The document discusses the history and evolution of medical diagnostics from 1911-1921. Some key developments include the invention of the fluorescent microscope in 1911, the establishment of the first clinical laboratory method for serum phosphorus in 1920, and the founding of the Denver Society of Clinical Pathologists in 1921. The document also provides an overview of different diagnostic methods and tools used in clinical pathology laboratories today.

1. Medical Diagnostics
Dr. I. Manjubala
Dr. I. Manjubala
SBST, VIT University
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2. History
Dr. I. Manjubala
SBST, VIT University
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Timeline
1911 Oskar Heimstadt invents the fluorescent microscope
1912 American College of Surgeons is chartered in Illinois.
1913 DD Van Slyke is appointed chemist at Rockefeller Hospital
Laboratory; American Association of Immunologists is founded.
1916 KMG Seigbahn develops x-ray spectroscopy
1918 N. Wales and EJ Copeland develop the electric refrigerator
1919 FW Aston develops the mass spectrograph
1920 First clinical laboratory method for serum phosphorus is established;
the use of venipuncture for diagnostic testing becomes widespread; Meyers
establishes the University of Iowa center for training clinical chemists,
primarily for hospital positions; Conference of Public Health Laboratories
is founded.
1921 First clinical laboratory method for serum magnesium is introduced;
The Denver Society of Clinical Pathologists, precursor of ASCP, is
founded.

3. • Traditional (Chinese) Medicine:
specifies four diagnostic methods:
(i) inspection,
(ii) auscultation-olfaction,
(iii) interrogation, and
(iv) palpation.
• Hippocrates was known to make diagnoses by tasting
his patients' urine and smelling their sweat.
Dr. I. Manjubala
SBST, VIT University
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4. What is a Disease?
•A disease is a physical or functional disorder of normal
body systems that places an individual at increased risk of
adverse consequences
•Diseases are diagnosed by physicians or other health care
providers through a combination of tools
•When a disease is diagnosed, treatment is given to
prevent or ameliorate complications and to improve
prognosis
Dr. I. Manjubala
SBST, VIT University
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5. Diagnosis
(Gr. dia“through” + gnosis“knowledge”)
Diagnoses are made by three general categories of
physicians or health care providers:
•Clinical diagnosticians identify diseases by examination of
patient’s history and physical examination
•Pathologists identify diseases by examining cells and
tissues removed from the body
•Radiologists identify diseases by imaging the intact body
Dr. I. Manjubala
SBST, VIT University
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6. The Tree of Medicine
Dr. I. Manjubala
SBST, VIT University
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7. Clinical laboratories
• Clinical labs are important in diseases diagnosis,
determination its severity and patient response to
specific treatment.
• Diagnosis of any disease is first done by physical
examination by physician and confirmed by lab
diagnostic tests.
• Lab values are very important in determination of
disease severity, drug doses and in follow up.
Dr. I. Manjubala
SBST, VIT University
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8. Clinical Laboratory
Functions:
1) Reveal the cause of the disease
2) Screen easy diagnosis
3) Suggest effective treatment
4) Assist in monitoring progress of pathological condition
5) Help in assessing response to treatment
Types of samples that are used in testing:
Body fluids: blood, serum, plasma, urine, cerebrospinal
fluid (CSF), feces, and other body fluids or tissues.
Dr. I. Manjubala
SBST, VIT University
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9. The sections of clinical laboratory are:
I.Anatomic pathology: histopathology, cytopathology, and electron
microscopy.
II.Clinical pathology:
1. Clinical Microbiology: bacteriology, virology, parasitology, immunology,
and mycology.
2. Clinical Chemistry: instrumental analysis of blood components,
enzymology, toxicology and endocrinology.
3. Hematology: analysis of blood cells. (coagulation and blood bank).
4. Genetics (cytogenetics.)
5. Reproductive biology: Semen analysis, Sperm bank and assisted
reproductive technology.
Dr. I. Manjubala
SBST, VIT University
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Clinical Laboratory

10. Clinical diagnosis
A diagnosis made on the basis of medical signs and patient-
reported symptoms, rather than diagnostic tests
1. Laboratory diagnosis
A diagnosis based significantly on laboratory reports or
test results, rather than the physical examination of the patient.
2. Radiology diagnosis
A diagnosis based primarily on the results from medical
imaging studies.
3. Principal diagnosis
The single medical diagnosis - most relevant to the
patient's chief complaint or need for treatment.
Dr. I. Manjubala
SBST, VIT University
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11. 4. Admitting diagnosis
The diagnosis given as the reason why the patient was
admitted to the hospital; it may differ from the actual problem or
from the discharge diagnoses,
5. Differential diagnosis
A process of identifying all of the possible diagnoses that
could be connected to the signs, symptoms, and lab findings,
and then ruling out diagnoses until a final determination can be
made.
Dr. I. Manjubala
SBST, VIT University
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12. 6. Diagnostic criteria
Designates the combination of signs, symptoms, and test
results that the clinician uses to attempt to determine the correct
diagnosis.
– They are standards, normally published by international committees,
and they are designed to offer the best sensitivity and specificity
possible, respect the presence of a condition, with the state-of-the-art
technology.
7. Prenatal diagnosis
Diagnosis work done before birth
8. Diagnosis of exclusion
A medical condition whose presence cannot be
established with complete confidence from history, examination
or testing. Diagnosis is therefore by elimination of all other
reasonable possibilities.
Dr. I. Manjubala
SBST, VIT University
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13. 9. Dual diagnosis
The diagnosis of two related, but separate, medical
conditions or co-morbidities; the term almost always refers to a
diagnosis of a serious mental illness and a substance addiction.
10. Self-diagnosis
The diagnosis or identification of a medical conditions in
oneself. Self-diagnosis is very common.
11. Remote diagnosis
A type of telemedicine that diagnoses a patient without
being physically in the same room as the patient.
Dr. I. Manjubala
SBST, VIT University
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14. 12. Nursing diagnosis
Rather than focusing on biological processes, a nursing
diagnosis identifies people's responses to situations in their lives,
such as a readiness to change or a willingness to accept
assistance.
13. Computer-aided diagnosis
Providing symptoms allows the computer to identify the
problem and diagnose the user to the best of its ability. Health
screening begins by identifying the part of the body where the
symptoms are located; the computer cross-references a database
for the corresponding disease and presents a diagnosis.
Dr. I. Manjubala
SBST, VIT University
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15. 14. Overdiagnosis
The diagnosis of "disease" that will never cause symptoms,
distress, or death during a patient's lifetime
15. Wastebasket diagnosis
A vague, or even completely fake, medical or psychiatric label
given to the patient or to the medical records department for essentially
non-medical reasons, such as to reassure the patient by providing an
official-sounding label, to make the provider look effective, or to obtain
approval for treatment.
that amount to overmedicalization, such as the labeling of
normal responses to physical hunger as reactive hypoglycemia.
16. Retrospective diagnosis
A retrospective diagnosis (posthumous diagnosis) is the
practice of identifying an illness after the death of the patient,
sometimes in a historical figure using modern knowledge, methods and
disease classifications.
Dr. I. Manjubala
SBST, VIT University
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