Question

case study: A 46-year-old woman presented at the out-patient department with a vague history of persistent headaches, muscle weakness, tiredness, and loss of weight and energy. Clinical examination revealed a well-hydrated, thin, anxious, pale woman with a blood pressure of 150/95 mmHg, There was no specific signs or symptoms. She had four children and with the last , now aged six years, She had a “difficult birth” and developed a “kidney” infection. At the time of admission she was on antidepressant medication for an “anxiety-depressive” illness but she admitted to no other medication. The admission biochemical profile was

Plasma

Na​141​mmol/L​(132-144)

K​5.2​mmol/L​(3.2-4.8)

HCO3​18​mmol/L​(23-33)

Urea​14.5​mmol/L​(3.0-8.0)

Creat​0.28​mmol/L​(0.06-0.12)

Urine (24 hr)

Volume 2.6 L

Creat​5.1​mmol/L​

Na​67​mmol/L

Questions:

Q1. Explain the steps in which the specimen is collected, handled, and how the specimen is analyzed.   

Q2. Evaluate and explain the patient’s lab results.

Q3. Explain the lab tests and methods that you will carry out and use in order to diagnose the patient.

Q4. Explain how you would determine the acceptability of quality control test result data.

Q5. Discuss the importance of quality management on the laboratory operation during the various laboratory analytic phases.

Q 6. Illustrate and explain the critical pathways that you used to aid patient diagnosis.

Q 7. From the case study, explain how you would demonstrate ethical behavior, professionalism, and maintain patient confidentiality.

Answer 1

Q1, the biochemical profile is a blood test evaluate the function of the organs like kidney and liver. collecting blood samples for this test by a minimally invasive procedure. the specimen will be collected, labeled, handled, and stored during the testing process. document for the patient preparation prior to collecting the specimen is important, it should include patient name, DOB, ward, hospital ID, type of specimen and site obtained, date and time of specimen collection should be mentioned. It should include patient diagnosis, history, etc. for collecting plasma collect the specimen in addictive indicated in the test needed. mix with addictive soon after collecting with 5 to 10 times, avoid hemolysis, fill the tube completely, avoid dilution, sperate the plasma from cells within two hours
after the specimen collected, label as plasma, indicate the type of anticoagulant. Urine collection needs clean -catch, midstream specimen, stoor the specimen in a cool place. provide instruction to the patient for 24 hours collection. add preservative prior to the urine collection, carefully close the container with full urine, provide complete 24 hours collection, urine volume Blood should be collected in a room temperature container, use 21to 22gauge needle, avoid air leakage around the needle, equipment should be clean, dry and sterile one.use tourniquet or routine venipuncture if there are invisible veins, be gentle, and draw the blood evenly, use alcohol to clean the puncture site allow specimen to clot fully before centrifuging but not more than 10 minutes.
Q2, patient potassium level is increased, low Hco3, high urea, and creatinine level and high urine output, high creatinine. It indicates the patient is in chronic kidney disease.
Q3, patient symptoms showing the patient is suffering from chronic kidney disease. different biochemical markers used in blood and urine for assessing renal function. creatinine is a commonly used biochemical marker for renal function. plasma samples give numeric value directly provide an evaluation of renal function. various methods used to determine creatinine level including enzymatic methods, chromatographic methods, Jaffe reaction, and its variation. urine biomarkers find the renal diseases in the tubular cells and in the lumen.
Q4, quality control is important to detect, reduce, and correct the fault of lab tests prior to patient results release to the patient. using graphic and statistics methods it will be evaluated. control target the values and medical decision points, reference intervals, and control using quantitative tests to analyze the test reports.