Principles of Medical Laboratory Science Practice

Definition of Terms
 Medical Technology (Republic Act 5527/ Medical Technology Act of 1969)
o An auxiliary branch of laboratory medicine which deals with the
examination of tissues, secretions of the human body, and body fluids by
various Electronic, Chemical, Microscopic, and other medical laboratory
procedures or techniques either Manual or Automated which will aid the
physician in the diagnosis, study, and treatment of diseases and in the
promotion of health in general.
 Medical Technology (Heinemann)
o The application of the principle of natural and biologic sciences to the
performance of laboratory procedures which aid in the diagnosis and
treatment of disease.
 Medical Technology (Fagelson)
o Branch of medicine concerned with performance of laboratory
determination and analyses used in the diagnosis and treatment of
disease and the maintenance of health.
 Medical Technology (Walters)
o Health profession concerned with performing laboratory analyses in view
of obtaining informations necessary in the diagnosis and treatment of
disease as well as in the maintenance of good health.
 Medical Technology (Suba and Florida)
o A wide range of healthcare products that are used to diagnose, monitor or
treat diseases or medical conditions affecting humans.
 Clinical Laboratory Science (Suba and Florida)
o A healthcare profession that provides laboratory information and services
needed for the diagnosis and treatment of disease.
 Laboratory Sections:
o Anatomical pathology – ex. Uterus (usually after operation)
o Hematology – blood examination
o Biochemistry – common is blood, determine glucose
o Microbiology – concerns on organisms ex. Urine (bacteria)
o Molecular genetics – involves the genes (high tech lab)
o Point of care – done beside the patient ex. Random blood sugar collection
o Immunology – antibodies or antigens, ex. Hbs antibodies or antigens
o Cytogenetics – only performed in high tech laboratories
 Medical Technologist (Suba and Florida)
o Also known as clinical laboratory scientist, an allied healthcare
professional who exercises technical and scientific functions in medical
laboratories.
  Medical Technology
o Commission on Higher education (CHED) Requirements for Medical
technologist
 Baccalaureate degree program
 Bachelor of Science in Medical technology (BSMT)
 Bachelor of Clinical Laboratory Science (BCLS)
 Bachelor of Medical laboratory Science (BMLS)
 Has completed a clinical internship in a training accredited by
facilities and services of the Department of Health
 Has passed the licensure examinations administered by the board
of medical technology of the Professional Regulation Commission
(PRC)
 New curriculum training: 10 months
 Will be assigned in two laboratories:
o 1 government (5 months)
o 1 private (5 months)
 Accredited Laboratories affiliated with HNU
 Celestino Gallares Memorial Hospital
 Perpetual Succour in Cebu City
 Divine Word Hospital in Tacloban City
 Holy Name University Medical center
 Ramiro Community Hospital
 Medical Technology Scope for Examination (board exam)
o Clinical chemistry – 20%
o Microbiology and Parasitology – 20%
o Hematology – 20%
o Blood Banking/ Immunohematology – 20%
o Clinical Microscopy/ Urinalysis of Urine and Body Fluids – 10%
o Histopathologic Technique, cytotechnology, Medical Technology Laws,
and its implementing rules and code of ethics – 10%
o In order to pass, you have to get a 75% passing grade (74.9, considered
as failed but will be given a license as a medical technician)

Medical Technology
 Medical technology
o An applied science (Medicine and Technology)
o A series of stepwise scientific processes
o Employs technologies that provide meaningful diagnostic findings
 o Focuses on scientific inquiry (Investigative solicitation of relevant
information that may establish cause and effects of health concerns and
issues)
 Ex. Smoking and diabetes (increase glucose level in the blood)
Weather and dengue (rainy seasons are the breeding season
for mosquitos)
 Comparison between a natural science and medical technology (applied science
by Suba and Florida
Criterion Natural Science Medical Technology
Scope o General o Humans
Impact of Laboratory o Research o Diagnosis of
diagnosis Human disease
Area of study o Living things o Human
diseases
Application o Research o Research and
Clinical Laboratory
 Governing bodies of Medical technology in the Philippines:
o Commission on Higher Education (CHED)
 Memorandum order 14 series of 2006 (BSMT Qualification)
 To develop foundation of BSMT Education which: Consists
of clinical laboratory testing important for diagnosis,
prognosis, treatment, prevention of diseases.
 Requires BSMT students to have academics, internship and
specialized training
o Board of Medical Technology
 Administers board examination in Manila, Cebu, and Davao: on
August or September, February or March
o Professional Regulation Commission (PRC)
 Implementation and enforcement of regulatory policies of various
professions
o Philippine Association of Schools of Medical Technology and Public
Health, Incorporated (PASMETH)
 Recognized schools of medical technology objectives:
 Study on the problems of medical technology and public
health education
 Enhancement and continuous development of medical
technology and public health education
 Take united stand in matters that affect the interest of
medical technologists and public health education
 Seek the advice and assistance of government and private
entities for the fulfillment of the aim and purpose of
PASMETH
 Accomplishments
 Continuing professional education/ CPD (write shops,
seminars, and conventions
 Preparation of standard curriculum
 Preparation of Standard syllabi
 Scholarship grants for students (safeguard)
 Community outreach projects
 Recognition of graduates (gold medal for excellence award)
 Accreditation as CPD provider for Med Tech
 Events
 June 22, 1970: 1st Organizational meeting of PASMETH and
election of officers (Held in UST, University of Santo Tomas)
o Pres: Dr. Gustavo Reyes (UST)
o V-Pres: Dr. Serafin Juliano (FEU)
o Secretary/ Treasurer: Dr. Velia Trinidad
o Press relation officer: Dr. Faustino Sunico
 May 7, 1971: 1st annual meeting at UST and 2 nd election of
officers (re-elected)
 3rd election 1972
o Pres: Dr. Gustavo Reyes (UST)
o V-Pres: Dr. Claro Cabrera
o Secretary/ Treasurer: Dr. Elvira Silva
o Press relation officer: Dr. Faustino Sunico (FEU)
 Others who served as PASMETH Presidents:
o Dr. Ibarra Panopio (Velez College, 1973 – 1974)
o Dr. Angelita Adeva (UST, 1974 – 1975)
o Dr. Elizabeth Del Rio (Martinez Memorial Colleges,
1977 – 1981)
o Dr. Gustavo Reyes (UST, 1980 – 1981)
o Dr. Claro Cabrera (1981 – 1982)
o Dr. Elizabeth Del Rio (Martinez Memorial Colleges,
1982 – 1983)
o Dr. Norma Lerma (UST, 1983 – 1984)
o Dr. Vivencio Torres (University of Luzon, 1984 –
1985)
o Prof. Nardito Moraleta (FEU, 1985 – 1988)
o Dean Norma Chang (San Juan de Dios educational
Foundation, Inc, 1988 – 1996)
o Dr. Rodolfo Rabor (UST, 1996 – 1999)
o Dr. Nini Festin Lim (PWV, 1999 – 2002)
 o Dr. Zenaida Cajucom (World Citi Colleges, 2002 –
2010)
o Dean Magdalena Natividad (FEU – NRMF, QC, 2010
– 2012)
o Dean Bernard Ebuen (Arellano University, 2012 –
present)
o Philippine Association of medical Technologies (PAMET)
 The only accredited professional organization of all registered
medical technologists in the Philippines
 Organized by Crisanto Almario (Father of PAMET)
 September 15, 1963: Public Health Laboratory, Santa Cruz, Manila
 September 20, 1964: 1st National Convention of PAMET, FEU-
Manila
 PAMET Presidents:
 Charlemagne Tamondong, 1963 – 1967 (Emergence of the
Profession)
 Nardito Moraleta, 1967 – 1970 (Professional Recognition)
 Felix Asprer, 1970 – 1971 and 1973 – 1977 (Legislative
Agenda)
 Bernardo Tabaosares, 1971 – 1973 (Celebration of the
Practice)
 Angelina Jose, 1973 (Career Advocacy)
 Venerable Oca, 1977 - 1982 (Educational Advancement)
 Carmencita Acedera, 1982 -1992 (Image Building)
 Marilyn Atienza, 1992 – 1996 (Proactivism)
 Dean Norma Chang, 1996 – 2000 (International Leadership)
 Agnes Medenilla, 2000 – 2002 (Organizational Dynamism)
 Shirley Cruzada, 2002 – 2006 (Interdisciplinary Networking)
 Dr. Leila Florento, 2006 – 2010 (Global Perspectives:
Beyond Expectations)
 Romeo J. Ignacio, 2011 – Present (Soar High through Voice)
 History of Medical Technology
o 460 BC: Hippocrates- founder of Scientific Medicine
 Whoever wishes to investigate Medicine properly should proceed
this:
 Consider the effects of each season of the year
 Qualities of water
 Mode of living of the inhabitants
 Amount of food and drinks
 Exercise and labor
o 1550 BC: Vivian Herrick
  Intestinal parasites (Ebers Papyrus)
 Ascaris Lumbricoides
 Taenia Spp.
 Hookworm
 Anenzoa (Scabies is caused by a parasite (anenzoa))
o 1098 – 1498: Indians
 Diagnosis of diabetes mellitus
 The beginning of urinalysis
 Ants in Urine
 Tasting of sweet urine
 An Introduction to the profession of Medical Technology (Williams, Ruth)
o 14th century: Anna Fagelson
 Laboratory Acquired infectiob caused the death of Alexander
Gillani, a laboratory worker
th
o 17 century: anton Von Leeuwenhoek
 Invented oldest microscope (first to describe bacteria and red blood
cells)
th
o 18 century: Medical practitioners from North Africa and Southern Europe
 Classical Medical Education
 Physiological and Anatomical Theory
 4 basic humors of the human body (Balance)
 Blood
 Phlegm
 Black bile
 Yellow bile
 Humors are influenced by: Hot, Cold, Dry, Wet
o 1821 – 1902: Rudolf Virchow (Father of Pathology)
 Major Contribution to Science:
 Cell biology – cell theory, leukemia, theory of Biogenesis
 Anatomy – cells of the bone and connective tissues,
comparative anatomy, describe Myelin
 Pathology – microscopic pathological anatomy, systematic
clinical observations, zoonosis (animals to humans, ex.
Trichinella Spiralis)
o 1821 – 1902: Dr Calvin Ellis
 1st to utilize microscope in examining specimens
 Massachusetts General Hospital (worked in)
o 1821 – 1902: Dr. William Occam
 Used laboratory findings as preliminary evidence in diagnosis and
evaluation of a patient’s disease
o Baron Karl Von Humboldt
 Apothecaries Act 1815
  Lab findings in the treatment of diseases
o 1821 – 1902: Apothecaries Act 1815 (England and Wales)
 Society of Apothecaries
 Compulsory Apprenticeship of general practitioners
 Regulation of Medical Profession of the United Kingdom
 Anatomy
 Botany
 Chemistry
 Physics
 Universities involved in the apprenticeship of general practitioners:
 Harvard University
 University of Pennsylvania
 University of Michigan
o John Hopkins Hospital Pathological Anatomy Learning by Doing (1871)
o William H. Welch and Michell Prudden
 Clinical Pathology to Medical diagnosis (1870)
 Established a clinical laboratory at Bellevue Hospital Medical
College (1870)
 1st laboratory course in Pathology (1875)
 1st Professor of Pathology of John Hopkins University (1885)
o William Osler
 Clinical Professor of the University of Pennsylvania (1880)
 Microscope and blood counter
o Dr. Douglas: University of Michigan
 Best equipped laboratory for Medicine
o Dr. George Dock, Dr. Osler, and Dr. Douglas built a laboratory at the
University of Philadelphia (1887)
 Urinalysis and blood examination of patients
 Examination of vomitus, exudates, and other body fluids
 Dr. Douglas: first to give laboratory instructions
 First clinical laboratory (Dr. William Osler, 1896) The John Hopkins
Hospital
 William Pepper laboratory at University of Pennsylvania (1896)

History of Medical Technology

 A manual for clinical diagnosis/ clinical diagnosis by laboratory methods by
James Todd (1908)
 Insurance act approved laboratory Science: Disease Diagnosis (1911)
 State legislature of Pennsylvania enacted a law requiring hospitals to have
complete laboratory facilities (1915)
 Denver Society for clinical pathologist (1921)
 Courses in medical technology for clinical and laboratory technicians: University
of Minnesota (1922 – 1923)
 American Board of Pathology (1936)
 2-year curriculum for Medical technology: 1-year actual training (1940)
 History of Medical Technology in the Philippines
o World war II: 1936 – 1945
o Invasion of Pearl Harbor and the Philippines by Japan: 1941
o US bases in Leyte, 1944
o Invasion of the Phil. By the USA, 1945
o End of World War II
o 1st Clinical Laboratory: Quiricada Street, Santa Cruz, Manila: Manila Public
Health Laboratory (26th Medical Laboratory of the 6th US Army)
o 1945:
 One-year training of High School Graduates (laboratory
Technicians)
 US army left the Philippines
 Clinical Laboratory of the Department of Health stopped operations
 Dr. Pio de Roda (Bacteriologist) and Dr. Mariano Icasiano (1 st City
Health officer of Manila), and Dr. Prudencia Santa Ana re-
established the laboratory
o Dr. Santa Ana: Prepared a syllabus for the training of medical technicians
(1954)
o Dr. Tirso Briones conducted a 6-month training course with certification
(1954)
o 1st 4-year BS Med Tech course offered at Philippine Union College/ PUC,
BAESA, Caloocan City; Now Adventist University of the Philippines / AVP,
Silang Cavite (1956)
o 1956
 Manila Sanitorium and Hospital (internship training)
 Dr. Willa Hilgert Hedrick, PUC: founder of Medical Technology
Education of the Philippines
 Assisted by Mrs. Antoinette Mckelvey
 1st graduate of BSMT (1956) – Dr. Jessie Dy Umali, an ob-
gynecologist of Omega Lab, Vito Cruz, Manila. Graduated Medicine
at FEU Manila
 Dr. Willa Hilgert Hendrick assisted by Mrs. Antoinette Mckelvey,
established the 1st complete laboratory in Microbiology,
Parasitology, Histopathology, at the Manila Sanitorium Hospital and
PUC
nd
o 2 4- year BS Med Tech course offered at the University of Santo Tomas/
UST, 1957
  Dr. Gustavo Reyes and Dr. Antonio Gabriel (organizers for UST
Course)
o Bureau of Education approved: 1st 3-years: Academic course, 4th year:
Internship (1960 – 1961)
o 3rd 4-year BS Med Tech course offered at the Far Eastern University –
MLA/ FEU – MAL, (1961)
 Dr. Horacio Ilagan (Technical Director), Dr. Serafin Julliano, Dr.
Lauro Panganiban, Dr. Jesus Nolasco (Dean, College of Medicine)

Clinical Laboratory Sections

 Clinical Chemistry Section
o Quantitative Analysis of Liquid Component of Blood and Other body fluids
(Cerebrospinal Fluid/ CSF, Synovial Fluid, Pericardial Fluid, Peritonial
fluid, Urine, Gastric Juice, Etc.)
o Serum (liquid portion of clotted blood), Plasma (liquid portion of unclotted
blood)
o Fluids are collected using syringe or evacuated tube system/ ETS,
Nasogastric Tubes (Gastric Juice)
o Manual or automated Method of determination
o Detection of Chronic or Lifestyle – associated Diseases like:
 Diabetes Mellitus: Insulin Deficiency/ Resistance (Glucose)
 Cardiovascular diseases (Asther…)
 Ex. Heart attack (troponin)
 Monitoring:
o Lipid profile
o Total cholesterol, triglyceride, high density lipoprotein
(HDL), Low density Lipoprotein (LDL), Very Low-
density Lipoprotein (VLDL)
 Hepatic Diseases
 Ex. Hepatitis, hepatic cirrhosis
 Synthesized in the liver:
o Alanine Amino Transferase/ ALT
o Aspartatate Amino Transferase/ AST
o Alkaline Phosphate/ ALP
o Albumin
 Metabolized in the liver: Bilirubin
 Abused drugs and alcoholism (MDMA. THC, MHC, Breath
Analysis)
 Renal Diseases (creatinine, blood urea nitrogen/BUN)
 Gastro-Intestinal Diseases
 Ex. Gastritis, Ulcer, Gastric Cancer
  Gastric juice analysis, gastrin
 Pulmonary diseases (Sputum microscopy, sputum culture)
 Ex. TB, lung cancer, Pneumonia, COPD
 Diseases of the Joints
 Arthritis (inflammation)
 Gout (Deposition of Uric Acid)
 Rheumatoid Arthritis (Antibodies attack the joints)
 Diseases of the Pancreas
 Pancreatitis (Amylase, Lipase)
 Diseases With possible genetic linkage
 Hormonal Diseases
o Thyroxine for goiter
o Simple Graves’ disease
o Cortisol for Cushing disease
o Estrogen for feminization
o Testosterone for Turner’s Syndrome, Stein-Leventhal
Syndrome/ Polycystic Ovary Syndrome
o Growth hormone for gigantism, dwarfism an
acromegaly, and Simmond’s disease.
o Cancer: biopsy of the organ for detection of cancer
cells though microscopic examination by the
pathologist and cyto technologist (gold standard)
o Tumor Marker detection in the blood (Med-Tech) Non-
Specific tests (for monitoring only)
o Colon: Carcinoembryonic Antigen/ CEA
o Breast Cancer: CA – 153
o Ovarian Cancer: CA – 125
o Pancreatic Cancer: CA – 19 – 9
o Prostate Cancer: Prostate Specific Antigen/ PSA
 Hematology Section
o Microscopic examination of the solid components of blood
 Red blood cells = Erythrocytes
 White blood cells = Leukocytes
 Platelets = Thrombocytes
o Determination of Hemoglobin level (Respiratory Pigment of the
erythrocyte) and Hematocrit (Red Cell Volume)
o Detection of Diseases of the Blood:
 Anemias/ Anemia
 Low oxygen – carrying capacity caused by: Low hemoglobin,
hematocrit or erythrocyte count due to deficiency of:
o Iron, folate, Vitamin B12, and other causes
  Leukemias/ leukemia
 Excessive proliferation of Mature or immature white blood
cells caused by Chemicals, drugs, etc.
 Clinical Microscopy Section
o Study of samples cannot be seen by the naked eye
 Physical (PH, Turbidity/ Transparency)
 Chemical (Protein, Glucose, others)
 Microscopic (Bacteria, RBC’s, WBC’s, Crystals, and others)
 Characteristics of Urine and other body fluids except blood
o Detection of diseases of the:
 Kidneys
 Liver
 Pancreas
 And others
 Microbiology Section
o Isolation, cultivation, characterization, and identification of bacteria, fungi,
viruses, and other microorganisms
o From human samples like:
 Blood
 Urine
 Sputum
 Stool
 Other body fluids
o Detection of infections of various organs
o Methods of identification:
I. Gram Staining
 Gram positive cocci (Spherical, violet/ blue)
 Gram negative cocci (Spherical, pink/ red)
 Gram positive bacilli (rod-like, violet/ blue)
 Gram negative bacilli (rod-like, pink/red)
II. Biochemical tests: detects enzymes from the
microorganisms
III. Polymerase Chain reaction: detects DNA content of the
bacteria, fungi, viruses
IV. Cell culture: using animal or human cells for viruses
V. Morphological Identification: uses stain for fungi
VI. Antibiotic Sensitivity Testing: determination of the best
antibiotic for the treatment of bacterial disease
VII. Isolation and culturation: of bacteria and fungi require culture
media (agar with nutrients)
 Parasitology Section
o Study of parasites (medical parasites)
  Physical (color, consistency) and Microscopic Examination of
parasite:
 Ova (Eggs)
 Larva
 Adult
o Detection of parasitic diseases of the digestive tract, respiratory tract,
urinary tract, nervous system, blood
 Blood Banking and Serology Section
o Blood banking
 The process that takes place in the lab to make sure that donated
blood or blood products, are safe before they are used in blood
transfusions and other medical procedures
 It includes typing the blood for transfusion and testing for infectious
disease
o Serology
 Scientific study of serum and other body fluids
 Refers to the diagnostic identification of antibodies in the serum
 Such antibodies are typically formed in response to an infection,
against other foreign proteins, or to one’s own protein
o Blood banking and serology
 Determination of major and minor blood types
 Major blood types
 ABO system: A+, B+, AB+, O+, A-, B-, AB-, O-
 Rh system: Rh+, Rh-
 Minor Blood groups
 MNS, P, I, Le, Lu, Fy, KELL, KIDD, etc.
 Determination of the compatibility of donor’s blood and patient’s
blood
 Incompatible blood transfused to patients causes:
 Transfusion reactions:
o Allergic (hypersensitivity of the immune system)
 Mild: Facial flushing, hives/ rashes
 Severe: Increased anxiety, wheezing,
decreased BP
o Hemolytic (RBC lysis)
 Decreased BP
 Increased RR (respiratory rate)
 Hemoglobinuria
 Chest pain
 Apprehensions
 Low back pain
 Fever
  Tachychardia (increased heart rate)
 Chills
o Febrile (Infection)
 Headache
 Tachychardia (increased heart rate)
 Tachypnea (increased in breathing)
 Fever/ chills
 Anxiety
 Screening of:
 Donor: HIV, HBV, Malaria, Syphilis, etc.
 Patient: HIV, HBV, Syphilis, Dengue fever, etc.
 Preparation of blood components for transfusion:
 Whole blood (blood loss)
 Fresh frozen plasma (severe burns)
 Platelet and WBC concentrate (Dengue fever, etc.)

 Histopathology and cytopathology

o Is the preparation of slid tissues of the body either from Autopsy
(examination of tissue from a cadaver or a dead person) / Biopsy (taking
an organ from a living person from operation) to the slide for microscopic
diagnosis.
o Diagnosis of cancer and other diseases using tissues from:
 Biopsy (Appendix, vaginal smear/ PAP’s smear, uterus, ovary, liver,
lungs, etc.)
 Final detection of the cause of death (autopsy: pathologist and
med. Tech)
o Pathologist examines the tissues and the med tech prepares the slides
with tissues
o Med Tech may also be trained (cytotechnologist)
o Steps in routine tissue processing in Histopath Section
 Fixation (decalcification- special procedure, not all will undergo) =
10% formalin
 Dehydration (draining water) = 5 – 10% HNO3
 Clearing (to make the tissue transparent) = Xylene/ Xylol
 Infiltration (impregnation) = Liquified paraffin wax
 Embedding = Liquified paraffin wax
 Trimming = Knife or blade
 Section – cutting = rotary microtome
 Staining (give aesthetic value to slide and differentiate clearly the
nucleus from cytoplasm) = H & E staining method
 Mounting = Eukitt
 Labeling (permanent way of labelling slide) = Gum label
 Filling = Chronological label (filling cabinet)