other anticoagulants as well. Doctors may also recommend a prothrombin time test before surgery if they are concerned about their patient's blood clotting ability.

This test is also helpful for evaluating patients for liver disease. It is often used as a part of screening patients for liver transplants. Finally, although a prothrombin time test is helpful for identifying potential health conditions, doctors often need additional tests to confirm conditions such as a bleeding disorder or liver issues.

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Blood Transfusions

Although it is not a test like many of the others, blood transfusions are a common hematology procedure. Blood transfusions involve patients receiving donated blood through a narrow tube inserted into one of the veins in their arm. These transfusions can be life-saving. They help patients who have lost blood due to a serious injury or during surgery. Blood transfusions are also incredibly helpful for patients with a blood disorder in which their body cannot make certain blood components properly. For instance, blood transfusions are common among hemophilia patients and those with von Willebrand disease, both of which mean a patient's blood lacks certain clotting factors. Thankfully, blood transfusions do not often have complications. In the rare event that they do occur, complications are usually mild.

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