Clinical Laboratory Studies

Chapter 6

Laboratory Testing

• Peripheral venous blood

• Body fluids or secretions– Sputum– Pleural fluid– Cerebrospinal fluid– Urine– Feces– Sweat

Hematology

1. Cellular Elementsa. CBCb. Platelet countc. Reticulocyte count

2. Proteins in the Plasmaa. PTb. INRc. APTT

WBC - leukocytes RBC – erythrocytes Platelets - thrombocytes

WBC

• WBC Differential– Granulocytes

• Neutrophils• Eosinophils• Basophils

– Lymphocytes– Monocytes

WBC Abnormalities

• Leukocytosis• Leukopenia• Neutrophilia• Neutropenia• Pseudoneutrophilia• Pseudoneutropenia• Left Shift• Eosinophilia• Basophilia• Lymphocytosis• Lymphocytopenia• Monocytosis

• Leukemia• Myeloproliferative

disorders

RBC

• Normoblasts• Hematocrit• Hemoglobin• MCV• MCH• MCHC• RDW

RBC Abnormalities

• Anemia– Microcytic hypochromic– Normocytic normochromic– Macrocytic

• Polycythemia– Primary– Secondary– Spurious

• Reticulocyte count

• Sedimentation rate

• Platelet count

• Coagulation studies– Bleeding time– Platelet count– APTT– PT/INR

Chemistry

• Electrolyte Concentrations• BUN/Creatinine• Enzymes• Glucose• Proteins• Lipids• Tumor Markers• Drug Monitoring

Electrolyte Concentrations

• Sodium (Na+)– Hypernatremia– Hyponatremia

• Potassium (K-)– Hyperkalemia– Hypokalemia

• Chloride (Cl-)– Hyperchloremia– hypochloremia

• Total CO2

• Anion Gap• Electrolyte

concentration of Sweat

Renal Function

• BUN

• Creatinine

Enzymes

• AST• ALT• ALP• ACP• LDH• CK

• Myoglobin• Troponin• Amylase• Lipase

Glucose

• Hyperglycemia

• Hypoglycemia

• Proteins

• Lipids

• Tumor Markers

• Drug Monitoring

Microbiology

• Normal flora vs sterile areas of the body

• Pathogenic organisms

• Classification• Culture and

Sensitivity

• Sputum Collection• Sputum Examination• BAL• Pleural Fluid

Examination

Urinalysis

• Appearance• Specific gravity• pH• Protein - proteinuria• Glucose – glucosuria• Ketones• Blood - hematuria• Bilirubin• Urobilinogen• Nitrate• Sediment

• Histology - Biopsy– Lung tissue– Tumors

• Cytology– Fluids– Secretions

• Skin Testing