Clinical Pathology Test

In a pathology lab, clinical blood tests involve analyzing blood samples to assess health, diagnose diseases, monitor treatment efficacy, or detect abnormalities. These tests are often grouped into profiles based on the systems or conditions they evaluate. Below are the common profiles and tests included in a clinical blood analysis:

1. Complete Blood Count (CBC)

Evaluates overall health and detects disorders like infections, anemia, and leukemia.

• Hemoglobin (Hb)
• Hematocrit (Hct)
• White Blood Cell (WBC) Count
• Red Blood Cell (RBC) Count
• Platelet Count
• Mean Corpuscular Volume (MCV)
• Mean Corpuscular Hemoglobin (MCH)
• Mean Corpuscular Hemoglobin Concentration (MCHC)

2. Biochemical Profile

Focuses on organ function and metabolic state.

a. Liver Function Test (LFT)

• Alanine Aminotransferase (ALT)
• Aspartate Aminotransferase (AST)
• Bilirubin (Total, Direct, Indirect)
• Alkaline Phosphatase (ALP)
• Total Protein and Albumin/Globulin Ratio

b. Renal Function Test (RFT)

• Blood Urea Nitrogen (BUN)
• Serum Creatinine
• Uric Acid
• Electrolytes (Sodium, Potassium, Chloride)

c. Lipid Profile

• Total Cholesterol
• High-Density Lipoprotein (HDL)
• Low-Density Lipoprotein (LDL)
• Triglycerides (TG)

d. Glucose Tests

• Fasting Blood Sugar (FBS)
• Postprandial Blood Sugar (PPBS)
• Glycated Hemoglobin (HbA1c)

e. Electrolytes

Sodium (Na⁺)

• Normal Range: 135–145 mmol/L
• Function: Maintains fluid balance, blood pressure, and nerve/muscle function.
• Abnormal Levels:
  • Hyponatremia (low): Dehydration, kidney failure, or overhydration.
  • Hypernatremia (high): Excessive water loss, diabetes insipidus.

Potassium (K⁺)

• Normal Range: 3.5–5.0 mmol/L
• Function: Regulates heart rhythm, nerve signaling, and muscle contraction.
• Abnormal Levels:
  • Hypokalemia (low): Diarrhea, diuretics, or malnutrition.
  • Hyperkalemia (high): Kidney disease, acidosis, or medication effects.

Chloride (Cl⁻)

• Normal Range: 98–106 mmol/L
• Function: Maintains fluid balance, acid-base balance, and blood pressure.
• Abnormal Levels:
  • Hypochloremia (low): Vomiting, chronic lung disease.
  • Hyperchloremia (high): Dehydration, metabolic acidosis.

Bicarbonate (HCO₃⁻)

• Normal Range: 22–28 mmol/L
• Function: Maintains pH balance in the blood.
• Abnormal Levels:
  • Low: Metabolic acidosis.
  • High: Metabolic alkalosis or lung diseases.

Calcium (Ca²⁺) (sometimes included in extended electrolyte panels)

• Normal Range: 8.5–10.5 mg/dL
• Function: Bone health, muscle contraction, and blood clotting.

Common Tests in a Fever Profile

1. Complete Blood Count (CBC)

• Evaluates overall blood health.
• Detects infection, inflammation, or anemia.
• Key Indicators:
  • High WBC Count: Suggests bacterial or viral infection.
  • Low Platelet Count: Associated with dengue or malaria.

2. Erythrocyte Sedimentation Rate (ESR)

• Measures the rate at which red blood cells settle.
• Elevated ESR indicates infection or inflammation.

3. C-Reactive Protein (CRP)

• Detects inflammation in the body.
• Elevated levels suggest infection or tissue damage.

4. Malaria Test

• Peripheral Blood Smear: Identifies Plasmodium parasites.
• Rapid Diagnostic Test (RDT): Detects antigens of malaria.

5. Dengue Test

• NS1 Antigen Test: Early detection of dengue virus.
• IgM/IgG Antibody Test: Confirms current or past infection.

6. Typhoid Test

• Widal Test: Detects antibodies against Salmonella typhi and paratyphi.
• Typhidot Test: Rapid serological test for typhoid.

7. Liver Function Test (LFT)

• Assesses liver health, which may be affected by infections like typhoid, dengue, or hepatitis.
• Elevated liver enzymes (ALT, AST) suggest liver involvement.

8. Kidney Function Test (KFT)

• Detects kidney involvement in fever-related conditions.
• Parameters include Creatinine, Urea, and Electrolytes.

9. Blood Culture

• Identifies bacterial or fungal pathogens in the bloodstream.
• Essential for diagnosing sepsis or typhoid fever.

10. Urine Routine and Culture

• Identifies urinary tract infections (UTIs), a common cause of fever.
• Detects bacteria, pus cells, or blood in urine.

11. Other Specific Tests

Based on symptoms and clinical suspicion, additional tests may be included:

• Hepatitis Panel: For viral hepatitis.
• Tuberculosis Test: Mantoux test or Interferon Gamma Release Assay (IGRA).
• Leptospirosis Test: For leptospiral infections.

3. Hormone Profile

Evaluates endocrine system function.

• Thyroid Function Tests (T3, T4, TSH)
• Cortisol
• Insulin
• Testosterone/Estrogen/Progesterone

4. Hematology Tests

• Coagulation Profile (Prothrombin Time [PT], Activated Partial Thromboplastin Time [APTT])
• Erythrocyte Sedimentation Rate (ESR)
• Reticulocyte Count

5. Infection and Immunology Panel

• C-Reactive Protein (CRP)
• Erythrocyte Sedimentation Rate (ESR)
• Widal Test (Typhoid)
• Dengue NS1 Antigen
• Malaria Parasite Smear

6. Cancer Markers

• Prostate-Specific Antigen (PSA)
• CA-125 (Ovarian Cancer)
• Alpha-Fetoprotein (AFP)
• Carcinoembryonic Antigen (CEA)

7. Serology Tests

Identify antibodies or antigens to diagnose infections.

• HIV Test (ELISA, Western Blot)
• Hepatitis B Surface Antigen (HBsAg)
• Rheumatoid Factor (RF)
• Anti-Nuclear Antibodies (ANA)

8. Microbiological Tests

• Blood Culture
• Gram Staining
• Antibiotic Sensitivity Testing

9. Genetic and Molecular Tests

Advanced analysis for genetic disorders or specific diseases.

• Polymerase Chain Reaction (PCR)
• DNA/RNA Sequencing

Steps in a Pathology Lab for Blood Testing

1. Sample Collection: Venipuncture is used to collect blood in tubes.
2. Labeling and Processing: Tubes are labeled and prepared for analysis.
3. Centrifugation: Serum or plasma is separated.
4. Analysis: Automated analyzers or manual methods are used.
5. Quality Control: Ensures results’ accuracy and reliability.
6. Reporting: Results are compiled and sent to the physician.

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