Diagnostic Techniques

Question 1

Pathology is involved in

Answer 1

70% of diagnoses

14 test/ everyperson/each year

Question 2

How many different disciplines make up pathology?

Answer 2

19

Question 3

Changes in chemical composition of body fluids

Answer 3

Clinical Biochemistry

Question 4

Bodys immune system and its disorders

Answer 4

Immunology

Question 5

Infection - bacterial, viral, fungi and parasites

Monitor response to treatment

Answer 5

Microbiology

Question 6

blood cells study

Answer 6

Haematology

Question 7

Diseased tisc/cells

Answer 7

Histopathology/Cytopathology

Question 8

study of DNA

Answer 8

Genetics

genetically transmitted disorders

Question 9

Why use lab test?

Answer 9

Inform Clinical Decision

Screening (detection), Diagnosis (confirmation/rejection of clinical diagnosis), Monitoring(natural history/response to treatment e.g. CRP: resolve infection; CD4 and viral load for HIV), Prognosis (prediction of course, outcome - tumour markers)

Question 10

Why is correct info important?

Answer 10

Allows lab to produce right result on right patient at the right time
Allows clinicians to give right treatment on time

Question 11

Which are essential information required on a sample?

Answer 11

10 Digit CHI no.
Patients forename and surname
Patient DOB
Anatomical site
Specimen type
Investigations required
Date and time of collection
Relevant Clinical History

Question 12

Prevent paracetamol induced liver damage.

Answer 12

N-acetylcysteine

Overdose of Paracetamol - High paracetamol + ALP + GGT (gamma-glutamyl transferase) level

Both ALP and GGT are elevated in disease of the bile ducts and in some liver diseases

Question 13

Tendon Xanthomata

Answer 13

skin lesions caused by the accumulation of fat

associated with type II hyperlipidemia, chronic biliary tract obstruction, and primary biliary cirrhosis

Question 14

Familial Hypercholesterolaemia

Answer 14

Diagnosis by Simon Broome Criteria
	Total Cholesterol (adult) 		>7.5mmol/L
	LDL Cholesterol (adult)		>4.9mmol/L
	Tendon Xanthomata
	Family History

This patient fitted all the above criteria so a blood sample was sent away for genetic testing, looking specifically for mutations in the LDL receptor gene, which is responsible for the removal of LDL from the blood.

Genetic testing: FH mutations – LDLR gene, APOB gene and PCSK9 gene

Question 15

The patient’s son (heterozygous) has a child with a heterozygous female, what is the chance of the child being homozygous for the condition?

Answer 15

1 in 4

Question 16

Laboratory testing performed in the clinical setting by non-laboratory healthcare professionals.

Answer 16

POCT - Point of care testing

Blood gasses, Blood glucose, Urine dipsticks, Urine analysis

Question 17

Why is POCT useful?

Answer 17

Improved turnaround time
Potential for better monitoring of certain conditions
Smaller sample volumes
Less clinically invasive
In some out-patient settings, POCT results can be used to adjust patient’s medication resulting in less frequent clinic appointments

Disadv:

Incidents filed with FDA re blood glucose monitoring

Question 18

Iso-propanol (alcohol) swab inhibits ….. in the test strip.

Answer 18

Glucose oxidase

Glucose levels not detected accurately (lower than actual)