RAPHC CPD COURSE FULL

Many accidents in the Lab do not just happen; they are caused by carelessness, lack of attention to detail, or lack of proper communication. Most laboratory accidents are preventable by exercising good technique, staying alert, and using common sense.

Quality can be defined as the worth of services. Six Sigma and Lean define the components critical to quality as the key measurable characteristics of a product or process whose performance requirements or specification limits must be met to satisfy the customer. Quality and safety are of the utmost importance in a clinical laboratory.

This lesson introduces the generic analytic methods used in many areas of the clinical laboratory—the binding of antibody (Ab) to antigen (Ag) for the specific and sensitive detection of an analyte. The Ag–Ab interactions may involve unlabeled reactants in less analytically sensitive techniques or a labeled reactant in more sensitive techniques.

Precipitation and agglutination are unlabeled immunoassays. These assay methods produce a visible expression of the aggregation of antigens and antibodies.

Precipitation and agglutination are unlabeled immunoassays. These assay methods produce a visible expression of the aggregation of antigens and antibodies. Precipitation is the term for the aggregation of soluble test antigens. Precipitation is the combination of soluble antigen with soluble antibody to produce a visible insoluble complex. Agglutination is the process whereby specific antigens (e.g., RBCs) aggregate to form larger visible clumps when the corresponding specific antibody is present in the serum. The IgM class of antibodies is the best at agglutination and precipitation.

The term hepatitis refers to inflammation of the liver.

Viral hepatitis is the most common liver disease worldwide. The viral agents of acute hepatitis can be divided into two major groups, as follows:

• Primary hepatitis viruses: A, B, C, D, E, and G

• Secondary hepatitis viruses: EBV, CMV, herpesvirus, and others

As a clinical disease, hepatitis can occur in acute or chronic forms. The signs and symptoms of hepatitis are extremely variable. It can be mild, transient, and completely asymptomatic, or it can be severe, prolonged, and ultimately fatal. Many fatalities are attributed to hepatocellular carcinoma, of which hepatitis viruses B and C are the primary causes. The course of viral hepatitis can take one of four forms: acute, fulminant acute, sub-clinical without jaundice, and chronic

AIDS is the best-known immunodeficiency. Patients with AIDS exhibit some of the most severe manifestations of cell-mediated immunity.

AIDS is the best-known immunodeficiency. Patients with AIDS exhibit some of the most severe manifestations of cell-mediated immunity

A major goal of the microbiology laboratory is to aid in the diagnosis of infectious diseases. Appropriate specimen selection, collection, and transportation are critical if laboratory results are used to provide information that establishes a diagnosis and successful treatment.

This lesson introduces the concepts of specimen collection and processing. The steps to ensuring specimen quality and the steps that follow specimen receipt in completing the processing for microbiology workup.

Generally, the colonial morphology is observed after 18 to 24 hours of incubation. Many specimens, such as sputum and wounds that arrive in the clinical laboratory, are plated on various culture media such as BAP, CHOC, and MAC. Each type of agar plate is examined in relationship to the other.

Antimicrobial susceptibility testing (AST) is performed on bacteria isolated from clinical specimens to determine which antimicrobial agents might be effective in treating infections caused by the bacteria. Only bacteria that are likely to be contributing to an infection should be tested.

Susceptibility testing is usually performed by a disk diffusion or dilution (minimal inhibitory concentration) method.

Among bacteria, there is great diversity in the ability to use carbohydrates; however, determining lactose utilization is the most important.

Lactose degradation can be used to differentiate bacterial species able to ferment lactose (lactose fermenters [LFs]) from species that are NLFs.

Formalin can be used when a wet mount or concentration procedure (sedimentation or flotation) will be performed. The fixative sodium acetate–acetic acid–formalin (SAF) can be used for the preservation of fecal specimens when concentration procedures and permanent stains will be used. Vials of merthiolate-iodine-formalin (MIF) can also be used to preserve trophozoites, cysts, larvae, and helminth eggs for wet mount or concentration procedures. This preservative, however, is not routinely used for permanently stained smears.

Plasmodium spp., which cause malaria, remain endemic throughout the world in tropical and subtropical countries. Plasmodium vivax, Plasmodium ovale, Plasmodium malariae, and Plasmodium falciparum are the causative agents of human malaria. In general, infections caused by P. vivax, P. ovale, and P. malariae are less severe than those caused by P. falciparum. A fifth species, Plasmodium knowlesi, which causes malaria in the macaque monkey, has also been implicated in cases of zoonotic human malaria in Malaysia and the Philippines.

Babesiosis is a zoonotic intraerythrocytic infection transmitted by the bite of a tick. Although Babesia microti and B. Babesia hominis, have been reported to infect humans, B. microti is the most common. The hard tick (Ixodes spp.) serves as the vector, and white-footed mice and white-tailed deer are the reservoirs. There also have been simultaneous transmission of B. microti and Borrelia burgdorferi (the causative agent of Lyme disease) because these two organisms use the same tick vector.

Pretransfusion testing is the use of serologic principles and tests to ensure compatibility and prevent an IMHTRs

Pretransfusion testing is the use of serologic principles and tests to ensure compatibility and prevent an immune-mediated hemolytic transfusion reaction.

Depending on the collection system used, a whole blood component typically contains either 450 mL (±10%) of whole blood with 63 mL of anticoagulant-preservative or 500 mL (±10%) of whole blood with 70 mL of anticoagulant preservative, collected from blood donors with a minimum hematocrit of 38%. 

Whole blood must be stored at 1° to 6°C, and the shelf life is dependent on the anticoagulant used.

Whole blood collected in ACD-A, CPD), or (CP2D) has a shelf life of 21 days; Whole blood collected in CPDA-1 has a shelf life of 35 days.

Mycobacteria are slender, slightly curved or straight, rod-shaped organisms. They are nonmotile and do not form spores. The cell wall has extremely high lipid content; thus, mycobacterial cells resist staining with Gram stain, at RT. Mycobacteria take up dye with increased staining time or application of heat but resist decolorization with acid-ethanol. This characteristic is referred to as “acid fastness”— hence, the term AFB.

Mycobacteria are strictly aerobic, but increased CO2 will enhance the growth of some species. Most pathogenic mycobacteria require 2 to 6 weeks of incubation on complex media at specific optimal temperatures. The rapidly growing species generally grow on simple media in 2 to 3 days at temperatures of 20°C to 40°C. M. leprae, fails to grow in vitro.

Enzymes catalyze physiologic reactions by lowering the activation energy level that the reactants (substrates) must reach for the reaction to occur.

Clinically significant enzymes are: (Oxidoreductases, Transferases, Hydrolases, Lyases, Isomerases, Ligases.

An acid is a substance that can donate hydrogen ions (H⁺) when dissolved in water. A base is a substance that can accept hydrogen ions. pH of a solution is defined as the negative log of the hydrogen ion conc.

Toxicology is the study of the adverse effects of xenobiotics in humans. Xenobiotics are chemicals and drugs that are not normally found in or produced by the body. Poisons are also exogenous agents mainly from an animal, plant, mineral, or gas that have an adverse effect on a biological system. Toxins are endogenous substances biologically synthesized either in living cells or in microorganisms. Examples include botulinum toxin produced from Clostridium botulinum, hemotoxins produced from venomous snakes, and mycotoxins produced from fungus. 

Even though use of brightfield microscopy predominates despite its difficulty in identifying low-refractile entities, phase-contrast microscopy and supravital stains are strongly recommended in the urinalysis testing area.

Urinary casts are formed in the distal and collecting tubules with a core matrix of uromodulin (formerly known as Tamm-Horsfall protein) that is secreted by the renal tubular cells of the ascending loop of Henle and by the distal convoluted tubules; and its traps and enmeshes formed and chemical element in concentrated urine.

Crystals result from the precipitation of urine solutes out of solution. They are not normally present in freshly voided urine but form depending on storage.  When are present in freshly voided urine, they are always clinically significant.

Regardless of the crystal type, crystal formation within the nephrons can cause significant tubular damage. Although most crystals are not clinically significant

Amniotic fluid is the liquid medium that bathes a fetus throughout its gestation. Amniotic fluid protects the fetus while enabling fetal movement and plays an important role in numerous biochemical processes. Fetal cells and many biochemical compounds, such as electrolytes, nitrogenous compounds, proteins, enzymes, lipids, and hormones, are present in the amniotic fluid.

The study of amniotic fluid is performed primarily for three reasons: (1) to enable antenatal diagnosis of genetic and congenital disorders early in fetal gestation (15 to 18 weeks), (2) to assess fetal pulmonary maturity later in the pregnancy (32 to 42 weeks), and (3) to estimate and monitor the degree of fetal anemia caused by isoimmunization or infection.

Seminal fluid, or semen, is a complex body fluid used to transport sperm or spermatozoa. It is analyzed routinely to evaluate infertility and to follow up after a vasectomy to ensure its effectiveness. Other reasons for analysis include the evaluation of semen quality for donation purposes and forensic applications (e.g., DNA analysis, detection of semen).

Arthritis and other joint diseases are common, and synovial fluid analysis assists in the diagnosis and classification into one of four categories: noninflammatory, inflammatory, septic, or hemorrhagic. 

Arthritis and other joint diseases are common, and synovial fluid analysis assists in the diagnosis and classification into one of four categories: noninflammatory, inflammatory, septic, or hemorrhagic. A definitive diagnosis is possible when microorganisms are identified (septic arthritis) or crystals are present (crystal synovitis) in the synovial fluid.

Normally, serous fluids do not contain blood or fibrinogen, but a traumatic puncture or hemorrhage can result in bloody and clotted fluid

CSF bathes the brain and spinal cord, protects and supports the brain and spinal cord and provides a medium for the transport and exchange of nutrients and metabolic wastes.

As CSF is collected, it is dispensed into three (or more) sequentially labeled sterile collection tubes. The first tube is used for chemical and immunologic testing, the second tube is used for microbial testing, and the third tube is reserved for the microscopic examination of cellular components (i.e., red and white blood cell counts and cytologic studies). 

Examination of feces provides important information that aids in the differential diagnosis of various gastrointestinal tract disorders, which range from maldigestion and malabsorption to bleeding or infestation by bacteria, viruses, or parasites; hepatic, biliary conditions as well as pancreatic diseases that cause insufficient digestive enzymes.

Examination of feces provides important information that aids in the differential diagnosis of various gastrointestinal tract disorders, which range from maldigestion and malabsorption to bleeding or infestation by bacteria, viruses, or parasites; hepatic, biliary conditions as well as pancreatic diseases that cause insufficient digestive enzymes.

By far occult, or hidden, blood test the commonly chemical test for performed on feces. Occult blood is recognized as the earliest and initial symptom of colorectal cancer. It is recommended to be performed routinely on all individuals 50 years of age and older.

Fecal analysis is also valuable for determining the presence of increased fecal lipids (steatorrhea) and in the differential diagnosis of diarrhea.

This CPD Final test is intended to assess CPD courses taker for their eligibility to obtain CPD points which enable them to renew their practicing licenses. The CPD course package is tailored according to the current and acceptable standards of Laboratory practice. Apart from text lessons prepared for you, you will also benefit from recorded lectures just next to each text content to make sure that you understand the concepts not just with reading but also with listening to and taking notes of explanations provided. Questions undertaken are prepared from the course content and you need to read the whole content to be able to pass the set questions. Let's together improve and strengthen Laboratory practices in our country for the safety of our patients. Good luck. Polycarpe Nkundayezu MLS, ASCPi International MLS, Certified by the American Society for Clinical Pathology. TriumphClass principal instructor.