Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5543_Библиотеки_им_академика_М_И_Перельмана.pdf
X
- •Foreword
- •Preface to the Fourth Edition
- •Preface to the Third Edition
- •Contributors
- •Commonly Used Abbreviations in Medical Laboratories
- •Contents
- •Healthcare in India
- •Clinical Laboratories and Laboratory Personnel in India
- •1. Human Health and Clinical Diagnosis in Developing Countries
- •Human Body in Health and Disease
- •Medical Care in India
- •Status of Medical Laboratories in Developing Countries
- •Commonly Requested Laboratory Tests in India and Other Developing Countries
- •Review Questions
- •2. Introduction to Clinical Laboratories
- •Introduction to Clinical Laboratories
- •Organization of Clinical Laboratories
- •Ethics and Laboratory Medicine
- •Automation in Clinical Laboratories
- •Review Questions
- •3. Laboratory Safety and First Aid
- •Clinical Laboratory Environment
- •Laboratory Safety Policies
- •Radiation Hazard
- •Fire Hazard and Explosion
- •Specialized Equipment
- •Laboratory Hygiene and Housekeeping
- •Personal Safety of Laboratory Workers
- •Warning Signs
- •Accident Record and Training
- •First Aid Kits and Procedures
- •Poisoning with Strong Acids and Caustic Alkalis
- •Guide to Standard Precautions
- •Review Questions
- •4. Introduction to Laboratory Equipment and Basic Laboratory Operations
- •Overview
- •Identification and Use of Common Laboratory Glassware and Equipment
- •Use and Care of Laboratory Glassware and Plastic Ware
- •Techniques of Simple Laboratory Operation
- •Storage, Handling and Preparation of Laboratory Reagents
- •Techniques for Heating a Liquid in a Test Tube
- •Graphical Presentation of Data
- •Use and Care of Common Laboratory Instruments
- •Laboratory Water
- •Water for Human Consumption
- •Common Laboratory Equipment
- •Special Laboratory Equipment
- •Review Questions
- •5. Specimen Handling and Laboratory Records
- •Overview
- •Collection and Pre-Analytical Handling of Specimens
- •Procedures for Common Laboratory Specimens
- •Reporting of Laboratory Results
- •Discarding Specimens after Use
- •Clinical Laboratory Records
- •Review Questions
- •International System of Measurement: The Metric System
- •Units of Measurement
- •Preparation of Reagent Solutions
- •Laboratory Calculations
- •Review Questions
- •7. Good Laboratory Practices and Statistical Quality Control
- •Sources of Common Errors in Laboratory
- •Proficiency Testing
- •Statistical Quality Control of Quantitative Data
- •Basic Statistics
- •Summary
- •Review Questions
- •8. Introduction to Haematology
- •Introduction
- •Components of Blood and Their Functions
- •Haematopoietic System of the Body
- •Review Questions
- •9. Basic Laboratory Procedures in Haematology
- •Overview
- •Collection and Processing of Blood Specimen
- •Preparation of Blood Films
- •Cleaning of Laboratory Glassware in Haematology
- •Review Questions
- •10. Routine Haematological Tests
- •Determination of Haemoglobin Concentration
- •Determination of Haematocrit
- •Red Blood Cell Indices
- •Interpretation of Abnormal Findings
- •Erythrocyte Sedimentation Rate (ESR)
- •Enumeration of Formed Elements
- •Microscopic Study of Blood Smear
- •Automated Systems in Haematology
- •Reticulocyte Count
- •Absolute Platelet Count
- •Review Questions
- •Laboratory Diagnosis of Haemoglobinopathies
- •Screening Test for Sickle Cell Anaemia
- •Laboratory Diagnosis of Blood Parasite Infection
- •Miscellaneous Disorders
- •Review Questions
- •Review Questions
- •12. Interpretation of Laboratory Findings in Haematology
- •Overview
- •Anaemias
- •Leukaemias
- •13. Introduction to Haemostasis and Haemostatic Disorders
- •Haemostasis (Stoppage of Bleeding)
- •Mechanism of Blood Coagulation
- •Fibrinolysis
- •Disorders of Haemostasis
- •Control Mechanisms of Haemostasis
- •Laboratory Tests for Haemostatic Function
- •Review Questions
- •14. Laboratory Investigation of Bleeding Disorders
- •Basic Screening Tests for Bleeding Disorders
- •Coagulation Tests
- •Determination of Activated Partial Thromboplastin Time
- •Rapid Haemostatic Tests and Point-of-Care Instruments
- •Tests for Fibrin Degradation Products (FDP) or D-Dimer
- •Protamine Sulphate Test
- •Laboratory Diagnosis of Bleeding Disorders
- •Therapy of Bleeding Disorders
- •Review Questions
- •15. Introduction to Blood Transfusion Therapy
- •Basic Concepts of Immunology and Immunohaematology
- •Discovery of Basic Human Blood Groups (ABO)
- •Principles of Immunohaematology
- •Red Cell Antigens
- •Recognition of Immunologic Reactions of Red Cells
- •Laboratory Methods in Detecting Antibodies
- •Human Blood Group Systems
- •Basic Blood Group System: ABO
- •Rhesus (Rh) Blood Group System and Immune Antibodies
- •Other Blood Group Systems
- •Pretransfusion Testing
- •Antibody Screen
- •Compatible Blood Groups
- •Review Questions
- •16. Collection and Processing of Blood for Transfusion
- •Selection of Blood Donors
- •Method of Blood Collection
- •Transportation of Blood After Collection
- •Storage of Blood
- •Common Equipment in a Blood Bank
- •Reagents
- •Preparation of Blood Components
- •Autotransfusion
- •Plasmapheresis
- •Transportation of Blood
- •Delivery of Blood and Blood Components to Clinical Areas
- •Review Questions
- •17. Routine Laboratory Procedures in Blood Bank
- •Significance of Quality Control in Blood Bank
- •Specimen Collection for Blood Bank
- •General Laboratory Preparations in Blood Bank
- •Preparation of Laboratory Reagents in Blood Bank
- •Reporting of Haemagglutination Reaction
- •ABO Blood Grouping
- •Rh Blood Typing
- •Antihuman Globulin (AHG) or Coombs’ Test
- •Major Cross-Match
- •Antibody Screening Test
- •Identification of Unexpected Antibodies
- •Titration of Anti-D
- •Review Questions
- •18. Blood Transfusion Services and Clinical Approach to Haemolytic Disease of the Newborn
- •Introduction to Blood Transfusion Services
- •Pretransfusion Testing
- •Release of Blood for Transfusion
- •Blood Transfusion Therapy
- •Transfusion Reactions
- •Haemolytic Disease of the Foetus and/or Newborn
- •Review Questions
- •Laboratory Information Systems

Preface to the Third Edition
In the last 27 years, since the publication of the first edition of Medical Laboratory Technology, many
changes in the field of laboratory medicine have occurred. Although some of these updates were included
in our second edition (2010), we felt that the time has come for a thorough revision, and thus we bring forth
the current edition.
When I look back, at my age of ninety, I can see how far medical technology has come through these
years. I could never forget the limited facilities I had for teaching science in India early in my career. It
was only after I moved to the United States that I was exposed to advanced medical laboratory education.
After gaining years of teaching experience on the subject here, I felt compelled to share what I learned
with my people whom I had left behind. Endless support came from my new friends in the United States
as well as in India with whom I worked during my tenure as a Fulbright Professor to lecture on Medical
Laboratory Technology across India. The best support was from the readers and academic institutions of
developing countries, who honoured our honest efforts. This would have not been possible without the help
from numerous doctors from rural and urban regions of India and people who were associated with the most
advanced laboratories in the United States. Thus the book stands as a model of collaboration in the field of
medical technology between those who truly understand the needs of the developing world and those who
have the knowledge of the developed world. I acknowledge with a deep sense of gratitude, my friends,
colleagues, students and members of my own family who have contributed to this bold endeavour.
As I worked with two dozen young authors in this edition, I could feel their motivation and eagerness to
share their hard-earned experience with new students, no matter how far away they may be in the world. As
they worked with me, they inspired me at every step and I felt young again. We, as a team, kept in mind that
the economic condition of developing countries will not permit the clinical laboratories to run on par with
advanced laboratories. Yet, the needs of the sick must be addressed and a doctor needs accurate laboratory
information to make the correct diagnosis. Hence, the laboratories of developing countries, including
those located far away from urban centres, have to operate on a limited budget and depend on resourceful,
knowledgeable laboratory technologists, who may have limited training or education.
Unfortunately, as I have observed, there remains a significant lack of professionalism in the clinical
laboratories of many developing countries. This has resulted in unreliable laboratory reports that can then
lead to wrong diagnoses, and as a result, unnecessary illness and death. A firm understanding of the critical
role of laboratories in alleviating human suffering may help increase the care and diligence with which
laboratory technicians perform their jobs. I hope and pray that this book can help make that change.
Kanai L Mukherjее
Professor Emeritus
Fulbright Visiting Professor to India (1983-1984)
Essex Community College,

Contents
Foreword vii
Preface to the Fourth Edition ix
Preface to the Third Edition x
Contributors xvii
Commonly Used Abbreviations in Medical Laboratories xix
SECTION 1: INTRODUCTION
1. Human Health and Clinical Diagnosis in Developing Countries 3
Kanai L Mukheriee, Swarajit Ghosh and Chhotelaal Pande
Human Body in Health and Disease 3
Medical Care in India 4
Healthcare in India 6
Clinical Laboratories and Laboratory Personnel in India 7
Status of Medical Laboratories in Developing Countries 11
Commonly Requested Laboratory Tests in India and Other Developing Countries 12
Review Questions 14
2. Introduction to Clinical Laboratories 16
Ashoke Khanwalkar and Chhotelaal Pande
Introduction to Clinical Laboratories 16
Organization of Clinical Laboratories 17
Ethics and Laboratory Medicine 24
Automation in Clinical Laboratories 25
Review Questions 28
3. Laboratory Safety and First Aid 29
Monisha Bhatia
Clinical Laboratory Environment 30
Laboratory Safety Policies 30
Biohazard and Safety Precautions 37
Radiation Hazard 40
Fire Hazard and Explosion 40
Specialized Equipment 43
Laboratory Hygiene and Housekeeping 45
Personal Safety of Laboratory Workers 45
Warning Signs 47
Accident Record and Training 47
First Aid Kits and Procedures 48
Poisoning with Strong Acids and Caustic Alkalis 51
Guide to Standard Precautions 53
Review Questions 53

xii
Medical Laboratory Technology: Volume I
4. Introduction to Laboratory Equipment and Basic Laboratory Operations 54
Kanai L Mukherjee and Piyali Basu
Overview 55
Identification and Use of Common Laboratory Glassware and Equipment 55
Use and Care of Laboratory Glassware and Plastic Ware 58
Techniques of Simple Laboratory Operation 59
Storage, Handling and Preparation of Laboratory Reagents 87
Techniques for Heating a Liquid in a Test Tube 92
Graphical Presentation of Data 93
Use and Care of Common Laboratory Instruments 95
Laboratory Water 122
Water for Human Consumption 127
Common Laboratory Equipment 129
Special Laboratory Equipment 132
Review Questions 139
5. Specimen Handling and Laboratory Records 140
Chhotelaal Pande, Anant Kumar Pandey
Overview 141
Collection and Pre-Analytical Handling of Specimens 141
Procedures for Common Laboratory Specimens 145
Mailing Laboratory Specimen 170
Reporting of Laboratory Results 171
Discarding Specimens after Use 174
Clinical Laboratory Records 174
Review Questions 180
Appendix: Sample Copies of Laboratory Forms and Records 182
6. Units of Measurement and Preparation of Reagent Solutions 196
Tara Chattoraj
International System of Measurement: The Metric System 196
Units of Measurement 198
Preparation of Reagent Solutions 203
Laboratory Calculations 207
Review Questions 210
7. Good Laboratory Practices and Statistical Quality Control 212
Aloka Chakravarty
Sources of Common Errors in Laboratory 213
Proficiency Testing 214
Statistical Quality Control of Quantitative Data 218
Basic Statistics 218
Summary 226
Review Questions 226
SECTION 2: HAEMATOLOGY AND COAGULATION
8. Introduction to Haematology 229
Anuradha Chakravarthy
Introduction 229
Components of Blood and Their Functions 230
Haematopoietic System of the Body 232
Review Questions 235

Contents
xiii
9. Basic Laboratory Procedures in Haematology 236
Anuradha Chakravarthy
Overview 236
Collection and Processing of Blood Specimen 236
Preparation of Blood Films 238
Cleaning of Laboratory Glassware in Haematology 241
Review Questions 241
10. Routine Haematological Tests 242
Anuradha Chakravarthy and Volkmar Dierolf
Determination of Haemoglobin Concentration 243
Determination of Haematocrit 252
Red Blood Cell Indices 258
Interpretation of Abnormal Findings 261
Erythrocyte Sedimentation Rate (ESR) 262
Enumeration of Formed Elements 266
Microscopic Study of Blood Smear 271
Automated Systems in Haematology 292
Reticulocyte Count 296
Absolute Platelet Count 300
Review Questions 304
11. Special Haematological Test 306
Anuradha Chakravarthy
Laboratory Diagnosis of Haemoglobinopathies 306
Screening Test for Sickle Cell Anaemia 307
Laboratory Diagnosis of Blood Parasite Infection 313
Review Questions 331
12. Interpretation of Laboratory Findings in Haematology 332
Anuradha Chakravarthy
Overview 333
Anaemias 333
Leukaemias 334
Miscellaneous Disorders 336
Review Questions 337
13. Introduction to Haemostasis and Haemostatic Disorders 338
Ritwik Bhatia
Haemostasis (Stoppage of Bleeding) 339
Mechanism of Blood Coagulation 341
Fibrinolysis 342
Disorders of Haemostasis 343
Control Mechanisms of Haemostasis 345
Laboratory Tests for Haemostatic Function 346
Review Questions 346
14. Laboratory Investigation of Bleeding Disorders 348
Ritwik Bhatia
Basic Screening Tests for Bleeding Disorders 349
Coagulation Tests 356
Determination of Activated Partial Thromboplastin Time 363
Rapid Haemostatic Tests and Point-of-Care Instruments 364

xiv
Tests for Fibrin Degradation Products (FDP) or D-Dimer 365
Protamine Sulphate Test 366
Laboratory Diagnosis of Bleeding Disorders 366
Therapy of Bleeding Disorders 369
Review Questions 370
Medical Laboratory Technology: Volume I
SECTION 3: IMMUNOHAEMATOLOGY OR BLOOD BANKING
15. Introduction to Blood Transfusion Therapy 373
Pampee Paul Young and Jay S Raval
Basic Concepts of Immunology and Immunohaematology 374
Discovery of Basic Human Blood Groups (ABO) 376
Principles of Immunohaematology 378
Red Cell Antigens 378
Recognition of Immunologic Reactions of Red Cells 380
Laboratory Methods in Detecting Antibodies 381
Human Blood Group Systems 382
Basic Blood Group System: ABO 382
Rhesus (Rh) Blood Group System and Immune Antibodies 385
Other Blood Group Systems 388
Pretransfusion Testing 389
Antibody Screen 389
Compatible Blood Groups 391
Review Questions 392
16. Collection and Processing of Blood for Transfusion 393
Pampee Paul Young and Jay S Raval
Selection of Blood Donors 394
Method of Blood Collection 398
Transportation of Blood After Collection 404
Storage of Blood 405
Common Equipment in a Blood Bank 406
Reagents 410
Preparation of Blood Components 411
Autotransfusion 417
Plasmapheresis 417
Transportation of Blood 417
Delivery of Blood and Blood Components to Clinical Areas 418
Review Questions 419
17. Routine Laboratory Procedures in Blood Bank 420
Pampee Paul Young and Jay S Raval
Significance of Quality Control in Blood Bank 421
Specimen Collection for Blood Bank 421
General Laboratory Preparations in Blood Bank 422
Preparation of Laboratory Reagents in Blood Bank 424
Reporting of Haemagglutination Reaction 426
ABO Blood Grouping 427
Rh Blood Typing 437
Antihuman Globulin (AHG) or Coombs’ Test 441
Major Cross-Match 446
Antibody Screening Test 452
Identification of Unexpected Antibodies 453

Contents
Titration of Anti-D 454
Review Questions 456
Appendix 17.1: Request for Blood Transfusion 458
xv
18. Blood Transfusion Services and Clinical Approach to
Haemolytic Disease of the Newborn 459
Pampee Paul Young and Jay S Raval
Introduction to Blood Transfusion Services 459
Pretransfusion Testing 460
Release of Blood for Transfusion 461
Blood Transfusion Therapy 462
Transfusion Reactions 462
Haemolytic Disease of the Foetus and/or Newborn 464
Review Questions 468
Laboratory Information Systems i
Phlebotomy/Venipuncture Procedure ix
Index I.1
CONTENTS OF VOLUME 2
SECTION 4: MICROBIOLOGY AND VIROLOGY
19. Introduction to Diagnostic Microbiology 471
20. Identification of Pathogenic Bacteria 544
21. Laboratory Diagnosis of Mycotic Infections 644
22. Laboratory Diagnosis of Parasitic Infections 678
SECTION 5: SEROLOGY
23. Introduction to Immunology and Principles of Serodiagnosis 729
24. Laboratory Procedures in Serology 750
SECTION 6: CLINICAL PATHOLOGY
25. Urine Analysis 805
26. Laboratory Examination of Miscellaneous Body Fluids 845
27. Semen Analysis 872
28. Stool Examination 882
Molecular Pathology i
Morphology and Life Cycles of Himan Parasites xi
Index I.1

xvi
Medical Laboratory Technology: Volume I
CONTENTS OF VOLUME 3
SECTION 7: CLINICAL BIOCHEMISTRY
29. Biochemical Processes of the Body Under Normal and Pathogenic Conditions 901
30. Specimen Collection and Processing for Biochemical Analyses 920
31. Techniques of Analytical Chemistry 932
32. Automation in Clinical Biochemistry 961
33. Routine Biochemical Test Procedures 985
34. Biochemical Test Profiles 1081
35. Therapeutic Drug Monitoring and Clinical Toxicology 1102
SECTION 8: HISTOLOGY AND CYTOLOGY
36. Introduction to Histotechnology and Cytotechnology 1127
37. Laboratory Techniques in Histology 1147
38. Laboratory Techniques in Diagnostic Exfoliative Cytology 1206
39. Basics of Immunohistochemistry 1222
40. Polymerase Chain Reacion in Clinical Diagnosis 1240
Medical Terminology 1387
Glossary and Technical Terms 1391
Appendices 1421
Index 1441

Contributors
Bibhas Bandy, MD
Otolaryngologist (ENT Specialist)
Washington County Hospital
Hagerstown, MD, USA
Piyali Basu, MS
Research Associate
Kolkata University, India
Monisha C Bhatia
Vanderbilt University, USA
Ritwik Bhatia
Vanderbilt University, USA
Shovan Bhatia
Research Associate
Ransom Everglades School
Miami, Florida, USA
Ishita Bhattacharya, BS
Research Associate
Monmouth Medical Scholar
Monmouth University, New Jersey, USA
Rohini Chakravarthy
Research Associate
Vanderbilt University Medical Centre
Tennessee, USA
Anuradha Chakravarthy, MD
Professor, Department of Radiation Oncology
Vanderbilt University Medical Centre
Tennessee, USA
Aloka Chakravarthy, PhD
Head of Statistics Department
US Food and Drug Administration
Washington, DC, USA
Aurin Chakravarty, BS
Research Associate
Johns Hopkins University
Baltimore, MD, USA
Dipto Chakravarty, MS
Specialist in Computer Technology
Washington, DC, USA
Tara Chattoraj, BS
Research Associate
University of Illinois
Urbana Champaign, USA
Maya Chattoraj
Research Associate
Wheaton Warrenville South High School
Illinois, USA
Volkmar Dierolf, PhD
Professor and Head
Department of Physics
Lehigh University, Allentown,
Pennsylvania, USA
Swarajit Ghosh, MD
New Delhi, India
Vissagan Gopalakrishnan
Rush Medical College
Chicago, Illinois, USA
Ashoke Khanwalkar, MD
Northwestern University
Chicago, Illinois, USA
Krishna Maliik, MD
Specialist in Orthopaedic Surgery and Arthroscopy
Reconstruction, Mountain Vista Medical Centre
Mesa, Arizona, USA
Venk Mani, MD
Chief Pathologist
Dickson Medical Associates
Dickson, Tennessee, USA
Kanai L Mukherjee, MT, PhD
Fulbright Professor (1983),
Emeritus Retired Director of MLT Program (ECC)
Baltimore, MD, USA
Chhotelaal Pande, BSc, MLT (ASCP), CLSH (NCA),
CLSpH (NCA)
Formerly Clinical Laboratory Supervisor,
Dar es Salaam, Tanzania, and
Metropolis Clinical Pathology Laboratory
Mumbai, Maharashtra, India

xviii
Medical Laboratory Technology: Volume I
Anant Kumar Pandey, BS (Medical Biotechnology)
Amity University, Noida, Uttar Pradesh, India
Jay Raval, MD
Assistant Professor
Medical Director of Therapeutic Apheresis
Division of Transfusion Medicine
University of North Carolina School of Medicine
Pampee Paul Young, MD, PhD
Professor and Director
Blood Bank
Stem Cell Laboratory and Transfusion Services
Vanderbilt University Medical Centre
Nashville, Tennessee, USA

Commonly Used Abbreviations in Medical Laboratories
Rohini Chakravarthy
Abbreviation Expanded Version
A
Ab
ACT
AFB
Ag
AHG
AIDS
Absorbance
Antibody
Activated clotting time
Acid-fast bacillus
Antigen
Antihuman globulin
Acquired immunodeciency
syndrome
ALL
ALP, AP
ALT
AML
ANA
APTT
Acute lymphocytic leukemia
Alkaline phosphatase
Alanine aminotransferase
(formerly, SGPT)
Acute myelogenous leukaemia
Anti-nuclear antibody
Activated partial
thromboplastin
AST
Aspartate aminotransferase
(formerly, SGOT)
BA
BBP
BP
BSC
BSI
BT
BUN
С
CBC
cc
CGL
chol
CK
CLL
Blood agar
Blood borne pathogen
Blood pressure
Biological safety cabinet
Body substance isolation
Bleeding time
Blood urea nitrogen
Celsius, centigrade
Complete blood count
Cubic centimetre
Chronic granulocytic leukaemia
Cholesterol
Creatine kinase
Chronic lymphocytic leukaemia
Abbreviation Expanded Version
CLS
CLT
cm
CNS
CO
CO
CPD
CPK
crit
C&S
CSF
2
Clinical laboratory scientist
Clinical laboratory technician
Centimetre
Central nervous system
Carbon monoxide
Carbon dioxide
Citrate-phosphate-dextrose
Creatinine phosphokinase
Haematocrit
Culture and sensitivity
Cerebrospinal uid, colony
stimulating factor
cu mm
DAT
DIC
Cubic millimetre (mm
Direct antiglobulin test
Disseminated intravascular
coagulation
Di
EBV
EDTA
EIA
EMB
ESR
EU
F
FBS
FDP
Dierential count of WBC
Epstein-Barr virus
Ethylenediaminetetraacetic acid
Enzyme immunoassay
Enzyme immunoassay
Erythrocyte sedimentation rate
Ehrlich units
Farenheit
Fasting blood sugar
Fibrinogen degradation
products
FUO
G
g
GGT
GI
Fever of unknown origin
Gravitational force in dynes/cm
Gram
Gamma glutamyl transferase
Gastrointestinal
3
)
Соседние файлы в папке Библиотека им академика М.И. Перельмана
