((Requistion & ((Requistion & Interpretation))Interpretation))

Bushehr University Of Medical Bushehr University Of Medical SciencesSciences

Dept. OF Pathology & Lab. Dept. OF Pathology & Lab. MedicineMedicine

Screening & Case Screening & Case FindingFinding

Diagnosis of DiseasesDiagnosis of Diseases

Therapeutic MonitoringTherapeutic Monitoring

Preanalytical stagePreanalytical stage

Analytical StageAnalytical Stage

Post analyticcal stagePost analyticcal stage

What is your clinical Impresion and D.D?What is your clinical Impresion and D.D?

What is the role of lab datWhat is the role of lab dataa in patient in patient management?management?

How is your Lab. Facilities?How is your Lab. Facilities?

What is the test ofWhat is the test of choice? choice?

The most effectiveThe most avaliableThe least costThe least invasion

cont .

Patient demographicsPatient demographics

Hospital numberHospital number

Brief historyBrief history date of referingdate of refering

List of requested TestList of requested Testss

Physition name & Signature Physition name & Signature

Diurnal variationsDiurnal variations -- smoking smoking

-- Ex Exccersize ersize - - Drugs Drugs

-- Fasting & Eating Fasting & Eating

-- Diet Diet - - Ethanol Ethanol

CortisolCortisol

IRONIRON

P.M.N CountP.M.N Count

ExcersizeExcersize

CPKCPK

AST LDHAST LDH

Testostron Testostron

AndrostaAndrostanndiondionee

LHLH

FFAFFA

Alanin Alanin 180% 180%

Lactate 300%Lactate 300%

CPK , AST , LDHCPK , AST , LDH

Coagulation , Coagulation , PlatPlat

Transient effectsTransient effects Longterm effectsLongterm effects

BilirubinBilirubinGlucoseGlucoseTGTGFFAFFACholestrolCholestrol

K K TGTG ALPALP C.MC.M

High protein diet urea , UA , AmoniaHigh protein diet urea , UA , Amonia

U/S Fat. Diet CholestrolU/S Fat. Diet Cholestrol

Banana , Tomato , … Banana , Tomato , … SerotoninSerotonin

Beverage (Caffeine)Beverage (Caffeine)FFA , FFA , CatchalaminesCatchalamines

LactateLactate UrateUrate TGTG HDLHDL GGTGGT MCVMCV

CortisolCortisol

CatecholamineCatecholaminess

FFAFFA

HbcoHbco HbHb Rbc countRbc count MCVMCV Leukocytosis Leukocytosis

(EOS)(EOS)

Biochemistry Hematology

- Liver function- Liver function

- Renal - Renal functionfunction

- …………- …………

- Preservatives- Preservatives

- Anticoagulants- Anticoagulants

- ……………- ……………

Physiologic effectsPhysiologic effects Invitro effectsInvitro effects

What is the specimen of What is the specimen of choice?choice?

What is the best method for What is the best method for SP. Collection?SP. Collection?

Posture & Position : Alb , Prot , Posture & Position : Alb , Prot , ca , Enzymes , Tca , Enzymes , TGG , Ch. , Ch.,,,,,,,,,,

Tourniquet : Ca , Lactate , Tourniquet : Ca , Lactate , Protein , EnzymesProtein , Enzymes

Stress & Anxiety : Hormones , Stress & Anxiety : Hormones , Wbc , Lactate , FFAWbc , Lactate , FFA

AnticoagulantsAnticoagulants

Protection from heat & coldProtection from heat & cold

Inhibition of contaminationInhibition of contamination

Transportation to Ref. LabTransportation to Ref. Lab

ObObttaining the best specimenaining the best specimen

Separation , centrifugationSeparation , centrifugation

Mixing , Rotation , ShakingMixing , Rotation , Shaking

WarWarmming & Boilinging & Boiling

MeasuringMeasuring

Cont …Cont …

NNature of specimenature of specimen Level of Lab. ManagingLevel of Lab. Managing Accessing Materials & Accessing Materials &

ReagentsReagents InstrumentationInstrumentation Pit falls & error resources and

economic benefits

InstrumentationInstrumentation

(Automated & Non (Automated & Non automated)automated)

Materials and MethodsMaterials and Methods

Techical personalsTechical personals

QQuality managementuality management Reporting Reporting

- Rapid (tat)- Rapid (tat)

- Accurate & precise- Accurate & precise

- Prompt- Prompt Lab. Information system Lab. Information system

(LIS)(LIS)

Pre analytical stagePre analytical stageAnalytical stageAnalytical stagePost analytical stagePost analytical stage

QA monitors quality performance from ordering to interpretation and application of results in patient care.

Assay of Control SampleAssay of Control SampleInstrument MaintenanceInstrument MaintenanceStatistical data analysisStatistical data analysisProficiency testing surveyProficiency testing survey

Pre analytical Pre analytical

Analytical Analytical

Post analytical Post analytical

80%80%

15%15%

5%5%

Clinical ImpressionClinical Impression Sensitivity & specificity of Sensitivity & specificity of

TestTest Limitation of TestLimitation of Test Reproducibility of TestReproducibility of Test Lab. Quality assuranceLab. Quality assurance