1. The Clinical Laboratory

2. Anatomical Laboratory Organizational Divisions:
Responsible for the analysis of tissues from the body including surgical specimens, frozen sections, biopsies, cytological specimens & autopsies

3. Laboratory Organizational Divisions: Department of Pathology
Anatomical
Cytology: looking for abnormal cells (ie, cancer)
Cytologic specimens (tissue & body fluids)
Pap smears
Histology
Surgical specimens
Frozen sections
Biopsies
Autopsies
Cytogenetics
Genetic testing (blood, amniotic fluid, tissue & bone marrow)

4. Clinical Laboratory Organizational Chart

5. Hematology
The study of the formed (cellular) elements of the blood for the purpose of making a diagnosis.

6. Hematology RBCs, WBCs and platelets are counted and classified
Uses whole blood (blood as it comes from the client without removing any components)
Whole blood is obtained using a collection tube with an anticoagulant to prevent clotting
*Lavender collection tubes
*Anticoagulant EDTA
*Requires immediate inversion of tube 8 times to activate

7. Hematology Blood is analyzed as whole, plasma or serum
*Plasma: liquid portion of blood from a specimen that has not been allowed to clot; contains fibrinogen
*Serum: specimen allowed to clot; no fibrinogen

8. Hematology Complete Blood Count (CBC)
White blood cell (WBC) count is a count of the actual number of white blood cells per volume of blood.
White blood cell differential looks at the types of white blood cells present. There are five different types of white blood cells, each with its own function in protecting us from infection.
Red blood cell (RBC) count is a count of the actual number of red blood cells per volume of blood. Both increases and decreases can point to abnormal conditions.
Hemoglobin measures the amount of oxygen-carrying protein in the blood.
Hematocrit measures the percentage of red blood cells in a given volume of whole blood.

9. Hematology
Complete Blood Count (CBC) most common whole blood test continued:
The platelet count is the number of platelets in a given volume of blood. Both increases and decreases can point to abnormal conditions of excess bleeding or clotting.
Mean corpuscular volume (MCV) is a measurement of the average size of your RBCs.
Mean corpuscular hemoglobin (MCH) is a calculation of the average amount of oxygen-carrying hemoglobin inside a red blood cell.
Mean corpuscular hemoglobin concentration (MCHC) is a calculation of the average concentration of hemoglobin inside a red cell.
Red cell distribution width (RDW) is a calculation of the variation in the size of your RBCs.

10. Coagulation Studies in Hematology
Coagulation Studies (clotting times)
*PT and PTT
*Light Blue collection tubes *Anticoagulant used is sodium citrate
*Must be returned to the lab in 30 minutes

11. Chemistry
Study of components in the blood including enzymes, hormones, electrolytes, chemicals or poisons

12. Chemistry
Tests performed on serum, plasma, urine and other body fluids
Serum and plasma obtained by using the centrifuge
*Must be completed within one hour of collection
*Serum separator tubes contain gel
*Must allow specimen to clot completely prior to centrifuge
*Red or tiger top collection tubes
Most automated area of the lab

13. Chemistry
Chem 7 & Chem 17 most common tests to assess general health; gives your doctor important information about the current status of your kidneys, blood sugar, and electrolyte and acid/base balance
Cardiac enzymes and drug screening also common

14. Blood Bank
Blood collection, storage and preparation for blood transfusion
*Red collection tubes additives will interfere

15. Blood Bank Blood typed and for blood group and Rh factor
Units (pints) collected and tested for presence of blood-borne pathogens; stored for transfusion
- 42 days: how long most donated red blood cells can be stored days: how long most donated platelets can be stored
- 1 year: how long frozen plasma can be stored
Autologous transfusion
*Donate your own blood for personal transfusion if needed from upcoming surgery, usually beginning 3-5 weeks before procedure

16. Blood Bank Most Common Tests
Type & Crossmatch = ABO, Rh typing and compatibility
Type & Screen = ABO, Rh typing and antibody screen
Group & Type = ABO and Rh typing

17. Serology (Immunology)
Evaluates the body’s immune response through the detection of antibodies to bacteria, fungi, parasites, and viruses and antibodies produces against body substances (autoimmunity)

18. Serology (Immunology))
Most Common Tests
Anti-HIV
Hepatitis B Surface Antigen
VDRL for syphilis
Western blot confirms HIV
HCG = pregnancy
Red collection tubes

19. Microbiology
Identification of pathogens, effective antibiotic therapy and infection control

20. Microbiology
Culture & Sensitivity most common procedure = ID pathogen & most effective antibiotic
Bacteria is IDed based on morphology & gram stain reactions
Types of Specimens
Blood
Sputum
Wounds
Feces
Urine
GI tract
Throat

21. Microbiology
Yellow or clear glass collection tubes using sterile technique
Most Common Tests
Blood culture
Culture & Sensitivity
Gram stain
Ova & parasites

22. Urinalysis
Detects disorders and infections of the kidney and metabolic disorders such as Diabetes and liver disease through components present in the urine
Urinalysis most common test

23. Laboratory Management
Laboratory Director (Pathologist)
Credentials
Medical doctor (MD)
Functions
Anatomic pathology
Clinical pathology
Laboratory Manager (Administrator)
Master’s degree and 5 or more years of laboratory experience
Technical and administrative management

24. Clinical Laboratory Personnel
Medical Laboratory Scientist (MLS)
Bachelor of science degree (4 year)
Performs laboratory testing requiring independent judgment
Minimal supervision
Medical Laboratory Technician (MLT)
Associate degree (2 year)
Performs laboratory testing by protocol under supervision
Phlebotomist (PBT)
High school diploma
Phlebotomy training program
Sample collection and processing