ANALIZE MEDICALE CU PLATĂ Din data: -...

ol

Estradiol

FSH - Hormon foliculos t

Hormon de crestere (hGH)

Intact Parathormon (Intact PTH)

LH - Hormon luteinizant

Progesteron

Pr

Testosteron liber

Testosteron total

37

38

33

46

45

35

32

35

55

40

Hormoni

Medic trimițător:.......................................Telefon:.....................................Semnatura................................

ANALIZE MEDICALE CU PLATĂ Din data:___/___/_______

PacientNume:................................................Prenume: ............................................ Data nașterii ___/__/__ Sex____CNP: ............................................ cu domiciliul în: ..............................,localitatea:.........................................Str.: ..............................................., Nr................., Tel:.............................., e-mail:...........................................

Diagnostic prezumtiv/Comentarii clinice:.....................................................................................................................................................................................................................................................................................

APTT

Determinare grup sangvin 0AB

Determinare Rh

Ex. citologic al fr

Fibrinogen

Hemoleucograma completa

INR

Timp de protrombina

VSH

Hematologie13

12

15

15

16

17

11

11

6

BiochimieAcid uric

Albumina

Amilaza

Aspartataminotransferaza (AST/GOT)

Alaninaminotransferaza (ALT/GPT)

Bilirubina directa

Bilirubina indirecta

Bilirubina totala

Calciu ionic

Calciu total

Clor

Colesterol total

Colesterol HDL

Colesterol LDL

Colesterol VLDL

Complement seric C3

Complement seric C4

Crea

Crea fosfokinaza(CK)

Crea a MB (CK - MB)

Electroforeza hemoglobinei

Electroforeza lipoproteinelor

Electroforeza proteinelor serice

Fier

8

9

15

8

8

8

8

8

9

9

10

10

12

9

8

24

25

9

15

84

33

30

19

10

Examen complet urina

(strip + sediment)

Glucoza urinara

Proteine urinare

19

8

8

Fosfataza alcalina

Fosfor

Glucoza

Gamma glutamiltransferaza(Gama GT)

Hemoglobina glicozilata (Hb A1c)

Imunoglobulina A

Imunoglobulina G

Imunoglobulina M

Lactatdehidrogenaza (LDH)

Lipaza

Lipide totale

Magneziu

Potasiu

Proteine totale

Sodiu

Trigliceride

Uree

10

11

9

8

40

22

22

22

10

27

8

9

11

8

11

10

9

Biochimie urinara

Tiroida

ATPO - An oidperoxidaza

An orpi an oglobulina

FT3 - T onina libera

FT4 - Tiroxina libera

T3 - T oidina

T4 - Tiroxina

TSH - Hormon de s oidiana

42

46

33

33

33

33

31

Markeri TumoraliAFP (alfa fetoproteina)

CA 125 (cancer ovarian)

CA 15-3 (cancer san)

CA 19-9 (cancer gastrointes

CA 72-4 (cancer gastric)

Calcitonina

CEA (an en carcinoembrionar)

NSE

PSA

PSA liber

Sangtec 100 (melanom + AVC)

50

44

44

47

64

57

45

63

35

35

165

Markeri Virali

An orpi an HAV Ig G

An orpi an HAV Ig M

An orpi an

An orpi an

An orpi an Ig G

An orpi an HCV - calita

50

42

55

44

38

25

Pachet screening 59Pachet TORCH 250Pachet mamici 59

Pachet inf 59Pachet markeri tumorali 250Pachet profil PSA 59

Pachet mark oida 69Pachet markeri f ate 159Pachet microbiologie 19/34

An�corpi an� HDV

An�corpi an� HIV 1+2

An�gen Hbe

An�gen Hbs

An�gen HBs (Ag HBs) calita�v

60

35

44

135

25

Markeri Infectiosi

An�corpi Chlamydia trachoma�s-IgA

An�corpi Chlamydia trachoma�s-IgG

Ac. An� Listeria

monocytogenes - serologie

50

50

71

Imunologie

ASLO (An�streptolizina O)

ASLO (Titrat)

Factor reumatoid

Proteina C reac�va

RPR Carbon

TPHA

An�corpi an� Herpes

Simplex Virus 1+2 Ig G

An�corpi an� Herpes

Simplex Virus 1+2 Ig M

An�corpi an� Toxoplasma

gondii Ig G

An�corpi an� Toxoplasma

gondii Ig M

An�corpi an�virus rubeolic Ig G

An�corpi an�virus rubeolic Ig M

CMV Ig G (Citomegalovirus)

CMV Ig M (Citomegalovirus)

7

18

8

8

10

14

40

49

42

42

43

43

45

56

Ac. an� pep�d ciclic citrulinat

Ac. an� virus Epstein Barr EA Ig G

Ac. an� virus Epstein Barr EA Ig M

An�corpi an� ADN dublu catenar

An�corpi an� cardiolipina Ig G

An�corpi an� cardiolipina Ig M

An�corpi an� fosfolipide Ig G

An�corpi an� fosfolipide Ig M

An�corpi an� gliadina Ig A

An�corpi an� gliadina Ig G

An�corpi an� Helicobacter pylori

An�corpi an�nucleari - depistaj

An�corpi an�nucleari - �trare

Feri�na

70

58

55

78

59

59

57

57

57

57

20

45

67

36

Analize de Sarcina

Beta HCG -

Beta Gonadotropina corionica umana

Bitest (10 – 13 sapt.)

(Free Beta HCG, PAPP-A)*

Triplu test (15 – 21 sapt.)

(AFP, Beta HCG, Free Estriol)*

40

170

130

An�gen Chlamydia trachoma�s

(recoltare din colul uterin)

An�gen Giardia

An�gen Helicobacter pylori

Coprocultura (include an�biograma)

Cultura colec�e purulenta

Bacteriologie

Cultura col uterin

Cultura exudat faringian (include an�biograma)

Cultura exudat nazal (include an�biograma)

Cultura fungi

Cultura micoplasme urogenitale

Cultura secre�e conjunc�vala

Cultura secre�e vaginala (include an�biograma)

Cultura secre�e endocervicala

pentru streptococ de grup B

Cultura secre�e o�ca (include an�biograma)

Determinare Candida spp.

(exudat faringian)

Determinare Candida spp.

(secre�e vaginala)

Ex.microscopic secre�e vaginala

Mycoplasma + Ureaplasma

Spermocultura

Urocultura (include an�biograma)

Ex.coproparazitologic (proba 1)

Ex.coproparazitologic (proba 2)

Ex.coproparazitologic (proba 3)

Toxocara canis Ig G

Toxocara canis Ig M

Parazitologie

Examen Citologic

in mediu uscat (PAP-test)Babes-Papanicolau

Examen Citologic

in mediu lichid (PAP-test)

Citologie

65

59

32

11

11

11

45

45

51

80

Alte analize medicale: ....................................................................................................................................

..........................................................................................................................................................................

..........................................................................................................................................................................Recoltarea probelor biologice s-a efectuat în urmatoarele recipiente : Produsul biologic recoltat Produsul biologic autorecoltat vacutainere rosii coprocultoare vacutainere mov urocultoare vacutainere albastre alte recipiente vacutainere negre vacutainere galbene alte recipienteProbele sunt prelevate de: Starea probelor prelevate :....................................................................................................................................................Data/Ora recoltării ..................................

Am luat la cunoştinţă riscurile şi eventualele efecte adverse ale acestor proceduri, acestea mi-au fost aduse la cunoştinţă de personalul medical din unitate.

Am luat la cunoştinţă Data

40

15

40

17

92

59

35

37

59

83

59

50

30

38

20

35

59