Principles of Medical Laboratory Science 1 – Comprehensive Bullet-Point Study Notes

History of Medical Technology Profession

• Ancient Roots (≈300 BC – 180 AD)
• Hippocrates – “Father of Medicine,” qualitative assessment of the 4 humors (blood, phlegm, yellow & black bile).
• Galen – related urine appearance to disease; called diabetes “diarrhea of urine.”
• Medieval “water-casting” (uroscopy): decorative flasks; refusal to examine → public beatings.
• 18th–19th C. Transition
• Cadaver dissection & mechanical devices (spirometer, sphygmomanometer).
• Chemistry used for diagnosing diabetes, anemia, diphtheria, syphilis.
• Breakthrough Instruments
• Thermometer, stethoscope (1816), microscope, ophthalmoscope (1850), laryngoscope (1855), X-ray (1895).
• Early 20th C.
• Cardiac catheterization (1929), Drinker respirator (1927), Kenny method for polio rehab (1939), heart-lung machine (1941).
• Electron microscope, CT, MRI, prosthetics, robotics, genetic engineering, tele-medicine.
• USA Laboratory Milestones
• William Pepper Laboratory (1895).
• 1918 Kolmer’s call for national certification.
• 1922 ASCP founded; Code of Ethics.
• Philippine Milestones
• Spanish era hospitals (San Lazaro 1578, San Juan de Dios 1596).
• Bureau of Government Laboratories (1901) → Bureau of Science (1905).
• WWII 6th Infantry Division lab at Quiricada St. → Manila Public Health Lab.
• 1954 Manila Sanitarium opened 1st MT school; PUC (now AUP) absorbed program; UST recognized MT 1961.
• Notable Scientific Contributors (selected)
• Edward Jenner (1796) – vaccination.
• Antonie van Leeuwenhoek – first practical microscope.
• Karl Landsteiner – ABO\text{ABO} blood groups.
• Kary Mullis (1985) – PCR\text{PCR}.

Defining the Practice of Medical Technology

• Nature
• Interdisciplinary application of science + technology for detection, diagnosis & monitoring.
• Dependent on chemistry, electronics, optics, mechanics.
• Philippine Legal Definition (R.A. 5527 §2)
• Enumerates 8 core services: examination of body fluids & tissues, blood banking, microbiology/mycology/parasitology, histopathology/cytotechnology, clinical research, reagent prep, QA, specimen collection.
• Roles & Responsibilities
• Perform basic–advanced tests; operate special procedures (molecular, nuclear).
• Ensure accuracy/precision; uphold honesty, timely release (STAT, ER/OR); professionalism & confidentiality.
• Collaborate with other HCPs; conduct research; participate in community health promotion.
• Other Laboratory Personnel
• Pathologist – MD, heads lab, validates results.
• Medical Laboratory Technician – assists MT (≥70 % board score).
• Phlebotomist – draws blood.
• Cytotechnologist – detects cellular abnormalities.
• Histotechnologist – tissue processing & staining.
• Nuclear MT, Toxicologist, etc.

Ethics

• Ethics = moral code governing behaviour; seeks meaning in logical, epistemological, cosmological, ethical, aesthetic & scientific problems.
• Schools of Ethics
• Ethical Relativism – morality = culture-dependent.
• Ethical Pragmatism – truth judged by practical consequences.
• Ethical Utilitarianism – good→maximise happiness\text{good} \to \text{maximise happiness} (Bentham, Mill).
• Major Moral Issues
• Abortion – Philippine Constitution Art II §12 protects unborn + mother.
• Euthanasia – voluntary / non- / involuntary mercy killing.
• Genetic Engineering – screening, interventions, stem-cell therapy, IVF.
• Professional Ethics – code of conduct within workplace; fosters professionalism, compliance, governance.

Medical Terminology & Abbreviations

• Word Parts: roots (cardi-, gastr-), prefixes (hyper-, hypo-), suffixes (-itis, ‑logy).
• Common Lab Abbreviations: CBC, FBS, BUN, C&S, STAT, Hct, HbA1c1c, AST/ALT, HBsAg, PCR.

MT / CLS Education

• CHED CMO 13 s2017 – 4-yr BS MT/MLS curriculum.
• Units: 3 lec = 54 h54\text{ h}/sem; 1 lab = 3 h/week3\text{ h/week}.
• Core GE (9) – e.g., Ethics, STS, Rizal.
• Professional Courses – Principles 1&2, Bacteriology, Hematology 1&2, Clin Chem 1&2, Blood Bank, Histopath, Myco/Viro, Lab Mgmt, Laws & Bioethics, Molecular Diagnostics.
• Internship – 32 h/week×52 weeks=1 664 h32\,h/week \times 52\,weeks = 1\,664\,h; section allotment: Clin Chem 300 h, Hematology 300 h, etc.
• Licensure Exam (R.A. 5527)
• Major 20 %: Clin Chem, Micro-Para, Hema, Blood Bank/Immunology.
• Minor 10 %: Clin Microscopy, Histopath.
• Passing: ≥75%\ge 75\% GWA, no major <50\%.

Laboratory Biosafety & Biosecurity

• History: US BW program (1943), Camp Detrick, CDC & NIH biosafety levels (1983-84).
• Risk Groups 1-4 based on pathogenicity & availability of treatment.
• Biosafety Levels BSL1→BSL4\text{BSL1}\to\text{BSL4} – increasing containment.
• Philippine Framework – NCBP 1990, EO 514 (2006), DOH AO 2007-0027.

Biorisk Management (AMP Model)

• A – Assessment: define situation, risks, characterize, decide acceptability.
• M – Mitigation: hierarchy – Eliminate, Substitute, Engineering, Administrative, PPE.
• P – Performance Evaluation: define indicators, collect data, refine.

Nature of the Clinical Laboratory

• Functions: diagnostics (70 % clinical decisions), research, surveillance.
• Classifications
• By function: Clinical Pathology vs Anatomic Pathology.
• By institutional: institution-based vs free-standing.
• By ownership: government vs private.
• By service capability: Primary (UA, fecalysis, CBC), Secondary (adds routine chem), Tertiary (adds micro, immunology, special chem, blood bank), National Reference Lab.
• Legal Framework
• R.A. 4688, DOH AO 59-2001 – licensing rules.
• Sections & Common Tests
• Clinical Chemistry – FBS, HbA1c\text{HbA1c}, BUN, electrolytes.
• Hematology/Coag – CBC, PT\text{PT}, APTT\text{APTT}.
• Microbiology – cultures, AST.
• Clinical Microscopy – UA, fecalysis.
• Blood Bank – ABO/Rh, Coombs, component prep.
• Immunology/Serology – HBsAg, HIV, dengue NS1.
• Histopathology – tissue processing, H&E.
• Laboratory Testing Cycle – Pre-analytic → Analytic → Post-analytic.
• Quality Assurance – IQA + EQA (e.g., NRL-SLH HIV, LCP Chem).

Professional Organizations

• PAMET (1963) – core values Integrity, Professionalism, Commitment, Excellence, Unity.
• PASMETH (1970) – association of MT schools.
• PHISMETS – student arm.
• Types – Accrediting (PAASCU), Credentialing (ASCP, AMT), Professional Societies (local & international).

Continuing Professional Development (CPD)

• R.A. 10912 (2016) – mandatory CPD; PRC Resolution 1032 (2017).
• Objectives – align to PQF/AQRF, ensure competence.
• MTs: 45 CU / 3 yrs45\text{ CU / 3 yrs}; transition 0-30-60-100 % (2017-2019).
• CPD Activities – formal acad (Master =45=45 CU), seminars, publication (Intl journal =15=15 CU/article), professional work.

Health Care Waste Management

• Waste Profile PH: ≈30%\approx 30\% hazardous, 70%70\% general; avg 0.34 kg0.34\,\text{kg} infectious per bed-day.
• Categories & Color Codes
• Infectious – yellow bin/liner.
• Pathological/Anatomical – yellow bin; biohazard.
• Sharps – puncture-proof, biohazard.
• Chemical – yellow with black band.
• Pharmaceutical – yellow-black / cytotoxic bag.
• Radioactive – lead-lined; orange liner.
• General – black/green.
• Waste Hierarchy: Prevent → Reduce/Reuse/Recycle/Recover → Treat → Dispose.
• Treatment Options: Pyrolysis, Autoclave (121 °C 15 psi 15-30 min), Microwave, Chemical disinfection (5 % NaOCl\text{NaOCl}), Biological, Encapsulation, Inertization.
• Key Laws: R.A. 6969 (Toxic & Hazardous Waste), R.A. 8749 (Clean Air), R.A. 9275 (Clean Water), DOH-DENR JAO 02-2005, DOH AO 2008-0021 (Mercury phase-out).

Fundamental Equations & Data Samples

• GPA / GWA: GWA=∑w<em>ix</em>i∑wi\text{GWA}=\dfrac{\sum w<em>i x</em>i}{\sum w_i}
• Hematocrit-Hb rule of three: \text{Hct(%)\approx 3 \times Hb\,(g/dL)}
• BMI calc: BMI=weight(kg)height(m)2\text{BMI}=\dfrac{\text{weight(kg)}}{\text{height(m)}^{2}} (used in wellness screening section).
• Risk Assessment Matrix qualitative: Risk=Likelihood×Severity\text{Risk}=\text{Likelihood}\times\text{Severity} (scored 1-5).

Ethical & Professional Implications

• Automation improves accuracy but can distance patient–physician rapport.
• Biosafety lapses may lead to LAI and community outbreaks.
• CPD law balances public safety & professionals’ burden; equitable access remains a policy issue.
• Health care waste mismanagement contributes to antimicrobial resistance & environmental toxicity.