clinical laboratory test
TRANSCRIPT
![Page 1: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/1.jpg)
![Page 2: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/2.jpg)
![Page 3: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/3.jpg)
![Page 4: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/4.jpg)
![Page 5: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/5.jpg)
• HAEMATOLOGY TESTS• LIVER FUNCTION TESTS• KIDNEY FUNCTION TESTS• CARDIAC MARKERS• GTU QUESTIONS• REFERENCES
FLOW OF PRSENTATION
![Page 6: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/6.jpg)
![Page 7: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/7.jpg)
![Page 8: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/8.jpg)
BLOOD TESTS
• Bleeding time : <8 minutes• Cloting time : 1-3 minutes• Prothrombine time: 8.5-10.5 seconds
CAPILLARY
PLATELETS
THROMBOCYTOPENIAPLATELET DYSFUNCTION
BLEEDING TIME INCREASE
OTHER CAUSES OF ABNORMAL BLEEDING TIME• NSAIDS• ANTI-COAGULANTS
CAPILLARY INJURY TISSUE FACTORE
ACTIVATED X
Ca+2
PROTHROMBINASE
FACTORE V
Ca+2THROMBIN
PROTHROMBIN
FIBRINOGEN
FIBRIN
PROTHROMBINE TIME INCREASES• WARFARIN• DIMINISHES CLOTTING FACTORS DUE TO LIVER DISEASE• VITAMIN K DEFICIENCY
CLOTTING TIME• UNFRACTIONATED HEPARIN THERAPY• FACTOR DEFICIENCY
![Page 9: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/9.jpg)
![Page 10: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/10.jpg)
BLOOD TESTS
• MCV : 80-101 fl• MCHC : 31.5-34.5 mg/dl
• MCV : MEAN CORPUSCULAR VOLUME
NORMOCYTES MACROCYTES MICROCYTES
• MCHC : MEAN CORPUSCULAR HEMOGLOBIN CONTENT
NORMOCHROMIC MACROCHROMIC MICROCHROMICMCV
NORMOCHROMIC
MACROCHROMIC
MICROCHROMIC
NORMOCYTES MACROCYTESMICROCYTES
MCH
C
![Page 11: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/11.jpg)
![Page 12: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/12.jpg)
ESR: ERYTHROCYTE SEDIMENTATION RATE
AFFECT BY:• IMMUNOGLOBULINS• FIBRINOGEN
INDICATION OF INFLAMMATION
APPLICATION:• UNEXPECTED FEVER• ARTHRITIS• MUSCLE SYMPTOMS
• ESR : 0.10 mm/hr• BUN: 7-21 mg/dL• TRANSFERRIN : 1.7/3.4 gm/L• FERITIN : 30-400 ng/ml
BLOOD TESTS
![Page 13: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/13.jpg)
CHOLESTEROL : 160-200 mg/dL TRIGLYCERIDES : 50-150 mg/dL GLYCOSYLATED Hb : 5-6.5 % FASTING BLOOD SUGAR : 3.3-6 mmol/L PO2 : 8-10 mmHg PCO2 : 35-45 mmHg
OTHER BLOOD TESTS
![Page 14: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/14.jpg)
![Page 15: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/15.jpg)
URINE ANALYSIS
ColourOdourVolumeSpecific gravity
![Page 16: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/16.jpg)
BLOOD EXAMINATION
BUN : 7-21 mg/dlURIC ACID : 3.7-7 mg/dlSerum Creatinine : 0.8-1.3 mg/dl (men), 0.6-1 mg/dl (women)
URIC ACID
PURINES LIVER AND INTESTINE URIC ACID
65 %KIDNEY
EXCRETION
INTESTINEINDICATION:• RENAL FAILURE• RENAL DISEASES• GOUT
CREATININE
KIDNEYARGININEGLYCINE
GUANIDINO ACETATE
CREATININE
LIVER
MUSCLE
PHOSPHOCREATININE
CREATININE
MUSCLE
• LOW SERUM CREATININE: LOW MUSCLE MASS
• HIGH SERUM CREATININE: ACUTE KIDNEY INJURY, CHRONIC KIDNEY DISEASE KIDNEY
![Page 17: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/17.jpg)
Creatinine clearance = (140-age)*weight in kg/ s.creatinine*72
GFR MEASUREMENT
CREATININE KIDNEY FILTERED BY CAPSULE
NOT ABSORB OR NOT SECRETED BY ANY OTHER PART
OF NEPHRONE
![Page 18: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/18.jpg)
GFR MEASUREMENT
INULINE:
C = --------U*V
PC = clearance.
U = urinary concentration
V = plasma concentration
P = urine volume
KIDNEY FILTERED BY CAPSULE
NOT ABSORB OR NOT SECRETED BY ANY OTHER PART
OF NEPHRONE
KNOWN CONC. OF INULINE IS GIVEN
IV ROUTE
![Page 19: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/19.jpg)
![Page 20: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/20.jpg)
SPLEENSPLEEN
SPLEENSPLEEN
SPLEENSPLEEN
BILIVERDIN BILIRUBIN
BLOOD VESSELS
AA
A
AAA
LIVER
BLOOD
SINUSOIDAL MEMBRANE
HEPATOCYTES
AAA
SMOOTHENDOPLASMIC RETICULUM
U
U
INTESTINE
U
STOOL PIGMENT
RBC BILIRUBIN
![Page 21: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/21.jpg)
LIPIDS
LIVER INJURY
• PGA index• Prothrombine time• γ- glutamyl transferase• Apo1-A protein
ALCOHOL
• Cholesterol Acyltransferase• Lipoprotein lipases
CHOLESTIC
• Lipoprotein X
![Page 22: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/22.jpg)
BLOOD
SINUSOIDAL MEMBRANE
HEPATOCYTES
SINUSOIDAL MEMBRANE
HEPATOCYTES
HEPATOCYTES
ASTALT
ALT
AST
• HEPATOCELLULAR INJURY• ALCOHOLIC INDUCED
INJURY• HEPATITIS
AST/ALT
![Page 23: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/23.jpg)
AST/ALT AMINOACIDS
GLUTAMATE KETOACIDS
VIT. B6 ALCOHOL
![Page 24: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/24.jpg)
ALBUMIN
• SYNTHESIZED IN THE LIVER• MOST ABUNDANT PROTEIN• WATER SOLUBLE
• DECREASED PRODUCTION (MAL NUTRITION, LOW PROTEIN DIET)• CIRRHOSIS OF LIVER• EXCESS EXCRETION BY KIDNEY• PROLONGE DIARHHOEA
![Page 25: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/25.jpg)
CARDIAC MARKER TROPONIN
COMPLEX OF THREE PROTEINSTROPOMYOSIN SUBUNIT+ INHIBITORY SUBUNIT+ CALCIUM BINDING SUBUNIT
CA+2
ACTIN + MYOSININ CARDIAC MYOCYTES THIS PROTEIN BOUND TO MUSCLE FIBRESSO,MYOCARDIAL INFRACTION ITS RELEASED WITHIN 24 HOURS
![Page 26: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/26.jpg)
REFERENCES
• Gerard J. Tortora, Bryan Derrickson. “Principle of anatomy and physiology”. 12TH Edition.
• Roger walker. “clinical pharmacy and therapeutics”. 5TH Edition.• Emedicine.Medscape.com
![Page 27: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/27.jpg)
GTU QUESTIONS
• DISCRIBE LIVER FUNCTION TESTS.• CLASSIFY ANEMIA.• DISCRIBE VARIOUS HAEMATOLOGICAL TESTS
![Page 28: Clinical laboratory test](https://reader036.vdocuments.site/reader036/viewer/2022062401/587633681a28ab68098b530b/html5/thumbnails/28.jpg)
THANK YOU