Pathology Specimen Handbook

Recent changes for all departments


 Recent changes for 14-3-3 PROTEIN CSF TEST

Recent changes for 14-3-3 PROTEIN CSF TEST
DateFieldChanged FromChanged To
16th June 2022Volume (Adults)2.50 mL2.00 mL
Minimum/Paediatric Volume2.50 mL2.00 mL
Preferred Container TypeFlorey tubeCSF Sterile Tubes
16th June 2022Volume (Adults)2 mL2.5 mL
Minimum/Paediatric Volume2 mL2.5 mL
Preferred Container TypeCSF Sterile TubesFlorey tube

 Recent changes for ALZHEIMER DISEASE SCREEN (CSF)

Recent changes for ALZHEIMER DISEASE SCREEN (CSF)
DateFieldChanged FromChanged To
7th July 2022Preferred Container TypeCSF Polypropylene TubeFlorey tube
28th June 2022Collection & Request Instructions

Propylene tubes MUST be used for collection.

Glass and CSF tubes should not be used. Do not transfer CSF from regular CSF tubes.

Retrospective analysis unsuitable.

Refer to infomation sheet prior to collection. (DB handbook -Referred tests)

Non rebatable test.

DO NOT FREEZE 

Non rebatable test

 Recent changes for AMMONIA

Recent changes for AMMONIA
DateFieldChanged FromChanged To
10th June 2022Collection & Request Instructions

Collect on ice and keep cold until analysis

The sample has to be analysed within 3 hours of collection

For Casey, Moorabbin and Wonthaggi collections, check with the laboratory before collecting to ensure the sample is collected before the courier run to MMC or DH

Collect on ice and keep cold until analysis

The sample has to be analysed within 3 hours of collection

For Casey, Moorabbin and Wonthaggi collections, check with the laboratory before collecting to ensure the sample is collected before the courier run to MMC or Dandenong Hospital

6th June 2022Collection & Request Instructions

The sample has to be analysed within 3 hours of collection

For Casey, Moorabbin and Wonthaggi collections, check with the laboratory before collecting to ensure the sample is collected before the courier run to MMC or DH

Collect on ice and keep cold until analysis

The sample has to be analysed within 3 hours of collection

For Casey, Moorabbin and Wonthaggi collections, check with the laboratory before collecting to ensure the sample is collected before the courier run to MMC or DH

 Recent changes for ANTI XA ( LMW HEPARIN) ASSAY

Recent changes for ANTI XA ( LMW HEPARIN) ASSAY
DateFieldChanged FromChanged To
1st June 2022Collection & Request Instructions

(a) Preferred collection time is 3-4 hrs post injection / tablet - consult with clinical haematologist (b) Please note heparin type on request slip

(a) Preferred collection time is 3-4 hrs post injection / tablet - consult with clinical haematologist

(b) MANDATORY: Please note heparin type on request slip

 Recent changes for B27

Recent changes for B27
DateFieldChanged FromChanged To
1st July 2022Volume (Adults)4 mL6 mL
Minimum/Paediatric Volume2 mL6 mL
Preferred Container TypeHeparin Whole Blood (No Gel)EDTA Whole Blood
Optional Container TypeEDTA Whole Blood
Collection & Request Instructions

For Coeliac Disease HLA typing (HLADQ2 / HLADQ8), refer to COELIAC GENETIC TEST.

For HLA Tissue Typing (Transplant patients), refer to entry HLA TISSUE TYPING (TRANSPLANT PATIENTS)

For other HLA typing (including HLA B57), refer to entry HLA TYPING.

Please collect 2x3mL EDTA tubes for adults and children for HLA-B27.

For Coeliac Disease HLA typing (HLADQ2 / HLADQ8), refer to COELIAC GENETIC TEST.

For HLA Tissue Typing (Transplant patients), refer to entry HLA TISSUE TYPING (TRANSPLANT PATIENTS)

For other HLA typing (including HLA B57), refer to entry HLA TYPING.

 Recent changes for BCR-ABL1 MUTATION

Recent changes for BCR-ABL1 MUTATION
DateFieldChanged FromChanged To
28th June 2022Minimum/Paediatric Volumenull mL

 Recent changes for BETA 2 GLYCOPROTEIN ANTIBODIES

Recent changes for BETA 2 GLYCOPROTEIN ANTIBODIES
DateFieldChanged FromChanged To
1st June 2022Volume (Adults)2 mL5 mL

 Recent changes for CYANIDE

Recent changes for CYANIDE
DateFieldChanged FromChanged To
21st July 2022Alternative namesTHIOCYANATE, NITROPRUSSIDETHIOCYANATE, NITROPRUSSIDE, SCN
Minimum/Paediatric Volumenull mL
Collection & Request Instructions

If the Duty Biochemist says the test is for exposure to cyanide and not for hypertension and nitroprusside therapy then collect as soon as possible after atmospheric exposure or ideally two hours after ingestion.

Collect Serum 5 mL red top for Thiocyanate.

 

Non-CMBS test

If the Duty Biochemist says the test is for exposure to cyanide and not for hypertension and nitroprusside therapy then collect as soon as possible after atmospheric exposure or ideally two hours after ingestion.

Collect Serum 5 mL gold top for Thiocyanate.

 

Non-CMBS test

 Recent changes for GLIVEC TRIAL

Recent changes for GLIVEC TRIAL
DateFieldChanged FromChanged To
1st June 2022Minimum/Paediatric Volumenull mL
Collection & Request InstructionsMust be arranged by referring doctor with the Special Haematology laboratory (9594 3490) before patient collection. 20 mL EDTA for BCR-ABL QPCR, and 20 mL Lithium Heparin for Kinase Inhibition studies. 5 mL EDTA for Glivec level assay.

Method obsolete - mononuclear cells collection for this trial no longer available.

 Recent changes for HAEMOPHILIA A DNA TESTING

Recent changes for HAEMOPHILIA A DNA TESTING
DateFieldChanged FromChanged To
6th July 2022Minimum/Paediatric Volumenull mL

 Recent changes for HAEMOPHILIA B DNA TESTING

Recent changes for HAEMOPHILIA B DNA TESTING
DateFieldChanged FromChanged To
6th July 2022Minimum/Paediatric Volumenull mL

 Recent changes for KEPPRA

Recent changes for KEPPRA
DateFieldChanged FromChanged To
7th July 2022Collection & Request Instructions

Trough (pre-dose) level 8 hours post oral dose

MUST be non gel lithium heparin tube

Collect trough (pre-dose) level 

Must be non-gel lithium heparin tube

FrequencyOn requestWeekly

 Recent changes for LAMOTRIGINE

Recent changes for LAMOTRIGINE
DateFieldChanged FromChanged To
7th July 2022Volume (Adults)4 mL3 mL
Minimum/Paediatric Volume2 mL3 mL
Collection & Request InstructionsGel tubes, Serum and Lith Hep, are unsuitable. Non Gel tube only as the gel adsorbs Lamotrigine.

 Recent changes for LINEZOLID

Recent changes for LINEZOLID
DateFieldChanged FromChanged To
7th July 2022Volume (Adults)5 mL3 mL
Minimum/Paediatric Volume5 mL3 mL
Optional Container TypeHeparin Plasma (No Gel)
Collection & Request Instructions

Collect 2 EDTA tubes just before the next dose (trough collection) at least 48 hours after initiation or dose change (to reach steady state).

Measure trough levels at least 48-hours following initiation or dose change of linezolid

FrequencyWeekly

 Recent changes for Monkeypox Virus PCR

Recent changes for Monkeypox Virus PCR
DateFieldChanged FromChanged To
19th August 2022Volume (Adults)null mL
Minimum/Paediatric Volumenull mL
Optional Specimen TypeRefer to collection instructionsTissue - Fresh
Blood
Refer to collection instructions
19th August 2022Assay nameMonkey Pox Virus PCRMonkeypox Virus PCR
Volume (Adults)5 mLnull mL
Minimum/Paediatric Volumenull mL
Preferred Specimen TypeFluid
Tissue - Fresh
Nasopharyngeal Aspirate (NPA)
Swab
Tissue - Fresh
Optional Specimen TypeBloodRefer to collection instructions
Preferred Container TypeSwab (Dry Dacron)Swab (Dry Dacron)
Sterile Yellow Top Container
Optional Container TypeRefer to collection instructions
Collection & Request Instructions

Specimen Types:

lesion Fluid/Tissue

lesion crust or skin biopsy

Nasopharyngeal swab

throat swab

5 mL of EDTA and 10 mL of serum is recommended

For collectors and pathology transport staff: Samples must be transported DOUBLE-BAGGED. The patient request form or printed EMR request with details of the tests required and specimen type/site of collection should be placed in the pouch of the outer specimen bag.

Specimen collection is performed by team treating the patient. 

Swab from skin lesions/rash is preferred specimen type

Sterile dry swab (no liquid or gel transport media in collection tube) from multiple active skin lesions. Two swabs from morphologically distinct lesions and/or anatomical locations should be collected.

Swabs in liquid media should be avoided as this may dilute the specimen and increase the risk of leakage during transport. If swabs have already been placed into suitable transport medium (for example, viral transport media) these can still be tested.

If testing for other viral pathogens (eg. Enterovirus, varicella zoster virus, herpes simplex virus) or bacterial MCS is required a separate specimen/swab should be collected.

Nasopharyngeal/throat swab may be collected (but is not the preferred specimen site)

Blood may be considered in specific cases. Whole blood or serum specimens can be tested to detect the presence of monkeypox virus. However, these have low sensitivity for detection due to the transient nature of viraemia, and therefore should not be used to exclude monkeypox. A minimum of 5 mL of EDTA whole blood or 10 mL of serum is recommended.

 

 Recent changes for MTHFR GENETIC MUTATION TEST

Recent changes for MTHFR GENETIC MUTATION TEST
DateFieldChanged FromChanged To
1st June 2022Volume (Adults)4 mL3 mL

 Recent changes for MYCOPHENOLATE

Recent changes for MYCOPHENOLATE
DateFieldChanged FromChanged To
7th July 2022Request GroupMPAPRE or MPASPOT or MPA1 or MPA2 etcMPAPRE or MPA1 or MPA2 or MPA4 MISCBIO
Volume (Adults)5 mL3 mL
Minimum/Paediatric Volume1 mL3 mL
Collection & Request Instructions

Collect specimen prior to dose. Record the dosage, date and time of last dose.

 

Sample must be collected on ice.

Requesting doctors must fill in a questionnaire of patient information

https://monashpathology.org/wp-content/uploads/2019/07/Mycophenolic_Acid.pdf

Collect specimen prior to dose. Record the dosage, date and time of last dose

Sample must be collected on ice.

Requesting doctors must fill in a questionnaire of patient information

https://monashpathology.org/wp-content/uploads/2019/07/Mycophenolic_Acid.pdf

Continue to use the Austin form

 Recent changes for PFA 200

Recent changes for PFA 200
DateFieldChanged FromChanged To
1st June 2022Assay namePFA 100PFA 200

 Recent changes for PLATELET AGGREGATION STUDIES

Recent changes for PLATELET AGGREGATION STUDIES
DateFieldChanged FromChanged To
1st June 2022Volume (Adults)null mL
Minimum/Paediatric Volumenull mL

 Recent changes for PYRUVATE

Recent changes for PYRUVATE
DateFieldChanged FromChanged To
26th August 2022Collection & Request InstructionsPrior arrangement with Duty Biochemist. ext 44525. Collect into specially prepared tube. Weigh a 10 mL centrifuge tube to 3 decimal places. Add 1 mL of perchloric acid (1M), to the tube and weigh to 3 decimal places. Chill for 30 minutes before collection. Add 1 mL of whole blood to the tube, mix thoroughly and transport to lab in ice bath. Record the weight of perchloric acid and the weight of blood on the request slip and scan slip.

 Recent changes for PYRUVATE (CSF)

Recent changes for PYRUVATE (CSF)
DateFieldChanged FromChanged To
28th June 2022Volume (Adults)2 mLnull mL
Minimum/Paediatric Volume1 mLnull mL
28th June 2022Collection & Request Instructions

Put into dry ice immediately upon collection. (ie. at site of collection)

 Recent changes for QUANTIFERON-TB GOLD PLUS ASSAY

Recent changes for QUANTIFERON-TB GOLD PLUS ASSAY
DateFieldChanged FromChanged To
11th May 2022Collection & Request Instructions

Requires QuantiFERON-TB Gold Plus Blood Collection Tubes set of four.

Collect 1 mL into each tube. Use black sqaure on label for reference. Refer to photograph for order of draw and volume indication. Mix gently by turning tube end-over end X10 ensuring that the entire inner surface of the tube has been coated in blood.

EMR and MediPATH labels can be adhered to the QGT tubes in ANY order. All 4 x tubes MUST be labelled. Microbiology staff will process the samples according to tube type/colour.

Send to laboratory immediately after collection.

Preferred collection: Monday to Friday between 0900-1600 hours.

Please answer question if patient is immunosuppressed.

If non-MBS then non CMBS test

DO NOT STORE IN FRIDGE BEFORE SENDING

Requires QuantiFERON-TB Gold Plus Blood Collection Tubes set of four.

Collect eactly 1 mL into each tube. Testing cannot be performed if incorrect volume is collected.

Use black sqaure on label for reference. Refer to photograph for order of draw and volume indication. Mix gently by turning tube end-over end X10 ensuring that the entire inner surface of the tube has been coated in blood.

EMR and MediPATH labels can be adhered to the QGT tubes in ANY order. All 4 x tubes MUST be labelled. Microbiology staff will process the samples according to tube type/colour.

Send to laboratory immediately after collection.

Preferred collection: Monday to Friday between 0900-1600 hours.

Please answer question if patient is immunosuppressed.

If non-MBS then non CMBS test

DO NOT STORE IN FRIDGE BEFORE SENDING

 Recent changes for Telomere Length Test

Recent changes for Telomere Length Test
DateFieldChanged FromChanged To
26th August 2022Collection & Request Instructions

Instructions for requesting doctor:

1. This is a sendaway test that must be booked in advance by the requesting doctor with Westmead Laboratory (P: 02 9845 3302). 

2. The requesting doctor must fill Requisition Form  located at: 

 

Instructions for collection staff:

1. Contact Specimen Reception (Ph: 9594 4538) before collecting the sample.

2. Collect sample only on Monday before 10:00am. Do not spin or separate. Keep at room temperature at all times.

 

Instructions for requesting doctor:

1. This is a sendaway test that must be booked in advance by the requesting doctor with Westmead Laboratory (P: 02 9845 3302). 

2. The requesting doctor must fill Requisition Form  located at: 

https://s3.ap-southeast-2.amazonaws.com/cmri-assets/resources/Telomere-Length-Testing-at-CHW.pdf

 

Instructions for collection staff:

1. Contact Specimen Reception (Ph: 9594 4538) before collecting the sample.

2. Collect sample only on Monday before 10:00am. Do not spin or separate. Keep at room temperature at all times.

 

26th August 2022Collection & Request Instructions

Instructions for requesting doctor:

1. This is a sendaway test that must be booked in advance by the requesting doctor with Westmead Laboratory (P: 02 9845 3302). 

2. The requesting doctor must fill Requisition Form  located at: http://www.palms.com.au/clinical/FLOW_FISH_Telomere_request_form_CHW.pdf

 

Instructions for collection staff:

1. Contact Specimen Reception (Ph: 9594 4538) before collecting the sample.

2. Collect sample only on Monday before 10:00am. Do not spin or separate. Keep at room temperature at all times.

 

Instructions for requesting doctor:

1. This is a sendaway test that must be booked in advance by the requesting doctor with Westmead Laboratory (P: 02 9845 3302). 

2. The requesting doctor must fill Requisition Form  located at: 

 

Instructions for collection staff:

1. Contact Specimen Reception (Ph: 9594 4538) before collecting the sample.

2. Collect sample only on Monday before 10:00am. Do not spin or separate. Keep at room temperature at all times.

 

 Recent changes for THIOCYANATE

Recent changes for THIOCYANATE
DateFieldChanged FromChanged To
28th June 2022Optional Container TypeHeparin Plasma (Gel)
Uncontrolled when downloaded or printed.
Date printed: 29th September, 2022 23:41:32