Be careful when looking at the protocol and data; some are for animals and not humans.
The medical laboratory technologists (MLTs) are trained by the institution or by other institutions. They perform the lab tests on automated clinical chemistry laboratory analyzers. While most clinical lab tests are performed on automated analyzers, some tests have to be performed manually.
All clinical lab tests have a Quality Control (QC) program and a Quality Assurance Program (QAP) for the lab (UK NEQAS and Australian RCPA-QAP).
Not all clinical labs perform all the lab tests listed below.
Not all clinical labs categorise their lab tests as shown below.
UK and Malaysian clinical labs report lab data in SI Units; USA labs still use old units.
Lab tests are grouped into panels by chemistry, organ, disease, or disease process:
- Electrolytes: Sodium, potassium, chloride
- Acid-base: Bicarbonate and anion gap, acid-base disturbances
- Renal: Urea and creatinine
- Minerals: Calcium (total and ionized), phosphate, magnesium
- Proteins: Total protein, albumin, globulins, A/G ratio, ammonia, uric acid, electrophoresis
- Carbohydrates: Glucose, fructosamine and glycosylated hemoglobin,
- Lipids: Triglycerides, cholesterol, non-esterified fatty acids (NEFA)
- Ketones: β-hydroxybutyrate (BHB)
- Liver: Enzymes (ALT, AST, SDH, GLDH, LDH, ALP, GGT), bilirubin (total, indirect, direct), bile acids, ammonia
- Pancreas: Amylase, lipase
- Muscle enzymes: AST, CK, LDH
- Iron: Iron, total iron binding capacity, % saturation, ferritin
- Interference indexes: Lipemia, hemolysis, icterus
The students of the Masters of Medicine (MMed) 4-year program have a basic MD or MBBS degree and at least 2 years work experience at a hospital before joining the program at the university. Topics covered in the MMed training covers some of the following:
QC and QA
Clinical Lab Management
Clinical Biochemistry (see 1-13 above)
Haematology and Coagulation
Adult Endocrinology
Pediatric Endocrinology
Metabolic Medicine
Nephrology
Neonatology
Cytogenetics
GI & Hepatology
Research
Electives (Toxicology, Nutrition TPN, Genetics)
Hospital posting (field work)
The MMed trainees in Chemical Pathology are competent to interpret lab tests data. These include:
- Calcium and metabolic bone disorders
- Diabetes mellitus: Plasma glucose, Glucose tolerance test (GTT), HbA1C
- Inherited metabolic disorders; Inborn Errors of Metabolism (IEM)
- Lipidology/Lipids: HDL, LDL cholesterol, Triglycerides, oxLDL
- Cardiovascular risk assessment/Heart attack markers: AST, LDH, Troponins, CKMB, Myoglobin, beta-type natriuretic peptide
- Nutrition
- Renal disease
- Thyroid disease: TRH, TSH, T3 and T4
- Liver disorder
- Tumour markers: Ca-125, Ca-119, Ca-153, oncogenes and specificity
- Arterial blood gases
The clinicians who teach in the MMed program are university lecturers and they serve as laboratory consultants; they also supervise the general running of the clinical lab and are paid a 'critical allowance' for doing so. They have a basic MD/MBBS degree and a postgraduate degree (MSc/MPath/MMed) in Chemical Pathology. At present, none have a PhD degree or FRCPath. None are professors.
External links:
Cornell University
P. Pannall. Pitfalls in the Interpretation of Blood Chemistry Results. S. Afr. Med. J., 45, 1184 (1971).
Errors in Clinical Biochemistry (Nursing perspectives)
Lab Tests Online. American Association for Clinical Chemistry
Analytical and Interpretative Service (Biochemistry). 17 Sept 2012. Updated 14 Nov 2013. NHS UK
Interpretation of clinical laboratory tests (PowerPoint)
Study of Tissue Morphology by Electron Microscopy
Microwave Techniques for Electron Microscopy (Springer)
Ortho Molecular Nutrition & Wellness Center
eHow
MyBookez
Newport
Lab Info
Buzzle
AARP
Wikipedia - http://www.ganfyd.org/index.php?title=Laboratory_results:_normal_ranges
Biochemia Medica. Croatian Society of Medical Biochemistry and Laboratory Medicine
Interpreting Paediatric Biochemistry Results
Interpretation of Lab Test Profiles
Edward O. Uthman, MD; Diplomate, American Board of Pathology
Last update 6 Jan 2002. Copyright 1994-98
http://web2.airmail.net/uthman/lab_test.html
YouTube VIDEOS - Introduction to Lab Tests
http://www.youtube.com/watch?v=_mGszRbve9s
YouTube VIDEOS - Blood Tests Interpretation
http://www.youtube.com/watch?v=9UaiPovkxbk
LFT - http://www.youtube.com/watch?v=8B2a-HZEqtY
Fatty Liver - http://www.youtube.com/watch?v=n4qkXgAX6Jg
YouTube VIDEOS - Venepuncture
Need a new video on venepuncture
YouTube VIDEOS - Lipids
http://www.youtube.com/watch?v=_jjk13K47uo
YouTube VIDEOS - ABG Sampling
http://www.youtube.com/watch?v=xfso_M7pn9E
http://www.youtube.com/watch?v=KbszTXeg71g
http://www.youtube.com/watch?v=XCe_qzXFAPM
YouTube VIDEOS - Interpretation of ABG
http://www.youtube.com/watch?v=f7E-s95tbsE
YouTube VIDEOS - Acid & Base
https://www.youtube.com/watch?v=WHTxkedhxA8
YouTube VIDEOS - Electrolyte Imbalance
https://www.youtube.com/watch?v=XkiJcLQdjR8
YouTube VIDEOS - Renal
https://www.youtube.com/watch?v=JKKpvuV5HY8
JOURNALS
Verras, P and Greaves, R. 2005. Abnormal laboratory results: Interpreting paediatric biochemistry results. Australian Prescriber, vol. 28, no. 5, pp. 126-129.
RMIT University Research Bank http://researchbank.rmit.edu.au/view/rmit:19732
http://www.australianprescriber.com/magazine/28/5/126/9/
CG Fraser and Y Fogarty. 1989. Interpreting laboratory results. BMJ. 24 June; 298(6689): 1659-1660.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1836738/
TRAINING PROGRAMS AND MANUALS
Clinical Biochemistry Residency Program. Information Booklet. June 2009
Oman Medical Specialty Board. Al Athaiba, Sultanate of Oman
www.omsb.org
Email: biochemistry@omsb.org and omsb@omsb.org
http://www.omsb.org/Files/Biochemistry/Biochemistry_INFORMATION__BOOKLET.pdf
A Clinical Biochemistry Laboratory Training Module for Technicians
Dr Jagarati Jha
Dept of Biochemistry
SMS Hospital, Jaipur, India
http://www.rmsc.nic.in/pdf/Training%20Module%20-%20Biochemistry.pdf
Chemistry 422: Biochemistry Laboratory Manual
Mark Brandt, PhD
Third edition, January 2002
Dept of Chemistry and Biochemistry
California State University, Fullerton, California, USA
http://www.rose-hulman.edu/~brandt/publications/422_Manual_3rd_Ed.pdf
Introduction to Clinical Biochemistry: Interpreting Blood Results. 2011.
Dr. Graham Basten
Copyright Dr. Graham Basten & Ventus Publishing ApS
ISBN 978-87-7681-673-5
Download free books at bookboon.com
http://tailieu.vn/doc/introduction-to-clinical-biochemistry-interpreting-blood-results.1301732.html
The LabAssist Report Made Simple
Copyright 2008 Lab Interpretation LLC
http://www.labinterpretation.com
http://labinterpretation.com/files/LabAssistInterpretationManual.pdf
http://labinterpretation.com/
Carramar Education Courses
Carramar Consulting Pty Ltd
ABN 64 116 505 134
Unit 8, 220 Boundary Street
Spring Hill Qld 4000 Australia
Telephone: +61 7 3832 7727
Email: admin@carramarconsulting.com.au
http://www.carramarconsulting.com.au/consulting_and_advisory
BOOKS
Practical Clinical Biochemistry
Harold Varley
5th edition 1984
Clinical Biochemistry Principle and Practice.
Praful B. Godkar
1994
Tietz Textbook of Clinical Chemistry
2ne edition'1994
Micro Analysis in Medical Biochemistry
Editor, IDP Wooten
6th edition
Practical Biochemistry
RC Gupta
3rd edition 2004
Hawk's Physiological Chemistry
Editor, Osler
14th edition
Lecture Notes on Clinical Chemistry
Whitby, Robb and Smith
2nd edition
Clinical Biochemistry Illustrated
Allan Gaw
2nd edition 1999
Clinical Chemistry & Metabolic Medicine
7th Edition
Martin A. Crook
2006
ISBN 0-340-90617-0
Hodder Arnold Publisher
Clinical Biochemistry, Metabolic and Clinical Aspects
1st Edition
William J. Marshall and Stephen K. Bangert
Churchill Livingstone Publisher
ISBN 0443-043418
Analytical Biochemistry
3rd Edition
David J. Holme and Hazel Peck
Prince Hall Publisher
ISBN 978-0-582-29438-7
Clinical Chemistry
Ken Lewandrowsky
ISBN 0683-30085-7
Basic QC Practices Manual
Westgaard
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