PRINCIPLES OF MEDICAL LABORATORY SCIENCE PRACTICE 1

ROUTINE LABORATORY TESTS

SECTIONS IN THE LABORATORY
1. Clinical Chemistry
2. Clinical Hematology
3. Clinical Microscopy
4. Serology
5. Blood Banking
6. Microbiology
7. Histopathology

CLINICAL CHEMISTRY
o is the area of chemistry that is generally concerned with analysis of body fluids for diagnostic and therapeutic
purposes
o most current laboratories are now highly automated to accommodate the high workload typical of a hospital
laboratory. Test performed are closely monitored and quality controlled
o performed on any kind of fluid, but mostly on serum.
 SERUM – yellow watery part of blood that is left after blood has been allowed to CLOT and all blood cells
and platelets to the bottom of the centrifuge tube, leaving the liquid serum fraction resting above the
packed cells
 PLASMA – is the essence the same as serum, but it is obtained by centrifuging the blood WITHOUT
CLOTTING. Plasma is obtained by centrifugation before clotting occurs. The type of test required dictates
what type of sample is used.
o Common blood chemistry tests: FBS, lipid profile (total cholesterol, triglycerides, LDL, HDL, VLDL), BUA, BUN,
SGOT (serum glutamic oxaloacetic transaminase)/AST ( aspartate aminotransferase), SGPT (serum glutamic
pyruvic transaminase)/ALT (alanine aminotransferase), Electrolytes (K, Na, Cl, Ca, Mg), HbA1C, Total protein and
albumin/Globulin ratio (TPAG), Bilirubin (TB, DB, IB), etc

THESE TESTS TYPICALLY REQUIRE FASTING:

 FASTING BLOOD SUGAR (FBS) – measures the amount of glucose (sugar) in the blood to test for
diabetes or pre-diabetes. Fasting time: at least 8 hours
 LIPID PROFILE – checks the level of cholesterol and other blood fats, like triglycerides. High levels put
you at risk for developing heart disease or having stroke. Not all situations require fasting. You may not
need it if you are younger than 25 or if you require only a partial lipid panel or if your doctor is looking
for a “non-fasting” result. Fasting time: 9-12 hours

CLINICAL HEMATOLOGY
o Refers to the study of the numbers and morphology of the cellular elements of the blood – the RBC’s
(erythrocytes), WBC’s (leukocytes), and the platelets (thrombocytes) – and the use of these results in the
diagnosis and monitoring of disease.
 COMPLETE BLOOD COUNT (CBC) – a blood test used to evaluate your overall health and detect a wide
range of disorders, including anemia, infection and leukemia
 Measures several components and features of blood including:
 Red blood cells – which carry oxygen
 White blood cells – which fight infection
  Haemoglobin – the oxygen-carrying protein in red blood cells
 Haematocrit – the proportion of red blood cells to the fluid component, or plasma in
your blood
 Platelets – which help in blood clotting
Why is CBC done? 1. To review your overall health 2. To diagnose a medical condition 3. To monitor
medical condition 4. To monitor medical treatment.

CLINICAL MICROSCOPY
o Performs scientific analysis of non-blood body fluids such as urine, semen and stool. The macroscopic, chemical
and microscopic examinations of urine provide initial valuable diagnostic information concerning metabolic
dysfunctions of both renal and non-renal origin
 SEMEN ANALYSIS – very important in evaluating fertility cases and status of post vasectomy cases
 STOOL ANALYSIS (FECALYSIS) – stool concentration technique, occult blood determination and stool
examination for fats help clinician in early detection if GI bleeding, liver and biliary duct disorders and
mal-absorption syndrome. Parasite identification and assessment of the extent of the parasitism is also
possible.

SEROLOGY
o Scientific study of serum and other body fluids. Usually refers to the diagnostic identification of antibodies in the
serum. Such antibodies are typically formed in response to an infection (against a given microorganism), against
other foreign proteins (in response, example, to a mismatched blood transfusion), or to one’s own proteins (in
instances of autoimmune disease).
Tests include: HBsAg Test – Hepatitis B, RPR Test – Syphilis, HIV test – HIV/AIDS, Blood typing (ABO and
Rh typing), and Antigen and antibody tests

BLOOD BANKING
o Process that takes place in the lab to make sure that donated blood, or blood products, are safe before they are
used in blood transfusions and other medical procedures. Includes typing the blood for transfusion and testing
for infectious diseases.
 CROSS MATCHING – procedure performed prior to a blood transfusion to determine whether donor
blood is compatible (or incompatible) with the recipient blood
 Compatibility is determined through matching of different blood group systems, the most
important of which are the ABO and Rh system, and/or by directly testing for the presence of
antibodies against a sample of donor tissues or blood.

MICROBIOLOGY
o Scientific study of microorganisms, those being unicellular (single cell), or multicellular (cell colony), or acellular
(lacking cells).
o Encompasses numerous sub-disciplines including virology, bacteriology, protistology, mycology, immunology
and parasitology.
 GRAM STAINING – common technique used to differentiate two large groups of bacteria based on their
different cell wall constituents. It also distinguishes between gram positive and gram negative groups by
coloring these cells red or violet.
 Gram positive bacteria stain violet due to the presence of a thick layer of peptidoglycan in their
cell walls, which retains the crystal violet these cells are stained with.
 Gram negative bacteria stain red, which is attributed to a thinner peptidoglycan wall, which
does not retain the crystal violet during the decoloring process.
 CULTURE AND SENSITIVITY – for a culture, a sample of body fluid or tissue is added to a substance that
promotes the growth of germs. If no germs grow, the culture is negative. If germs that can cause
 infection grow, the culture is positive. The type of germ may be identified using a microscope or
chemical tests. Bacteria usually grow quickly in a culture (2 days), while other types of organisms, such
as fungus, can take longer.
 Culture is a test to find germs (such as bacteria or a fungus) that can cause infection
 Sensitivity test checks to see what kind of medicine, such as an antibiotic, will work best to treat
the illness or infection.

HISTOPATHOLOGY
o Is the diagnosis and study of diseases of the tissues, and involves examining tissues and/or cell under the
microscope. Histopathologists are responsible for making tissue diagnoses and helping clinicians manage a
patients care.
o Histopathologists provide a diagnostic service for cancer; they handle the cells and tissues removed from
suspicious ‘lumps and bumps’, identify the nature of the abnormality and, if malignant, provide information to
the clinician about the type of cancer, its grade and, for some cancers, its responsiveness to certain treatments.