CLINICAL &

LABORATORY TESTS
FERDOUS-UL-HAQUE JOY
LECTURER
DEPARTMENT OF PHARMACY
STATE UNIVERSITY OF BANGLADESH
Important tests in clinical laboratory
• Hematological tests
• Liver function tests
• Renal function tests
• Thyroid function tests
• Cardiology tests
• Lung functioning tests
Hematological tests
A hematology test is a blood test. Any test that requires blood or blood
parts is a hematology test. These tests can offer information to a
doctor about what is happening in the blood.
Hematology tests help to diagnose blood cancers, anemia, and
disorders related to clotting, bleeding, and coagulation.
• The most common hematology tests include:
1. CBC test
2. Platelet count
3. Prothrombin time
Complete blood count (CBC) - This test counts the number
of white blood cells, red blood cells, platelets, and more.
This test helps to diagnose anemia, some blood cancers,
inflammatory diseases, infections, and other health
concerns. A complete blood count (CBC) measures several
components and features of your blood. A CBC and its
individual components are tested on whole blood. It can
include measurements of the following:
➢Platelet count - This test is included in a CBC, but can
also be done on its own in order to monitor clotting or
bleeding disorders.
➢Prothrombin time or Partial Thromboplastin Time -
These tests evaluate some blood disorders and monitor
ongoing therapies.
1. White blood cells (WBC):
• Make up the body's primary defense system, and knowing their
number is an important tool in diagnosing and monitoring infection
and leukemic disorders.
• A normal WBC level is 4,500 - 11,000 per mm³ of blood.
• Increased WBC levels are most notably found in those with any type
of infection, but are also found in anemia, collagen disorders, and
those with physiologic stress, such as pregnancy.
• Low WBC levels are seen in malnutrition, rheumatic disorders (like
lupus, arthritis), some viral infections, and those undergoing
chemotherapy or other forms of bone marrow suppression.
2. Red blood cells
• Red blood cells (RBC) are responsible for the transport and exchange of
oxygen. Measurement of RBCs is important in monitoring the effects of
blood loss and the progression of chronic disease.
• Normal counts of RBCs are 3,900,000 - 5,800,000 per mm³ of blood.
• RBC values are increased in those with anxiety or stress, bone marrow
failure, and dehydration.
• A decreased RBC value will be found in those with chronic inflammatory
diseases, chemotherapy patients, anemia, blood loss, and many cancers.
• In addition to a count of WBCs and RBCs, a complete blood count can
include further tests to evaluate the size, weight, and shape of those cells.
These more detailed tests are helpful in diagnosing and monitoring therapy
for cancer and anemic patients.
3. Hematocrit and Platelets
• Hematocrit (HCT) is the proportion of red blood cells to
plasma, the fluid component of your blood.
• HCT helps to evaluate anemia and hydration. A normal
percentage of hematocrit is 33 to 49%.
• HCT helps to evaluate anemia and hydration.
• Platelets
(PLT) have an essential function in blood clotting.
A normal value is 150,000 - 450,000 platelets per mm³ of
blood.
• An increased platelet value is seen in conditions that
involve inflammation, such as acute infection, trauma, and
some malignant cancers.
•A decreased platelet count is found in alcohol toxicity,
anemia, blood loss, infection, many congenial conditions,
and coagulation disorders.
4. Hemoglobin
• Hemoglobin (HgB) is the oxygen-carrying protein in red blood cells.
Hemoglobin levels are a direct reflection of the amount of oxygen in
the blood.
• A normal hemoglobin concentration is 11-15 grams per deciliter of
blood.
• Increased HgB is seen in those with dehydration, chronic obstructive
pulmonary disease, or COPD, and congestive heart failure, or CHF,
and those at high altitude.
• A decreased HgB value is seen in anemia, blood loss, liver disease,
as well as leukemia and lymphomas.
LIVER FUNCTION TEST
• Liver function tests (also known as a liver panel) are blood
tests that measure different enzymes, proteins, and other
substances made by the liver.
• LFTs include liver enzymes, albumin and other proteins,
and bilirubin.
• The liver enzymes are produced by cells within the liver.
They include alkaline phosphatase (ALP), ɣ–glutamyl
transpeptidase (GGT), alanine aminotransferase (ALT) and
aspartate aminotransferase (AST).
• Liver function tests are most often used to:
1. Help diagnose liver diseases, such as hepatitis
2. Monitor treatment of liver disease. These tests can show
how well the treatment is working.
3. Check how badly a liver has been damaged or scarred by
disease, such as cirrhosis.
4. Monitor side effects of certain medicines.
• Need liver function testing if you have symptoms of liver disease.
These include:
1. Jaundice, a condition that causes your skin and eyes to turn yellow
2. Nausea and vomiting
3. Diarrhea
4. Abdominal pain
5. Dark-colored urine
6. Light-colored stool
7. Fatigue
RENAL FUNCTION TEST
• Renal function tests (RFT) are a group of tests that may be
performed together to evaluate kidney (renal) function. The tests
measure levels of various substances, including several minerals,
electrolytes, proteins, and glucose (sugar), in the blood to determine
the current health of the kidneys.
• If the kidneys are not functioning properly, waste products can
accumulate in the blood and fluid levels can increase to dangerous
volumes, causing damage to the body or a potentially life-
threatening situation. Numerous conditions and diseases can result in
damage to the kidneys. The most common causes of and main risk
factors for kidney disease are diabetes and hypertension.
• Clinically, the most practical tests to assess renal function is to get an
estimate of the glomerular filtration rate (GFR) and to check for proteinuria
(albuminuria).
• According to the Kidney Disease Improving Global Outcomes (KDIGO),
The stages of chronic kidney disease (CKD):
1. Stage 1 GFR greater than 90 ml/min/1.73 m²
2. Stage 2 GFR-between 60 to 89 ml/min/1.73 m²
3. Stage 3a GFR 45 to 59 ml/min/1.73 m²
4. Stage 3b GFR 30 to 44 ml/min/1.73 m²
5. Stage 4 GFR of 15 to 29 ml/min/1.73 m²
6. Stage 5-GFR less than 15 ml/min/1.73 m² (end-stage renal disease)
OTHERS:
• Creatinine: Serum creatinine is elevated when there is a significant
reduction in the glomerular filtration rate or when urine elimination
is obstructed. About 50% of kidney function must be lost before a
rise in serum creatinine can be detected. Thus serum creatinine is a
late marker of acute kidney injury.
• BUN: Serum urea/BUN level increases in acute and chronic renal
disease.
• eGFR equations are used to determine the presence of renal disease,
stage of CKD, and to monitor response to treatment.
THYROID FUNCTION TEST:
• Thyroid function tests are blood tests which help to check
the function of your thyroid gland. They are mainly used to
detect an underactive thyroid gland (hypothyroidism) and
an overactive thyroid gland (hyperthyroidism).
• Thetwo hormones, thyroxine (T4) and thyroid-stimulating
hormone (TSH), work together and are usually in balance.
• Normal range for thyroid-stimulating hormone: 0.4-4.0
mU/L.
• Normal range for thyroxine: 9-24 pmol/L.
• Soin general if TSH is low and thyroxine level is high,
you may have an overactive thyroid gland.
• Converselyif TSH is high and thyroxine level is low, you
may have an underactive thyroid gland.
TESTS ASSOCIATED WITH CARDIAC
DISORDERS
Many different tests are used to diagnose heart disease. Besides blood
tests and a chest X-ray, tests to diagnose heart disease can include:
• Electrocardiogram (ECG or EKG). An ECG is a quick and
painless test that records the electrical signals in the heart. It can tell
if the heart is beating too fast or too slowly.
• Holter monitoring. A Holter monitor is a portable ECG device that's
worn for a day or more to record the heart's activity during daily
activities. This test can detect irregular heartbeats that aren't found
during a regular ECG exam.
• Echocardiogram. This noninvasive exam uses sound waves to
create detailed images of the heart in motion. It shows how blood
moves through the heart and heart valves. An echocardiogram can
help determine if a valve is narrowed or leaking.
• Exercise tests or stress tests. These tests often involve walking on a
treadmill or riding a stationary bike while the heart is monitored.
Exercise tests help reveal how the heart responds to physical activity
and whether heart disease symptoms occur during exercise. If you
can't exercise, you might be given medications.
• Cardiac catheterization. This test can show blockages in the heart
arteries. A long, thin flexible tube (catheter) is inserted in a blood
vessel, usually in the groin or wrist, and guided to the heart. Dye
flows through the catheter to arteries in the heart. The dye helps the
arteries show up more clearly on X-ray images taken during the test.
• Heart (cardiac) CT scan. In a cardiac CT scan, you lie on
a table inside a doughnut-shaped machine. An X-ray tube
inside the machine rotates around your body and collects
images of your heart and chest.
• Heart (cardiac) magnetic resonance imaging (MRI)
scan. A cardiac MRI uses a magnetic field and computer-
generated radio waves to create detailed images of the
heart.
LUNG FUNCTION TESTS
Lung function tests, also known as pulmonary function tests,
or PFTs, are a group of tests that check to see if your lungs
are working right. The tests look for:
• How much air your lungs can hold
• How well you move air in and out of your lungs
• How well the lungs move oxygen into your bloodstream.
There are several types of lung function tests. They include:
Spirometry. the most common type of lung function test. It measures
how much and how quickly you can move air in and out of your lungs.
Lung volume test. also known as body plethysmography. This test
measures the amount of air you can hold in your lungs and the amount
of air that remains after you exhale (breathe out) as much as you can.
Gas diffusion test. This test measures how oxygen and other gases
move from the lungs to the bloodstream.
Exercise stress test. This test looks at how exercise affects lung
function. These tests may be used together or by themselves,
depending on your specific symptoms or condition.
THANK
YOU