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

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

3. Medical Investigations
වෛද්‍ය පරීක්ෂණ
 A medical procedure that involves testing a sample of blood, urine,
other body fluids, cells ,tissue or other procedures carried out on a
person which helps in diagnosis and management of a disease
condition.
 වෛද්‍ය පරීක්ෂණ යනු වෛද්‍ය ක්‍රියා පටිපාටියකට අනුෛ යම් පුද්ගලයයකුයේ රුධිරය
,මුත්‍රා ,යෛනත් ශරීර තරල, වෛල ය ෝ පටක යයාද්‍ායගන සිදු කරනු ලබන පරීක්ෂාෛක්
ය ෝ කිසියම් යරෝග විනිශ්ෛයකට ය ෝ යරෝග තත්ත්ෛ ෛඳ ා ප්‍රතිකාර කිරීයම්දී තීරණ
ගැනීමට උපකාරී ෛන වෛද්‍ය ක්‍රියාපටිපටියකට අනුෛ පුද්ගලයයකුයේ සිදු කරනු ලබන
අයනකුත් ඕනෑම පරීක්ෂාෛක් යේ.

4. Types of Medical Investigations
 Biochemical Ix (වෛෛ වෛද්‍ය පරීක්ෂණ )
 Blood Ix (LFT/RFT/LIPID Profile/FBS/PPBS/HbA1C/Trop I/ Na/K)
 Urine Ix (UFR)
 Body fluids( Peritoneal fluid/CSF/Plural fluid/Sputum/Saliva)
 Hematological Ix (රක්තයේද්‍ පරීක්ෂණ )
 FBC/ Blood Picture/PT/INR
 Cytological/Histological Ix (වෛල ා පටක පරීක්ෂණ )
 Immunological Ix (ප්‍රතිශක්තිකරණය ෛම්බන්ධ පරීක්ෂණ)
 Microbiological Ix (ක්ුද්‍රජීෛ පරීක්ෂණ )
 Gram stain/Culture ABST/Viral/Fungal studies/Serology
 Radiological Ix (විකිරණයේද්‍ පරීක්ෂා )
 USS/MRI/CT/Angiogram
 Other procedures
 Endoscopy, ECG, Hearing tests, Vision tests

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

36. Urine Culture
 Culture and ABST

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

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

39. X ray KUB
 Fasting
 Bowel preparation

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

41. Thank You!