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Dr/ Ghada Mohamed Saied Assistant Professor Of Clinical Pathology Faculty Of Medicine-New Valley University  Agenda * Introduction * Sampling in Clinical Pathology laboratories * Types of Specimens * Methods of Sampling Types Of Tubes Factors Affecting Sample Quality Ke...

Dr/ Ghada Mohamed Saied Assistant Professor Of Clinical Pathology Faculty Of Medicine-New Valley University  Agenda * Introduction * Sampling in Clinical Pathology laboratories * Types of Specimens * Methods of Sampling Types Of Tubes Factors Affecting Sample Quality Key Considerations for Accurate Results Common Chemistry Analytes Automation and Future Trends Conclusion Assignments  Sampling in Clinical Pathology laboratories Introduction Sampling in clinical pathology laboratory is a critical process that directly impacts the accuracy and reliability of laboratory test results. It involves the careful collection, handling, and processing of biological specimens, primarily blood and urine, to ensure they accurately reflect the patient's physiological state.  Types of Specimens Blood: Serum: The liquid portion of blood after clotting. Obtained after centrifugation of a clotted blood sample (usually in a red-top or gold-top tube). Plasma: The liquid portion of blood that contains clotting factors. Obtained after centrifugation of an anticoagulated blood sample (usually in a green-top, purple-top, or light blue-top tube). Urine: Random Urine: Collected at any time of day. Easy to obtain but may have high variability. First Morning Urine: The first void after waking. More concentrated and often preferred for some tests. 24-hour Urine: Collected over 24 hours. Provides a comprehensive assessment of analytes excreted over a day. Other Body Fluids: Cerebrospinal fluid (CSF), synovial fluid, pleural fluid, peritoneal fluid, etc.  Methods of Sampling Venipuncture: Most common method using a needle to draw blood from a vein, usually in the arm. Capillary Puncture (Finger Stick): Used for smaller blood volumes, often for glucose monitoring or in infants. Arterial Blood Gas (ABG): Requires specialized training to collect arterial blood for analyzing blood gases and pH. Types Of Tubes  Factors Affecting Sample Quality Patient Preparation: Fasting requirements, medication restrictions, and recent exercise can influence analyte levels. Specimen Collection: Proper venipuncture technique, correct anticoagulant use, and adequate sample volume are crucial. Specimen Handling: Prompt processing, temperature control, and light protection help preserve analyte integrity. Interfering Substances: Hemolysis (rupture of red blood cells), lipemia (high blood lipid levels), and icterus (high bilirubin levels) can interfere  Key Considerations for Accurate Results (Importance of Proper Sampling) Patient Identification: Double-check patient information before each draw. Proper Technique: Use appropriate needle size, angle, and vein selection to minimize hemolysis (destruction of red blood cells) and ensure a clean draw. Tube Filling: Fill tubes to the designated line to maintain the correct blood-to-additive ratio. Gentle Mixing: Invert tubes containing additives gently to ensure proper mixing without causing hemolysis. Timely Processing: Deliver samples to the laboratory promptly to minimize analyte degradation. Special Handling: Some tests require specific transport conditions like ice slurry or protection from light. Follow laboratory instructions carefully.  Common Chemistry Analytes Clinical chemistry analyzes numerous substances in blood and other body fluids. Some common examples include: Electrolytes: Sodium (Na+), Potassium (K+), Chloride (Cl-), Bicarbonate (HCO3-) Kidney Function: Blood urea nitrogen (BUN), Creatinine Liver Function: Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Alkaline phosphatase (ALP), Bilirubin, Albumin Cardiac Markers: Troponin, Creatine kinase (CK-MB)  Automation and Future Trends Automated Analyzers: Clinical chemistry labs increasingly rely on automated analyzers for high-throughput, standardized testing. Point-of-Care Testing (POCT): Allows for rapid testing at the patient's bedside or in other non-laboratory settings. Dried Blood Spot (DBS) Testing: Uses small samples of dried blood, offering advantages for newborn screening and remote testing.  conclusion Understanding proper blood collection techniques, including tube types and the order of draw, is crucial for accurate and reliable clinical pathology results. By adhering to these guidelines, healthcare professionals can ensure the delivery of high-quality patient care. Proper sampling techniques are fundamental for reliable clinical pathology chemistry testing. Healthcare professionals involved in specimen collection, handling, and analysis must be well-trained and follow standardized protocols to ensure accurate results and ultimately contribute to improved patient care. Assignments 1. Which of the following is NOT a common type of specimen used in clinical pathology chemistry? a) Blood b) Urine c) Synovial Fluid d) Bone Marrow 2. What is the main difference between serum and plasma? a) Serum contains clotting factors, while plasma does not. b) Plasma contains clotting factors, while serum does not. c) Serum is obtained from urine, while plasma is obtained from blood. d) Plasma is obtained from urine, while serum is obtained from blood. 3. Which of the following can negatively affect the accuracy of clinical chemistry test results? a) Proper venipuncture technique b) Hemolysis of the blood sample c) Prompt processing of the specimen d) Storing samples at appropriate temperatures 4. What does the abbreviation "HbA1c" stand for in clinical chemistry? a) Hemoglobin A1c b) Hepatitis B Antigen 1c c) Human Beta-carotene 1c d) High Blood pressure Antigen 1c 5. Point-of-Care Testing (POCT) offers which of the following advantages? a) Requires specialized laboratory equipment b) Allows for rapid testing at the patient's location c) Typically involves a longer turnaround time for results d) Not suitable for monitoring critical care patients 6. Which tube is most appropriate for a complete blood count (CBC)? a) Light Blue b) Green c) Lavender/Purple d) Grey 7. Which additive prevents clotting by binding to calcium in the blood? a) Sodium Heparin b) EDTA c) Sodium Citrate d) Both b and c 8. What is the most likely consequence of insufficient mixing of a blood collection tube containing an additive? a) Hemolysis b) Clot formation c) Lipemia d) Icterus 9. Which of the following can cause hemolysis in a blood sample? a) Using a needle with too small a gauge b) Gently inverting the tube c) Filling the tube to the designated line d) Delivering the sample to the lab promptly 10. Which tube contains an additive that inhibits glycolysis? a) Green b) Grey c) Lavender/Purple d) Red/Gold (SST) 11. What does the acronym "SST" stand for in relation to blood collection tubes? a) Sodium Sulfate Tube b) Serum Separator Tube c) Sterile Sampling Tube d) Standard Solution Tube  Thank you Ghada.M.Saied [email protected]