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Essentials of Clinical Pathology
Shirish M Kawthalkar
SECTION 1: CHEMICAL PATHOLOGY AND RELATED STUDIES
CHAPTER 1:
Examination Of Urine
COMPOSITION OF NORMAL URINE
INDICATIONS FOR URINALYSIS
COLLECTION OF URINE
Time of Collection
Collection Methods
Changes which Occur in Standing Urine at Room Temperature
Preservation of Urine Sample
PHYSICAL EXAMINATION
Volume
Color
Appearance
Odor
Specific Gravity (SG)
Reaction and pH
CHEMICAL EXAMINATION
Proteins
Causes of Proteinuria
Tests for Detection of Proteinuria
Quantitative Estimation of Proteins
Microalbuminuria
Bence Jones Proteinuria
Glucose
Causes of Glycosuria
Tests for Detection of Glucose in Urine
Method
Ketones
Causes of Ketonuria
Tests for Detection of Ketones in Urine
Method
Bile Pigment (Bilirubin)
Tests for Detection of Bilirubin in Urine
Bile Salts
Urobilinogen
Causes of Increased Urobilinogen in Urine
Causes of Reduced Urobilinogen in Urine
Tests for Detection of Urobilinogen in Urine
Blood
Causes of Hematuria
Tests for Detection of Blood in Urine
Hemoglobin
Causes of Hemoglobinuria
Tests for Detection of Hemoglobinuria
Hemosiderin
Myoglobin
Chemical Tests for Significant Bacteriuria (Indirect tests for urinary tract infection)
MICROSCOPIC EXAMINATION
Cells
Red Blood Cells
White Blood Cells (Pus Cells)
Renal Tubular Epithelial Cells
Squamous Epithelial Cells
Transitional Epithelial Cells
Oval Fat Bodies
Spermatozoa
Organisms
Bacteria
Yeast Cells (Candida)
Trichomonas vaginalis
Eggs of Schistosoma haematobium
Microfilariae
Casts
Non-cellular Casts
Cellular Casts
Crystals
Normal Crystals
Abnormal Crystals
REFERENCE RANGES
CRITICAL FINDINGS
CHAPTER 2:
Renal Function Tests
FACTORS AFFECTING RENAL FUNCTION
INDICATIONS FOR RENAL FUNCTION TESTS
CLASSIFICATION OF RENAL FUNCTION TESTS
Tests to Evaluate Glomerular Function
Clearance Tests to Measure Glomerular Filtration Rate (GFR)
Inulin Clearance
Clearance of Radiolabeled Agents
Cystatin C Clearance
Creatinine Clearance
Urea Clearance
Estimation of Creatinine Clearance from Serum Creatinine by Prediction Equations
Blood Biochemistry
Blood Urea Nitrogen (BUN)
Serum Creatinine
Causes of Increased Serum Creatinine Level
Causes of Decreased Serum Creatinine Level
Methods for Estimation of Serum Creatinine
BUN/Serum Creatinine Ratio
Causes of Increased BUN/Creatinine Ratio (>20:1):
Causes of Decreased BUN/Creatinine Ratio (<10:1)
Microalbuminuria and Albuminuria
Tests to Evaluate Tubular Function
Tests to Assess Proximal Tubular Function
Tests to Assess Distal Tubular Function
RENAL BIOPSY
Indications for Renal Biopsy
Contraindications
Complications
Procedure
REFERENCE RANGES
CRITICAL VALUES
CHAPTER 3:
Diabetes Mellitus
METABOLIC ACTIONS OF INSULIN
CLASSIFICATION OF DIABETES MELLITUS
Type 1 Diabetes Mellitus
Type 2 Diabetes Mellitus
Other Specific Types
Gestational Diabetes Mellitus (GDM)
PREDIABETES
METABOLIC SYNDROME (INSULIN RESISTANCE SYNDROME, REAVEN'S SYNDROME, SYNDROME X)
METABOLIC ALTERATIONS IN DIABETES MELLITUS
LONG-TERM COMPLICATIONS OF DIABETES MELLITUS
ROLE OF LABORATORY TESTS IN DIABETES MELLITUS
Laboratory Tests for Diagnosis of Diabetes Mellitus
Estimation of Blood Glucose
Oral Glucose Tolerance Test (OGTT)
Preparation of the Patient
Test
Laboratory Tests for Screening of Diabetes Mellitus
Laboratory Tests to Assess Glycemic Control
Glycated Hemoglobin (Glycosylated Hemoglobin, HbA1C)
Self-Monitoring of Blood Glucose (SMBG)
Glycosuria
Laboratory Tests to Assess Long-term Risks
Urinary Albumin Excretion
Lipid Profile
Laboratory Tests in the Management of Acute Metabolic Complications of Diabetes Mellitus
REFERENCE RANGES
CRITICAL VALUES
CHAPTER 4:
Liver Function Tests
FUNCTIONS OF LIVER
NORMAL BILIRUBIN METABOLISM
INDICATIONS AND LIMITATIONS OF LIVER FUNCTION TESTS
CLASSIFICATION OF LIVER FUNCTION TESTS
Tests that Assess Excretory Function of the Liver
Jaundice
Serum Bilirubin
Urine bilirubin and urobilinogen
Tests which Assess Synthetic and Metabolic Functions of Liver
Proteins
Prothrombin time (PT)
Blood Ammonia
Tests which Assess Hepatic Injury (Liver Enzyme Studies)
Serum Aminotransferases
Serum Alkaline Phosphatase (ALP)
Serum γ–glutamyl transferase (GGT)
5’–nucleotidase (5’–NT)
Tests that Assess Clearance of Exogenous Substances from the Liver
INTERPRETATION OF LIVER FUNCTION TESTS
LIVER BIOPSY
TYPES OF LIVER BIOPSY
Percutaneous ‘Blind’ Liver Biopsy
Percutaneous Guided Liver Biopsy
Percutaneous ‘Plugged’ Liver Biopsy
Transvenous (Transjugular) Liver Biopsy
Laparoscopic Liver Biopsy
REFERENCE RANGES
CRITICAL VALUES
CHAPTER 5:
Disorders of Lipids and Biochemical Cardiac Markers
DISORDERS OF LIPIDS
PHYSIOLOGY
Cholesterol and Triglycerides
Lipoproteins
Lipoprotein Metabolism
Apolipoproteins
CLASSIFICATION OF LIPOPROTEIN DISORDERS
LABORATORY TESTS FOR LIPOPROTEIN DISORDERS
BIOCHEMICAL CARDIAC MARKERS
Acute coronary syndrome
Biochemical Cardiac Marker Studies
REFERENCE RANGES
CRITICAL VALUES
CHAPTER 6:
Examination of Cerebrospinal Fluid
COMPOSITION OF NORMAL CEREBROSPINAL FLUID IN ADULTS
FUNCTIONS OF CEREBROSPINAL FLUID
COLLECTION OF CEREBROSPINAL FLUID
INDICATIONS FOR LUMBAR PUNCTURE
COMPLICATIONS OF LUMBAR PUNCTURE
CONTRAINDICATIONS TO LUMBAR PUNCTURE
LABORATORY EXAMINATION OF CEREBROSPINAL FLUID
1. Opening pressure
Causes of increased CSF pressure:
Causes of decreased CSF pressure:
2. Gross appearance of cerebrospinal fluid
3. Cell counts in cerebrospinal fluid
Method:
Causes of increased cell count in CSF:
4. Chemical examination of cerebrospinal fluid
5. Microbiological examination
6. Special Investigations
REFERENCE RANGES
CRITICAL VALUES
CHAPTER 7:
Examination of Pleural and Peritoneal Fluids
PLEURAL FLUID
Causes of pleural effusion
Collection of pleural fluid
Examination of pleural fluid
PLEURAL BIOPSY
PERITONEAL FLUID
Causes of Ascites
Indications for Abdominal Paracentesis
Collection of Sample
Examination of Ascitic Fluid
CHAPTER 8:
Examination of Sputum
COLLECTION OF SPUTUM
Induction of Sputum
APPEARANCE OF SPUTUM
MICROBIOLOGICAL EXAMINATION
Gram Staining
Bacteriological Culture
EXAMINATION OF SPUTUM FOR MYCOBACTERIUM TUBERCULOSIS
Examination of Sputum Smear
Culture (Conventional)
Commercial Automated Culture Systems
Molecular Methods
EXAMINATION FOR OTHER ORGANISMS
CYTOLOGICAL EXAMINATION OF SPUTUM
CHAPTER 9:
Examination of Feces
MICROSCOPIC EXAMINATION
Collection of Specimen for Parasites
Color/Appearance of Fecal Specimens
Preparation of Slides
Concentration Procedure
Classification of Intestinal Parasites of Humans
PROTOZOA
Coccidia
Laboratory Diagnosis
Microsporidia
Laboratory Diagnosis
HELMINTHS
Ascaris lumbricoides (Roundworm)
Clinical Features
Laboratory Diagnosis
Hookworms
Clinical Features
Laboratory Diagnosis
Trichuris trichiura
Strongyloides stercoralis
Clinical Features
Laboratory Diagnosis
Enterobius vermicularis
Clinical Features
Laboratory Diagnosis
Taenia solium
Clinical Features
Laboratory Diagnosis
Taenia saginata
Clinical Features
Laboratory Diagnosis
CHEMICAL EXAMINATION
Test for Occult Blood in Stools
Tests Based on Peroxidase-like Activity of Hemoglobin
Causes of False-positive Tests
Causes of False-negative Tests
Immunochemical Tests
Radioisotope Test Using 51Cr
Test for Malabsorption of Fat
Causes of Malabsorption of Fat
Test for Urobilinogen in Feces
Test for Reducing Sugars
Fecal Osmotic Gap
Fecal pH
REFERENCE RANGES
Critical Values
CHAPTER 10:
Gastric Analysis
NORMAL GASTRIC ANATOMY AND PHYSIOLOGY
INDICATIONS FOR GASTRIC ANALYSIS
CONTRAINDICATIONS TO GASTRIC ANALYSIS
Method of Gastric Analysis
Collection of Sample
Titration
Interpretation of Results
OTHER TESTS FOR GASTRIC ANALYSIS
REFERENCE RANGES
CHAPTER 11:
Tests for Malabsorption and Pancreatic Function
MALABSORPTION SYNDROMES
Normal Absorption of Carbohydrates, Fats, and Proteins
Causes of Malabsorption
Evaluation of Malabsorption Syndromes
Clinical Features
Laboratory Evaluation
Tests for malabsorption of carbohydrates
PANCREATIC FUNCTION TESTS
Anatomy and Physiology of Pancreas
Tests of Pancreatic Function
Direct (Invasive or Tube) Tests
Indirect (Non-invasive or Tubeless) Tests
Pancreatic Enzymes Used as Markers of Active Pancreatic Disease
REFERENCE RANGES
CHAPTER 12:
Thyroid Function Tests
ANATOMY AND PHYSIOLOGY
Metabolism of Thyroid Hormones
DISORDERS OF THYROID
Hyperthyroidism
Clinical Characteristics
Laboratory Features
Hypothyroidism
Laboratory Features
THYROID FUNCTION TESTS
Thyroid Stimulating Hormone (TSH)
Uses of TSH measurement
TOTAL THYROXINE (T4)
Causes of Increased Total T4
Causes of Decreased Total T4
Free Thyroxine (FT4)
Total and Free Triiodothyronine (T3)
Uses
Thyrotropin Releasing Hormone (TRH) Stimulation Test
Uses
Procedure
Interpretation
Antithyroid Antibodies
Radioactive Iodine Uptake (RAIU) Test
Causes of Increased Uptake
Causes of Decreased Uptake
Uses
Thyroid Scintiscanning
Neonatal Screening for Hypothyroidism
REFERENCE RANGES
CHAPTER 13:
Pregnancy Tests
CLINICAL APPLICATIONS OF TESTS FOR HUMAN CHORIONIC GONADOTROPIN
Normal Pregnancy
Two types of pregnancy tests are available:
Ectopic Pregnancy
Abortion
Gestational Trophoblastic Disease (GTD)
LABORATORY TESTS FOR HUMAN CHORIONIC GONADOTROPIN
Bioassays
Immunological Assays
REFERENCE RANGES
CHAPTER 14:
Infertility
MALE INFERTILITY
Causes of Male Infertility
Investigations of Male Infertility
FEMALE INFERTILITY
Causes of Female Infertility
Investigations
Tests for Ovulation
Tests to Determine the Cause of Anovulation
Investigations to Assess Tubal and Uterine Status
REFERENCE RANGES
CHAPTER 15:
Semen Analysis
INDICATIONS FOR SEMEN ANALYSIS
COLLECTION OF SEMEN FOR INVESTIGATION OF INFERTILITY
EXAMINATION OF SEMINAL FLUID
Physical Examination
Microscopic Examination
Sperm Motility
Sperm Viability or Vitality
Sperm Count
Sperm Morphology
Round Cells
Immunologic Analysis
Antisperm Antibodies
Biochemical Analysis of Semen
Test for Fructose
Sperm Function Tests or Functional Assays
Postcoital (Sims-Huhner) Test
Cervical Mucus Penetration Test
Hamster Egg Penetration Assay
Hypo-osmotic Swelling of Flagella
Computer-assisted Semen Analysis
EXAMINATION FOR THE PRESENCE OF SEMEN IN MEDICOLEGAL CASES
Collection of Sample
Tests
EXAMINATION OF SEMEN TO CHECK THE EFFECTIVENESS OF VASECTOMY
SECTION 2: LABORATORY HEMATOLOGY
CHAPTER 16:
Hematopoiesis
RED BLOOD CELLS
Erythropoiesis
Hemoglobin
Red Cell Enzymes
Red Cell Membrane
WHITE BLOOD CELLS
Neutrophils
Eosinophils
Basophils
Monocytes
Lymphocytes
Human Leukocyte Antigens
Importance of HLA antigens
Methods for HLA Antigen Typing
Serological Testing
Molecular Genetic Techniques
THROMBOPOIESIS
CHAPTER 17:
Collection of Blood
SKIN PUNCTURE
VENOUS BLOOD COLLECTION
Method
Precautions
Complications
ANTICOAGULANTS
Ethylene Diamine Tetra-acetic Acid (EDTA)
Preparation
Heparin
Double Oxalate (Wintrobe Mixture)
Preparation
Trisodium Citrate (3.2%)
Preparation
Other Tubes for Collection of Blood
SEQUENCE OF FILLING OF TUBES
USE OF PLASMA VS. SERUM
CHAPTER 18:
Estimation of Hemoglobin
INDICATIONS FOR HEMOGLOBIN ESTIMATION
METHODS FOR ESTIMATION OF HEMOGLOBIN
Tallqvist Hemoglobin Chart
Sahli's Acid Hematin Method
Equipment(Fig 18.1)
Reagents
Method
Note:
WHO Hemoglobin Color Scale
Cyanmethemoglobin (Hemiglobincyanide) Method
Principle
Equipment
Reagents
Method
Notes:
Oxyhemoglobin Method
Specific Gravity Method
GENERAL REMARKS
REFERENCE RANGES (WORLD HEALTH ORGANIZATION)
CRITICAL VALUES
CHAPTER 19:
Packed Cell Volume
USES OF PCV
MACRO METHOD (WINTROBE METHOD)
Principle
Equipment
Specimen
Method
Significance
MICRO METHOD
Principle
Equipment
Specimen
Method
GENERAL NOTES
REFERENCE RANGES
CRITICAL VALUES
CHAPTER 20:
Total Leukocyte Count
MANUAL METHOD
Principle
Equipment
Reagent
Specimen
Method
Technical Errors
Inherent Error (Statistical Error)
REFERENCE RANGES
CRITICAL VALUES
CHAPTER 21:
Reticulocyte Count
USES
PRINCIPLE
REAGENT
SPECIMEN
METHOD
REPORTING THE RESULT
REFERENCE RANGES
CHAPTER 22:
Blood Smear
USES
PREPARATION OF BLOOD SMEAR(WEDGE METHOD)
Notes
STAINING OF BLOOD SMEAR
Reagents
Method
EXAMINATION OF BLOOD SMEAR
Red Cells
White Cells
Neutrophilia
Causes
Eosinophilia
Monocytosis
Lymphocytosis
Platelets
Organisms
REFERENCE RANGES
Normal blood smear
Differential leukocyte count
Critical Values
CHAPTER 23:
Red Cell Indices
USES OF RED CELL INDICES
MEAN CELL VOLUME
Causes of Increased MCV
Causes of Low MCV
MEAN CELL HEMOGLOBIN (MCH)
MEAN CELL HEMOGLOBIN CONCENTRATION (MCHC)
Red Cell Distribution Width (RDW)
REFERENCE RANGES
CHAPTER 24:
Erythrocyte Sedimentation Rate
STAGES OF ERYTHROCYTE SEDIMENTATION RATE
FACTORS AFFECTING ERYTHROCYTE SEDIMENTATION RATE
SIGNIFICANCE OF ERYTHROCYTE SEDIMENTATION RATE
INDICATIONS FOR MEASUREMENT OF ERYTHROCYTE SEDIMENTATION RATE
METHODS FOR ESTIMATION OF ERYTHROCYTE SEDIMENTATION RATE
Westergren Method
Equipment and Reagent
Method
Precautions
Other Methods
Wintrobe Method
Zeta Sedimentation Ratio (ZSR)
Micro-ESR
ACUTE PHASE REACTANTS
Uses of C-reactive Protein
REFERENCE RANGES
Erythrocyte Sedimentation Rate by Westergren Method
Erythrocyte Sedimentation Rate by Wintrobe Method
C-reactive Protein
CHAPTER 25:
Examination of Bone Marrow
NORMAL BONE MARROW
INDICATIONS FOR BONE MARROW EXAMINATION
INDICATIONS FOR BONE MARROW ASPIRATION
INDICATIONS FOR BONE MARROW BIOPSY
CONTRAINDICATIONS
SITES FOR BONE MARROW ASPIRATION OR BIOPSY
METHOD
Bone Marrow Aspiration
Bone Marrow Trephine Biopsy
COMPLICATIONS OF BONE MARROW ASPIRATION AND/OR BIOPSY
PROCESSING OF MARROW SPECIMENS
Bone Marrow Aspiration
Bone Marrow Trephine Biopsy
EXAMINATION OF MARROW SPECIMENS
Bone Marrow Aspiration Smears
Iron Staining of Bone Marrow Aspiration Smears
Bone Marrow Trephine Biopsy
REFERNCE RANGES
Differential Count in Bone Marrow in Adults
Iron Staining of Bone Marrow Smears
CRITICAL VALUES
CHAPTER 26:
Diagnosis of Malaria and Other Parasites in Blood
MALARIA
LIFE CYCLE OF MALARIA PARASITES
CLINICAL FEATURES
MODES OF TRANSMISSION
ROLE OF GENETIC FACTORS IN MALARIA
Methods of Diagnosis
LYMPHATIC FILARIASIS
Life Cycle
CLINICAL FEATURES
LABORATORY DIAGNOSIS
Microscopic Examination of Blood for Demonstration of Microfilaria
Thick Blood Smear
Concentration techniques
Morphology of Microfilariae on Romanowsky-stained Blood Smears
Detection of Filarial Antigen in Blood by Rapid Immunochromatographic Test
Detection of Filarial DNA by Polymerase Chain Reaction
VISCERAL LEISHMANIASIS
Life Cycle of Leishmania Donovani
LABORATORY DIAGNOSIS OF VISCERAL LEISHMANIASIS
Examination of Splenic Aspirate, Bone Marrow Aspirate, or Buffy Coat Preparation of Peripheral Blood for Amastigote Forms
Tests for Detection of Anti-Leishmania Antibodies
Skin Test
Parasite Culture
Animal inoculation Studies
DNA Diagnosis
CHAPTER 27:
Laboratory Tests in Anemia
CLASSIFICATION OF ANEMIAS
ANEMIAS DUE TO DECREASED PRODUCTION OF RED BLOOD CELLS
Iron Deficiency Anemia
Clinical Features
Stages of Iron Deficiency
Laboratory Features
Megaloblastic Anemia
Laboratory Features
Anemia of Chronic Disease
Laboratory Features
Sideroblastic Anemia
Aplastic Anemia
Investigations in a Suspected Case of Aplastic Anemia
Severity of Aplastic Anemia
HEREDITARY DISORDERS OF HEMOGLOBIN
Thalassemias
Classification
Distribution
Sickle Cell Disorders
Hemoglobin D
HEREDITARY SPHEROCYTOSIS
GLUCOSE–6–PHOSPHATE DEHYDROGENASE DEFICIENCY
IMMUNE HEMOLYTIC ANEMIAS
HEMOLYTIC DISEASE OF NEWBORN
PAROXYSMAL NOCTURNAL HEMOGLOBINURIA
MICROANGIOPATHIC HEMOLYTIC ANEMIA
APPROACH TO DIAGNOSIS OF ANEMIA
Establishing the Presence and Severity of Anemia
Estimation of Hemoglobin
Estimation of Packed Cell Volume (PCV)
Determining the Cause of Anemia
Evaluation of Clinical Features in Anemia
Basic Laboratory Studies in Anemia
Microcytic Hypochromic Anemia
Macrocytic Anemias
Normocytic Normochromic Anemia
Hemolytic Anemia
Specific Laboratory Studies in Anemia
Vitamin B12 and Folate
Iron Studies
Bone Marrow Examination
Tests for Hemoglobin S
Hemoglobin Electrophoresis
High Performance Liquid Chromatography
Estimation of Hemoglobin A2 (Hb A2)
Estimation of Hemoglobin F (Hb F)
Red Cell Inclusions
Osmotic Fragility Test
Autohemolysis Test
Tests for Glucose–6–PhosphateDehydrogenase Deficiency
Antiglobulin (Coombs’) Test
Applications of IAT
Tests for Paroxysmal Nocturnal Hemoglobinuria
REFERENCE RANGES
Hemoglobin
Packed Cell Volume
Red Cell Count
Red Cell Indices
Osmotic Fragility of Red Cells
Iron Studies
Vitamin B12 and Folate Studies
Serum Haptoglobin
CRITICAL VALUES
CHAPTER 28:
Laboratory Tests in Hematological Malignancies
ACUTE LEUKEMIAS
Classification of Acute Leukemias
Laboratory Diagnosis of Acute Leukemias
Myeloperoxidase (MPO)
Nonspecific Esterase (NSE)
Periodic Acid Schiff (PAS)
CHRONIC LEUKEMIAS
Chronic Myeloid Leukemia
Chronic Lymphocytic Leukemia
PLASMA CELL DYSCRASIAS
CHAPTER 29:
Laboratory Tests in Bleeding Disorders
PHYSIOLOGY OF HEMOSTASIS
Blood Vessel Wall
Platelets
Plasma Proteins
Coagulation System
Inhibitors of Coagulation
Fibrinolytic System
BLEEDING DISORDERS
Disorders of Blood Vessels
Disorders of Platelets
Immune Thrombocytopenic Purpura (ITP)
Thrombotic Thrombocytopenic Purpura
Hemolytic Uremic Syndrome
Post-Transfusion Purpura
Disorders of Platelet Function
Inherited Disorders of Coagulation
Hemophilia A (Classical Hemophilia, F VIII Deficiency)
Hemophilia B (Christmas Disease, F IX Deficiency)
von Willebrand Disease (VWD)
Acquired Disorders of Coagulation
Disseminated Intravascular Coagulation (DIC)
Vitamin K Deficiency
Liver Disease
Acquired Inhibitors of Coagulation (Circulating Anticoagulants)
APPROACH TO THE DIAGNOSIS OF BLEEDING DISORDERS
Clinical Evaluation
Laboratory Evaluation
Screening Tests for Hemostasis
Complete blood count including blood smear
Platelet Count
Manual Method
Method
Automated Method
Bleeding Time
Platelet Function Analyzer (PFA-100)
Clotting Time
Prothrombin Time (PT)
Activated partial thromboplastin time (APTT)
Thrombin Time (TT)
Causes of Prolongation of TT
Interpretation of Screening Tests
Specific Tests for Hemostasis
REFERENCE RANGES
CRITICAL VALUES
CHAPTER 30:
Laboratory Tests in Thrombophilia
INHERITED THROMBOPHILIA
ACQUIRED THROMBOPHILIA
LABORATORY TESTING IN THROMBOPHILIA
Indications for Testing for Thrombophilia
Laboratory Tests
CHAPTER 31:
Laboratory Tests in Porphyrias
CLINICAL FEATURES
LABORATORY DIAGNOSIS
Initial Studies
Test for Porphobilinogen in Urine
Test for Total Porphyrins in Urine
Test for Total Porphyrins in Feces
Tests for Porphyrins in Erythrocytes and Plasma
Further Testing
CHAPTER 32:
Automation in Hematology
AUTOMATED HEMATOLOGY ANALYZER
Advantages of Automated Hematology Analyzer
Disadvantages of Automated Hematology Analyzer
PRINCIPLES OF WORKING
PARAMETERS MEASURED BY HEMATOLOGY ANALYZERS
Estimation of Hemoglobin
Estimation of Red Blood Cell Count and Mean Cell Volume (MCV)
Estimation of MCH, MCHC, and Hematocrit
Estimation of Red Cell Distribution Width (RDW)
WBC Differential
Platelet Count
Reticulocyte Count
WBC Cytogram (Scattergram)
FLAGGING
CAUSES OF ERRONEOUS RESULTS (INTERFERENCES CAUSING ABNORMAL RESULT)
FLOW CYTOMETRY
TERMINOLOGY IN FLOW CYTOMETRY
Fluorescence
Light Scatter
Data Analysis
Gating
Sorting
COMMON APPLICATIONS OF FLOW CYTOMETRY IN HEMATOLOGY
SECTION 3: PRACTICAL BLOOD TRANSFUSION
CHAPTER 33:
Blood Group Systems
ABO SYSTEM
Blood Group O
Blood Group A
Blood Group B
Blood Group AB
Antigens of the ABO system
Formation of ABH Antigens
Secretors and Non-secretors
Antibodies of the ABO System
Concepts of Universal Donor and Recipient
THE Rh SYSTEM
Antigens of the Rh System
Rh Antibodies
OTHER BLOOD GROUP SYSTEMS
CHAPTER 34:
Blood Grouping
ABO GROUPING
SLIDE TEST
Principle
Specimen
Reagents
Method
TUBE METHOD
Positive (+) Test
Negative (−) Test
MICROPLATE METHOD
FALSE REACTIONS IN ABO GROUPING
Rh D GROUPING
CHAPTER 35:
Collection of Donor Blood, Processing and Storage
TYPES OF BLOOD DONORS
CRITERIA FOR SELECTION OF BLOOD DONORS
Age
Donation Interval
Volume of Donation
Pregnancy and Lactation
Infectious Diseases
Human Immunodeficiency Virus (HIV)
Viral Hepatitis
Malaria
Illness
Medications
Dental Treatment
Skin Piercing
Blood Transfusion
Immunization
Physical Examination
Estimation of Hemoglobin
COLLECTION OF DONOR BLOOD
Equipments and Materials
Technique
Donor Reactions
PROCESSING OF DONOR BLOOD
Changes Occurring during Storage
CHAPTER 36:
Screening Tests for Infections Transmissible by Transfusion
VIRUSES
Hepatitis B Virus (HBV)
Reverse Passive Hemagglutination Assay
Enzyme-linked Immunosorbent Assay
Hepatitis C Virus (HCV)
Human Immunodeficiency Virus
BACTERIA
PARASITES
Plasmodium Species
CHAPTER 37:
Compatibility Test (Cross-match)
IMMEDIATE SPIN CROSS-MATCH
Causes of False-negative Test
Causes of False-positive Test
INDIRECT ANTIGLOBULIN TEST
EMERGENCY CROSS-MATCH
ANTIBODY SCREENING AND IDENTIFICATION
CHAPTER 38:
Adverse Effects of Transfusion
ACUTE HEMOLYTIC TRANSFUSION REACTION
FEBRILE NON-HEMOLYTIC TRANSFUSION REACTION
BACTERIAL CONTAMINATION OF DONOR UNIT
TRANSFUSION-ASSOCIATED LUNG INJURY
DELAYED HEMOLYTIC TRANSFUSION REACTION
ANAPHYLACTIC REACTION
ALLERGIC REACTION
VOLUME OVERLOAD
IRON OVERLOAD
TRANSMISSION OF INFECTIONS
COMPLICATIONS ASSOCIATED WITH MASSIVE TRANSFUSION
RECOGNITION AND INVESTIGATION OF A TRANSFUSION REACTION
CHAPTER 39:
Blood Components
WHOLE BLOOD
BLOOD COMPONENTS
RED CELL COMPONENTS
PLATELETS
PLASMA COMPONENTS
PLASMA DERIVATIVES
General References
INDEX
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