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Overview of Medical Laboratory
Investigations And other
Investigations
ෛවද$ රසායනාගාර පරීක්ෂණ සහ
අෙනකුත් ෛවද$ පරීක්ෂණ
Dr. C V Karunarathna, MBBS (Kelaniya), MSc in Community Medicine(Colombo)
Medical Officer – Training
Provincial Health Training Centre North Central Province.
Objectives
´ To understand what medical laboratory investigations/Medical
investigations are
´ To know the types of medical laboratory investigations/other investigations
´ To understand the importance of knowing about investigations as a
caregiver
´ Getting familiar with some selected , basic and common investigations.
´ Get to know the importance of preparation for some specific
investigations
Medical Investigations
ෛවද$ පරීක්ෂණ
´ A medical procedure that involves testing a sample of blood, urine,
other body fluids, cells ,tissue or other procedures carried out on a
person which helps in diagnosis and management of a disease
condition.
´ ෛවද$ පරීක්ෂණ යනු ෛවද$ කියා පටිපාටියකට අනුව යම් පුද්ගලෙයකුෙග් රුධිරය
,මුතා ,ෙවනත් ශරීර තරල, ෛසල ෙහෝ පටක ෙයාදාෙගන සිදු කරනු ලබන පරීක්ෂාවක්
ෙහෝ කිසියම් ෙරෝග විනිශ්වයකට ෙහෝ ෙරෝග තත්ත්ව සඳහා පතිකාර කිරීෙම්දී තීරණ
ගැනීමට උපකාරී වන ෛවද$ කියාපටිපටියකට අනුව පුද්ගලෙයකුෙග් සිදු කරනු ලබන
අෙනකුත් ඕනෑම පරීක්ෂාවක් ෙව්.
Types of Medical Investigations
´ Biochemical Ix (ෛජව ෛවද% පරීක්ෂණ )
´ Blood Ix (LFT/RFT/LIPID Profile/FBS/PPBS/HbA1C/Trop I/ Na/K)
´ Urine Ix (UFR)
´ Body fluids( Peritoneal fluid/CSF/Plural fluid/Sputum/Saliva)
´ Hematological Ix (රක්තෙව්ද පරීක්ෂණ )
´ FBC/ Blood Picture/PT/INR
´ Cytological/Histological Ix (ෛසල හා පටක පරීක්ෂණ )
´ Immunological Ix (පතිශක්තිකරණය සම්බන්ධ පරීක්ෂණ)
´ Microbiological Ix (ක්ෂුදජීව පරීක්ෂණ )
´ Gram stain/Culture ABST/Viral/Fungal studies/Serology
´ Radiological Ix (විකිරණෙව්ද පරීක්ෂා )
´ USS/MRI/CT/Angiogram
´ Other procedures
´ Endoscopy, ECG, Hearing tests, Vision tests
Overview of Medical Investigations.pdf
Types of
Investigations
Bed
side/Chair
side
Laboratory
Investigations
Other
medical
procedures

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Overview of Medical Investigations.pdf

  • 1. Overview of Medical Laboratory Investigations And other Investigations ෛවද$ රසායනාගාර පරීක්ෂණ සහ අෙනකුත් ෛවද$ පරීක්ෂණ Dr. C V Karunarathna, MBBS (Kelaniya), MSc in Community Medicine(Colombo) Medical Officer – Training Provincial Health Training Centre North Central Province.
  • 2. Objectives ´ To understand what medical laboratory investigations/Medical investigations are ´ To know the types of medical laboratory investigations/other investigations ´ To understand the importance of knowing about investigations as a caregiver ´ Getting familiar with some selected , basic and common investigations. ´ Get to know the importance of preparation for some specific investigations
  • 3. Medical Investigations ෛවද$ පරීක්ෂණ ´ A medical procedure that involves testing a sample of blood, urine, other body fluids, cells ,tissue or other procedures carried out on a person which helps in diagnosis and management of a disease condition. ´ ෛවද$ පරීක්ෂණ යනු ෛවද$ කියා පටිපාටියකට අනුව යම් පුද්ගලෙයකුෙග් රුධිරය ,මුතා ,ෙවනත් ශරීර තරල, ෛසල ෙහෝ පටක ෙයාදාෙගන සිදු කරනු ලබන පරීක්ෂාවක් ෙහෝ කිසියම් ෙරෝග විනිශ්වයකට ෙහෝ ෙරෝග තත්ත්ව සඳහා පතිකාර කිරීෙම්දී තීරණ ගැනීමට උපකාරී වන ෛවද$ කියාපටිපටියකට අනුව පුද්ගලෙයකුෙග් සිදු කරනු ලබන අෙනකුත් ඕනෑම පරීක්ෂාවක් ෙව්.
  • 4. Types of Medical Investigations ´ Biochemical Ix (ෛජව ෛවද% පරීක්ෂණ ) ´ Blood Ix (LFT/RFT/LIPID Profile/FBS/PPBS/HbA1C/Trop I/ Na/K) ´ Urine Ix (UFR) ´ Body fluids( Peritoneal fluid/CSF/Plural fluid/Sputum/Saliva) ´ Hematological Ix (රක්තෙව්ද පරීක්ෂණ ) ´ FBC/ Blood Picture/PT/INR ´ Cytological/Histological Ix (ෛසල හා පටක පරීක්ෂණ ) ´ Immunological Ix (පතිශක්තිකරණය සම්බන්ධ පරීක්ෂණ) ´ Microbiological Ix (ක්ෂුදජීව පරීක්ෂණ ) ´ Gram stain/Culture ABST/Viral/Fungal studies/Serology ´ Radiological Ix (විකිරණෙව්ද පරීක්ෂා ) ´ USS/MRI/CT/Angiogram ´ Other procedures ´ Endoscopy, ECG, Hearing tests, Vision tests
  • 7. Types of Investigations ´ Chair side/Bed side investigations ´ RAT ´ Urine HCG, ´ Urine dipstick tests for Protein, Sugar ´ CBS ´ ECG
  • 8. Types of investigations ctd…. ´ Laboratory Investigations Urine Blood Other body fluids Tissue
  • 9. Types of investigations ctd…. ´ Other Medical Procedures ´ Radiological investigations ´ Endoscopy
  • 10. Types ctd….. Types of Investigations Screening Tests Diagnostic tests Routine investigations Special Investigations
  • 11. Why you need to know about investigations as a Caregiver ?
  • 13. Investigations alone can not help in the management of the patient. In a hospital/Clinical setting- Doctors/Nurses ´ History ´ Examination ´ Investigations ´ Diagnosis ´ Management ´ Follow up At Home/Care Institution Caregiver ´ Patient Assessment(Physical, Mental, Medical conditions) ´ Preparing a Care plan ´ Maintain Nutrition of the client ´ Administering drugs ´ Appointments for tests ´ Preparation for investigations ´ Identify emergency situations ´ When to seek help for the client
  • 15. When you read an Lab investigation ´ Check for ´ Name ´ Age ´ Date ´ Compare with previous investigations. ´ Look who has referred ´ Check from where the investigation has done. ´ Reference range (There can be slight difference from lab to lab) ´ Units (May differ)
  • 16. Common Laboratory Investigations a caregiver should know ´ Some of bed side/Lab investigations ´ Content ´ Uses ´ Preparation ´ Values
  • 17. Full Blood Count (FBC) ´ White blood cells ´ Red blood cells ´ Hb (Haemoglobin) ´ Platelets ´ No need of special preparation
  • 18. ESR ´ Detection of inflammation in body. ´ Increase in Inflammation(Artherites) ´ Long-term illnesses/infections ´ Cancer No need of special preparation
  • 19. C reactive protein (CRP) ´ High in acute infections/injury ´ Or in chronic infections ´ No Special Preperation
  • 20. Blood Sugar evaluation ´ Capillary Blood Sugar (CBS) ´ Random Blood Sugar (RBS) ´ Fasting Blood Sugar (FBS) ´ Post Prandial Blood Sugar (PPBS) ´ HbA1C ´ Oral Glucose Tolerance Test(OGTT)
  • 21. Capillary Blood Sugar (CBS) ´ Bed side test ´ Glucometer ´ Need to know how to check (Skills) ´ Range ´ Low Level – 70 mg/dl ´ High level - >126 mg/dl (Fasting) ´ > 180/200 mg /dl (symptomatic) ´ HI ´ Look for the symptoms of hypoglycemia/Hyperglycemia ´ No need of special preparation
  • 22. Random Blood Sugar (RBS) ´ Venous blood sample ´ A blood sugar level less than 140 mg/dL is normal. ´ A reading of more than 200 mg/dL after two hours means you have diabetes. ´ A reading between 140 and 199 mg/dL prediabetes. ´ > 200 mg/dl consider as high ´ No need of special preparation
  • 23. Fasting blood sugar (FBS) ´ Venous Blood sample ´ Diagnosis ´ 100-125mg/dl Pre-diabetic ´ =/> 126 mg/dl with symptoms diabetes + ´ =/> 126 mg/dl without symptoms repeat test ´ Treatment ´ 126-200 mg/dl –one drug ´ >200 mg/dl –start with two drugs ´ >300 mg/dl / complications/severe symptoms - 2/3 drugs with insulin. ´ Maintenance ´ Diabetic patient- Glycemic target (FBS- 80- 130 mg/dl )
  • 24. FBS ctd ´ Preparation ´ 8-10 hour overnight fasting ´ Avoid caloric food drink ´ Can take water
  • 25. Post Prandial Blood Sugar (PPBS) ´ Venous Blood ´ 2 hours after meal ´ Timing stats from the start of the meal ´ Usual antidiabetic drugs should be taken in regular intervals Range < 140 mg/dl for normal person < 180 mg/dl for a diabetic patient (glycemic control)
  • 26. HbA1C ´ Venous blood ´ No need preparation ´ Long term control of blood sugar ´ Over past 3 months ´ =/> 6.5% cut off for diagnosis ´ Control – 7% ´ Individualized glycemic targets ´ HbA1C level will high with advanced aging and other diseases
  • 27. Lipid Profile ´ Venous Blood ´ Cholesterol levels ´ Need 12 Hour Overnight fasting ´ Can take small amount of water ´ Total Cholesterol - <200 mg/dl ´ Triglycerides -,150 mg/dl ´ LDL - < 100 mg/dl ´ HDL - > 60 mg/dl ´ VLDL
  • 28. TSH/T3/T4 ´ TSH - thyroid stimulating hormone ´ Blood test that measures this hormone. ´ TSH levels that are too high or too low may be a sign of a thyroid problem. ´ T3/T4 Thyroid hormone levels
  • 29. B.Urea,S.Cr,eGFR ´ Blood investigations ´ Kidney function ´ Venous Blood samples ´ To test the renal (kidney)functions ´ eGFR < 60 –Kidney damage ´ No need fasting ´ Hydrate well before test
  • 30. Liver Function Tests (LFT) ´ Liver function tests ´ Liver function ´ Liver profile ´ Venous blood ´ No need preparation ´ AST ´ ALT ´ ALP ´ GGT ´ Bilirubin ´ Protein(Albumin/Globulin)
  • 31. ECG ´ Check your heart's rhythm and electrical activity. ´ Heart rate ´ Rhythm ´ Wall function abnormalities(Heart attacks/Heart failure) ´ Abnormal electrical activity
  • 32. Other Cardiac investigations ´ Troponin I ´ Echocardiogram ´ Angiogram
  • 33. Urine Full Report (UFR) Done in a laboratory. ´ Color, cloudiness and concentration of the urine. ´ Chemical composition -Using a test strip. ´ Examination of the urine Under a microscope to look for bacteria, cells and parts of cells. No need special preparation Collect to UFR normal bottle
  • 34. Urine Culture ´ A urine culture is a lab test to check for bacteria or other germs in a urine sample. ´ How to collects ´ sterile urine bag, ´ urethral catheterization (CATH), suprapubic aspiration (SPA), ´ Clean-catch (CC)
  • 35. Urine culture ´ Clean catch/Midstream urine sample ´ Wash your hands ´ Clean the surrounding area – tip of penis (push back foreskin if needed) for men and in between the labia for women ´ Start to urinate, stop if possible or wait until the first part of urine has passed, then using your container capture a midstream urine sample. ´ Void the rest of urine ´ close the container ,wipe the specimen container and wash your hands.
  • 37. USS Abdomen/Pelvis ´ Full bladder ´ Fasting ´ Don't give /eat solid food for 6 hours before the ultrasound. ´ Drink 4 to 6 cups of water 1 hour before your ultrasound. ´ Don't urinate (pee) before the ultrasound.
  • 38. Ctd.. ´ Chest X-ray ´ Abdominal x-ray ´ X-ray head, neck, limbs, Spine
  • 39. X ray KUB ´ Fasting ´ Bowel preparation
  • 40. Summery ´ Always clarify your doubts. Ask from Doctor and Nurse ´ Prepare for investigations(Fasting, Premedication, Bladder bowel preparations, Pre-investigations, Pre-consultations, Need admission) ´ Get the investigations timely and get the opinion. ´ Always check the name, date, relaent details to confirm. ´ Things to consider after the investigations ´ Know the basics ´ Maintain Confidentiality