Lab and Diagnostic Terms / Words For Medical Transcriptionists



Section A - Common Laboratory Terms:

WBC , hemoglobin , hematocrit , platelet count , segs , lymphs, eos, monos, bands, basos, retic count.




ESR ,  PT , INR , PTT .


sodium , potassium , chloride , CO2 , BUN , creatinine , glucose , albumin , magnesium, calcium .




alkaline phosphatase , AST , ALT, bilirubin (direct or total).


albumin, protein


amylase, lipase


creatine kinase, CK-MB , MB% , troponin less than 0.3, digoxin level .


ABG , pH , pCO2 , pO2 , bicarb , oxygen saturation on room air.


BNP level


BUN and creatinine


complement C3, complement C4


C-reactive protein or CRP


D-dimer, ESR, GGT


HDL, LDL, triglycerides, cholesterol


IgA, IgG, IgM, IgE


serum iron, TIBC




CD4, CD8




TSH, T3, T4, free T3 and free T4


anion gap, base excess


Urinalysis essentially within normal limits.  specific gravity, wbc's, rbc's, blood, ketones, protein, nitrites, leukocytes, bacteria, squamous epithelial cells, etc. UA by clean catch midstream. Urine beta hCG.


cerebrospinal fluid (CSF) - albumin, cell count, chloride, glucose, IgG, pressure, protein


fecal white blood cell, ova and parasites (O&P), Clostridium difficile toxin (CDT) assay


HIV serology


protein electrophoresis


rapid strep, Monospot, Chem-7, influenza antigen


rheumatoid titers 


(x) sets of cardiac enzymes (where x  =  2, 3, 5, etc)


stool for culture and ova/parasite

Lab Section Transcribed Examples     

Section B - Diagnostic Terms:

Chest x-ray Terms:

chest x-ray reveals: (one of the following below):


congestive heart failure

elevated hemidiaphragms


hilar fullness

hyperexpanded lungs

increased reticular markings


infrahilar mass

patchy infiltrate

pleural effusion


pulmonary congestion

reversible ischemia


Electrocardiogram Terms in Diagnostic Data Section:
12-lead EKG - leads I, II, III, V1, V2, V3, V4, V5, V6, aVF, aVL, aVR, etc.

atrial fibrillation

beats per minute

left axis deviation

nonspecific ST-T wave changes

normal sinus rhythm

Still More Lab Section Examples   

Common types of scans in medical reports:

carotid Doppler scan

CT/CAT scan

DEXA bone scan

GI bleeding scan

HIDA scan

MRI scan

MUGA scan

myocardial perfusion scan

PET scan

SPECT scan

V/Q scan (or ventilation/perfusion scan)

venous duplex scan

Other Diagnostic Terms:
Holter monitor

portable chest x-ray


More Studies or Tests:
24-hour pH study


24-hour urine study


48-hour Bravo pH study


adenosine isotope study


arterial flow study


barium enema study


barium study


bedside swallow study


blood volume study


bone marrow study


brain flow study


CDT study


color flow study


cystogram study


cystometric study


DNA PCR study


Endocapsule study


EP study


esophageal manometry study


esophageal motility study


gastric emptying study


Gastrografin study


HIDA CCK study


HIPA study


intrathecal pump dye study


leak point pressure study


M2A capsule study


mapping study


multigated acquisition study


Myoview study


nerve conduction study


nuclear medicine study


overnight oxygen saturation study


peak flow study


perfusion imaging study


pneumogram study


PSG study


radionuclide shunt study


reflux study


right retrograde ureteropyelogram study


sleep study


small bowel study


STA-MCA bypass study


stool study


stress nuclear study


symptom index study


tagged red cell study


tilt-table study


transesophageal echo with bubble study


transthoracic echocardiogram with bubble study


urodynamic study


video swallow study


visual field study


voiding pressure study