Lesson 8: Nature of the Clinical Laboratory Flashcards
● Is the place where specimens (e.g., blood and other body fluids, tissues, feces, hair nails) collected from individuals are processed, analyzed, preserved, and properly disposed.
● 70%
Clinical Laboratory
serves as the integral partner of medical doctors and is an important member of the
health care delivery system.
Medical Technologist/Clinical Laboratory Scientist
In the past - manual, taxing, labor-intensive, and time-consuming.
Recently - less laborious, with shortened turnaround time
Assays
Diagnosis and
treatment of diseases
performed through
laboratory testing of
blood and other body
fluids
Clinical Pathology
Diagnosis of
diseases through
microscopic
examination of
tissues and
organs
Anatomic Pathology
operates within the premises or part of an institution
Institution-based
A clinical laboratory is not part of an
established institution.
Free-standing
Owned, wholly or partially, by national or local government units
Government-owned
Owned, established and operated by an individual, corporation,
institution, association, or organization
Privately Owned
● Basic, routine laboratory
testing
● At least 10 square meters
● Microscopes, centrifuge,
hematocrit centrifuge
● Routine urinalysis, routine stool examination, routine
hematology or CBC (hemoglobin, hematocrit, WBC & RBC
count, WBC differential count, qualitative platelet count,
blood typing, Gram-staining (if hospital-based)
Primary Category
● 20 square meters
● Microscopes, centrifuge, hematocrit centrifuge, semi-
automated chemistry analyzers, autoclave, incubator, oven
● Hospital-based – Gram stain, KOH mount, crossmatching
Secondary Category
● All laboratory tests performed in the secondary category laboratory
● Immunology and serology, microbiology, bacteriology, mycology,
special clinical chemistry, special hematology, immunohematology and
blood banking
● At least 60 square meters
Tertiary Category
●Government hospital laboratory designated by the DOH to provide special diagnostic functions and services for certain diseases
National Reference Laboratory
Testing of blood and other body fluids to quantify essential soluble chemicals including waste products useful for the diagnosis of certain diseases
Clinical Chemistry
enumeration of cells
in the blood and other body fluids
Hematology and Coagulation Studies
Identification of
bacteria and fungi
Blood and other
body fluids, stool,
tissues and swabs
Microbiology
Urinalysis
○ Macroscopic examination – color, transparency, specific gravity, pH
○ Microscopic examination – abnormal cells/parasites, quantify
RBC and WBC
Fecalysis – identification of parasitic
worms and ova
CLINICAL MICROSCOPY
● Most critical
section in the
clinical laboratory
● Blood typing and
compatibility
testing
● Screening and identification of antibodies and blood components used for transfusion
BLOOD BANK/IMMUNOHEMATOLOGY
Analyses of serum antibodies in certain
infectious agents (primarily viral agents)
Immunology and Serology
● Tissue (biopsy and
autopsy) processing
● Cutting into sections
● Staining
● Microscopic examination
by a pathologist
Anatomic Pathology
● Detection of tumor-specific
antigens, oncogenes and tumor
suppressor genes
● Assess responses of patients to
cancer therapy
● Diagnosis of certain
neurodegenerative disorders
Immunohistochemistry
● DNA and RNA are identified
and sequenced to detect any
pathologic conditions/disease
processes
● Polymerase Chain Reaction
(PCR) – most common
technique
Molecular Biology and Biotechnology
▪ receipt of the laboratory request
▪ patient preparation
▪ specimen collection
▪ proper transport and processing
of specimen to the clinical
laboratory
Pre-analytic
● Actual testing of the submitted/collected specimen
● Equipment and instruments used, reagents, internal quality
control program
Analytic
● Transmission of test results to the medical doctor for
interpretation
● TAT – Turnaround time
● Application of doctor’s recommendations
POST-ANALYTIC
○ All activities performed by laboratory personnel to ensure
reliability of test results
○ Organized, systematic, well-planned, regularly done with the
results properly documented and consistently reviewed
QUALITY ASSURANCE
● Day-to-day activities that are undertaken in order to control factors
or variables that may affect test results
● Regular review and audit of results
INTERNAL QUALITY ASSURANCE SYSTEM (IQAS)
● System for checking performance among clinical laboratories and is
facilitated by designated external agencies
● National Reference Laboratories (NRL) – DOH designated EQAS
EXTERNAL QUALITY ASSURANCE SYSTEM (EQAS)
➢ Hematology and Coagulation.
National Kidney and Transplant Institute (NKTT)
➢ Microbiology (identification and
antibiotic susceptibility testing) and
➢ Parasitology (identification o
Research Institute of Tropical Medicine (RITM)
➢ Clinical Chemistry (for testing 10
analytes, namely glucose, creatinine,
total protein, albumin, blood urea
nitrogen, uric acid, cholesterol, sodium,
potassium, and chloride)
Lung Center of the Philippines (LCP)
➢ Drugs of abuse (methamphetamine and
cannabinoids)
East Avenue Medical Center (EAMC)
Infectious immunology
hepatitis B surface
antigen (HBsAg),
Human
Immunodeficiency
Virus (HIV), Hepatitis
C virus (HCV)
San Lazaro Hospital STD-AIDS Cooperative Center Laboratory
(SACCL)
