Laboratory Medicine

Question 1

Laboratory medicine specialites

Answer 1

Histopathology, medical microbiology, clinical biochemistry, immunology, genetics, cytopathology, haematology

Question 2

Reasons to request a lab specialities

Answer 2

To inform clinical decision;

1. Screening - detection of sub-clinical disease eg. PKU and cervical smear.
2. Diagnosis - conformation or rejection of clinical diagnosis.
3. Monitoring - natural history or response to treatment.
4. Prognosis - prediction of course/outcome of disease.

Question 3

Laboratory acceptance policy

Answer 3

Essential: CHI no, full pt name, DoB, specimen type, anatomical site, investigations required, date/time of collection, relevant clinical Hx.
Ideal: pt location, full name of practitioner and contact details, pr home address, lab speciality.
Why? It allows the laboratory to produce the right result i the right patient at the right time. Thus allowing clinicians to give the right treatment in a timely manner.

Question 4

Examples of lab tests in patient pathway

Answer 4

1) Paracetamol OD; rapid turnaround of the sample, showing increased liver enzymes and paracetamol conc allowed the patient to receive the required treatment quickly preventing liver damage.
2) Biochemistry report for suspected familial hypercholesterolaemia. Then a subsequent test to look for mutations in the LDL receptor gene.

Question 5

POCT

Answer 5

Point of care testing is lab testing preformed in the clinical setting by non-laboratory HCPS e.g blood gases, BM, urine dip-stix, urine analysis.