Laboratory Tests for Patient Evaluation
For a comprehensive patient evaluation, laboratory testing should include complete blood count, urinalysis, serum electrolytes, blood urea nitrogen, serum creatinine, glucose, lipid profile, liver function tests, iron studies, and thyroid-stimulating hormone. 1
Core Laboratory Tests for Initial Patient Assessment
Basic Testing (First-Line)
- Complete blood count (CBC) with differential
- Comprehensive metabolic panel including:
- Serum electrolytes (sodium, potassium, calcium, magnesium)
- Blood urea nitrogen (BUN)
- Serum creatinine with estimated glomerular filtration rate (eGFR)
- Glucose
- Liver function tests (AST, ALT, alkaline phosphatase, bilirubin)
- Lipid profile
- Thyroid-stimulating hormone (TSH)
- Urinalysis
- Electrocardiogram (ECG)
The American College of Cardiology/American Heart Association guidelines strongly recommend this comprehensive panel of tests for initial patient evaluation to assess organ function, identify comorbidities, and establish baseline values 1.
Condition-Specific Additional Testing
Cardiovascular Assessment
- Additional cardiac biomarkers if cardiac disease suspected:
- Troponin
- BNP/NT-proBNP (for heart failure)
- Orthostatic blood pressure measurements to assess volume status 2
Hematologic Evaluation
- Iron studies (serum iron, ferritin, transferrin saturation) 1
- If eosinophilia present: serum tryptase, vitamin B12 levels 1
Autoimmune Disease Workup
For patients with suspected autoimmune conditions:
- Erythrocyte sedimentation rate (ESR)
- C-reactive protein (CRP)
- Autoantibody panel as indicated:
- ANA, anti-dsDNA, anti-Ro, anti-La, anti-RNP, anti-Sm, anti-phospholipid antibodies
- Complement levels (C3, C4) 1
Endocrine Assessment
- HbA1c for diabetes screening/monitoring
- Additional thyroid function tests (T3, T4) if TSH abnormal
Special Considerations
Secondary Hypertension Workup
For patients with suspected secondary hypertension, consider:
- Aldosterone-to-renin ratio
- 24-hour urinary metanephrines (for pheochromocytoma)
- Sleep study (for obstructive sleep apnea) 1
Kidney Disease Evaluation
For patients with abnormal urinalysis or elevated creatinine:
- Urine protein/creatinine ratio
- Urine microscopy
- Renal ultrasound 1
Neurological/Cognitive Assessment
For patients with cognitive concerns:
- Vitamin B12 levels
- Folate levels
- Syphilis serology
- HIV testing (if risk factors present) 1
Monitoring Recommendations
Laboratory tests should be repeated based on:
- Clinical condition changes
- Medication adjustments (especially diuretics, RAS blockers)
- Disease-specific monitoring protocols
For patients with stable chronic conditions, laboratory monitoring every 6-12 months is generally appropriate 1.
Important Caveats
- Laboratory results must always be interpreted in clinical context
- Abnormal results should prompt appropriate follow-up testing
- Consider preanalytical factors that may affect results (timing, fasting status, medications)
- Cost-effectiveness should be considered when ordering extensive panels
The comprehensive approach outlined above ensures thorough evaluation of organ systems and establishes baseline values for future comparison, supporting early detection of disease and optimal management of existing conditions.