The Clinical Laboratory Sections PDF

PMLS 1: Module 4 and Module 5 z The Clinical Laboratory Sections Instructor: Princess Jonalyn Agabao  z OBJECTIVES  Describe the clinical chemistry section and enumerate the services it offers  Enumerate and describe the scope of clinical hematology  Enumerate ro...

PMLS 1: Module 4 and Module 5 z The Clinical Laboratory Sections Instructor: Princess Jonalyn Agabao  z OBJECTIVES  Describe the clinical chemistry section and enumerate the services it offers  Enumerate and describe the scope of clinical hematology  Enumerate routine tests performed in the hematology section and describe how they are correctly performed  z OBJECTIVES  Differentiate an immunology laboratory from serology section  Enumerate common tests performed in the serology section and describe how they are correctly performed  Describe Blood Bank and enumerate routine services it offers  Module 4: PMLS 1 z Unit 1: The Clinical Chemistry Section  z Objectives  Describe the nature of Clinical Chemistry section  Discuss the historical events leading to the development of Clinical Chemistry  Enumerate routine services offered in Clinical Chemistry section  CLINICAL CHEMISTRY  CLINICAL CHEMISTRY - Is a branch of medical science that involves the analysis of chemical components of body fluids. - The development of Clinical Chemistry was made possible by significant contributors from biology and natural philosophy CLINICAL CHEMISTRY HISTORY  History A. Early Beginnings: ‘Attribution of Disease to Imbalances of Bodily Humors vs. Anatomic Approach’ Hippocrates 300BC  The “Father of Medicine” Author of “Hippocratic Oath” Greek Physician He started the belief that disease are caused by imbalances of humors in the body Giovanni Battista Morgagni (1682-1771) Italian Anatomist He introduced the anatomic approach of disease process and explained diseases in terms of localized pathologic anatomy Adversaria Anatomica De Sedibus (1761) Antoine Laurent Lavoisier (1743-1794) “Father of Modern Chemistry” French Chemist He recognized and named two elements: O2 and H2 He started the belief that the chemical analysis is a refined type of dissection that sparked a renewal of interest in the examination of body fluids  History B. Opposing Figures: Vitalists Mechanist Darwinist 1. Vitalists They believed that living organisms contain a “Vital Force” Vital Force – “Very essence of life” 1. Vitalists In vitro synthesis of “organic” compounds is impossible and denied that chemistry has a role in physiology. 1. Vitalists Mari Francois Xavier Bichat (1771-1802) French Anatomist Father of Histology 1. Vitalists Johannes Peter Muller (1801-1858) German Physiologist “Elements of Physiology” 1. Vitalists Justus Baron Von Leibig (1803-1873) German Chemist “If you want to become a chemist, you will have to ruin your health. If you don't ruin your health studying, you won't accomplish anything these days in chemistry.” 2. Mechanists They believed that animals are no more than “Machines” and that life could be explained fully by chemical and physical principles and properties alone. 2. Mechanists Rene Descartes (1596-1650) French Mathematician, Natural Scientist, Philosopher 2. Mechanists Carl F.W. Ludwig (1816-1895) German Physician and physiologist 2. Mechanists Invented the kymograph 2. Mechanists Ernst Brucke (1819-1892) 3. Darwinists They believed that man is not unique. The believe that there is continuity between ma nad the animals as attested by Darwin’s publication “Origin of Species” 3. Darwinists Charles Darwin (1809-1882) English Biologist  History C. Animal Chemistry How it slowly toppled Vitalism Antoine Francois de Fourcroy (1755-1809) French Chemist He was successful in isolating urea from urine samples Friedrich Wohler (1800-1882) German Chemist He was able to synthesize urea in vitro by evaporating an isomeric solution of ammonium cyanate. Marcellin Berthelot (1827-1907) French Chemist and Politician He was able to synthesize organic compounds via chemical treatments of inorganic compounds Organic Compounds: Ethanol, Formic acid, benzene Claude Bernard (1813-1878) French Physiologist He discovered the Glycogen is formed in the liver which contradicted the vitalism belief that plants can produce complex compounds. John Bostock (1773-1846) British Physiologist He was the first to observe: Urea and Albumin concentration is plasma decreases as their concentration increases in the urine of patients.  History D. Chemistry in Medical Education William Prout (1785-1850) English Chemist and Biochemist Credited as the first to make the true connection between chemistry and medical practice. Henry Bence Jones (1813-1873) English Physician and Chemist He stressed the practical diagnostic value of chemistry “Medical men would be better served if they spent some time in acquiring knowledge about chemistry and physics instead of learning some Latin and Greek.” Thomas Hodgkin (1793-1866) British Pathologist “Chemical studies are relevant to clinical medicine” “It is in the blood that we must look for many important modifications in connection with disease” In 1847, The Hospital recognized the powerful aid that the science of medicine “has received from the study of organic chemistry and knowledge and use of the microscope”, thus authorizing the purchase of a microscope (budget not exceeding 50 US dollars) In 1851: the position of a “Chemist-Microscopist” was established. Otto Knot Folin (1867-1934) American Biochemist He proposed that the American hospitals must employ clinical chemist to advance their ability to differentiate between the physiologic and the pathologic. He also developed the Duboscq type colorimeter for the measurement of creatinine in urine. Pioneer of Colorimetry  History E. Clinical Chemistry Take the Center Stage Donald Dexter Van Slyke (1883-1971) American Chemist He invented a volumetric gas- measuring apparatus for the determination of CO2 concentration. Scientists who determined reference intervals at chemicals/analytes. They correlated variations/ abnormal values with pathological conditions. Hsien Wu (1893-1959) Chinese Biochemist They developed a method for production of a protein-free filtrate that can be used for the determining blood sugar Max Jaffe (1841-1911) German Chemist He developed the alkaline picrate method for the determination of creatinine concentration Reddish-orange complex  History F. Early Instrumentation in Clinical Chemistry Colorimetry Its basic principle involves the observation of the intensity of colored product after chemical reaction. E.g. Spectrophotometry The measurement of light absorbance at selected wavelengths which was initiated by the development of Beckman DU Spectrophotometer (by Cary and Beckman) Spectrophotometry Beckman DU Spectrophotometer (by Cary and Beckman) Auto-analyzer In an attempt to automate instruments used in clinical chemistry laboratory, this instrument was introduced. Auto-analyzer This is a continuous-flow instrument that reacted specimen and reagents to produce a measurable color density Centrifugal Analyzer The second attempt at automation Introduced by Norman Anderson First clinical analyzer to incorporate a computer Sequential Multiple Analyzer with Computer (SMAC) Capable of performing multiple tests analyzed one after another on a given clinical specimen Beckman Astra Introduced the perfected technology of automated pipetting which is the approach of choice for automation in clinical chemistry. Beckman Astra Laboratory results are the basis for many clinical conclusions that doctors and clinicians make regarding a person’s health.  z Objectives Describe the nature of Clinical Chemistry section Discuss the historical events leading to the development of Clinical Chemistry x Enumerate routine services offered in Clinical Chemistry section