Bulletins and Guides


Bulletin or Guide



AMH fertility test
  • The anti-Mullerian Hormone (AMH) is the best single pathology test available for assessing a woman's egg reserve.
  • AMH reference graph - AMH vs Age.
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.
Blood culture collections
  • Procedure for the collection of blood culture bottles.
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.
Cardiology Services
  • Information on the cardiology services offered by SNP
  • Ambulatory blood pressure monitoring
  • Holter monitoring
  • Resting electrocardiographs (ECGs)
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.
CFTR gene testing - Medicare update for doctors
  • Information about changes to the Medicare rebates for CFTR gene testing from July 1, 2018.
CFTR gene testing - Flow chart for Medicare rebate
  • This leaflet outlines the clinical situations in which genetic testing for cystic fibrosis mutations is rebated by Medicare or requires a private payment.
Chlamydia and gonorrhoea testing: 
Self collections
  • Illustrated information for patient self collection of chlamydia and gonorrhoea samples.
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).
Dysplastic naevi - the controversy continues
  • The entity ‘mildly dysplastic naevus’ has been removed from the World Health Organisation’s classification of dysplastic naevi.
  • Dysplastic naevi are now to be graded as ‘low grade dysplastic naevus’ (previous moderately dysplastic naevus) or ‘high grade dysplastic naevus’ (previous severely dysplastic naevus).
  • Current data suggest no further treatment is necessary for dysplastic naevi with low grade dysplasia (previous moderately dysplastic naevi) in which there are clear histologic margins and no pigment evident clinically (unless there was a high level of pre-biopsy clinical concern).
  • Re-excision with a 2-5mm clinical clearance is recommended for high grade dysplastic naevi (previous severely dysplastic naevi) with involved histologic margins.
  • There is growing evidence that observation may be reasonable for low grade dysplastic naevi (previous moderately dysplastic naevi) with histologically involved margins, if they were excised with clinically clear margins and no residual clinical pigment is observed. More data may be required before this is accepted into clinical practice.
  • There does not appear to be a clear consensus regarding whether high grade dysplastic (previous severely dysplastic) naevi require re-excision if completely excised with clear margins, albeit less than 2mm.
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).
Expanded reproductive carrier screening
  • What expanded reproductive carrier screening is.
  • The disorders that are detected by testing.
  • How the results are presented.
  • What support is offered to patients and doctors.
  • The costs involved.
  • And, much more.
Fine needle aspirate (FNA) preparation
  • Instructions on preparation for fine needle aspirates (FNA).
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.
Helicobacter pylori: Its new superbug status demands a paradigm shift in therapy 
  • Helicobacter pylori, the aetiological agent for some non-ulcer dyspepsia, peptic ulcer disease, gastric MALT lymphoma and gastric cancer has attained superbug status.
  • In February 2017, it was listed as a high priority organism by the World Health Organisation.
  • How has the situation arisen.
  • Some of the key points that have arisen from a re-examination of the guidelines.
Hereditary spherocytosis Eosin-5-Maleimide test
  • Hereditary Spherocytosis (HS) is covered within in this bulletin.
  • Topics such as what is is, principles of the test and clinical applications are explained.
HPV/CST patient self-collect testing
  • Sonic Healthcare now has an accredited facility for testing.
  • Criteria for offering the self-collected HPV testing.
  • Information on collecting the sample.
  • Screening pathway for self-collected samples.
How Much human ringworm is zoophilic?A bulletin with focus on characterizing and comparing zoophilic with non-zoophilic dermatophyte human infections isolated at Sullivan Nicolaides Pathology (SNP) for the year 2013.2016-09-01
Investigating acute diarrhoea
  • Each Australian suffers on average a bout of foodborne diarrhoeal illness every five years.
  • This bulletin includes flowcharts that provide information to assits in identifying acute diarrhoea, therapies and testing options available.
  • Included is important information to consider when treating and testing for acute diarrhoea.
Lactose intolerance
and genetic testing
  • Lactose intolerance affects approximately 75% of the population.
  • Genetic testing can confirm lactose tolerance (also referred to as lactase persistence).
  • What causes lactose intolerance?
  • Who is affected by lactose intolerance?
  • Information for arranging a test.
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.
National Bowel Screening
Program - online with Sonic Dx
  • Information on how to access results from the National Bowel Screening Program via Sonic Dx.
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.
Platelet function analysis (PFA)
  • Information about the PFA-100 test
  • Principles of the test.
  • Clinical applications
Rheumatic and connective tissue diseases
  • Investigations into rheumatic and connective tissue diseases.
  • Comments on antibodies. 
  • Other useful test including lupus anticoagulant and anticardiolioin antibodies, HLA B27, complements,  anti-neutrophil cytoplasmic antibodies.
Souvenirs your skin brings home - cases from exotic places
  • In this bulletin cases from exotic places are discussed including the cause, diagnosis and treatment.
Swab Guide 2019
  • General information and illustrations of commonly used swabs.
  • Which swab/s to use for what test, site or application.
  • Preparation and information on collection.
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.
Testing for inherited thrombophilia
  • Thrombophilia is discussed including suggested tests for ivestigation, Medicare requirements and general information.
Trichophyton verrucosum - An uncommon zoophilic dermatophyte infection
  • A bulletin reviewing cases of T. verrucosum infection diagnosed at Sullivan Nicolaides Pathology (SNP) over the past 5 years(<2014).
Tumor marker - HE4 and CA125 in ovarian cancer detection
  • In this bulletin it is discussed HE4 and CA125 tumour markers used in the detection of ovarian cancer.
Understanding the skin pathology report
  • Information on normal skin structures, diagnoses, and a glossary of the commonly used terms in skin pathology reports.
Understanding the melanoma report
  • Information for understanding melanoma reports including classifications, interpretations and explanation of terminology used.