Overview of Medical Investigations.pdf

1. Overview of Medical Laboratory
Investigations And other
Investigations
ෛවද$ රසායනාගාර පරීක්ෂණ සහ
අෙනකුත් ෛවද$ පරීක්ෂණ
Dr. C V Karunarathna, MBBS (Kelaniya), MSc in Community Medicine(Colombo)
Medical Officer – Training
Provincial Health Training Centre North Central Province.

2. Objectives
´ To understand what medical laboratory investigations/Medical
investigations are
´ To know the types of medical laboratory investigations/other investigations
´ To understand the importance of knowing about investigations as a
caregiver
´ Getting familiar with some selected , basic and common investigations.
´ Get to know the importance of preparation for some specific
investigations

3. Medical Investigations
ෛවද$ පරීක්ෂණ
´ A medical procedure that involves testing a sample of blood, urine,
other body fluids, cells ,tissue or other procedures carried out on a
person which helps in diagnosis and management of a disease
condition.
´ ෛවද$ පරීක්ෂණ යනු ෛවද$ කියා පටිපාටියකට අනුව යම් පුද්ගලෙයකුෙග් රුධිරය
,මුතා ,ෙවනත් ශරීර තරල, ෛසල ෙහෝ පටක ෙයාදාෙගන සිදු කරනු ලබන පරීක්ෂාවක්
ෙහෝ කිසියම් ෙරෝග විනිශ්වයකට ෙහෝ ෙරෝග තත්ත්ව සඳහා පතිකාර කිරීෙම්දී තීරණ
ගැනීමට උපකාරී වන ෛවද$ කියාපටිපටියකට අනුව පුද්ගලෙයකුෙග් සිදු කරනු ලබන
අෙනකුත් ඕනෑම පරීක්ෂාවක් ෙව්.

4. Types of Medical Investigations
´ Biochemical Ix (ෛජව ෛවද% පරීක්ෂණ )
´ Blood Ix (LFT/RFT/LIPID Profile/FBS/PPBS/HbA1C/Trop I/ Na/K)
´ Urine Ix (UFR)
´ Body fluids( Peritoneal fluid/CSF/Plural fluid/Sputum/Saliva)
´ Hematological Ix (රක්තෙව්ද පරීක්ෂණ )
´ FBC/ Blood Picture/PT/INR
´ Cytological/Histological Ix (ෛසල හා පටක පරීක්ෂණ )
´ Immunological Ix (පතිශක්තිකරණය සම්බන්ධ පරීක්ෂණ)
´ Microbiological Ix (ක්ෂුදජීව පරීක්ෂණ )
´ Gram stain/Culture ABST/Viral/Fungal studies/Serology
´ Radiological Ix (විකිරණෙව්ද පරීක්ෂා )
´ USS/MRI/CT/Angiogram
´ Other procedures
´ Endoscopy, ECG, Hearing tests, Vision tests

6. Types of
Investigations
Bed
side/Chair
side
Laboratory
Investigations
Other
medical
procedures

7. Types of Investigations
´ Chair side/Bed side investigations
´ RAT
´ Urine HCG,
´ Urine dipstick tests for Protein, Sugar
´ CBS
´ ECG

8. Types of investigations ctd….
´ Laboratory Investigations
Urine
Blood
Other body fluids
Tissue

9. Types of investigations ctd….
´ Other Medical Procedures
´ Radiological investigations
´ Endoscopy

10. Types ctd…..
Types of
Investigations
Screening Tests Diagnostic tests
Routine
investigations
Special
Investigations

11. Why you need to know
about investigations as a
Caregiver ?

13. Investigations alone can not help in the
management of the patient.
In a hospital/Clinical setting-
Doctors/Nurses
´ History
´ Examination
´ Investigations
´ Diagnosis
´ Management
´ Follow up
At Home/Care Institution
Caregiver
´ Patient Assessment(Physical, Mental,
Medical conditions)
´ Preparing a Care plan
´ Maintain Nutrition of the client
´ Administering drugs
´ Appointments for tests
´ Preparation for investigations
´ Identify emergency situations
´ When to seek help for the client

15. When you read an Lab investigation
´ Check for
´ Name
´ Age
´ Date
´ Compare with previous
investigations.
´ Look who has referred
´ Check from where the
investigation has done.
´ Reference range (There can be
slight difference from lab to lab)
´ Units (May differ)

16. Common Laboratory Investigations a
caregiver should know
´ Some of bed side/Lab
investigations
´ Content
´ Uses
´ Preparation
´ Values

17. Full Blood Count (FBC)
´ White blood cells
´ Red blood cells
´ Hb (Haemoglobin)
´ Platelets
´ No need of special preparation

18. ESR
´ Detection of inflammation in
body.
´ Increase in
Inflammation(Artherites)
´ Long-term illnesses/infections
´ Cancer
No need of special preparation

19. C reactive protein (CRP)
´ High in acute infections/injury
´ Or in chronic infections
´ No Special Preperation

20. Blood Sugar evaluation
´ Capillary Blood Sugar (CBS)
´ Random Blood Sugar (RBS)
´ Fasting Blood Sugar (FBS)
´ Post Prandial Blood Sugar (PPBS)
´ HbA1C
´ Oral Glucose Tolerance Test(OGTT)

21. Capillary Blood Sugar (CBS)
´ Bed side test
´ Glucometer
´ Need to know how to check (Skills)
´ Range
´ Low Level – 70 mg/dl
´ High level - >126 mg/dl (Fasting)
´ > 180/200 mg /dl (symptomatic)
´ HI
´ Look for the symptoms of
hypoglycemia/Hyperglycemia
´ No need of special preparation

22. Random Blood Sugar (RBS)
´ Venous blood sample
´ A blood sugar level less than 140
mg/dL is normal.
´ A reading of more than 200
mg/dL after two hours means
you have diabetes.
´ A reading between 140 and 199
mg/dL prediabetes.
´ > 200 mg/dl consider as high
´ No need of special preparation

23. Fasting blood sugar (FBS)
´ Venous Blood sample
´ Diagnosis
´ 100-125mg/dl Pre-diabetic
´ =/> 126 mg/dl with symptoms
diabetes +
´ =/> 126 mg/dl without symptoms
repeat test
´ Treatment
´ 126-200 mg/dl –one drug
´ >200 mg/dl –start with two drugs
´ >300 mg/dl /
complications/severe symptoms -
2/3 drugs with insulin.
´ Maintenance
´ Diabetic patient- Glycemic target
(FBS- 80- 130 mg/dl )

24. FBS ctd
´ Preparation
´ 8-10 hour overnight fasting
´ Avoid caloric food drink
´ Can take water

25. Post Prandial Blood Sugar (PPBS)
´ Venous Blood
´ 2 hours after meal
´ Timing stats from the start of the
meal
´ Usual antidiabetic drugs should
be taken in regular intervals
Range
< 140 mg/dl for normal person
< 180 mg/dl for a diabetic patient
(glycemic control)

26. HbA1C
´ Venous blood
´ No need preparation
´ Long term control of blood sugar
´ Over past 3 months
´ =/> 6.5%
cut off for diagnosis
´ Control – 7%
´ Individualized glycemic targets
´ HbA1C level will high with
advanced aging and other
diseases

27. Lipid Profile
´ Venous Blood
´ Cholesterol levels
´ Need 12 Hour Overnight fasting
´ Can take small amount of water
´ Total Cholesterol - <200 mg/dl
´ Triglycerides -,150 mg/dl
´ LDL - < 100 mg/dl
´ HDL - > 60 mg/dl
´ VLDL

28. TSH/T3/T4
´ TSH - thyroid stimulating hormone
´ Blood test that measures this
hormone.
´ TSH levels that are too high or too
low may be a sign of a thyroid
problem.
´ T3/T4 Thyroid hormone levels

29. B.Urea,S.Cr,eGFR
´ Blood investigations
´ Kidney function
´ Venous Blood samples
´ To test the renal (kidney)functions
´ eGFR < 60 –Kidney damage
´ No need fasting
´ Hydrate well before test

30. Liver Function Tests (LFT)
´ Liver function tests
´ Liver function
´ Liver profile
´ Venous blood
´ No need preparation
´ AST
´ ALT
´ ALP
´ GGT
´ Bilirubin
´ Protein(Albumin/Globulin)

31. ECG
´ Check your heart's rhythm and
electrical activity.
´ Heart rate
´ Rhythm
´ Wall function abnormalities(Heart
attacks/Heart failure)
´ Abnormal electrical activity

32. Other Cardiac investigations
´ Troponin I
´ Echocardiogram
´ Angiogram

33. Urine Full Report (UFR)
Done in a laboratory.
´ Color, cloudiness and
concentration of the urine.
´ Chemical composition
-Using a test strip.
´ Examination of the urine
Under a microscope
to look for bacteria, cells and parts
of cells.
No need special preparation
Collect to UFR normal bottle

34. Urine Culture
´ A urine culture is a lab test to
check for bacteria or other germs
in a urine sample.
´ How to collects
´ sterile urine bag,
´ urethral catheterization (CATH),
suprapubic aspiration (SPA),
´ Clean-catch (CC)

35. Urine culture
´ Clean catch/Midstream urine sample
´ Wash your hands
´ Clean the surrounding area – tip of penis
(push back foreskin if needed) for men and in
between the labia for women
´ Start to urinate, stop if possible or wait until
the first part of urine has passed, then using
your container capture a midstream urine
sample.
´ Void the rest of urine
´ close the container ,wipe the specimen
container and wash your hands.

36. Urine Culture
´ Culture and ABST

37. USS Abdomen/Pelvis
´ Full bladder
´ Fasting
´ Don't give /eat solid food for 6
hours before the ultrasound.
´ Drink 4 to 6 cups of water 1 hour
before your ultrasound.
´ Don't urinate (pee) before the
ultrasound.

38. Ctd..
´ Chest X-ray
´ Abdominal x-ray
´ X-ray head, neck, limbs, Spine

39. X ray KUB
´ Fasting
´ Bowel preparation

40. Summery
´ Always clarify your doubts. Ask from Doctor and Nurse
´ Prepare for investigations(Fasting, Premedication, Bladder bowel
preparations, Pre-investigations, Pre-consultations, Need admission)
´ Get the investigations timely and get the opinion.
´ Always check the name, date, relaent details to confirm.
´ Things to consider after the investigations
´ Know the basics
´ Maintain Confidentiality

41. Thank You!