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Presentation on theme: "Introduction to laboratory medicine"— Presentation transcript:
Slide1
Introduction to laboratory medicine
Slide2
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
Slide3
Course contents
Clinical Biochemistry
Cardiac profiles
Liver and renal panels
Bone metabolism
Lipid chemistry
Special chemistry
Cardiovascular markers
Tumour
markers
Nutritional markers
Calculi
Slide4
Immunology and ImmunodiagnosticsDrug 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
Slide5
Laboratory HematologyRoutine and special hematology
Hemoglobinopathy
studies
Special stains
Hematopathology
Bone marrow consultations and interpretive
report
Special coagulation
Coagulation profiles, screening and factors and inhibitors
Platelet studies
Thrombophilia
testing
Slide6
MicrobiologyInfection control
Reference centre for medical microbiology and infectious diseases
Detection and typing of epidemiologically significant
organisms
Molecular Diagnostic 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
Slide7
Recommended Books
Textbook
:
Clinical biochemistry an illustrated color atlas
by Allan
Gaw
District laboratory practice in tropical countries
by Monica
Cheesbrough
.
Clinical chemistry
by William J Marshall.
Reference books:
Medical Laboratory technology
by
Ramnik
Sood
.
Slide8
Reasons for ordering tests
Confirm diagnosis
Aid
in
diagnosis
Evaluate prognosis
Monitor therapy
Screen for a
disease
Slide9
Sections of the Laboratory
CLINICAL PATHOLOGY
1. Clinical Chemistry
Liver profile
Lipid profile
Glucose profile
Special chemistry
(
endocrinology, fertility)
2.Clinical
Microscopy
Analysis of body fluidsUrin analysisFecal anaysisSemen analysis
3. Microbiology
Cultures (sputum,
blood, urine)
Sensitivity tests
4. Hematology
Biggest section
Includes
CBC,coagulation
, PT, APTT
Slide10
Blood bankVery
critical
section
Bec
. May have errors
Blood
typing
Cross
match
Goes
hand in hand
with serology
and immunology Tests done forMALARIASYPHILISHIVSerology/Immunology Cardiac and thyroid fxntestII. ANATOMY PATHOLOGYHistopathology
Request is neededToday Confusing Performed as soon as possible, given priority Based on “running time”Routine
Done
with the batch
Wait
for TAT stated
by laboratory
Slide23
Automation and computerization
Test Repertoire (Range
)
More than 400 tests can be performed in the lab
Analyzers
Laboratory
personnels
Slide24
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 valueUsually when 2x to 3x
Slide25
CRITICAL VALUES
Needs immediate attention
“
panic values”
Should
call physician
Patient
is at
risk
Glucose less than 45mg/dl
More than 500mg/dl
Potassium less than 6.6 g/dl
More than 19.9 g/dl
Slide26
Reference Values
Not fixed for
all
Should consider:
Age
Sex
Pregnancy
Diurnal
Variation
Race
Blood type
Slide27
Routine Examinations
ROUTINE ADMISSION
TESTS
CBC
, Urinalysis,
Fecalysis
ROUTINE CHEMISTRIES
BUN
,
Creatinine
, Glucose, Uric Acid, Cholesterol
Sometimes triglycerides
Slide28Slide29
Specimen collectionCorrect sample
Correct information (history)
More information is required while reassessing or assessing prognosis.
Identification must be clear and correct.
Slide30
QUALITY ASSURANCE TO OBTAIN CORRECT TEST RESULTS
Immediate and long term clinical, public health, and
health planning decisions are based on the results of
laboratory tests. Incorrect, delayed, or misinterpreted
test results can have serious consequences for
patients and communities, undermine confidence in
the service, and waste scarce district health
resources.
Achieving reliability of test results is dependent on:
Understanding what are the commonest
causes of
inaccuracy and imprecision in the
performance of
tests and of delayed or misinterpreted
Slide31
and sources of error). Taking the necessary steps to prevent and
minimize errors
by:
– implementing
Standard Operating
Procedures
(
SOPs) with quality control for
all district
laboratory activities.
– introducing every month a quality
control day
and an external quality
assessment scheme
for outreach laboratories (see later text, Role of the district medical officer in TQM).– appointing a district laboratory coordinator to monitor the performance of district laboratories (see later text). Agreeing with those requesting laboratory tests, policies of work that will enable the laboratory to provide an efficient, safe, cost-effective, and reliable service (see subunit 2.4). Maintaining good communications between laboratory staff and those requesting tests.
