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Introduction to laboratory medicine

Introduction to laboratory medicine. Definition . Laboratory medicine a specialty in which pathologists provide testing of patient samples (usually blood or urine) in several different areas . Determination of the level of enzymes in blood in case of heart attack or

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Introduction to laboratory medicine

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  1. Introduction to laboratory medicine

  2. Definition Laboratory medicine a specialty in which pathologists provide testing of patient samples (usually blood or urine) in several different areas. • Determination of the level of enzymes in blood in case of heart attack or • Level of glucose (sugar) in the blood of a patient with diabetes. • The presence of bacteria and other microorganisms. • Blood cells studies for various types of anemias

  3. Course objectives • application of basic science to those clinical disciplines practiced by the medical laboratory scientist. • the scope of Laboratory Medicine, and of its potential applications. • How to analyze various samples under certain circumstances.

  4. Course contents • Clinical Biochemistry • Cardiac profiles • Liver and renal panels • Bone metabolism • Lipid chemistry • Special chemistry • Cardiovascular markers • Tumour markers • Nutritional markers • Calculi

  5. Immunology and Immunodiagnostics • Drug monitoring • Urine and serum proteins • Autoimmune disease testing • Endocrinology tests • Fertility testing • Point-of-Care Testing • Cardiac markers • Glucose monitoring program • Blood gases and metabolites • Routine chemistry panels • Routine urinalysis and pregnancy screening • Coagulation • Complete Blood Counts • Urine toxicology screening

  6. Laboratory Hematology • Routine and special hematology • Hemoglobinopathy studies • Special stains • Hematopathology • Bone marrow consultations and interpretive report • Flow cytometry • CD 34 (stem cell) enumeration • CD4/CD8 monitoring • Leukemia/lymphoma immunophenotyping • PNH

  7. Special coagulation • Coagulation profiles, screening and factors and inhibitors • Platelet studies • Thrombophilia testing • Microbiology • Bacterial culture and sensitivities • Blood cultures • Molecular typing of organisms • Viral detection methodologies • HIV viral load -public health lab accredited site for viral load • Chlamydia detection

  8. Infection control • Reference centre for medical microbiology and infectious diseases • Detection and typing of epidemiologically significant organisms • Serology • Clostridium difficile toxin testing • Wide range of viral and non-viral serologies • Molecular Diagnostic Testing • Wide range of molecular testing for viral and bacterial agents • Mycology • Fungus detection • Cells/tissues/organ donor testing • Blood Bank/Donor Center • Concepts of immunohematology and histocompatibility • Blood transfusion services and quality assurance • Blood donation and storage of blood • Blood grouping • Compatibility testing

  9. Recommended Books Textbook: District laboratory practice in tropical countries by Monica Cheesbrough. Clinical chemistry by William J Marshall. Reference books: Medical Laboratory technology by RamnikSood.

  10. Reasons for ordering tests • Aid in diagnosis • Confirm diagnosis • Evaluate prognosis • Monitor therapy • Screen for a disease

  11. Sections of the Laboratory CLINICAL PATHOLOGY 1. Clinical Chemistry • BUN • Cholesterol • FBS 2. Clinical Microscopy • Analysis of body fluids • Urin analysis • Fecal anaysis • Semen analysis 3. Microbiology • Cultures (sputum, blood, urine) 4. Hematology Biggest section  Includes CBC,coagulation, PT, PTT 

  12. Blood bank Very critical section Bec. May have errors • Blood typing • Cross match • AB • Identification Goes hand in hand with serology and immunology Tests done for • MALARIA • SYPHILIS • HIV Serology/Immunology • Cardiac and thyroid fxntest II. ANATOMY PATHOLOGY Histopathology  Submission of tissues for tests

  13. Nature of Request STAT • Performed immediate lyandby itself   • Run control and standard • 20-50% More expensive • TAT is shortened • Request is needed Today • confusing • Performed as soon as possible, given priority • Based on “running time” Routine • Done with the batch • Wait for TAT stated by laboratory

  14. Values REFERENCE VALUES • Better term than “normal value” • Pulled value, usually 95%of population • Vary in diff. hospitals but not that far SIGNIFICANT VALUES • Clinical decision should be made if higher or lower than reference value • Usually when 2x to 3x

  15. CRITICAL VALUES • Needs immediate attention • “panic values” • Should call physician • Patient is at risk

  16. Reference Values Not fixed for all Should consider: • Age • Sex • Pregnancy • Diurnal Variation • Race • Blood type

  17. Routine Examinations ROUTINE ADMISSION TESTS CBC, Urinalysis, Fecalysis ROUTINE CHEMISTRIES BUN, Creatinine, Glucose, Uric Acid, Cholesterol Sometimes triglycerides

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