CREATED BY: GROUP 4

SECTIONS OF THE
CLINICAL LABORATORY
 A clinical laboratory is made up of different sections cohesively
and comprehensively performing different activities and
procedures for each specimen collected from patients to produce
reliable test results. At the forefront of theses activities are the
clinical laboratory personnel, namely the pathologists, medical
technologists/clinical laboratory scientists, medical technicians,
phlebotomists, and other laboratory personnel.
CLINICAL This section is intended for the testing of

CHEMISTRY
blood and other body fluids to quantify
essential soluble chemicals including
waste products useful for the diagnosis
of certain diseases. Blood and urine are
the two most common body fluids
subjected for analysis in this section.

In terms of the number of tests

performed, this section is considered
to be one of the busiest. In majority of
tertiary-level clinical laboratories, this
section is characterized as a state-of-
the-art, fully automated facility.
AUTOMATED ANALYZER

VACUTAINER TUBES
 IMPORTANCE OF CLINICAL
CHEMISTRY

PROVIDES THE BASES FOR DIAGNOSTIC, PROGNOSTIC,

FORENSIC AND DRUG MONITORING

POINTS OUT SPECIAL AREAS OF INTEREST IN HUMAN

HEALTH AND INDICATORS OF IMPENDING DISEASES

INSTRUMENTATION MADE LABORATORY TESTING MORE

EFFICIENT AND PRODUCTIVE WITH REDUCED TURN
AROUND TIME
 DISEASES DIAGNOSED
USING CLINICAL CHEMISTRY EXAMPLES TESTS PERFORMED
Fasting Blood Sugar (FBS) and
Cardiac failure
Glycosylated Hemoglobin (HbA1c)
Liver Cirrhosis
Cholesterol testing (HDL and LDL)
Cancer Triglycerides (TAG)
Acute liver failure Blood Uric Acid (BUA)
Alcoholic liver disease Blood Urea Nitrogen (BUN):
Renal failure Creatinine
Hepatitis Electrolytes
Meningitis Total Protein (TP)
Hormone imbalance Albumin
Clinical Enzymology
MICROBIOLOGY
The work in this section is more focused on the
identification of bacteria and fungi on specimens received.
Specimens usually submitted are blood and other body
fluids, stool, tissues, and swabs from different sites in the
body.

FOUR SECTIONS OF MICROBIOLOGY

1. Bacteriology- is the branch and specialty of biology

that studies the morphology, ecology, genetics and
biochemistry of bacteria as well as many other aspects
related to them.
2. Mycobacteriology- is a branch of microbiology that focuses
on the study of Mycobacterium species. This group includes
important pathogens like Mycobacterium tuberculosis, which
causes tuberculosis, and Mycobacterium leprae, which causes
leprosy.

3. Mycology- is the branch of biology that studies fungi,

including their genetic and biochemical properties, taxonomy,
and uses to humans. (Yeast, molds, mushrooms)

4. Virology- is the scientific study of viruses, including their

molecular biology, structure, interactions with hosts, and the
diseases they cause.
MICROBIOLOGY
Tests include the microscopic visualization of microorganisms after
staining, isolation, and identification of bacteria (aerobes and
anaerobes) and fungi using varied culture media and different
biochemical tests, and at times, antigen typing, and antibacterial
susceptibility testing.

Other activities performed in this section include the preparation of

culture media and stains, quality assurance and control, infection
control, and biosafety and proper waste disposal. Mycobacteriology
looks into the identification of mycobacterium (e.g., Mycobacterium
tuberculosis) from the specimens submitted. Although not as
automated as clinical chemistry, automated instruments are
available such as those used for blood culture and antimicrobial
susceptibility testing.
 BLOOD
ANAEROBIC GLASS JAR CULTURE MEDIA
 HEMATOLOGY AND
COAGULATION STUDIES

This section deals with the enumeration of

cells in the blood and other body fluids
There are also developments and
(e.g., CSF, pleural fluid, etc.).
innovations that contribute to the
The examinations done in this section automation of activities in this
include complete blood count (CBC), section.
hemoglobin, hematocrit, WBC differential
count, red cell morphology and cell indices, Automated hematology analyzers
quantitative platelet count, total cell count are currently available in the
and differential count, blood smear market. Bone marrow examination
preparation, and staining for other body
using automated analyzers is also
fluids. Coagulation studies focus on blood
conducted in this section.
testing for the determination of various
coagulation factors.
BLOOD SMEAR PREPARATION
 CLINICAL Is a branch of medical technology that focuses on
the microscopic examination of bodily fluids, such

MICROSCOPY as urine, semen, and stool, to identify and analyze

various components and abnormalities. There are
two major areas in this section.

The first area focuses on urine analysis. This includes

macroscopic examinations (color, transparency,
specific gravity, pH level) and microscopic
examinations to detect abnormal cells, parasites, and
quantify red blood cells and white blood cells.

The second area focuses on stool analysis. This

includes routine fecal analysis, with the primary
activities being the detection and identification of
parasitic worms and ova (eggs).
BLOOD BANK/ IMMUNOHEMATOLOGY
Is an area of laboratory medicine that involves the preparation of
blood and blood components for transfusion as well as the selection
and monitoring of those components following transfusion.

Blood typing and compatibility testing are the two main activities
performed in this section. Screening for all antibodies and
identification of antibodies as well as the blood components used for
transfusion are also conducted in this section. This section is
considered as the most critical in the clinical laboratory.

In hospital-based clinical laboratories, blood donation activities

prompt other activities such as donor recruitment and screening,
bleeding of donor, and post-donation care.
IMMUNOLOGY AND SEROLOGY
In the Immunology and Serology section, serum antibody
analyses for specific infectious agents, mainly viruses,
are conducted.

Examples of tests include Hepatitis B profile tests,

serological tests for syphilis, and screenings for
hepatitis C and dengue fever.

Automated analyzers, like those used in Clinical

Chemistry and Hematology sections, are commonly used
in this section when performing different serological
tests.
 HISTOPATHOLOGY/CYTOLOGY
WHAT IS HISTOPATHOLOGY WHAT IS CYTOLOGY
The study of tissues to diagnose diseases by The study of cells to diagnose disease by
examining the architecture of the tissue.
examining individual cells or clusters of
Histopathology involves preparing a tissue sample by
preserving, slicing, and staining it with dyes. The cells. Cytology is usually painless
tissue is then examined under a microscope to identify because only a small sample of cells is
diseases such as cancer, infections, and inflammatory needed for examination.
conditions.

Both histopathology and cytology are used to diagnose and stage cancer, and to
assess the extent of the disease. Histopathology provides more information about the
tissue than cytology.

Activities performed in this section include tissue (removed surgically as in biopsy

and autopsy) processing, cutting into sections, staining, and preparation for
microscopic examination by a pathologist.
SPECIALIZED SECTIONS
OF THE LABORATORY
IMMUNOHISTOCHEMISTRY (IHC)

It is a specialized section of the laboratory

that combines anatomical, clinical, and
biochemical techniques where antibodies
(monoclonal and polyclonal) bounded to
enzymes and fluorescent dyes are used to This is useful in the diagnosis of some
detect presence of antigens in tissue. types of cancers by detecting the presence
of tumor-specific antigens, oncogenes, and
tumor suppressor genes. It can also be
used to assess the responses of patients to
cancer therapy as well as diagnosis of
certain neurodegenerative disorders.
 MOLECULAR BIOLOGY AND
BIOTECHNOLOGY
This area of medicine focuses on using the tools of molecular biology and
biotechnology to detect and analyze biological molecules, primarily using
different enzymes and other reagents, DNA and RNA are identified and
sequenced to detect any pathologic conditions/disease for diagnostic
purposes. This approach offers unparalleled precision and sensitivity
compared to traditional methods.

The most common technique currently in use is the POLYMERASE

CHAIN REACTION (PCR). This technique has contributed to
scientific advancements in laboratory research and is useful for a
number of clinical techniques such as screening genetic indicators
of disease and diagnosis cancer and infectious diseases.
LABORATORY TESTING CYCLE

The laboratory testing cycle encompasses all

activities starting from a medical doctor writing
a laboratory request up to the time (called the
turnaround time [TAT]) the results are
generated and become useful information for
the treatment and management of patients.
This cycle has three phases.
 3 PHASES OF LAB TESTING CYCLE

1. ) PRE-ANALYTIC PHASE includes the

receipt of the laboratory request, patient
preparation, specimen collection, and
proper transport and processing of
specimen to the clinical laboratory.

2.) ANALYTIC PHASE deals with the 3.) POST-ANALYTIC PHASE includes the
actual testing of the submitted/collected transmission of test results to the medical
doctor for interpretation, TAT, and application
specimen. Important consideration
of doctor's recommendations. The diagnosis
should be given to equipment and
and treatment are based on the generated
instruments used, reagents, and internal
data.
quality control program.
 PRE-ANALYTIC PHASE
Laboratory test requisition /order

POST-
Order reception ANALYTIC PHASE
Data
transmission/interpretation
Patient preparation Results application
Specimen collection TAT

Specimen transport Actual testing

and processing
ANALYTIC PHASE
 QUALITY ASSURANCE IN THE
CLINICAL LABORATORY
Quality assurance (QA) encompasses all activities performed by
laboratory personnel to ensure reliability of test results. It is
organized, systematic, well-planned, and regularly done with the
results properly documented and consistently reviewed.

2 MAJOR COMPONENTS:

1. ) Internal Quality Assurance System (IQAS) includes day-to-

day activities that are undertaken in order to control factors
or variables that may affect test results. Regular review and
audit of results are done in order to identify weaknesses and
consequently perform corrective actions/EQAS.
2.) External Quality Assurance System (EQAS) is a system for
checking performance among clinical laboratories and is
facilitated by designated external agencies.

Quality assurance includes monitoring and controlling

the competence of personnel,
quality of materials,
methods, reagents and instruments,
and the reliable reporting of test results
The National Reference Laboratories (NRL) is the DOH-designated EQAS. An
unknown sample with known test results is regularly sent to a clinical
laboratory for testing. Results are then returned to the external facility and are
compared with the known result. This procedure determines the performance
of the laboratory. A certificate of performance is given to the participating
clinical laboratory.
At present, the designated NRL-EQAS are the following:

National Kidney and Transplant Institute (NKTI) - Hematology and Coagulation

Research Institute of Tropical Medicine (RITM) - Microbiology (identification and

antibiotic susceptibility testing) and Parasitology (identification of ova and
quantitation of malaria)

Lung Center of the Philippines (LCP) - Clinical Chemistry (for testing 10 analytes,
namely glucose, creatinine, total protein, albumin, blood urea nitrogen, uric acid,
cholesterol, sodium, potassium, and chloride)

East Avenue Medical Center (EAMC) - Drugs of abuse (methamphetamine and

cannabinoids)

San Lazaro Hospital STD-AIDS Cooperative Center Laboratory (SACCL) - Infectious

immunology hepatitis B surface antigen (HBsAg), human immunodeficiency virus
(HIV), hepatitis C virus (HCV)
 THANK YOU FOR
YOUR ATTENTION