lab interpretation for medical students

Clinical features of thrombocytopenia include mucosal bleeding (e.g. Elevated levels may indicate blood loss or hemolysis. They highlighted several of the foundations of laboratory medicine,8 such as preanalytic, analytic, and postanalytic issues of concern for clinical laboratory testing as well as how those issues affected the interpretation of the laboratory results and patient diagnoses in their cases. The book is very basic; this is not the book for you if you are a lab tech, a lab tech student, a medical student, or resident. Wilson ML. A raised reticulocyte count in the absence of anaemiamay indicate that the body is effectively compensating for blood loss or haemolysis (i.e. The gram-positive cocci have been identified as coagulase-negative Staphylococcus. Tip: Most polycythaemia is secondary, with the most common causes being smoking and excess alcohol intake. Specific-gravity test demonstrated concentrated urine. Normal levels range from 16 percent-45 percent. The laboratory is an important part of medical diagnostic procedure, adding its objective information to the more subjective history and physical examination of the patient. UCLA's Laboratory Tour for Medical Students Is a Model to Replicate correctly choose laboratory tests (minimal number of tests required for diagnosis); identify the pitfalls in interpreting certain test results; describe cost factors in ordering test profiles; and. What do you think when one test is out of reference range in a laboratory panel, but all others are within reference limits? Terms of Use Inclusion in an NLM database does not imply endorsement of, or agreement with, Facilitators pointed out that one of the highlights of the panel discussion was the patient who noticed the lack of engagement and drew the students into an active conversation by asking them questions. What is crucial to find in the chart in relation to this level? Of the 84 medical students who took both the before and after MSCLE quizzes, 16 students (19%) scored a 7 or greater on the pre-MSCLE quiz, and 34 students (40%) scored a 7 or greater on the post-MSCLE quiz. eosinophilic oesophagitis), Malignancy (any solid organ or haematological), Haematological malignancies (myeloproliferative disorders), Reactive (severe infection or treatment with G-CSF), Medications (e.g. The quiz did not count toward passing or failing a student and was not used as an incentive for completing the module, which may account for lack of motivation to complete it or to score well. It was encouraging to see an increase in medical student knowledge in such a short period; however, some limitations and areas for improvement were identified, not only by the medical students but also by the MSCLE facilitators. (1999). Examination utilizing multiple choice and matching questions. Day 1 included the pre-MSCLE quiz, introductory panel, logistics, and the delivery of the case studies. Why has the laboratory only indicated there are gram-positive cocci in clusters and not identified the bacteria (staphylococci or other) at this time? The format of the MSCLE is presented in Figure 1. The nephrologist changes the patient to everolimus and asks for a blood level test on that drug. Laboratory Values and Interpretation - A Nurse's Ultimate Guide This could be due to nutritional deficiencies (e.g. Laboratory and diagnostic tests with nursing implications. Medical students who were matched with internal medicine and neurology were assigned a visit to the laboratory of an adult tertiary-care hospital and were given a case study of a renal transplant patient with multiple infections who was taking medications that required monitoring (Appendix). Normal levels of WBCs for men and women are 4,300-10,800/cubic mm. A week later, the patient has the test performed at his local laboratory. The laboratory calls back saying that they cannot find a laboratory that can measure that drug. When you visited the microbiology laboratory during the tour: What measures did you see the technologists using to protect themselves from the different infectious agents? official website and that any information you provide is encrypted An anonymous student survey was performed for the entire CAPSTONE course, and 3 questions pertained to the MSCLE. The causes of a high or low red cell count are the same as those for haemoglobin and haematocrit. Hint: When neutrophil counts are low (<1.5) there is a higher infection risk. There was evidence of previous sternotomy. What do you do with this abnormal result? Nicoll D, & Lu C, & Pignone M, & McPhee S.J.(Eds. 1.3 Organization of the laboratory 4 1.4 Structure of medical laboratory service 4 1.5 Role of medical laboratory services 9 1.6 Role of medical laboratory technologist 10 1.7 Lab. Journal of the American Medical Association: "JAMA Diagnostic Test Interpretation." To access the articles, go to . Departments of Pathology and Laboratory Medicine (Drs Guarner, Molinaro, Winkler, Kraft, Fantz, Stowell, Ritchie, and Koch) and Emergency Medicine, (Drs Heron, Liebzeit, and Santen) Emory University, Atlanta, Georgia, Reprints: Jeannette Guarner, MD, Department of Pathology and Laboratory Medicine, Emory University, 1364 Clifton Rd, Atlanta, GA 30322 (, The publisher's final edited version of this article is available free at. Using a case-based approach, this program is designed to help you refine your skills in ordering and analyzing the results of laboratory tests. Expand All CHEMISTRY LAB MONOGRAPHS. A comprehensive assessment is always required to help narrow the differential diagnosis of leukopenia and guide the need for further investigations. Previous students have reported that this course is an excellent and broad review in preparation for the USMLE exams. Work and Integrity: The Crisis and Promise of Professionalism in America. Basic Metabolic Panel A collection of data interpretation guides to help you learn how to interpret various laboratory and radiology investigations. PDF Guidance on Interpreting Laboratory Values - ASHP He described the back pain as dull and constant and without radiation to groin. The MSCLE quiz distribution shifted toward the right after the students went through MSCLE (B). As Co-Founder of Medical Creations, I have embarked on the journey to empower medical students worldwide and provide them with the tools necessary to succeed in the . Check out our NEW quiz platform at app.geekymedics.com, To be the first to know about our latest videos subscribe to our YouTube channel . Less emphasis on presentation preparation. Which other National Patient Safety Goals affect the laboratory? aplastic anemia, in which the patient experiences loss of bone marrow function; leukemia, in which the bone marrow is replaced by malignant cells. Indices measure the average characteristics of the erythrocyte. Also, would probably have the facilitators be more active in the discussionespecially with references that they need.. Facilitators felt students were more intent on completing their required presentations than they were in delving into the questions in each case scenario and the presentation preparation was redundant. To compound the issue, many medical schools have modified their curricula, so the different topics are presented in a more-integrated context. Diagnostic and laboratory tests are tools that provide invaluable insights and information about the patient. chronic infection or inflammation. This is useful information in the context of mixed anaemia (i.e. B12/folate or iron) or a primary bone marrow disorder (e.g. If the haematocrit continues to rise, hyperviscosity syndrome can develop, which is associated with the development of thrombi and symptoms such as headaches, blurred vision and chest pain. FOIA Emails full of tips, news, resources and advice will be sent your way soon. Transient, isolated basophilia is rarely clinically significant as it can be caused by many benign processes. How long will it take to get an identification of the organism(s) grown in the blood? The hospitalist discusses the patients condition with the nephrologist. The MSCLE was designed to cover the chosen topics; however, the facilitators did not focus discussions or tours to address quiz questions specifically. Haematocrit can be affected by either the number of red blood cells or the volume of blood plasma. Biochemistry 2 2. Medical students who were matched with emergency medicine and obstetrics were assigned a visit to a laboratory at a university-owned, community-based, acute care teaching hospital and were given a case study of a pregnant woman with ketoacidosis and a previous history of cervical dysplasia (case not shown). Though the discussion below lists each differential cell and describes increases or decreases in percentage in response to various stimuli, the reader must also remember that most of these percentages can also fluctuate in patients with certain kinds of leukemia and other pathologic conditions.Neutrophils: The function of neutrophils is to destroy and ingest bacteria. There are some other studies which have identified shortcomings among medical students and/or non-pathology residents (1,3,14,18-20) in some aspects of laboratory medicine such as inappropriate test ordering, incorrect interpretation (3,14), microscopic exam (3,15) and calculation of pre and post-test probabilities (3,16). Federal government websites often end in .gov or .mil. The long list of acronyms and numbers can seem daunting at first, however, by following a structured approach you can make sense of them all! As a result, physicians increasingly rely on laboratory test results in addition to other clinical data commonly generated by health care professionals outside of direct patient contact (such as radiology).2 The number, type, and complexity of laboratory testing have increased markedly during the past 50 years. Are critical values part of the National Patient Safety Goals? Some representative comments from the facilitators included: More time in labs. Contents (5) This presentation will discuss common laboratory studies utilizing a case-based method. Should the University Hospital laboratory send the specimen to be tested by the Minnesota laboratory? Interpreting the Complete Blood Count and Differential The repeat value just 1 hour later is 20 ng/mL, still critical, and likely, the cause of the patients vomiting. Red cell distribution width (RDW) is useful to take a more in-depth look at the MCV (average of the red cell size). Interpreting Lab, Medical & Clinical Tests | KnowledgeDose ; Red cell tests can also provide important insights into the underlying cause(s) of anaemia or polycythaemia by looking at the average size of . The patient was started on vancomycin and levofloxacin. Physicians in specialties that order the tests are teaching medical students laboratory medicine and test use with minimal input from laboratory scientists who implement and maintain the quality control for those tests. As a result, physicians in different specialties teach medical students the tests they use. 2) They often come back abnormal. The CBC tests for the amount of RBCs, hemoglobin, hematocrit, reticulocytes, mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration. This section features links to clinical practice resources on lab, medical and clinical tests such as HbA1c, spirometry, TFTs (thyroid function tests), LFTs (liver function tests) and ABGs (arterial blood gases). Causes of a very low monocyte count include: Eosinophils account for between 2-3% of the total white cell count. In what order would you need to draw the 2 tubes? If this was a clinic (not the hospital), would the steps be different?
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