1. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.1 CHAPTER 22 LABORATORY CAREERS

2. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.2 Chapter 22 Learning Objectives  Define at least 10 terms relating to laboratory careers.  Specify the role of selected laboratory health care workers, including personal characteristics, levels of education, and credentialing requirements.

3. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.3 Chapter 22 Learning Objectives  Differentiate between pathogenic and nonpathogenic microorganisms.  Identify six groups of organisms that may be pathogenic in humans.  Describe the conditions that are favorable for the growth of microorganisms.

4. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.4 Chapter 22 Learning Objectives  Identify three ways in which the skin serves as a defense against infection.

5. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.5 Clinical Laboratory Science  Clinical Laboratory Improvement Amendments (CLIA) standards  Ensures quality laboratory testing  Personnel of certified labs must meet specific educational qualifications

6. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.6 Laboratory Careers

7. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.7 Laboratory Careers: Educational Costs and Earnings

8. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.8 Clinical Laboratory Science  Pathologist  Medical doctor who examines specimens of body tissue, fluids, and secretions to diagnose disease  Education Medical school Medical school Specialized education and training Specialized education and training

9. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.9 Clinical Laboratory Science

10. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.10 Clinical Laboratory Science  Clinical laboratory scientist (CLS)  Also called laboratory technologist  Performs clinical laboratory testing and analyzes results  Education Bachelor’s degree plus a 1-year training program Bachelor’s degree plus a 1-year training program Bachelor’s degree and examination to become a certified technologist (CT) Bachelor’s degree and examination to become a certified technologist (CT)

11. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.11 Clinical Laboratory Science  Areas of specialization for laboratory technologists  Microbiology technologist Collects, grows, and isolates microorganisms to assist with their identification Collects, grows, and isolates microorganisms to assist with their identification  Cytotechnologist Specializes in preparation and screening of cells used to diagnose cancer, infectious agents, or inflammation Specializes in preparation and screening of cells used to diagnose cancer, infectious agents, or inflammation

12. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.12 Clinical Laboratory Science  Chemistry technologist  Analyzes body fluids and wastes  Other areas of specialization  Hematology Study of blood Study of blood  Immunology Study of resistance to pathogens Study of resistance to pathogens

13. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.13 Clinical Laboratory Science  Medical laboratory technician (MLT)  Works under the supervision of a laboratory technologist or pathologist  Responsibilities Obtains blood samples, prepares tissue slides, analyzes body specimens, and performs cell counts and urinalysis Obtains blood samples, prepares tissue slides, analyzes body specimens, and performs cell counts and urinalysis  Education Two years of training Two years of training Some states require certification or licensure Some states require certification or licensure

14. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.14 Clinical Laboratory Science  Histology technician (HT)  Medical laboratory technician specializing in histology  Responsibilities Preparation of tissues for diagnosis, research, and teaching purposes Preparation of tissues for diagnosis, research, and teaching purposes  Education Certified histology technician must have 1 year of experience in histopathology or 3 years under the supervision of a certified pathologist Certified histology technician must have 1 year of experience in histopathology or 3 years under the supervision of a certified pathologist

15. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.15 Clinical Laboratory Science  Medical laboratory assistant (MLA)  Performs routine tests under the supervision of the technologist or other qualified personnel  MLA may work in the following testing areas: Urinalysis Urinalysis Hematology Hematology Serology Serology Bacteriology Bacteriology  Education  1 year of training in a hospital or a 2-year college or vocational program  Certification is available.

16. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.16 Clinical Laboratory Science  Phlebotomist  Obtains and processes blood specimens  Education Community college or vocational program Community college or vocational program On-the-job training On-the-job training

17. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.17 Phlebotomists Use a Centrifuge To Process Blood FIGURE 22-4 The phlebotomist uses a centrifuge to process blood. (From Klieger D: Saunders textbook of medical assisting, St. Louis, 2005, Elsevier.)

18. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.18 Blood Banking  Careers in blood banking  Donor recruitment  Collection and processing of donor blood  Testing and typing of blood  Laboratory supervision  Teaching

19. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.19 Blood Banking  Specialists in blood bank (SBB) technology  Responsibilities Selecting donors Selecting donors Drawing blood Drawing blood Typing blood Typing blood Pretransfusion testing to ensure safety of recipient Pretransfusion testing to ensure safety of recipient  Education Must be a certified medical laboratory technologist and have a baccalaureate degree. Must be a certified medical laboratory technologist and have a baccalaureate degree. Completion of 12-month blood bank specialist program and may be qualified for certification Completion of 12-month blood bank specialist program and may be qualified for certification

20. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.20 Life Science  Life scientists or researchers study living organisms and life processes.  Responsible for development of new drugs, plant varieties, methods of treatment, and methods of environmental protection  Education Master’s degree or doctoral-level preparation Master’s degree or doctoral-level preparation

21. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.21 Life Science  Careers in life science  Biotechnologist Explores the genetic design of plants and animals Explores the genetic design of plants and animals  Microbiologist Studies bacteria, algae, viruses, and other microorganisms that cause disease or may be used to prevent disease Studies bacteria, algae, viruses, and other microorganisms that cause disease or may be used to prevent disease  Virologist Specializes in researching the methods by which viruses infect cells and cause disease Specializes in researching the methods by which viruses infect cells and cause disease  Mycologist Studies fungal organisms such as mold and yeast Studies fungal organisms such as mold and yeast

22. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.22 Life Science  Immunologist Uses the body’s defense mechanisms (antibodies) to fight disease Uses the body’s defense mechanisms (antibodies) to fight disease Uses biotechnology techniques Uses biotechnology techniques  Biochemist Analyzes the effect of hormones, enzymes, serums, and food on tissue and organs of animals Analyzes the effect of hormones, enzymes, serums, and food on tissue and organs of animals  Biochemistry technologist Works under a biochemist Works under a biochemist Requires a 2-year associate degree or vocational program Requires a 2-year associate degree or vocational program

23. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.23 Microbiology  Microorganisms (microbes) are present in the air and on the surfaces of all objects.  Nonpathogenic microorganisms Live on the surface or inside the body without causing harm Live on the surface or inside the body without causing harm  Normal flora Microorganisms that usually live in a certain location of the body Microorganisms that usually live in a certain location of the body  Resident microorganisms Microorganisms that are always present Microorganisms that are always present

24. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.24 Microbiology  Transient microorganisms Microorganisms that are found temporarily Microorganisms that are found temporarily  Parasites Microorganisms that harm the host organism Microorganisms that harm the host organism  Aerobic organisms Aerobic organisms can live in presence of oxygen. Aerobic organisms can live in presence of oxygen.  Anaerobic Organisms Anaerobic organisms cannot live in presence of oxygen. Anaerobic organisms cannot live in presence of oxygen.

25. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.25 Microorganisms Normally Found in the Body

26. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.26 Relative Size of Organisms and Structures

27. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.27 Infection  Infection is a state of disease caused by the presence of pathogenic microorganisms in the body.  Several factors are necessary for a microorganism to cause disease Portal of entry for the organism Portal of entry for the organism Mode of transmission Mode of transmission  Transferred by direct contact or droplets of water in the air  Transferred by other animals, plants, and fomites

28. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.28 Infection Process FIGURE 22-5 Infectious process.

29. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.29 Microorganisms Microorganisms  Six major groups cause disease in humans:  Bacteria: most common cause of human disease and infection  Fungi: grows in groups or colonies  Protozoans: unicellular organisms  Metazoans: microscopic animals that may be parasites in humans  Viruses: cause illness inside the cell  Rickettsiae: cannot live outside living tissue

30. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.30 Pathogenic Microorganisms and Their Associated Diseases

31. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.31 Bacteria FIGURE 22-6 Bacterium surrounded by viruses.

32. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.32 Types of Media

33. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.33 Epidemiology  Study of diseases occurring in human populations  Includes contagious (communicable) diseases and the distribution, causative factors, and prevalence of infectious, chronic, and degenerative disease  Uses demographic data

34. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.34 Communicable Diseases  Communicable diseases  Caused by specific organisms that are capable of producing a contagious disease  Cause outbreaks (epidemics) of diseases that affect a large number of people

35. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.35 Causes, Reservoirs, and Modes of Transportation of Communicable Diseases

36. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.36 Epidemiology  Infectious, chronic, and degenerative diseases  Cardiovascular disorders  Cancer  Arthritis  Mental illness  Congenital defects  Nutritional disorders  Accidents

37. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.37 Epidemiology  Diseases resulting from contaminated environmental resources  Cholera  Typhoid  Malaria  Typhus

38. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.38 Epidemiology  Community immunity  Unvaccinated individuals may be protected by having enough people in a community who are vaccinated against a disease.  Size of the reservoir or source of the pathogen is reduced by having many vaccinated individuals.  Re-emergence of a previously eliminated disease  May be caused by an increased number of people who are not vaccinated  Example: U.S. measles outbreak in the in 1989

39. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.39 Secretions Analysis  Study of secretions by separation of the liquid and solid portions of a specimen using centrifugal force  Specimen is spun at high speed.  Each portion can be then be seen under a microscope or used for testing.

40. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.40 Centrifuge FIGURE 22-7 Blood and other body fluids are separated using a centrifuge. (From Bonewit-West K: Clinical procedures for medical assistants, ed 7, St. Louis, 2008, Saunders. In Bonewit-West K, Hunt S, Applegate E: Today’s medical assistant: clinical & administrative procedures, St. Louis, 2009, Saunders.)

41. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.41 Secretions Analysis  Clinical chemistry  Analysis of the serum portion of blood, urine, spinal fluid, and other body fluids  Hematology  Study of the components of formed (solid) elements of blood and blood-forming tissue  Serology  Study of antibody reactions in serum, whole blood, or urine

42. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.42 Immunology  Immunology is the study of how blood cells prevent disease caused by microorganisms  Immunohematology Specialized branch of immunology Specialized branch of immunology Studies and identifies blood groups Studies and identifies blood groups Uses 300 blood factors to crossmatch blood before it is used for transfusion Uses 300 blood factors to crossmatch blood before it is used for transfusion

43. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.43 Defense Systems of the Body  First line of defense is the skin.  Acts as a barrier to prevent microorganisms from entering the body  Second line of defense is the action of the phagocytic cells of the immune system.  Immune system prevents infection by producing antibodies and antitoxins to combat the action of pathogens that enter the body.

44. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.44 Defense Systems of the Body  Immunity can be inborn or acquired  People are born with an innate immunity to some organisms.  Acquired immunity results when the body produces cell or antibodies to combat a specific organism  Immunity to some microorganisms results from administering a vaccine.

45. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.45 Performance Instruction  Preparation of bacterial cultures  Agar Growth medium on which bacteria can grown Growth medium on which bacteria can grown May be made of nutrients from seaweed, potato, or blood May be made of nutrients from seaweed, potato, or blood Uses sterile technique to prevent contamination Uses sterile technique to prevent contamination  Microscope Used to identify bacteria and urine particles Used to identify bacteria and urine particles Before viewing, specimen is placed in a centrifuge to separate solid particles from the liquid portion. Before viewing, specimen is placed in a centrifuge to separate solid particles from the liquid portion.

46. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.46 Agar Media FIGURE 22-9 The agar media may be sterilized separately from the sterile Petri dish if sterile technique is used during transfer.

47. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.47 Microorganism Transfer to the Agar Plate FIGURE 22-10 A, The cap is removed so that it can be held during the procedure to prevent contamination from a countertop. B, The lip of the test tube is flamed to kill any microorganisms that may be present on the outside of the test tube. C, The inoculating loop is inserted into the test tube to remove a specimen. D, The lip of the test tube is flamed again to kill any contaminants. E, The cap is replaced on the test tube without touching it to any surface. F, The plate is streaked in a pattern to promote even growth of the microorganism. G, The inoculating loop is flamed to kill all microorganisms before it is touched to any surface.

48. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.48 Microorganism Spread Evenly on the Agar Surface FIGURE 22-11 The microorganism is spread evenly over the surface of the agar without breaking it.

49. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.49 Microscope FIGURE 22-12 The microscope is a precise instrument made of several lenses to increase magnification. (From Klieger DM: Saunders essentials of medical assisting, ed 2, St. Louis, 2010, Saunders.)

50. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.50 Microscope Slide FIGURE 22-13 Air bubbles can be prevented on a wet mount microscope slide by placing the cover slip on it from one side to another.

51. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.51 Summary  Laboratory technologists test and analyze results, using independent judgment. This can include crossmatching blood for transfusion. Technologists usually complete a bachelor’s degree and additional training.  Pathogenic microorganisms cause disease, and nonpathogens do not.

52. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.52 Summary  Six groups of organisms that may be pathogenic to humans  Bacteria  Fungi  Protozoans  Metazoans  Viruses  Rickettsiae

53. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.53 Summary  Conditions that promote growth of microorganisms  Warmth  Darkness  Moisture  Food source

54. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.54 Summary  Three ways that skin serves as a defense against infection  Acidity  Dryness  Barrier that prevents microorganisms from entering the body