Intro to Lab Med Flashcards
Hematology
Whole blood analysis and coagulation
coagulation
clotting
Urinalysis
Urine
Chemistry
Body Fluids component, organ functions
Special Chemistry
elaborate techniques such aselectrophoresis, and manual testing methods.
Microbiology
Pathogenic microorganisms
Serology/Immunology
Antibody studies
Role of Lab testing
The decision making model
History and physical exam
Patient assessment and the differential diagnosis (hypothesis)
Deciding on a management plan
60-70% of heath care decision rest on clinical lab tests-
play crucial role in decision making
Diagnosing symptoms, deciding course of treatment, monitor response to therapy
Chest pain what are your differentials?
Use of test called CK-MB/CPK or troponins….…..enzyme/protein released from myocytes during cardiac damage…… level is elevated during an MI in the serum
What do you need to learn?
when & what to order to aid your decision
how these correlate with the physiologic condition of the patient
Once diagnosis is made…
Use in continuous management Monitor disease course and therapeutic response Provide information on prognosis Information on risk of future disease Screening tests Detection of subclinical disease
PSA is a tumor marker for…
initial diagnosis of prostate CA then to follow and check for metastatic disease occurrence or return of CA once treatment complete
Are lab tests always needed?
some substance in the blood, urine, cerebrospinal fluid, other body fluids
ONLY AS GOOD AS SPECIMEN SUBMITTED
Don’t order lab tests if…
you know why (how will you use info)
you know WHAT to order
it will help narrow your differentials
it will change your treatment decision
Ordering Parameters are
Over 1,000 from less to very invasive simple to complex Cost money Practical limitations Lab capabilities Time to receive results- can you wait
CBC versus H&H means
complete blood count versus bone marrow
Do all labs off all tests?
NO, – may use reference labs or substitute one test for another- need to understand and know what information you need and best way to get it in terms of turn around for your patient – will ordering it help your tx decision or your patient
example of troponins versus CK-MB
Sequential versus concurrent ordering
Turnaround time for results important here
minimize # of tests ordered to promote efficiency and accuracy
Assess potential for patient risk
Single test versus profile/panel testing
Collection of different measurements related to specific organ system or disease
Useful in initial screening evaluation
IMPROPER use in continued monitoring
Is a Greater # of tests ordered always better?
NO
Long wait for results or high perceived risk for patient…….
need to order all of those, useful
When you need glucose measurement…
Order Chem 7