Recommendations when to order or not order the test. May include related or preferred tests. Initial test for the diagnosis and monitoring of neuroblastoma. Should be ordered concurrently with Homovanillic Acid (HVA), Urine (0080422). Unique test identifier. VMA U Process(es) used to perform the test. Quantitative High Performance Liquid Chromatography-Tandem Mass Spectrometry Days of the week the test is performed.
Sun, Tue-Sat Expected turnaround time for a result, beginning when ARUP has received the specimen. 1-4 days Indicates test has been approved by the New York State Department of Health. This test is New York DOH approved.
Patient Preparation Abstain from medications for 72 hours prior to collection. Collect 24-hour or random urine. Refrigerate 24-hour specimens during collection. Specimen Preparation Transfer 4 mL aliquot from a well-mixed 24-hour or random collection to an ARUP Standard Transport Tube. (Min: 1 mL) Record total volume and collection time interval on transport tube and test request form. Storage/Transport Temperature Refrigerated.
Unacceptable Conditions Specimen types other than urine. Stability Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 2 weeks Normal range/expected value(s) for a specific disease state. May also include abnormal ranges.
Interpretive DataBackground information for test. May include disease information, patient result explanation, recommendations, details of testing, associated diseases, explanation of possible patient results. Vanillylmandelic acid (VMA) results are expressed as a ratio to creatinine excretion (mg/g CRT). No reference interval is available for results reported in units of mg/L. Slight or moderate increases in catecholamine metabolites may be due to extreme anxiety, essential hypertension, intense physical exercise, or drug interactions. Significant increase of one or more catecholamine metabolites (several times the upper reference limit) is associated with an increased probability of a secreting neuroendocrine tumor. Per 24h calculations are provided to aid interpretation for collections with a duration of 24 hours and an average daily urine volume. For specimens with notable deviations in collection time or volume, ratios of analytes to a corresponding urine creatinine concentration may assist in result interpretation. This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes. Compliance Category Laboratory Developed Test (LDT) NoteAdditional information related to the test. Moderately elevated VMA (vanillylmandelic acid) can be caused by a variety of factors such as essential hypertension, intense anxiety, intense physical exercise, and numerous drug interactions (including some over-the-counter medications and herbal products). Medications that may interfere with catecholamines and their metabolites include amphetamines and amphetamine-like compounds, appetite suppressants, bromocriptine, buspirone, caffeine, chlorpromazine, clonidine, disulfiram, diuretics (in doses sufficient to deplete sodium), epinephrine, glucagon, guanethidine, histamine, hydrazine derivatives, imipramine, levodopa (L-dopa, Sinemet®), lithium, MAO inhibitors, melatonin, methyldopa (Aldomet®), morphine, nitroglycerin, nose drops, propafenone (Rythmol), radiographic agents, rauwolfia alkaloids (Reserpine), tricyclic antidepressants, and vasodilators. The effects of some drugs on catecholamine metabolite results may not be predictable. CPT CodesThe American Medical Association Current Procedural Terminology (CPT) codes published in ARUP's Laboratory Test Directory are provided for informational purposes only. The codes reflect our interpretation of CPT coding requirements based upon AMA guidelines published annually. 84585 ComponentsComponents of test
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map. AliasesOther names that describe the test. Synonyms.
Vanillylmandelic Acid (VMA), Urine Which client instruction is important when the client is scheduled for a Vanillylmandelic acid?The patient should avoid self-prescribed medications (especially aspirin) and prescribed medications (especially pyridoxine, levodopa, amoxicillin, carbidopa, reserpine, and disulfiram) for 2 wk before testing and as directed. The patient should avoid excessive exercise and stress during the 24-hr collection of urine.
Which laboratory values should the nurse expect in a patient with diabetic ketoacidosis?Diabetic ketoacidosis is typically characterized by hyperglycemia over 250 mg/dL, a bicarbonate level less than 18 mEq/L, and a pH less than 7.30, with ketonemia and ketonuria.
Which laboratory test is most important for the nurse to monitor to determine how effectively the client's diabetes is being managed?HbA1C (A1C or glycosylated hemoglobin test)
The A1C test can diagnose prediabetes and diabetes. It measures your average blood glucose control for the past two to three months.
Which findings should the nurse expect in a patient with hyperosmolar hyperglycemic state HHS )?Common signs and symptoms include profound thirst (polydipsia) and diuresis (polyuria), along with mental status or other neurologic changes. Frequent nausea, vomiting, weakness, and weight loss also may occur with HHS onset. Other findings may include poor skin turgor, tachycardia, and hypotension.
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Which client instruction is important when the client is scheduled for a Vanillylmandelic acid test?
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