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General
12 “sins” in laboratory testing in mental health
ICD-10 diagnostic codes for laboratory tests
Is it essential to be fasting for lab tests?
Biotin can interfere with many laboratory tests—and lead to serious misdiagnosis
Which laboratory tests should we order?
What laboratory tests should a mental health clinician order and when?
Clinicians’ guide to screening tests in mental health
What should I be doing to monitor patients who are on an antipsychotic?
Which laboratory tests should be done in persons taking valproate/ divalproex (Depakote-ER®)?
Which laboratory tests in persons with first-episode psychosis?
Which laboratory tests in men with erectile dysfunction?
A primer on tests for identifying 2019 novel coronavirus (SARS-CoV-2) infection
Alcohol use: Laboratory tests
How to use laboratory testing for alcohol use
Abstinence from alcohol can be monitored by a urine screening test
Basic metabolic panel (BMP, Chem 7)
Also see: Kidney (Renal) Function Tests
How to calculate the corrected serum calcium
Metabolic acidosis: A primer
How to monitor for possible metabolic acidosis
What is the anion gap and how can we easily calculate it from the lab results?
Complete blood count (CBC)
Why we sometimes specifically order a “CBC with differential”
A primer on the Absolute Neutrophil Count (ANC)
How is beta-thalassemia minor relevant to mental health clinicians?
C-reactive protein
Electrocardiogram (ECG)
When to do an electrocardiogram (ECG or EKG)
How often should we order ECG (EKG) during treatment with a psychotropic medication?
Does this drug cause QT prolongation and torsades?
Antipsychotics and QT prolongation
Antibiotics, antipsychotics, and QT prolongation
Hydroxyzine (Vistaril®, Atarax®) and QTc prolongation
SSRIs and QT prolongation
Can mirtazapine increase the risk of QT prolongation?
Lithium’s effects on the electrocardiogram (ECG, EKG)
Iron studies
Laboratory testing to identify iron deficiency
How to order and interpret iron studies
What is the best single test for checking the body’s iron stores?
Restless Legs Syndrome (RLS) and iron deficiency
Are we missing iron deficiency without anemia?
Management of iron deficiency
Instructions for WHEN and HOW to take iron supplements
How to maximize absorption of iron supplements
How to improve the tolerability of iron supplementation
Which foods are rich in iron?
Iron deficiency, pica, and restless legs syndrome associated with blood donation
Let’s ask about heavy menstrual bleeding
Kidney (renal) function tests
What is the estimated GFR (eGFR)?
What serum creatinine is and why it is important
Factors that can affect serum creatinine
Can creatine supplements lead to “false” elevation in serum creatinine?
Why it is important to longitudinally chart serum creatinine and eGFR values
Another way in which charting serum creatinine values can be helpful
How to know if the BUN and creatinine are elevated due to dehydration
In suspected kidney disease, check the urine albumin-creatinine ratio
24-hour urine for creatinine clearance
How to collect a 24-hour urine sample
Liver (hepatic) function tests
Tips about Hepatic Function Tests
False-positive elevation of plasma ammonia
Valproate (Depakote®) and elevated serum ammonia level (hyperammonemia)
Elevated alkaline phosphatase
Neuroimaging
Pharmacogenetic testing
Serotonin transporter promoter region
Serotonin transporter linked polymorphic region (5-HTTLPR)
5-HTTLPR and efficacy of antidepressants
5-HTTLPR and adverse effects of antidepressants
5-HTTLPR and antidepressant-induced mania
Serotonergic receptors
Serotonin 2A receptor gene (HTR2A) polymorphisms and adverse effects
HTR2C polymorphisms and medication-induced weight gain
Blood-brain barrier/ P-glycoprotein
Cytochrome P450 enzymes
HLA gene testing
Melanocortin 4 receptor (MC4R)
Commercially-available pharmacogenomic tests
(listed alphabetically)
CNSDose® (CNSDose, LLC)
Genecept assay® (Genomind, LLC)
GeneSight® pharmacogenomic test batteries (Assurex Health)
Commercially available pharmacogenomic test panels
Miscellaneous
Prolactin
Serum levels of medications
When to measure serum levels of mood stabilizers
Lithium augmentation in major depressive disorder: How much?
If serum lithium levels vary unexpectedly, consider these possible causes
What is the optimal serum valproic acid (valproate) level?
Lamotrigine level and adverse effects
Oxcarbazepine (Trileptal®): Plasma levels
Thyroid function tests
Urine drug screening
Which urine drug screen do most workplaces require?
False-positive urine drug screen: Principles and a table for reference
Opioids in the urine drug screen
Special tests are needed to identify fentanyl in the urine
Standard urine drug screens can be false-negative for some benzodiazepines
Will zolpidem be detected on a standard urine drug screen?
For how long are substances detected in a urine drug screen (UDS)?
“Fingerprint” metabolites that uniquely identify substances in a urine drug screen
Vitamin levels
Serum folate is not the right test to order
Elevated vitamin B12 levels are common and could be very serious
Miscellaneous
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Can you comment on lab tests to measure inflammation: C-reactive protein (CRP) and other lab markers?