Dr. Candido Otero, M.D.

The test result take from 1 – 3 days for the final urine culture. Thank you.

A normal lymphocyte range is between 1,000 and 4,800 cells in 1 microliter (µL). of blood. A diagnosis of chronic lymphocytic leukemia requires a lymphocyte level of greater than or equal to 5,000 B cells per µL for a minimum of 3 months. This is called monoclonal lymphocytosis. Monoclonal means that the cancer cells all came from one original cell. A high lymphocyte count can point to infection (bacterial, viral, or other type), cancer of the blood or lymphatic system. Check with a hematology oncologist for treatment. Thank you.

The causes of low white blood cells are cancer treatment, antipsychotic medication, medicine of an overactive thyroid, leukemias, infections (HIV, Hepatitis), autoimmune diseases (rheumatoid arthritis). Low white blood cell means that you son immune system is depressed and unable to combat infection. Also, low white blood cells means that maybe the bone marrow is not producing in off neutrophils or another WBC lineage.
A bone marrow is where the stem cells produce the lineage of cells in blood and in the body. under the lineage of the white blood cells are white blood cells. The following are the different WBCs.
WBC = white blood cells: most of the time indicates that you are fighting infection or inflammation. Normal range is 4,500 to 11,000 WBCs per microliter (4.5 to 11.0 x 109/L). There are three major classifications of WBCs. The main purpose oof WBCs, are to recognize intruders.
1. Monocytes – They have the longer lifespan than other WBCs. They help to break down bacteria.
2. Lymphocytes – They create antibodies to fight against bacteria, viruses, and other invaders to the body.
3. Granulocytes – They kill and digest bacteria, fungi, and many other things. Neutrophils, 4. Eosinophils and Basophils are a subset of granulocytes. Basophils are mainly responsible for allergens. Eosinophils are responsible for parasitic infections.
The WBCs are the defenders of our body. Also, he would like to see if there are immature versus mature ratio of cells produced. Immature cells in the blood stream become non-functional and would not help combating any infection. Thank you.

A group of blood tests called liver function tests can be used to diagnose liver disease.
The most common pediatric liver disease is Nonalcoholic Fetty Liver Disease (NAFLD). Is the most common form of chronic liver disease in children and adolescents. Studies reveal that 5% to 10% of children have NAFLD. The most common causes are hepatitis and other viruses, and alcohol. In very young children. In very young children, cirrhosis is the most often caused by genetic (inherited) liver problem such as biliary atresia. Early symptoms are feeling unwell, tired, loss of appetite, feeling sick, tenderness or pain around the liver, spider angiomas (spider-like small blood capillaries on the skin above the waist), blotchy red palms and disturbed sleep pattern. Liver damage can often be reversed with a well-managed treatment plan. Consult your pediatric. Thank you.

This will depend on the child’s age, medical problems and the tests or procedure. Distraction during the test will calm down the child and no sedation would be needed. Thank you.

The sample is collected with a syringe and small needle. Sent to the laboratory for culture. Thank you.

Urinalysis is a test in the urine. It can detect UTI, Kidney disease, diabetes. Urine culture can detect and identifies specific bacteria and yeast that may be causing the UTI. A urine dipstick may be the only test healthy women with typical UTI symptoms need. The urine is examined under microscope for bacteria or white blood cells which are signs of infection.

No. The only thing that you need to be aware is for what type of test the blood was ordered. If it is because of cholesterol and other specific tests, you need to go fasting. Thank you.

Toxicology is the scientific discipline that study the detection, effects, and mechanism of action of poisons and toxic chemicals. Toxicity is a relative phenomenon that depends on the those and the inherent chemical property of the chemical. Dose response curve are produced in laboratory animals exposed to various amounts of the test substance.
Threshold dose – is the amount to chemical producing a measurable response.
No observed effect level – is the dose lower than the threshold dose.
Ceiling effect – is a plateau that is reached at which the response is no increased.
From this information is possible to stablish the daily threshold limit for the permissible level of occupational exposures. Exogenous chemicals are absorbed after ingestion, inhalation, and skin absorption which is then metabolized in different organs. Chemicals are metabolized to products that are more of less toxic than the parent chemical. The site of toxicity is where metabolism or excretion of toxic metabolites occurs. The absorption distribution of toxicants is exposure, absorption at portal entry, distribution to body, from here there could be excretion of the toxin or metabolism to a more toxic, to a less toxic, or to a conjugate (a totally different product). A metabolism to a more toxic goes to a distribution to interaction with macromolecules (protein, DNA, RNA receptors), which can go two ways, to turnover and repair then excretion, and toxic effects (genetics, carcinogenic, reproductive and immunotoxin). Now the laboratory is governed by several governmental agencies that regulates the laboratory and their strict rule and regulations have to be followed by the laboratory because of possible exposure and contamination. There are several specific OSHA standards that apply to laboratories as well as other OSHA standards that apply to various specific aspects of laboratory activities. The occupational exposure to Hazardous Chemicals in Laboratories standards (29 CFR 1910.1450) was created for non-production laboratories. These standards were developed to address workplaces where relatively small quantities of hazardous chemicals are used on a non-production botany. The purpose of OSHA’s laboratory standards (29 CFR 1910.1450) to ensure that workers in the workplace are protected from those chemicals. OSHA every year inspect the laboratory for compliance. No going back to your initial question. If your husband present with symptoms or if you feel that it is necessary, please contact an occupational physician to help you. Thank you.

Chronic obstructive pulmonary disease (COPD), and sleep apnea are two common conditions associated with hypercapnia (high CO2). Dehydration can cause increase CO2. Also, another cause is hypoxemia (low level of oxygen in blood). In children causes are many and they are kidney diseases, lung diseases, metabolic conditions like diabetes. When we do arterial blood gases, is a very precise procedures, however, talk to your doctor to repeat the test, he will do it. Thank you.

Depending at what stage and what type of anemia you get. It is a very serious disease. Usually the patient feels tired, fatigue, sometimes unable to do their daily living activity. The complete blood count (CBC) is the most common test used to confirm anemia. It is part of the routine tests done. The complete CBC test the hemoglobin and hematocrit. The hemoglobin is the iron-rich protein part in the red blood cell that carries the oxygen. The hematocrit is a measure how much space the red blood cells take up in your blood. Low level of hemoglobin or hematocrit signify anemia. Everything has to do with the type of anemia and how it was acquired. For example, iron deficiency anemia due to blood loss or due to lack of nutrients, can be corrected by stopping the blood loss and eating food that are reach in iron. Diet: beans, dried fruits, eggs, lean red meat, salmon, iron-fortified bread and cereal, peas, tofu, dark green leafy vegetables (Spanish cucumber, broccoli) among others. No, anemia due to hereditary condition, the etiology (cause) of that condition needs to be assessed to find the right treatment. Severe anemia could be very serious. Loosing blood quickly can be fatal. The three main causes are red blood cell loss, lack of red blood production in the bone marrow or red cell destruction by the immune system. A hematologist would be a great choice. They will send the test to the lab. For analysis. But a complete work up is appropriate to find the etiology of the anemia. Thank you.

Blood test can detect signs of hepatitis B virus in your body and tell your provider whether is acute or chronic. Detection of Hepatitis B surface antigen (HBsAg), or core antigen (HBcAg) in liver tissue by immunohistochemical staining and of HBV DNA by Southern Hybridization, in situ. HBV was originally called serum hepatitis. Hepatitis B virus plays an important role in hepatocellular carcinoma. HBsAg is a marker that appears before symptoms and is a marker of active infection. IgM anti-HBc is usually the first antibody to appear. HBeAg, HBV DNA appear soon after HBsAg and it may indicate persistence or progression. Consult your healthcare provider.
The tests are Hepatitis C (HCV) antibody test, RNA, or viral load test, polymerase chain reaction (PCR) test. Most people believe that because they had a blood test, they are going to be tested automatically for hepatitis B, and C. No, you are not tested for hepatitis as part of a routine blood test. It must be ordered by you physician. High viral load, which is usually greater than 800,000 IU/L (international units per liter or low viral load which is less than 800,000 IU/L. Your liver enzymes, (normal liver Enzymes are Aspartate Transferase (AST), 10 to 40 units per liters (u/L), and Alanine Transferase (ALT), 7 to 56 units per liters (u/L). The normal range to Gamma Glutamyl Transferase GGT is 9 to 48 U/L Then, Alkaline phosphatase (ALP), 30 to 120 IU/L, will be elevated.
Hepatitis C is treated with direct-acting antiviral (DAA) medications. Your doctor will determine the hepatitis C genotype for a specific medication. About 75% of American are genotype 1a or 1b according to the American Liver Foundation. Thank you.

High hemoglobin level most often causes by low oxygen (O2) level (hypoxia). Common reasons include bone marrow disease that causes abnormal increase in red blood cells (polycythemia vera) congenital heart disease, cancer, lung disease, kidney disease, and liver disease. Things that could help you are drinking plenty of water (dehydration), quitting smoking, stopping the consumption of iron-containing multivitamins. Consult an endocrinologist or your healthcare provider. Thank you.

Yes, the fact that her urine was dark, your dr. wants to rule out blood in the urine.
Urinalysis is a test of your urine. It can detect UTI, Kidney disease, diabetes. Urine culture can detect and identifies specific bacteria and yeast that may be causing the UTI. A urine dipstick may be the only test healthy women with typical UTI symptoms need. The urine is examined under microscope for bacteria or white blood cells which are signs of infection. Thank you.

That’s depend on the biopsy. We look at the prepared tissue in the microscope. Check the cells and identify atypical or malignant cells. The report usually says whet we see in the microscope. Blood test is more automated, however, any abnormality, the pathologist looks at them in the microscope and render a diagnosis. Thank you.

No, we help the surgeon in the process doing frozen section of the tissue before the surgeon have finished the surgical procedure. At that moment we give the surgeon a preliminary diagnosis and check for the margins of the specimen to see if they are compromised so the surgeon can go back and cut more until the margin are free of cancer. Thank you.

Simple X-rays can identify only the calcified gallstones, only 10% of cases. Other test is ultrasound scan, MRI scan, cholangiography, and CT scan. Blood tests may include liver tests, which are blood tests that show evidence of gallbladder disease. Also, blood test for lipase and amylase, look for information of the pancreas. Thank you.

The PTH test measures the parathyroid hormones. The most common test is a serum calcium test. An elevated value suggests the presence or a parathyroid tumor or hyperplasia. Blood tests are most effective in determining the type of hyperparathyroidism. Thank you.

A pathologist is the one who tells the doctor, clinicians (pediatric, internal medicine, surgeon, urologist, dermatologist and so on), the diagnosis of whatever is taking out of your body (blood, urine, organs, biopsies etc.), tell them the differential diagnosis of what was encountered. A pathologist study or go to a residency program, after medical school for five years, and most pathologists study one or two additional fellowships before practicing pathology. A pediatric pathologist is a pathologist who after the five years pathology residency, he or she did one year fellowship in pediatric (kids) pathology. For example, I did two additional fellowships (Cytopathology and Oncological Surgical Pathology). The pathologist is the doctor behind the doctors. We are the dr. of doctors. Pathology is divided in two main branches, clinical pathology (body fluids), and anatomical pathology (body parts). There are many subspecialties within the specialty of pathology. Thank you.

The majority of ophthalmic pathologists are board-certified ophthalmologists who have done additional fellowship training in ophthalmic pathology. The pathologist also do ophthalmic pathology. Thank you.