CLINICAL PATHOLOGY CONTENT SPECIFICATIONS
CHEMICAL PATHOLOGY

I.Cardiovascular
 Biochemical markers for myocardial damage (troponins, CK-MB)
 Biochemical markers of heart failure (BNP, NT-proBNP)
 Risk assessment (lipid testing, inflammatory markers, hsCRP, homocysteine)
 D-dimer
 National Cholesterol Education Program (NCEP) Guidelines
  
II.Endocrine
 Diabetes - glucose point-of-care testing, HbA1c; Fructosamine; Blood glucose control in ICUs
 Thyroid – interpretation of thyroid panels, ultrasensitive TSH
 Adrenal – diagnosis of adrenal cortical hyperfunction (eg, Cushing’s, Conn’s) and hypofunction (eg. Addison’s, congenital adrenal hyperplasia); ACTH stim test to evaluate adrenal reserves in ICU; Salivary cortisol
 Interpretation of tests for pheochromocytoma (urine and serum catecholamines and metanephrines, VMA)
 Pituitary – testing for hormone-secreting pituitary tumors (especially prolactinomas), testing for selective or generalized pituitary gland failure
 Parathyroid - intraoperative PTH
  
III.Obstetric
 Prenatal screen advances: first trimester testing/integrated 1st and 2nd trimester screening; dimeric inhibin A for Down syndrome detection (quad screening tests)
 Neonatal screening for most common metabolic diseases
 Fetal fibronectin for premature labor
  
IV.Urinary System
 Microalbumin
 Use of estimating equations to predict glomerular filtration rate (eGFR) that use only measured serum creatinine and patient specific demographic factors (age, sex, race) to detect early renal disease
  
V.Electrolytes
 Point-of-care testing
 Interpretation of anion gap (clinical and for QC)
 Interpretation of electrolyte abnormalities
 Osmolality; osmolar gap calculation (as surrogate for alcohol/methanol measurement)
  
VI.Markers for Neoplasia
 CEA, AFP, CA 15-3/27.29, CA125, CA 19-9, total and free PSA, β-hCG
 her2/neu
 Work-up of suspected monoclonal gammopathy (serum free Ig light chain assays in the diagnosis of plasma cell dyscrasias, including AL) amyloidosis
 General interpretation of IFEs and SPEPs
 PSA role and limitations
  
VII.Nutrition and Anemia (overlap with Heme)
 New testing methods for folate and B12 deficiency
 HPLC for hemoglobinopathies
 Iron overload disorders
 Thalassemia heterogeneity and lab diagnosis
  
VIII.Toxicology, New Drugs and Adulterants
 Screening vs. confirmation for drugs of abuse
 Drugs of abuse masking agents
 Use of genetic tests to predict patient-specific pharmokinetic responses to drugs (i.e. pharmacogenetics/pharmacogenomics). example: warfarin metabolism and appropriate initial dosing
 TDM-sample timing relative to PK, common drugs, transplant Immunosuppression drug monitoring
 Principles of TDM
  
IX.Methodologies
 Tandem mass spectroscopy-technology, common applications
 Electrophoresis—general interpretation of SPEPs and IFEs: e.g. IgG-specific isoelectric focusing for multiple sclerosis capillary zone electrophoresis
 HCV and cryoglobulin evaluation
 Immunosubtraction
 HbA1c limitations with hemoglobinopathies, eg sickle trait, HbC trait
 RAST
 General understanding of modern clinical laboratory instrumentation (e.g. spectrophotometry, ISE's, ELISA and RIA techniques, etc)
 Methods and method interferences
     PCR/RT-PCR
     FISH
     HPLC
     ELISA
     Spectrophotometric analysis
  
X.Administration and Management
 Point of Care testing

This page was last modified on February 8, 2008.