Principles of MedLab. Sci 2 PDF

Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER \ 2024 - 2025 process/treatment plan of a person with disease Week 1: Understanding Phlebotomy & ​ DIAGNOSTIC...

Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER \ 2024 - 2025 process/treatment plan of a person with disease Week 1: Understanding Phlebotomy & ​ DIAGNOSTIC MEASURE - most Sections of the Laboratory and common; to determine diagnosis of a Commonly Requested Lab Tests patient; performed when physician orders specific lab test ​ Derived from Greek Phlebos (vein) TOPIC OVERVIEW and Temnein (to cut) or A.​ Phlebotomy Tomos/Tome. a.​ Evolution of Phlebotomy ​ Also called a VENESECTION b.​ Main Goals of Phlebotomy ○​ Latin word Vena (vein) and c.​ Methods of Phlebotomy Sectio (cutting) d.​ Role of Phlebotomists i.​ Traits A1 EVOLUTION OF PHLEBOTOMY ii.​ Credentials iii.​ Patient-Client Interaction 1.​ Stone Age iv.​ Professionalism ○​ Crude tools were used to cut v.​ Basic Concepts of vessels and drain blood Communication e.​ The Healthcare Setting 2.​ 1400 BC f.​ Different Clinical Analysis ○​ Ancient Egyptians practice Areas phlebotomy visa bloodletting i.​ Clinical ○​ Also used leeches to gain blood ii.​ Anatomical samples from patient B.​ Clinical Chemistry C.​ Microbiology 3.​ 460-377 BC D.​ Hematology and Coagulation ○​ Hippocrates, a Greek Studies physician, otherwise known as E.​ Clinical Microscopy the Father of Medicine and the F.​ Blood Bank and proponent of the Hippocratic Immunohematology Oath, believed a person’s G.​ Immunology and Serology health balanced on 4 Humors: i.​ Earth (blood and brain) ii.​ Air (phlegm and lungs) A PHLEBOTOMY iii.​ Fire (black biles and spleen) iv.​ Water (yellow bile and ​ Process of collecting blood through gallbladder) vein by using incision or puncture ○​ Bloodletting must be performed method to draw blood for analysis to keep the balance ​ THERAPEUTIC MEASURE - performed as part of the treatment 4.​ Middle Ages PG. 1 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER \ 2024 - 2025 ○​ Blood letting was performed by ​ For removal of blood for polycythemia barber-surgeons as part of or therapeutic purposes illness treatment 5.​ 17th and 18th Centuries A3 METHODS OF PHLEBOTOMY ○​ Phlebotomy was treated as major therapy 1.​ Venipuncture ○​ Method of blood collection CUPPING through the vein using a needle ​ Alternative medicine; collects blood samples 2.​ Capillary Puncture ​ Vasodilation (widening of blood ○​ Blood is collected via skin vessel) occurs wherein blood migrates puncturing by a lancet into the tissues ​ Increase in heat leads to increase in blood vessel permeability A4 ROLE OF PHLEBOTOMISTS ​ Apply special heated suction cups on patient’s skin ​ Incision using fleam or lancet ​ To collect blood samples for laboratory testing or for transfusion. ​ Properly label collected blood samples LEECHING with the necessary data for proper ​ Known as Hirudotherapy identification. ​ Uses leeches for bloodletting ​ Responsible for delivering or ​ Used for microsurgical replantation transporting collected samples within ​ Medicinal Leeches scientifically known appropriate prescribed time limits. as hirudo medicinalis ​ Also process collected blood samples ​ Leeches inject natural vasodilator such as centrifuging (used to leading to promotion of blood separate blood samples) and migration aliquoting (separate sample into ​ Leeches contain Hirudin, a natural several fractions) samples ready for anticoagulant that prevents blood laboratory testing. from clotting ​ They are asked to assist in collecting other specimens such as urine and other non-blood samples from patients. A2 MAIN GOALS OF PHLEBOTOMY ​ Perform front-office duties, current procedural terminology coding, and ​ For diagnosis and treatment via blood paperwork. samples; ​ Promote good relations with patients ​ For transfusion, to remove blood from and hospital personnel. donor; PG. 2 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER \ 2024 - 2025 ​ Provide proper instruction to ○​ Personal feeling of “wholeness” patients/customers for customer derived from honesty and specimen collection. consistency of character ​ Train new technicians and students in duties and responsibilities 4.​ Compassion. ○​ Being sensitive to a person’s needs and willing to offer Traits forming the Professional Image of reassurance in a caring and Phlebotomists humane way ​ Good Manual dexterity ​ Special communication skills 5.​ Self Motivation ​ Good organizational skills ○​ Takes initiative to follow ​ Thorough knowledge of laboratory through on tasks specimen requirements ○​ Consistently strives to improve ​ Training in phlebotomy skills and correct behavior ○​ Makes every effort to provide Credentials excellence in all aspects of ​ Certification or license patient care ​ Continuing education ​ Trainings and seminars 6.​ Dependability ○​ Observe proper work ethic ○​ Take personal responsibility for Patient-Client Interaction their actions ​ Reassuring and pleasant ​ Good communication with patients 7.​ Ethical Behavior ​ Maintain positive customer relations ○​ System of moral principles or ​ Understand patient’s diversity standards that govern conduct and the distinction between right and wrong Professionalism (PSICSDE) ○​ Code of ethics 1.​ Professional Appearance ○​ To safeguard the patient’s ○​ Conservative clothing welfare and avoid harming the ○​ Observe proper personal patient in any way hygiene Basic Concepts of Communication 2.​ Self Confidence 1.​ Verbal Communication ○​ Decisions and judgements to ○​ Expresses idea through words patients and fellow co-workers 2.​ Non-verbal Communication ○​ Must know what they’re doing ○​ Patient’s facial expressions; ○​ Kinesics (body motion and 3.​ Integrity language); ○​ Proxemics (use of space/proximity); PG. 3 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER \ 2024 - 2025 ○​ Appearance (attire); therapeutic radiology, etc. in ○​ Touch (thoughtful expression) same-day service center 3.​ Active Listening Levels of Healthcare (Williams-Tungpalan, 1981) 1.​ Primary ○​ Health units in rural areas and A5 THE HEALTHCARE SETTING sub-units Categories of Healthcare Facilities 2.​ Secondary 1.​ Inpatient (non-ambulatory) ○​ Non-departmentalized ○​ Stays 24 hours; overnight or hospitals longer ○​ Secondary or primary hospitals ○​ Key resource and center ○​ Offer specialized 3.​ Tertiary instrumentation and technology ○​ Medical centers and large to assist in unusual diagnoses hospitals and treatments ○​ More complex technology e.g. ○​ Serve tertiary care (highly chemotherapy, surgery complex services and therapy) ○​ E.g. acute care hospitals, nursing homes, extended care Other Healthcare Services facilities, hospices, and 1.​ Ambulatory Care rehabilitation centers ○​ Given to patients requiring medical care or follow-up 2.​ Outpatient (ambulatory) check-ups after hospital ○​ Goes home after consultation, discharge visit, e.g. ○​ Principal source of healthcare 2.​ Homebound Care services for most people ○​ Done in patient’s home or ○​ Offer routine care in physician’s long-term facility office to specialized care in a ○​ E.g. special healthcare freestanding ambulatory practitioner, private nurse setting ○​ Serve primary care physicians 3.​ Public Health Services who assume ongoing ○​ Local level unit; under responsibility for maintaining government health department patient health jurisdiction ○​ Serve secondary care ○​ E.g. barangay health center, physicians (specialists) who primary health centers perform routine surgery, emergency treatments, PG. 4 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER \ 2024 - 2025 A6 DIFFERENT CLINICAL ANALYSIS AREAS B CLINICAL CHEMISTRY Hospital ​ Permanent inpatient beds ​ 24-hour nursing service ​ Section for testing blood and other ​ Managed by organized medical team body fluids to quantify (determine ​ 2 MAJOR DIVISIONS: whether analyte is within reference ○​ CLINICAL ANALYSIS AREA range) essential soluble chemicals for ○​ ANATOMICAL AND SURGICAL diagnosis of certain diseases PATHOLOGY AREA ​ Analyzes serum and plasma for chemical constituents to evaluate CLINICAL PATHOLOGY. general health and disorders of the body 1.​ Clinical Chemistry 2.​ Immunohematology 3.​ Medical Microbiology Fasting Blood Sugar (FBS) & Glycosylated 4.​ Immunology and Serology Hemoglobin 5.​ Hematology ​ For diagnosis of diabetes mellitus 6.​ Coagulation ​ Glycosylated Hemoglobin (HbA1c) - 7.​ Clinical Microscopy assesses metabolism of glucose throughout the body; serves as monitoring ANATOMIC PATHOLOGY. ​ FBS - serves as screening; 8-10 hours ​ Focuses on the diagnosis of diseases through microscopic examination of Total Cholesterol tissues and organs ​ Under lipid profile - how many fats in the body 1.​ Histopathology - process different ​ High and low-density lipoprotein types of tissues suffering from a ​ Triglycerides disease ​ For diagnosis of cardiovascular 2.​ Immunohistopathology - use labels disease e.g. antigens or antibodies to detect disease 3.​ Cytology - examine structure of cells Blood Uric Acid whether benign (does not metastasize ​ Elevated levels indicate kidney or spread) or malignant disorders or gout (metastasizes) ​ Can form uric crystals and develop 4.​ Autopsy arthritis 5.​ Forensic Pathology PG. 5 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER \ 2024 - 2025 Blood Urea Nitrogen ​ Elevated levels indicate myocardial ​ Amount of urea nitrogen found in infarction (heart attack) or lung and blood and if high levels, could liver disorders determine renal (kidney function) ​ Can indicate kidney disorders Amylase and Lipase ​ Elevated levels indicate pancreatitis Creatinine ​ Indicate kidney disorders or muscular dystrophy Electrolytes (Na, K, Cl, CO2) ​ Evaluate body fluid balance Alanine aminotransferase (ALT) ​ Also known as Serum Glutamic Pyruvic B-type (Beta) natriuretic Peptide (BNP) Transaminase (SGPT) test ​ High levels in the blood indicate congestive heart failure Aspartate aminotransferase (AST) ​ Otherwise known as Serum Glutamic-Oxaloacetate Transaminase Drug Analysis (SGOT) ​ Monitors therapeutic range to avoid ​ Indicate liver disorders toxic levels for drugs Alkaline phosphatase (ALP) Total Protein ​ Elevated levels indicate bone or liver ​ Indicates liver and kidney disorders disorders Troponin I Bilirubin ​ Early diagnosis of acute myocardial ​ Elevated levels indicate liver or infarction hemolytic disorders ​ Cardiac marker Gamma-glutamyltransferase (GGT) ​ Indicate early liver disorders ​ Indicate alcoholic tendencies; alcohol-induced liver Lactic Dehydrogenase (LHD) PG. 6 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER \ 2024 - 2025 C MICROBIOLOGY ​ Divided into 4 sections: ○​ Bacteriology ○​ Mycobacteriology ○​ Mycology ○​ Virology ​ Identification of bacteria and fungi on received specimens ​ Samples are obtained from blood, urine, throat, sputum, genitourinary tract, wounds, cerebrospinal fluid, and feces D HEMATOLOGY AND COAGULATION Culture and Sensitivity STUDIES ​ Detects microbial infection and determines antibiotic treatment HEMATOLOGY SECTION. Blood Culture ​ Detects bacteria and fungi in blood ​ Enumeration of cells in the blood and ​ PINK BACTEC - pediatrics; BLUE other body fluids BACTEC - adult/aerobic culture; ​ Coagulation studies focus on blood ORANGE BACTEC/BROWN BACTEC - testing for the determination of anaerobic culture various coagulation factors ​ WHOLE BLOOD - most common body fluid analyzed in this section; obtained Fungal Culture using collection tubes with lavender ​ Detects presence and type of fungi stopper containing ethylenediaminetetraacetic acid (EDTA), inverted 8 times Gram Stain ​ PLASMA - liquid portion of the blood ​ Detects presence and helps in obtained from an anticoagulated identifying bacteria sample; contains protein fibrinogen ​ GRAM POSITIVE (purple); GRAM ​ SERUM - liquid portion of the clotted NEGATIVE (pink) sample Complete Blood Count (CBC) ​ Most common in the Hematology section PG. 7 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER \ 2024 - 2025 ​ Screening tests to assess patient conditions such as infections and malignancy 1.​ Differential Count ​ Perform blood smear ​ Determined percentage of different types of WBC and evaluates RBC and platelet morphology ​ Basophil - presence of intense granules; indicates allergic reaction 2.​ Hematocrit (Hct) ​ Lymphocyte - irregular levels ​ Determined volume of RBC indicate viral infection packed by centrifugation ​ Monocyte - kidney bean-shaped nucleus; irregular levels indicate viral infection 3.​ Hemoglobin (HgB) characterized by chronic ​ Determines the inflammation oxygen-carrying capacity of ​ Eosinophil - bright orange RBC granules; indicates allergy and parasitic infection ​ Band Cell - immature 4.​ Mean Corpuscular neutrophil Hemoglobin (MCH) ​ Neutrophil - presence of ​ Expressed in picograms (pg) lobules or ​ Determines amount of segmentation/segments; hemoglobin increase in neutrophils indicate infection 5.​ Mean Corpuscular Hemoglobin Concentration (MCHC) ​ Determines weight of hemoglobin in RBC and compares it with cell size ​ In percentage 6.​ Mean Corpuscular Volume (MCV) ​ Determines RBC size PG. 8 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER \ 2024 - 2025 ​ Expressed in femtoliters (fL) ​ If increased or decreased levels, may be a sign of issues e.g. arthritis 7.​ Platelet Count ​ Determines platelet number in blood circulation 14.​Reticulocyte Count ​ Helps in stopping the bleeding ​ Evaluates bone marrow production of RBC ​ Anemic patients may have 8.​ Red Blood Cell (RBC) Count higher reticulocyte count ​ Determined number of RBC in blood circulation 15.​Sickle Cell ​ For diagnosis of sickle cell 9.​ RBC Distribution Width disease ​ Calculation to determine difference in RBC size ​ Improved Neubauer - enumerates different types of COAGULATION STUDIES. cells in a sample ​ Overall process of Hemostasis (stoppage of blood flow from 10.​White Blood Cell Count damaged blood vessels) is evaluated ​ Determines WBC number in incl. platelets, blood vessels, blood circulation coagulation factors, fibrinolysis, inhibitors and anticoagulant therapy ​ Plasma from drawn sample in light 11.​Body Fluid Analysis blue stopper contains sodium citrate ​ Determines number and type ​ Most common type of sample is whole of cells in fluid e.g. sperm, blood for hematology; plasma for pleural fluid, etc coagulation studies Activated Partial Thromboplastin Time 12.​Bone Marrow (APTT)/Partial Thromboplastin Time ​ Determines number and type ​ Monitors heparin therapy of cells in bone marrow ​ Evaluates intrinsic system of coagulation process; happens when there is damage to endothelium 13.​Erythrocyte Sedimentation Rate (ESR) ​ Determines rate of RBC sedimentation PG. 9 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER \ 2024 - 2025 Fibrinogen ​ Determines fibrinogen amount in plasma Platelet Aggregation ​ Evaluates platelet function Prothrombin Time & International Normalized Ratio ​ Paired with APTT ​ Evaluates extrinsic system of coagulation cascade ​ Monitors Coumadin therapy Antithrombin III ​ Screening test for increased clotting Thrombin Time tendencies ​ Determines if adequate fibrinogen is present for normal coagulation Bleeding Time ​ Evaluate platelet function D-dimer ​ Measures abnormal blood clotting E CLINICAL MICROSCOPY and fibrinolysis ​ Fragments of fibrinolytic products ​ Comprises of two areas: ○​ Urine Analysis and other Body Factor Assays Fluids ​ Detects factor deficiencies that ○​ Examination of Stool/Routine prolong coagulation Fecalysis ​ Factors up to 12 ​ Urinalysis is the routine screening test to detect disorders of the kidney and Fibrin Degradation Products metabolic disorders e.g. diabetes ​ Test for increased fibrinolysis mellitus, liver disease; physical, chemical, microscopic examination of urine PG. 10 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER \ 2024 - 2025 Types of Analysis Performed 1.​ Macroscopic Examination ○​ Examination of color, transparency, and other test via naked eye 2.​ Chemical Examination ○​ Examination of glucose, protein, blood bilirubin, urobilinogen, nitrite, leukocyte esterase 3.​ Microscopic Examination ○​ Examination of cellular elements e.g. RBC, WBC, other cellular structures such as crystals, casts 2.​ Appearance ​ Detects cellular and crystalline elements Urinalysis Parameters ​ Can be clear, slightly cloudy, cloudy, or turbid 1.​ Color ​ Detects blood, bilirubin, and 3.​ Specific Gravity other pigments ○​ Measures urine concentration ​ Depends on hydration ​ Normal color of urine is Yellow 4.​ pH ○​ Determines urine acidity 5.​ Protein ○​ Elevated levels indicate kidney disorders 6.​ Glucose ○​ Elevated levels indicate diabetes mellitus 7.​ Blood ○​ Detects RBC or hemoglobin 8.​ Bilirubin ○​ Elevated levels indicate liver disorders PG. 11 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER \ 2024 - 2025 9.​ Urobilinogen ○​ Elevated levels indicate liver/hemolytic disorder Group and Type ​ ABO and Rh (Rhesus) typing 10.​Nitrite ○​ Detects bacterial infection e.g. UTI Antibody Screen ​ Detects abnormal antibodies in 11.​Leukocyte esterase serum ○​ Detects WBC ○​ Increased neutrophils indicates UTI Direct Antihuman Globulin test/Direct Coomb 12.​Microscopic ​ Detects abnormal antibodies in RBC ○​ Determines number/type of cellular elements Antibody Panel ​ Identifies abnormal antibodies in serum Type and Crossmatch ​ ABO, Rh typing, compatibility test F BLOOD BANK AND IMMUNOHEMATOLOGY Type and Screen ​ Main activities include: BLOOD ​ ABO, Rh typing, compatibility test TYPING & COMPATIBILITY TESTING ​ Screening for all antibodies and Additional Information !! antigen and their identifications as ​ Identification of abo & rh well as blood components for transfusion ​ Blood bank samples are collected via plain red, lavender, or pink stopper plasma. ​ Commercial Antisera - produced via monoclonal/polyclonal production; detects presence of agglutination to determine if result is positive or negative ​ Agglutination - the interaction of antigen and antibody present in RBC PG. 12 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER \ 2024 - 2025 G IMMUNOLOGY AND SEROLOGY Hepatitis C antibody ​ Detects hepatitis C infection ​ Performs test to evaluate body’s immune response i.e. production of antibodies and cellular activation Immunoglobulin (IgA, IgG, IgM) levels ​ Analyses of serum antibodies in ​ Evaluates immune system function certain infectious/viral agents are performed ​ Samples of antibody screening tests Venereal Disease Research Laboratory include: Hepa B profile, serological test (VDRL) and Rapid Plasma Reagin (RPR) for syphilis, Hepa C, dengue fever, etc. ​ Screening test for syphilis ​ Blood is collected via red stoppers STAT Laboratory Anti-HIV ​ STAT refers to short turnaround time ​ Screening test for Human ​ Means immediately, prioritize; usually Immunodeficiency Virus (HIV) located near emergency room of some tertiary-care facilities Human chorionic gonadotropin (HCG) ​ Hormone found in urine during Reference Laboratory pregnancy ​ Large and independent lab ​ Pregnancy tests can come in forms via ​ Provides specialized and strip, cassette, midstream confirmatory/reference lab tests for blood, urine, and tissues ​ Has FAST turnaround time C-reactive protein (CRP) ​ Elevated levels indicate inflammatory disorders National Reference Laboratory External Quality Assurance System (NRL-EQAS) Cytomegalovirus antibody (CMV) 1.​ National Kidney and Transplant ​ Detects Cytomegalovirus Infection Institute (NKTI) ○​ Clinical Hematology ○​ Immunohematology/Blood Hepatitis A banking ​ Detects hepatitis A infection ○​ Immunopathology & Histopathology Hepatitis B surface antigen (HBsAG) ​ Detects hepatitis B infection PG. 13 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER \ 2024 - 2025 2.​ Research Institute for Tropical Medicine (RITM) ○​ Microbiology and Parasitology for diseases like dengue, influenza, tuberculosis, malaria, etc. 3.​ Lung Center of the Philippines ○​ Clinical Chemistry 4.​ East Avenue Medical Center (EACM) ○​ Drugs of Abuse ​ e.g. Methamphetamine (cocaine), tetrahydrocannabinol (cannabis/marijuana) ○​ Environmental and Occupational Health ○​ Toxicology ○​ Micronutrient Assay ○​ Water Bacteriology 5.​ San Lazaro Hospital ○​ Sexually-Transmitted Infectious Diseases ​ E.g. HIV, Syphilis, Hepatitis B & C, and STIs PG. 14 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 Week 2: Infection Control, Safety, Normal Flora First-aid, Personal Wellness ​ Non-pathogenic microorganisms in our skin and in other areas of the body e.g. gastrointestinal tract TOPIC OVERVIEW ​ However, if put in other parts of the body, may cause infection A.​ Infection Control ​ Ex. Escherichia coli (colon) - also the a.​ Chain of Infection most common cause of UTI i.​ Components ii.​ Breaking Chain of Local Infection Infection ​ Affecting only one area of the body iii.​ Ways to Break Chain of Infection Systemic Infection b.​ Infection Control Program ​ Affecting the entire body c.​ Infection Control Methods i.​ Hand Hygiene Autogenous Infection ii.​ Personal Protective ​ Infection by one’s own flora Equipment (PPE) iii.​ Donning Communicable Infection iv.​ Doffing ​ Spread from one person to another d.​ Isolation Procedures i.​ Standard Precautions Nosocomial Infection ii.​ Transmission-based ​ Acquired from hospitals, healthcare Precautions facilities B.​ Exposure Control Plan a.​ Biohazard Antibiotic-resistant Infection b.​ Electrical Hazard ​ Microorganisms resistant to specific c.​ Fire Hazard antibiotics d.​ Radiation e.​ Chemical Hazard Multidrug resistant organisms (superbugs) C.​ First-aid ​ Microorganisms resistant to several D.​ Personal Wellness drugs A INFECTION CONTROL A1 CHAIN OF INFECTION Infection ​ Microorganism in body invades, ​ Continuous link in transmission of multiplies, causes harm or disease harmful organisms between source and host Pathogens ​ Infectious Agent > Reservoir > Exit ​ Microorganisms that cause disease Pathway > Means of Transmission > PG. 1 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 Entry Pathway > Susceptible Host 4.3 Airborne Transmission (IREMES) ​ infective for long periods in particles less than 5 micrometers 1. Infectious Agents (Source) ​ can be inhaled; indirect ​ Causative agent ​ droplet nuclei or dried residue ​ Microbe responsible for infection of droplets ​ Ex. Bacteria, parasites, fungi, virus ​ airborne droplet nuclei develops when fluid of pathogenic 2. Reservoir droplets evaporates ​ Source of infectious agent ​ small and light, may remain ​ Place where microbe grows and suspended in air for hours thrives ​ can be spread via ventilation ​ Ex. Humans, animals, insects, food, water, soil, equipment 4.4 Vehicle ​ transfer through contaminated 3. Exit Pathway items e.g. food, water ​ Infectious agent leaves reservoir ​ Ex. Secretions from eyes, nose, mouth, 4.5 Vector-borne wounds, tissue specimen, blood, feces, ​ transmission via insect/animal urine vectors e.g. Dengue, Malaria 4. Means (Mode) of Transmission (CDAVV) 5. Portal of Entry (Entry Pathway) ​ A way microorganism enters host 4.1 Contact Transmission ​ Ex. Body orifice, mucous membrane, ​ most common means of breaks in skin transmitting infection Direct - transfer straight from 6. Susceptible Host source to host through close or ​ Someone prone to infection intimate contact ​ Ex. Elderly, newborn, Indirect - transfer of infective immune-suppressed, unvaccinated material via object e.g. bed ​ Factors of Susceptibility: Age, Health, linens, furniture Immune Status of Host 4.2 Droplet Transmission ​ transfer to mucous membrane via infectious droplets Breaking the Chain of Infection ​ more than or equal to 5 ​ stop infections at source micrometers ​ prevent contact with substances ​ Ex. Coughing, sneezing, talking from exit pathways ​ eliminate means of transmission ​ block exposure to entry pathways ​ reduce/eliminate host susceptibility PG. 2 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 A3 INFECTION CONTROL METHODS Ways to Break Chain of Infection ​ effective hand hygiene 1. Hand Hygiene — effective way to prevent ​ good nutrition, adequate rest, stress spread of infection reduction ​ immunization 1.1 Routine handwashing ​ surface and instrument ​ plain soap & water decontamination ​ when hands are dirty ​ proper disposal of sharps and ​ before eating; after restroom infectious waste ​ use of PPE ​ use needle safety devices Routine Hand Washing Technique Ways Healthcare Institutions Break the Remove jewelry, then; Chain ​ Infection control programs 1.​ Stand few inches from ​ Insect & rodent control sink. ​ Isolation procedures 2.​ Turn on faucet and place hands under water. 3.​ Soap and lather. 4.​ Scrub all surfaces. 5.​ Apply friction and rub for A2 INFECTION CONTROL PROGRAM at least 15-20s. 6.​ Rinse hands from wrist to fingertips downwards. Functions 7.​ Dry hands with paper 1.​ Protect patients, employees, visitors towel. from infection. 8.​ Use paper towel to close 2.​ Screen employees for infectious faucet if manual. diseases and require immunization if needed. Entire Procedure: 40-60s 3.​ Provide evaluation and treatment to health workers who have been exposed to infections at duty. 1.2 Hand antisepsis 4.​ Monitor employees and patients ​ antimicrobial who are at risk of infection and to soap/alcohol-based sanitizers collect data from patients and (when hands are not visibly health workers who already have dirty) been exposed. ​ put sanitizer, rub for 20s or until dry PG. 3 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 Use of Alcohol-based Level of PPE Antiseptic Hand Cleaners 1.​ 60% alcohol 1 Surgical mask 2.​ If hands are not visibly soiled 2 Surgical Mask, Goggles/Face 3.​ Cover all surfaces Shield, Gown, Gloves 4.​ Allow to evaporate for 3 N95 Mask, Goggles/Face Shield, 20-30s. Gloves, Surgical Cap, Scrub Suits, Gowns (coveralls), Shoe covers 1.3 2-minute scrub 4 N95 Mask (PAPR), Goggles/Face Shield, Double Gloves, Surgical Cap, Scrub Suits, Coveralls (Hazmat Suit), Dedicated Shoes, Situations that Require Hand Hygiene Shoe covers ​ before/after patient contact ​ between patient procedures ​ before putting gloves on; after 2.1 Gloves taking them off ​ Wear during blood ​ before leaving laboratory collection/specimen handling ​ before going to lunch/break ​ Worn over the cuffs of gown ​ before/after restroom ​ Purpose: patient care and ​ when hands are contaminated environmental services ​ Material: vinyl, latex, nitrile, etc. Hand Hygiene for Direct Patient Care ​ Sterile or non-sterile ​ before touching patient ​ One or two pair ​ before performing clean procedure ​ Single-use or reusable ​ after risk of body fluid exposure ​ DON’T: ​ after touching patient; ○​ Touch surfaces with ​ and their surroundings contaminated gloves ○​ Touch face or adjust PPE with contaminated 2. Personal Protective Equipment gloves ○​ Reuse disposable gloves ​ Equipment worn to minimize exposure to hazards that cause injuries in the 2.2 Mask workplace ​ Wear when catering to isolated ​ Specialized clothing/equipment patients employees wear for protection against ​ Fluid-proof masks for infection splattering liquids ​ Disposable ​ Should cover nose and mouth; never around neck PG. 4 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 2.3 Gown 4. Doffing ​ Fluid-resistant ​ Gloves > Goggles/Face Shield > Gown ​ Disposable > Mask/Respirator ​ Make sure it is tied and ​ During COVID-19: Gloves > Gown > fastened Hand Hygiene > Goggles/Face Shield > Mask/Respirator > Hand Hygiene 3. Donning ​ Gown > Mask/Respirator > 4.1 Gloves Goggles/Face Shield > Gloves ​ Grasp outside near wrist; peel ​ Contaminated PPE - outside front, inside-out likely to have made contact with ​ Hold in opposite hand infectious organisms ​ Slide ungloved finger under ​ Clean PPE - inside, outside back, wrist of remaining glove ties/elastic, likely to not have made ​ Peel from inside; dispose contact with infectious organisms 4.2 Goggles/Face Shield 3.1 Gown ​ Remove from back by lifting ​ Neck to knees; arms to end of headband or ear pieces wrists, fully wrap around back ​ If reusable, place in container ​ If gown too small, use two for reprocessing or discard 3.2 Mask 4.3 Gown ​ Place over nose, mouth, chin ​ Unfasten gown ties; sleeves ​ Fit nose piece over nose bridge should not make contact with ​ Secure on head via ties/elastic your body ​ Pull gown away from neck and 3.3 Respirator shoulders; touch inside of gown ​ Secure ties/elastic at middle of only head and on neck ​ Turn gown inside-out ​ Fit nose piece over nose bridge ​ Fold or roll into bundle; discard ​ Fit snug to face and below chin 4.4 Mask 3.4 Goggles ​ Grasp ties without touching ​ Place over face and eyes to front adjust fit ​ Discard 3.5 Gloves A4 ISOLATION PROCEDURES ​ Extend to cover wrist of isolation gown ​ Separate patients with certain transmissible infections from other patients PG. 5 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 ​ Limit their contact with personnel and ○​ Airborne - pulmonary visitors tuberculosis, measles (rubeola), ​ Protective/Reverse Isolation - used chickenpox (varicella) for patients highly susceptible to ○​ Droplets - influenza infections ○​ Contact - diarrhea, skin/wound infection Blood-borne Pathogens ​ Microorganisms in the blood that can cause human disease; infectious Common Blood-borne Pathogens B EXPOSURE CONTROL PLAN HEPA B Can survive a week on objects ​ Exposure to blood borne-pathogens HEPA D Symptoms: flu-like, fatigue, via: appetite loss, fever, muscle ○​ Needle-stick injury joints/abdominal pain, nausea, ○​ Blood or body fluid splashes in vomiting eye, nose, mouth ○​ Blood or body fluid contact with Mode of Transmission: cut, scratch, abrasion needlesticks, sexual contact ○​ Human bite cuts skin Vaccine: Hepa B Caused by Needlestick/Sharp Objects 1.​ Remove sharp/foreign object. HEPA C 2.​ Bleed it, encourage bleeding. 3.​ Wash site with soap and water for at IMMUNODEFICIENCY VIRUS least 30s. Standard Precautions Through Mucous Membrane ​ Specific precautions used in caring for 1.​ Flush with water/saline for at least 10 all patients regardless of condition minutes. ​ Include: hand hygiene, PPE, 2.​ Eyes: use eyewash station (remove respiratory hygiene/cough etiquette, contact lenses) sharps safety, sterile instruments, 3.​ Report incident to supervisor. disinfected surfaces Surface Decontamination Transmission-based Precautions 1.​ Clean up spills/soiled areas with ​ For patients diagnosed with disinfectant. transmissible disease 2.​ 1:10 bleach (sodium hypochlorite) ​ Precautions whether the disease is solution transmitted via: 3.​ Prepared daily 4.​ Use gloves 5.​ Use absorbent material PG. 6 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 6.​ Do not pick up broken glass with cleaning broken glass; never hands; use brush, dustpan, or tongs handle broken glass with bare hands 5.​ Permucosal B1 BIOHAZARD ○​ Through mucous membranes: eyes, nose, mouth ​ Biohazard: material that could be ○​ Practice proper specimen harmful to one’s health handling; avoid rubbing mucous ​ Biosafety: safe handling of biological membranes substances that pose health risks; used to prevent and protect laboratories from incidents via B2 ELECTRICAL HAZARD biohazards BIOHAZARD EXPOSURE ROUTES: Electric Shock 1.​ Airborne ​ Shut off electricity source ○​ Aerosols and splashes can be ​ If it cannot be shut off: use created when specimens are non-conducting material to remove centrifuged, tube stoppers electricity source from victim removed, specimen aliquots are ​ Call medical assistance being prepared ​ Start CPR if necessary ○​ Observe proper handling ​ Keep victim warm practices; wear PPE properly; use safety shields/guards Electrical Safety ​ Avoid using extension cords. 2.​ Ingestion ​ Do not attempt to repair equipment ○​ Can be ingested if workers without training. don’t wash hands before eating ​ Do not handle electrics with wet ○​ Wash hands frequently; avoid hands/standing on wet floor. hand-mouth activities; avoid ​ Do not overload electrical circuits. placing items in mouth ​ Inspect cords/plugs for breaks/frays. ​ Know location of circuit breaker box. 3.​ Non-intact Skin ​ Unplug; do not use malfunctioning ○​ Through breaks or cuts in skin equipment. ○​ Cover skin cuts/breaks with ​ Unplug equipment that’s been spilled non-permeable bandages with liquid. ​ Unplug equipment when you are 4.​ Percutaneous serving it. ○​ Through skin due to sharps/needles ○​ Use needle safety devices; wear heavy-duty utility gloves when PG. 7 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 B3 FIRE HAZARD Fire Safety ​ Conduct regular fire drills: be familiar with location of emergency exits & evacuation plans/routes ​ Post location of fire extinguishers/heavy blankets ​ Know how to use extinguishers 5 CLASSES OF FIRE CLASS CAUSE EXTINGUISHER A Ordinary Water, foam, dry combustible chem mats. (wood, paper) B Flammable Block oxygen, dry liquids chem., CO2, foam, (paint, oil, halon grease, gasoline) C Electrical Non-conducting equipment agents, dry chem., CO2, halon (do Reminders not use foam) ​ Never use water extinguisher on grease, electrical, or class D fires - D Combustible Power agents, they will spread and make fire bigger. chemicals/re sand or dry ​ Class ABC: all-purpose extinguisher active powder works; called a dry chemical metals ​ CO2 extinguishers don’t leave harmful residue; good choice for K Cooking oil, Liquids that electrical fire grease, fats prevent splashing, and cools & smothersfire PG. 8 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 ​ DON’T: ○​ Panic ○​ Run ○​ Use elevators B4 RADIATION ​ Radiation exposure depends on distance, shielding, and time ​ Effects are cumulative ​ Radiation hazards include: ○​ Collecting specimens from patients injected w/ radioactive Fire Tetrahedron dyes or from nuclear medicine ​ Heat, fuel, oxidizing agent (oxygen), department chemical reaction ○​ Delivering specimens to ​ Fire naturally occurs when all elements radioimmunoassay sections are combined ​ The phlebotomist should be: ​ Extinguished if even ONE element is ○​ Aware of institutional radiation removed safety procedures ○​ Cautious when entering areas What to DO in case of fire with radiation hazard symbol ​ RACE (Rescue, Alarm, Contain, Extinguish) ​ Rescue anyone in immediate danger. ​ Activate institutional fire alarm system ​ Close all doors ​ Attempt to extinguish fire if possible Fire Safety: DOs and DON’Ts ​ DO: ○​ Pull the nearest fire alarm ○​ Call fire department ○​ Attempt to extinguish small fire (only if flames are shorter than you; if contained in small space) ○​ Close all doors/windows ○​ Smother a clothing fire with fire blanket or person rolling on the floor ○​ Crawl to nearest exit if there’s heavy smoke PG. 9 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 B5 CHEMICAL HAZARD FLAME General Rules for Chemical Safety ​ Always wear proper PPE. ​ Always use proper chemical cleanup materials. ​ Never store chemicals above eye level. ​ Never add water to acid. ​ Flammables ​ Never indiscriminately mix chemicals ​ Pyrophorics together. ​ Self-heating ​ Never store chemicals in unlabeled ​ Emits flammable gas containers. ​ Self-reactives ​ Never pour chemicals in dirty ​ Organic Peroxides containers, esp. when previously used to store other chemicals. EXCLAMATION MARK ​ Never use chemicals in ways other than intended use. Chemical Spill Procedure ​ Use specialized kits containing absorbent and neutralizer. ​ Irritant (skin and eye) ​ Skin sensitizer GLOBALLY HARMONIZED SYSTEM OF ​ Acute Toxicity CLASSIFICATION AND LABELING OF ​ Narcotic Effects CHEMICALS (GHS) ​ Respiratory Tract Irritant ​ Hazardous to Ozone Layer HEALTH HAZARD (nonmandatory) GAS CYLINDER ​ Carcinogen ​ Mutagenicity ​ Reproductive Toxicity ​ Gases under pressure ​ Respiratory Sensitizer ​ Target Organ Toxicity ​ Aspiration Toxicity PG. 10 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 CORROSION SKULL AND CROSSBONES ​ Skin corrosion/burns ​ Acute toxicity (fatal or toxic) ​ Eye damage ​ Corrosive to metals EXPLODING BOMB C FIRST-AID External Hemorrhage ​ Abnormal or profuse bleeding ​ Steps: firmly apply direct pressure to ​ Explosives wound until bleeding stops or rescuers ​ self-reactives arrive; ​ Organic peroxides ​ Pressure should be applied using cloth or gauze with additional material FLAME OVER CIRCLE Shock ​ Insufficient return of blood flow to the heart resulting in lack of oxygen supply to all organs/tissues of the body ​ Common Symptoms of Shock: ○​ Pale, cold, clammy skin ​ Oxidizers ○​ Rapid, weak pulse ENVIRONMENT (nonmandatory) ○​ Increased, shallow breaths ○​ Expressionless face, staring eyes ​ First-aid for Shock: 1.​ Maintain open airway for victim 2.​ Call for assistance 3.​ Keep patient lying down with ​ Aquatic toxicity head lower than rest of body 4.​ Attempt to control bleeding or other cause of shock PG. 11 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 5.​ Keep victim warm until help ○​ Tilt patient’s head and lift chin arrives to open airway; allows mouth to fall open slightly. Cardiopulmonary Resuscitation (CPR) ○​ Deliver rescue breaths. Pinch ​ Emergency lifesaving procedure nose shut and go mouth-mouth, performed when heart stops beating blow air into the person's mouth ​ Aims to keep blood and oxygen to make the chest rise. flowing through body ○​ Deliver two rescue breaths, ​ Can keep oxygenated blood flowing to continue compressions the brain and other vital organs until other medical treatment can restore Red Cross CPR Steps normal heart rhythm ​ Continue CPR steps. ​ Before giving CPR: ​ Replicate cycle of 30 chest ○​ Check scene and person compressions w/ rescue breaths. ○​ Patient should lie on their back ​ Repeat until person exhibits signs of on steady surface life. ○​ Call 911 for assistance ○​ Ask bystander to call 911, or call How to Perform CPR 911 then begin ​ For General Public: ○​ Check for breathing; if no ○​ Compression-only or breathing, do CPR hands-only ○​ No mouth-to-mouth ○​ Call 911 ○​ Push hard and fast on center of chest. ​ Steps to Perform CPR: ○​ Kneel beside patient and place ​ For Trained: hands on the middle of patient’s ○​ Conventional CPR, both chest chest. compressions and ○​ Cover first hand with heel of mouth-to-mouth breathing other hand, interlock fingers. ○​ Ratio of 30:2 Fingers should be raised so they ○​ In adult victims of cardiac don’t touch ribcage. arrest, perform chest ○​ Lean forward (shoulders compressions at a rate of directly above patient’s chest) 100-120/min with a depth of at and press down on chest for least 2 in. (5 cm) about two inches. Release the pressure to allow chest to come back up. ○​ Do not release hands, repeat. ○​ Give 30 compressions at a rate D PERSONAL WELLNESS of 100 compressions per minute. PG. 12 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 1.​ Personal Hygiene ​ Negative Stress: damages personal 2.​ Proper Nutrition wellness, affects organs and systems, 3.​ Rest weakens immune system 4.​ Exercise ​ Ways to Control Stress: 5.​ Proper Posture/Back Protection ○​ Identify problem and talk about 6.​ Stress Management it ○​ Learn to relax throughout the Personal Hygiene day ​ Bathe and use deodorant regularly ○​ Exercise regularly ​ Brush teeth after eating ○​ Avoid making too many ​ Keep hair clean and neatly combed changes at once ​ Fingernails should be clean, short, ○​ Plan the time you have neatly trimmed ○​ Set realistic goals ​ Avoid heavily scented products ○​ Avoid procrastination Proper Nutrition ​ Nutritious food ​ Plant-based diet rich in vegetables, fruits, legumes ​ Minimally processed starchy staple foods ​ Balance carbs, fat, protein, vitamins, minerals, and fiber Rest ​ Get required hours of sleep (6-8) ​ Take breaks during day to rest, refresh, and stay fit Exercise ​ Strengthens immune system ​ Increases energy ​ Reduces stress by releasing endorphins ​ Reduces symptoms of depression and anxiety Proper Posture/Back Protection ​ Use proper techniques when lifting heavy objects Stress Management PG. 13 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 ​ Helps in coagulation process; regulated body temperature; assists Week 3: Circulatory System body in fighting disease ​ MAIN COMPONENTS: Cardiovascular and Lymphatic System TOPIC OVERVIEW A.​ Circulatory System a.​ Layers, Structures, and A1 LAYERS, STRUCTURES, AND Functions of the Heart FUNCTIONS OF THE HEART b.​ Disorders and Diagnostic of Circulatory System c.​ Main Divisions, Structures and ​ Hollow, muscular organ Functions of Vascular System ​ Four chambers: left and right atrium, d.​ Disorders and Diagnostics of left and right ventricles Vascular System ​ Surrounded by pericardium (thin, e.​ Blood Cells and Blood fluid-filled sac; filled with pericardial f.​ Blood Disorders and fluid) Diagnostics ​ Same size as your clenched fist B.​ Lymphatic System ​ Less than 1 lb. (250-350g) a.​ Structure and Functions of Lymphatic System Layers of the Heart b.​ Disorders and Diagnostics of 1.​ Epicardium Lymphatic System ○​ Thin, watery membrane; outer C.​ Hemostasis, Basic Coagulation, layer and Fibrinolysis Processes ○​ Covers heart, attached to a.​ Hemostasis pericardium b.​ Coagulation Factors and i.​ Parietal (outer layer), Pathways visceral (inner layer) - c.​ Fibrinolysis attached to epicardium d.​ Hemostatic Disorders and ○​ outermost layer of the heart Diagnostics D.​ Major Arm and Leg Veins in 2.​ Myocardium Venipuncture ○​ Thick layer of cardiac muscles; middle layer ○​ Pumps blood to arteries via A CIRCULATORY SYSTEM contraction 3.​ Endocardium ​ Transports oxygenated blood from ○​ Thin layer of epithelial cells; heart and lungs throughout the body inner layer through the arteries ○​ Lines the valves and interior ​ Deoxygenated blood is returned to chambers origin through veins ○​ innermost layer PG. 1 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 Chambers of the Heart Valves of the Heart ​ Right Atrium 1.​ Right Atrioventricular (AV) Valve ○​ Upper right chamber ○​ Tricuspid valve (three cusps) ○​ Receives ○​ Located between right atrium deoxygenated/CO2-rich blood and ventricle from the body ○​ Closes as right ventricles contract; prevent blood ​ Right Ventricle backflow to right atrium ○​ Lower right chamber ○​ Receives blood from right 2.​ Left Atrioventricular (AV) Valve atrium; pumps into pulmonary ○​ Bicuspid (two cusps)/mitral artery valve ○​ Located between left atrium ​ Left Atrium and ventricle ○​ Upper left chamber ○​ Closes as left ventricles ○​ Receives oxygenated blood contract; prevent blood from lungs; pumps it into left backflow to left atrium ventricle 3.​ Right Semilunar Valve ​ Right Ventricle ○​ pulmonary/pulmonic valve ○​ Lower left chamber ○​ Located at entrance of ○​ Receives blood from left pulmonary artery atrium; pumps it into aorta ○​ Closes when right ventricle relaxes; prevent blood backflow to right ventricle 4.​ Left Semilunar Valve ○​ Aortic valve PG. 2 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 ○​ Located at entrance of aorta ○​ Closes when left ventricle Functions of the Heart relaxes; prevent blood backflow to left ventricle Cardiac Cycle Systole (contraction) & diastole (relaxation); lasts about 0.8s Electrical Sends electric impulses Conduction throughout myocardium; System initiated by Sinoatrial (SA) node, aka pacemaker Electrocardio Provides graphical rep. Of gram (ECG) cardiac cycle activity Origin of “Lubb” first sound as Heart Sounds ventricles contract or when AV valves close, “dupp” second sound Septa heard when semilunar 1.​ Interatrial Septum valves close and ventricles ○​ Separates right and left atria relax 2.​ Interventricular Septum Heart Rate & Ave. heart rate is 72 bpm; Cardiac cardiac output is volume ○​ Separates right and left Output of blood pumped/minutes ventricles Pulse Rhythmic throbbing from expansion and Coronary Circulation contraction of arteries ​ Receives blood supply from left an right coronary arteries; Blood Force exerted by blood on ​ coronary veins return deoxygenated Pressure vessel walls; measured by blood from heart muscle to heart sphygmomanometer; BP is difference between Heart Function systolic and diastolic ​ Coronary circulation supplies blood; pressure provides drainage from tissues ​ Composed of left and right coronary arteries and veins PG. 3 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 ​ Aspartate aminotransferase (AST) or A2 DISORDERS AND DIAGNOSTICS Serum glumatic-oxaloacetate OF CIRCULATORY SYSTEM transaminase (SGOT) ○​ Cardiac markers - enzymes DISORDERS that increase if there is heart 1.​ Angina pectoris damage ○​ Chest pain; reduced blood from ​ Cholesterol to heart ○​ Increased LDL is more prone to heart attack 2.​ Aortic stenosis ○​ Increased HDL has lower ○​ Murmur sound produced when chance to experience heart aortic leaflets fail to fully open diseases during systole ​ Creatine kinase (CK) ​ Creatine kinase (CK)-MB 3.​ Bacterial endocarditis ​ Digoxin ○​ Infection where bacteria enters ○​ Monitors digoxin (medication) in heart lining or blood vessel, in blood; used to improve specifically endocardium strength and efficiency of heart; controls rate and reading 4.​ Congestive Heart Failure (CHF) of heartbeat ○​ General feeling of weakness ​ Electrocardiogram (ECG/EKG) due to insufficient blood ​ Lactate dehydrogenase (LD) pumping isoenzymes ​ Microbial cultures 5.​ Myocardial Infarction ​ Myoglobin ○​ Otherwise known as heart ​ Potassium (K) attack ​ Triglycerides ○​ Decrease or full stoppage of ○​ Build-up of cholesterol can lead blood flow that damages heart to obstruction of the heart muscle ​ Troponin T (TnT) ○​ Most specific enzyme found in 6.​ Pericarditis the heart ○​ Inflammation of pericardial sac; due to infection A3 MAIN DIVISIONS, STRUCTURES, DIAGNOSTICS AND FUNCTIONS OF VASCULAR ​ Arterial Blood Gases (ABG) SYSTEM ○​ Can be Arterial Puncture ○​ Done by Respiratory Therapists ○​ Checks if there is enough Vascular System oxygen/CO2 that flows in blood ​ Loop that consists of blood vessel system PG. 4 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 ​ Where blood is circulated to body ​ 2 DIVISIONS: PULMONARY & 4.​ Venules SYSTEMIC CIRCULATION ○​ Very small vein that collects blood from capillaries 5.​ Capillaries ○​ Fine, hair-like blood vessels that connect to arterioles and veins Blood Vessel Structure 1.​ Layers ○​ Tunica adventitia (outer connective tissue) ○​ Tunica media (middle, muscle and elastic fiber) ○​ Tunica intima (inner, endothelial cells) 2.​ Lumen 3.​ Valves The Flow of Blood ​ Deoxygenated blood returns to heart through superior and inferior vena cava; enters right atrium ​ Right atrium contracts; pushes blood Structure of Vascular System through tricuspid valve; goes into right 1.​ Arteries ventricle ○​ Thick-walled blood vessels; ​ Right ventricle contracts; forces blood carry oxygenated blood from to pulmonary semilunar valve; to the heart to other body tissues pulmonary artery ​ Flows through pulmonary artery to 2.​ Arterioles capillaries ○​ Small-diameter blood vessel; ​ Oxygenated blood flows back to heart branches out from arteries and through the pulmonary veins; enters leads to capillaries left atrium ○​ Gas exchange ​ Left atrium contracts; blood goes into bicuspid valve into left ventricle 3.​ Veins ○​ Tubes with thin walls; carry deoxygenated blood from tissues to the heart PG. 5 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 2.​ Arteriosclerosis ○​ Hardening of arterial wall due to aging 3.​ Atherosclerosis ○​ Formation of plaque in inner walls 4.​ Embolism ○​ Clot or bubble in artery; causes obstruction 5.​ Embolus ○​ Obstruction that is carried and lodged into vessel ○​ Can come from thrombus parts 6.​ Hemorrhoids ○​ Swollen veins in anus area 7.​ Phlebitis ○​ Inflammation of vein walls 8.​ Thrombophlebitis ○​ Swelling of leg veins usually during pregnancy 9.​ Thrombus ○​ Blood clot that stops blood flow 10.​Varicose Veins ○​ Usually in legs; twisted and enlarged veins A4 DISORDERS AND DIAGNOSTICS DIAGNOSTICS OF VASCULAR SYSTEM ​ D-dimer ​ Fibrin Degradation Products (FDP) DISORDERS ○​ FDP and D-dimer checks if a 1.​ Aneurysm patient is suffering from a ○​ Enlargement of the artery due blood clotting disorder to weakening of artery wall ​ Lipoproteins PG. 6 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 ​ Triglycerides ​ Contains or can develop antibodies ○​ High Lipoprotein and directed at opposite blood type Triglycerides are a cause of ​ Wrong type of blood during obstruction of blood flow transfusion can cause agglutination ○​ May cause Atherosclerosis (clumping of blood cells) of RBC ​ Prothrombin Time (PT) ​ Partial Thromboplastin Time ABO Blood Group System (PTT/APTT) ​ Classification system of human blood ○​ PT and APTT measure presence via presence of A & B antigens and of clotting factors based on the antigenic components on RBC surface ​ Could be classified as: A, B, O (universal donors), or AB (universal patients/recipients) A5 BLOOD CELLS AND BLOOD ​ If antigen is present e.g. antigen A, their blood type is A and vice versa Blood ​ Red fluid that is transported by the RH (Rhesus) Blood-group System circulatory system throughout the ​ Important classification system in body obstetrics because of hemolytic ​ Composed of plasma and other disease of the newborn (HDN) formed elements ​ Based on “D” antigen or the Rh ​ Contains gases (O2, CO2, N), minerals factor. (Na, K, Ca, Mg), carbs & lipids, ​ Rh+ have D antigen RBC; Rh- does proteins, etc. not have D antigen ​ TWO FUNCTIONS: ARTERIAL ​ An individual who has Rh- or does not (OXYGENATED) & VENOUS have the D antigen will be in danger if (DEOXYGENATED) BLOOD D antigen is encountered. Plasma ​ Clear, straw-colored liquid portion of the blood ​ 90% water ​ Liquid portion of unclotted blood Components of Blood 1.​ Erythrocytes (RBC) 2.​ Leukocytes (WBC) 3.​ Thrombocytes (Platelets) Blood Type ​ Inherited and determined by surface antigens from RBC PG. 7 CHELSEA GRANADA 1 MT - Q  Principles of MedLab. Sci 2 PRELIMS LECTURE \ SECOND SEMESTER 2024 - 2025 Whole Blood, Serum, and Plasma 4.​ Leukopenia ​ Three blood specimen that are ○​ Reduced WBC in blood collected for testing purposes ​ Serum (liquid portion of clotted blood), 5.​ Polycythemia plasma (liquid portion of unclotted ○​ Marrow produces too much blood), and whole blood (RBC, WBC, RBC; leads to blood thickening platelets, plasma & serum) 6.​ Thrombocytosis ○​ Increased production of platelets; affects blood clotting 7.​ Thrombocytopenia ○​ Low platelet count DIAGNOSTICS ​ Bone marrow examination ​ Complete Blood Count (CBC) ○​ Hematocrit (Hct) ○​ Hemoglobin (Hb or Hgb) ○​ Differential (Diff) ○​ Indices (MCH, MCV, MCHC) ​ Erythrocyte Sedimentation Rate (ESR) ○​ Test to know if patient is suffering of infection or inflammation ​ Reticulocyte (Retic) Count A6 BLOOD DISORDERS AND ○​ Abnormal cell; immature cell of DIAGNOSTICS RBC ○​ When present in blood, there is an abnormality DISORDERS ○​ May have anemia 1.​ Anemia ​ ABO & RH type/Blood Typing ○​ Lack of healthy RBC or ​ Cross-match hemoglobin ​ Ferritin ​ Iron (Fe) 2.​ Leukemia ​ Total Iron-binding Capacity (TIBC) ○​ Cancer of blood-forming