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  /Title (pmls1-nature-of-the-clinical-laboratory.pdf)
  /Creator (Cheatography)
  /Author (fayetta (katanawrites))
  /Subject (PMLS1: Nature of the Clinical Laboratory Cheat Sheet)
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    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{PMLS1: Nature of the Clinical Laboratory Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{fayetta (katanawrites)} via \textcolor{DarkBackground}{\uline{cheatography.com/139709/cs/29544/}}}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}fayetta (katanawrites) \\
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 25th October, 2021.\\
   Updated 25th October, 2021.\\
   Page {\thepage} of \pageref{LastPage}.
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{The Clinical Laboratory}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Clinical laboratory}} & essential component of health institutions \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
 & {\bf{main task:}} provide accurate and reliable information to medical doctors for the diagnosis, prognosis, treatment, and management of diseases \tn 
% Row Count 11 (+ 8)
% Row 2
\SetRowColor{LightBackground}
 & {\bf{involved in:}} research, community outreach program, surveillance, infection control in the hospital and community settings, information dissemination, and evaluation of the applicability or current and innovative diagnostic technologies \tn 
% Row Count 23 (+ 12)
% Row 3
\SetRowColor{white}
 & place where specimens {\bf{(e.g., blood and other body fluids, tissues, feces, hair, nails)}} collected from individuals are processed analyzed, preserved, and properly disposed. \tn 
% Row Count 32 (+ 9)
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{The Clinical Laboratory (cont)}}  \tn
% Row 4
\SetRowColor{LightBackground}
 & vary according to size, function, and the complexity of tests performed \tn 
% Row Count 4 (+ 4)
% Row 5
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{\bf{Laboratory Test Results}} & basis for 70\% of all decisions performed by medical doctors \tn 
% Row Count 7 (+ 3)
% Row 6
\SetRowColor{LightBackground}
{\bf{Medical \seqsplit{Technologist/Clinical} Laboratory Scientist}} & serves as the integral partner of medical doctors \tn 
% Row Count 10 (+ 3)
% Row 7
\SetRowColor{white}
 & important member of the health care delivery system \tn 
% Row Count 13 (+ 3)
% Row 8
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 & plays a very significant role in the performance of laboratory testing and ensuring the reliability of test results \tn 
% Row Count 19 (+ 6)
% Row 9
\SetRowColor{white}
 & {\bf{Assays in the past:}} manual, taxing, labor-intensive, and time-consuming \tn 
% Row Count 23 (+ 4)
% Row 10
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 & {\bf{Presently, with the advent of automation:}} less laborious, with shortened turn around time (TAT) \tn 
% Row Count 28 (+ 5)
% Row 11
\SetRowColor{white}
 & {\bf{Possible cause of changes in the future:}} shifting demographics, emergence of new and re-emergence of infectious and non-infectious diseases, demand for more efficient and effective workflow, and new government institutional policies \tn 
% Row Count 40 (+ 12)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{CCL: According to Functions}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Clinical Pathology}} & focuses in the areas of {\bf{clinical chemistry, immunohematology, and blood banking, medical microbiology, toxicology, therapeutic drug monitory, and endocrinology}} \tn 
% Row Count 7 (+ 7)
% Row 1
\SetRowColor{white}
 & concerned in the diagnosis and treatment of the diseases performed through laboratory testing of blood and other body fluids \tn 
% Row Count 12 (+ 5)
% Row 2
\SetRowColor{LightBackground}
{\bf{Anatomic Pathology}} & focuses in the areas of {\bf{histopathology, immunohistopathology, cytology, autopsy, and forensic pathology}} \tn 
% Row Count 17 (+ 5)
% Row 3
\SetRowColor{white}
 & concerned with the diagnostic of diseases through microscopic examination of tissues and organs \tn 
% Row Count 21 (+ 4)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{CCL: According to Institutional Characteristics}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Institution-based}} & operates within the premises or part of an institution {\bf{(e.g., hospital, school, medical clinic, medical facility for overseas workers and seafarers, birthing home, psychiatric facility, and drug rehabilitation center)}} \tn 
% Row Count 9 (+ 9)
% Row 1
\SetRowColor{white}
 & {\bf{most common example:}} Hospital-based clinical laboratories \tn 
% Row Count 12 (+ 3)
% Row 2
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{\bf{free-standing}} & not part of an established institution \tn 
% Row Count 14 (+ 2)
% Row 3
\SetRowColor{white}
 & {\bf{Example:}} free-standing out-patient clinical laboratory \tn 
% Row Count 17 (+ 3)
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{\bf{Government-owned}} & owned, wholly or partially, by national or local government units \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
 & {\bf{Examples:}} clinical and anatomical laboratories of DOH-run government hospitals {\bf{(San Lazaro Hospital, Jose R. Reyes Memorial Medical Center, University of the Philippines-Philippine General Hospital and local government-run hospital-based clinical laboratories of the Ospital ng Maynila Medical Center, Sta. Ana Hospital, and Bulacan Medical Center)}} \tn 
% Row Count 17 (+ 14)
% Row 2
\SetRowColor{LightBackground}
{\bf{Privately-owned}} & owned, established, and operated by an individual, corporation, institution, association, or organization \tn 
% Row Count 22 (+ 5)
% Row 3
\SetRowColor{white}
 & {\bf{Examples:}} St. Luke's Medical Center, Makati Medical Center, and MCU-FDTMF Hospital \tn 
% Row Count 26 (+ 4)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{CCL: According to Service Capability}}  \tn
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{\bf{Primary category}} & licensed to perform {\bf{routine laboratory testing}} ({\bf{e.g.,}} routine urinalysis and routine stool examination) \tn 
% Row Count 6 (+ 6)
% Row 1
\SetRowColor{white}
 & {\bf{ routine hematology or complete blood count:}} hemoglobin, hematocrit, WBC and RBC count, WBC differential count and qualitative platelet count, blood typing, and Gram staining (if hospital-based) \tn 
% Row Count 16 (+ 10)
% Row 2
\SetRowColor{LightBackground}
 & {\bf{Equipment:}} microscopes, centrifuge, and hematocrit centrifuge \tn 
% Row Count 20 (+ 4)
% Row 3
\SetRowColor{white}
 & {\bf{Space requirement:}} at least 10 square meters \tn 
% Row Count 23 (+ 3)
% Row 4
\SetRowColor{LightBackground}
{\bf{Secondary category (Hospital and non-hospital-based)}} & licensed to perform laboratory tests being done by the primary category clinical laboratories along with routine clinical chemistry tests \tn 
% Row Count 30 (+ 7)
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{CCL: According to Service Capability (cont)}}  \tn
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 & {\bf{routine chemical chemistry tests:}} blood glucose concentration, blood urea nitrogen, blood uric acid, blood creatinine, cholesterol determination, and qualitative platelet count \tn 
% Row Count 9 (+ 9)
% Row 6
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 & {\bf{If hospital-based:}} Gram stain, KOH mount, and cross-matching \tn 
% Row Count 13 (+ 4)
% Row 7
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 & {\bf{Minimum requirement:}} 20 square meters floor area \tn 
% Row Count 16 (+ 3)
% Row 8
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 & {\bf{Personnel requirement:}} depends on the workload \tn 
% Row Count 19 (+ 3)
% Row 9
\SetRowColor{LightBackground}
 & {\bf{Equipment:}} microscope, centrifuge, Hematocrit centrifuge, semi-automated chemistry analyzers, autoclave, incubator, and oven \tn 
% Row Count 26 (+ 7)
% Row 10
\SetRowColor{white}
{\bf{Tertiary category (Hospital and non-hospital-based)}} & licensed to perform all the laboratory tests performed in the secondary category laboratory \tn 
% Row Count 31 (+ 5)
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{CCL: According to Service Capability (cont)}}  \tn
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 & {\bf{Immunology and serology:}} NS1-Ag for dengue, rapid plasma reagin, and Treponema pallidum particle agglutination tests \tn 
% Row Count 6 (+ 6)
% Row 12
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 & {\bf{Microbiology, bacteriology, and mycology:}} differential staining techniques, culture and identification of bacteria and fungi from specimens, and antimicrobial susceptibility testing \tn 
% Row Count 16 (+ 10)
% Row 13
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 & {\bf{Special clinical chemistry:}} clinical enzymology, therapeutic drug monitoring, and markers for certain diseases \tn 
% Row Count 22 (+ 6)
% Row 14
\SetRowColor{white}
 & {\bf{Special hematology:}} bone marrow studies, special staining for abnormal blood cells, and red cell orphology \tn 
% Row Count 28 (+ 6)
% Row 15
\SetRowColor{LightBackground}
 & {\bf{Immunohematology and blood banking:}} blood donation program, antibody screening and identification, and preparation for blood components \tn 
% Row Count 35 (+ 7)
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{CCL: According to Service Capability (cont)}}  \tn
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 & {\bf{Minimum floor requirement:}} at least 60 square meters \tn 
% Row Count 3 (+ 3)
% Row 17
\SetRowColor{white}
 & {\bf{Equipment:}} microscope, centrifuge, Hematocrit centrifuge, semi-automated chemistry analyzers, autoclave, incubator, oven, automated chemistry analyzer, biosafety cabinet class II, and serofuge \tn 
% Row Count 13 (+ 10)
% Row 18
\SetRowColor{LightBackground}
{\bf{National Reference Laboratory}} & laboratory in a government hospital designated by the DOH \tn 
% Row Count 16 (+ 3)
% Row 19
\SetRowColor{white}
 & provide special diagnostic functions and services for certain diseases \tn 
% Row Count 20 (+ 4)
% Row 20
\SetRowColor{LightBackground}
 & {\bf{Functions:}} Referral services, provision of confirmatory testing, assistance for research activities, implementation of External Quality Assurance Programs (EQAP) of the government, resolution of conflicts regarding test results of different laboratories, and training of medical technologists on certain specialized procedures that requires standardization \tn 
% Row Count 38 (+ 18)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Republic Act No. 4688}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Approved:}} & June 18, 1966 \tn 
% Row Count 1 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Sections of the Clinical Laboratory}}  \tn
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\SetRowColor{LightBackground}
{\bf{Clinical laboratory}} & made up of different sections cohesively and comprehensively performing different activities and procedures for each specimen collected from patient to produce reliable test results \tn 
% Row Count 10 (+ 10)
% Row 1
\SetRowColor{white}
 & {\bf{Clinical laboratory personnel:}} pathologists, medical \seqsplit{technologists/clinical} laboratory scientists, medical technicians, phlebotomists, and other laboratory personnel \tn 
% Row Count 19 (+ 9)
% Row 2
\SetRowColor{LightBackground}
{\bf{Clinical Chemistry}} & intended for testing blood and other body fluids to quantify essential soluble chemicals including waste products useful for diagnosis of certain diseases \tn 
% Row Count 27 (+ 8)
% Row 3
\SetRowColor{white}
 & {\bf{Most common body fluids:}} blood and urine \tn 
% Row Count 30 (+ 3)
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Sections of the Clinical Laboratory (cont)}}  \tn
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\SetRowColor{LightBackground}
 & {\bf{Test Performed:}} fasting blood sugar (FBS), glycosylated hemoglobin (HbA1c - diabetes), total cholesterol - HDL and LDL, triglycerides (TAG) - cardiovascular diseases, blood uric acid (BUA), blood urea nitrogen (BUN), creatinine - diseases involving the kidney, total protein (TP), albumin, electrolytes (sodium, potassium, chloride), clinical enzymology (aminotransferase and creatine kinase) \tn 
% Row Count 20 (+ 20)
% Row 5
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 & One of the busiest sections of the clinical laboratory \tn 
% Row Count 23 (+ 3)
% Row 6
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 & characterized as {\bf{state-of-art, fully automated facility}} \tn 
% Row Count 26 (+ 3)
% Row 7
\SetRowColor{white}
 & {\bf{Endocrinology:}} hormone in blood and urine \tn 
% Row Count 29 (+ 3)
% Row 8
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 & {\bf{Thyroid hormone tests:}} thyroid stimulating hormone (TSH), T3 and T4 (triiodothyronine and thyroxine) \tn 
% Row Count 35 (+ 6)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Sections of the Clinical Laboratory (cont)}}  \tn
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 & {\bf{Other tests:}} estrogen, prolactin, and testosterone \tn 
% Row Count 3 (+ 3)
% Row 10
\SetRowColor{white}
 & {\bf{Other laboratories:}} Toxicology and Drug Testing \tn 
% Row Count 6 (+ 3)
% Row 11
\SetRowColor{LightBackground}
 & {\bf{Important activities:}} Internal Quality Assurance (IQA), Continuous Quality Improvement (CQA), and participation in National External Quality Assurance Program (NEQAP) \tn 
% Row Count 15 (+ 9)
% Row 12
\SetRowColor{white}
{\bf{Microbiology}} & {\bf{Four major sections:}} bacteriology, mycobacteriology, mycology, and virology \tn 
% Row Count 19 (+ 4)
% Row 13
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 & focused on the identification on bacteria and fungi on specimens received \tn 
% Row Count 23 (+ 4)
% Row 14
\SetRowColor{white}
 & {\bf{Specimens:}} blood and other body fluids, stool, tissues, and swabs \tn 
% Row Count 27 (+ 4)
% Row 15
\SetRowColor{LightBackground}
 & {\bf{Tests:}} microscopic visualization of microorganisms after staining, isolation, and identification of bacteria (aerobes and anaerobes) and fungi using varied culture media and different biochemical tests (antigen typing and antibacterial susceptibility testing) \tn 
% Row Count 41 (+ 14)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Sections of the Clinical Laboratory (cont)}}  \tn
% Row 16
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 & {\bf{Other activities:}} preparation of culture media and stains, quality assurance and control, infection control, and biosafety and proper waste disposal \tn 
% Row Count 8 (+ 8)
% Row 17
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 & {\bf{Mycobacteriology:}} identification of {\bf{mycobacterium (e.g., Mycobacterium tuberculosis)}} \tn 
% Row Count 13 (+ 5)
% Row 18
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{\bf{Hematology and Coagulation Studies}} & enumeration of cells in the blood and other body fluids {\bf{(CSF and pleural fluid)}} \tn 
% Row Count 18 (+ 5)
% Row 19
\SetRowColor{white}
 & {\bf{Examinations:}} CBC, hemoglobin, hematocrit, WBC differential count, red cell morphology, total cell count and differential count, blood smear preparation, and staining for other body fluids \tn 
% Row Count 28 (+ 10)
% Row 20
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 & {\bf{Coagulation studies:}} focuses on blood testing for determination of various coagulation factors \tn 
% Row Count 33 (+ 5)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Sections of the Clinical Laboratory (cont)}}  \tn
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 & {\bf{Bone marrow examination:}} performed in automated hematology analyzers \tn 
% Row Count 4 (+ 4)
% Row 22
\SetRowColor{white}
{\bf{Clinical Microscopy}} & {\bf{First Area:}} allotted to routine and other special examinations of urine ({\bf{macroscopic examination:}} determine the color, transparency, specific gravity, and pH level and {\bf{microscopic examination:}} detect the presence of abnormal cells and/or parasites as well as to quantify red cells and WBC and other chemicals found in urine \tn 
% Row Count 21 (+ 17)
% Row 23
\SetRowColor{LightBackground}
 & {\bf{Second Area:}} examination of stool or routine fecalysis \tn 
% Row Count 24 (+ 3)
% Row 24
\SetRowColor{white}
 & {\bf{Routine fecalysis:}} identification of parasitic worms and ova \tn 
% Row Count 28 (+ 4)
% Row 25
\SetRowColor{LightBackground}
{\bf{Blood Bank/Immunohematology}} & screening for all antibodies and identification of antibodies and blood components used for transfusion \tn 
% Row Count 34 (+ 6)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Sections of the Clinical Laboratory (cont)}}  \tn
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 & {\bf{Tests:}} blood typing and compatibility testing \tn 
% Row Count 3 (+ 3)
% Row 27
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 & most critical in the clinical laboratory \tn 
% Row Count 5 (+ 2)
% Row 28
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 & {\bf{Hospital-based clinical laboratories:}} blood donation activities (donor recruitment and screening, bleeding of donor, and post-donation care \tn 
% Row Count 13 (+ 8)
% Row 29
\SetRowColor{white}
{\bf{Immunology and Serology}} & analyses of serum antibodies in certain infectious diseases (primarily viral agents) \tn 
% Row Count 18 (+ 5)
% Row 30
\SetRowColor{LightBackground}
 & {\bf{Tests:}} Hepatitis B profile tests, serological tests for syphilis \tn 
% Row Count 22 (+ 4)
% Row 31
\SetRowColor{white}
 & {\bf{Antibody screening tests:}} test for hepatitis C and dengue fever \tn 
% Row Count 26 (+ 4)
% Row 32
\SetRowColor{LightBackground}
 & Automated analyzers are also used in this section for different serological tests \tn 
% Row Count 31 (+ 5)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Sections of the Clinical Laboratory (cont)}}  \tn
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{\bf{Anatomic Pathology: Section of Histopathology/Cytology}} & {\bf{Activities:}} tissue processing (removed surgically: biopsy/autopsy), cutting into sections, staining, and preparation for microscopic examination by a pathologist \tn 
% Row Count 9 (+ 9)
% Row 34
\SetRowColor{white}
{\bf{Specialized Sections of the Laboratory: Immunohistochemistry}} & combines anatomical, clinical, and biochemical techniques where antibodies (monoclonal and polyclonal) bounded to enzymes and fluorescent dyes are used to detect presence of antigens and tissue \tn 
% Row Count 19 (+ 10)
% Row 35
\SetRowColor{LightBackground}
 & useful in the diagnosis of some types of cancers by detecting the presence of tumor-specific antigens, oncogenes, and tumor suppressor genes. \tn 
% Row Count 27 (+ 8)
% Row 36
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 & assess the responses of patients to cancer therapy as well as diagnosis for certain neurodegenerative disorders \tn 
% Row Count 33 (+ 6)
\end{tabularx}
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\vfill
\columnbreak
\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Sections of the Clinical Laboratory (cont)}}  \tn
% Row 37
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{\bf{Molecular Biology and Biotechnology}} & uses different enzymes and other reagents, {\bf{DNA and RNA}} are identified and sequenced to detect any pathologic conditions/disease processes \tn 
% Row Count 8 (+ 8)
% Row 38
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 & {\bf{Most common technique: polymerase chain reaction (PCR)}} - contributed to scientific advancements in laboratory research; useful for clinical techniques (screening genetic indicators of disease \& diagnosis of cancer and infectious diseases \tn 
% Row Count 21 (+ 13)
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\end{tabularx}
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Laboratory Testing Cycle}}  \tn
% Row 0
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{\bf{Laboratory Testing Cycles}} & encompasses all activities starting from the 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 of patients \tn 
% Row Count 12 (+ 12)
% Row 1
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 & {\bf{Three phases:}} pre-analytic, analytic, and post analytic \tn 
% Row Count 15 (+ 3)
% Row 2
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 & {\bf{Pre-analytic phase:}} receipt of laboratory request, patient preparation, specimen collection, and proper transport and processing of specimen to the clinical laboratory \tn 
% Row Count 24 (+ 9)
% Row 3
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 & {\bf{Analytic phase:}} actual testing of the submitted/collected specimen \tn 
% Row Count 28 (+ 4)
% Row 4
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 & {\bf{Equipment and instruments:}} reagents and internal quality control program \tn 
% Row Count 32 (+ 4)
\end{tabularx}
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\vfill
\columnbreak
\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Laboratory Testing Cycle (cont)}}  \tn
% Row 5
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 & {\bf{Post-analytic phase:}} transmission of test results to the medical doctor for interpretation, TAT, and application of doctor's recommendations; diagnosis and treatments are based in the generated data \tn 
% Row Count 11 (+ 11)
% Row 6
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{\bf{Medical \seqsplit{Technologist/Clinical} Laboratory Scientist}} & Must have clear understanding of the testing cycle to avoid erroneous test results \tn 
% Row Count 16 (+ 5)
% Row 7
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 & {\bf{variables may affect the tests results:}} preparation of the request slip for the patient \tn 
% Row Count 21 (+ 5)
% Row 8
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 & {\bf{variables that may cause errors:}} physiological factors, diet, medications, alcohol and caffeine intake, exercise, underlying disease conditions, identification of patients and labeling of specimens, anticoagulant used, and volume of specimen collected  vis-a-vis volume of anticoagulant \tn 
% Row Count 36 (+ 15)
\end{tabularx}
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\vfill
\columnbreak
\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Laboratory Testing Cycle (cont)}}  \tn
% Row 9
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 & {\bf{Post-analytic phase:}} control of the variables of TAT and transcription errors {\bf{(e.g., wrong value used, result given to the wrong patient).}} \tn 
% Row Count 8 (+ 8)
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\end{tabularx}
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Quality Assurance in the Clinical Laboratory}}  \tn
% Row 0
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{\bf{Quality Assurance}} & encompasses all activities performed by laboratory personnel to ensure reliability of test results \tn 
% Row Count 5 (+ 5)
% Row 1
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 & organized, systematic, well-planned, and regularly done with the results properly documented and consistently reviewed \tn 
% Row Count 11 (+ 6)
% Row 2
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{\bf{Two Major Components}} & {\bf{Internal Quality Assurance System (IQAS)}} and {\bf{External Quality Assurance System (EQAS)}} \tn 
% Row Count 16 (+ 5)
% Row 3
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{\bf{Internal Quality Assurance System (IQAS)}} & day-to-day activities that are undertaken in order to control factors or variables that may affect test results \tn 
% Row Count 22 (+ 6)
% Row 4
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 & {\bf{Regular review and audit of test results:}} done to identify weaknesses and consequently perform corrective actions \tn 
% Row Count 28 (+ 6)
% Row 5
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{\bf{External Quality Assurance System (EQAS)}} & system for checking performance among clinical laboratories and is facilitated by designated external agencies \tn 
% Row Count 34 (+ 6)
\end{tabularx}
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\vfill
\columnbreak
\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Quality Assurance in the Clinical Laboratory (cont)}}  \tn
% Row 6
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 & {\bf{National Reference Laboratories (NRL):}} DOH-designated EQAS \tn 
% Row Count 4 (+ 4)
% Row 7
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 & Unknown sample with known test results -\textgreater{} clinical laboratory for testing -\textgreater{} results returned to external facility -\textgreater{} compared to the known result {\bf{(determines the performance of the laboratory)}} \tn 
% Row Count 14 (+ 10)
% Row 8
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{\bf{Certificate of Performance}} & given to the participating clinical laboratory \tn 
% Row Count 17 (+ 3)
% Row 9
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{\bf{Designated NRL-EQAS}} & {\bf{National Kidney and Transplant Institute (NKTI)}} - Hematology and Coagulation \tn 
% Row Count 21 (+ 4)
% Row 10
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 & {\bf{Research Institute of Tropical Medicine (RITM)}} - Microbiology (identification and antibiotic susceptibility testing) and Parasitology (identification of ova and quotation malaria) \tn 
% Row Count 31 (+ 10)
\end{tabularx}
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\vfill
\columnbreak
\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Quality Assurance in the Clinical Laboratory (cont)}}  \tn
% Row 11
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 & {\bf{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 chlorine \tn 
% Row Count 11 (+ 11)
% Row 12
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 & {\bf{East Avenue Medical Center (EAMC)}} - Drug of abuse (methamphetamine and cannabinoids) \tn 
% Row Count 16 (+ 5)
% Row 13
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 & {\bf{San Lazaro Hospital STD-AIDS Cooperative Center Laboratory (SACCL)}} - Infectious immunology hepatitis B surface antigen (HBsAg), human immunodeficiency virus (HIV), Hepatitis C virus (HCV) \tn 
% Row Count 26 (+ 10)
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\end{tabularx}
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% That's all folks
\end{multicols*}

\end{document}