Describes the mission of laboratory services, the phases of performing laboratory tests, factors affecting laboratory tests and strorage and transport of laboratory samples
Blood investigations in Dental Practice.Dr AyeshaDr Ayesha Taha
This document discusses various hematological investigations that are sometimes required for diagnosis and treatment planning in dental practice. It describes tests like complete blood count, white blood cell count, differential leukocyte count, hemoglobin, hematocrit, erythrocyte sedimentation rate, and coagulation tests. The tests help detect abnormalities such as infections, anemia, and allergies. Proper collection of blood samples and interpretation of the test results are important for evaluating disorders related to the oral cavity.
The document describes the organizational divisions and sections within a clinical laboratory. It outlines the departments of pathology, including anatomical pathology, cytology, histology, cytogenetics, and clinical pathology. The clinical pathology department contains sections for hematology, chemistry, blood bank, serology, microbiology, and urinalysis. Each section is described in terms of its functions, common tests performed, and specimen requirements. The document also discusses laboratory personnel roles and requirements.
This document discusses hematological investigations that are useful in clinical dentistry. It begins by explaining that laboratory studies provide information to identify the nature of diseases by examining tissues, blood, and other specimens. Some key points covered include:
- Laboratory tests can confirm or reject clinical diagnoses and provide guidance for patient management.
- Tests are classified as screening or diagnostic based on their sensitivity and specificity.
- Common hematological investigations performed include complete blood count, hemoglobin analysis, and coagulation tests.
- Proper collection and preservation of blood samples is important for accurate test results.
So in summary, the document outlines the role of laboratory hematological tests in clinical dentistry for diagnosing systemic conditions and
Clinical laboratory test: Which, Why and What do results mean?.fullPeter Bautista
This document discusses the laboratory testing cycle and selecting appropriate laboratory tests for diagnostic decision making. It begins by describing the three phases of the laboratory testing cycle: pre-analytic, analytic, and post-analytic. It then reviews how to evaluate the diagnostic performance of laboratory tests using metrics like sensitivity and specificity. Key factors to consider before ordering a test are discussed, such as the reason for ordering, how well it distinguishes health from disease, and how results will impact management. Ordering targeted tests based on the differential diagnosis is advocated over a shotgun approach. The importance of understanding these principles for optimal test selection and cost-effective care is emphasized.
Lab Tests are tools that provide information about the client.
Tests may be used for basic screening as part of a wellness check.
Frequently tests are used to help confirm a diagnosis, monitor an illness, and provide valuable information about the client’s response to treatment.
Hematology is the branch of medicine, that is concerned with the study of blood, blood forming organs and blood diseases. It includes study of etiology, diagnosis, treatment, prognosis and prevention of blood diseases .
After the completion of this presentation we will know about:
What is hematology and its purpose.
hematology laboratory.
Blood and its compositions and collections
Hematology lab equipment's
Some hematological tests , disease and hazards too.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document provides an overview of various laboratory tests that can be used in clinical diagnosis and patient management. It defines laboratory investigations as tests that examine tissues, blood, urine or other specimens to aid diagnosis. The document then categorizes common lab tests into hematological, endocrine, hepatobiliary, renal, bone, immunologic, and microbiological tests. For each category, it lists some examples of specific tests and provides reference ranges for normal results. The conclusion states that diagnostic lab tests are increasingly being used to prevent, monitor, and treat periodontal disease and its relationship to systemic health.
Blood investigations in Dental Practice.Dr AyeshaDr Ayesha Taha
This document discusses various hematological investigations that are sometimes required for diagnosis and treatment planning in dental practice. It describes tests like complete blood count, white blood cell count, differential leukocyte count, hemoglobin, hematocrit, erythrocyte sedimentation rate, and coagulation tests. The tests help detect abnormalities such as infections, anemia, and allergies. Proper collection of blood samples and interpretation of the test results are important for evaluating disorders related to the oral cavity.
The document describes the organizational divisions and sections within a clinical laboratory. It outlines the departments of pathology, including anatomical pathology, cytology, histology, cytogenetics, and clinical pathology. The clinical pathology department contains sections for hematology, chemistry, blood bank, serology, microbiology, and urinalysis. Each section is described in terms of its functions, common tests performed, and specimen requirements. The document also discusses laboratory personnel roles and requirements.
This document discusses hematological investigations that are useful in clinical dentistry. It begins by explaining that laboratory studies provide information to identify the nature of diseases by examining tissues, blood, and other specimens. Some key points covered include:
- Laboratory tests can confirm or reject clinical diagnoses and provide guidance for patient management.
- Tests are classified as screening or diagnostic based on their sensitivity and specificity.
- Common hematological investigations performed include complete blood count, hemoglobin analysis, and coagulation tests.
- Proper collection and preservation of blood samples is important for accurate test results.
So in summary, the document outlines the role of laboratory hematological tests in clinical dentistry for diagnosing systemic conditions and
Clinical laboratory test: Which, Why and What do results mean?.fullPeter Bautista
This document discusses the laboratory testing cycle and selecting appropriate laboratory tests for diagnostic decision making. It begins by describing the three phases of the laboratory testing cycle: pre-analytic, analytic, and post-analytic. It then reviews how to evaluate the diagnostic performance of laboratory tests using metrics like sensitivity and specificity. Key factors to consider before ordering a test are discussed, such as the reason for ordering, how well it distinguishes health from disease, and how results will impact management. Ordering targeted tests based on the differential diagnosis is advocated over a shotgun approach. The importance of understanding these principles for optimal test selection and cost-effective care is emphasized.
Lab Tests are tools that provide information about the client.
Tests may be used for basic screening as part of a wellness check.
Frequently tests are used to help confirm a diagnosis, monitor an illness, and provide valuable information about the client’s response to treatment.
Hematology is the branch of medicine, that is concerned with the study of blood, blood forming organs and blood diseases. It includes study of etiology, diagnosis, treatment, prognosis and prevention of blood diseases .
After the completion of this presentation we will know about:
What is hematology and its purpose.
hematology laboratory.
Blood and its compositions and collections
Hematology lab equipment's
Some hematological tests , disease and hazards too.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document provides an overview of various laboratory tests that can be used in clinical diagnosis and patient management. It defines laboratory investigations as tests that examine tissues, blood, urine or other specimens to aid diagnosis. The document then categorizes common lab tests into hematological, endocrine, hepatobiliary, renal, bone, immunologic, and microbiological tests. For each category, it lists some examples of specific tests and provides reference ranges for normal results. The conclusion states that diagnostic lab tests are increasingly being used to prevent, monitor, and treat periodontal disease and its relationship to systemic health.
This document provides an overview of laboratory investigations in dentistry. It defines laboratory investigations, outlines their need and applications. It then classifies laboratory investigations and discusses the most common hematological, biochemical, microbiological, immunological, and histopathological/cytopathological investigations. Specific tests are explained in detail including complete blood count, erythrocyte sedimentation rate, bleeding time, and platelet count. The significance and interpretation of results for these common dental laboratory tests are also summarized.
This document provides an overview of laboratory investigations. It begins by outlining the need for lab investigations to supplement clinical findings. It then defines lab investigations and discusses their generic applications and classifications based on location, specificity/sensitivity, and frequency of use in dentistry. The document goes on to cover crucial questions to consider prior to ordering lab tests and provides examples of commonly used hematological, biochemical, microbiological, immunological, and histopathological investigations. It concludes by discussing common clinical scenarios where lab tests are useful.
1) The patient has signs of shock including hypotension, tachycardia, and elevated lactate and base deficit.
2) Fluid resuscitation with 2L LR improved hemodynamics but lactate and base deficit remain elevated, indicating ongoing shock.
3) Aggressive resuscitation with blood products following a 1:1:1 ratio of PRBCs, FFP, and platelets is indicated to replace blood loss and prevent coagulopathy, given the suspicion for hemorrhage.
This document summarizes the history of fluid resuscitation and discusses various resuscitation fluids. It describes the ideal properties of a resuscitation fluid and notes that currently no single fluid exists that meets all criteria. Several types of colloid and crystalloid fluids are discussed, along with major studies investigating their safety and efficacy in different patient populations. The document concludes that isotonic crystalloids are generally appropriate for initial resuscitation, and that specific considerations apply to fluid selection for different categories of patients such as those with sepsis, traumatic brain injury, or burns.
Laboratory investigations are an important aid for oral and maxillofacial surgeons. This document discusses various hematological, biochemical, and microbiological tests that are relevant for presurgical evaluation and management. Key hematological tests covered include complete blood count, coagulation tests, and electrolyte levels. Biochemical tests discussed include tests assessing kidney and liver function. Together, laboratory evaluations can help diagnose diseases and allow for optimized presurgical planning and postoperative care of patients.
Kancir et al-2015-anesthesia_&_analgesiasamirsharshar
This randomized controlled trial investigated the effect of hydroxyethyl starch (HES) on renal function in patients undergoing radical prostatectomy. Forty patients received either 6% HES 130/0.4 or saline during surgery. Urine and blood samples were collected before, during, and after surgery to measure markers of renal function like urinary neutrophil gelatinase-associated lipocalin (u-NGAL), creatinine clearance, and urine output. While blood loss was higher in the HES group, the study found no significant differences in the measured markers of renal function between the HES and saline groups. This suggests that 6% HES 130/0.4 did not negatively impact renal function in patients with normal preoperative
This document summarizes a presentation on therapeutic plasma exchange (PEX) given by Kamal Mohamed Okasha. It provides an overview of the PEX procedure and potential indications for PEX, including Goodpasture's Syndrome, thrombotic thrombocytopenic purpura, cryoglobulinemia, multiple myeloma, and ANCA disease. It discusses complications of PEX and guidelines for efficacy based on recent studies. In particular, it examines the use of PEX for Goodpasture's Syndrome, noting that PEX aims to remove circulating anti-GBM antibodies and that studies have found improved outcomes, including renal function and survival, for patients receiving PEX treatment.
Jeevani ( Role of clinical biochemistry in laboratory)Potu Jeevani
The cell is considered the structural and functional unit of life. It contains several organelles that perform important functions. The nucleus contains dense bodies like the nucleolus that is rich in RNA. Mitochondria are known as the powerhouses of the cell and have inner and outer membranes with cristae to increase surface area. Other organelles include the endoplasmic reticulum for protein biosynthesis, Golgi apparatus for membrane synthesis, lysosomes for digestion, and peroxisomes that contain enzymes to protect the cell. Clinical biochemistry utilizes biological fluids and cells to diagnose diseases through quantitative and qualitative tests. Precise methods and quality controls are important for accurate results.
1) The document discusses the debate around using colloids versus crystalloids for fluid resuscitation.
2) Several major studies are reviewed that have found no evidence that colloids improve survival outcomes compared to crystalloids, and some studies found increased acute kidney injury and coagulation abnormalities with some colloids.
3) However, colloids may allow for faster shock reversal and less total volume administered in some cases. The evidence on outcomes varies depending on the specific colloid used and patient population. Ongoing studies continue to investigate the risks and benefits of different fluid options.
This document provides an overview of various laboratory investigations that are important for oral and maxillofacial surgeons. It summarizes hematological investigations including complete blood count, coagulation tests, and biochemical investigations like lipid profile, glucose, kidney/liver function tests. It describes the purpose and clinical significance of these common blood tests and their normal ranges.
This editorial addresses 10 common myths about the diuretic frusemide and its use in critically ill patients. It summarizes the evidence regarding each myth, finding that while frusemide can effectively promote diuresis in patients with fluid overload, it does not directly cause or prevent acute kidney injury, kick-start kidney function after AKI, help wean patients from renal replacement therapy, or imply full renal recovery following AKI. Continuous infusion of frusemide is no more effective than bolus doses. Co-administration of frusemide and fluids or albumin may be beneficial in select patient groups but not as a general rule. An increase in creatinine during frusemide therapy does
Therapeutic plasma exchange (TPE) is an extracorporeal blood purification technique used to remove large molecular weight substances from the plasma, such as pathogenic autoantibodies, immune complexes, and myeloma light chains. There are two main methods for TPE - centrifugal plasma separation and membrane plasma separation. TPE aims to remove the target pathogenic substance by exchanging 1-1.5 plasma volumes in each procedure to allow for redistribution between plasma and tissues. Complications are generally minor but can include hypotension, allergic reactions, and in rare cases mortality. TPE has various indications like myasthenia gravis, Guillain-Barré syndrome, and cryoglobulinemia where removal of
This document discusses transfusion support for children with thalassemia major. It notes that transfusion therapy should begin once thalassemia major is diagnosed based on clinical and laboratory findings. The goals of transfusion therapy are to maintain red blood cell viability and function, achieve appropriate hemoglobin levels, minimize effects of anemia, and avoid adverse reactions. The optimal regimen involves phenotype matched and leukoreduced red blood cells transfused every 3 weeks to maintain hemoglobin between 9-10.5 g/dL. Regular screening for transfusion-transmitted infections is also recommended.
Haemodialysis related ascites prof. mohamed sobhFarragBahbah
This document discusses nephrogenic ascites, a condition where patients with end-stage renal disease develop refractory ascites. It defines nephrogenic ascites and notes the condition is diagnosed by excluding other causes of ascites through tests and imaging. The document outlines the clinical presentation, poor prognosis, and various treatment options for nephrogenic ascites that have been attempted, including fluid restriction, peritoneal dialysis, peritoneovenous shunt placement, and renal transplantation, with transplantation found to be the most effective treatment.
This document discusses fluid management in the ICU. It covers assessing volume status through history, exam, and tests. Common types of IV fluids are described including crystalloids like normal saline and lactated Ringer's, as well as colloids like albumin and HES. Normal saline can cause hyperchloremic acidosis while HES is no longer recommended due to safety concerns. Guidelines for fluid resuscitation in hypovolemia and septic shock are provided, emphasizing initial bolus volumes and ongoing reassessment. In general, balanced crystalloids are preferred to normal saline due to safety advantages.
This document provides information on continuous renal replacement therapy (CRRT) modalities and dosing. It discusses CRRT principles, indications, modes of therapy including CVVH, CVVHD and CVVHDF. Details are given on vascular access, replacement fluids, anticoagulation options, and monitoring patients on CRRT. Examples show calculations for setting flow rates based on patient weight and condition. Guidelines are provided for initiating and managing heparin anticoagulation during CRRT.
The document discusses clinical laboratory tests and their importance in diagnosis, describing common tests performed, potential sources of error, and factors that can cause variation in test results. Routine tests are outlined for hematology, urinalysis, and feces. Laboratory errors can occur from pre-analytical issues like improper specimen handling or post-analytical issues like transcription mistakes. Test results are also influenced by biological and pathological factors in individuals like diet, exercise, and use of medications.
GENERAL INTRODUCTION TO CHEMICAL PATHOLOGY-SPECIMENS COLLECTION BY DR ABUDU...Xavier875943
This document provides an overview of chemical pathology and clinical chemistry laboratory testing. It discusses common terminology used in chemical pathology, such as reference values and units of measurement. It describes the collection, handling, and preservation of specimens in chemical pathology laboratories. The document outlines the purpose and types of clinical chemistry tests, including tests that measure substances involved in biological functions, waste products, substances indicating cell damage or disease, and drugs or toxins. It discusses the types of specimens used in chemical analysis, including whole blood, serum, plasma, urine, and other fluids. The document provides details on patient preparation, phlebotomy procedures, and factors that can affect test results such as fasting, lipemia, and hemolysis.
This document provides an overview of laboratory investigations in dentistry. It defines laboratory investigations, outlines their need and applications. It then classifies laboratory investigations and discusses the most common hematological, biochemical, microbiological, immunological, and histopathological/cytopathological investigations. Specific tests are explained in detail including complete blood count, erythrocyte sedimentation rate, bleeding time, and platelet count. The significance and interpretation of results for these common dental laboratory tests are also summarized.
This document provides an overview of laboratory investigations. It begins by outlining the need for lab investigations to supplement clinical findings. It then defines lab investigations and discusses their generic applications and classifications based on location, specificity/sensitivity, and frequency of use in dentistry. The document goes on to cover crucial questions to consider prior to ordering lab tests and provides examples of commonly used hematological, biochemical, microbiological, immunological, and histopathological investigations. It concludes by discussing common clinical scenarios where lab tests are useful.
1) The patient has signs of shock including hypotension, tachycardia, and elevated lactate and base deficit.
2) Fluid resuscitation with 2L LR improved hemodynamics but lactate and base deficit remain elevated, indicating ongoing shock.
3) Aggressive resuscitation with blood products following a 1:1:1 ratio of PRBCs, FFP, and platelets is indicated to replace blood loss and prevent coagulopathy, given the suspicion for hemorrhage.
This document summarizes the history of fluid resuscitation and discusses various resuscitation fluids. It describes the ideal properties of a resuscitation fluid and notes that currently no single fluid exists that meets all criteria. Several types of colloid and crystalloid fluids are discussed, along with major studies investigating their safety and efficacy in different patient populations. The document concludes that isotonic crystalloids are generally appropriate for initial resuscitation, and that specific considerations apply to fluid selection for different categories of patients such as those with sepsis, traumatic brain injury, or burns.
Laboratory investigations are an important aid for oral and maxillofacial surgeons. This document discusses various hematological, biochemical, and microbiological tests that are relevant for presurgical evaluation and management. Key hematological tests covered include complete blood count, coagulation tests, and electrolyte levels. Biochemical tests discussed include tests assessing kidney and liver function. Together, laboratory evaluations can help diagnose diseases and allow for optimized presurgical planning and postoperative care of patients.
Kancir et al-2015-anesthesia_&_analgesiasamirsharshar
This randomized controlled trial investigated the effect of hydroxyethyl starch (HES) on renal function in patients undergoing radical prostatectomy. Forty patients received either 6% HES 130/0.4 or saline during surgery. Urine and blood samples were collected before, during, and after surgery to measure markers of renal function like urinary neutrophil gelatinase-associated lipocalin (u-NGAL), creatinine clearance, and urine output. While blood loss was higher in the HES group, the study found no significant differences in the measured markers of renal function between the HES and saline groups. This suggests that 6% HES 130/0.4 did not negatively impact renal function in patients with normal preoperative
This document summarizes a presentation on therapeutic plasma exchange (PEX) given by Kamal Mohamed Okasha. It provides an overview of the PEX procedure and potential indications for PEX, including Goodpasture's Syndrome, thrombotic thrombocytopenic purpura, cryoglobulinemia, multiple myeloma, and ANCA disease. It discusses complications of PEX and guidelines for efficacy based on recent studies. In particular, it examines the use of PEX for Goodpasture's Syndrome, noting that PEX aims to remove circulating anti-GBM antibodies and that studies have found improved outcomes, including renal function and survival, for patients receiving PEX treatment.
Jeevani ( Role of clinical biochemistry in laboratory)Potu Jeevani
The cell is considered the structural and functional unit of life. It contains several organelles that perform important functions. The nucleus contains dense bodies like the nucleolus that is rich in RNA. Mitochondria are known as the powerhouses of the cell and have inner and outer membranes with cristae to increase surface area. Other organelles include the endoplasmic reticulum for protein biosynthesis, Golgi apparatus for membrane synthesis, lysosomes for digestion, and peroxisomes that contain enzymes to protect the cell. Clinical biochemistry utilizes biological fluids and cells to diagnose diseases through quantitative and qualitative tests. Precise methods and quality controls are important for accurate results.
1) The document discusses the debate around using colloids versus crystalloids for fluid resuscitation.
2) Several major studies are reviewed that have found no evidence that colloids improve survival outcomes compared to crystalloids, and some studies found increased acute kidney injury and coagulation abnormalities with some colloids.
3) However, colloids may allow for faster shock reversal and less total volume administered in some cases. The evidence on outcomes varies depending on the specific colloid used and patient population. Ongoing studies continue to investigate the risks and benefits of different fluid options.
This document provides an overview of various laboratory investigations that are important for oral and maxillofacial surgeons. It summarizes hematological investigations including complete blood count, coagulation tests, and biochemical investigations like lipid profile, glucose, kidney/liver function tests. It describes the purpose and clinical significance of these common blood tests and their normal ranges.
This editorial addresses 10 common myths about the diuretic frusemide and its use in critically ill patients. It summarizes the evidence regarding each myth, finding that while frusemide can effectively promote diuresis in patients with fluid overload, it does not directly cause or prevent acute kidney injury, kick-start kidney function after AKI, help wean patients from renal replacement therapy, or imply full renal recovery following AKI. Continuous infusion of frusemide is no more effective than bolus doses. Co-administration of frusemide and fluids or albumin may be beneficial in select patient groups but not as a general rule. An increase in creatinine during frusemide therapy does
Therapeutic plasma exchange (TPE) is an extracorporeal blood purification technique used to remove large molecular weight substances from the plasma, such as pathogenic autoantibodies, immune complexes, and myeloma light chains. There are two main methods for TPE - centrifugal plasma separation and membrane plasma separation. TPE aims to remove the target pathogenic substance by exchanging 1-1.5 plasma volumes in each procedure to allow for redistribution between plasma and tissues. Complications are generally minor but can include hypotension, allergic reactions, and in rare cases mortality. TPE has various indications like myasthenia gravis, Guillain-Barré syndrome, and cryoglobulinemia where removal of
This document discusses transfusion support for children with thalassemia major. It notes that transfusion therapy should begin once thalassemia major is diagnosed based on clinical and laboratory findings. The goals of transfusion therapy are to maintain red blood cell viability and function, achieve appropriate hemoglobin levels, minimize effects of anemia, and avoid adverse reactions. The optimal regimen involves phenotype matched and leukoreduced red blood cells transfused every 3 weeks to maintain hemoglobin between 9-10.5 g/dL. Regular screening for transfusion-transmitted infections is also recommended.
Haemodialysis related ascites prof. mohamed sobhFarragBahbah
This document discusses nephrogenic ascites, a condition where patients with end-stage renal disease develop refractory ascites. It defines nephrogenic ascites and notes the condition is diagnosed by excluding other causes of ascites through tests and imaging. The document outlines the clinical presentation, poor prognosis, and various treatment options for nephrogenic ascites that have been attempted, including fluid restriction, peritoneal dialysis, peritoneovenous shunt placement, and renal transplantation, with transplantation found to be the most effective treatment.
This document discusses fluid management in the ICU. It covers assessing volume status through history, exam, and tests. Common types of IV fluids are described including crystalloids like normal saline and lactated Ringer's, as well as colloids like albumin and HES. Normal saline can cause hyperchloremic acidosis while HES is no longer recommended due to safety concerns. Guidelines for fluid resuscitation in hypovolemia and septic shock are provided, emphasizing initial bolus volumes and ongoing reassessment. In general, balanced crystalloids are preferred to normal saline due to safety advantages.
This document provides information on continuous renal replacement therapy (CRRT) modalities and dosing. It discusses CRRT principles, indications, modes of therapy including CVVH, CVVHD and CVVHDF. Details are given on vascular access, replacement fluids, anticoagulation options, and monitoring patients on CRRT. Examples show calculations for setting flow rates based on patient weight and condition. Guidelines are provided for initiating and managing heparin anticoagulation during CRRT.
The document discusses clinical laboratory tests and their importance in diagnosis, describing common tests performed, potential sources of error, and factors that can cause variation in test results. Routine tests are outlined for hematology, urinalysis, and feces. Laboratory errors can occur from pre-analytical issues like improper specimen handling or post-analytical issues like transcription mistakes. Test results are also influenced by biological and pathological factors in individuals like diet, exercise, and use of medications.
GENERAL INTRODUCTION TO CHEMICAL PATHOLOGY-SPECIMENS COLLECTION BY DR ABUDU...Xavier875943
This document provides an overview of chemical pathology and clinical chemistry laboratory testing. It discusses common terminology used in chemical pathology, such as reference values and units of measurement. It describes the collection, handling, and preservation of specimens in chemical pathology laboratories. The document outlines the purpose and types of clinical chemistry tests, including tests that measure substances involved in biological functions, waste products, substances indicating cell damage or disease, and drugs or toxins. It discusses the types of specimens used in chemical analysis, including whole blood, serum, plasma, urine, and other fluids. The document provides details on patient preparation, phlebotomy procedures, and factors that can affect test results such as fasting, lipemia, and hemolysis.
Current Component Therapy by Diane Eklund, MDbloodbankhawaii
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This document discusses the interpretation of clinical biochemistry laboratory results. It begins by explaining that understanding laboratory numbers is crucial for correct diagnosis and treatment. Results are usually reported as concentrations or activities. Concentrations contain units of quantity and volume, such as milligrams per deciliter. Standard International (S.I.) units are now commonly used, with substances reported in moles per liter where possible. Activities measure the rate of enzymatic processes and are affected by testing conditions. The document emphasizes that correctly interpreting results is essential for clinical decision making.
Clinical laboratory test results are very important for diagnosis, monitoring, and screening. 70-80% of diagnostic decisions are based on laboratory results. Thus, it is imperative that clinicians understand laboratory tests and how to properly interpret results. Laboratory results must be interpreted using reference intervals that distinguish health from disease states. Clinicians must consider biological variation and the potential for false positive or negative results. The laboratory also has a responsibility to provide clinicians with information to assist in correct interpretation.
This document discusses the laboratory investigation of transfusion reactions. It begins by defining transfusion and transfusion reactions. It then outlines the initial measures taken before investigation, including maintaining IV saline and notifying physicians. The main laboratory investigations include clerical checks to identify errors, visual checks of plasma for hemolysis, and serology checks including ABO testing and direct antiglobulin testing on pre-and post-transfusion samples. If these preliminary tests have positive results, additional tests like grouping, antibody screening and crossmatching are repeated from before transfusion.
Chemical pathology involves measuring analytes in body fluids to aid in diagnosis, screening, monitoring, and prognosis of diseases. It provides over 70% of objective medical record data through tests of electrolytes, liver/kidney function markers, hormones, drugs, and tumor markers. Test results are interpreted using reference ranges which provide context for medical decisions by defining normal and abnormal values. Chemical pathology tests body fluids like blood, urine, CSF, pleural fluid, and synovial fluid to measure analytes like ions, proteins, enzymes, and organic molecules.
This document discusses the uses and types of clinical biochemistry investigations as well as quality control procedures. It notes that lab tests are used to confirm diagnoses, start treatment, screen for risk, monitor disease progression and response to therapy. Tests can be emergency, routine, special, or panels focusing on specific organs or metabolic processes. Quality control ensures accuracy, precision and error-free reporting through procedures like internal controls, reference ranges, and external quality assessments. Factors like specimen collection, transport, drugs, and physiology can influence test results.
Interpretation of clinical laboratory values.pptxNathanGospel
Laboratory tests are performed to discover, diagnose, stage or classify diseases, and monitor therapy effectiveness. Tests are classified as screening or diagnostic. Pharmacists monitor laboratory tests to assess drug effects, determine proper dosing, and assess need for alternative therapy. Common tests include complete blood count, liver and kidney function tests, and cardiac enzyme levels. Abnormal results can indicate various diseases and conditions. Proper interpretation requires considering patient factors and potential sources of error.
Chemical pathology involves the biochemical analysis of bodily fluids to aid in disease diagnosis and management. Dr. S.A. Sakyi's presentation outlines the scope and objectives of chemical pathology, which includes describing disease mechanisms, selecting appropriate tests, and specimen collection and handling. Key aspects covered include common tests performed in chemical pathology laboratories, the roles of chemical pathology in healthcare, and factors that can influence laboratory test results such as diet, medications, and specimen processing.
The urinalysis is one of the most commonly ordered tests in pediatrics due to the ease of urine collection and testing. The urine dipstick test screens for various disorders and remains a common test performed in primary care clinics. Abnormal dipstick results can be due to pathological or non-pathological causes, and false positives and negatives are also common. It is important to consider the clinical context and perform repeat testing or microscopic analysis when abnormal dipstick results are found.
This document provides guidance on evaluating and managing anemia in patients. It discusses evaluating the cause of anemia based on history, physical exam, and lab tests. Causes in critically ill patients especially include blood loss from phlebotomy and bleeding, decreased erythropoiesis from inflammation, and nutritional deficiencies. Transfusions are used to manage anemia but have risks, so restrictive protocols targeting Hgb <7g/dL are recommended except for patients with cardiovascular conditions. New blood substitutes are still experimental and have shown adverse effects.
Lab Results Interpretation for Pharmacist A.NouriAhmed Nouri
PHARMACISTS dealing with LAB RESULTS reading, each pharmacist needs to have the basic knowledge regarding lab results and how to deal with it . Ahmed Nouri, PharmD
1) The ATTIRE trial investigated whether daily albumin infusions would reduce infections and organ dysfunction in hospitalized patients with cirrhosis compared to standard care. 2) Over 700 patients with cirrhosis were randomly assigned to either daily albumin infusions or standard care without explicit albumin therapy for up to 14 days. 3) The trial found no benefit of albumin therapy over standard care on the composite primary outcome of infections, organ dysfunction and mortality.
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8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
2. Mission and Management of
Laboratory Services
Mission of Laboratory Services:
To provide high quality of services, in the right place and at
the right time in respect of the needs of:
- Patients
- Clinicians
- Epidemiologists
- Environmental Sanitarians
Management of Laboratory Services:
Is the guiding of human and physical resources (money,
equipment, reagents, materials and space) through the
laboratory towards determined goals and objectives,
achieving beneficial results for those served.
3. Phases of The Laboratory
Analytical Process
Phases Of The Laboratory Analytical Process
25 %
Analytical phase
Laboratory Technicians
18%
Post-Analytical phase
Reporting
Registration
Sending
20%
Pre-Analytical phase
outside laboratory
Nurses
Doctors
Patients
37%
Pre-Analytical phase
inside laboratory
Patients
Laboratory Technicians
4. Sources of Variations in
Laboratory Results
A- Pre-Analytical Sources:
Preparation of the patient
Obtaining the specimen
Processing the specimen
Specimen interference
Storing the specimen
5. Sources of Variations in
Laboratory Results
B- Analytical Sources:
Dispensing a sample aliquot into a reaction vessel.
Combining the sample with one or more reagents.
Recording some physical or chemical consequences of
the reaction.
Calculating the value of the parameter measured.
C- Post-Analytical Sources:
Accepting the result of the test by the Laboratory
Technician as being of good quality.
Sending the report of the test to the requesting
physician.
6. Pre-Analytical Control
The pre-analytical control includes control on the
following variations:
a. Biological sources of variation.
b. Variation due to specimen collection, transport and
storage.
They are frequent sources of misinterpretation of
laboratory results, even when the laboratory
investigation has been satisfactorily performed.
They may give rise to unnecessary discussions
between the laboratory and health care personnel and
may also lead to further unnecessary investigations.
7. Pre-Analytical Control
It is therefore very important that collection of
specimens be done under standardized conditions,
which include:
a. The preparation of a patient prior to sampling
b. Recording of personal data, e.g. age, sex and clinical
diagnosis and treatment.
8. 1. Biological sources of
variation
The range of the reference values, as well as the results
obtained from measurements in a patient’s specimen are
affected by a number of pre-analytical influences, as
follows:
• Genetic
• Sex
• Age
• Nutrition
• Posture of the patient during specimen sampling.
• Physical activity.
• Non-periodic changes.
9. 1.1 Genetic Variation
A number of genetically determined diseases are
endemic in certain populations. In these populations
the prevalence of the disease may be high,
Some examples are:
- Sickle cell anaemia in African populations.
- Thalassaemia in Mediterranean and Asian
populations.
Other genetic disorders are more or less equally
distributed in different populations.
10. 1.1 Genetic Variation
Examples are:
• Familial hypercholesterolaemia.
• Phenylketonuria.
• Cystinuria.
• Hypothyroidism.
More than 300 variants of the haemoglobin molecule
have been identified, only a few of which cause
clinical symptoms
11. 1.2 Sex-related variation
The differences of the reference ranges for some of the
analytes as observed in an adult population are given
below:
Test Male Female
ESR mm/h 1-13 1-20
Heamoglobin (g/dl) 13-18 12-16
Haematocrit (%) 40-54 39-51
Uric acid (µmol/L) 210-420 150-350
ALT (U/L) 10-50 10-35
AST (U/L) 10-50 10-35
For the following analytes the sex-dependent differences in
concentration are negligible: urea, glucose, alkaline phosphatase.
12. 1.3 Age-dependent variation
Age-dependent changes occur in a number of
haematological and chemical tests.
Most impressive are the differences of results from
blood of a neonate when compared with the normal
ranges for adults, such as in the case of bilirubin,
glucose, total protein, and erythrocyte
sedimentation rate.
Some analytes reach values which could be
misinterpreted as highly pathological if the age of the
patient is not taken into account.
13. 1.4 Nutrition-dependant
variant
The nutritional status of the patient may sometimes
strongly affect the concentration of a number of
analytes in blood. It may even be necessary to keep
him/her on a special diet prior to the investigation of
blood, so as to obtain more accurate information
about metabolic status.
Ingestion of large volumes of water may result in
falsely normal urine glucose concentration; on the
other hand dehydration may cause elevated urine
glucose concentration.
In some subjects ethanol ingestion acutely changes
activities of ALT and AST.
14. 1.4 Nutrition-dependant
variant
Smoking does not usually influence results of common
tests; however, Hb is increased in chronic smokers.
Changes in some analytes due to nutritional state:
Analyte Change
Serum triglycerides Elevated after fat-rich meal
Serum urea Elevated after meat ingestion
Serum glucose Elevated after carbohydrate
ingestion
Aspartate aminotransferase
(AST)
Elevated after alcohol ingestion
Urine ketone bodies Increased during fasting
Urine pH Elevated after ingestion of
vegetables.
15. 1.5 Variation due to posture of the
patient during blood sampling
The changes are more pronounced when blood is
taken from a healthy person changing position from
horizontal to upright, than changes resulting from
technical factors during investigation in a laboratory
with good practice.
A change from the upright to the horizontal position
may result in a change in concentration or activity of
certain tests up to 15%.
Changes in analytes of patients who changed from a
horizontal to an upright position:
16. 1.5 Variation due to posture of the
patient during blood sampling
Analyte Change
Urea -3%
Creatinine +5%
Protein +10%
AST +15%
ALT +15%
Alkaline Phosphatase +12%
Cholesterol +8%
Haematocrit +10%
Albumin +10%
17. 1.6 Variation due physical exercise
Physical exercise may cause pronounced changes in the
activity of enzymes occurring in muscle.
Creatine phosphokinase activity (CK) as well as
aspartate transaminase(AST) increase markedly after
physical exercise.
Increases of Hb concentration and PCV and of the RBC,
WBC and platelets in dehydrated patients are due to
the decrease in plasma volume.
There is an increase in the number of circulating
neutrophils during and following physical exercise.
18. 1.7 Variation due to non-periodic
changes
The occurrence of a non-periodic change, such s
pregnancy, may alter the reference value for a number
of common analytes., such as transaminase activities,
serum lipids and hormones.
There is usually and increase in the number of
neutrophils during pregnancy – sometimes, there is
even a neutrophilic leukocytosis.
The ESR also increases during pregnancy.
On the other hand, the Hb concentration, PCV and RBC
decrease, due at least partially to an increase in plasma
volume.
The effect of interactions and/or interferences,
especially by drugs, on laboratory results has to be
remembered.
19. 2. Variation due to specimen collection,
transport and storage
The most frequent source affecting laboratory analysis in
a well-functioning laboratory is not the laboratory
investigation itself but specimen preparation and errors in
identification or labeling.
Changes in the composition of a specimen can be caused
during:
• Collection.
• Transportation.
• Centrifugation.
• Storage.
20. 2.1 Blood specimens
2.1.1 Collection of blood specimens:
The simplest technique for blood collection is
capillary puncture.
Venous blood samples are preferable for
determination of platelet counts because platelets
adhere to the puncture wound.
Preventing haematoma during vein-puncture:
- Use preferably veins in the elbow area, and only
major veins.
- Be careful that the bevel of the needle is fully
inside the vein.
- Be careful not to transverse the vein.
21. 2.1 Blood specimens
Preventing haematoma during vein-puncture:
- Loosen the tourniquet and ensure haemostasis with a
dry sterile cotton ball before pulling out the needle.
Blood samples should preferably not be taken from
intravenous lines but, if this is unavoidable, care must be
taken to ensure that the intravenous fluid does not dilute
the sample.
If the blood has been collected in a syringe, the needle is
removed before the tube is filled.
The syringe is placed below the rim of the tube and the
blood is expelled gently down the side.
If the sample is to be anticoagulated, the blood is mixed
gently with anticoagulant by repeated inversion.
22. 2.1.2 Preservation of Blood
specimens
The preferred anticoagulant for most haematological
investigations (e.g. of Hb concentration, PCV, WBC, RBC,
reticulocyte counts or platelet count) is a dry EDTA.
The final concentration of anticoagulant should be 1.5 ( + 0.3)
mg/ml blood.
If the final concentration is more than 2mg/ml blood, this may
cause erroneously low PVC, it may also cause cellular artifacts
due to shrinkage of blood cells in films made from the blood
samples.
For erythrocyte sedimentation rate (ESR) the ratio of blood to
citrate is 4:1 (v/v).
Although heparin can be used for routine haematological
investigations, it is not recommended because cells deteriorate
more rapidly in heparinized than in EDTA-anticoagulated blood.
23. 2.1.3 Preparation of thin blood
film
Making the spreaders: select a slide with perfectly
smooth edges and make a diagonal scratch across the
two corners at one end and snap off the two corners
with a pain of pliers.
Disinfect the tip of the third or fourth finger with
ethanol. With the lancet prick the lateral side of the
ball, not too close to the nail bed.
Bring the end of the slide into contact with a small
drop of blood, being careful not to let the slide come
into contact with the skin.
Place the slide on a flat surface and steady it with the
index finger and the thumb.
24. 2.1.3 Preparation of thin blood
film
Place the end of the spreader at an angle of 45” to the first
slide slanting towards the drop of blood. Draw the
spreader back until it touches the drop of blood and wait
until the blood has spread along the entire edge of the
spreader.
With a firm fast motion push the spreader along the first
slide maintaining the 45” angle. In this way the blood is
drawn after the spreader in a thin smear which if the
original drop is small enough, ends in a drawn-out tail well
before reaching the end of the first slide.
Wave the slide so it dries quickly, In humid seasons the
drying of the film can be speeded up by waving the slide 5
cm away from the flame of spirit lamp.
With a lead pencil mark the thick part of the film with the
patient’s name or number.
25. 2.1.4 Common faults in
preparing thin blood films
Common faults in preparing thin blood films
Fault Cause
The end of the film is lost The drop of the blood is too
big
The film ends in a thick line The spreader has been lifted
up too early
The end of the film is ragged The edge of the spreader is
uneven
Lines along the film Blood is clotting when the film
is made
Lines across the film The spreader was pushed
forward jerkily
Holes in the film Greasy slide
26. 2.1.5 Transport and storage of
blood
As a principal rule in laboratory investigation, whole
blood should not be stored.
Blood, urine, other body fluids and excreta are excellent
media for the growth of contaminating bacteria
If blood, plasma or serum cannot be directly
transported to the laboratory or immediately
investigated, they should be kept in the dark at 4 to 8
oC in a stoppered vial to prevent evaporation of water
and degradation of analytes by light.
Analytes affected by prolonged storage of blood
specimen:
Creatinine, Glucose, Alkaline phosphatase, AST, Hb,
PCV, WBC, Reticulocytes, Platelets, ESR.
27. 2.1.5 Transport and storage of
blood
Stability of analytes in serum stored in a stoppered
tube:
Analyte 4 oC 20-25 oC
Bilirubin measurement in fresh serum
Creatinine 24 d not recommended
Protein 6 d
Triglyceride 2 d not recommended
Urea 3 d 24 h
Uric acid 5 d 5 d
Alkaline phosphatase 7 d 7 d 10% decrease
AST 3 d 8% 3 d 10% decrease
ALT 3 d 10% 3 d 17% decrease
28. 2.1.6 Haemolysis
It is important to avoid haemolysis at every step during blood
sampling, transportation and storage.
Artificial causes of haemolysis:
Blood sampling through a too small needle.
Forced suction of blood in the syringe during blood
collection.
Vigorous shaking of blood in the syringe or test tube.
Forced expulsion of blood from the syringe, especially
through a needle.
Centrifuging blood samples at high speed before
completion of clotting.
Freezing and thawing of blood.
Unclean tubes with residual detergent.
29. 2.1.6 Haemolysis
Artificial causes of haemolysis:
Water (or hypotonic solutions) in syringe or tube.
Chemical tests affected by haemolysis:
Bilirubin
Cholesterol
Alkaline phosphatase.
30. 2.1.7 Sources of analytical variation
after blood collection:
Contamination (microbial or chemical)
Prolonged transportation and storage prior to measurement due
to:
- glucose uptake by blood cells
- liberation of enzymes from blood cells
- liberation of ions from blood cells
- rapid decay of enzyme activity
Temperature
Incorrect specimen identification.
Exposure to light: bilirubin.
Transport in open or poorly stoppered vials or leaving specimens
uncapped on the bench. This leads to evaporation of water from
plasma, or conversely water uptake in a humid atmosphere.
31. 2.2 Urine specimen
A random urine specimen collected in a clean, but not-
sterile container is used for qualitative or semi-quantitative
examination of contents such as glucose, protein, pH,
specific gravity, bile pigments, and possible presence of
blood, pus, or crystals.
Often the first morning-voided specimen is requested
because it gives the urine concentration most accurately.
Quantitative urine analysis is helpful for assessment of
kidney function.
For chemical and microbiological examination the urine
must be collected “clean”, because any discharge or pus
from the vagina or external genitals added to the urine will
invalidate the examination.
32. 2.2 Urine specimen
For the demonstration of eggs of schistosomes a random
urine sample should preferably be collected between 10
am and 2 pm, as the concentrations of eggs are greater
during this period. Particularly in the last drop of the
passed urine. Exercise prior to the collection will result in
an excretion of more eggs.
33. 2.2.1 Urine collection
Give the patient a clean, preferably sterile container of
appropriate size (50 ml or more; for quantitative chemical
investigations the whole volume excreted during 24 hours must
be carefully collected in a 2-litre container).
The container must be free of detergents, which may cause false
determinations.
The container should be pre-lablelled with identification data, at
least the patient’s first name and surname.
Instruct the patient before the collection, preferably with
illustrations. Tell him or her not to touch the inside or rim of the
container. Ensure that his/her hands are clean.
Specific instructions should be given to each category of patients:
- Male patients - Female patients
- Patients not requiring assistance
- Bedridden patients requiring assistance - Infants
34. 2.2.2 Urine transportation
Urine specimens should be transported to the laboratory
within one hour for chemical and microbiological
investigations, the reason being the growth of bacteria.
A specimen containing 103
bacteria/ml after collection may
have 105
bacteria/ml 2 hours later when kept at ambient
temperature.
If transport cannot be immediately assured, the specimen
should be refrigerated and processed within 24 hours.
Additives are not required.
35. 2.3 Sexually transmitted disease
specimens:
Sexually transmitted diseases (STD) are caused by a large variety of
viruses, bacteria, fungi and parasites.
With a few exceptions all these microorganisms are too delicate and
fastidious to grow in vitro. Culture of these organisms will also
detect a number of asymptomatic carriers, and is therefore not
recommended.
Their identification depends therefore upon the collection of an
appropriate specimen and upon its transportation under optimal
conditions to the laboratory.
All specimens should be collected before the administration of
antibiotics or the application of topical drugs.
Vaginal fluid should be collected by a doctor using a speculum and a
cotton swab.
The exudate is immediately mixed with a drop of saline on a slide,
covered with a cover slip, and examined under the dry x40 objective
for motile trichomonas, budding yeasts, or clue cells. Yeasts can be
easily visualized by adding a drop of 10% potassium hydroxide (KOH)
to the exudate.
36. 2.4 Stool specimens:
2.4.1 Collection of stool specimen:
Faecal material should be collected directly in the
container.
The specimen should not be contaminated with urine.
Stool specimens must not be left exposed to the air in
containers without lids.
Rectal swabs should only be taken if the patient is unable
to produce a stool specimen.
The technician should inspect every stool specimen and
record the observations on the request form. Note the
consistency (watery, liquid, mushy or formed) and the
presence of blood, pus, mucus or adult parasitic worms.
37. 2.4 Stool specimens:
2.4.2 Collection of stool specimen:
Specimens for bacteriological examination should be
transported to the laboratory and processed within a few
hours. In case of delay the specimen should be refrigerated. If
longer delays cannot be avoided a special transport medium
should be used.
Stool for parasitological examination can be preserved for
several weeks by mixing the specimen with at least 3 volumes
of preservative fluid.
A 10% formalin (3.4% formaldehyde) solution is
recommended.
For the detection of motile forms of Entamoeba histolytica
and other protozoa, suspected stools should be examined
within one hour after defecation, without preliminary
refrigeration.
38. 2.4 Stool specimens:
2.4.2 Collection of stool specimen:
A wet mount in saline of freshly passed faecs is prepared and
examined at once under the microscope.
Microscopic examination of stools for amoebae requires
technical expertise. False results are common, especially
when examination is done by a non-expert.
39. 2.5 Criteria for rejection of
specimens:
Missing or inadequate identification.
Insufficient volume.
Specimen collected in wrong collection tube.
Contamination.
Inappropriate transport and storage.
Unknown time delay.