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ROLE OF A PATHOLOGICAL LABORATORY IN DIAGNOSIS OF MEDICAL EMERGENCIESOP Kapoor
Hon. Visiting Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.
The following are the investigations where good pathological laboratory might help you in diagnosing medical emergencies:
Cardiovascular System : In myocardial infarction serum troponin (T and I) rises within an hour or two and CPK (MB) rises within a few hours.
Respiratory System : Pulmonary embolism - Urine test or blood test for D. Dimer and O2 saturation (PO2) which always falls.
CNS : After any seizure (differential diagnosis of fainting), serum prolactin levels go up within 2 hours and remain high for 24 hours.
GI : In upper GI bleed the blood urea rises without rise in blood creatinine - diagnostic of upper GI bleed before PCV and haemoglobin fall.
Liver : In a patient who has swallowed a rat poison, SGPT may rise to 10 to 1000 times before jaundice appears (after 2-3 days) while the patient may be having symptoms of cardiotoxicity.
Falciparum malaria : Fall of platelets and the rise of LDH in the blood is more guiding than the malarial parasites which may be missed.
Dengue Fever : Fall of platelets and rise of SGPT may point that the patient is going to develop haemorrhagic dengue fever.
Does your pathological laboratory do the above tests?
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