5-2

• Pathology

  The study of diseases, bridges science and medicine and underpins every aspect of patient care
• Pathology is involved in over 70% of all diagnoses made in the NHS (Some sources now saying up to 80%)
• Careers in Pathology

  • Doctor
  • Clinical Scientist
  • Biomedical Scientist
• Haematology

  The discipline associated with the study of blood and the treatment of its disorders
• Haematology tests

  1. Observe reactions in samples of whole blood or plasma when they are mixed with certain reagents

  2. Make blood films in order to examine cellular components of blood

  3. Blood films are stained with Romanowsky-based stains which stain the nuclei purple and cytoplasm blue

  4. Red cell abnormalities, white cell relative proportions and parasites can be detected
• Full Blood Count (FBC)

  A test which is commonly performed to help with diagnosis, involves determining the concentration of haemoglobin, red and white blood cells, reticulocytes and platelets
• Coagulation Assays

  Prothrombin time (PT) and activated partial thromboplastin time (APTT) assess the different pathways of clot formation
• Determining Blood Group

  The patients blood is mixed with the various antibodies to determine what reactions occur
• Clinical Biochemistry

  Concerned with the analysis of chemicals within the body and establishing whether any are at unusually high or low levels
• Multiple Myeloma

  A malignancy which causes overproduction of plasma cells in the bone marrow, initial diagnostic tests would show raised levels of total protein and increased levels of IgG antibodies
• Thyroid Function Test

  The concentrations of TSH in the patients blood can be measured using a sandwich-type enzyme immunoassay (EIA)
• Blood Glucose Levels

  Monitoring and screening blood glucose is important in the treatment and early detection of diabetes, the test is based on the activity of the enzyme glucose oxidase
• Immunology

  The clinical immunology service provides tests for autoimmunity, rheumatology and allergies, as well as serology such as HIV and hepatitis testing
• Allergy Testing

  Selective testing for specific IgE antibodies, the allergen of interest reacts with the specific IgE in the patient sample
• Coeliac Disease Screening

  Initially, an enzyme linked immunosorbent assay (ELISA) is used to detect transglutaminase antibody, high concentration is suggestive but not diagnostic, indirect immunofluorescent assay using endomysial antibodies is used to confirm the diagnosis
• Alison is a 32-year old woman who has a history of bowel frequency with occasional bouts of constipation going back over 15 years, she was diagnosed with irritable bowel syndrome (IBS) and now has severe diarrhoea after a meal
• Cellular Sciences

  Concerns diagnosis by studying the characteristics of cells, including human cells and tissues as well as microorganisms
• Cellular Sciences disciplines

  • Microbiology
  • Cytology
  • Histology
• Medical Microbiology

  Involves the examination of a wide range of samples to look for microorganisms which cause disease (pathogens)
• Urinary Tract Infections

  Establishing whether a patient has a bacterial urinary tract infection (UTI) and then identification of the causative agent is important, as it allows the patient to be prescribed an effective antibiotic treatment
• Cellular Pathology

  It is known what normal cells/tissue look like under the microscope so abnormal-looking cells may be indicative of diseases caused by inflammation, infection and cancer
• Histology

  The study of tissues to detect any abnormal arrangements or morphologies which would indicate disease (pathology)
• Skin Biopsy for Investigation of Cancer

  The biopsy is cut into thin pieces and impregnated with paraffin wax so that it can be sliced using a microtome to produce sections, the tissue is stained with haematoxylin and eosin (H&E) to observe the components
• Cytology

  The study of cells to detect any abnormal arrangements or morphologies which would indicate disease (pathology)
• Early Diagnosis and Prevention of Cervical Cancer

  Exfoliative Cytology (Pap Smear) using Papanicolaou stain
• CIN I (Cervical Intraepithelial Neoplasm)

  Mild dysplasia means the skin cells of the cervix are reproducing slightly more quickly than normal, the cells are slightly more plump than they should be and have larger, darker nuclei
• CIN II

  Moderate dysplasia means the skin of the cervix is growing faster than it should and has progressed beyond the mild stage, a biopsy would show immature basal cells growing partway through to the surface of the skin, without significant maturation
• CIN III

  Severe dysplasia means that the skin of the cervix is growing so rapidly that the immature basal cells extend completely through the skin thickness to the surface with any maturation