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CONTENTS

I. HEMATOLOGY 03
Conversation in context
1. In ward room at community centre Hospital
03
2. Meanwhile HMT staff is visiting patients ward room
04
3. Reporting Lab.Result
04
4. At a Clinic
.........05
Ways to Say (doing physical of blood examination) .06
Pair up and Practice (Case Study) 06
Reading Comprehension
(Clinical Hematology) ... 07

II. THE USAGE OF GENERAL LABORATORY EQUIPTMENTS09


Conversation in context
Conversation 1 09
Conversation 2 10
Conversation 3 11
Assignments 12
Reading Comprehension

1
(The usage of LABORATORY Devices) 13

III. CLINICAL CHEMISTRY 15


Conversation in context
(Case History) 15
ROLE PLAY
1. Case 1 17
2. Case 2 17
3. Case 3 18
4. Case 4 18
Reading Comprehension
(Chemical reaction in several importance diseases) 19

IV. URINALYSIS ...20


Conversation in context
1. At School Laboratory 20
2. At The Laboratorium 22
Case Study 23
Reading Comprehension
1. Urinalysis 24
2. Urine 25

V. CLINICAL MICROBIOLOGY 26
Conversation in context
1. At Public Health Care 26
2. Between Medical Lab.Staff and patient Jessica 27
3. At the E.R 29
Case Study ...31
Reading Comprehension
(Methods Used to Determine Antimicrobial Susceptibility) 32

VI. SEROLOGY AND IMMUNOHEMATOLOGY .33

2
Conversation in context 33
* CASE - STUDY ..33
* CASE - History ..36
Reading Comprehension
(Commun Immunology and Serologic Tests)....37
GLOSSARY.....38

Chapter I : H E M A T O L O G Y
General Purpose (GRAMMAR FOCUS) : Present, Future, Perfect
LEARNING Passive Voice Tense, Auxilliary (M o d a l s) for making r e q u e s t
and also g o o d GREETING in a way to communicate with patients
Objectives ii
Spesific Purposes : * Students are expected to be able to give useful
expression related of ways to say in B l o o
d
D i a g n o s i s
* Students are expected to create dialogue by
using vocabularies of HEMATOLOGY

Conversation in context
Note : The speakers are among Doctor, Hospital Medical Technologist (HMT) and
Mrs. Kania (mother of the patient = patients Mom)

in ward room at Community Centre


Hospital (1)

3
Doctor : Could you do me a favor, please ?
HMT : Absolutely, what could I do for you Doc ?
Doctor : This patient - named David - (son of Mrs.Kania) is identified being

infected to Dengue Haemorrhagic Fever (DHF). I have made some tests according to
her son condition and to get a better confirmation, we of course have to do
next evaluation which is Blood Count Test
especially ThrombocytesTest.

HMT : I get your idea Doctor and I will do those tests right away !
(2) Meanwhile HMT staff is visiting patients
ward room

HMT : Good morning madame, according to doctors instruction I


need to have your sons blood to make some laboratory
tests.
Mrs. Kania : Can you tell me whats happening with my son, please ?
HMT : Hmm., we dont exactly know Maam, until we find out
the Lab. Test
Mrs. Kania : So, what precisely are you going to do with him ?
HMT : First of all, Ill take the sample of your sons blood on his
hand and bring it to the laboratory. After that we will
examine the blood to get a result and give it to the doctor.
Within few hours you can find out your sons blood test by
asking directly to the doctor.
Mrs. Kania : IF thats so, then Ill ask the doctor directly !
HMT : Its better like that Maam.
Now, will you excuse me, please ?

4
Reporting Lab.Result (3)

HMT : Good afternoon Doc. Id like to make a report and give you
the result of Mrs. Kanias son, your patient.
Doctor : Well, what do you get then?
HMT : Actually, based on the Blood Count Test theres no significant observations
that weve got from patients blood specimen. Which means the number of
red blood cells (erythrocytes) and white blood cells (leukocytes) are
basically normal in this case. Eventhough there isnt any decreasing of RBC
and WBC but one thing for sure is we obtain a significant decreasing of
thrombocyte cells count. Heres I enclose you the exact number of each
particular cells which has already been stated on this report.

Doctor : Thank you so much for your assessment. This


one certainly helps me a lot to make a better
diagnosis.
HMT : My pleasure Doc ! I am glad it does.

5
(4) At a C l i n i c
NOTE : Conversation is between Shanty (Patient) and Mark (Laborant)

Mark : Hello, good afternoon. How can I help you ?


Shanty : Actually I bring doctors recommendation letter here to get my blood
inspection which according to the doctor is related to my Anemic disease.
Mark : Could I see your doctors recommendation firstly, please ?
Shanty : Sure, here it is.
Mark : I see..Well, before we do some examinations, firstly can you please tell me
the other diagnosis of your doctor concerning about your health maam ?
Shanty : No, there isnt any other. Only what you read on that letter.
Mark : OK, I guess we need to have your blood sample then. Concerning of that,
one of our staffs will take your blood on your hand tobe examinated.
Do you want to wait for your blood test result ?
Because it might take times to have it.
Shanty : Ok, i will ! Thanks anyway ....
Mark : With all my pleasure !
Ways to Say (of doing physical blood examination)

1) IF you dont mind, Id like to take your blood sample, so :

2) Could you just hop on the examination couch for a moment, please because I need to
take (to get) your blood for the sample.

3) Would you lie flat on the examining couch for a minute, please. Im going to have your
blood sample (I will have your blood sample).

Could you lay (give me) your arm, please?


Just hold out your arms for a second .. Good ! . . Now, you may loose(release) your hand !
4) Now, Im going to cuff on the manset around your arm and then Ill give an injection
and insert the syringe (insert the catheter) into your skin. Its probably/maybe/might
be hurt a lil (a little) bit but NO need to worry.

6
Pair up and

Practice
Case Study :
1. Mr. Bendex has suffered hepatitic chronic for quite long time (more less 4 - 5 years).
He comes to see the Internist and asks for specific diagnose from the doctor.
After examining him, the Internist writes down a notification letter to a Laboratory
Technician to conduct more in depth particular analysis related to Mr. Bendexs health.
Create your own dialogue between yourself, patient and also with The Internist
using appropriate terms for this case.
2. A - fourteen years old - girl being recognized of getting diabetic disease.
* Explain to the patien (her) what kind of necessary steps you are going to make for
the laboratory assessments.
* Make an improvisation of how to give good explanation to her parents.
* Lastly, make a final report to the physician based on the examination (Lab. Test Result).
Reading

Comprehension
C L I N I C A L H E M A T O L O G Y
Clinical hematology is primarily concerned with testing
the formed elements within the blood. This includes red cells,
white cells and platelets. The oxygen-carrying capacity of
the blood is routinely measured by measuring the hemoglobin
concentration and the hematocrit (percentage of total blood
volume occupied by the RBCs), counting the RBCs, and observing

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the morphology or appearance of the RBCs on a peripheral blood
film. RBCs production by the marrow is assessed by means of
reticulocyte count and examination of the bone marrow may be
necessary in certain disease states. The measurement of
hemoglobin is relatively simple and can be done quickly by
the laboratorian. Along with the hematocrit measurement, the
hemoglobin value is used to follow many disease states, especially
the anemias. The measurement of the concentration of hemoglobin
in the blood is called hemoglobinometry.
The one used by most laboratories is the hemiglobincyanide
(HiCN) or cyanmethemoglobin method. All forms of circulating
hemoglobin, except for sulfhemoglobin, are readily converted to
cyanmet-hemoglobin. The Spectrophotometric hemoglobin
determinations are rapid and give an accurate result. The degree
of accuracy will also depend on the basic technique which is used
and the accuracy of the equipment, the stability of the reagents,
and the cleaness of the glassware. Hemoglobin synthesis is a
complex process, staring in the bone marrow with the production
of the erythrocytes. The heme (iron-containing) portion of
the molecule combines with globin (the protein portion) and forms
an activated form of hemoglobin that is ready to transport oxygen.
Each hemoglobin molecule consists of four heme groups and
a globin moiety, which is composed of four polypeptide chains.
The leukocytes in the blood are routinely assessed by
counting the number of cells present in a particular volume, and
observing the morphology and determining the percentage of each
cell type present in a peripheral blood film. This is referred as
a white blood cell differential. Here again, examination of the bone
marrow may be necessary in certain cases, however, this is not
a routine procedure.
Platelets are also routinely assessed in clinical hematologic
studies by observing their number and morphology in the peripheral
blood film. If certain disorders are suspected platelets may also

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be counted. The blood clotting mechanism may also be checked,
when necessary, by testing for the clotting factors that are
present within the plasma.
Since the equilibrium of the blood is affected by a great
many factors, hematology tests are useful in the study of all sorts
of disease, of hematologic or non-hematologic origin.
Thus, hereditary, nutrional, metabolic, traumatic, inflammatory,
infectious, hormonal, immunologic, neoplasmic, drug induced and
other disease states can be assessed by hematologic studies.
The physician will depend on such laboratory results, in combination
with the clinical history and physical examination to determine
the state of health or disease of the patient.
Match each word with its definition !
1. observe a. test the value of
2. count b. change
3. measurement c. passed on from one generation to
following generation
4. convert d. act of counting
5. marrow e. special
6. chain f. watch carefully
7. assess g. size or quantity
8. particular h. tending to inflame
9. hereditary i. connected things
10. inflammatory j. fatty subtances that fills bones

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Chapter II : THE USAGE OF GENERAL
LABORATORY EQUIPMENTS
General Purpose (GRAMMAR Focus):
Wh - Question and Yes / No - Question
LEARNING This - These and That - Those
Singular and Plural Noun
Objectives
Specific Purposes:
* Student are able to describe and interpret the various types and
uses of Laboratory GLASSWARES such as :
Erlenmeyer Flask
Beaker Glass
Test Tube (Rx.tube)
and also VOLUMETRIC
glasswares (e.g: volumetric pipette, volumetric flask, buret)

* Students are able to identify each part of instruments and describe


the uses of Laboratory BALANCES, e.g :
Manual (mechanical) analytical Balance
Electronic (automatic) analytical Balance
Triple Beam Balance

* About MICROSCOPE
Part & the Function of Microscope in laboratory analysis
* About PHOTOMETER
Part and The USAGE of Spectrophotometer

LABORATORY GLASSWARES
Conversation in Context
N O T E : The dialogue is among The Instructor and Students
CONVERSATION - 1
Instructor : What is this called in English, Dena ?
Dena : It is called Beaker Glass
Instructor : What is the beaker glass for Denny ?

10
Denny : It is for reagent preparation and also used along with other
flasks for general mixing
Instructor : OK, now its your turn Sarah. How do you call this thing ?
Sarah : It is called E r l e n m e y e r F l a s k
Instructor : And what does Erlenmeyer flask use for, Kumiko ?
Kumiko : Erlenmeyer Flask is one of laboratory instruments which
commonly used
in the laboratory for preparing reagent and also for titration
procedures
Instructor : Next is you Anton ! What do you think this is ?
Anton : Well, that is Test Tube (Rx.Tube)
Instructor : What is the function of it, Dado ?
Dado :The function of Test Tube (Rx. Tube) is for examining the chemical
reaction
Instructor : Excellent ! i think all of you are very capable in describing
of each
Laboratory Glasswares. I guess, its enough for now
and well have
another topic of discussion which is determining
VOLUMETRIC GLASSWARES. See you then !

CONVERSATiON -2

Instructor : Hello again to you all !


Now, lets talk about another kind of laboratory glasswares, which are
VOLUMETRIC glasswares. Could you mention what kind of volumetric
glasswares that you know, Marcia ?

Marcia : Hmm., there are several kind of volumetric glasswares commonly used
in laboratory (such as: volumetric pipette, volumetric flask and buret)

Instructor : Good, now you Alexander !


How do you describe each of those glassware instruments ?

Alexander : 1st : Volumetric flask is flask with a round bulb at the bottom. It has a
long neck, on which the calibration mark is found.
2nd : Pipette is another type of volumetric glassware used extensively in
the laboratory. It is a cylindrical glasstube used in measuring fluids.
There are 2 types of pipette, they are : Manual and Automatic Pipette.
For most general laboratory use, the manual pipette is divided into two
main types as well : A. volumetric pipette
B. and measuring pipette, e.g : micro pipette

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3rd : BURET is: a long cylindrical tube of glassware with graduation
divisions on it and a stopcock at the end.
Instructor : Excellent ! You can describe them in detail. How about you Mia ?
Can you mention one by one of their usage, please ?
Mia : Yes, surely I can.

The usage of volumetric flask is for the preparation of specific


volumes or reagents or other laboratory solutions.
And the function of pipette is : used in measuring fluids and also to
deliver OR transfer a specified volume from one vessel to another.

The last one is Buret which is used to deliver measured quantities


of fluids or solution in the process of TITRATION.
Instructor : Very good .! Well..., thats all for now students !
The next topic will be a discussion about types and usages of of
Laboratory BALANCES. Please do prepare yourselves for that, students!

Conversati
on-3
Instructor : Nice to meet you all again, students !
So, have you prepared for our topic of discussion today ?

Students : Yes, we already have Maam !

Instructor : Good ! Now you Fuad, will you please mention some of Laboratory
BALANCES that you know.

Fuad : CERTAINLY ! They are : Analytical Balances which divided into :


MANUAL (mechanical) analytical balance and Automatic (ELECTRONIC)
analytical balance. The other type of balance is Triple Beam Balance.

Instructor : OK, and how bout their uses related for the laboratory ?
Now explain the function of Analytical Balance, yes Anne please !

12
Anne : The basic principle of using Analytical Balance is to measure
the quantitative measurement of the mass which is to balance
an unknown mass (the substance being weighed) with a known mass.

Instructor : Terrific ! Well then, based on our discussion today, I figure out that
you all have completely understood about determining and also
interpreting each of laboratory equipments (Lab.instruments).
Thats it for today and thanks for giving such explanations !

Assignments:
1. Identify parts of THE MICROSCOPE and explain them
clearly (name its parts and the usages) !

2. Figure out and describe the components of


SPECTROPHOTOMETER in detail !

3. Mention and elaborate EACH Division of ANALYTICAL


BALANCES !

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READING -

Comprehension

The Usage of LABORATORY DEVICES


Laboratory glassware and plasticware . Most of
laboratory glasswares and other laboratory wares can be divided into
two main categories according to the use of which they are classified :
containers or receivers and volumetric wares. Examples of containers or
receivers are beakers, tests tubes, Erlenmeyer flasks and reagent
bottles. Examples of volumetric wares are pipettes -automatic and
manual-; volumetric flasks; graduated cylinders and burets. Beakers are
wide, straight-sided cylindrical vessels and are available in many sizes
and in several forms. Beakers are used along with flasks for general
mixing and for reagent preparation. Erlenmeyer flasks are used
commonly in the laboratory for preparing reagents and for titration
procedures. Test tubes come in many sizes, test tubes without lips are
the most satisfactory, because there is less chance of chipping and
eventual breakage. Reagent bottles can be made of glass or some other
materials like plastic. Photometry cuvettes are the special tubes used for
photometry. Pipette is another type of volumetric glassware used
extensively in the laboratory. Pipettes are calibrated to deliver, or
transfer, a specified volume from one vessel to another. For
most general laboratory use, there are two main types of manual
pipettes: the volumetric pipette and the graduated pipette. Buret is a
long cylindrical tube of glassware used to deliver measured quantities of
fluids or solutions in the process of titration.
Laboratory centrifuges. Centrifugation is used in the
separation of a solid material from a liquid by application of increased
gravitational force by rapid rotating or spinning. It is also used in
recovering solid materials from suspensions as in the microscopic
examination of urine, in the separations of serum or plasma
from cells in blood specimens. The solid material or sediment packed at

14
the bottom of the centrifuge tube is sometimes called the precipitate,
and the liquid or top portion is called the supernatant. Centrifugation
is employed in many areas of the clinical laboratory in chemistry,
urinalysis, hematology, and blood banking, among others. The most
important rule to remember in using any centrifuge is : always balance
the centrifuge, in the centrifuge cup opposite the material
to be centrifuged, a container of equivalent size and shape with an equal
volume of liquid of the same specific gravity as the load must be placed.
The Use of Microscope. The microscope is probably the piece
of equipment that receives the most use (and mis-use) in the
clinical laboratory. Microscope is a basic part of the work in many areas
of the laboratory-hematology, urinalysis, and microbiology. In simple
terms, a microscope is a magnifying glass. The compound of light
microscope (or the bright field microscope, the type used in most clinical
laboratories) consist of two magnifying lenses, the objective and the
eyepiece (ocular). It is used to magnify an object to a point where it
can be seen with the human eye. Because of microscope is such an
important piece of equipment and is a precision instrument, it must be
kept in excellent condition, optically and mechanically. It must be kept
clean, and it must be kept aligned.
Photometry. In the clinical laboratory there is a continual need
for the use of quantitative techniques. By using of a quantitative
method, the exact amount of an unknown substance can be determined
accurately. One of the techniques used most frequently in the clinical
laboratory is photometry, or specifically, absorbance OR reflectance
spectrophotometry. Photometry OR colorimetry employs colour and
colour variation to determine the concentration of substances. The
use of spectrophotometry as the means of quantitative measurement
depends primarily on two factors, the color itself and the intensity of the
color. Any substance to be measured must be colored to begin with or
must be capable of being coloured. When spectrophotometry is used as
a method for quantitative measurement, the unknown colored substance
is compared with a similar substance of known strength, according to
the principle that the intensity of the color is directly proportional to the
concentration of the substance present. Another quantitative
spectrophotometric technique is reflectance spectrophotometry where
the light reflected from the surface of a colorimetric reaction is used to
measure the amount of unknown coloured product generated in the
reaction. To use a reflectance spectrophotometer, the system must use a
standard with the same specific surface optical properties as the specific
surface used in the test system. The use of reflectance
spectrophotometry provides the quantitative measurement of reactions
on surface such as strip, cartridge and dry film. Flame emission
photometry is used for quantitative measurement of lithium, sodium and
potassium in body fluids.

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Complete this cross word puzzle with words from the passage

Across
1. used along with flasks for general mixing
and for reagent preparation
2. the outside of any object
3. room for scientific experiments
4. make (a thing) appear larger
5. instrument with lenses for making very
small objects appear larger

Down
1. receptacle, especially for liquid

2. used in the separation of a solid material


from a liquid
3. cause (a solid) to separate from a liquid

4. law or custom

Chapter III : CLINICAL CHEMISTRY

General Purpose (GRAMMAR Focus) :


* Present Tense and Question Tag
LEARNING
Objectives Specific Purpose: Student are able to analyze chemical
reactions occurred in a specific laboratory test of several
important disease.

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Conversation in Context
Note : The dialogue happens between Angeline & Head of Lab.Department (HLD)

CASE HISTORY

Polymicturate Polydipsi - Polyfagia Weight Loss


An adult female patient with known Diabetes Mellitus (DM) disease has blood drawn test.
The laboratory inspection performs on specimen taken from patient both in a fasting state
(during prandial) and taken 2 hours after the patient has had a meal (post prandial = pp).
HLD : Hai Angeline ! We have something to discuss today, dont we ?
Angeline : Certainly we do, Maam.
HLD : So, whats the case then ?
Angeline : Its about a patient with known as DM problem.
HLD : And you already make the test, dont you ?
Angeline : Yes, I do already make the test.
HLD : What did you get from the lab.test report ? Can I see it, please ?
Angeline : Surely thing Maam, here you are.
HLD : (The HLD is seeing the report), wellwhat is your evaluation based on it ?
Angeline : (f.y.i) Ive made two kind of blood glucose tests, during fasting
(during prandial) & 2 hours after the patient had a meal (p.p)

HLD : is there any other significant observations with those two tests performed ?

17
Angeline : Yes, there is, indeed. During fasting time, we have glucose
concentration more than 126 mg/dl, specifically the patients
glucose concentration in fasting serum is 170 mg/dl.

HLD : Well, that is really significant, isnt it? And how bout blood glucose
concentration of post prandial ?
Angeline : It is also significant, Maam. We got a result of 300 mg/dl for
Blood Glucose concentration of post prandial.

HLD : So, give me your final conclusion then !

Angeline : Fine, based on the Lab.Test result, we obtain :


Plasma or Blood Glucose level during fasting (during prandial) is 170 mg/dl
& for the post prandial result, we have plasma glucose level 300 mg/dl

Those two concentrations are both more (greater) than normal, and
referred to Clinical Laboratory Reference by Jean Jorgenson Linne
it is said that there are 3 diagnostic criterias for Diabetes Mellitus :
(1) Plasma glucose level of fasting serum is Equal to (GREATER than) 126 mg/dl.
(2) Two hours post load glucose level is Equal or GREATER than 200 mg/dl.

HLD : Ok, I get your points. Those explanations are absolutely correct.
Thanks for giving me such detail information.

Angeline : Youre welcome, Maam !

R O L E -P L A Y
Instruction : make an evaluation or analysis based on each cases study below
and create the conversations using your own words !
Case - 1
A - 35 years old man (height 67 inches: weight 73.3 kg) with known chronic renal disease
for 6 months has blood drawn for serum creatinine and urea tests. Urine is collected for
a 24 hour quantitative creatinine test; the total volume of urine collected is 1139 ml.
The following laboratory results are obtained for the testing done :
Urine creatinine 56 mg/dl
Serum creatinine 9.6 mg/dl
Serum urea 75 mg/dl

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1. Given the above data, calculate the patients standardized creatinine clearance, in
ml/min. Standardized creatinine clearance for this patient is :

A. 4.3 ml/min
B. 4.6 ml/min
C. 6.2 ml/min
D. 5.8 ml/min

2. What is the normal range for creatinine clearance for this patient ?

Case - 2

As part of a lipid screening profile, the following result were obtained for a blood
specimen drawn from a - 30 years old woman - directly after she had eaten breakfast :

Triglycerides 200 mg/dl


Cholesterol 180 mg/dl
Which of the following would be a reasonable explanation for these results ?

A. The result fall within the reference values for the two tests; they are not affected by
the recent meal.
B. The cholesterol is normal; the triglyceride test is elevated; retest using a 12 hour fasting
specimen, as the triglyceride test is affected by the recent meal.
C. The results are elevated for the two tests; retest for both using a 12 hour fasting
specimen, as both cholesterol and triglyceride tests are affected by the recent meal.
D. The result for both tests are below the normal reference values despite the recent meal.

~ Case 3 ~
Adult male patient with jaundice complains of fatigue. He has a decreased blood
hemoglobin level (he is anemic) and an elevated serum bilirubin value, most of which
represents unconjugated bilirubin. His liver enzyme tests are within the normal reference
ranges. The most likely disease process for this patient is :
A. A gallstone obstructing the common bile duct
B. Hemolytic anemia in which his red blood cells are being destroyed
C. Infectious (viral) hepatitis
D. Cirrhosis of the liver

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Case - 4
An 8 years old boy comes to see his family physician with his mother. He has been
urinating excessively and has also has been drinking an excessive quantity of water.
He recently recovered from a viral upper respiratory infection, he has lost some weight
since his last visit to the clinic six months ago, and he has a slight fever (100 0F).
Laboratory tests are ordered, fasting blood is drawn for testing, and a urinalysis is done.
The following laboratory results are reported :

Serum creatinine 0.8 mg/dl


Serum glucose 180 mg/dl
White blood count 15 x 109/L
Hemoglobin 14.0 g/dl
URINALYSIS:
Specific gravity 1.025
Glucose 1000 mg/dl
Ketones moderate
Protein, nitrite, blood negative
Sediment no abnormal findings

On the basis of case history and the laboratory findings, what is a likely diagnosis
of this patients disease?
A. Diabetes mellitus
B. Hyperthyroidism
C. Acute glomerulonephritis
D. Recurring upper respiratory infection
Reading Comprehension

Chemical Reaction in Several


Importance Diseases
One of the most commonly performed procedures in the clinical
chemistry laboratory is the assay of blood glucose. Blood glucose test
are performed in all types of clinical laboratories, clinics, and physicians
offices, and by bedside or point-of-care testing (POCT). These tests
are used primarily for the diagnosis and treatment (or management) of
the diabetes mellitus. Although several different methods are used to
quantitatively measure the amount of glucose in a blood specimen, most
methods depend on the formation or disappearance of color in a solution
and employ a photometer for this measurement. Most of the methods
have been automated, but the same principles apply as for the non-
automated. Self-tests for blood glucose are also being done routinely by
many diabetics to manage their disease better. Glucose determinations

20
may be performed on specimens taken from patients on a fasting
state (during prandial) in which NO food or drink, other than
water, has been consumed for 8 to 12 hours, and on specimens taken 2
hours after the patient has had meal (post prandial), or as
part of a glucose tolerance test, in which the patient has consumed a
high-glucose drink or meal, depending on the physicians instructions.
The methods used for glucose determinations can be
divided into three categories: the classic oxidation methods, which
depend on the reducing ability of glucose; aromatic amine methods,
which involve a reaction between the aldehyde group of glucose and the
amino group of o-toluidine, an aromatic amine; and enzymatic methods,
which are based on the enzymes glucose oxidase and hexokinase. Since
many additional substances that normally occur in the blood can be
measured as glucose or can interfere with various tests, the term true
blood glucose is often encountered when the tests of blood glucose
are described. The enzyme methods are more specific for glucose and
are widely used for that reason.
Find the synonym of these words :
1. treatment a. intrude
2. physician b. explain
3. determination c. illness
4. specimen d. doctor
5. disease e. confront
6. interfere f. healing
7. encountered g. resolve
8. described h. sample

Chapter IV: U R I N A L Y S I S

General Purpose (GRAMMAR Focus):


Student must be able to use Imperative Sentences, able to make
LEARNING REQUEST sentences and also able to implement Present Tense and
Objectives Passive Voice
Specific Purposes: * Student are capable to explain appropriate
steps for procedures ( instructions ) in
Urinalysis Laboratory Experiments.
* Student have to give useful expressions using
Urinalysis Terminologies in several Specific
Diseases or conditions which related to urine
test or urine inspection.

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C o n v e r s a t i o n - in
Context

1. At SchooL
Laboratory
Note : The dialogue happens among group of students (GA : GB : GC) and
Lab.Instuctor (LI) inside school laboratory.

LI : Hello again to you all students ! How are you doing this day ?
Students : We are all doing fine !
LI : Alright then, todays practice is about detecting of liver disease and determining
the cause of clinical condition known as JAUNDICE (icteric).
Therefore, I need each of you to make the procedure and also an evaluation.
So, please divide yourselves into 3 group of students, specifically :
1st group (Group A) makes a presentation about Bilirubin procedure
2nd group (Group B) presents Urobilinogen procedure
3rd group (Group C) evaluates the test result of the other 2 groups
Now, would you please step forward Group A !
GA : First, we would like to say thank you for giving us a chance to present our
procedure. Today, were going to present BILIRUBIN test which specifically
called: Ictotest Tablet for Bilirubin,
1st : Place 10 drops of urine on the center of either side of the special test mat
(Rx. Tube) supplied with the reagent tablets.
2nd : Place the ictotest tablet in the center of the urine-moistened area.
Do not touch the tablet with your hands.
3rd : Place 1 drop of water on to the tablet. Wait for 5 seconds; then place a 2nd
drop of water onto the tablet so that the water runs off the tablet onto
the mat.
4th : Remove the tablet, and observe the mat for the appearance of a blue to
purple color at second.

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5th : Report the result as positive or negative according to the following
CRITERIA :
Negative: The mat shows NO blue or purple within 60 seconds. Ignore any
color that forms after 60 seconds, or a slight pink or red that
may appear.
Positive : The mat around or under the tablet turns blue or purple within 60
Ignore any color change on the tablet itself.
(Linne, J.J and Ringsrud, K.M, Clinical Laboratory Science, 4th Edition, page 480)

LI : Well, that was the presentation of group A !


Now, let us hear next presentation of group B !

GB : Thanks to you all and now our presentation is about Urobilinogen Test usually
known as : Watson - Schwartz Test for Urobilinogen.
1st : Place 2.5 ml urine in a 15 x 125 mm test tube.
Add 2.5 ml Ehrlichs reagent. Mix well by inversion.
nd
2 : Add 5.0 ml of saturated sodium acetate and mix it well.
Observe for the development of a pink to deep cherry-red colour.
(colour development indicates the presence of urobilinogen,
porphobilinogen, or intermediate Ehrlich - Reactive Compounds)
3rd : Report the result as :
Positive or negative for urobilinogen
Positive for porphobilinogen
Positive for both urobilinogen and porphobilinogen (very rare)
Do not report the finding of intermediate Ehrlich-Reactive Compounds.
There are false-positive reactions of NO clinical significant observation.
(Linne, J.J and Ringsrud, K.M, Clinical Laboratory Science, 4th Edition, page 486)

LI : OK, students ! As we all heard those two groups presentation just now, I guess
it is time for group C now to get some data from them and then make an
evaluation based on it. Please not to forget the conclusion you also have to
make, concerning for the information you need to report to the physician.
DATA ( RESULT )
Ictotest for Bilirubin Watson-Schwartz Test for Urobilinogen

Result : Bilirubin ( + ) Result : Urobilinogen ( + )


(The mat around or under the tablet turns (Observed by : pink colour development)
blue or purple within 60)

GC : Well everyone, before we evaluate and make a conclusion about patients


disease, please take a look to this chart. As you seen the results obtained, its
OBVIOUSLY known that the patient is indicated to LIVER DISEASE since

23
its showed both Bilirubin and Urobilinogen have positive result. These data
also become as parameters that we can give to the physician.
LI : I guess that is all for today and thank you so much for your presentation.
We will have the same discussion again in some other time with another
topics. See you then !

2. At The

Laboratorium
Note : The conversation are between yourself as Medical Analyst (MA) & Patient (P)
P : Hi, could you do me a favor ?
MA : Yes. How can I help you Sir ?
P : Hmm, today I go to the doctor and she gives me a reference letter to
take to a laboratory. She said that I need to do some tests.
MA : May I see the Doctors reference letter, please ?
P : Oh, absolutely you can. Here you are !
MA : (meanwhile: you open the letter and read the doctors instruction. It is said that
this patient must be examined for the cholesterol test).
Well Sir, regarding to your doctors reference we need to exam your URINE
sample. For your information, firstly I need your urine sample and then I have
to bring it to our laboratory to analyze it interm of getting some data.

Have you collected and brought your urine liquid yet ? Because if you already
have, you can give it to me Sir.
P : No, I havent unfortunately.
MA : Well then, please go to the rest room over there and collect your urine into this
instrument called kidney dish and then put it into this small plastic pot and
after that bring your urine sample here, Ok Sir ?

24
P : (meanwhile, the patient is collecting his urine)
Here is my urines sample !
MA : Thank you Sir.
Now, you may wait here for the result in about couple hours while I am going
to check this sample to the Lab, Ok ?
(meanwhile: the MA is doing the LAB.Test Procedure)
MA : Now Sir, your Lab. Test is finished !
So, heres your Lab. result Sir. I will put it in this envelope.
Please give this result to your physician directly as possible as it can sothat
the doctor will be able to determine the right therapy for you.
P : Thanks so much anyway !
MA : With all my pleasure and take care of yourself Sir !

Case Study
1. A patient - named Rony - comes to your hospital. Hes been given a notification letter
from his physician to get some laboratory examinations. On the notification letter, it is
said that you have to check his renal function. The doctor assumed that patient Rony
has suffered Chronic Renal Failure (CRF). Create you own dialogues among :
yourself - patient - and doctor.
2. There is class discussion among group of students. The subject is to make
presentations about analyzing procedures, evaluating and giving conclusion of chronic
diabetic (hyperglycemic) disease. Make the conversations based on that !

READING Comprehension - 1
Urinalysis

25
The composition of urine varies a great deal, depending on such factors as diet,
nutritional status, metabolic rate, the general state of the body, and the state of the kidney
or its ability to function normally.
Urine is a complex aqueous mixture consisting of 96% water and 4% dissolved
substances, most of which are divided from the food eaten or are waste products
of metabolism. The dissolved substances consist primarily of salt (sodium and potassium
chloride) as well as urea (the principal end product of protein metabolism).
In addition to urea, the principal organic substances found in urine are acid and
creatinine. Urea, uric acid and creatinine are nitrogenous waste products of
protein metabolism, which must be eliminated from the body because increased levels are
toxic. Urea makes up about one half of dissolved substances in urine. It is the end product
of amino acid and protein breakdown.
The amount of creatinine excretion is related to the muscle mass of the body, not diet.
Each individual excretes a constant amount of creatinine daily; therefore, urine creatinine
measurements are used to assess the completeness of timed urine collections. Blood
(plasma) creatinine levels are used to indicate renal function, because of the fact that
creatinine is normally filtered through the glomerulus and none is reabsorbed back into the
blood. Therefore, an increase in the plasma creatinine indicates impaired glomerular
filtration-impaired renal function. The glomerular filtration rate is calculated from the urine
and plasma creatinine levels together with 24 hour urine volume, height and weight.
In addition to sodium and chloride, the main inorganic substances present in urine
include potassium, calcium, magnesium, ammonia plus phosphates and sulfates.

Find out the meaning of these words !


1. in paragraph 1 (line 2) kidney probably means ...

2. in paragraph 2 (line 1) dissolved probably means .. ....

3. in paragraph 3 (line 3) increased probably means ......

4. in paragraph 4 (line 1) muscle probably means ...

5. in paragraph 4 (line 7) impaired probably means ...

Reading

Comprehension - 2
U R I N E
Normal urine is an amber fluid which consist of approximate 96% water,
2% urea and 2% salts. It has slightly acid reaction gravity of between 1.004

26
and 1.025. The amount of urine passed depends on the fluid intake and
the needs of the body. When the fluid intake is decrease or there is profuse
sweating, excessive emesis or diarrhea, the volume of urine passed-in
is decrease. It is darker and has a higher specific gravity than usual.
When the fluid intake is increase and in cold weather, the volume of urine
passed-in is increased as well. It is lighter and has lower specific gravity
than usual.

The following terms are used to describe abnormalities in the excretion of urine
* Polyuria : an increase in the amount of urine excreted
* Oligouria : a decrease in the amount of urine excreted
* Dysuria : difficult micturation (difficulty in micturating)
* Anuria or Suppression : failure of the renal to excrete the urine and retained in the bladder

* Retention : urine is excreted by renal but retained in the bladder


* Frequency : micturation occurs more frequently than usual

* Incontinence : absence of control over the passing urine

* Haematuria : the presence of blood in urine

* Proteinuria or Albuminurea : the presence of protein or albumin in urine

Answer the following questions :


1. What is the medical term of difficulty in passing water ?
2. What is another way of saying Anuria ?
3. What are the four factors can lead to Oligouria ?
4. What is the opposite of acid ?
5. What can cause urine to have a higher specific gravity than usual ?
6. When is urine getting darker than usual ?
7. What is commoner way of saying Micturate ?
8. What is the medical term for absence of control of Micturation ?
9. How is the production of urine affected by cold weather ?
10. What is another way of saying Haematuria ?

CHAPTER V : CLINICAL MICROBIOLOGY


General Purpose (GRAMMAR Focus):
LEARNING
Past Tense
Objectives
Present Tense
Perfect Tense

27
Request Sentence (asking request)

Specific Purposes:
Student are capable in using each of terminologies in Clinical
Microbiology of which fields will be focused to :
A. Bacteriology terms (terms about Bacteria)
B. Mycology terms (terms about Fungi)
C. Virology terms (terms about Viruses)
D. Parasitology terms (terms about Parasites)
Student are also expected to cover several of important and
major pathogen diseases caused by each of microorganisms
mentioned above which can be observed in different specimens
such as :
Feces / Fecal
Sputum
Swabs of various fluids (e.g : urethral and vaginal fluids)
Cerebro Spinal Fluids (CFS)
Blood
& Urine

Conversation in Context
(1) At Public Health Care

Note : The dialogue are among physician (P) - Head of Laboratory Department (HLD) -
Medical Laboratory Staff (MLS) and patient Jessica (J)
P : Good morning
HLD : Good morning to you too, Doc !
P : Could you do me a favor, please ?
HLD : Certainly ! How may I help you Doc ?
P : I need you to find out the cause factor of a patient.
Heres some notes of her anamnesis :
She complained of having spasmodic and pain in her stomach
She said that she had food poisoning
She also got acute diarrhea for the last 3 days

HLD : Well, these anamnesis are quite help for us.

28
P : For your information (f.y.i), I need your report urgently, CITO !
HLD : Alright, I am absolutely going to pursue this case and when its finished I will
let you know right away, Doc !
P : Fine then ! Thanks anyhow !
HLD : Likewise.

Mean while the Head Division of Laboratory straigthly giving an instruction to one of
Medical Lab.Staffs to analyze the cause factor of patients disease.

HLD : Just now, I had some notes from a physician reported a case of patient - named
Jessica - and she is 20 years old. I want you to find out the cause factor of her
disease and before handing the report to doctor, its better for us to discuss first.
Now, you may go to the patient room to get her fecal specimen.
MLS : Thats what I thought and what Im going to do right away !
Now, will you excuse me, please ?

(2) The following conversations are between


Medical Lab.Staff and a little girl patient names JESSICA
MLS : Hello, you are Jessica, arent you ?
J : Yes, I am and how bout yourself ?
MLS : Well, my name is Anton and I work here in this public health care as medical
laboratory staff. And I guess that is a reason why I am here with you that is to get
your fecal sample to be analyzed in our laboratory.
In this case, I need your fresh feces sample and since its still early in the morning
that will be better to have the sampling.

J : So, what am I supposed to do then? is it complicated to do the sampling?

MLS : It is not as complicated as you think. All you have to do is collecting your feces as
sufficient as it needs in this specific medical instrument called Kidney Dish.

29
This instrument is used to place soiled dressings. Ive already prepared
the instrument for you, Dear. Here you are !

J : OK then, Ill do that ! Thanks for your assist !

After collecting the specimen, medical lab.staff brings it directly to the laboratory to be
analyzed. So, next dialogue are between Medical Lab. Staff (MLS) and Head of
Laboratory Department (HLD) its about reporting the result

HLD : Well, have you done the analysis ?


So, what do you come up then?

MLS : Yes, I ve made the analysis and it is obviously known that the patient has been
infected by E.Coli as the analysis result shows some evidences such as :

It gives the stain purple colour (dark blue or black) by staining technique
specifically by gram stain technique

And the conclusion is specifically obtained by spot indole test as it gives


positive result on the culture being test it shows blue green colour on the filter
paper. I guess, that is all I need to report.
Do you probably have any inquiries ?

HLD : That is all what I need to know right now. I will have this report to be
explained for the physician. Thank you for your big help.

MLS : My pleasure .

CASE HISTORY

A - 67 years old - male comes to the emergency room complaining of right - sided chest
pain each time he breathed and coughed that has produced a rust - coloured sputum.
He also states that his symptoms began abruptly with chills just the day before this visit to
the E.R. He had previously been healthy. Examination by the physician shows a fever of
1020F and coarse breathing sounds in the right anterior chest also a chest X - Ray shows a
right upper lobe infiltrate.

30
(3) at The

E.R.
Note : The conversations below happen between Male Patient (MP) and Medical
Laboratory Staff (MLS) in the Emergency Room (E.R)

MP : Hello, I need some help, please ?

MLS : Yes Sir, how may I help you ?

MP : Hmm, I was told by the doctor to do some medical inspections


regarding of my illness.

MLS : If you dont mind, could you tell me your problem, please ?

MP : Well, I have right sided chest pain complaining each time I breath and
cough which produces rust coloured sputum. And heres my Med.Report
and also my X - Ray result from the physician.

MLS : OK, what else did you feel Sir ?

MP : Oh yeah, I almost forgot ! I also felt that the symptoms began


abruptly with chills just the day before I visited the E.R

MLS : Alright then, to have some more detail informations I would like
to ask you some questions concerning your medical history Sir.
Do you mind if I ask you some questions ?

MP : No, Absolutely I dont mind at all !

31
MLS : First, could you tell me more bit about your chest pain, please
Sir ?
Did you feel any chest pain every time you had activities or
exercises ?
MP : Yeah, actually I did.

MLS : And besides your right - sided chest pain that you feel each time
you breath, how about short of breath ? Do you ever get short
of breath Sir ?

MP : Yes, I ever get short of breath in different time. Sometimes I


get one in the morning and sometimes its also during day or night.

MLS : Well, I think I already have sufficient data based on your


information.
And one last thing Sir, I need to do the sampling process for you.

So, heres the specimen container or receiver. I want you to


do like this : Please, do some cough actions in the rest room
especially deep coughing one, OK! And then by the time you feel
you get deep coughing you can just directly do it into this sample
receiver and when youre done please handle the sample to me,
will you ? Do you have any question Sir ?

MP : No, I dont. Its perfectly clear. Ill do it right away !

MLS : Great then, and thanks for your co-operation.

Meanwhile the sputum specimen is collected, directly done gram stained and cultured.
Heres the conversation below between Medical Lab. Staff ( MLS ) and Head of Lab.
Division ( HLD ) discussing the result.

MLS : Good afternoon, I need to report the patient


examination result who has chest pain problem.
HLD : Ok, what is the findings you have obtained ?

MLS : I have found that the patient had been infected


by Streptococcus pneumonia as the lab.test result shows
evidences and heres the detail report.

Sputum being tested by gram stain method Gives (+) Result


Media : Chocolate agar plate
Used for bile solubility test
Reagent : Bile salt reagent
(the result is: positive) observed by:
visible dissolution (autolysis) of the
colony within 30 after exposure to the
test reagent.
32
HLD : Alright then ! This data will be absolutely useful for our analysis
record. Thank you for giving me this report.

Case Study

1. Situation and condition (of Patients Personal Data)


Sex : FEMALE
Age : 35 years old
Case History : being infected by Candida albicans (vaginal infection)
Other Health Profile: NORMAL
INSTRUCTION : * Make or create the dialogues among patient, Medical Lab.
Staff and Head of Laboratory Department based upon
the Patients Personal Data.

* Make a list of laboratory findings (all related conclusions


and also procedures of testing Candida albicans).
* Discuss the result with HLD.
2. A patient - named Mr. Garreth - is a Botanical Researcher.

Hes been working in a tropical forest located in Bangladesh for more less 3 months.
He came to see his doctor yesterday with a condition of high fever. The doctor assumed
that Mr Garreth was being infected by malaria tropicana disease. Make a laboratory
finding regarding to doctors assumption by using blood specimen and create the dialogues
among yourself - patient - and physician.

33
3. A gynaecologist gives you an instruction to make a confirmation

test of laboratory finding concerning about a patient disease whom to be diagnosed being
infected by Neisseria gonorrhoeae. Create the conversation among patient - yourself - and
physician by using urine specimen.
READING

Comprehension
Methods Used to Determine Antimicrobial
Susceptibility
Susceptibility
or sensitivity and resistance are
functions of the site of the infection to the
microorganism itself and the antimicrobial agent being
considered. By using a standard method, the
microbiology laboratory can produce consistent results
to aid the physician in his or her therapeutic choice.
Two principal methods are employed to determine
antimicrobial susceptibility: agar disk diffusion test,
such as broth tube dilution or agar plate dilution. Disk
diffusion methods are not used as commonly now as
they were in the past; they have been replaced by
either broth microdilution or automated instrument
methods in many laboratories.
It is important to remember that any in vitro test for antibiotic
sensitivity is an artificial measurement and will give only an estimate of
the effectiveness of an agent against a microorganism in vivo. The only

34
absolute test of antibiotic sensitivity is the clinical response of the patient to
the dosage of the antibiotic.
The classic method for testing the susceptibility of the microorganisms is
the broth dilution method, yielding a quantitative result for the amount of
antimicrobial agent need to inhibit the growth of a specific microorganism.
The adaptation of the broth dilution methods to a microbroth method, either
automated or done manually, is used by many laboratories because it saves time
for the laboratorian doing the test, costs effective, and gains efficiency from
replicate inoculation of the prepared system being used. The preparation of
the inoculums is the most important step in doing the susceptibility test.
The isolated organism being tested is the first inoculated into a broth medium,
whether a diffusion method or a macro or micro dilution method is used.

Find the synonym of these words below !


1. Employed 6. Artificial
2. Yield 7. Replicate
3. Aid 8. Against
4. Broth 9. Inhibit
5. Considered 10. Gain
Chapter VI : SEROLOGY AND IMMUNOHEMATOLOGY

General Purpose (GRAMMAR FOCUS):


Past tense - Present tense - Perfect tense - and Request sentence
LEARNING
Specific Purpose: Students have to understand the basic of
OBJECTIVES IMMUNOLOGY tests, e.g :

Pregnancy Tests
Routine Tests for Syphillis
Test for Rheumatoid Factor (RF)
and also Screening Test for Anti Nuclear Antibody (ANA) in
Systemic Lupus Erythematosus (SLE)

Conversation in Context

35
C A S E HISTORY

A - 25 years old - woman comes to the clinic for pregnancy testing. She reports that her last
menstrual period began 30 days ago and the woman said that she did the pregnancy test by
herself but it seemed that the result was negative even though she was already late for her
menstrual period.

Note : The conversations are between Laboratorian (L) and Female Patient (FP) & also
between Head of Laboratory Division (HLD) and The Laboratorian (L)

Conversations are between Laboratorian (L) & Female Patient (FP) :

L : Yes Madame, how could I help you ?

FP : Yes, please. I really hope that you could help me.


L : What seems to be the problem ?
FP : Well, actually I come here to have a confirmation test about my late menstrual
period condition. It started 30 days ago and I also have tried my own
pregnancy test but it was negative. So, could you help me to overcome my
problem, please?

L : Certainly. I will, Maam. But do you bring your urine sample right now ?

FP : Unfortunately, NO i dont.
L : Well then, I suggest you to come here again tomorrow with your morning fresh
urine sample. All you need to do is collecting your first morning urine and put it
into a small plastic pot and bring it to me.

FP : Alright, Ill be here again tomorrow bringing the sample requested. See ya !

(meanwhile, the patient collected her morning urine sample)

L : Hello again to you.

36
Have you collected your morning fresh urine sample ?

FP : Yes, I have. Here it is.

L : Well, you better come again tomorrow morning for the result, is it fine Maam ?

FP : Ok fine, I will.

(meanwhile, the Laboratorian is discussing

the Lab. Result with Head of Laboratory Division)

L : Good afternoon, madame.

HLD : Good afternoon to you too.


Do you have something to discuss ?

L : Yes Maam. Yesterday morning, a patient come here asking for pregnancy test
confirmation because according to her the pregnancy test done by her own gave
negative result. She also said that she was already late for her menstrual period
started 30 days ago.

HLD : OK, so what seems to be the problem then ?

L : As a matter of fact, theres a lil bit problem Maam. When I made the test by using
Latex Agglutination Pregnancy Test, it seemed that the result was negative.

HLD : So, what is your point of view regarding of this matter ?

L : I think, related to her problem, it might be caused by two factors :


1 st : the urine specimen is not concentrated enough
2nd : the test lacks of sensitivity to detect the concentration of HCG present in
the specimen.
HLD : Then, what had you done for the next evaluation ?

L : Id tried to do more specific test with Enzyme Immuno Assay called ELISA test.

37
As we know, the ELISA test has more sensitivity in detecting HCG presents in
urine specimen.

HLD : Yes, you are absolutely right in this case.


And what do you obtain for the result ?

L : Its obviously the test result is reported as HCG positive which means this
patient is positively determined pregnant.

HLD : Ok then, you can use this finding result for your explanation to the patient.

L : Right, and thanks for your time.

HLD : Likewise.

(meanwhile, the laboratorian explaining the Lab.Result to the patient)

The Conversation is between Laboratorian (L) and Patient (P)

L : Hi, its nice to see you again.

FP : The same to me. By the way, have you got the result ?

L : Yes, weve already got the result.

FP : So, how was it then ? Do you mind telling me the result, please ?
L : No, I dont mind at all telling you the result. Based on our laboratory
findings, we come up to the positive result because the test showed
HCG positive. This means HCG as the prior hormone specifically found
in pregnant woman showed positive result after we did the pregnancy test.
So that, the conclusion is youre positively determined pregnant, Madame.

FP : Well, iM glad to know that. Thank you so much for giving me such
a complete information.

L : Our pleasure, Maam.

38
CASE -STUDY
1. A - 45 years old woman - comes to a clinic with complaints of morning
stiffness in her ankle joints , worse on rising in the morning and improving
during the day. Her comfort is responsive to aspirin. She also has been
fatigue and weak. During the last week she has noticed that her wrist
and ankle joints on both sides of her body are also painful and swollen.

INSTRUCTION :
Make an Immulogic Blood Test for Rheumatoid Factor (RF) and create dialogues
between yourself and patient also between yourself and Head of Laboratory when you
report the finding result of Lab.test.

2. A - 39 years old man - seemed to have Sex Transmitted


Disease (STD) syphilis caused by Bacterium Treponema
Pallidum.
INSTRUCTION :
Make an analysis by using urine specimen on the laboratory findings. Create the dialogues
between patient and yourself as well as between yourself and Head of Laboratory.

39
READING

COMPREHENSION
Common immunology and
serologic tests
Classical serologic testing has been an important part of some
diagnostic tests in the clinical laboratory for many years. Traditional
serologic tests have been done for viral and bacterial diseases. The use
of monoclonal antibodies has allowed the identification of specific
bacterial and viral proteins and the isolation and characterization of the
cell surface histocompatibility markers. Monoclonal antibodies
continue to play a significant role in advancing the knowledge of
malignant processes, as more tumor antigens and hormone receptors
are identified. Immunologic testing is employed in tissue typing
procedures for organ transplantation. The immune mechanism is
currently recognized as a very important factor in diseases across all
medical disciplines, as immunologic deficiencies or abnormal
immune responses are seen in many types of diseases and
disorders.
Among some of the common serologic and immunologic tests that are
important in clinical laboratory diagnoses are tests for syphilis; infectious
mononucleosis (heterophil antibodies); C-reactive protein; streptococcal infections
(antistreptolysin O antibodies); cold agglutinins; human gonadotropin hormone
(hCG) in tests for pregnancy; rheumatoid arthritis (RA) factors; hepatitis, rubella,
herpes simplex, and human immunodeficiency viruses (HIV); auto antibodies such
as antinuclear antibodies (ANAs); thyroid disorder antibodies; and febrile disease
antibodies.

Complete this crossword puzzle with words from the passage


ACROSS
1. transfer heart or kidney from one person to another
2. make progress
3. actors part in a play
4. disease can cause death
5. give permission

DOWN

40
1. mass of cells in the body
2. disturbance of the body
3. within a group
4. now passing of the present time
5. virus

G L O S S A R Y

Abruptly : Tiba-tiba (secara mendadak)


Align : Gabungan
Amber fluid : Cairan berwarna kuning
Anamnesis : Hasil berdasarkan wawancara dgn pasien
Aqueous mixture : Campuran yang mengandung air
Assessment : Pengujian (penilaian terhadap hasil uji)
Balance : Neraca (timbangan)
Bile : Empedu
Blood Count Test : Uji Hitung Sel Darah
Cartridge : Isi
Catheter : Selang kateter
Cerebro Spinal Fluid (CSF) : Cairan Selaput Otak
Chill : Menggigil
Chronic Renal Failure (CRF) : Gagal Ginjal Kronik (GGK)
Cito = urgent : Segera
Clotting : Pembekuan
Coarse breathing : Napas berat
Container = receiver : Wadah
Deep coughing : Batuk dalam

41
:
DHF (Dengue Haemmorhagic Fever) Demam Berdarah Dengue (DBD)
Drug induce : Penggunaan obat
Equilibrium : Keseimbangan (kesetaraan)
Evidence : Bukti
Examination (Examining) Couch : Tempat baring u/pemeriksaan pasien
Excrete : Hasil ekskresi
Exposure : Terpapar
Extensively : Secara berlebihan
Feces = fecal : Tinja
Flame emission : Emisi panas
Flask : Labu
Gynaecologist = Obstretician : Ahli Penyakit Kelamin
Hereditary : Sifat turunan
Impaired : Rusak
Inflammatory : Radang
In vitro test : Uji laboratorium
In vivo test : Uji dalam tubuh
Inquiries : Pertanyaan (keraguan)
Insert : Memasukkan
Intake : Asupan
Jaundice = ICTERIC : Gejala penyakit kuning
Kidney dish : Wadah penampung berbentuk ginjal
Lobe : Lubang
Mass : Massa benda (berat benda)
Measurement : Pengukuran
Med-inspection : Pemeriksaan medis
Metabolic rate : Laju metabolisme
Organic substance : Senyawa organik
Overcome : Mengatasi
Peripheral : Tepi
Protein breakdown : Pemecahan senyawa protein
RBC (Red Blood Cell) : Sel darah merah (eritrosit)
Reflectance : Pemantulan

42
Replicate = multiple : Penggandaan
Rust-coloured : Warna kemerahan
Soiled dressing : Kotoran-kotoran manusia (tinja, urine)
Spasmodic : Gejala keram atau pengencangan pada otot/perut
Specimen = SAMPLE : Contoh atau bahan yang akan diuji
Sputum : Dahak
Stain : Pewarnaan
Susceptibility : Kepekaan (resistensi)
Swab : Apusan
Test tube (Rx.tube) : Tabung reaksi
Triple Beam Balance : Neraca (timbangan) tiga skala
Urethral : Saluran kemih
Vessel : Pembuluh, tabung, saluran, pipa
Waste product : Limbah, produk buangan
WBC (White Blood Cell) : Sel darah putih (leukosit)
Yielding : Menghasilkan

BIBLIOGRAPHY

1. Linne, Jean Jorgenson and Ringsrud, Karen Munson;


Clinical Laboratory Science - The Basic and Routine
Techiques - 4th Edition.

43
2. English for Nurse, Gramedia Publishing.

3. Garnisha Medical English Training

44