Index of Glossary Terms

A 24-hour urine sample is simply a collection of all urine passed over a 24-hour period of time.

Before Starting a urine collection:

• Read and follow any instructions given to you by your GP or laboratory.
• Speak to your doctor or laboratory if you have any questions
• There may be certain foods you need to avoid before and during the collection period for some tests
• There may be certain medications you need to avoid before and during the collection period, if so, your doctor should have discussed this with you. Don’t stop taking your medication if you have not discussed this with your doctor. Your doctor may prefer to keep you on the medication but interpret the results in light of your medication intake.
• It is usually best to drink your usual volume of water or other beverages (there is normally no need to drink more or less than usual) - if you know you drink and urinate a lot, you may want to ask for an extra collection container.
• You may wish to use a clean, disposable tub with a wide lid to urinate into and then transfer this to the collection bottle provided
• Plan when you do the collection:
  i. It is usually best to start your collection in the morning so you can take the sample to the GP or lab the next day when it is fresh
  ii. you may find it easiest to do this on a day when you can stay at home. However, you may be best to avoid collection on a Friday or Saturday if the GP/ laboratory opening hours mean you cannot take your sample to the lab soon after the collection on Saturday or Sunday
• Acid
  i. For some tests, there may be a known volume of acid in the bottom of the collection container in order to preserve certain substances in the urine that the laboratory will measure
  ii. Follow any specific instruction given with these collection bottles e.g. do not rinse out or touch the acid
  iii. Follow any instructions given in case of spillage of the acid.

How to do a 24-hour urine collection

Note - sometimes, you may be asked to do a shorter or longer collection period, the instructions are just the same as below, only the collection time is changed.

1. Check that your name and other requested details are filed in on the bottle
• When your sample gets to the lab, they will need to know who the test results are for
2. Empty your bladder (go to the toilet and flush away the urine as normal) and record the time e.g. 8 am.
Imagine your bladder is a bucket, to measure the volume of urine produced over 24 hours you need to start with an empty bucket.
3. The next time you need to urinate, collect the urine in the collection container supplied (or transfer it from your own tub)
• This is the first batch of liquid in your bucket and since you recorded the time you emptied your bladder this is the amount of urine produced over that time period
• If you need a bowel movement, any urine passed with the bowel movement should be collected but try not to include faeces with the urine collection.
• Store the urine in a cool, dark place, such as the refrigerator, if possible
4. Continue to collect your urine for the next 24 hours
• You may want to leave a note (or the container) on top of the toilet, so you don’t miss any collections (i.e. flush your urine away), especially if you get up to urinate at night
5. 24 hours later (e.g. at 8 am if that is when you first emptied your bladder), empty your bladder and collect your urine for a final time. Again, record the time you finished the collection.
• This represents the volume of urine produced over that 24-hour period
• Ensure the lid of the container is on securely
6. Take your sample to your GP or lab (depending on where you have been asked to take it) as soon as possible

What happens to the sample when it gets to the laboratory?

1. The urine volume is measured
• Usually the laboratory will weigh your collection container with your 24-hour urine collection in it.
• They will then take a small (e.g. 20 ml) sample for later testing and discard the rest
• They will then measure the empty container and calculate the difference in weight
• 1 ml of water weighs 1 gram so the volume can be easily calculated
2. It depends what the test is for:
• They may measure the pH of the urine
• They may measure the creatinine concentration to see how concentrated/dilute the urine sample is (depends on how much you drank over the collection period)
• They may be able to measure the requested test in the urine quickly (e.g. urine protein)
• They may have to freeze your sample and measure it at a later date if it is a complex test that needs to be performed in a batch
• They may need to freeze your sample and transport it to a specialist laboratory for analysis.
3. Your results will normally be electronically sent to your GP or the doctor who requested the test for you. You can then contact the doctor’s receptionist to request the results or ask to speak to your doctor about the results. Or the doctor may contact you to ask you to make an appointment to discuss the results.

An illness which occurs quickly and doesn't last long.

Sex organs (genitals) that are not distinctly male or female in appearance. It is a condition present at birth (congenital) that results from a disruption in the formation of sex organs during fetal development.

2) The process by which the signal from a detection system is increased so as to improve detection or quantitation of an analyte of interest, such as genes or drugs

3) When there is more than the normal number of copies of a gene or genes in a cell, as in tumor cells, the gene is said to be amplified.

A life threatening, severe allergic reaction which occurs over a short period of time.  Triggers include bee stings and drugs such as penicillin.  Initial symptoms can include hives, wheezing and low blood pressure which can lead to collapse and even death. Patients at risk may be given self-injectable adrenaline for use in an emergency.  This treatment is only a holding measure and an ambulance should be called.

Weakened portion of a blood vessel wall that widens or bulges and may eventually rupture; a ruptured aneurysm can bleed heavily and may be fatal.

Medical procedure used to widen blood vessels that have been narrowed or blocked.  During the procedure, a balloon-tipped catheter is inserted into the body (usually through a small incision in the groin). The catheter is guided to the site of the blockage using X-rays and injected dye. The balloon on the catheter is then gently inflated to flatten the blockage and open the blood vessel.

1. Action of breathing in, especially inhaling an unwanted substance or foreign object
2. Use of suction to take liquids or gases from a body cavity or area, as in aspiration biopsy

Common disease of the arteries in which patches (plaques) consisting mostly of cholesterol and other lipids form on the inner arterial wall. The effect of these deposits is that the vessels become rigid and narrowed, leading to a reduced flow of blood.

Narrowing of arteries in different parts of the body leads to different problems.  If arteries in the heart (coronary arteries) become narrowed it can lead to a heart attack.  If arteries leading to the brain become narrowed, the result can be a stroke.  Atherosclerosis in the legs can lead to problems with ulcers in the feet and toes.

Atherosclerosis is associated with high blood pressure, obesity, diabetes, and some inherited metabolic diseases. In some cases, segments of blocked arteries may be surgically bypassed (as in coronary bypass surgery). Preventive measures include cessation of smoking, a low-fat diet, exercise, and avoidance of stress.

Common disorder of the arteries in which deposits consisting mostly of cholesterol and lipids form on the inner arterial wall. As a result, the vessels become nonelastic and narrowed, leading to decreased blood flow. One of the most important examples is coronary artery disease.

A substance produced by the body, often detectable in body fluids such as blood or urine, that indicates a specific process, condition or disease

A painful, inflamed area of skin with a defined border, collection of pus and a hard central core usually caused by a bacterial infection of a hair follicle and surrounding tissue

The smaller airway passages/branches of the lower respiratory tract

One of the two main branches of the windpipe (trachea) that lead directly to the lungs

1. Tiny blood vessels approximately 0.008 mm in diameter connecting small arteries (arterioles) and small veins (venules). Through the one cell-layer thick walls of capillaries, oxygen and nutrients are passed from arterioles to body tissues, and carbon dioxide and other wastes are passed from body tissues to venules.
2. Any other small, hairlike tube for carrying lymph or other material.

Cardiomyopathy is a general term for diseases of the heart muscle. It is when the walls of the heart chambers have become stretched, thickened or stiff, affecting the heart's ability to pump blood around the body.

1. Person, generally in apparent good health, who harbours organisms that can infect and cause disease in others. Probably the most notorious carrier was Typhoid Mary.
2. Person who has one copy of a recessive disease gene but is not affected themselves.

Cartilage a medical term for gristle.  It is important in lining joints to absorb shock and in producing the shape of body parts such as the ear or nose.

1. long, thin, flexible tube inserted into a body cavity or vessel to allow the passage of fluids
2. thin, flexible tube inserted into a vessel in the body for the purpose of opening (distending) the vessel

An illness which occurs over a long time.

(noun) Cell, group of cells, or organisms that descend from a single cell or organism; clones are genetically identical

(verb) To replicate or produce identical copies

What is it?
The scanner is a doughnut shaped machine that takes x-rays of your body. This test is not performed in a Pathology laboratory but may well be requested at the same time as laboratory tests.

How does it work?
The machine produces a series of narrow beams as it moves through an arc around the body.  The beams are detected after passing through the body.  Beams that pass through dense tissue will be weaker and those that pass through less dense tissue will be stronger.  A detailed picture two dimensional picture can then be produced from these x-rays which is not possible from a simple x-ray.

There is now a relatively new scanner called spiral CT that is quicker and more accurate for many diseases.  The x-ray beam makes a continuous spiral path with no gaps between images.

What is it used for?
Scans can give detailed views of bone, lungs, soft tissue and blood vessels and are commonly used to investigate the head and abdomen.  The brain may be investigated for tumours or bleeding while scans of the abdomen can give information about tumours, tears of organs (following a road accident), or enlarged or inflamed organs.  It is also useful for guiding needles when taking tissue biopsies.

How is it carried out?
The patient must remove all metal objects before lying on a motorised couch that passes through the hole of the machine.  A contrast medium may be given, by mouth, injection or enema, to improve the sharpness of the images.  The patient usually lies on their back but may be asked to lie on their side or front.  You will be asked to lie very still but breathe normally.  After each x-ray the couch will be moved forward a small amount.  The scan lasts from a few minutes to about thirty minutes.

What are the risks?
CT scans are considered very safe and use low amounts of radiation.  They are quick and accurate and eliminate the need for invasive surgery.

Pregnant women should not have a CT scan.  Nursing mothers should wait 24 hours after a scan before resuming breast-feeding.

The contrast media often contain iodine.  Some people are sensitive to iodine and have an allergic reaction.  If you know that you are allergic to iodine or have other allergies you should tell the doctor.  Very rarely the contrast medium can cause kidney damage in patients who already have kidney problems.

A water-soluble form of bilirubin formed in the liver by the chemical addition of sugar molecules to unconjugated bilirubin; when present in the blood, some conjugated bilirubin can become chemically bound to albumin, forming delta-bilirubin (also known as biliprotein).

Form of isolation in which anyone entering the patient's room and having direct contact with the patient wears gloves and a gown.

An autopsy ordered by the Coroner, a legal official responsible for assessing the cause of death in an individual

Crohn's disease is a type of inflammatory bowel disease (IBD) that may affect any segment of the gastrointestinal tract from the mouth to the anus. Symptoms often include abdominal pain, diarrhoea (which may be bloody if inflammation is severe), fever, and weight loss.

A machine for rapidly freezing specimens of tissue

1) a hollow space or fluid-filled cavity surrounded by a distinct lining that develops abnormally in tissue or in an organ in the body, such as "ovarian cyst"

2) a cellular form of a parasite that has a thick cell wall, which allows for survival of the parasite in the environment and transmission into an uninfected host

The living substance within a cell that is located outside of the nucleus; it is a semi-fluid substance consisting of proteins, fat and other molecules

Part of a physical examination performed in order to examine nearby structures (e.g., the prostate in men)

deep vein thrombosis.  This is a clot that occurs in the veins of the legs.  It can occur at times of poor circulation - for instance on long-haul flights.  If the clot travels from the legs it can get lodged in the lung (pulmonary embolism) which may be life-threatening.

Inflammation of the outer layers of the skin. There are three main groups of eczema. Atopic eczema is a broad allergic reaction similar to hay fever and asthma. Seborrhoeic eczema is a life-long condition often described as cradle cap in infants or dandruff in adults. Contact dermatitis occurs after irritation (often from chemical substances) or as a specific allergic reaction (often to metals such as nickel).  The most common treatments are moisturisers and steroid creams/ointments.

Graphic recording, produced by an electrocardiograph, of the electrical activity of the heart. It permits the detection of abnormalities in the transmission of the cardiac impulse through the heart muscle and serves as an important aid in the diagnosis of heart ailments.

Originating in or produced within an organ, tissue, cell or by the body. The term may be used to distinguish between an internal or external source of a substance, such as insulin or testosterone.

External, originating outside of an organ, tissue, cell or the body. It may refer to a substance that is administered to the body, such as exogenous insulin or testosterone.

The body uses feedback systems to control certain functions. A feedback system uses one of the products of a pathway, usually the end product, to control the activity of the pathway and to regulate the amount of that product. Feedback control may be positive or negative.

To understand negative feedback, think of how the thermostat in your house controls the temperature. Let’'s say that the thermostat is set at 70 degrees F (the end product concentration). When the temperature falls below 70 degrees F, the feedback system is triggered and the furnace lights and starts to pump warm air into the house. When the air in the house reaches 70 degrees F, the thermostat shuts off the furnace (no more product made; no more hot air generated). A negative feedback system maintains a '“steady state'” or equilibrium and is the one most commonly found in the body.

Positive feedback systems increase the rate of formation of the product. This tends to cause change in the system rather than maintain a steady state. Think of how when a person works hard and is praised for their efforts (given positive feedback), they work harder still, expecting more praise. There are very few positive feedback systems in the body. One example, however, is lactation. The suckling action of an infant produces prolactin, which leads to milk production; more suckling leads to more prolactin, which in turn leads to more lactation. This is a positive feedback system as the product (milk) produces more suckling and more hormone. When the child is no longer breast feeding, the prolactin drops off and milk production goes down.

The property of some materials to emit light when exposed to radiation or to light of a different colour. The light produced is called fluorescence.

A fluorescent substance is one possessing the property of fluorescence.

A chemical solution (formaldehyde in water) used to harden and preserve tissues prior to staining and microscopic study. One of a number of fixatives used in pathology laboratories.

Type of substance found on the surface of cells, particularly in the brain, that is important in cell-to-cell communication

Process of determining the risk of a particular genetic disorder occurring within a family and providing information and advice based on that determination; used to help couples in family planning and in the care of children affected or thought to be affected with a particular genetic disorder. An accurate diagnosis is essential and may require special biochemical and cell studies; a careful and complete family medical history is also needed. The subjects of prenatal diagnosis, artificial insemination, sterilization, and termination of pregnancy may be included in the counselling, depending on the particular disease and circumstances involved.

Related content
Elsewhere on the web
NHS: Genetic testing and counselling

A group of diseases where the glomerulus in the kidney becomes damaged

An enlarged thyroid gland

Enlargement of breast tissue in the male

A procedure that removes waste substances from the circulating blood; often performed on patients with kidney disease

Rupturing of red blood cells.

A condition in which antibodies in a pregnant woman's blood cross the placenta and destroy her baby's red blood cells; it may develop when the mother and baby have differences in one or more blood group antigens

Abnormal deposition of an iron-containing compound (haemosiderin) in tissues, often associated with diseases in which there is extensive destruction of red blood cells (e.g., thalassaemia).

The stopping of bleeding or the flow of blood

Lower than normal sodium levels in the blood

The body's means of protection against microorganisms and other foreign substances; it is composed of two major parts: the humoral response (B lymphocytes and production of antibodies) and the cell-mediated response (T lymphocytes that attack foreign substances directly).

State of being not susceptible to a particular disease. Immunity may be natural or innate, or it may be acquired during life (e.g., as a result of infection or vaccination).

Having a reduced ability of the immune system to mount a normal response to infection; can be caused by certain conditions, such as HIV infection, or certain drugs, such as chemotherapy agents; can also be induced deliberately by immune-suppressing drugs, such as those used to help prevent rejection of transplanted organs

Time between exposure to an infectious agent, such as a virus, and the onset of symptoms of disease

Death of an area of tissue due to lack of blood supply.  It is often used in the term myocardial infarction (MI) which is the medical term for a heart attack. This occurs when a coronary artery (blood vessel supplying part of the heart) becomes blocked.  An infarct (area of dead tissue) can be very small or very large.

1. Invasion of the body by disease-producing micro-organisms, where they may multiply, causing a disease.
2. Disease caused by micro-organisms (e.g., certain bacteria).

The response of body tissues to injury such as trauma or infection. Inflammation is a complex process that can be localised or systemic.  When localised, it causes pain, heat, swelling and redness of the affected area; when systemic, it may present as a general feeling or malaise with fatigue and fever.

1) A substance that stops, blocks, or slows down the action of an enzyme
2) A substance that stops or impedes a process from taking place in the body

A rare genetic condition in boys and men caused by an extra X chromosome. (Males normally have one X and one Y chromosome.) The presence of the extra X chromosome may or may not produce obvious signs and symptoms (usually in teens and adults), such as low testosterone, small penis and testicles, enlarged breasts, tall stature and/or behavioral, learning, speech or language disabilities. Most of these individuals are infertile.

Protein in the blood whose primary purpose is to transport cholesterol, tryglycerides, and other fats throughout the body

What is it?
The MRI scan is relatively new and uses radio and magnetic waves. This means it does not use X-rays or other forms of damaging radiation. This test is not performed in a Pathology laboratory but may well be requested at the same time as laboratory tests.

How does it work?
The powerful magnet of the instrument affects the body’s hydrogen atoms contained in body water. The hydrogen atoms line up in the magnetic field. Radio waves are then passed through the body and alter the position of some of the hydrogen atoms. When the radio waves are switched off the hydrogen atoms move back to their original position. When they do this they give out small radio waves of their own that are detected by the instrument.  From these radio waves, the MRI instrument is able to produce a detailed picture of the body.  Parts of the body with little water, like bone, show up dark while areas containing a lot of water, like fat, show up bright.  The machine produces cross sectional pictures along the body and can produce pictures at all angles through the body.  Usually two dimensional pictures are taken but it is possible to take three dimensional pictures.  It can show up soft tissues very clearly.

What it is used for?
It is commonly used to look at the brain, spinal cord, pelvis and abdomen, and to investigate injuries to bone, joints and soft tissue.  MRI scans are particularly useful for looking for tumours.

How is it carried out?
MRI scans are usually carried out as an outpatient procedure.  The patient lies in a cylindrical chamber open at both ends.  It is important that all metal containing objects are removed, such as watches, jewellery, belts, studs etc.  Also the doctor needs to know if the patient has any surgical clips in the body or if the patient uses any electrical appliances like an internal hearing aid (cochlea implant) or pacemaker as an MRI scan will not be possible in such cases.  It is important that the patient lies perfectly still during the test.  Movement during the test will make images less clear.  Because of this children may be given an anaesthetic.  Some patients may find the chamber claustrophobic and need to tell the doctor, in advance, if they are anxious about this as the doctor may give a mild sedative.  Sometimes an injection is given of a contrast medium, a substance that helps produce clearer images.  You can have a person sit with you during the test but they also must have no metal objects on their person. The test takes from about half an hour to an hour and a half.

What are the risks?
There are no known side effects to MRI scans.  The test is not painful and cannot be felt.  The machine makes a banging noise that can be unpleasant but the patient is usually offered headphones to help reduce this unpleasantness.  You can even bring in your own music for the radiographer to play through the headphones.  The test can be repeated as radiation is not used.  The test is not carried out in women less than 12 weeks pregnant.

A type of tissue cell found throughout the body but especially in connective tissue such as the skin, lining of the intestine and air passages as well as in the bone marrow. Mast cells contain granules that store chemicals. These chemicals are released as part of the body's normal response to injury but also may be released as part of an allergic response to exposure to an allergen. The chemicals that are released can cause the allergic signs and symptoms.

Abnormal accumulation of mast cells within one or more organs. Mast cells are a type of tissue cell found throughout the body that release chemicals as part of the body's normal response to injury but sometimes as part of an allergic response. Cutaneous mastocytosis is a benign disease of the skin, usually affecting children. Systemic mastocytosis affects mostly adults, who may experience signs and symptoms related to the organs affected such as skin rashes or characteristic red, blistering lesions, peptic ulcers, chronic diarrhea, joint pain or enlargement of the liver, spleen, or lymph nodes. Systemic mastocytosis may progress slowly or may be aggressive, causing organ dysfunction and, in rare cases, causing a form of leukaemia.

Large cells in the bone marrow that produce blood platelets

Abnormal condition in which clones of a single plasma cell or B lymphocyte produce greatly increased amounts of an immunoglobulin molecule; analysis of serum or urine will show a distinct "monoclonal" band, typically in the "gamma" or beta region.

The fatty covering that insulates nerve fibers

Discrete bands observed on an electrophoretic gel as a result of a patient’s sample being analyzed by protein electrophoresis

An epidemic that occurs over a wide geographic area (across continents)

Tumour that causes excess production of epinephrine (adrenaline) and norepinephrine (noradrenaline) and usually occurs in one or both of the adrenal glands but may also occur elsewhere in the abdomen.

The organ that connects a pregnant woman with her developing baby in the uterus; blood from the mother and baby do not mix directly, but a thin membrane within the placenta allows nutrients from the mother to pass to the baby and waste products to pass from the baby to the mother for elimination.

1. Flat, raised patch on the skin or mucous membrane
2. Deposit on the inner arterial walls in atherosclerosis
3. Deposit of saliva and bacteria on teeth that encourages the development of decay (caries)

1. one that comes before or gives rise to another
2. in chemistry, one substance that comes before or gives rise to another often more stable substance

Primary biliary cholangitis (often referred to as primary biliary cirrhosis) is an autoimmune disorder that causes inflammation and scarring of the bile ducts inside the liver, causing continual liver damage and blockage of the bile flow. It is found most frequently in women between the ages of 35 and 60. More than 90% of those affected by primary biliary cirrhosis will have high levels of antimitochondrial antibodies.

1) prediction about the course or outcome of a disease or illness
2) the likelihood of recovery from a disease or illness

The term septicaemia was historically used to describe sepsis with evidence of bacteraemia, but is no longer considered to accurately describe the processes involved.

A metal or plastic device to allow viewing and access to the cervix and vagina

Sticky thick liquid is which is coughed up from the lungs and bronchi. It may contain substances such as mucous, blood, pus and/or bacteria. It is not the saliva that is produced by the glands in the mouth.

The term steroid describes a wide variety of chemicals. When discussed as a treatment it most commonly refers to drugs such as prednisolone or dexamethasone which have powerful anti-inflammatory effects.

A decreased number of platelets in the blood.  Platelets help the body to produce clots and therefore thrombocytopenia can lead to bruising and occasionally bleeding (usually from the gums or as a nosebleed).

Organ located behind the upper breastbone at the base of the neck that is part of the lymphatic and immune systems; disease-fighting white blood cells called T-cells develop and mature in the thymus before entering circulation. The thymus is most active in childhood showing some reduction in immune activity in adults.

(v. translocate) In genetics, movement of one section of a chromosome to a different position on another chromosome resulting in abnormal chromosome structure

Drug used to treat certain types of cancer; it inhibits the action of tyrosine kinase, an enzyme involved in cell growth, thus impeding the growth of cancer cells.

Using sound waves to form an image of organs and tissues within the body

A water insoluble but fat-soluble form of bilirubin that is formed during the initial chemical breakdown of haemoglobin and, while being transported in the blood, is almost entirely bound to albumin.

Main breakdown product of proteins and the form in which nitrogen is excreted from the body in urine.

Development of masculine physical characteristics in a woman