analize medicale cu platĂ din data: -...
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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