Medical Diagnostics

Dr. I. Manjubala

Dr. I. Manjubala SBST, VIT University

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History

Dr. I. Manjubala SBST, VIT University

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Timeline 1911 Oskar Heimstadt invents the fluorescent microscope 1912 American College of Surgeons is chartered in Illinois. 1913 DD Van Slyke is appointed chemist at Rockefeller Hospital Laboratory; American Association of Immunologists is founded. 1916 KMG Seigbahn develops x-ray spectroscopy 1918 N. Wales and EJ Copeland develop the electric refrigerator 1919 FW Aston develops the mass spectrograph 1920 First clinical laboratory method for serum phosphorus is established; the use of venipuncture for diagnostic testing becomes widespread; Meyers establishes the University of Iowa center for training clinical chemists, primarily for hospital positions; Conference of Public Health Laboratories is founded. 1921 First clinical laboratory method for serum magnesium is introduced; The Denver Society of Clinical Pathologists, precursor of ASCP, is founded.

• Traditional (Chinese) Medicine:

specifies four diagnostic methods:

(i) inspection,

(ii) auscultation-olfaction,

(iii) interrogation, and

(iv) palpation.

• Hippocrates was known to make diagnoses by tasting his patients' urine and smelling their sweat.

Dr. I. Manjubala SBST, VIT University

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What is a Disease?

•A disease is a physical or functional disorder of normal body systems that places an individual at increased risk of adverse consequences

•Diseases are diagnosed by physicians or other health care providers through a combination of tools

•When a disease is diagnosed, treatment is given to prevent or ameliorate complications and to improve prognosis

Dr. I. Manjubala SBST, VIT University

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Diagnosis (Gr. dia“through” + gnosis“knowledge”)

Diagnoses are made by three general categories of physicians or health care providers:

•Clinical diagnosticians identify diseases by examination of patient’s history and physical examination

•Pathologists identify diseases by examining cells and tissues removed from the body

•Radiologists identify diseases by imaging the intact body

Dr. I. Manjubala SBST, VIT University

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The Tree of Medicine

Dr. I. Manjubala SBST, VIT University

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Clinical laboratories

• Clinical labs are important in diseases diagnosis, determination its severity and patient response to specific treatment.

• Diagnosis of any disease is first done by physical examination by physician and confirmed by lab diagnostic tests.

• Lab values are very important in determination of disease severity, drug doses and in follow up.

Dr. I. Manjubala SBST, VIT University

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Clinical Laboratory

Functions:

1) Reveal the cause of the disease

2) Screen easy diagnosis

3) Suggest effective treatment

4) Assist in monitoring progress of pathological condition

5) Help in assessing response to treatment

Types of samples that are used in testing:

Body fluids: blood, serum, plasma, urine, cerebrospinal fluid (CSF), feces, and other body fluids or tissues.

Dr. I. Manjubala SBST, VIT University

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The sections of clinical laboratory are:

I.Anatomic pathology: histopathology, cytopathology, and electron microscopy.

II.Clinical pathology: 1. Clinical Microbiology: bacteriology, virology, parasitology, immunology,

and mycology.

2. Clinical Chemistry: instrumental analysis of blood components, enzymology, toxicology and endocrinology.

3. Hematology: analysis of blood cells. (coagulation and blood bank).

4. Genetics (cytogenetics.)

5. Reproductive biology: Semen analysis, Sperm bank and assisted

reproductive technology.

Dr. I. Manjubala SBST, VIT University

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Clinical Laboratory

Clinical diagnosisA diagnosis made on the basis of medical signs and patient-reported symptoms, rather than diagnostic tests

1. Laboratory diagnosis

A diagnosis based significantly on laboratory reports or test results, rather than the physical examination of the patient.

2. Radiology diagnosis

A diagnosis based primarily on the results from medical imaging studies.

3. Principal diagnosis

The single medical diagnosis - most relevant to the patient's chief complaint or need for treatment.

Dr. I. Manjubala SBST, VIT University

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4. Admitting diagnosis

The diagnosis given as the reason why the patient was admitted to the hospital; it may differ from the actual problem or from the discharge diagnoses,

5. Differential diagnosis

A process of identifying all of the possible diagnoses that could be connected to the signs, symptoms, and lab findings, and then ruling out diagnoses until a final determination can be made.

Dr. I. Manjubala SBST, VIT University

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6. Diagnostic criteria

Designates the combination of signs, symptoms, and test results that the clinician uses to attempt to determine the correct diagnosis.

– They are standards, normally published by international committees, and they are designed to offer the best sensitivity and specificity possible, respect the presence of a condition, with the state-of-the-art technology.

7. Prenatal diagnosis

Diagnosis work done before birth

8. Diagnosis of exclusion

A medical condition whose presence cannot be established with complete confidence from history, examination or testing. Diagnosis is therefore by elimination of all other reasonable possibilities.

Dr. I. Manjubala SBST, VIT University

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9. Dual diagnosis

The diagnosis of two related, but separate, medical conditions or co-morbidities; the term almost always refers to a diagnosis of a serious mental illness and a substance addiction.

10. Self-diagnosis

The diagnosis or identification of a medical conditions in oneself. Self-diagnosis is very common.

11. Remote diagnosis

A type of telemedicine that diagnoses a patient without being physically in the same room as the patient.

Dr. I. Manjubala SBST, VIT University

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12. Nursing diagnosis

Rather than focusing on biological processes, a nursing diagnosis identifies people's responses to situations in their lives, such as a readiness to change or a willingness to accept assistance.

13. Computer-aided diagnosis

Providing symptoms allows the computer to identify the problem and diagnose the user to the best of its ability. Health screening begins by identifying the part of the body where the symptoms are located; the computer cross-references a database for the corresponding disease and presents a diagnosis.

Dr. I. Manjubala SBST, VIT University

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14. Overdiagnosis

The diagnosis of "disease" that will never cause symptoms, distress, or death during a patient's lifetime

15. Wastebasket diagnosis

A vague, or even completely fake, medical or psychiatric label given to the patient or to the medical records department for essentially non-medical reasons, such as to reassure the patient by providing an official-sounding label, to make the provider look effective, or to obtain approval for treatment.

that amount to overmedicalization, such as the labeling of normal responses to physical hunger as reactive hypoglycemia.

16. Retrospective diagnosis

A retrospective diagnosis (posthumous diagnosis) is the practice of identifying an illness after the death of the patient, sometimes in a historical figure using modern knowledge, methods and disease classifications.

Dr. I. Manjubala SBST, VIT University

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