clinical laboratory - 3rd yr (values+ definition) - Flashcards in University Medicine

Test selection. Patient preparation. Specimen acquisition. Laboratory analysis. Reporting of results. Interpretation of results. Reference range of laboratory tests

lab test ordered for 1/3 reasons: diagnosis, screening for disease+ patient management (prognosis, therapy).
dx: positive, negative, false -ve and false +ve.
specificity vs sensitivity:
sensitive: find disease.
specificity: find w/out disease. screening:

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Urine in laboratory diagnostics (urinalysis) Characteristics of the urine: Quantity, Colours, pH, Specific Gravity, Osmolarity.

urine minimum: 300-500 ml/daily. max: 2 Liter. 750 ml-2,000 mL (over 24hr).
color: Er+ WBC (cloudy, dark red-brown) vaginal bleeding contaminate. artifical changes due to food color,betroots,drugs, myo/haemoglobin (haematuria-> ARF (crushing S)
Spg: 1.025

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Routine chemistry Urinalysis: Protein, Blood, Glucose. Test principles of measurement. Sources of errors. Clinical aspects.

test: protein, blood, gluocose+ WBC.
protein= 150 mg/24 hr albumin.
nephrotic syndrome: > 3.5 g /24 hr.
protein in serum -66-68 g/L.
dipstick test for albumin (bromphenol blue) stains green.
sulfosalicylic acid-> IG/bence jones (indicate multiple myeloma)

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Routine chemistry Urinalysis: Ketone Bodies, Bilirubin, Urobilinogen, Nitrite. Test principles of measurement. Sources of errors. Clinical aspects.

urine DIPSTICK: ketone, spg, blood, protein, nitrate, glucose,urobilinogen, bilirubin.
nitrate: presence of E.coli (UTI's)->leukocyte esterase test (purple-positive).
ketone body: metabolised via B-oxid->acetoacetate,beta-hydroxybutryic acid ,acetone (sho

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Microscopic examination of urine: cells, casts, crystals.

RBC: shouldnt be present, if any found in 5 HPF then abnormal in uncontaminated sample. color and morphology depend on Spg and exposure period.
consider method of collection: cystocystesis, catheterization.
-haematuria caused via hemorrhage, tumour, UTI

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WBC differential count

Neutrophils -2.0–7.0×109/L
Lymphocytes -1.0–3.0×109/L
Monocytes -0.2–1.0×109/L
Eosinophils -0.02–0.5×109/L
Basophils -0.02–0.1×109/L
function: parasitic, immune function, anaphylactic, IG.

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RBC

Red blood cell count→actual number of RBCs per volume of blood
Male : 4.7 to 6.1 x10^12 /L
Female: 4.2 to 5.4 x10^12 /L
Biconcave disc shape- diameter of 6-8 μm in thickness

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Hb

M: 140 to 180 g/L
F: 120 to 160 g/L

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haematocrit

M: 40.7 to 50.3 %
F: 36.1 to 44.3%
Haematocrit = MCV (height dependent on volume) x RBC
ESR: 11-15 mm/hr (male)
12-18 mm/hr (female)

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ESR

-->inflammation, non-specific, indicate inflammation occurs but not exactly where/why? how many minutes it takes to descend in 1hr. 0.22 mm/hr -male
0.29 mm/hr -female.

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RBc morphology

anisocytosis- variation
polikocytosis> 10%.
cigar shaped ,acanyocytosis,spherocytosis, stomatocytosis -(stoma-mouth)
sickle cell, tear drops, echinocytosis-fragmented),schistocytosis,
hypo/polychromasia

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platelets:

Diameter about 2-4 μm
Normal range; 150-360x10^9 /L
Destroyed by macrophage cells in the spleen.
↑-preg,exercise, splenectomy.↓ haemorrhage,bone marrow disease.

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neutrophil patholgoy morphology

hyper-segmented (myeloblastic anaemia, liver disease).
-ring shaped nucelus (acute myeloid anaemia). toxic granulation- severe bacteria infection. dahle body- inflammation + burns)

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coagulation pathway: intrinsic, common and extrinsic pathway

1.Intrinsic
▪ XII is cleaved → XII a which then cleaves XI → Xia which cleaves IX → IXa
▪ IXa attaches to Cofactor VIIIa on one side and X attach to the other side → Xa.

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clinical laboratory - 3rd yr (values+ definition)

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