Bulletins and Guides


Bulletin or Guide



Anti-CCP (Cyclic citrullinated peptides)
  • Rheumatoid Arthritis (RA) and serologic markers.
  • Rheumatoid factor positive (IgM RF) is not an ideal test in the early detection of Rheumatoid Arthritis (RA).
  • The combination of Anti-CCP and RF tests is now considered to be the ‘gold standard’ in early detection of Rheumatoid Arthritis (RA).
  • This enables about 80% (i.e. 80% sensitivity) of RA patients to be detected in the early phase.
BAP-oma (BAP-1 negative melanocytic tumour)
  • BAP-oma is a recently described melanocytic tumour, characterised by a mutation in the BAP-1 gene.
  • Patients with a germline mutation in BAP-1 are at increased risk of other tumours including cutaneous melanoma, uveal melanoma and mesothelioma.
  • BAP-1negative melanocytic lesions have distinct morphologic features, and BAP-1 loss can be demonstrated by immunohistochemistry.
Biotin interference           
  • Taking high-dose biotin prior to blood collection may cause significant interference with some test results.
  • These are immune-based assays that use biotin-streptavidin in their matrix.
  • The majority of immunoassay tests performed at Sullivan Nicolaides Pathology are unaffected by high-dose biotin.
Blood and body fluid exposures - medical centre incidents
  • Anyone sustaining blood or body fluid exposure (BBFE) is at risk of acquiring a blood borne viral infection such as HIV, HCV and HBV.
  • This provides information on the estimated risks of transmission.
  • Antibody testing, vaccination and follow-up.
BRCA1 and BRCA2 testing - Medicare update for doctors
  • Genetic testing of the genes responsible for familial breast or ovarian cancer is now rebated by Medicare.
  • This gives information on the MBS item numbers (73295, 73296, 73297) and the conditions that apply to them.
  • BRCA1 and BRCA2 are the genes most commonly implicated, but familial mutations in other genes such as STK11, PTEN, CDH1, PALB2, and TP53 can also cause familial breast cancer.
Cervical screening test collection guide
  • ThinPrep® collection instructions for brush, spatula and broom-like devices.
  • ThinPrep® instructions for cervex sampler.
  • ThinPrep®, Pap test cytobrush / spatula protocol.
  • ThinPrep®, Pap Test Rovers®, Cervex-Brush®, Combi device protocol.
Critical results values    
  • Critical values are those results that may indicate a life threatening medical condition and require immediate notification to the referring doctor (irrespective of whether the pathology request was marked urgent).
  • If a result outside the critical limits is obtained, a scientist or pathologist will make every attempt to contact the referring doctor.
  • This guide lists critical results by laboratory department(biochemistry, Haematology/Coagulation, Microbiology/Molecular Pathology, Arterial gases).
Dermatophytes: Focus on dermatophytes
  • Dermatophytes are a group of fungi capable of parasitising keratinised tissue such as skin, hair, and nails due to the presence of a unique enzyme keratinase.
  • This provides a comprehensive overview of testing, results, treatment and management.
Enhanced liver fibrosis (ELF) score
  • An overview of three new non-invasive direct biomarkers of liver fibrosis (most commonly caused by chronic hepatitis B & C, alcohol abuse, and non-alcohol-related steatohepatitis or NASH).
  • Direct blood markers are products of activated hepatic stellate cells (myofibroblasts).
  • SNP uses a panel of the most promising markers, which are incorporated into a calculation, the Enhanced Liver Fibrosis (ELF) score. They are the N-terminal peptide of procollagen III (P3NP/PIIINP), hyaluronic acid and tissue inhibitor of matrix metalloproteinase 1 (TIMP-1).
Fine needle aspirate (FNA) preparationInstructions on preparation for fine needle aspirate (FNA).01-10-2018
Guide to allergy testing
  • Allergic disorders result from an inappropriate, usually IgE-mediated, immune response upon exposure to either environmental or food allergens.
  • Common manifestations of allergy include rhinoconjunctivitis, asthma, eczema, acute urticaria and anaphylaxis. Disorders, such as chronic urticaria, hereditary angioedema and T-cell dermatitis (metal allergy), while clinically similar in some ways, are not IgE-mediated.
  • Allergic disease manifests in different ways through life and the likely causative agents can also change with age.
Medicare Criteria requirements
  • Most tests automatically qualify for a Medicare rebate, however for some tests, certain conditions apply. Some do not qualify for a rebate under any circumstances.
  • This provides information on the Medicare criteria applying to many of the tests. 
Medicare rule 3 exemptions
  • Under certain circumstances, Medicare Australia regulations allow a single signed request form to cover repeat testing.
  • This bulletin details the maximum number of repeat tests allowed.
  • Once the maximum number of tests has been reached, or six months have passed since the initial request, a new request form for repeat testing is required.
Perfluorinated chemical testing - PFAS - PFOS
  • SNP is now testing for perfluoroalkyl substances including perfluorooctane sulphonate (PFOS) and perfluorooctanoic acid (PFOA).
  • This provides an overview of the compounds, sources of contamination and the local experience.
  • Also included is information on how to request testing.
Testing for salmonella: A clean sweep of the broom
  • SNP has discontinued the Widal agglutination test for Salmonella typhi in the diagnosis of typhoid.
  • Two sets of blood cultures (for Salmonella Typhi and Salmonella Paratyphi)are the single-most useful diagnostic procedure for the diagnosis of enteric fever.
  • Other bodily fluids and tissues may yield positive cultures including faeces, urine, and if seeded, bones and joints, liver and gall bladder.
  • Information on what to request.
Understanding the skin pathology report
  • Information on normal skin structures, diagnoses, and a glossary of the commonly used terms in skin pathology reports.