Lesson 8: Nature of the Clinical Laboratory

● 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%

serves as the integral partner of medical doctors and is an important member of the health care delivery system.

In the past - manual, taxing, labor-intensive, and time-consuming. Recently - less laborious, with shortened turnaround time

Diagnosis and treatment of diseases performed through laboratory testing of blood and other body fluids

Diagnosis of diseases through microscopic examination of tissues and organs

operates within the premises or part of an institution

A clinical laboratory is not part of an established institution.

Owned, wholly or partially, by national or local government units

Owned, established and operated by an individual, corporation, institution, association, or organization

● 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)

● 20 square meters ● Microscopes, centrifuge, hematocrit centrifuge, semi- automated chemistry analyzers, autoclave, incubator, oven ● Hospital-based – Gram stain, KOH mount, crossmatching

● 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

●Government hospital laboratory designated by the DOH to provide special diagnostic functions and services for certain diseases

Testing of blood and other body fluids to quantify essential soluble chemicals including waste products useful for the diagnosis of certain diseases

enumeration of cells in the blood and other body fluids

Identification of bacteria and fungi Blood and other body fluids, stool, tissues and swabs

Urinalysis ○ Macroscopic examination – color, transparency, specific gravity, pH ○ Microscopic examination – abnormal cells/parasites, quantify RBC and WBC Fecalysis – identification of parasitic worms and ova

● Most critical section in the clinical laboratory ● Blood typing and compatibility testing ● Screening and identification of antibodies and blood components used for transfusion

Analyses of serum antibodies in certain infectious agents (primarily viral agents)

● Tissue (biopsy and autopsy) processing ● Cutting into sections ● Staining ● Microscopic examination by a pathologist

● Detection of tumor-specific antigens, oncogenes and tumor suppressor genes ● Assess responses of patients to cancer therapy ● Diagnosis of certain neurodegenerative disorders

● DNA and RNA are identified and sequenced to detect any pathologic conditions/disease processes ● Polymerase Chain Reaction (PCR) – most common technique

▪ receipt of the laboratory request ▪ patient preparation ▪ specimen collection ▪ proper transport and processing of specimen to the clinical laboratory

● Actual testing of the submitted/collected specimen ● Equipment and instruments used, reagents, internal quality control program