Intro_to_Clin_Lab_2021
The MLS Program
Introduction to Clinical Laboratory Science/Lab Specimens
Overview of the Clinical Laboratory Science (CLS) program with relevance to laboratory specimens.
Introduction to Clinical Laboratory Science
Possible Career Pathways
Medical technologists/Clinical lab scientists
Various departments/divisions within clinical laboratories.
Introduction to Clinical Laboratory Science
Regulation and Testing Sites
Regulatory frameworks governing clinical laboratories.
Various testing sites where laboratory tests are performed.
Importance of handling specimens correctly.
Possible Career Pathways
Graduate Studies
Graduate studies towards a Master's degree or PhD.
Possible Career Pathways
Basic Research
Opportunities in academia (universities) and industry (biotech or pharmaceutical companies).
Management
Roles in health administration.
Possible Career Pathways
Teaching and Professional Schools
Opportunities in medical, dental, and veterinary schools.
Possible Career Pathways
Other Clinical Professions
Nursing, Physician Assistant, Physical Therapy.
Possible Career Pathways
Research Technician Roles
Work in universities, research institutes, and industry.
Medical Technologist/Clinical Lab Scientist
Qualifications
Required qualifications include a Bachelor's Degree in Medical Technology or a life science with training in medical technology.
Medical Technologist/Clinical Lab Scientist
Accreditation and Certification
Accredited by NAACLS or the New York State Department.
National Board Examination leads to certification from agencies like the American Society of Clinical Pathologists.
Medical Technologist/Clinical Lab Scientist
Additional Accreditation Agencies
National Certification Agency for Medical Laboratory Personnel (NCAMLP) for Clinical Laboratory Scientists (CLS).
International Society for Clinical Laboratory Technology (ISCLT).
Medical Technologist/Clinical Lab Scientist
New York State License
Licensing implemented on September 1, 2006.
Relevant links for additional information on licensing.
The Medical Technologist’s Role in the Clinical Lab
Importance
Critical in disease detection, diagnosis, and treatment.
The Medical Technologist’s Role in the Clinical Lab
Tests Performed
Perform tests on blood, body fluids, tissue samples, identify pathogens, and conduct genetic testing.
The Medical Technologist’s Role in the Clinical Lab
Specialization
Often specialize in specific areas like Blood Bank, Microbiology, Molecular Biology, etc.
Types of Clinical Laboratories
Categories
Medical or dental clinics, independent labs, and hospital labs.
Types of Clinical Laboratories
Manufacturers
Manufacturers of home diagnostic kits, lab equipment, and supplies, involving product testing, marketing, sales, and training.
Some Statistics on Clinical Laboratories
Financial Impact
Clinical lab tests cost over $25 billion/year.
Some Statistics on Clinical Laboratories
Workforce Composition
As of 2014, there were over 320,000 clinical lab technologists and technicians.
Some Statistics on Clinical Laboratories
Employment Distribution
Approximately 50% of medical technologists worked in hospital labs, with others in medical labs or physician offices.
Organization of a Clinical Laboratory
Organizational structure adapted from established clinical chemistry references.
Departments of Clinical Laboratories
Traditional Divisions
Clinical Chemistry: Analysis of body fluids (e.g., serum, plasma).
Urinalysis: Physical, chemical, and microscopic urine analysis.
Departments of Clinical Laboratories
Hematology
Study of blood components, focusing on red and white blood cells.
Departments of Clinical Laboratories
Coagulation
Evaluation of bleeding and clotting disorders.
Departments of Clinical Laboratories
Microbiology
Testing for pathogenic microorganisms, including bacteria and viruses.
Subdivisions of Microbiology
Mycology (fungi) and Parasitology (parasites) as subdivisions of microbiology.
Departments/Divisions of the Clinical Labs
Blood Bank
Immunohematology: collecting, testing, processing, storing, and distributing blood for transfusions.
Departments of Clinical Laboratories
Immunology/Serology
Assessing antibody-antigen reactions and measuring specific antibodies during immune responses.
Departments of Clinical Laboratories
Histology/Histopathology
Microscopic study of tissue structures and analysis of surgically removed specimens.
Additional Divisions in Larger Labs
Cytogenetics
Focus on the study of chromosome structure in health and disease.
Cytogenetics
Importance
Detection of chromosomal abnormalities for genetic counseling.
Additional Divisions in Clinical Labs
Toxicology
Study of toxins and their effects
Additional Divisions in Clinical Labs
Molecular Pathology and Diagnostics
DNA analysis for human disease diagnosis.
Main Functions of the Clinical Lab
Role in Diagnosis
Aid in the diagnosis process for various conditions.
Aid in Diagnosis
Patient Evaluation
Examination includes patient history and recent events, like trauma.
Aid in Diagnosis
Diagnostic Tests
Use of physical tests (e.g., Ultrasound) to visualize internal organs.
Aid in Diagnosis
Clinical Lab Tests
Blood count evaluations, particularly for white blood cells in conditions like appendicitis.
Aid in Diagnosis
Monitor Therapy
Tracking clotting time in blood plasma for patients on anticoagulants.
Aid in Diagnosis
Detect Hidden Disorders
Tests for increased blood glucose levels and drug screenings.
Regulation of Clinical Laboratories
Purpose of Regulations
Ensures reliable laboratory work and safe working environments.
Regulation of Clinical Laboratories
Federal Regulations
Introduction of CLIA ’88 to ensure high-quality results from clinical labs.
Regulation of Clinical Laboratories
CLIA '88 Overview
Specifications on who may perform tests and quality control protocols.
Regulation of Clinical Laboratories
Proficiency Testing Requirement
Labs conducting complex tests must enroll in approved proficiency testing programs.
Regulation of Clinical Laboratories
Service Providers
PT programs approved by CAP, CDC, and state health departments.
Sites of Testing
Technological Advances
Decentralization and increased automation in laboratory testing.
Sites of Testing
Point-of-Care Testing (POCT)
Includes bedside, operating rooms, and patient homes.
Automation in Laboratories
Overview
Automation improves through-put but does not necessarily enhance accuracy.
Automation in Laboratories
Uses of Automated Analyzers
Chemistry lab analyzers for hormone and protein levels, and urine analysis.
Automation in Laboratories
Hematology Lab Analyzers
Automated cell counters for counting RBCs, WBCs, and platelets.
Disadvantages of Automation
Limitations
Types of analyses that can be performed may be restricted; results may be less accurate than manual methods.
Disadvantages of Automation
Operator Dependency
Operators may rely too heavily on machines rather than applying their judgment.
Disadvantages of Automation
Economic Considerations
High cost of machines and the need for back-up systems.
Types of Clinical Lab Specimens
Common Specimen Types
Blood, urine, extravascular fluids (e.g., cerebrospinal fluid), feces, swabs, etc.
Blood Sample Analysis
Composition
Blood consists of cells (RBCs, WBCs, platelets) and fluid (plasma).
Blood Sample Analysis
Types of Blood Components
Plasma includes nutrients, ions, and clotting factors.
Blood Sample Analysis
Serum Description
Serum is the liquid remaining after blood clotting.
Functions of Blood
Transportation
RBCs deliver oxygen and remove carbon dioxide; blood transports nutrients.
Functions of Blood
Immune Response
WBCs are involved in responses to pathogens.
Functions of Blood
Regulatory Functions
Blood plays a role in temperature and pH regulation.
Types of Blood Analyses
Complete Blood Count (CBC)
Includes RBC count, WBC count, platelet count, hemoglobin concentration, hematocrit.
RBC Indices
Important Indices
MCV, MCH, MCHC, used to diagnose anemias and leukemias.
Tests for Blood Glucose Levels
Importance
Key in diagnosing and monitoring diabetes mellitus.
Other Common Types of Blood Tests
Cholesterol Levels
Used for assessing heart disease risk.
Other Common Types of Blood Tests
Serum Enzyme Tests
Measure enzyme levels to identify organ damage.
Urinalysis
Overview
Urine is an ultrafiltrate of blood produced by kidneys.
Urinalysis - Physical Properties
Physical properties can indicate various health conditions based on appearance and constituents.
Urinalysis - Color and Odor
Color changes can signify hydration or pathology; odors can indicate diseases.
Urinalysis - Protein and Foam
Presence of protein can indicate kidney disease; foam indicates protein levels.
Other Urine Tests
pH, presence of blood, glucose, and ketones examined.
Extravascular Fluids
Definition
Fluids found outside of the blood or lymphatics, like CSF.
Cerebrospinal Fluid (CSF)
Production
CSF produced in the choroid plexus, important for brain function.
Major Functions of CSF
Circulates nutrients; provides mechanical protection to the brain; removes wastes.
CSF Collection
Procedure
Collected via lumbar puncture; risks include potential spinal damage.
CSF Analysis
Diagnostic Importance
Cloudy appearance may suggest infection; evaluated for various conditions including meningitis.
Other Extravascular Fluids
Types
Including serous fluids in body cavities like pleural, pericardial, and peritoneal.
Formation of Serous Fluids
Influencing Factors
Governed by hydrostatic pressure, capillary permeability, and osmotic pressure.
Effusion Mechanisms
Causes
Accumulation of fluids due to heart failure, infections, or malignancies.
Effusion Types
Exudates vs. Transudates classified by protein content and biological activity.
Chemical Analysis of Effusions
Diagnostic Markers
Different organs release specific markers; analysis helps in identifying organ involvement.
Summary of Clinical Lab Science
CLS is a comprehensive field with diverse applications in healthcare, providing numerous career opportunities. Clinical lab personnel significantly contribute to patient care.