Biomedical filter paper and left to dry. The

Biomedical laboratory testing
is needed to routinely check-up for changes in a patient’s health. Samples are
taken from the patient in the form of blood, tissue or urine and are sent to a
laboratory to be tested using advanced medical equipment. Specific tests are
designed to detect specific diseases, the results are usually found within a
few days. The laboratory analyses whether a specific disease or disorder is
present in the sample and can use the information found to show where the
disease has originated from. The results of the tests allow the doctor to find
a suitable treatment or treatment plan and evaluate whether it is effective. There
are different areas of testing depending on who needs to be tested and why.
There are tests for individuals needing a diagnosis of a disease after
presenting the symptoms and tests that are required for a large group of specific
people to detect whether they have a disease that commonly occurs within the
group.

Whole population screening is
a test that is offered to all people in a target group such as all females or
all new-born babies. It involves looking for specific changes or early signs of
a disease before any symptoms have occurred. An example of whole population screening
is the blood spot-test carried out on babies. This test helps detect early
signs of diseases such as cystic fibrosis and sickle cell anaemia. When the
baby is five days old a nurse or doctor pricks the heel of a baby and takes a
few drops of blood on a collection card which is usually made of filter paper
and left to dry. The dry blood is then tested for any analytes which show the
presence of a disease. Another example of whole population screening is
diabetic eye screening which is offered to all people with diabetes after the
age of 12. The test screens for diabetic retinopathy which is a major cause of
sight loss. The screening allows early detection of the condition before any noticeable
change to eye sight can occur. Early detection can allow the doctor to treat
the condition before any serious damage happens. During the screening, eye
drops will be given to the patient to enlarge their pupils and photographs of
the retina are taken. The photos are then analysed by a professional to see if
there is any damage to the blood vessels in the eye which leads to sight loss. Whole
population screening does not offer an exact diagnosis, instead it puts people
in higher or lower risk categories. This is due to the test not usually being
specific enough to give an exact diagnosis and also because not everyone will
volunteer for a very specific test when they do not suspect they have the disease
for example a biopsy to test for cancer.

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Disease diagnosis is another
example of clinical laboratory testing. It tests for specific diseases in which
the patient has shown the symptoms of. For example, a liver biopsy test is when
a small piece of liver tissue is taken from the patient and examined under a
microscope. The tissue is examined for any abnormal cells within the liver,
which helps the doctor get a better understanding of what is wrong with the
patient. A liver biopsy is only taken if the patient has shown the symptoms of
possible liver disease such as abdominal pains or digestive issues. If the
patient shows no symptoms of liver disease, a biopsy would not be taken. Another
example of disease diagnosis is a colonoscopy. There are many different types
of colonoscopy’s depending on the symptoms present. Doctors usually offer the
test when the patient shows symptoms such as irritable bowels, bleeding from the
anus and abdominal pains. The test allows the doctor to find the cause of the
symptoms and a suitable treatment to get rid of it. Disease diagnosis tests
have many advantages the main being it accurately identifies the disease the
patient is suffering and the best suitable action or treatment needed.

Some diseases may need
monitoring whilst the patient is undergoing treatment. Patients with chronic
leukaemia do not necessarily stay in the hospital during treatment. They are
permitted to stay at home and come to the hospital for routine checks to
monitor the progression of their disease and the effectiveness of the
treatment. There are different ways in which the disease is monitored within
the laboratory. A common test to monitor the patient’s disease is a blood test.
Blood is taken from the patients Hickman line (the line where they usually receive
chemotherapy treatment) and is tested for red blood cell and white blood cell
count, amongst other things. This shows how the bone marrow is coping with the
chemotherapy treatment as it usually takes time for the counts to come back up
after treatment. Monitoring a patient’s disease is vital for the patient’s
wellbeing. It allows the doctor to see how the patient is coping with the
treatment as well as seeing whether it is effective or not.

 

 

Q2) Select two pathology
disciplines and describe the main
tests carried out by that laboratory stating what the test is being used to
investigate and why. (30 marks, approx
word count 800)

 

Laboratories in healthcare
are split into different sections depending on what is being tested and why. The
different sections are known as pathology disciplines. There are many different
types of pathology disciplines such as haematology and clinical biochemistry.

Haematology is the measurement
of components of blood, blood cells and associated proteins. It also measures any
abnormalities within the blood and identifies how they arise (Pitts and Cunningham).
Haematology also measures components of the bone marrow where the blood cells
are produced. One of the main tests in a haematology laboratory include testing
patients for anaemia. Anaemia is a disease which occurs when the amount of haemoglobin
and the number of red blood cells falls below the normal amount. Red blood
cells and haemoglobin is necessary to transport oxygen from the lungs to the
rest of the body. Blood tests can detect which type of anaemia the patient has
as there are many different types. A tourniquet (tight band) is wrapped around
the patient’s arm, this restricts the blood flow to the arm and causes the
veins to dilate so the sample can easily be extracted. The blood is then collected
into a tube and sent to the laboratory to be tested. The laboratory checks how
much haemoglobin and haematocrit levels there are in the blood. Haemoglobin is
a protein in the blood which transports oxygen around the body. Haematocrit is
a measure of how much space the red blood cells take up within the blood. Low
levels of both show signs of anaemia. Other blood tests can also be taken to
see how severe the disease is and where it originated from. Another example of
a blood test is growing a bacterial culture from a sample to check for
infection. Blood cultures are grown to check for systemic infection which is
when there is an infection within the entire body, not just one specific area.
Blood is collected from the patient’s arm and put into two culture bottles. The
first culture bottle contains nutrients required for microorganisms that prefer
oxygen rich conditions and the second for microorganisms that prefer a reduced-oxygen
environment. The bottles are then incubated in the laboratory. A positive
culture grown in either of the bottles can help the doctor diagnose the
infection and find a suitable antibiotic treatment to fight it. The blood
culture test is usually required when the patient shows signs of sepsis (damage
to the systemic inflammatory response) which is common for patients receiving chemotherapy
for blood cancer.

Clinical biochemistry is the
measure of chemical analytes and abnormal electrolytes within the body. The tests
are usually carried out on samples of blood or urine from the patient. Urinalysis
is a test performed on a sample of urine to help detect possible kidney disease
or diabetes. A test strip is added to the urine which changes colour in the
presence of red blood cells (RBC), white blood cells (WBC) and bacteria. The
presence of these usually means the patient has a urinary tract infection. The
urine is then further analysed under a microscope for any abnormalities, this
is usually done after the chemical strip gives a positive result and the doctor
is concerned. The microscope can detect what the abnormalities are but cannot
detect where they originated from. Further testing of the kidneys is then
needed to find the cause of the symptoms. Another example of a clinical
biochemistry test is a liver function test which measures enzymes and proteins
in the blood. It is used to screen for liver diseases such as hepatitis C and
monitor certain drugs that are known to affect the liver. The liver has many
important functions such as removing bacteria from the blood, maintaining a
normal hormone balance and producing enzymes and bile. The albumin test
measures how well the patient’s liver is at making this protein. Albumin has
many important functions in the body such as preventing fluids from leaking out
of blood vessels and nourishing tissues. Blood is taken from the patient and
analysed in a laboratory. If the albumin levels of the patient are lower than
normal (3.5-5 g/dL) then there is a clear indication that the liver is not functioning
properly. The doctor will then use these results to find a suitable treatment
for the patient.