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.