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-1 :

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: 12

( ) .

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-2 -:

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-3 ( )Haemolysis

.
-:
( )Thalassemia ( Sickle Cell Anaemia
)
.
: ( ) (
. )
.
.
.

.
-4
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-5
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( )1 ( )
.

6 5
6 14

( )
( )

100/
11
12
13
12
11

( )1996
-:
:
:
( 37 ) ( 5 2 )
.
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_:
:
.
. .

.


.
-:
.

.

.
:
. . .
.
:

( + )( .)
.
:
( )%80
)F Hb ( )A Hb (
( )%3.5-1.5
,.
.) )A2 Hb (( 2

Hb
A
Hb 2

A
Hb

F
Hb

Bart
Hb
H

%98

%3

%2

%0
%0


%90

%0
%0

S Hb

%0

%0

= 16-13 100 /
= 15-12100 / .

(
) () .
.
.
:
-1 ( (Comple Blood Count CBC):
7 10 100
(
) .
.
. .
-2 "" ( sickling test) :


.
.
(
.sickle test) Positive
.
. .
-3 :

. (
)HBs %50
.
.

2 (
) A Hb ( .) Hb F (

)Hb s

.
4 Hb (
)A .)s Hb (

) s HB(



......

.




spectrophotometers -Colorimeters or ( )
Specimen

Serum .
.

( Solution Standard )

.

.
"Absorbance "A
"Transmittance "T

:

( )A ( ) Blank
( )T
( ) :
/ X ... = /
AT / AS X Cs = mg/dl
:

A

T

S
Cs
mg/dl 100 ()
Kits
( ) ( )Kits
.
( )
(
)
Kits
.1 .

.2
.
.3 .
.
.
.
.
.
( ) .
.
:


.
R2- R3 ( R
......
-).R1 . Reagent
.
:


( )
.
Cuvettes .

.
.

.
:


:
:Tungestic Acid
%10

3/2 ( 18.6 )
.
%10 .%20

110 70 100 8

12 150 120 100


)Physiological Hyperglycemia

( 18 12) 70 60 100
" " Physiological Hypoglycemia).
()( )

) (Insulin

)(Anti-Insulin . ) (Glucagons )(Adrenaline

) ( Glucocorticoid ) (Growth Hormone (Thyroxin).

) ( Diabetes Mellitus :
.

.
" ".

:
- ( Hyperglycemic Coma):

, .

-1

-2 ( ) .

-3 .
-4 .

) ) Ketones Bodies

.

.
-( Hypoglycemic Coma):


60 100 .
:
- 1

- 2

- 3
- 4



( 24) .
) (Diabetes Mellitus):
(

.
:

) (1 ) ( Insulin Dependent Diabetes Mellitus


( IDDM):

) ( Type 1 40 30

) ( IDDM

()2 ( Non- Insulin Dependent Diabetes

)Mellitus ( NIDDM):

) ( Type

.
.

( ) .
))
-1:

:
( )

) ( Fehling ) ( Benedict

) ( Strips ) ( Glucose Oxidase

) (Glucose Analyzer (Glucose


)Oxidase ) ( Oxygen Electrode

.
-2 ( Random Blood Glucose):


.
-3 ( Fasting Blood Glucose) :

12 8

110 70 100 120


130
3 .
-4 ( Post Prandial Blood Glucose):

( 75 )
.
140 .
-5 )( Glucose Tolerance Test
( GTT):

12 8

75 ( 1 ) 3
.

110 70 130 120

2 3
" )" ( Insulin Shot
.

130 180
.

3 2
.

-6)( Glycosylated Haemoglobin - HbA 1c

() Haem

) )

A1c
%10 - 5 ( HbA1c).

) ( HbA1c


120 %8 - 5
.
-7( Fructosamine):

20 - 15 .

) (Glycosylated Proteins
.

()

-1 .
-2 .

-3 (

103 105 )
.

-4
.

-5 .

-6
.
-7 ( )


:
: : 10



5.5 - 3.5 100 / ( 55 - 35 /(.
:
. . . .:
- .

. . . . .:
. " "
. " "
:

3.6 - 2 100 / ( 36 - 20 / )
:

- .

:
-

: 8

.
.

0.6 - 0.2 100 / ( 6 - 2 /( .


:
:

: : :

. :

. :

8 - 6 100 ( ( 60 - 80 /.
: :


( )

( )

: : :

- :

) (GGT ) ( ALT/GPT ) ( AST/GOT


.
( ) :

() ) ( AST/GOT)( ALT/GPT
.

) ( GPT 45 /.
) (GOT 41 /..
) ( GPT ) ( GOT

) ( GOT .

" " 6 .

))()GGT


30
25

50 .
:-

- ()

)) )(ALP


" " .

) (PH 7

71 - 24 /
( 30) 350 /
:

- .

. -

)):


) ( ID - BIL

) ( D - BIL .
) ( T- BIL

19 - 3.5 /

7 /.
:-:

" ".

" "
-

" "
"
" " " .

- .

:Kidney Function Tests



:
) (1 ( Urea) :

) ( NH3 .

%50

40 - 20 100 / ( 7 - 3.5 /)

) Blood Urea Nitrogen ( BUN 25 - 8 100 / ( 8.9 - 0.9


/(

40 - 20 100 / 15 - 5 100 /
20 - 5 100 / .
:


Hepatic Coma

Hemodialysis
.
Cachexia Malnutrition Starvation
:

) (2 Creatinine :

Anhydrous
Creatine Phosphocreatine
24
.

1.5 - 0.5 100

1.5 24 /
1.0 24 /

:
-

0.5 100 / .
) (3 Creatinine Clearance Test:

24
24.
140 - 90 /
125 - 80 /

) Creatinine Clearance (c :
C= Uc Tv/24 60 Sc

Uc

Sc

24

Tv
24

60
:
Water Depletion -

)(4 )( Uric Acid

Purine
Adinine Guanine.

7 - 3 100 ( 0.53 - 0.18 / )


6 - 2 ( 0.45 - 0.15 / .

% 80

.
700 - 300 24 /

) ) ( )

24 .

:
- Gout

Pre - Eclampsia &Eclampsia Leukaemia -

Glycogen Storage Disease - Type 1 -

- Alcoholism

:
-

Allpurinol Probenicid .

:
Total Lipids


( ) (

: ) (Triglyceride ) ( Fatty Acids) ( Waxes


) ( Steroid ) ( Terpenes

,
) Cholesterol ) (Triglyceride
1000 - 450 100 /

))-:

"" .

) ( Lipoproteins
.

() .
:

:
-

.
:-

1 - 20

120 - 230100/

21 - 30

120 - 240100/

31 - 40

140 - 260100/

41 - 50

150 - 290100/

51 - 60

160 - 300 100/

) " TG" :
% 90 ) ( Chylomicron
) 10 % ( Very
)Low Density Lipoprotein - VLDL

1 - 30

10 - 140100/

31 - 40

10 - 150100/

41 - 50

10 - 160100/

51 - 60

10 - 170 100/

:
-

- ( LDL )

:-

( Fatty
)Liver

: Lipoproteins Analysis



:
)( Chylomicrons )( VLDL )( LDL- Low Density Lipoproteins- )( HDL - High Density Lipoproteins

:-

() )( HDL - High Density Lipoproteins

HDL ) ( - lipoprotein % 25
% 45 -

HDL HDL

HDL
HDL HDL

HDL .

HDL 40 / 100 ( 0.83 2.5 / (


) )(LDL- Low Density Lipoproteins

) ( - Lipoproteins

% 75 - 50 LDL
LDL HDL

LDL 180 100 / ( 3.88 - 0.5 /)

LDL :
LDL Cholesterol (mg/dl) = Total Cholesterol - HDL Cholesterol - Triglyceride
5
Triglyceride mg/dl 400
LDL :
LDLCholesterol (mmol/L) = Total Cholesterol - HDL CholesterolTriglyceride
22
:
Triglyceride
LDL Cholesterol
HDL Cholesterol

Total Cholesterol

35 - 55 55

HDL-Chol mg/100ml
45 - 65 65
150 - 190 150
LDL-Chol mg/100ml
________ ________
LDL - 3.8 - 5.9 3.8
Chol
3.1 - 4.6 3.1

35
45
190
________
5.9
4.6



Electrochemiluminescence and Elecsys 1010 Elecsys 2010

.....

"

" ()53:

.....

" "
( ) " "

" "
( 1000/1)

-:

- 1

- 2
- 3
- 4

- 5

-:

- 1

" "

()DNA

- 2 " "

- 3 "
"

.
- 4 " "

- 5

: "Pituitary gland ":

TSH

ACTH
FSH
LH

)ADH(Anti- diuretic Hormones



Oxytocin


TSH

ACTH

GH

FSH +
LH

-:

( T4)Thyroxin ( ) T3
:

- 1
- 2

- 3
- 4

Calcitonin
.

.1T3T4

( )T4

T4 12-5 100/ ( 156-65 /).


T3 0.17-0.07 100 / ( 2.2 - 0.91
/)

T3T4

T3T4:

() .

()
() .

() .
() T3

T3T4:

() .

() .
() .

-2(:)HormoneThyroid Stimulating()TSH
( )Anterior Pituitary Gland
( ( )Hypothalamus - )
T3 T4
.

5-0.5 /.

TSH

()TSH:
- .

. ( ). - .

( )1 :
.

( )2 :

/ :

/ : Myxodema
.

:-:

Parathrmone

-:
" "
.

- :
.

:() -:Adrenal gland

: :

- 1

- 2

- 3
:

.
: .

( )
.

- 1
.

- 2 glucagon
.

: .ovary

- 1 :

-:
:

440 - 70 /

620 - 220 /

130000 - 20000 /

70

330

70

FSH

( . ) LH

- 2 :

10
.

28
14-7

ng/dl

100

6-1

ng/dl

20-150

28-15

ng/dl

250-2800


ng/dl

900-4700

ng/dl

1700-14700

ng/dl

5500- 20000

ng/dl

100

1
8 .

: Testis

.
.

nmol/l

nmol/l

9-38
( 0.35-3.8 )

* 3.5 nmol/l
* nmol/l

(1.4 )

: -:LH ( )Hormone Luteinizing


( )LH ( )Hypothalamus
( )Glycoprotein (

)Estrogens ( )Progesterone .

( )LH ( )Testosterone
.

( )LH 20-2 / .
80-15 /

( )LH 8.4-1 /

( )LH 0.4 /.

()LH:

( )Menopause Normal ( Premature


.)Menopause

()LH:

( .)Shihan Syndrome

-:()FSH()Follicle Stimulating Hormone

( )FSH ( )LH
.
()FSH.
()FSH()LH:

( )Infertility

()FSH

()FSH:

( .)Menopause

( .)Failure Seminiferous Tublar

( . )Climacteric

( .)Ovarian

()FSH:

( ).

( .)Panhypopituitarism

( .)Anorexia Nervosa

( .)Hypogonadism

( )FSH -2
12 /.

( )Ovulation 22-8

( )FSH 10.5-1 /

/.

( )FSH 2.5 /

-:( .)Prolactin

( )Follicular Phases
( .)Luteal Phases



.

( )Amenorrhea ( .)Oligomenorrhea

( .)Oligospermia

( )Galactorrhea ( .)Gynecomastia

( .)Galactorrhea

* 25-4 /.
* 25 600 /.
* 17-6 /.

.

( )Phenothiazine

( )Haloperidol

-:

- Bulimia

- (

-:
*

* 3 8
*

* 30

*
*

-:()GH(:)Growth Hormone

( )Anabolic
.

( )Lipolysis .

( )GH 0.48 /.

( )GH ( )Stress

( )GH .

( )GH
:

( )Dwarfism

( )Gigantism 10

/ ( )GH
.

(:)GH

( )Stress ( - - ).
.

( .)Gigantism

( -).

(:)GH

( )Glucocorticoids .

-:-:


.


:

.


Hepatitis C

"" ( )
. ( )
HIV
. ( ) 170
9 4 .
.
180,000
( ) 10,000 .
.
().
()
.
( ) (A, B, C, E, D, G)
.

15 . 30
" . " ( )
. .
%80 .
20 5
( )
.
. 600
.
( ) ( )
. 1989
( )
() .1992
(ANTI-HCV).
()
:

( ).

( ) .

( ).



.

1991
.
( ) . ()
( Hemophilia )


.
.
( ) ( )

. ( )
.
:
(
.1
).
(
.2
)
.3

HIV ( )

.4

()

()

( ) .
.%15
.

()
.%70 - %85 %25
10 .

.



.
. ( )
.


. ( )


. .
( )


( ) ( )
( ) HIV
().

( )

.

.
.

( ) .

)
( ) . (

.%6 .
.
.

HIV ( ) . (
) ( ) .
.


.

AST ALT
().

( )

.
.

()

( )
() .ANTI-HCV
( ) ELISA

() .
.
.

ALT .
5 % ( )

() HCV-RNA.

( ) ALT
ANTI-HCV
.
() ANTI-HCV

()

HCV-RNA

.

()

( )
:

( - ).

).

( )

() .

()



. ()
() .
( ) ( ) ( ) .
( ) ( ).
()
Alpha Interferon 3
ribavirin ()
6 12 .


( ) Biopsy



.


(
)

) excisional biopsy (
(
)
.) incisional biopsy (


) needle biopsy (

( ) Core biopsy
1.5
12.5

.
) Fine needle aspiration
(

) CT scan (

.


)Staging
) Grading (
(


.


) biopsy (

.

( )
( )

- / /



) (

-:

) Preanalytical ( - 1
) Analytical( - 2

) Postanalytical( - 3

-:
-: -
:

: 1
LE Cell (60%)
- 1
ANA, Anti Dn\NA
- 2
Infectious mononucleosis : 2
CBC Paul Bunuel Monospot (70%) -1
Serology for Epstein- Barr , Virus ( VCA,EIZNA) -2
VCA IgM
Stage
1- Primary EBV infection
+ve
(Early phase )
2-Primary EBV infection
+ve
(Transient phase )
3-Primary EBV infection
- ve
(Convalescent phase)

VCA IgG EBNA IgG

- ve

- ve

+ve

- ve

+ ve

+ ve

4- Reactivated infection

+ ve

1-HBsAg
2-HBc IgM

+ ve

+ ve

B -: 3
Exposure &cusonicity
Recent infection
3-

HBc IgG
4-HBeAg
5-HBeAg
6-PCR
7-HBsAb

Old infection
Infectivity
Partial convalescence
Viral replication(Viraemia)
complete recovery &Immunity

HCG in blood -: 4
: Latex -: 5

Rheumatoid factor, CRP, ASOT


Turbidimetry & Rephlonetry

( ) -: 6
Glycolated Hb
-:
Prgnancy Test
Thyroid function
Liver function
Kidney function
Diabtes profile
Antinatal and prenatal screening
Collagenic disease profile

) (

--:

-1-:

* -:

# 6 8 ( 12 )

# 10 12 ( 14 )

# Iron, ESR, CA19.9 :

* : 4 7

* -:

* -: & &

* :-PSA
0

* -:
0

* -: 24

* -:

* -:

* -: TIBC , Iron , G6ph 3 4


* _: Catecolamine , VMA ,5HIAA 48

* -: Aldosterone
0

* -: Renin

* , , 3 -: 0

* -:

* -:
3-2( FSH )

23- 21( Progestrone ) 0

* 9 -: ACTH Cortisol 9
* -:

# , , , ,
# ( )

# , ( P.T , P.T.T
)

# ( )

# ( ) 0
# :

#
#

-:

* 24 -:
0

* -:

20

30 Container0

* -:
0

* -: ,
,
0

* -: 0

* -:

-:

# 0

# 0

# 0
# 0
# 0

# ,
0

1 3

4.9%
6.7%

Total protein

Iron
Total Lipids

4.7%

5.1%

Cholesterol

9.3%

AST

8.4%

Bilirubin

6.2%

Potassium

# 0
# 0

# &
# 0
#
Citrate 0.2 ml ----- EDTA ----- Citrate 0.4 ml ----- Serum
# (
0) Vacutainer

# 2 3 " "
# CBC 0 EDTA
# 0

0 0 Hemolysis :K, Ck, LDH , SGOT , Mg

Bilirubin , Glucose
# :
Frozen 20 0- Refrigerated 8-2 0

25 18 :

- CK 0 LDH

# 0
# 0

# :
20 37 2000 5 0
# 0

# 0
# 0

#
0

--:

-1 0

-2 ( , , )
0 Quality Control

-3 Kits
0

-4 0 Standard $ Control
-5 0
-6 0

-7 0
-8 0
-9 ( )
0

-10 0
-11 0 Pamphlets
-12 :

* ( )
Reagent

* ( )

0
-13 0 Accuracy & Precesion

* : Accuracy Calibrator

: 90-89-90-91-90

* : Precesion Calibrator

:
91-88-92-95-90

-14 Reagent
0
-15 Pipetting 0 Pipettes

-16 CBC Coulter


:

Platelets : <1 oil immersion field --- decreased


: several oil immersion field --- normal
: >25 oil immersion field --- increased
WBCs :
2-4 /HPF --- 4000 7000
: 4 -6 /HPF ---- 7000 10000
: 6-10/ HPF --- 10000 12000
: 10 20/HPF --- 13000- 18000
-17 Duplicates %10 0
-18 Media (
)0

-19
0
-20 Lot 0

-21
0
-22 (
) 0

2 3

--:

# 0
# 0
#
0

#
0

-#
# -:
1- Bilirubin (Total) > Direct
2- 1 h value is the highest in sugar curve
.
3- HDL + LDL + VLDL = Total Cholesterol .
4- VLDL x5 = Triglycerides .
5- Cholesterol + Triglyceride < Total Lipids, usually 2/3.
6- CK Total > CKMB .
7- Drug peats > TCoughs.
8- Post Prandiel sugar > Fasting except in diabetics especially
insulin dependent.
-# GGT , Alk.phos. 0

-# Direct
1.5
-# PH 0
--- , 0 Amorph.urates ,
---

0 Amorph. Phosphates ,

-# %100 /
/ 0
-#

Gram +ve , -ve , Cocci , Bacilli 0

-#
-# :
TSH
T4,T3

1-

2- TSH
T4,T3
0
-# ( ) 0

:
Roche Hitachi 912 Chemistry Auto-analyzer

:
.


ELecsys 1010

Spectrophotometer 5010

Microlab 200

C.B.C
( BLOOD FILM )
R.B.Cs

R.B.Cs HB Content
Variation in Size
Variation in Shape

W.B.Cs

Granulocytes
Lymphocytes

Plateletes
Reticulocytes

Steps For Stain

THE GROWTH
OF BACTERIA
AFTER 24 hours.

()ELISA - PCR

Rapidlab 248
and 348 Systems

C B
C

PCR

Ventana