Medicine and Surgery

Definition, limits, and purposes of laboratory medicine. Pre-analytical variability (patient preparation, various types of biological sample collection for clinical pathology investigations, methods of sampling, transportation, and storage). Analytical variability, accuracy, precision, analytical sensitivity, and analytical specificity. Biological variability (intraindividual and interindividual). Prevalence, diagnostic sensitivity, diagnostic specificity, predictive values, efficiency, and characteristic operating curve of laboratory tests. Interpretation of laboratory tests: reference values, decision limits, analytical panels, time series, critical difference. Quality Control Principles. Clinical Biochemistry Techniques: Spectrophotometry, Spectrofluorimetry, Nephelometry, Electrophoresis. Clinical Molecular Biology Techniques: In vitro Enzyme Amplification (PCR), Forward Hybridization, Reverse Hybridization, PCR/OLA/SCS, DNA Sequencing, Next-Generation Sequencing Principles. Mass Spectrometry: Principles and Main Applications. Laboratory Test Ordering Strategy: Screening, Individual Tests, Organ Profiles, Diagnostic Protocols, Therapy Monitoring, In-Depth Diagnostics. Function and Lesion Markers: Their Pathophysiological Significance, Time of Appearance and Half-Life in Biological Fluids: Early and Late Markers. Clinical Application: Specific and Nonspecific Markers. Phenotypic Tumor Markers: Requirements for the Ideal Marker and Clinical Application. The Concept of Threshold (Standard/Pathological/Neoplastic). Oncofetal and tumor-associated antigens, tumor-secreted hormones, enzymes, and proteins as tumor markers. Genotypic tumor markers: importance and limitations of their characterization, relevance of investigational methodology. The concept of minimal residual disease. Immunometric techniques. Enzymes as markers of function and injury. Diagnostic significance of plasma enzymes: recognition of the type, extent, and severity of injury, organ identification. Isoenzymes. Isoforms. Enzyme profiles and organ enzymograms. Plasma proteins and protein analysis. General functions of plasma proteins; principal techniques for analyzing plasma proteins; protein analysis: principal plasma components analyzed and their functions, characteristic profiles of the principal alterations and their interpretation. Characterization of monoclonal components: immunofixation and immunosubtraction. Metabolism of nonprotein nitrogenous compounds and their use in assessing renal and hepatic function: blood urea nitrogen, creatine and creatinine, uric acid, ammonium. Acid-base and electrolyte balance, and principal laboratory tests. Urine analysis. General principles and applications of clinical molecular biology.

Ciaccio M. Trattato di Biochimica Clinica e Medicina di Laboratorio. EdiSES Ciaccio M., Lippi G.: Biochimica clinica e Medicina di Laboratorio. EdiSES Antonozzi I., Gulletta E.: Medicina di Laboratorio Logica e Patologia clinica. Editore Piccin Nuova Libreria S.p.A. Antonozzi I., Gulletta E.: Fondamenti di Medicina di Laboratorio. Editore Piccin Roberto Cevenini: Microbiologia Clinica. Piccin