Comprehensive Study Guide for PMLS 1 - Medical Technology Foundations

Early Diagnostic Technologies and Ancient Medical Concepts

  • The First Diagnostic Technology: The Stethoscope is considered the first diagnostic technology.

  • The First Visual Technology: The Ophthalmoscope was the first visual technology used to view the interior of the eye.

  • The Four Humors: Described by Hippocrates and Galen, these represented an attempt to qualitatively measure a deficiency or excess of body fluids. The four humors are:

    • Phlegm

    • Blood

    • Yellow bile

    • Black bile

  • Galen's Contribution to Diabetes: He described diabetes as "diarrhea of urine" and established the definitive relationship between fluid intake and urine volume.

Medical Practice Through the Centuries

  • 11th Century: Medical practitioners were strictly prohibited from conducting physical examinations of the patient's body.

  • 13th Century: Historically significant as a period before the widespread diagnostic mechanical shift.

  • 19th Century: This era marked a transition where physicians increasingly utilized machines for diagnosis and therapies.

Key Figures and Breakthroughs in Medical Science

  • Wilhelm Roentgen: Discovered the X-ray.

  • Dr. John H. Gibbon (1939): Introduced the first heart-lung bypass machine.

  • Edward Jenner (1796): Discovered vaccination to establish immunity to smallpox.

  • Agostino Bassi (1835): Produced disease in worms by injection of organic material, marking the beginning of bacteriology.

  • Louis Pasteur (1857): Successfully produced immunity to rabies.

  • Gregor Mendel (1866): Enunciated the law of inherited characteristics from studies of plants.

  • Joseph Lister (1870): Demonstrated that surgical infections are caused by airborne organisms.

  • Robert Koch (1877): Presented the first pictures of bacilli (anthrax) and later identified tubercle bacilli.

  • Ellie Metchnikoff (1886): Described phagocytes in the blood and their role in fighting infections.

  • Ernst von Bergmann (1886): Introduced steam sterilization in surgery.

  • Karl Landsteiner (1902): Distinguished blood groups through the development of the ABO blood group system.

  • August von Wassermann (1906): Developed immunologic tests for syphilis.

  • Howard Ricketts (1906): Discovered microorganisms whose range lies between bacteria and viruses, called Rickettsiae.

  • Baruch Samuel Blumberg (1980): Introduced the hepatitis B vaccines.

  • Marcello Malpighi (1628-1694): Recognized as the "Founder of pathology."

  • Herman Fehling (1848): Performed the first quantitative test for urine sugar.

Evolution of Clinical Laboratories and Education

  • First Chemical Laboratory related to Medicine: Established by Dr. Douglas at the University of Michigan College.

  • Dr. William H. Welch: Gave the first laboratory course in pathology offered in an American Medical School and became the first professor of pathology.

  • Dr. William Osler (1896): Opened the first clinical laboratory at the Johns Hopkins Hospital.

  • John Kolmer: Published "The Demand for and training of laboratory technicians." His work led Pennsylvania to enact a law requiring all hospitals and institutions to have a fully-equipped laboratory for routine testing and a full-time laboratory technician.

  • American Society for Clinical Pathology (ASCP): Established with the objective to encourage cooperation between physicians and clinical pathologists and maintain the status of clinical pathologists.

  • Dr. James C. Todd (1908): Wrote "A Manual of Clinical Diagnosis," which was later retitled "Clinical Diagnosis by Laboratory Methods" and became the standard reference.

  • University of Minnesota: One of the first schools for training laboratory workers.

Medical Technology in the Philippines

  • San Lazaro Hospital (1578): Built by the Franciscans for the poor and lepers.

  • Hospital de San Juan de Dios (1596): Founded specifically for poor Spaniards; recognized as the first laboratory hospital-based in the Philippines.

  • University of Santo Tomas (1611): Founded by the Dominicans.

  • Introduction to the Philippines (WWII): Medical technology practice was introduced by the 26th Medical Infantry of the 6th US Army.

  • 6th Infantry Division (US Army): Established the first clinical laboratory in the Philippines at Quiricada St., Sta. Cruz, Manila, during World War II. It is now known as the Manila Public Health Laboratory.

  • Training Programs: Dr. Pio de Roda and Dr. Prudencia Sta. Ana conducted training for aspiring lab workers. Dr. Sta. Ana prepared a six-month formal syllabus with certificates for trainees.

  • Mrs. Willa Hilgert Hedrick: Known as the Founder of Medical Technology Education in the Philippines. She opened the first school at Manila Sanitarium and Hospital (MSH) in 1954.

  • Philippine Union College: Offered the first B.S. degree course in Medical Technology in conjunction with Manila Sanitarium.

  • Dr. Jesse Umali (1956): The first graduate of the BS Medical Technology program from Philippine Union College.

  • Bureau of Government Laboratories: Paul Freer served as the first director, ensuring the biological laboratory was equipped with adequate supplies.

  • Transition of Power: In June 1943, the US Army left the clinical laboratory and endorsed it to the National Department of Health.

Professional Roles and Definitions

  • Science: Primarily concerned with the study of the natural world and the interrelationship among the biological, psychological, and social worlds.

  • Clinical Laboratory Scientists: Personnel who perform most laboratory tests involved in the examination and analysis of body fluids, tissues, and cells.

  • Pathologist: A duly registered physician specially trained in laboratory medicine and the microscopic study of tissues, secretions, and excretions to diagnose disease, follow its course, and determine treatment effectiveness.

  • Phlebotomist: An individual who draws blood for laboratory tests or donations via skin puncture or venipuncture.

  • Cytotechnologists: Personnel who work with pathologists to detect changes in body cells important for early disease diagnosis.

  • Histotechnologists: Responsible for the routine preparation, processing, and staining of biopsies and tissue specimens for microscopic examination.

Ethics and Medical Philosophy

  • Ethics: A moral code guiding individual behavior; it deals with diverse prescriptions of universal concepts and principles as foundations for moral belief.

  • Ethical Utilitarianism: States that the rightness or wrongness of actions is determined by their consequences.

  • Ethical Pragmatism: A theory more on knowledge, truth, and meaning rather than morality.

  • Euthanasia (Mercy Killing): The practice of intentionally ending a life as a merciful release from incurable sickness.

  • Genetic Engineering: Genetic manipulation perceived to be against societal moral standards.

  • Stem-cell Therapy: A form of genetic engineering using stem cells to treat or prevent disease.

  • In-vitro Fertilization: Known as laboratory fertilization.

  • Genetic Screening: Procedures to screen and select genes for detecting genetic diseases or chromosomal malformations.

  • Abortion: Considered illegal in the Philippines under Article II Section 12 of the 1987 Constitution.

Medical Terminology and Abbreviations

  • Medical Terminology: Language used to describe the human body, procedures, diseases, and pharmacology.

  • Structure:

    • Prefix: Found at the beginning; assigns specific meaning.

    • Root Word: The main part of the term.

    • Suffix: Terminal portion of the term.

  • Common Terms:

    • Malignant: Growing or spreading.

    • Hepatitis: Inflammation of the liver.

    • Macro: Large.

    • Arthro: Joint.

  • Suffixes & Prefixes:

    • -penia: Deficiency.

    • -ectomy: Surgical removal.

    • pseudo: False.

  • Acronyms:

    • VDRL: Venereal Disease Research Laboratories.

    • AMI: Acute Myocardial Infarction.

    • PCQACL: Philippine Council for Quality Assurance in the Clinical Laboratories.

    • BAP: Blood Agar Plate.

Education and Licensure (MTLE)

  • Curriculum: Derived from the Latin word "currere," meaning "to run."

  • Course Definitions:

    • Clinical Parasitology: Study of animal parasites in humans and their medical significance.

    • Clinical Bacteriology: Study of physiology and morphology of bacteria.

    • Histopathologic Techniques: Covers basic concepts of disease processes and etiology.

    • Clinical Microscopy: Focuses on urine and other body fluids (excluding blood).

    • Clinical Chemistry 2: Covers endocrine glands, hormones, enzymes, and therapeutic drug monitoring.

  • Regulatory Bodies:

    • CHED: Established on May 18, 1994.

    • Professional Regulation Commission (PRC): Tasked to administer licensure exams.

  • Academic Workload:

    • 1 unit Lecture=1 hour/week1\,\text{unit Lecture} = 1\,\text{hour/week}

    • 1 unit Laboratory=3 hours/week1\,\text{unit Laboratory} = 3\,\text{hours/week}

  • Internship: Requirement of 12 months for MT/MLS.

  • Licensure Requirements (MTLE):

    • Passing GWA: 75%75\% minimum.

    • Must pass at least 60%60\% of the courses computed by relative weights.

    • Age requirement: Minimum 21 years old.

    • Refresher Course: Required after failing the exam 3 times.

  • Types of Assessment:

    • Diagnostic Assessment: Given prior to instruction.

    • Formative Assessment: Done during or within the instructional process.

    • Summative Assessment: Done at the end of instruction.

Biosafety and Biosecurity

  • Laboratory Biosafety: Limiting the agent/pathogen's access to people.

  • Laboratory Biosecurity: Limiting people's access to the agent/pathogen.

  • Key Personnel:

    • Ira L. Baldwin: First scientific director of Camp Detrick (Fort Detrick).

    • Newell A. Johnson: Designed modifications for biosafety at Camp Detrick.

  • History of Biosafety:

    • 1974 CDC Publication: "Classification of Etiological Agents on the Basis of Hazard" introduced ascending levels of containment.

    • ABSA (1984): American Biological Safety Association founded to promote biosafety.

    • Charles Baldwin: Created the biohazard symbol for significant health risks.

    • Morton Reitman: Analyzed outbreaks at laboratories in 1966.

  • Risk Groups (RG):

    • Risk Group 1: No or low individual and community risk (unlikely to cause disease).

    • Risk Group 2: Moderate individual risk, low community risk (unlikely serious hazard).

    • Risk Group 3: High individual risk, limited to moderate community risk (causes serious disease).

    • Risk Group 4: High individual and community risk (life-threatening diseases).

  • Biosafety Levels (BSL):

    • BSL 1: Suitable for viable microorganisms known not to cause disease in humans.

    • BSL 2: For indigenous moderate-risk agents; appropriate for human blood/body fluids.

    • BSL 3: For agents with potential for respiratory transmission and lethal infection (e.g., Mycobacterium tuberculosis, Coxiella).

    • BSL 4: Required for dangerous/exotic agents with high risk of life-threatening disease via aerosol route (e.g., Ebola Virus, Crimean-Congo hemorrhagic fever).

  • Biorisk Management (BRM): The effective management of risks involving infectious agents. Components: Assessment, Mitigation, Performance.

Clinical Laboratory Laws and Classification

  • RA 5527: Medical Technology Act of 1969.

  • RA 4688: Clinical Laboratory Law, approved on June 18, 1966.

  • License Renewal: Clinical laboratories must renew annually; filings must be done 90 days before expiry.

  • Ownership Classifications:

    • Institution-Based: Operates within a larger institution.

    • Free-standing: Not part of an established institution.

  • Service Capability:

    • Primary: Basic routine testing (Urinalysis, Fecalysis, Hematology). Minimum area: 10 sqm10\,sqm.

    • Secondary: Primary tests plus basic chemistry. Minimum area: 20 sqm20\,sqm.

    • Tertiary: Routine tests plus Immunology, Serology, Microbiology, and Special Chemistry. Minimum area: 60 sqm60\,sqm.

  • National Reference Laboratories (NRLs):

    • NKTI: Hematology and Coagulation.

    • RITM: Microbiology and Parasitology.

    • LCP: Clinical Chemistry.

    • San Lazaro Hospital (SACCL): HBsAg, HIV, HCV.

Professional Organizations

  • PAMET (Philippine Association of Medical Technologists):

    • Founded: September 15, 1963, by Dr. Crisanto G. Almario.

    • First Organizational Meeting: Public Health Laboratory, Sta. Cruz, Manila.

    • First Convention: September 20, 1964, at Far Eastern University.

    • First President: Charlemagne Tamondong.

    • Current President (2015-present): Ronaldo Puno.

  • PASMETH (Philippine Association of Schools of Medical Technologists and Public Health):

    • Founded: May 13, 1970.

    • First President: Gustavo Reyes.

  • PHISMETS (Philippine Society of Medical Technology Students): Led by Zenaida Cajucom.

  • CPD (Continuing Professional Development): Inculcation of advanced knowledge. Required units for PIC renewal: 45 units (average of 15 per year).

Healthcare Waste Management

  • Waste Distribution (WHO Statistics):

    • Non-hazardous: 70−90%70-90\%

    • Hazardous/Infectious: 10−25%10-25\%

  • Waste Categories:

    • Infectious: Suspected to contain pathogens in sufficient concentration.

    • Pathological: Tissues/body fluids from biopsies/autopsies.

    • Sharps: Most dangerous due to injury and infection potential.

    • Radioactive: Cobalt, radionuclides, irradiated blood.

    • Pharmaceutical: Drug vials, vaccines.

  • Color Coding and Containers:

    • Infectious/Pathological: Yellow plastic liner (must withstand autoclaving) in strong leak-proof bins with biohazard symbol.

    • Sharps: Puncture-proof container with wide mouth.

    • Chemical: Amber-colored glass (at least 4 Liters) in yellow bins with black band.

    • General: Black or colorless plastic liner.

  • Treatment Technologies:

    • Autoclave: Steam sterilization at high pressure.

    • Pyrolysis: Thermal decomposition in the absence of oxygen.

    • Microwaves: Shredding and heating.

    • Chemical Disinfection: Recommended 5% Sodium Hypochlorite.

    • Encapsulation: Filling containers with waste and immobilizing material (cubic boxes/metallic drums).

    • Inertization: Mixing pharmaceutical waste with cement.

  • RA 9003: Ecological Solid Waste Management Act of 2000.