INTRODUCTION TO LABORATORY
MEDICINE
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

COURSE OBJECTIVES
application of basic science to those clinical
disciplines practiced by the medical laboratory
scientist.
 the scope of Laboratory Medicine, and of its
potential applications.
 How to analyze various samples under certain
circumstances.

COURSE CONTENTS
Clinical Biochemistry
 Cardiac profiles
 Liver and renal panels
 Bone metabolism
 Lipid chemistry
 Special chemistry
 Cardiovascular markers
 Tumour markers
 Nutritional markers
 Calculi

Immunology and Immunodiagnostics
 Drug 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
Laboratory Hematology
 Routine and special hematology
 Hemoglobinopathy studies
 Special stains
 Hematopathology
 Bone marrow consultations and interpretive
report
 Flow cytometry
 CD 34 (stem cell) enumeration
 CD4/CD8 monitoring
 Leukemia/lymphoma immunophenotyping
 PNH

Special coagulation
 Coagulation profiles, screening and factors and
inhibitors
 Platelet studies
 Thrombophilia testing
 Microbiology
 Bacterial culture and sensitivities
 Blood cultures
 Molecular typing of organisms
 Viral detection methodologies
 HIV viral load -public health lab accredited
site for viral load
 Chlamydia detection





Infection control
 Reference centre for medical microbiology and infectious
diseases
 Detection and typing of epidemiologically significant
organisms
Serology
 Clostridium difficile toxin testing
 Wide range of viral and non-viral serologies
Molecular Diagnostic Testing
 Wide range of molecular testing for viral and bacterial
agents
 Mycology
 Fungus detection
 Cells/tissues/organ donor 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
RECOMMENDED BOOKS
Textbook:
District laboratory practice in tropical
countries by Monica Cheesbrough.
Clinical chemistry by William J Marshall.
Reference books:
Medical Laboratory technology by Ramnik
Sood.
REASONS FOR ORDERING TESTS

Aid in diagnosis

Confirm diagnosis

Evaluate prognosis

Monitor therapy

Screen for a disease
SECTIONS OF THE LABORATORY
CLINICAL
PATHOLOGY
1. Clinical Chemistry



BUN
Cholesterol
FBS
2. Clinical Microscopy




Analysis of body fluids
Urin analysis
Fecal anaysis
Semen analysis
3. Microbiology
Cultures (sputum,
blood, urine)

4. Hematology
Biggest section
Includes CBC,coagulation,
PT, PTT
BLOOD BANK
Very critical section
Serology/Immunology
Bec. May have errors

Blood typing

Cross match

AB

Identification
Goes hand in hand with serology
and immunology
Tests done for

MALARIA

SYPHILIS

HIV

Cardiac and thyroid fxntest
II. ANATOMY PATHOLOGY
Histopathology
Submission of tissues for tests
NATURE OF REQUEST
Today
 confusing
Performed immediate  Performed as
lyand by itself
soon as possible,
given priority
Run control and
standard
 Based on “running
time”
20-50% More
expensive
Routine
TAT is shortened
 Done with the
batch
Request is needed
 Wait for TAT
stated by
laboratory
STAT





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
value
 Usually when 2x to 3x
CRITICAL VALUES




Needs immediate attention
“panic values”
Should call physician
Patient is at risk
REFERENCE VALUES
Not fixed for all
Should consider:






Age
Sex
Pregnancy
Diurnal Variation
Race
Blood type
ROUTINE EXAMINATIONS
ROUTINE ADMISSION TESTS
CBC, Urinalysis, Fecalysis
ROUTINE CHEMISTRIES
BUN, Creatinine, Glucose, Uric Acid, Cholesterol
Sometimes triglycerides