Biomedical Sciences: Essential Laboratory Medicine

As the practice of clinical medicine and the diagnosis and management of human disease becomes more complex, there is an ever greater need for well–trained, highly skilled biomedical scientists: the professionals who perform the vital laboratory tests and investigations that underpin the diagnosis of disorders and the evaluation of the effectiveness of treatment.

This textbook provides a clinically focused resource that students can use at all levels of their study and career progression in biomedical science. After an overview of the anatomy and physiology of major organ systems, individual chapters cover those aspects of science that are relevant to the clinical laboratory: pathophysiology; clinical cell biology and genetics; cellular pathology; clinical chemistry; medical microbiology; clinical immunology; haematology and transfusion science, and it concludes with a chapter on professional practice.

Key Features:

A single volume resource written specifically for biomedical science students. Clinically focused, covering the science that is relevant to the working laboratory. Clearly written and well–presented with numerous illustrations in full colour throughout.

By focusing on clinical relevance and including contributions from practising biomedical scientists, this book gives a sense of what happens at the bench in the working clinical laboratory. It will therefore prove invaluable to all students of laboratory medicine and particularly those pursuing a dedicated career in this exciting and dynamic profession.

List of Contributors xi

Preface xiii

Chapter 1 Anatomy and physiology of major organ systems 1
Ray K. Iles, Iona Collins and Suzanne M. Docherty

1.1 The skeletal system 1

1.2 The digestive system 6

1.3 The cardiovascular system 11

1.4 The urinary system 17

1.5 Respiratory system 21

1.6 The nervous system 23

1.7 The endocrine system 31

Bibliography 33

Chapter 2 Pathophysiology 35
Suzanne M. Docherty

2.1 Pathophysiology: a definition 35

2.2 Introduction to epidemiology 35

2.3 Introduction to pharmacology 38

2.4 Gastroenterology 44

2.5 Liver, biliary tract and pancreatic disease 50

2.6 Rheumatology 56

2.7 Urinary tract disease 59

2.8 Cardiovascular disease 65

2.9 Respiratory disease 76

2.10 Endocrine disease 80

Bibliography 88

Chapter 3 Clinical cell biology and genetics 89
Ray K. Iles and Stephen A. Butler

3.1 The cell 89

3.2 Genetics 103

3.3 Human genetic disorders 116

3.4 Important techniques in molecular cell biology 136

Bibliography 138

Chapter 4 Cellular pathology 139
Christopher M. Stonard and Jennifer H. Stonard

Part I: Principles of cellular pathology 139

4.1 Structure and function of normal cells, tissues and organs 139

4.2 Tissues and organs 140

4.3 Cellular responses to injury 141

4.4 Tissue responses to injury: acute inflammation 143

4.5 Tissue responses to injury: chronic inflammation 149

4.6 Healing and repair 151

4.7 Hyperplasia and hypertrophy 154

4.8 Atherosclerosis 155

4.9 Thrombosis and embolism 157

4.10 Ischaemia and infarction 159

4.11 Amyloid and amyloidosis 160

4.12 Infections of histological importance 162

4.13 Metaplasia, dysplasia and carcinoma in situ 165

4.14 Neoplasia 168

Part II: Clinical application and laboratory techniques 175

4.15 Sampling modalities 175

4.16 Fixation 178

4.17 Specimen dissection 180

4.18 Processing and embedding 182

4.19 Microtomy 184

4.20 Standard staining methods and procedures 186

4.21 Frozen section 190

4.22 Immunohistochemistry 191

4.23 Cytopathology 196

4.24 Electron microscopy 197

4.25 In situ hybridization 201

Bibliography 203

Chapter 5 Clinical chemistry 205
Ray K. Iles and Stephen A. Butler

Introduction 205

Part I: Analytical methods 205

5.1 Sample collection 205

5.2 Analytical methods in clinical chemistry laboratories 210

5.3 Summary: common clinical tests for sample analytes 231

Part II: Clinical assessments 232

5.4 Urea and electrolytes (U and Es) 232

5.5 Metabolism and gastrointestinal markers 234

5.6 Renal function tests 236

5.7 Liver function tests 237

5.8 Heart disease and lipid disorder tests 238

5.9 Pancreatic function tests 240

5.10 Bone disease assessment 241

5.11 Endocrinological assessments 241

5.12 Pregnancy tests and pregnancy clinical chemistry 249

5.13 Therapeutic drug monitoring and toxicology 251

5.14 Clinical chemistry at the extremes of age 253

5.15 Cancer biomarkers 254

Bibliography 259

Chapter 6 Medical microbiology 261
Sarah J. Furrows and Catherine S. Fontinelle

Introduction 261

6.1 Overview of microorganisms 261

6.2 Laboratory investigation of infection 265

6.3 Bacteria 277

6.4 Fungi 284

6.5 Parasitology ––– protozoa and helminths 288

6.6 Viruses 290

6.7 Prions 297

6.8 Infections in the immunocompromised patient 298

6.9 Healthcare associated infections 299

6.10 Antimicrobial agents 302

6.11 Vaccines 307

6.12 Conclusion 309

Bibliography 309

Chapter 7 Clinical immunology 311
Ray K. Iles and Ivan M. Roitt

Part I: The fundamentals of immunology 311

7.1 Overview of the immune system 311

7.2 Overview of the immune response 316

7.3 MHC genotyping, autoimmunity and susceptibility to disease 321

7.4 Physical age and immunocompetency 322

Part II: Laboratory investigations and immune assessments 323

7.5 Inflammation and chronic infection 323

7.6 Autoimmune diseases 324

7.7 Transplant rejection 325

7.8 Hypersensitivities 326

7.9 Immune deficiency 326

Bibliography 328

Chapter 8 Haematology and transfusion science 329
Suzanne M. Docherty

8.1 Introduction and components of blood 329

8.2 Routine laboratory blood tests 332

8.3 Haemopoiesis 336

8.4 Red blood cell structure, disorders and metabolism 337

8.5 Haemoglobin 342

8.6 Anaemia 353

8.7 Benign white blood cell disorders 359

8.8 Haemostasis 361

8.9 Coagulation disorders 366

8.10 Myeloproliferative disorders 371

8.11 Haematological malignancies 373

8.12 Complement 378

8.13 Blood transfusion 380

8.14 Blood products 390

8.15 Haemopoetic stem cell transplantation 393

Bibliography 395

Chapter 9 Professional practice and biomedical science 397
David Ricketts

9.1 What is a biomedical scientist? 397

9.2 The IBMS 397

9.3 Professional practice and the role of the HPC 398

9.4 Standards of proficiency ––– biomedical scientists 399

9.5 Expectations of a health professional 400

9.6 Professional relationships 401

9.7 The skills required for the application of practice 401

9.8 Knowledge, understanding and skills 402

9.9 Standards of conduct, performance and ethics 403

9.10 CPD 403

9.11 Critical reflection 404

9.12 IBMS CPD scheme 404

9.13 The professional biomedical scientist as an agent for change in the wider healthcare setting 405

Appendix 407

Index 413

As an accompaniment to an undergraduate programme, this is an excellent text that manages to introduce all aspects of biomedical science to the reader.   (British Journal of Biomedical Science, 1 January 2013)

Overall, Biomedical Sciences: Essential Laboratory Medicine would make a fantastic starting textbook for biomedical students.  It is accessible, clinically–focused and covers all major relevant topics.  (Phenotype, 28 May 2012)