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Alkaline Phosphatase
Alkaline Phosphatase
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Alkaline Phosphatase
Category: Enzymes.
Subcategory: Hepatic enzymes.
Material studied: Blood.
Estimated cost of test: $3.50.
Patient time for test: 5-10 minutes.
Reliability of test results: Good.
Available as home self-test? No.
BEFORE THE TEST
Purpose of test:
Detects and identifies skeletal disease, especially diseases characterized by rapidly growing bone.
Detects liver diseases causing obstructions, such as a tumor* or abscess*.
Assesses response to vitamin D in treating rickets* caused by vitamin-D deficiency.
Where is test performed?
Commercial laboratory, hospital, doctor's office.
Who performs test?
Lab technician, nurse, doctor.
Risks and precautions:
If tourniquet is applied on the arm too long (over 1 minute), it may cause an inaccurate test result. Request another sample to be collected to ensure accuracy.
Patient preparation:
Activity--No changes necessary.
Diet--Don't eat any food or drink any liquid for at least 12 hours before the test.
Medicines--Inform the person performing the test if you have recently taken any medications listed under Taking these drugs may affect test results. You may be asked not to take this medication before the test.
Disrobing--None required. Roll up sleeve only.
THE TEST
Sensory factors:
Touching--You will feel mild discomfort when the needle is inserted into the vein or when the lancet pricks a finger, heel or ear lobe.
Seeing--You will see the technician, nurse or doctor, the basket or tray to hold the equipment, the needles, syringes, collecting tubes and bandages.
Feeling--Some degree of apprehension or fear is normal and should be expected. Discomfort disappears when the test is finished.
Other senses (hearing, smell, taste)--Not affected.
Equipment used:
Needles, syringes and heparinized* collecting tubes. Sterile, disposable equipment prevents contamination or spread of infection. There is no risk of becoming infected with the hepatitis virus, AIDS virus or any other infecting germ.
Description of test:
Technician, doctor or nurse applies a tourniquet or blood-pressure cuff to the upper arm if blood is collected from a vein.
Skin over the vein to be stuck is cleaned with alcohol or other antiseptic on a piece of cotton.
When blood is drawn from a vein, the operator feels the vein to be used then punctures both the skin and vein in one quick stroke. The needle used is a sterile, disposable needle attached to a sterile, disposable syringe.
Operator withdraws the needle and transfers sample from the collecting syringe into sterile tubes (identified with your name) before sending samples to the laboratory for analysis. Tubes are treated with an anti-coagulant chemical to prevent clotting.
If blood is collected from a finger, heel or ear lobe, skin over the selected site is cleaned with an antiseptic. The operator quickly pierces the skin to a shallow depth, using a sterile, disposable metal lancet. The drop or two of blood produced is collected into a capillary pipette.
AFTER THE TEST
Immediate post-test care:
Apply pressure to the puncture site with cotton provided by the laboratory.
If a vein has been punctured, raise your entire arm over your head while applying pressure.
Some discoloration, soreness or swelling may develop at the venepuncture site. This responds well to moist, warm compresses applied every 2 to 4 hours.
Activity after test:
Resume taking any medications that were withheld before the test.
Return to pretest activities right away.
Use warm compresses if blood collects under the puncture site or if the area becomes tender, red or painful.
Time before test results available:
Test requires only a few minutes in the laboratory. Time before results are reported to the doctor or patient varies from a few minutes to a few days.
TEST RESULTS
Test values:
Test results are determined by electrophoresis*, heat activation* and chemical analysis.
Normal values:
Alkaline phosphatase levels measured by chemical inhibition* range from:
Men--90 to 239u/liter.
Women (under age 45)--76 to 196u/liter.
Women (over age 45)--87 to 250u/liter.
Children normally have levels up to 3 times higher than adults.
What HIGH or INCREASED may indicate:
Acute or complete biliary obstruction*.
Deficiency-induced rickets*.
Osteomalacia*.
Extensive bone metastases.
Hyperparathyroidism*.
Paget's disease*.
What LOW or DECREASED may indicate:
Hypophosphatasia*.
Protein deficiency.
Magnesium deficiency.
Taking these drugs may affect test results:
Albumin.
Barbiturates.
Chlorpropamide.
Halothane.
Isoniazid.
Methyldopa.
Oral contraceptives.
Phenothiazines.
Phenytoin.
Rifampin.
Other factors that may affect test results:
Healing long-bone fractures.
Age (infants, children, adolescents, women over 45).
Pregnancy (third trimester).
Failure to fast overnight.
*See Glossary.
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From Complete Guide to Medical Tests by H. Winter Griffith, M.D. Copyright by Fisher Books. Electronic rights by Medical Data Exchange.
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