clin lab

• Classifications of clinical laboratories

  • According to Function
  • According to Institutional Characteristics
  • According to Ownership
  • According to Service Capability
• Clinical pathology


  Focuses on the areas of clinical chemistry, immunohematology, and blood banking, medical microbiology, immunology and serology, hematology, parasitology, clinical microscopy, toxicology, therapeutic drug monitoring, and endocriniology
• Clinical pathology


  Concerned with the diagnosis and treatment of diseases performed through laboratory testing of blood and other body fluids

  
• Anatomic pathology


  Focuses on the areas of histopathology, immunohistopathology, cytology, autopsy, and forensic pathology among others. Concerned with the diagnosis of diseases through microscopic examination of tissues and organs
• Institution-based clinical laboratory


  Operates within the premises or part of an institution such as a hospital, school, medical clinic, medical facility for overseas workers, etc.
• Free-standing clinical laboratory


  Not part of an established institution. The most common example is a free-standing outpatient clinical laboratory
• Government-owned clinical laboratory


  Owned wholly or partially, by national or local government units
• Government-owned clinical laboratories


  • DOH run government hospitals like: San Lazaro Hospital, Jose R. Reyes Memorial Medical Center, UP-PGH, Ospital ng Maynila (LGU)
• Privately-owned clinical laboratory


  Owned, established and operated by an individual, corporation, institution, association, organization
• Privately-owned clinical laboratories


  • St. Lukes Medical Center, Makati Medical Center, MCU-FDTMF Hospital
• Primary laboratory


  Licensed to perform basic, routine, laboratory testing
• Tests performed by primary laboratories


  • Routine urinalysis, CBC, Fecalysis
• Primary laboratory requirements


  • Microscopes, Centrifuge, Hematocrit centrifuge, 10 square meters space
• Secondary laboratory


  Licensed to perform laboratory tests being done by the primary category clinical laboratory along with routine clinical chemistry tests
• Tests performed by secondary laboratories

  • Blood glucose, Cholesterol, Creatinine/BUN, Gram stain, KOH (if hospital based)
• Secondary laboratory requirements


  • 20 sq.m area, Personnel requirement depends on workload, Primary lab requirements plus chemistry analyzers, autoclave, oven
• Tertiary laboratory


  Licensed to perform all laboratory tests performed in the primary and secondary laboratory plus immunology-serology, microbiology, blood banking
• Tertiary laboratory requirements


  • 60 sq.m area, Secondary lab requirements plus BSC II, serofuge, chemistry analyzers, blood bank refrigerators, etc.
• Reference laboratory


  Laboratory in a government hospital designated by the DOH to provide special diagnostic functions and services for certain diseases, in charge of training MTs and sending EQAS (external quality assurance)
• Hematology


  The study of blood and blood disorders, including blood and bone marrow cells. Hematological tests can help diagnose anemia, infection, hemophilia, blood-clotting disorders, and leukemia

  
• Hematologist


  Focuses on direct patient care and diagnosing and managing hematologic disease, especially cancers
• Hematopathologist


  Board-certified in both anatomical and clinical pathology with additional years of training in hematopathology. Studies disease of the blood, bone marrow, and organs/tissues that use blood cells
• Bone marrow biopsy is not a common test in general, but is a common test for hematologists. It involves taking cells from the bone marrow for analysis for many types of disease
• Hematology sample types


  • EDTA blood sample for CBC, manual counts, differential, platelet count
  • Sodium Citrate for Coagulation studies

  
• Clinical Microscopy


  Performs routine and special tests on patients' urine and fecal samples, chemically analyzing and examining at the microscopic level. Also analyzes other body fluids, UA, FA, Pregnancy Screening Test, Wet and Iodine preparation and Semenalysis
• Clinical Microscopy sample preparation

  • For Urine - process immediately/within 2 hours, mixed by swirling
  • For Stool - process immediately within 2 hours (stored in refrigerator)
  • For body fluids - process immediately at room temperature (storage varies)
  • For semen - allowed to liquefy for 30 mins to 1h
• Clinical Chemistry


  Quantitative science concerned with measurement of amounts of biologically important substances (called analytes) in body fluids
• Common Clinical Chemistry tests

  • Glucose, Protein
  • Kidney Function Tests
  • Liver Function Tests
  • Endocrine Function Tests
  • Trace Elements
  • Tumor Markers
  • Enzymes
• Microbiology


  Cultures samples to determine if pathogenic organisms are present and determines the organism's sensitivity to antibiotics
• Microbiology tests


  • Blood Culture, Throat Culture, Gram stain, Fungal culture, India ink, Biochemical analyses and Sensitivity testing
• Immunology and Serology


  Studies antigens and antibodies to determine immunity to disease or presence of disease. Antibody serology tests check for the presence or level of specific antibodies in the blood
• Immunology and Serology tests

  • HIV Test, Hepatitis Profile, RPR (syphilis), Rubella, VDRL
• Serology sample types


  • Serum at Room Temperature
  • Red Top or Serum Separator tube (Yellow top)
  • Separate serum from red cells if processing will be delayed
• Blood Bank


  Determines compatibility of blood and blood products that are to be administered to patients

  
• Blood Bank tests


  • Compatibility testing, antibody panel, ABO, Rh determination
• Histopathology


  The diagnosis and study of diseases of the tissues, involving examining tissues and/or cells under a microscope. Histopathologists make tissue diagnoses and help clinicians manage patient care
• Histopathology procedures


  • Tissue Processing
  • Autopsy
  • Biopsy
• Histopathology sample preparation


  Must be fixed immediately (Formaldehyde), Cryostat, Microtome