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Clinical Laboratory Science: Concepts, Procedures, and Clinical Applications 9th edition [Minkštas viršelis]

Mary Louise Turgeon (Associate Professor (Adjunct), University of Texas Medical Branch, Galveston, Texas; Clinical Laboratory Education Consultant, Mary L. Turgeon and Associates, Boston, Massachusetts; St. Petersburg, Florida, USA)

Formatas: Paperback / softback, 704 pages, aukštis x plotis: 276x216 mm, weight: 1510 g, 350 illustrations (350 in full color); Illustrations
Išleidimo metai: 14-Dec-2022
Leidėjas: Elsevier - Health Sciences Division
ISBN-10: 0323829341
ISBN-13: 9780323829342

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Medical laboratory testing & techniques - (Šiuo metu turimos knygos: 1 prekės)

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Formatas: Paperback / softback, 704 pages, aukštis x plotis: 276x216 mm, weight: 1510 g, 350 illustrations (350 in full color); Illustrations
Išleidimo metai: 14-Dec-2022
Leidėjas: Elsevier - Health Sciences Division
ISBN-10: 0323829341
ISBN-13: 9780323829342

Kitos knygos pagal šią temą:

Medical laboratory testing & techniques - (Šiuo metu turimos knygos: 1 prekės)

Pastovi nuoroda: https://www.kriso.lt/db/9780323829342.html

Raktažodžiai:

Diagnosis, Laboratory

Using a discipline-by-discipline approach, Turgeon's Clinical Laboratory Science: Concepts, Procedures, and Clinical Applications, 9^th Edition, provides a fundamental overview of the concepts, procedures, and clinical applications essential for working in a clinical laboratory and performing routine clinical lab tests. Coverage includes basic laboratory techniques and key topics such as safety, phlebotomy, quality assessment, automation, and point-of-care testing, as well as discussion of clinical laboratory specialties. Clear, straightforward instructions simplify laboratory procedures and are guided by the latest practices and CLSI (Clinical and Laboratory Standards Institute) standards. Written by well-known CLS educator Mary Louise Turgeon, this edition offers essential guidance and recommendations for today's laboratory testing methods and clinical applications.

Broad scope of coverage

makes this text an ideal companion for clinical laboratory science programs at various levels, including CLS/MT, CLT/MLT, medical laboratory assistant, and medical assisting, and reflects the taxonomy levels of the CLS/MT and CLT/MLT exams.
Detailed procedure guides and procedure worksheets on Evolve and in the ebook familiarize you with the exact steps performed in the lab.
Vivid, full-color illustrations depict concepts and applicable images that can be seen under the microscope.
An extensive number of certification-style, multiple-choice review questions are organized and coordinated under major topical headings at the end of each chapter to help you assess your understanding and identify areas requiring additional study.
Case studies include critical thinking group discussion questions, providing the opportunity to apply content to real-life scenarios.
The newest Entry Level Curriculum Updates for workforce entry, published by the American Society for Clinical Laboratory Science (ASCLS) and the American Society for Clinical Pathology (ASCP) Board of Certification Exam Content Outlines, serve as content reference sources.
Convenient glossary makes it easy to look up definitions without having to search through each chapter.
An Evolve companion website provides convenient access to animations, flash card sets, and additional review questions.
Experienced author, speaker, and educator Mary L. Turgeon is well known for providing insight into the rapidly changing field of clinical laboratory science.

NEW!

Content spans traditional principles and practices to the expanding applications of molecular diagnostics

that reflect the most current clinical laboratory practices and technology.
NEW! New Frontiers in Molecular Diagnostics chapter explores the future of the field.
NEW! Coverage of the "new face" of clinical laboratory practice recognizes of the important need for laboratories for SARS-CoV-2 testing during the COVID-19 pandemic, with an increased emphasis on safety, patient considerations, and delivery of testing modes.
NEW! Exploration of current laboratory safety issues, strategies, and the need for various safety-related officers to control problems such as supply chain interruptions and the risk of infection from aerosols.
NEW! Applications of innovative quality models, such as clinical outcomes and biological variation, improve the acceptable standards of laboratory testing and the interpretations of reference ranges.
NEW! Expanded information on new oral anticoagulants is presented along with the appropriate laboratory testing, with alternative testing added to the discussion of blood coagulation.
NEW! Increased focus on cell types in cerebrospinal fluid includes descriptions of associated clinical disorders and microbial examination.
NEW! Expanded comparisons of the characteristics of important body fluids, such as synovial fluid, serous fluids, seminal fluid, and amniotic fluid.
NEW! Appendix offers comprehensive overview of COVID-19.

Part I Basic Laboratory Techniques

(177)

1 Fundamentals of the Clinical Laboratory

(16)

Clinical Laboratory Science

(1)

Clinical Laboratory Science as a Profession

(1)

Original Credentialing and Professional Organizations

(1)

Individual Professional Recognition

(1)

Additional Individual Professional Certification and Licensure

(1)

Professional Recognition

(1)

Clinical Laboratory Science Program Accreditation

(1)

Clinical Laboratory Overview

(1)

Functions

(1)

Staffing

(1)

Clinical Laboratory Improvement Amendments of 1988

(1)

Clinical Laboratory Improvement Amendments Requirements for Personnel

(1)

Levels of General Laboratory Testing

(1)

Laboratory Departments

(1)

Traditional Departments of a Clinical Laboratory

(1)

Core Laboratory

(1)

Expanded Directions of Laboratory Testing: Molecular Diagnostics

(1)

Health Care Organizations

(1)

Primary Accrediting Organizations

(1)

Commission on Office Laboratory Accreditation

(1)

College of American Pathologists

(1)

The Joint Commission

(1)

Other Agencies

(1)

External Government Laboratory Accreditation and Regulation

(1)

Alternate Sites of Testing

(1)

Point-of-Care Testing

(1)

Reference Laboratories

(1)

Physician Office Laboratories

(1)

Medical-Legal Issues

(1)

Informed Consent

(1)

Health Insurance Portability and Accountability Act

(1)

New Patient Access Regulations

(1)

Chain of Custody

(1)

Other Legal Considerations

(1)

Medical Ethics

(1)

Case Studies

(3)

2 Safety: Patient and Clinical Laboratory Practices

(38)

Patient Safety

(1)

Joint Commission: Laboratory National Patient Safety Goals

(1)

US Institute of Medicine

(1)

Communications

(1)

Mitigating Patient Risk

(2)

Safety Standards and Governing Agencies

(1)

National Healthcare Safety Network

(1)

Occupational Safety and Health Administration Acts and Standards

(1)

Occupational Safety and Health Administration-Mandated Plans

(5)

Threats to Laboratory Safety: Supply Chain Interruption

(1)

Avoiding Transmission of Infectious Diseases

(1)

Biosafety and Biosafety Levels

(2)

Highlights of Sars-Cov-2 Laboratory Biosafety

(1)

Laboratory-Acquired Infections

(1)

Bloodborne Pathogens

(2)

Safe Work Practices for Infection Control

(1)

Other Practices Necessary for Safety Assurance

(1)

Protective Techniques for Infection Control

(1)

Personal Protective Equipment

(5)

Handwashing

(1)

Decontamination of Work Surfaces, Equipment, and Spills

(1)

Guidance for SARS-CoV-2 Decontamination

(1)

General Infection Control Safety Practices

(2)

Specimen Handling and Shipping Requirements

(1)

Final Decontamination of Waste Materials

(1)

Prevention of Disease Transmission

(1)

Immunization/Vaccination

(2)

Optional Immunizations

(1)

Screening Tests

(1)

Prophylaxis, Medical Follow-Up, and Records of Accidental Exposure

(1)

Respirators or Masks for Tuberculosis Control

(1)

Protection From Aerosols

(1)

Additional Laboratory Hazards

(1)

Chemical Hazards

(1)

Electrical Hazards

(1)

Fire Hazards

(1)

Labware Hazards

(1)

Infectious Waste

(1)

Final Decontamination of Waste Materials

(1)

Infectious Waste

(1)

Radioactive Waste

(1)

Safety Audit

(1)

Basic First-Aid Procedures

(1)

Case Study

(5)

3 Quality Assessment and Quality Control in the Clinical Laboratory

(25)

The Value of Quality

(1)

Patient Specimens

(1)

Clinical Laboratory Improvement Amendments

(1)

Voluntary Accrediting Organizations

(1)

The Joint Commission

(1)

College of American Pathologists

(1)

International Standards for Clinical Laboratories

(1)

Lean and Six Sigma Quality Systems

(1)

Quality Assurance

(1)

Quality Assessment---Error Analysis

(1)

Quality Assessment---Phases of Testing

(1)

Preanalytical Phase

(1)

Postanalytical Phase

(1)

Proficiency Testing

(1)

Requirements

(1)

Challenges

(1)

Alternative Assessment

(1)

Accuracy in Reporting Results and Documentation

(1)

Quality Control

(1)

Control Specimens

(1)

Quality Assessment Descriptors

(1)

Accuracy Versus Precision

(1)

Sensitivity and Specificity of a Test

(1)

Predictive Values

(1)

Quality Control Statistics

(1)

Mean, Median, and Mode

(1)

Standard Deviation

(1)

Z-Score

(1)

Confidence Intervals

(1)

Total Analytic Error

(1)

Coefficient of Variation

(1)

Determination of Control Range

(1)

Sources of Variance or Error

(1)

Monitoring Quality Control

(1)

Levey-Jennings Charts

(2)

Westgard Rules

(1)

Westgard Multirules

(1)

Other Quality Control Rules

(1)

Nonanalytical Factors in Quality Assessment

(2)

Testing Outcomes

(1)

Reference Values

(1)

Case Study

(5)

4 The Microscope

(17)

Description

(1)

Parts of the Microscope

(1)

Framework

(1)

Illumination System

(2)

Magnification System

(2)

Focusing System

(1)

Care and Cleaning of the Microscope

(1)

Cleaning the Microscope Exterior

(1)

Cleaning Optical Lenses

(1)

Cleaning the Objectives

(1)

Cleaning the Ocular

(1)

Cleaning the Condenser

(1)

Cleaning the Stage and Adjustment Knobs

(1)

Use of the Microscope

(1)

Alignment

(1)

Light Adjustment

(1)

Focusing

(1)

Other Types of Microscopes (Illumination Systems)

(1)

Darkfield Microscope

(1)

Differential Interference-Contrast Microscope

(1)

Electron Microscope

(1)

Fluorescence Microscope

(1)

Phase-Contrast Microscope

(2)

Polarized and Compensated Polarized Microscopes

(1)

Digital Microscopy

(1)

Artificial Neural Networks

(1)

Digital Cell Morphology and Workflow

(1)

Advanced Applications

(3)

5 Systems of Measurement, Laboratory Equipment, and Reagents

(21)

Systems of Measurement

(1)

English and Metric Systems

(1)

International System (SI System)

(1)

Base Units of SI System

(2)

Non-SI Units

101

(1)

Reporting Results in SI Units

101

(1)

Labware

102

(1)

Plasticware

102

(1)

Glassware

102

(3)

Pipetting

105

(2)

Cleaning Laboratory Glassware and Plasticware

107

(1)

Laboratory Balances

108

(1)

General Use of Balances

108

(1)

Analytical Balance

109

(1)

Top-Loading Balance

109

(1)

Laboratory Centrifuges

109

(1)

Types of Centrifuges

110

(1)

Centrifuge Speed

111

(1)

Uses for Centrifuges

111

(1)

Technical Factors in Using Centrifuges

111

(1)

Special Precautions for Centrifugation of Blood and Body Fluids

112

(1)

Laboratory Reagent Water

112

(1)

Levels of Water Purity

112

(1)

Quality Control and Impurity Testing

112

(1)

Storage of Reagent Water

113

(1)

Purification of Water Process

113

(1)

Reagents Used in Laboratory Assays

114

(1)

Reagent Preparation

114

(1)

Grades of Chemicals

114

(1)

Hazardous Chemicals Communication Policies

114

(1)

Storage of Chemicals

114

(1)

Reference Materials

115

(1)

Concentration of Solutions

115

(1)

Transfer and Dilution of Chemicals for Reagents

115

(1)

Labeling the Reagent Container

115

(1)

Checking a Reagent Before Use

115

(1)

Ready-Made Reagents

115

(1)

Immunoreagents

115

(3)

6 Laboratory Mathematics and Solution Preparation

118

(11)

Significant Figures

119

(1)

Rounding off Numbers

119

(1)

Exponents

119

(1)

Density and Specific Gravity

120

(1)

Expressions of Solution Concentration

120

(1)

Weight (Mass) per Unit Volume

120

(1)

Volume per Unit Volume

120

(1)

Percent

120

(1)

Molality

121

(1)

Molarity

121

(1)

Osmolality and Osmolarity

122

(1)

Titer

122

(1)

Proportions and Ratios

122

(1)

Concentrations of Solutions

123

(1)

Dilutions

123

(1)

Diluting Specimens

123

(1)

Dilution Factor

123

(1)

Single Dilutions

124

(1)

Use of Dilution Factors

124

(1)

Serial Dilutions

124

(1)

Standard Solutions

125

(1)

Blank Solutions

125

(4)

7 Basic and Contemporary Techniques in the Clinical Laboratory

129

(26)

Photometry

130

(1)

Absorbance Spectrophotometry

130

(1)

The Nature of Light

131

(1)

Beer-Lambert (Beer's) Law

132

(1)

Expressions of Light Transmitted or Absorbed

133

(1)

Preparation and Use of a Standard Curve

133

(2)

Instruments Used in Spectrophotometry

135

(1)

Parts Essential to All Spectrophotometers

136

(1)

Calibration of Cuvettes

137

(1)

Care and Handling of Spectrophotometers

137

(1)

Quality Control Tests for Spectrophotometers

137

(1)

Reflectance Spectrophotometry

137

(1)

Principle and Quality Control

138

(1)

Parts of a Reflectance Spectrophotometer

138

(1)

Applications of Reflectance Spectrophotometry

138

(1)

Fluorescence Spectrophotometry

138

(1)

Nephelometry

138

(1)

Principles of Use

139

(1)

Optical System and Measurement

139

(1)

Advantages and Disadvantages

139

(1)

Flow (Cell) Cytometry

140

(1)

Fundamentals of Laser Technology

140

(1)

Principles of Flow Cytometry

140

(1)

Immunoassays

140

(2)

Enzyme Immunoassay

142

(1)

Basic Immunofluorescence Labeling Techniques

143

(1)

Alternative Labeling Technologies

144

(1)

Time-Resolved Fluoroimmunoassay

144

(1)

Fluorescence Polarization Immunoassay

144

(1)

Fluorescence In Situ Hybridization

144

(1)

Signal Amplification Technology

144

(1)

Magnetic Labeling Technology

144

(1)

Radioimmunoassay

144

(1)

Chemiluminescence

144

(1)

Chromatography and Immunochromatography

145

(1)

Types of Chromatographic Methods

145

(1)

Lateral or Vertical Flow Immunoassays (Immunochromatography)

145

(1)

Electrochemical Methods

146

(1)

Potentiometry

146

(2)

Coulometry

148

(1)

Electrophoresis

148

(7)

8 Laboratory Testing: From Point of Care to Total Automation

155

(23)

Point-of-Care Testing

156

(1)

The Importance of Decentralized Laboratory Point-of-Care Testing Assays

156

(1)

Purpose and Cost

156

(1)

Quality Control and Regulations

157

(1)

Waived Testing

157

(1)

Patient-Centric Laboratory Testing

158

(1)

Personal Direct-to-Consumer Genetic Testing

158

(1)

Non--Instrument-Based Point-of-Care Testing

158

(1)

Ultralow-Cost Diagnostics

158

(1)

Nonautomated Point-of-Care Testing

159

(1)

Pregnancy Tests

160

(1)

Fecal Occult Blood Tests

161

(1)

Handheld Point-of-Care Testing Equipment

162

(2)

Emerging Patient-Centric Technologies

164

(1)

The Tricorder

164

(1)

Technology Transfer

164

(1)

Overview of Informatics

165

(1)

What Is a Laboratory Information Management System?

165

(1)

What Is a Laboratory Information System?

165

(2)

Software

167

(1)

Communication and Network Devices

168

(2)

Computer Applications

170

(1)

Preanalytical (Pre-Examination) Functions

170

(1)

Analytical (Examination) Functions

170

(1)

Postanalytical (Postexamination) Functions

171

(1)

Overview of Automation

172

(1)

Benefits of Automation

172

(1)

Process of Automation

172

(1)

Steps in Automated Analysis

172

(1)

Specimen Collection and Processing

172

(1)

Automated Analyzers

173

(1)

Case Study

174

(4)

Part II Basic Clinical Laboratory Specializations

178

(31)

9 Phlebotomy: Collecting and Processing Patient Blood Specimens

178

(29)

Quality Assessment

179

(1)

Patient Care Partnership

180

(1)

Pediatric Patients

180

(1)

Adolescent Patients

181

(1)

Adult Patients

181

(1)

Geriatric Patients

181

(1)

Infection Control

181

(1)

Isolation as a Safety System

181

(1)

Standard and Additional Precautions

181

(1)

Specimen Collection

182

(1)

The Phlebotomist

182

(1)

Blood Collection Variables

183

(1)

Blood Collection Procedures

184

(1)

Layers of Normal Anticoagulated Blood

184

(1)

Environmental Factors Associated With Evacuated Blood Collection Tubes

184

(1)

Expiration Dates of Evacuated Tubes

185

(1)

Changes in Shelf Life

185

(1)

Evacuated Blood Tubes

186

(2)

Venipuncture Procedure

188

(5)

Venous Blood Collection (Phlebotomy)

193

(1)

Supplies and Equipment

193

(1)

Special Blood Collection: Blood Cultures

193

(1)

Site Selection

193

(1)

Special Site-Selection Situations

194

(1)

Venipuncture Problems

194

(1)

Venipuncture Complications

195

(1)

Specimens: General Preparation

195

(1)

Processing Blood Specimens

195

(1)

Variations in Specimen Collection and Handling

196

(1)

Unacceptable and Rejected Specimens

196

(1)

Centrifugation of Specimens

197

(1)

Storage of Processed Specimens

198

(1)

Preserving Specimens

198

(1)

Logging and Reporting Processes

199

(1)

Capillary or Peripheral Blood Collection By Skin Puncture

199

(1)

Blood Spot Collection for Neonatal Screening Programs

200

(1)

Capillary Blood for Testing at the Bedside (Point-of-Care Testing)

201

(1)

Capillary Blood Collection

201

(1)

Supplies and Equipment

201

(1)

Capillary Blood for Slides

201

(1)

Collecting Microspecimens

201

(1)

Laser Equipment

202

(1)

Case Studies

202

(5)

10 An Introduction to the Principles and Practice of Clinical Hematology

207

(2)

Part One Hematopoiesis and Cellular Maturation

209

(16)

Erythrocytes

210

(1)

Erythrocyte Function and Maturation

210

(3)

Hemoglobin Synthesis, Structure, and Function

213

(1)

RBC Formation and Destruction

213

(1)

Hemoglobin Function

213

(2)

Hemoglobin Variants

215

(2)

Hemoglobin Derivatives

217

(1)

Variations in Hemoglobin Concentrations

218

(1)

Leukocytes

218

(1)

Granulocyte Maturation and Function

219

(1)

Neutrophils

219

(3)

Monocyte Maturation and Function

222

(1)

Lymphocyte Maturation and Function

222

(1)

Plasma Cells

223

(1)

Reporting Leukocyte Results (Total, Relative, and Absolute Counts)

224

(1)

Thrombocytes

225

(1)

Platelet (Thrombocyte) Maturation and Function

225

(1)

Part Two Hematology Laboratory Assessments

225

(15)

Anticoagulants

225

(1)

Processing and Testing the Specimen

226

(1)

Osmosis and Osmotic Pressure

227

(1)

Isotonic, Hypotonic, and Hypertonic Solutions

227

(1)

Hemoglobin Measurement in the Laboratory

227

(1)

Hematocrit (Packed Cell Volume)

228

(1)

Blood Cell Counts

229

(1)

Mean Corpuscular Volume

230

(1)

Mean Corpuscular Hemoglobin

230

(1)

Mean Corpuscular Hemoglobin Concentration

230

(1)

Red Blood Cell Distribution Width

231

(1)

Accuracy and Precaution

231

(1)

Platelet Counts

231

(1)

Automated Hematology Instrument Technology

232

(1)

Automated Cell-Counting Methods

233

(3)

Examples of Automated Hematology Technology

236

(2)

Automated Leukocyte Differentiation

238

(1)

Additional Hematology Procedures

239

(1)

Reticulocyte Counts

239

(1)

Erythrocyte Sedimentation Rate

240

(1)

Part Three Erythrocyte Disorders

240

(12)

Microscopic Examination of a Peripheral blood Film

240

(1)

Sources of Blood for the Blood Film

240

(1)

Microscopic Examination of the Blood Film

241

(6)

Platelet Estimation

247

(2)

Perform the Differential Count of White Cells

249

(1)

Types of Anemias

249

(3)

Hemoglobinopathies

252

(1)

Thalassemias

252

(1)

Part Four Nonmalignant Leukocyte Disorders

252

(3)

Quantitative Changes in the Total Concentration of Leukocytes

253

(1)

Quantitative Disorders of Granulocytes and Monocytes

253

(1)

Toxic Changes and Granulocyte Alterations

253

(2)

Lymphocytosis

255

(1)

Part Five Malignant Leukocyte Disorders: Leukemias, Lymphoid and Plasma Cell Neoplasms

255

(6)

Leukemia

256

(1)

Acute Myeloid/Myelogenous Leukemia

256

(2)

Acute Lymphoblastic Leukemia

258

(1)

Chronic Myelogenous Leukemia

258

(1)

Chronic Lymphocytic Leukemia

259

(1)

Lymphoid and Plasma Cell Neoplasms

260

(1)

Part Six Other Malignant Hematologic Categories

261

(353)

Case Studies

262

(7)

11 Hemostasis and Blood Coagulation

269

(27)

Hemostatic Mechanism

270

(1)

Extravascular Effects

271

(1)

Vascular Effects

271

(1)

Intravascular Effects

271

(1)

Platelets

272

(1)

Functions of Platelets

272

(1)

Quantitative Platelet Disorders

272

(1)

Thrombocytopenia

272

(1)

Disorders of Destruction and Utilization of Platelets

273

(1)

Disorders of Platelet Distribution of Platelets

273

(1)

Thrombocytosis

273

(1)

Qualitative Platelet Disorders

273

(1)

Coagulation

274

(1)

Fibrin

274

(1)

Coagulation Factors

274

(4)

Mechanism of Coagulation

278

(1)

Pathways for Coagulation Cascade

279

(1)

Intrinsic Versus Extrinsic Coagulation Pathway

279

(1)

Intrinsic Pathway (Activation of Factor X)

279

(1)

Extrinsic Pathway (Activation of Factor X)

279

(1)

Common Pathway (Formation of Fibrin Clot From Factor X)

280

(1)

Fibrinolysis

280

(1)

Protective Mechanisms Against Thrombosis

281

(1)

Normal Blood Flow

281

(1)

Removal of Materials

281

(1)

Natural Anticoagulant Systems

281

(1)

Therapeutic Anticoagulant Therapy

282

(2)

Tests for Hemostasis and Coagulation

284

(1)

Screening Tests for Disorders of the Hemostatic System

284

(1)

Tests for Platelet Function

285

(1)

Tests for Plasma Coagulation Factors

286

(2)

Performance of Coagulation Assays

288

(3)

Point-of-Care Tests for Coagulation Assays

291

(1)

Case Studies

292

(4)

12 Renal Physiology and Urinalysis

296

(62)

Overview of Urinalysis

298

(1)

History of Urinalysis

298

(1)

Modern Urinalysis

298

(1)

Quality Assessment and Quality Control

299

(1)

Renal Anatomy and Physiology

299

(1)

Renal Anatomy

299

(1)

Renal Physiology

300

(3)

Histology

303

(1)

Composition of Urine

303

(1)

Normal Urine

303

(1)

Identification of a Fluid as Urine

304

(1)

Collection and Preservation of Urine Specimens

304

(1)

Types of Urine Specimens

304

(1)

Containers for Urine Collection

305

(1)

Urine Volume for Routine Urinalysis

306

(1)

Preservation of Urine Specimens

306

(1)

Labeling and Processing of Urine Specimens

307

(1)

Physical Properties of Urine

307

(1)

Volume

308

(1)

Color

308

(1)

Transparency

308

(1)

Odor

309

(1)

Specific Gravity

309

(1)

Chemical Tests in Routine Urinalysis

310

(1)

Reagent Strip Tests

310

(3)

Protein

313

(3)

Blood (Hemoglobin and Myoglobin)

316

(2)

Nitrite

318

(1)

Leukocyte Esterase

319

(1)

Glucose (Sugar)

319

(2)

Ketone Bodies

321

(1)

Bilirubin and Urobilinogen

322

(4)

Summary

326

(1)

Microscopic Analysis of Urine Sediment

326

(1)

Specimen Requirements

326

(1)

Normal Sediment

327

(1)

Techniques for Examination of Urine Sediment

327

(1)

Laboratory Procedure

328

(1)

Specimen Preparation (Concentration)

329

(1)

Standardization

329

(1)

Constituents of Urine Sediment

329

(1)

Cellular Constituents

329

(3)

Epithelial Cells

332

(3)

Casts

335

(6)

Crystals and Amorphous Material

341

(6)

Other Cellular Constituents

347

(1)

Contaminants and Artifacts

348

(1)

Automation in Urinalysis

349

(1)

Semiautomated Systems

349

(2)

Fully Automated Systems

351

(1)

Automated Microscopy

351

(1)

Case Studies

351

(7)

13 Examination of Body Fluids and Miscellaneous Specimens

358

(26)

Overview of Body Fluids

359

(1)

Cerebrospinal Fluid

359

(1)

Collection of Cerebrospinal Fluid

360

(1)

Routine and Special Examination of Cerebrospinal Fluid

361

(5)

Characteristics of Transudates and Exudates

366

(1)

Collection of Serous Fluids

367

(1)

Routine Examination of Serous Fluids

367

(1)

Serous Fluids: Pericardial, Pleural, and Peritoneal

367

(2)

Description of Specific Serous Fluids

369

(1)

Synovial Fluid

370

(1)

Normal Synovial Fluid

370

(1)

Aspiration and Analysis

370

(1)

Classification of Synovial Fluid in Joint Disease

371

(1)

Collection of Synovial Fluid

371

(1)

Routine Examination of Synovial Fluid

371

(4)

Seminal Fluid

375

(1)

Semen Analysis

375

(3)

Amniotic Fluid

378

(1)

Fetal Lung Maturity

378

(1)

Fetal Fibronectin

378

(1)

Pulmonary Surfactants

379

(1)

Saliva

379

(1)

Automated Platforms In Body Fluid Analysis

379

(1)

Case Studies

380

(4)

14 Introduction to the Principles and Practice of Clinical Chemistry

384

(45)

Glucose and Glucose Metabolism

386

(1)

Diabetes

387

(1)

Type 1 Diabetes

388

(1)

Type 2 Diabetes

388

(1)

Symptoms of Diabetes

388

(1)

Gestational Diabetes Mellitus

389

(1)

Other Causes of Hyperglycemia

390

(1)

Hypoglycemia

390

(1)

Diagnosis of Diabetes

390

(1)

Collection of Blood Specimens for Glucose

391

(1)

Other Body Fluids

391

(1)

Point-of-Care Testing for Glucose

392

(1)

Methods for Qualitative and Semiquantitative Determination of Glucose

392

(1)

Methods for Quantitative Determination of Glucose

392

(1)

Glucose Reference Values

393

(1)

Laboratory Tests for Diabetic Management

393

(1)

Electrolytes

394

(1)

Sodium

394

(1)

Potassium

395

(1)

Sodium and Potassium in Body Fluids

395

(1)

Chloride

395

(1)

Bicarbonate

396

(1)

Anion Gap

396

(1)

Special Considerations for Specimens

396

(1)

Methods for Quantitative Measurement

397

(1)

Other Electrolytes

398

(1)

Reference Values

398

(1)

Acid-Base Balance and Blood Gases

399

(1)

Renal Function

400

(1)

Urea/Urea Nitrogen

400

(2)

Creatinine

402

(1)

Estimated Glomerular Filtration Rate

403

(1)

Cystatin C

404

(1)

Creatine

404

(1)

Uric Acid

404

(1)

Reference Values

404

(1)

Clinical Significance

404

(1)

Lipids

404

(1)

Cholesterol

405

(1)

Triglycerides

405

(1)

Secondary Hypertriglyceridemia

405

(1)

Lipoproteins

406

(1)

Secondary Elevations of Low-Density Lipoproteins

407

(1)

Reference Values

407

(1)

Cardiovascular Disease

407

(1)

Classifications of Cardiac Biomarkers

408

(1)

Historical Cardiac Biomarkers

409

(1)

Specific Biomarkers of Myocardial Damage

409

(1)

Other Biomarkers-Copeptin

410

(1)

Biomarkers of Coronary Risk

410

(1)

Biomarkers of Congestive Heart Failure

411

(1)

Other Miscellaneous Biomarkers

411

(1)

Liver and Pancreatic Testing

411

(1)

Ammonia

411

(1)

Bilirubin

412

(1)

Enzymes

413

(1)

Proteins

413

(2)

Coagulation: Prothrombin Time

415

(1)

Pancreatic Function

415

(1)

Hormone Assays

415

(1)

Thyroid

415

(1)

Tumor Markers

416

(1)

Miscellaneous Enzyme Biomarkers in Malignancies

416

(1)

Miscellaneous Hormone Biomarkers in Malignancies

416

(1)

Therapeutic Drug Monitoring

417

(1)

Peak and Trough

417

(1)

Drugs of Abuse

418

(1)

Automation in Clinical Chemistry

418

(1)

Clinical Chemistry and Immunochemistry Analyzers

418

(3)

Case Studies

421

(8)

15 New Frontiers in Molecular Diagnostics

429

(32)

Principles of Genetics

430

(1)

The Genetic Code

430

(1)

The Genetic Code

431

(1)

Forms of Ribonucleic Acid

432

(1)

Deoxyribonucleic Acid Mutations and Polymorphisms

432

(1)

Molecular Techniques

433

(2)

Amplification Techniques in Molecular Biology

435

(1)

Amplification Methods

436

(1)

Target Amplification Methods

436

(1)

Polymerase Chain Reaction

436

(1)

Real-Time Polymerase Chain Reaction

437

(1)

Restriction Fragment Length Polymorphism

437

(1)

Molecular Analysis of Amplification Products

437

(1)

Deoxyribonucleic Acid Sequencing

437

(1)

Sanger (Chain Termination) Sequencing

438

(1)

Nanoball Deoxyribonucleic Acid Sequencing Technology

438

(1)

Pyrosequencing

439

(1)

Hybridization Assays

439

(1)

Fluorescence In Situ Hybridization

440

(1)

Use of Fluorescence In Situ Hybridization in the Clinical Laboratory

441

(1)

Blotting Protocols

441

(1)

Southern Blot

441

(1)

Western Blot

441

(1)

Microarrays

442

(1)

Next-Generation Sequencing Technology or Massively Parallel Sequencing

442

(3)

Target Enrichment Strategies

445

(1)

Steps of Next-Generation Sequencing

445

(1)

Molecular Diagnostic Testing Clinical Applications

446

(1)

Infectious Diseases

446

(1)

Molecular Testing in Viral Diseases

446

(2)

Molecular Testing in Bacterial Diseases

448

(1)

Genetic Disorders

448

(1)

Cytogenetics

448

(1)

Molecular Diagnostic Testing in Genetic Disorders

448

(2)

Hematopathology

450

(1)

Myeloid Malignancies

450

(1)

Acute Myelogenous Leukemias

451

(2)

Solid Tumors

453

(1)

Cancer Biomarkers

453

(1)

Molecular Methods of Testing in Cancer

454

(1)

Case Studies

455

(6)

16 Introduction to Medical Microbiology

461

(64)

Introduction to Microorganisms

463

(1)

Prokaryotic and Eukaryotic Cell Differences

464

(1)

Classification of Microorganisms: Taxonomy

464

(1)

Normal Flora (Microbiota)

465

(1)

Pathogenic Microorganisms

466

(1)

Protection of Laboratory Personnel and Good Laboratory Practices

466

(1)

Classification of Biological Agents Based on Hazard to Personnel

466

(1)

General Safety Practices in the Microbiology Laboratory

467

(1)

Disinfection and Sterilization Techniques

468

(1)

Specimens for Microbiological Examination

468

(1)

Specimen Collection Requirements for Culture

469

(1)

Specimen Containers

469

(1)

Transport to the Laboratory

469

(1)

Handling and Storing Specimens in the Laboratory

469

(1)

Types of Microbiology Specimens Collected

470

(1)

Basic Equipment and Techniques Used In Microbiology

471

(1)

Inoculating Needle or Loop

471

(1)

Incinerators

472

(1)

Solid and Liquid Media

472

(1)

Culturing Techniques

472

(1)

Incubators

472

(2)

Identification of Bacteria

474

(1)

Smear Preparation and Stains Used in Microbiology

474

(6)

Bacterial Cultivation

480

(1)

Types of Culture Media

480

(1)

Requirements for Bacterial Cultivation

481

(5)

Biochemical or Enzymatic Tests

486

(3)

Urine Cultures

489

(1)

Collecting the Specimen

489

(1)

Methods for Detection of Urinary Tract Infections

489

(2)

Throat Cultures

491

(1)

Collecting the Specimen

491

(1)

Methods for Detection of Group A β-Hemolytic Streptococci

491

(1)

Genitourinary Cultures

492

(1)

Collecting the Specimen

493

(1)

Methods for Detection of Common Genitourinary Tract Infections

493

(1)

Enteric Disease

494

(1)

Conventional Testing

494

(1)

Mass Spectrophotometry

494

(1)

Molecular Diagnostics

494

(1)

Blood Cultures

495

(1)

Organisms Commonly Isolated from Blood

495

(1)

Collecting the Specimen

496

(1)

Examination of Blood Cultures

496

(1)

Other Methods for the Identification of Bacteremia

497

(1)

Wound or Soft Tissue Cultures

497

(1)

Organisms Commonly Isolated From Wounds or Soft Tissue Infections

497

(1)

Collecting the Specimen

497

(1)

Culture Media for Wound and Tissue Infections

497

(1)

Bacterial Disease

498

(1)

Antimicrobial Susceptibility Tests

498

(5)

Quality Control in The Microbiology Laboratory

503

(1)

Control of Equipment

503

(1)

Control of Media

503

(1)

Control of Reagents and Antisera

503

(1)

Control of Antimicrobial Tests

503

(1)

Control of Specimens, Specimen Collection, and Specimen Rejection

503

(1)

Mycobacteria

503

(1)

Laboratory Studies

503

(1)

Acid-Fast Stain

504

(1)

Acid-Fast Stain Using Kinyoun Carbolfuchsin Method

504

(1)

Tests for Fungi (Mycology)

504

(1)

Characteristics of Fungi

504

(1)

Fungi as Source of Infection

505

(1)

Collection of Specimens for Fungal Studies

505

(1)

Methods for Detection of Fungi

505

(3)

Tests for Parasites (Parasitology)

508

(1)

Parasites as Source of Infection

508

(1)

Collection of Specimens for Parasite Identification

509

(1)

Methods for Detection of Parasites

510

(1)

Common Parasites Identified

510

(4)

Tests for Viruses (Virology)

514

(1)

Characteristics of Viruses

514

(1)

Viruses as a Source of Infection

514

(1)

Collection of Specimens for Viral Identification

515

(1)

Methods for Detection of Viruses

515

(2)

Automation

517

(1)

Specimen Processing

517

(1)

Mass Spectrophotometry (MALDI-TOF)

517

(1)

Case Studies

518

(7)

17 Immunology and Serology

525

(45)

Overview of Immunology and Serology

527

(1)

Antigens and Antibodies

528

(1)

Nature of Antigens

528

(1)

Characteristics of Antibodies

528

(1)

Immune Complexes

529

(1)

Monoclonal and Polyclonal Antibodies

529

(1)

Complement

530

(1)

Acute-Phase Proteins

530

(1)

Overview

530

(2)

Synthesis and Catabolism

532

(1)

C-Reactive Protein

532

(1)

Body Defenses Against Microbial Disease

533

(1)

Microbiota

533

(1)

First Line of Defense

533

(1)

Second Line of Defense: Natural Immunity

533

(1)

Third Line of Defense: Acquired or Adaptive Immunity

533

(2)

Hypersensitivity

535

(1)

What Is Hypersensitivity?

535

(1)

Hypersensitivity Reactions

535

(1)

What Is an Allergy?

536

(1)

Types of Antigens and Reactions

536

(1)

Environmental Substances

537

(1)

Infectious Agents

537

(1)

Self-Antigens

537

(1)

Food Allergies

537

(1)

Cells and Cellular Activities of the Immune System

537

(1)

Role of Granulocytes and Mononuclear Cells: Phagocytosis

537

(1)

Role of Lymphocytes and Plasma Cells

538

(1)

Immunologic Disorders

538

(1)

Primary Immunodeficiency Disorders

538

(1)

Secondary Immunodeficiency Disorders

539

(1)

Principles of Immunologic and Serologic Methods

539

(1)

Principles of Agglutination

539

(1)

Microplate Agglutination Reactions

540

(1)

Immunofluorescent Assays

540

(1)

Other Labeling Techniques

540

(1)

Enzyme Immunoassays

540

(2)

Optical Immunoassays

542

(1)

Molecular Techniques

542

(1)

Specimens for Serology and Immunology

542

(1)

Testing for Antibody Levels

543

(1)

Antibody Titer

543

(1)

Twofold Dilutions

543

(1)

Immunologic and Serologic Testing for Bacterial and Viral Diseases

544

(1)

COVID-19 (SARS-CoV-2 disease)

544

(3)

Lyme Disease

547

(1)

Syphilis

548

(1)

Acquired Immunodeficiency Syndrome

549

(2)

Infectious Mononucleosis

551

(3)

Hepatitis

554

(2)

Autoimmune Disorders

556

(1)

Rheumatoid Arthritis

556

(2)

Systemic Lupus Erythematosus

558

(2)

Celiac Disease

560

(1)

Tumor Biomarkers

560

(1)

Historic Tumor Biomarkers

560

(2)

Categories of Tumor Antigens

562

(1)

Tumor-Specific Antigens

562

(1)

Tumor-Associated Antigens

562

(1)

Carcinofetal Antigens

562

(1)

Spontaneous Tumor Antigens

562

(3)

Case Studies

565

(5)

18 Immunohematology and Transfusion Medicine

570

(44)

Overview of Blood Banking

572

(1)

Benefits and Reasons for Transfusion

573

(1)

Whole Blood, Blood Components, and Derivatives for Transfusion

573

(1)

Whole Blood

573

(2)

Packed Red Blood Cells

575

(1)

Plasma

575

(1)

Platelets

575

(1)

Blood Donation Safety Factors

576

(1)

Blood Donation: Donor Screening, Collection, Storage, and Processing

576

(1)

Donor Screening

576

(1)

Donor Deferral Lists

576

(1)

Quarantine

576

(1)

Blood Testing

576

(1)

Problems and Deficiencies

577

(1)

Blood Donation: Donors, Collection, Storage, and Processing

577

(1)

Requirements by Donation Type

577

(1)

Plateletpheresis and Leukapheresis

577

(1)

Donor Selection and Identification

577

(1)

Common Reasons for Donor Rejection

577

(2)

Collection of Red Blood Cells

579

(1)

Storage of Blood

580

(1)

Blood-Processing Tests

580

(1)

Other Types of Blood Donations

581

(1)

Autologous Transfusions

581

(1)

Directed Transfusions

581

(1)

Antigens and Antibodies in Immunohematology

581

(1)

Red Blood Cell Groups

581

(1)

Inheritance of Red Blood Cell Groups

581

(1)

Isoantibodies and Immune Antibodies

582

(1)

Means of Detecting Antigen--Antibody Reactions

582

(3)

Blood-Banking Techniques

585

(1)

ABO Red Blood Cell Group System

586

(1)

ABO Phenotypes

586

(1)

ABO Genotypes

587

(1)

ABO Typing Procedures

587

(1)

Isoantibodies of ABO System

588

(2)

Universal Donors and Recipients

590

(1)

Rh Red Blood Cell Group System

591

(1)

Historical Background

591

(1)

Definition of Rh Antigens and Inheritance

591

(1)

Characteristics of Rh Antigens

592

(1)

Characteristics of Rh Antibodies

592

(1)

Types of Rh Typing Reagents (Antisera)

592

(1)

Typing Blood for Transfusion

593

(1)

Other Blood Group Systems

594

(1)

Antihuman Globulin Reaction

594

(1)

Preparation and Nature of Antihuman Globulin Reagent

595

(1)

Antihuman Globulin Test Procedures

595

(1)

Compatibility Testing: Definition and General Considerations

595

(1)

ABO and Rh Typing of Donor and Recipient

596

(1)

Clinically Significant Antibody Screening and Identification

596

(1)

Crossmatching

597

(2)

Molecular-Based Transfusion Testing

599

(1)

Benefits and Applications

599

(1)

Molecular-Based Testing Methods

600

(3)

Adverse Effects of Transfusion

603

(1)

Immediate Immunologic Adverse Reactions

603

(1)

Immediate Nonimmunologic Adverse Reactions

604

(1)

Other Severe Adverse Reactions

604

(1)

Hemolytic Disease of the Fetus and Newborn

604

(1)

Pathophysiology

604

(1)

ABO Antigens

605

(1)

Rh Antigens

605

(1)

Routine Laboratory Prenatal and Postnatal Testing

605

(1)

Treatment

606

(1)

Prevention of Rh Immunization

606

(2)

Automated Testing Technology and Systems

608

(1)

Gel Technology

608

(1)

Automated Solid-Phase Red Cell Adherence Assays

608

(1)

Case Studies

609

(5)

Appendix A Answers to Review Questions and Case Studies

614

(9)

Appendix B AMA Recognized Disease/Organ Panels

623

(3)

Appendix C Periodic Table

626

(1)

Appendix D Overview of COVID-19

627

(3)

Appendix E Molecular Testing Methods

630

(3)

Appendix F Quick Calculations and Adult Reference Values

633

(5)

Glossary

638

(17)

Index

655

Mary Louise Turgeon, EdD, MLS(ASCP)CM, is an educator, author, and consultant in medical laboratory science education. Her career includes roles as a community college professor, Medical Laboratory Technology program director, undergraduate and graduate university professor, Medical Laboratory Science program director, and departmental chairperson. Dr. Turgeon is currently an ad hoc educational content specialist for the College of Professional Studies, Northeastern University, Boston, and maintains an active clinical laboratory science consulting practice. Her practice, Mary L. Turgeon and Associates, focuses on new program development, curriculum revision, and increasing teaching effectiveness through the use of technology and interactive teaching strategies.

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