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188
5. URINE ANALYSIS
Medical Laboratory Technology: Volume 1
Date Specimen#Patient
* Microscopic examination includes reporting from:
(a) Wet mount of: RBC/h.p., WBC/h.p., Epithelial cells/h.p., Casts, Crystal, Ova, Proto zoa (T. vaginallis), yeast, cellular bodies.
(b) Stained preparation: Gram stained.
ID #
Referring
Physician
LABORATORY TESTS
Sp.Gr. App. Colour Micros.* Addis
count
pH Pro-
tein
Sug-arKe-
tone
Bili Uro. Oth-
6. FAECAL ANALYSIS
Date Specimen #
Note Indicate intensity of the parasite, when present.
* Physical examination: Colour, form (consistency), presence of mucus, blood, adult parasite, and gross parasite component.
** Microscopic examination: Mention method of concentration (otation, sedimentation). Report: Presence of ova, protozoa (form), red cells, pus cells
(WBC), others.
Patient
ID#
Presumptive
diagnosis
Referring
Physician
Physical*
Examination
LABORATORY TESTS
Microscopic
Examination**
Direct Cone.
Occult
blood
Date of
reporting
Others
ers
7. BODY FLUIDS
Date Speci-
men ID
* Total cell count reports: white cell count and red cell count.
** Dierential count (WBC) reports: % PMN and % lymphocytes.
*** Normal values: Globulin (Pandy test) faint opalescence.
Glucose (40–80 mg/dL); Chlorides (113–127 mEq/L).
Patient IDPresumptive
diagnosis
Referring
physician
Physical Microscopic Bio-
Total
cell
count*
Laboratory Tests Date of
Microbiology
chemical***
Di.** Globulin
(Pandy)
Glucose
Chlorides
Lab.
Culture
Grams
stain
AF
stain
reporting
Specimen Handling and Laboratory Records
8A. CLINICAL BIOCHEMISTRY (Routine)
189
Laboratory Tests Unit Date Specimen # Patient I.D. Referring
physician
Glucose mg/dL
Fasting mg/dL 65–105
Random mg/dL
Postprandial mg/dL
Urea (BUN) mg/dL 15–45
Creatinine mg/dL 0.5–1.5
Uric acid mg/dL 2.1–7.4
Total protein g/dL 6.0–8.0
Albumin g/dL 3.3–5.3
Globulin g/dL 1.8–3.3
A/G ratio 1.13–1.15
Cholesterol mg/dL 150–250
ALP U/L
ACP (total) U/L 2.5–11
ACP (Titrate labile) U/L 0.2–3.5
LDH U/L 95–200
SGOT(AST) U/L 12–30
SGPT (ALT) U/L 7–30
CPK U/L 10–120
Amylase U/L 110–330
Na mmol/L 135–145
K mmol/L 3.5–5.5
Cl mmol/L 98–109
Bicarbonate
(venous blood)
Ca mg/dL
Phosphate mg/dL
TGL mg/dL 50–150
Bilirubin direct mg/dL 0.1–0.4
Bilirubin indirect mg/dL 0.1–0.9
Bilirubin total mg/dL 0.2–1.3
Creatinine
clearance
mmol/L 22–28
mL/minute
Laboratory
report
Laboratory nor-
mal value
Adult: 15–65
Children:70–150
Adult 8.5–10.5
Children 9.5–11.0
Adult 2.5–4.8
Children 2.5–5.5
Male:113–167
Female:117–135
Others
Date
reporting
Tech.
190
Medical Laboratory Technology: Volume 1
8B. CLINICAL BIOCHEMISTRY (Special)
Laboratory
Test: 24 h urine
specimen
Volume/24-hr mL 750–2000
Chloride mEq/L 110–250
Calcium mg/day 100–300
Creatinine
(varies with
body weight)
VMA mg/day 1.5–7.5
17-Ketosteroid ? 8–15
Protein ? 10–100
Urobilinogen ? 0.4–1.0
Unit Date Specimen # Patient .D. Referring
physician
mg/day 1.5–2.0
Laboratory
report
Laboratory
normal
value
9. HISTOPATHOLOGY AND EXFOLIATE CYTOLOGY
Date Specimen source Specimen IDPatient ID Referring
physician
Histology
Biopsy
Surgery
Others
Exfoliate cytology
Cervicovaginal
Vaginal pool
Pleural uid
Esophageal
Gastric
Sputum
Urine
Bronchial
Comments Date
reporting
reporting
Date
Pathologist
Tech.
Specimen Handling and Laboratory Records
191
Appendix 5.4
Technician’s Record Book
Only a few examples are quoted here for guidance. In general, the register must have columns
for date of performing the test, laboratory serial number, specimen ID and series of tests
performed by the specic technician. Enter results directly into the register. It is bad practice
to take readings on loose sheets and then transfer the information into the register. This may
incur error. All instrument readings must be recorded (see haemoglobin determination) into
the register.
1. Haemoglobin Determination
* Number given daily by the technician for the convenience of writing on the glassware
during the performance of the test.
Note A similar record is kept for all tests in other areas as well. The technician must write
the actual reading so that the calculation can be checked.
Date Laboratory
serial#
2. Bacteriology
Date Specimen
accession #
Referring
physician
Specimen
Accession #
Preliminary
report
Instrument reading Hb concentration
Standard Control Test
Laboratory observations Antibiotic
Direct
Exam,
(unstained)
Direct
Exam,
(stained)
Pri-
mary
culture
Secondary*
culture
(g/dL)
Signature of
sensitivity
test
tech.
Signature
of tech.
In all secondary cultures, follow the same specimen accession number in order to avoid
transcription errors. If the number is too long, renumber by date and note the laboratory
number on the second column, along with the accession number.
192
Medical Laboratory Technology: Volume 1
3. Body Fluid Examination
A. Sputum
Date Specimen
accession
B. Others
Referring
physician
#
Volume Colour Blood Others Wet mount Stained smear
Physical Microscopic Protein Others Tech.
Organisms Cells Other
ndings
Wright
stain
Gram
stain
Acid
fast
Date Specimen
accession #
Referring
physician
LABORATORY TESTS Signature
of Tech.
Physical Microscopic examination Protein Others
Dierential count Stained smear
PMN Lymph Gram AF
Specimen Handling and Laboratory Records
4. Clinical Biochemistry
A. Routine Analysis
193
Date Specimen
accession #
Laboratory
Test
Methodology Instrument Reading Calculated
Blank Standard Control Test
В. Special Analysis
Creatinine Clearance Study (Glomerular ltration rate)
Date Ref.
Patient IDSpecimen Instrument Rd. (A) Creat, cone.
Phys.
Blank Stand. Test Start Finish Total
#1 Urine
Plasma
#2 Urine
Plasma
Time (AM/PM) Vol. of
(mg/dL)
value
urine
(mL)
reported
Urine vol
per min
(mL)
Date
Creat
clearance
(mL/hr)
Signature
of Tech.
Sig. of
tech.
#3 Urine
Plasma
194
Medical Laboratory Technology: Volume 1
Appendix 5.5
Daily Inventory of Supplies
Work Station No. 3: Bacteriology (a sample)
Location Item No. in stock No. used during the
day
Drawer No. 1 Sterile pipees* 10 mL 15 0 15
5mL 5 3 2
1 mL 10 g 2
Drawer No. 2 Petri dishes * 4 packages(12 in each) 8 3 packages
Drawer No. 3 Inoculating needle 2 NE 2
Inoculating loop 2 NE 2
Pasteur pipees 3 dozens 12 2 dozens
Coton swabs 2 dozens 18 6
Rubber bulbs 2 NE 2
Drawer No. 4 Microscope slides 4 boxes (50 in each) 12 4 boxes +
Cover slips 1 box (500 in each) 4 1 box (496)
Test tube racks 2 NE 2
Top bench Bunsen burner 1 NE 1
Continue for all
articles in
the laboratory
* If reusable, replace
with new sterile articles
NE = Nonexpendable
Balance
Specimen Handling and Laboratory Records
Appendix 5.6
INVENTORY CARD FOR LABORATORY SUPPLIES
Item:________________
Address of supplier: ___________________
___________________
___________________
Cost:____________________ (unit price)
195
Date Amount
received
Amount issued Name to whom
issued
Balance in hand Store clerk
signature
Units of Measurement
and Preparation of
6
Reagent Solutions
Tara Chattoraj
Chapter Outline
• International System of Measurement: The Metric System
• Units of Measurement
▪ Metric system in expressing concentration of solutions
▪ Reagent solutions
▪ Expressions of concentration of solutions
• Preparation of Reagent Solutions
▪ Preparation of standard solutions of acids and bases
• Laboratory Calculations
• Review Questions
All quantitative measurements are expressed in some kind of unit. Units of measurements
are used in our daily life and in scientic work. In clinical laboratory, measurements are
used to indicate the number of cells or quantity of substances in patient’s blood, serum or
other uids. In order to communicate properly, it is important that all the measurements be
expressed by a universally accepted system. In this chapter, we will try to introduce the basic
International System of Units (SI)—the metric system—and its application in the preparation
of laboratory solutions.
InternatIonal SyStem of meaSurement: the metrIc SyStem
The metric system is the system of measurements used in clinical laboratories. In many
developing countries, the metric system is also used in everyday life although other local
systems and the English systems also exist.
Laboratory units are used for the measurement of weight, length, time and concentration of
solutions. As dierent units were used in dierent parts of the world, scientic communication
became dicult. As a result, an International System of Units was introduced in 1971 and was
called SIU (Le Système International d’unités). It accepts the metric system of measurement.
The SI system uses seven dimensionally independent units of measurement (Table 6.1) to
provide logical and consistent measurements (Length, Mass, Time, Quantity of Substance,
Temperature, Luminous Intensity and Electric Current). Dimensionally independent means
that there is no way to meaningfully convert one unit into another. For example, there is no
way to express time (seconds) into length (metres). It is also called the system of base units
because all other units (density, concentration) are based o of these seven units. Of these
seven, in the common clinical laboratory, only the rst ve are used (Table 6.2).
Units of Measurement and Preparation of Reagent Solutions
C
5
9
Table 6.1 Common Laboratory Units
Quantity Unit Symbol
Length Metre m
Weight Gram g
Volume Litre L or I
Temperature Celsius °С
Quantity of substances Mole mol
Concentration Molarity M
Time Seconds, Minutes, Hours s, min, h
Table 6.2 SI base units as used in clinical laboratories
Older ternis New SI equivalent
Micron (μ) micrometre (μm; 10
Cubic micron (μ
Micro-micro-gram (μμg) picogram (pg; 10
Microgram (mcg) microgram (μg; 10
Millimicron (mμ) nanometre (nm; 10
Lambda (λ) microlitre (μL; 10
Cubic millimetre (mm
Angstrom (Å) nm × 10
3
) femtolitre (fL; 10−5 L)
3
) microlitre (μL; 10−6 L)
−1
−6
m)
−12
g)
−6
g)
−9
m)
−6 L
)
197
Often when converting into the SI system, the number that expresses the amount changes.
For example, 1 inch is equivalent to 2.54 centimetres. Occasionally, the numbers stay the
same. For example, chloride remains same in both the systems: 95 –105 mEq/L (conventional)
and 95 –105 mmol/L (SI). We will discuss these units later. See Appendix D at the end of
Volume III for more information.
This is called the metric system because it is based on the fundamental unit of distance,
the metre. In the metric system, metre (m) is the basic unit used to measure distance,
gram (g) is the basic unit to compare mass, and litre (L) is the basic unit used to measure
volume (Table 6.1). For the measurement of temperature, Celsius (°C) is the recommended
unit, while Fahrenheit (°F) is still in use but is growing obsolete in the scientic eld. The
conversion nomogram for Fahrenheit and Centigrade is given in Figure 6.1. Mole (molecular
mass in grams) is the weight measurement in chemical language. The concentration of a
solution is expressed in molarity, a concept which we will introduced later.
For the conversion of temperature unit, the following formula is used:
-32
F
=
where, С = temperature in Celsius and F = temperature in Fahrenheit
Alternatively, the nomogram provided in Figure 6.1 can be used and is also recommended.