medicine

1. SECTIONS OF THE
CLINICAL LABORATORY

2. CLINICAL CHEMISTRY
◦ Testing of blood and other body fluids: essential soluble chemicals: blood and urine
◦ FBS: fasting blood sugar, HbA1c: hemoglobin A1c, TC: total cholesterol, TG: triglycerides, HDL: high density
lipoprotein, LDL: low density lipoprotein
◦ BUA: uric acid, BUN: blood urea nitrogen, Crea: Creatinine, Electrolytes: Na: Sodium, Cl: Chloride, K: Potassium,
Ca: Calcium, Mg: Magnesium
◦ TP: Total protein, A: albumin, G: globulin, BIL: bilirubin, TropI: Troponin I, D-dimer, CRP: C reactive protein
◦ CK: creatine kinase, AMY: amylase, LP: lipase, GGT: gamma glutamyl transferase, AST: aspartate aminotransferase,
ALT: alanine aminotransferase
◦ Hormones: TSH: thyroid stimulating hormone, T3: Triiodothyronine, T4: thyroxine, estrogen, prolactin,
testosterone
◦ Fe: Iron, Ferritin, TIBC: Total Iron binding capacity
◦ Drug test, therapeutic drug monitoring
◦ Quality control & waste management

3. Example of a fully automated system

4. MICROBIOLOGY
◦ Bacteria, fungi
◦ Culture & identification of bacteria/fungi, Gram stain & other stains
for bacteria & fungi, Antibiotic susceptibility testing
◦ Quality control & waste management
◦ Infection control & biosafety
◦ Viruses
◦ cell culture & Microscopy,
◦ Immunodiagnosis: serology section
◦ PCR: molecular biology section

5. Example of automated bacteria culture

6. HEMATOLOGY &
COAGULATION
◦ Enumeration of cells in the blood and other
body fluid
◦ CBC: complete blood count: RBC count, WBC
count, Platelet count
◦ Hemoglobin, Hematocrit
◦ WBC differential count: Neutrophils,
Eosinophils, Basophils, Monocytes, Blast cells if
any
◦ Blood indices: MCV: mean corpuscular volume,
MCH: mean corpuscular hemoglobin, MCHC:
mean corpuscular hemoglobin concentration,
RDW: red cell distribution width
◦ Coagulation studies: PT: prothrombin time,
aPTT: activated partial thromboplastin time

7. CLINICAL
MICROSCOPY
◦ Urinalysis:
◦ Physical examination: color, clarity, specific
gravity
◦ Chemical examination: glucose, protein, leukocyte
esterase, bilirubin, blood, ketones, urobilinogen,
pH, nitrite
◦ Microscopic examination: RBC, WBC, SEC, cast,
crystals, bacteria, parasites, mucus
◦ Fecalysis/Stool analysis:
◦ Identification of parasites

8. BLOOD
BANK/IMMUNOHEMATOLOGY
◦ Blood typing, compatibility testing, antibody
screening
◦ Blood donation, screening of blood units, storage
◦ Processing of blood components: packed RBC,
whole blood, platelet concentrate, fresh frozen
plasma

9. IMMUNOLOGY &
SEROLOGY
◦ Antibodies to infectious agents
◦ Serological test: Hepatitis B, Syphilis, Dengue, Hepatitis C
◦ ELISA, RIA

10. HISTOPATHOLOGY/CYTOLOGY
Tissue processing, autopsy, slide preparation of stained tissues, frozen tissue sections
Cancer diagnosis

11. IMMUNOHISTOCHEMISTRY
◦ Detection of antigens in tissues by using
antibodies, enzymes and fluorescent dyes
◦ Cancer diagnosis

12. MOLECULAR BIOLOGY &
BIOTECHNOLOGY
DNA, RNA, PCR

13. LABORATORY TESTING CYCLE
◦ Pre-analytic: receipt of laboratory request, patient preparation, specimen collection, specimen transport
◦ Variables that may affect the test results
◦ Analytic: actual testing
◦ Equipment, instruments, reagents used, quality control program
◦ Post analytic: transmission of test results, turn around time

14. QUALITY ASSURANCE
◦ Activities to ensure reliability of test results
◦ Organized, systematic, well planned and regularly done
◦ Documented and reviewed
◦ Internal quality assurance: day to day activities
◦ External quality assurance: checking performance among clinical laboratories facilitated by NRL-DOH
◦ NKTI: hematology & coagulation
◦ RITM: microbiology & parasitology
◦ LCP: clinical chemistry
◦ EAMC: drugs of abuse & toxicology
◦ SACCL: infectious disease: HIV, HBV, HCV