Clinical Laboratory Studies

Chapter 6

Laboratory Testing

•  Peripheral venous blood •  Body fluids or secretions

– Sputum – Pleural fluid – Cerebrospinal fluid – Urine – Feces – Sweat

Hematology 1.  Cellular Elements

a.  CBC b.  Platelet count c.  Reticulocyte count

2. Proteins in the Plasma a.  PT b.  INR c.  APTT

  WBC - leukocytes   RBC – erythrocytes   Platelets - thrombocytes

WBC

•  WBC Differential – Granulocytes

•  Neutrophils •  Eosinophils •  Basophils

– Lymphocytes – Monocytes

WBC Abnormalities •  Leukocytosis •  Leukopenia •  Neutrophilia •  Neutropenia •  Pseudoneutrophilia •  Pseudoneutropenia •  Left Shift •  Eosinophilia •  Basophilia •  Lymphocytosis •  Lymphocytopenia •  Monocytosis

•  Leukemia •  Myeloproliferative

disorders

RBC

•  Normoblasts •  Hematocrit •  Hemoglobin •  MCV •  MCH •  MCHC •  RDW

RBC Abnormalities

•  Anemia – Microcytic hypochromic – Normocytic normochromic – Macrocytic

•  Polycythemia – Primary – Secondary – Spurious

•  Reticulocyte count •  Sedimentation rate •  Platelet count •  Coagulation studies

– Bleeding time – Platelet count – APTT – PT/INR

Chemistry

•  Electrolyte Concentrations •  BUN/Creatinine •  Enzymes •  Glucose •  Proteins •  Lipids •  Tumor Markers •  Drug Monitoring

Electrolyte Concentrations •  Sodium (Na+)

–  Hypernatremia –  Hyponatremia

•  Potassium (K-) –  Hyperkalemia –  Hypokalemia

•  Chloride (Cl-) –  Hyperchloremia –  hypochloremia

•  Total CO2

•  Anion Gap •  Electrolyte

concentration of Sweat

Renal Function

• BUN • Creatinine

Enzymes

•  AST •  ALT •  ALP •  ACP •  LDH •  CK

•  Myoglobin •  Troponin •  Amylase •  Lipase

Glucose

•  Hyperglycemia •  Hypoglycemia

•  Proteins •  Lipids •  Tumor Markers •  Drug Monitoring

Microbiology

•  Normal flora vs sterile areas of the body

•  Pathogenic organisms

•  Classification •  Culture and

Sensitivity

•  Sputum Collection •  Sputum Examination •  BAL •  Pleural Fluid

Examination

Urinalysis •  Appearance •  Specific gravity •  pH •  Protein - proteinuria •  Glucose – glucosuria •  Ketones •  Blood - hematuria •  Bilirubin •  Urobilinogen •  Nitrate •  Sediment

•  Histology - Biopsy – Lung tissue – Tumors

•  Cytology – Fluids – Secretions

•  Skin Testing