Clinical practicum mananal:
Name: Tamoor Zafar
Roll number:FA21- MLT- 032
Department: Medical laboratory
technology
University: Mirpur university of science
and technology
Supervisor:Ms. Shahla khan
Training institute:DHQ hospital mirpur
Section Practical name
Haematology section Complete Blood Count (CBC)
Blood Smear
Coagulation Studies (e.g., PT, APTT)
Serology section HIV Antibody Test
Hepatitis B Surface Antigen Test
Syphilis (RPR, VDRL)
Rheumatoid Factor
Blood banking Blood Grouping (ABO and Rh typing)
Crossmatch
Antibody Screening
Direct Antiglobulin Test (DAT)
Sampling section Venous blood collection
Urine collection (for urinalysis)
Stool sample collection
Special chemistry section Metabolic panels (e.g., liver and kidney
function tests)
Chemistry section Electrolytes (e.g., Na, K, Cl)
Glucose Levels
Lipid Profile (Cholesterol,
Triglycerides)
Microbiology section Blood Cultures
Urine Cultures
Stool Cultures
PCR for viral infections
Clinical pathology and urine analysis Protein , glucose ( Benedict test only)
bile pigment ( foam test, dye dilution
test and fouchet’s only ) bile salts,
blood , ketone bodies
Hematology
section:
Complete Blood Count (CBC)-
Introduction:
A CBC is a blood test used to evaluate overall health and detect a variety of
disorders, such as anemia, infection, and many other diseases.
Principle:
The CBC measures the quantity and quality of blood components, including
red blood cells (RBC), white blood cells (WBC), and platelets. It also measures
hemoglobin levels and hematocrit.
Procedure:
A blood sample is collected, usually from a vein in the arm, and analyzed
using an automated hematology analyzer.
Interpretation:
High WBC count: May indicate infection, inflammation, or leukemia.
Low RBC/hemoglobin: Suggests anemia.
High platelets: Can indicate clotting disorders or bone marrow diseases.
2. Blood Smear
Introduction:
A blood smear is used to examine the appearance of blood cells under a
microscope and can help diagnose conditions such as anemia, infections,
and blood cancers.
Principle:
A drop of blood is spread on a microscope slide, stained, and examined
under a microscope.
Procedure:
A drop of blood is placed on a slide, spread with another slide, and stained
with Giemsa or Wright’s stain.
1. Place a small drop of blood near one end of a clean glass slide.
2. Hold a spreader slide (another glass slide) at a 30-45° angle to the blood drop.
3. Spread the blood by quickly and smoothly pushing the spreader forward to create a thin, even
smear.
4. Allow the smear to air dry completely before staining.
Staining the Blood Smear
1. Flood the dried smear with Wright’s, Giemsa, or Leishman’s stain.
2. Let it stand for 2-3 minutes to allow staining of cells.
3. Add buffer or distilled water (1:1 ratio) and leave for another 5-10 minutes.
4. Rinse the slide gently with distilled water and allow it to dry.
Interpretation:
Abnormal cell shapes: Can indicate conditions like sickle cell anemia or
malaria.
a. Presence of abnormal cells: Suggests infections, leukemia, or other
blood disorders.
Coagulation Studies (PT, APTT)
Introduction:
Coagulation studies assess the blood’s ability to clot and are useful in
diagnosing bleeding disorders.
Principle:
Prothrombin Time (PT) measures the extrinsic pathway of clotting.
Activated Partial Thromboplastin Time (APTT) measures the intrinsic
pathway.
Procedure:
Blood is drawn into a tube containing an anticoagulant and mixed with
specific reagents to measure clotting time.
Interpretation:
Prolonged PT/APTT: Indicates clotting disorders, liver disease, or the
presence of anticoagulants (e.g., warfarin).
Short PT/APTT: May suggest a hypercoagulable state.
Serology
Section:
4. HIV Antibody Test
Introduction:
The HIV antibody test detects antibodies to the HIV virus and is used for
diagnosing HIV infection.
Principle:
The test identifies HIV-specific antibodies (IgM and IgG) in the blood or oral
fluid.
Procedure:
Blood is drawn and tested using enzyme-linked immunosorbent assay
(ELISA) or rapid diagnostic tests (RDT).
1. Prepare the patient: Obtain consent and explain the procedure.
2. Collect the sample:
• If using finger-prick blood, clean the fingertip with alcohol, prick with a lancet, and collect a
small drop.
• If using oral fluid, swipe the swab along the gums.
3. Add the sample to the test strip (cassette or dipstick).
4. Add buffer solution to facilitate the reaction.
5. Wait 15-30 minutes for results to appear.
Interpretation:
Positive result: Indicates HIV infection, though confirmation with a second
test is needed.
Negative result: No HIV antibodies detected, though testing window period
may apply.
5. Hepatitis B Surface Antigen Test
Introduction:
This test detects the presence of the hepatitis B virus (HBV) surface antigen
(HbsAg) in the blood.
Principle:
The test identifies HbsAg, which is produced by the hepatitis B virus.
Procedure:
A blood sample is tested by immunoassay methods such as ELISA.
1. Prepare the patient – Explain the test and obtain consent.
2. Collect the sample:
• If using finger-prick blood, clean the fingertip with alcohol and prick with a lancet.
• If using serum or plasma, collect venous blood and centrifuge to separate serum.
3. Apply the sample:
• Place 1-2 drops of blood, serum, or plasma into the test cassette sample well.
4. Add buffer solution:
• Add 2-3 drops to facilitate the reaction.
5. Wait for 15-30 minutes for results.
Interpretation:
Positive: Indicates current hepatitis B infection or carrier status.
Negative: No current infection.
6. Syphilis Test (RPR, VDRL)
Introduction:
The RPR and VDRL tests are used to screen for syphilis, caused by the
bacterium Treponema pallidum.
Principle:
Both tests detect antibodies produced in response to the infection.
Procedure:
Blood is drawn and mixed with cardiolipin antigens to detect antibodies.
Interpretation:
Positive result: Indicates syphilis infection, though confirmation with specific
treponemal tests (e.g., FTA-ABS) is necessary.
Negative result: No infection detected.
7. Rheumatoid Factor (RF)
Introduction:
The RF test detects the presence of rheumatoid factor antibodies, which can
indicate autoimmune diseases, particularly rheumatoid arthritis.
Principle:
It detects IgM antibodies that target the Fc portion of IgG.
Procedure:
Blood is drawn and tested using nephelometry or ELISA.
Interpretation:
Positive: Associated with rheumatoid arthritis, but can also be found in other
conditions like lupus or chronic infections.
Negative: Does not exclude rheumatoid arthritis, but decreases its
likelihood.
Blood
banking:
8): Blood Grouping (ABO and Rh Typing)
Introduction:
Blood grouping is used to determine a person’s ABO blood type and Rh
factor, which is important for transfusions and organ transplants.
Principle:
Blood cells are mixed with specific antibodies to identify ABO antigens and
Rh factor
Procedure:
Blood is mixed with anti-A, anti-B, and anti-Rh antibodies, and agglutination
is observed
Interpretation:
ABO system: Type A, B, AB, or O.
Rh typing: Rh-positive or Rh-negative.
9. Crossmatch
Introduction:
A crossmatch is performed before blood transfusion to ensure compatibility
between donor and recipient blood.
Principle:
The test assesses whether the recipient’s antibodies will react with the
donor’s red blood cells.
Procedure:
A small amount of recipient plasma is mixed with donor red blood cells.
Interpretation:
Negative crossmatch: Safe for transfusion.
Positive crossmatch: Incompatible and risky for transfusion.
10. Antibody Screening:
Introduction:
This test detects antibodies against foreign blood group antigens and is done
before blood transfusions.
Principle:
Screening for antibodies against common antigens (like Rh or Kell) is done
using indirect antiglobulin tests.
Procedure:
The patient’s serum is incubated with red blood cells from different donors.
Interpretation:
Positive result: Presence of antibodies that could cause transfusion
reactions.
Negative result: No antibodies detected.
11. Direct Antiglobulin Test (DAT):
Introduction:
The DAT is used to detect antibodies or complement proteins attached to the
surface of red blood cells, indicating conditions like autoimmune hemolytic
anemia.
Principle:
Patient’s red blood cells are mixed with anti-human globulin (Coombs
reagent).
Procedure:
A blood sample is incubated with anti-IgG antibodies and agglutination is
observed.
Interpretation:
Positive result: Suggests immune-mediated hemolytic anemia, transfusion
reaction, or hemolytic disease of the newborn.
Negative result: No antibodies or complement detected
Sampling
section:
12. Venous Blood Collection:
Introduction:
Venous blood collection is the process of drawing blood from a vein, typically
in the arm, for various diagnostic tests.
Principle:
Blood is drawn into a sterile container for analysis.
Procedure:
A tourniquet is applied to engorge veins, and blood is collected using a
sterile needle.
Interpretation:
Depends on the specific tests performed on the blood.
13. Urine Collection (for Urinalysis)
Introduction:
Urine collection is used to perform urinalysis, which helps in diagnosing
conditions like urinary tract infections, kidney disease, and diabetes.
Principle: Urine is analyzed for its physical properties, chemical
composition, and microscopic elements.
Procedure: A midstream urine sample is collected in a clean container.
Interpretation:
Presence of glucose: Suggests diabetes.
Presence of protein: Indicates kidney disease.
Presence of blood: Can indicate infection or injury.
14. Stool Sample Collection:
Introduction: Stool samples are collected for analysis to detect
gastrointestinal infections, parasitic infections, or conditions like cancer.
Principle: Stool is analyzed for parasites, bacteria, blood, and other
components.
Procedure: A stool sample is collected in a sterile container and sent for
analysis.
Interpretation:
Presence of blood: Indicates gastrointestinal bleeding.
Presence of parasites: Suggests infection with parasitic organisms.
Special
chemistry
Section:
15. Metabolic Panels (e.g., Liver and Kidney Function Tests)
Introduction: Metabolic panels are a group of tests that assess various
metabolic functions and can help diagnose liver or kidney diseases.
Principle: Tests measure the levels of enzymes, electrolytes, and metabolic
byproducts in the blood.
Procedure: Blood is drawn and analyzed for liver enzymes (e.g., ALT, AST),
kidney function markers (e.g., creatinine, BUN), and glucose.
Interpretation:
Elevated liver enzymes: Suggest liver damage or disease.
Elevated creatinine/BUN: Indicates kidney dysfunction.
Thyroid Function Tests (T3, T4, TSH)
✔ Purpose: Diagnoses thyroid disorders (hypothyroidism, hyperthyroidism).
✔ Sample Required: Serum.
✔ Method Used: Chemiluminescent Immunoassay (CLIA) or Enzyme-Linked Immunosorbent
Assay (ELISA).
Procedure (ELISA Method)
1. Collect 3-5 mL of venous blood and separate serum by centrifugation.
2. Add serum to ELISA plate wells coated with anti-T3, T4, or TSH antibodies.
3. Incubate for 30-60 minutes to allow antigen-antibody binding.
4. Wash the plate to remove unbound substances.
5. Add enzyme-linked secondary antibody and incubate again.
6. Add substrate solution, leading to a color change if the hormone is present.
7. Measure absorbance in an ELISA reader.
Interpretation
Test Low Levels High Levels
T3/T4 Hypothyroidism Hyperthyroidism
TSH Hyperthyroidism Hypothyroidism
Chemistry
Section:
[Link] (e.g., Na, K, Cl)
Introduction: Electrolyte tests measure the levels of essential minerals in
the blood, such as sodium (Na), potassium (K), and chloride (Cl).
Principle: The test uses ion-selective electrodes to measure the
concentration of each electrolyte.
Procedure: Blood is drawn and analyzed using an automated analyzer.
Interpretation:
Abnormal sodium levels: Can indicate dehydration, kidney disease, or
hormonal imbalances.
Abnormal potassium levels: Can affect heart rhythm, indicating possible
kidney issues or electrolyte imbalances.
17. Glucose Levels:
Introduction: Glucose level testing measures blood sugar levels and is
essential for diagnosing diabetes and monitoring treatment.
Principle: The test uses chemical reagents to detect glucose in the blood.
Procedure: A blood sample is collected, typically after fasting, and tested
for glucose concentration.
Interpretation:
High glucose: Indicates diabetes or impaired glucose tolerance.
Low glucose: May suggest hypoglycemia.
18. Lipid Profile (Cholesterol, Triglycerides):
Introduction: A lipid profile measures blood cholesterol levels and is used to
assess the risk of heart disease.
Principle: The test measures the levels of total cholesterol, LDL, HDL, and
triglycerides in the blood.
Procedure: Blood is drawn, typically after fasting, and analyzed using a lipid
analyzer.
Interpretation:
High LDL or total cholesterol: Increases cardiovascular risk.
Low HDL: Also increases cardiovascular risk.
Microbiology
section:
19. Blood Cultures:
Introduction: Blood cultures are used to detect infections in the bloodstream
(bacteremia or septicemia).
Principle: Blood is incubated in special media to encourage the growth of
microorganisms.
Procedure: Blood is drawn and cultured in bottles containing nutrient
media.
Interpretation:
Positive culture: Identifies bacteria or fungi, indicating infection.
Negative culture: No microbial growth detected.
Clinical
Pathology:
20. Urine Cultures:
Introduction: Urine cultures are used to detect urinary tract infections (UTIs).
Principle: A sample of urine is cultured to identify bacterial or fungal
infections.
Procedure: A midstream urine sample is cultured on selective media.
Interpretation:
Positive culture: Identifies pathogens causing UTI.
Negative culture: No significant growth.
21. Stool Cultures:
Introduction: Stool cultures are used to detect gastrointestinal infections
caused by bacteria, parasites, or viruses.
Principle: Stool is cultured on specific media to promote growth of
pathogens.
Procedure: A stool sample is placed on agar plates and incubated.
Interpretation:
Positive culture: Identifies the causative organism (e.g., Salmonella,
Shigella).
Negative culture: No pathogenic organisms detected.
22. PCR for Viral Infections
Introduction: PCR (Polymerase Chain Reaction) tests are used to detect viral
DNA or RNA and are highly sensitive.
Principle: PCR amplifies specific genetic material of the virus, making it
detectable even in small quantities.
Procedure: A sample (blood, saliva, etc.) is collected and the viral genome
is amplified using PCR techniques.
Interpretation:
Positive result: Indicates an active viral infection.
Negative result: No viral genetic material detecttion.
