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Laboratory diagnostics 3rd year, winter semester 2016/2017
Syllabus
1) Introducing clinical biochemistry (ICB) (1hr)
 The clinical biochemistry laboratory
 The use of biochemical tests
 Core biochemistry
 Specialized test
 The use of the laboratory
 Specimen collection
 Sampling errors – pre-laboratory errors
 Case history
 The interpretation of results
 Variation in results
 Precision and accuracy
 Analytical sensitivity and specificity
 Specificity and sensitivity of tests
 Reference intervals
 Analytical problems – laboratory errors
 Interpretive problems – post-laboratory errors
I.
Water and electrolyte metabolism (WEM) (2 hrs)
 Fluid and electrolyte balance
 Body fluid compartments
 Electrolytes
 Concentration
 Osmolality
 Oncotic pressure
 Water and sodium balance
 Water
 AVP and the regulation of osmolality
 Sodium
 Regulation of volume
 Hyponatraemia: pathophysiology
 Development of hyponatraemia
 Water retention
 Sodium loss
 Pseudohyponatraemia
 Assessment and management
 Hypernatraemia
 Water loss
 Sodium gain
 Clinical features
 Potassium disorders
 Potassium metabolism
 Serum potassium
 Hyperkalaemia
 Pseudohypekalaemia
 Hypokalaemia
II. Acid-base balance (ACB) (2 hrs)
 Acid-base concepts
 H+ concentration and production
 Buffering
 H+ excretion in the kidney
 Assessing status
 Acid-base disorders
 Metabolic acidosis
 Metabolic alkalosis
 Respiratory acidosis
 Respiratory acidosis
 Mixed acid-base disorders
 Acid-base diagnosis and management
 Specimens for blood gas analysis
 Interpreting results
 Oxygen transport
 Normal oxygen transport
 Respiratory failure
1) Urinalysis and investigation of renal function
(URINE) (2hrs)
 Urinalysis
 Procedure: appearance, specific gravity, pH,
glucose, protein, blood, leucocytes, bilirubin,
urobilinogen, ketones, nitrite
 Microbiological testing
 Renal function tests
 Function of the kidney
 Tests of glomerular function
 Urine collections
 Renal tubular function
 Specific tubular defects
III. Red blood cells (RBC) (1hr)
 Erythropoiesis
 Definition of anemia
 Etiology of anemia: blood loss, deficient
erythropoiesis, excessive hemolysis
 Laboratory evaluation of RBC: RBC indices (MCV,
MCH, MCHC, RDW), peripheral blood smear, bone
marrow aspiration
 Deficiency anemias: iron, vitamin B12, folic acid
 Anemia of chronic diseases
IV. White blood cells (WBC) (1hr)
 Laboratory evaluation of leucocytes
 Quantitive description: leucocytosis, leucopenia
 WBC differential: neutrophilia, neutropenia,
lymphocytosis, lymphopenia, monocytosis,
eosinophilia
 Absolute and relative lymphocytosis
 Myeloproliferative disorders: essential
thrombocythemia (ET), myelofibrosis, polycythemia
vera (PV), chronic myelocytic leukemia (CML)
 Lymphoid malignancies
 Myeloid malignancies
V. Serum proteins (PRO) (1hr)
 Assessment of body protein pool and serum protein
electrophoresis

Hyperproteinemia and hypoproteinemia

ESR erythrocyte sedimentation rate

Acute phase proteins (APP)
 Negative and positive

Immunoglobulins
 Paraproteins
 Multiple myeloma
 Electrophoretic patterns