The Medical Laboratory

The Medical Laboratory

Purpose of a Laboratory testing Record an individuals state of health Satisfy employment, Insurance or legal requirements Research and clinical trials Detect asymptomatic conditions or diseases Confirm clinical diagnosis Tell the difference between two or more diseases To diagnose Effectiveness of treatment Prevent disease or disorders Prevent exacerbation of disease

Types of Labs (Hospital based)

Reference Lab

POCT (point of care testing) This type of testing can be done bedside.

POLs These labs are set in a doctors office setting

Lab departments Hematology-study of blood WBC RBC Coagulation study s

Urinalysis Department

Toxicology Test for toxic substance in blood Monitors therapeutic levels of medication Exposure to metals and chemicals Drug testing

DNA Paternity testing Criminal cases

Microbiology Study Fungi Study Bacteria C&S performed Study viruses

Parasitology Study s ova & parasites Subdivision of Microbiology dept

Cytology Study of cells Detects early signs of cancer and other diseases Pap smear test

Histology Study of tissue samples Samples are sliced, stained & examined under a microscope for cancer and other anomalies

Billing for lab services Must use correct diagnosis code Medicare patients signs an advance beneficiary notice (ABN)

Tests Basic metabolic panel (BMP) Tiger tube Lipid panel Tiger tube Renal function panel (R-pan) Tiger tube Complete blood count (CBC) Lavender tube Glucose tolerance test (GTT) Light green

People who may work in a Laboratory MD Physician Pathologist PhD Scientist CLS Clinical Laboratory Scientist MT Medical technologist CLT clinical laboratory technologist MLT Medical Laboratory technician CPT Certified Phlebotomy Technician NCPT National certified phlebotomy technician CMA (AAMA) Certified Medical Assistant RMA (AMT) Registered Medical Assistant

Control tests Controls must be ran on all testing equipment daily or at the beginning of each shift

Laboratory requisitions and reports Providers name, account #, address and phone # Patients name, address, phone # Patients billing information Unique patient identifier Patients DOB & sex Source of specimen Time and date of specimen collection Test requested Medications patient is taking Clinical diagnosis Urgency of results Special collection/pt instructions Where copies are to be sent to

Reports Will be flagged in some way if abnormal Reports will have a star next to abnormalities

Compound Microscopes

BNP A brain natriuretic peptide (BNP) test measures the amount of the BNP hormone in your blood. BNP is made by your heart and shows how well your heart is working. Normally, only a low amount of BNP is found in your blood. But if your heart has to work harder than usual over a long period of time, such as from heart failure, the heart releases more BNP, increasing the blood level of BNP. The BNP level may drop when treatment for heart failure is working. Why It Is Done The brain natriuretic peptide (BNP) test is used to: Check for heart failure. A doctor may think you have heart failure if you are having problems such as difficulty breathing and swelling (edema) in the arms or legs. Find out how severe heart failure is. Check the response to treatment for heart failure.

CMP A comprehensive metabolic panel is a blood test that measures your sugar (glucose) level, electrolyte and fluid balance, kidney function, and liver function.

ESR or Sed Rate The erythrocyte sedimentation rate (sed. rate or ESR) is an indication of the degree of inflammation in the body. It is actually a measurement of the speed with which red blood cells fall in a test tube of blood. When the inflammation in the blood goes up, these inflammatory substances attach to red blood cells and the cells fall faster. In healthy persons, the sed. rate is low and it climbs with inflammation. It doesn't point to any particular disease, but is a general indication of the amount of inflammation in the body. In lupus and polymyalgia rheumatica, the ESR often correlates with disease activity.

CRP C-reactive protein (CRP) also indicates the amount of inflammation present. It is thought to be a better test than the sed. rate for certain diseases. In patients with rheumatoid arthritis, if the CRP is high, it suggests that there is significant inflammation or injury in the body.

TSH A thyroid-stimulating hormone (TSH) blood test is used to check for thyroid gland problems. TSH is produced when the hypothalamus releases a substance called thyrotropin-releasing hormone (TRH). TRH then triggers the pituitary gland to release TSH. See pictures of the thyroid gland and the pituitary gland. TSH causes the thyroid gland to make two hormones: triiodothyronine (T3) and thyroxine (T4). T3 and T4 help control your body's metabolism. Triiodothyronine (T3) and thyroxine (T4) are needed for normal growth of the brain, especially during the first 3 years of life. A baby whose thyroid gland does not make enough thyroid hormone (congenital hypothyroidism) may, in severe cases, be mentally retarded. Older children also need thyroid hormones to grow and develop normally. This test may be done at the same time as tests to measure T3 and T4.

PSA Prostate-specific antigen (PSA) is a substance produced by the prostate gland. Elevated PSA levels may indicate prostate cancer or a noncancerous condition such as prostatitis or an enlarged prostate.

Vitamin B12 measure the level of this vitamin in the blood.

H. pylori (Helicobacter pylori) A test that looks for antibodies in the blood that indicate exposure to H. pylori. Research shows that most ulcers -- 80% of stomach ulcers and 90% of those in the duodenum, the upper end of the small intestine -- develop because of infection with Helicobacter pylori (H. pylori

O&P A stool sample is collected and analyzed for the presence of the parasite G. lamblia or its cysts. The stool sample may be collected at home, in the doctor's office, or in the hospital. Substances that may interfere with test results include: Antacids and antidiarrheals. Antibiotics. Antiparasite drugs. Barium (a contrast material used for X-rays). Enemas or laxatives. If possible, these products should be avoided for 2 weeks before collecting a stool sample.