BLOOD CHEMISTRIES Non-fasting Fasting Nothing per oral (NPO) after dinner.

r dinner. Subject is not allowed to eat or drink before the test. Fasting Blood Sugar (FBS) 8 to 12 hours fasting Uric Acid 8 hours fasting Lipid Profile 9 to 12 hours fasting (total cholesterol, triglycerides, HDL, LDL, VLDL) With special preparation BUN - avoid diet high in meat a day before the exam Calcium - avoid calcium supplements for 8-12 hours Magnesium - avoid medicines (antacids, diuretics) with magnesium for 3 days before the exam FECAL OCCULT BLOOD Avoid eating red meat, fish, turnips, horse radish, broccoli, cauliflower, cantaloupe citrus fruits and Vitamin C containing foods 2-3 days prior to the test. Avoid taking aspirin or other anti- inflammatory drugs 7 days prior to test. Clear, wide-mouth bottle should be used. Specimen should not be contaminated with urine, toilet paper or menstrual blood. Collect small amount of stool. Do not overfill container. Do not seal tightly to allow escape of gas. Bring the sample to the laboratory within an hour of collection. SEMEN ANALYSIS URINE Males Bladder should be moderately full. Foreskin should be completely retracted. Tip of the penis should be thoroughly cleansed. Container must be very clean if not sterile. Refrain from sexual activity 2 to 5 days prior to test. Collect sample. Note and record time of collection. Avoid exposure of the sample to direct sunlight or extreme temperatures. Bring the sample to the laboratory within 3 hours of collection. COLLECTION Complete Blood Count BUN, Creatinine Total protein, albumin, globulin Cardiac enzymes (CPK - MB/MM, LDH) Electrolytes (Na, K , Cl, Phosphorous) Immunology Tests (Hepatitis, HIV, etc.) Prostate Specific Antigen Bilirubin (TB, B1, B2) 4 hours fasting

 Collect midstream sample at the clinic facility. Sample should fill at least half of container. Use very clean if not sterile container. Bring sample immediately to the laboratory. Females Urethral opening should be thoroughly cleansed. Lips of vagina should be spread. Collect midstream sample. Sample should fill at least half of the container. Avoid contaminating sample with menstrual blood and vaginal discharge. Use very clean and sterile container. Bring sample immediately to the laboratory.

STOOL COLLECTION Use clear, wide-mouth bottle should be used. Specimen should not be contaminated with urine or toilet paper. Collect small amount of stool. Do not overfill container. Do not seal tightly to allow escape of gas. Bring sample immediately to the laboratory within an hour after collection.

ORAL GLUCOSE TOLERANCE TEST Normal diet for 3 days prior to examination. No intake of alcohol and medicines like corticosteroids, thyroxine, phenytoin and oral contraceptives. Observe fasting for at least 8-10 hours on the night before the procedure. On the following morning, go to the laboratory for blood extraction for baseline fasting blood sugar. After the first blood extraction, drink the oral glucose solution which will be given by the laboratory staff. Blood will again be extracted at 1, 2 and 3 hours after intake of the glucose solution. ORAL GLUCOSE CHALLENGE TEST No fasting is required. Go to the laboratory and drink the oral glucose solution which will be given by the laboratory staff. Blood will be extracted 1 hour after intake of the oral glucose solution for blood sugar determination. SPUTUM COLLECTION Upon waking up, brush teeth and gurgle with water. Take a deep breath then cough out phlegm/ sputum. Spit phlegm/sputum into a clean and covered specimen bottle/plastic container. Bring the specimen to the laboratory within 1 hour of collection. Refrigerate specimen if it cannot be brought to the laboratory immediately. During transport, put the container with the specimen in ice. PROSTATE SPECIFIC ANTIGEN DETERMINATION Refrain from sexual activity for 48 hours. PSA may be released into the serum after sexual intercourse therefore sample should not be drawn within 48 hours after the last ejaculation. Go to the laboratory for blood extraction.

NEISSERIA CULTURE Do not urinate within 1 hour prior to collection of sample. For females, douching should be avoided within 24 hours prior to exam. Requesting physician collects the specimen. ULTRASOUND FOR UPPER ABDOMEN Take light, fat free meal the night before the scheduled examination. Do not smoke, eat or drink anything 8 hours prior to examination and NO BREAKFAST, even milk, coffee or candies Report to Imaging Department on time ULTRASOUND FOR LOWER ABDOMEN No fasting Drink 6-8 glasses of water before the examination Do not urinate or void until after the examination is done Report to the Ultrasound Section with full bladder before examination Inform the Imaging staff if you are pregnant ULTRASOUND FOR WHOLE ABDOMEN Light fat-free evening meal the night before the examination. Nothing by mouth after midnight. No smoking. Avoid eating for 8 to 12 hours before the test to avoid gas buildup in the intestines. Gas could interfere with the evaluation of the kidneys, which lay behind the stomach and intestines. Omit breakfast (If patient still has a laboratory procedure requiring fasting, instruct the patient to go ahead with the laboratory procedure first before taking the last two Disflatyl table). UPPER GI SERIES, BARIUM ENEMA Take light, fat free meal 1 day before the scheduled examination (take only soup, noodles or lugaw) Before bedtime (8 pm) take 30-60 cc of castor oil and two (2) tablets of Dulcolax at 9 pm Nothing by mouth after 12 midnight until the time of examination Do not smoke, eat or drink anything 8 hours prior to examination and NO BREAKFAST, even milk, coffee or candies Report to the Radiology Department on time as instructed TREADMILL STRESS TEST Be at appointed area 15-30 mins before the procedure Take light meal 2 hours before the test (ex. sandwich, no coffee, no chocolates) Wear or bring comfortable clothes, preferrably shorts/jogging pants, T-shirt, and rubber shoes Bring extra towel and shirts TRANSRECTAL Bowel prep the night before the exam; take two (2) tablets of Dulcolax before bedtime Insert one (1) Dulcolax suppository at 4 am Report to the Ultrasound Dept in the morning at least 15 mins before the scheduled time BLOOD EXTRACTION

The collection of blood samples is a standard procedure carefully performed by well-trained medical technologists. Although majority of the patients do not suffer from any side effects, a small percentage may experience some discomfort.

Hematoma A Hematoma or lump accompanied by bruising may occur during the collection of a blood sample. This may be caused by the needle passing through the underside of the vein and blood seeping out of the vein into the surrounding tissue. Although hematoma is a recognized complication of the procedure, it occurs in less than 0.1% of collects. If this happens, you should apply pressure for up to 5 minutes and then apply ice for another 5 minutes. The site may be sore for a few days and bruising may last for about 10 days, but there will be no lasting effects. Bruising A small bruise, which appears at the venipuncture site, is usually due to blood leaking from the hole in the vein into the surrounding tissue. Applying pressure to the affected site immediately after the collection may help prevent bruising. It is important that firm pressure be applied for at least three minutes or longer. Small bruises usually disappear in a few days and do not require medical attention. Fainting If you feel like fainting, inform the attending staff immediately. Stay in the Collection Room until you feel better and if possible, do not drive for at least half an hour. The next time you have a blood test, inform the attending staff that you have a history of fainting, so that he can assist you accordingly. EXECUTIVE CHECK UP PREPARATION Days prior to the exam: Females undergoing Pap smear should schedule their check up between the 10th and 20th day of their menstrual cycle. For ECU package with Fecal Occult Blood: 2-3 days prior to the test, avoid eating red meat, fish, turnips, horse radish, brocolli, cauliflower, cantaloupe, citrus fruits, and food with Vitamin C. Likewise, avoid dark colored food like chocolate and those with food coloring like gelatin, grape juice, etc.) Avoid taking Aspirin and other anti-inflammatory drugs prior to the test. On the day prior to the exam: For females undergoing pap smear, it is recommended by most Gynecologic Oncologist to refrain from sexual intercourse for at least 24 hours before the exam. Have a light and fat free meal the night prior to the scheduled exam. Fast starting 12 midnight (absolutely nothing per oral); light snack (beverage, crackers or sandwich) is allowed at 9:30pm. On the day of the check up: No breakfast in the morning even candies, juice, coffee, milk and smoking must be avoided. Patient must be at the clinic on the scheduled time. Bring jogging pants or shorts, t-shirt (preferably cotton), rubber shoes and bath towel for the treadmill stress test. Bring the stool specimen taken in the morning within an hour before the scheduled exam.

 On arrival at the clinic, look for the Patient Care Coordinator. He/She will assist you in undergoing your check up.