Professional Documents
Culture Documents
การตรวจทางห้องปฏิบัติการ
การตรวจทางห้องปฏิบัติการ
การตรวจทางห้องปฏิบัติการ
Laboratory Test
(Hematologic test)
CBC (Complete blood count)
1. Red blood cell ( RBC ) count
2. White blood cell ( WBC ) count
3. Hemoglobin ( Hgb )
4. Hematocrit ( Hct )
5. Platelet ( Plt )
6. Red blood cell indices
- Mean corpuscular volume ( MCV )
- Mean corpuscular hemoglobin ( MHC )
- Mean corpuscular hemoglobin concentration ( MCHC )
Red blood cell count
4.5 6.0 x 106 cell/mm3
4.5 6.0 x 106 cell/mm3
4.0 5.5 x 106 cell/mm3
Neutrophils 50 70 %
Lymphocytes 20 40 %
Monocytes 0 7 %
Basophils
01%
Eosinophils 0 5 %
manual key band
segmented neutrophil band
20% WBC PMNs 80% WBC left shift
bacterial infection, sepsis hemorrhage
Hemoglobin concentration (Hgb)
hemoglobin
RBC
14 18 gm/dl
12 16 gm/dl
Hgb = RBC(millions) x 3
Hematocrit
RBC
9
RBC =
(mm) x 100
40 54 %
37 47 %
Hct = Hgb x 3
7 2 3
150,000 400,000/mm3
platelets 100,000/ mm3 thrombocytopenia
platelets 50,000/ mm3
platelets 20,000/ mm3 spontaneous bleeding
platelets 10,000/ mm3
10
thrombocytopenia
- Idiopathic thrombocytopenia purpura ( ITP )
- Disseminated intravascular coagulation ( DIC )
- Marrow invasion or aplasia
- Hypersplenism
- Drugs Quinidine toxicity
- Cirrhosis
- Massive transfusion
- Viral infections (mononucleosis)
platelets thrombocytosis
- Postsurgery or postsplenectomy
- Malignancy
- Rheumatoid arthritis ( RA )
- Iron deficiency anemia
- Trauma
- Acute hemorrhage
Reticulocyte count
Reticulocyte 1% (0.2 2.0 %)
bleeding, hemolysis, iron, folate B12 Reticulocyte count
transfusion aplastic anemia
Erythrocyte sedimentation rate ( ESR )
plasma protein , tumor, degenerative
disease , 2
1. Modified westergren method
= 0 - 15 mm/h
= 0 - 20 mm/h
11
= 0 - 5 mm/h
= 0 -15 mm/h
60
20 80 infection
Blood Chemistry Test
electrolyte (blood glucose)
Electrolyte
Sodium(Na) 136-145 mEq/L
8-12 mEq/L
Renal function
Blood urea nitrogen (BUN) 6-20 mg/dl
13
1. Color
urobilinogen, pus, bacteria
2. Appearance : clear
phosphate, carbonate,uric acid, red cell, bacteria,pus
3. pH 4.5-8 respiratory acidosis, severe
diarrhea, dehydration acute or chronic renal failure,
respiratory alkalosis , proteus
4. Specific gravity 1.001-1.035
dehydration
diabetes insipidus, renal failure
5. Blood hemoglobin stone, trauma, tumor, infection
6. Glucose 10-30 mg/dl diabetes mellitus, pancreatitis, shock
7. Bilirubin hepatitis, obstructive jaundice
8. Protien fever, hypertension, nephritic syndrome, myeloma
9. Nitrite infection
10. Ketone uncontrol diabetes mellitus , starvation, vomiting, diarrhea
11. Microscopic
- RBC 20-30 cell/HPF infection
14
-globulin
Total protein multiple myeloma, dehydration, sarcoidosis
liver failure, starvation, inflammatory bowel disease
2. Alkaline phosphatase
isoenzyme cell , ,
30-115 units/L
biliary tract obstruction, Pagets disease, hyperparathyroidism,
osteolytic bone tumor
hypophosphatasia, hypothyroidism, malnutrition
15
3. Bilirubin
hemoglobin myoglobin plasma albumin
unconjugated bilirubin conjugate microsomal enzyme
conjugated bilirubin direct bilirubin
Total bilirubin
0.2 - 1.0 mg/dL
Unconjugate bilirubin 0.2 - 0.8 mg/dL
Conjugate bilirubin 0 - 0.2 mg/dL
Total bilirubin acute chronic hepatitis, cirrhosis, biliary tract
obstruction, hemolysis, fasting
Conjugate bilirubin obstructive liver disease, hepatitis, drug induced
cholestasis
Unconjugate bilirubin hemolytic anemia,hepatocellular liver disease
4. Transaminase enzyme
Serumglutamic-Oxaloacetic transaminase (SGOT) aspatate
aminotransferase(AST) Serum glutamic-pyruvic transaminase(SGPT) alanine
aminotransferase(ALT)
AST 3 35 units/L
ALT 7 33 units/L
AST liver disease,acute myocardial infarction, pancreatitis, muscle
trauma, congestive heart failure, hemolysis
ALT liver disease (specific AST), pancreatitis, biliary tract
obstruction
5. Cholesterol
140 - 260 mg/dL
hypercholesterolemia - hyperlipidemia, biliary tract obstruction,
pancreatitis, hypothyroidism, diabetes mellitus
starvation, chronic disease, hyperthyroidism, liver disease, steroid therapy
16
0 - 32 unit/L
0 - 13 unit/L
biliary tract obstruction 5-30
Blood coagulation
1.Bleeding time
2
1. Duke method
0 - 6
2. Ivy method
40 mmHg
0 - 8
Bleeding time thrombocytopenia, von Willebrands disease, aspirin
therapy, abnormal platelet function, vitamin correspond deficiency
2.Clotting time
6 - 7
heparin clotting factor deficiency
3.Prothrombin time(PT)
12 - 14
PT coumadin, vitamin K
deficiency, liver disease, DIC, tourniquet , extrinsic
coagulation factor
INR (International normalized ratio)
17
PT PT lab coumadin
1 1.5
4. Partial thromboplastin time (PTT)
intrinsic factor
25 - 45
heparin intrinsic coagulating
factor, hemophilia A, B, tourniquet
5. Thrombin time
thrombin fibrinogen fibrin
10 - 14
thrombin time heparin, DIC, fibrinogen deficiency
Diagnostic imaging
- Imaging of the head and neck
- Chest radiograph
- Computerized tomography (CT scan)
- Magnetic resonance imaging (MRI)
- Nuclear scans
- sialography
Imaging of the head and neck
1. Periapical film
2. Occlusal film periapical film
3. Panoramic radiograph
18
4. Lateral oblique view panoramic
posteroanterior film ( PA)
soft tissue
bony structure , clavicle, scapular, proximal humerus,
vertebrae osteolytic, osteoblastic lesion, fracture
-
- inflammation
-
-
- iodine compound
- acute salivary gland inflammation
1. Aspiration biopsy radiolucent lesion
2. Excisional biopsy
3. Incisional biopsy
10%
frozen section
10 - 30
21
1.
. Polychromacia
. Polycythemia
. Hyperglycemia
. Hyperchromic
.
2. white blood cell count 7,500 cell/mm3 lab
.
.
. leukemia
. Aplastic anemia
. Septicemia
3.
. Hemoglobin
. Hemoglobin oxygen
. hemoglobin concentration
. hemoglobin concentration dehydration
. anemia hemoglobin concentration
4. biopsy
. biopsy 10%
. aspiration biopsy (cyst)
. biopsy
. incision biopsy
.
22
5. investigation
. Panoramic radiograph (OPG)
. Waters View
. Townes View
.
.
23