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Book Details
Abstract
The Tietz Textbook of Clinical Chemistry and Molecular Diagnostics, 6th Edition provides the most current and authoritative guidance on selecting, performing, and evaluating the results of new and established laboratory tests. This classic clinical chemistry reference offers encyclopedic coverage detailing everything you need to know, including: analytical criteria for the medical usefulness of laboratory tests, variables that affect tests and results, laboratory medicine, applications of statistical methods, and most importantly clinical utility and interpretation of laboratory tests. It is THE definitive reference in clinical chemistry and molecular diagnostics, now fully searchable and with quarterly content updates, podcasts, clinical cases, animations, and extended content online through Expert Consult.
- Analytical criteria focus on the medical usefulness of laboratory procedures.
- Reference ranges show new approaches for establishing these ranges — and provide the latest information on this topic.
- Lab management and costs gives students and chemists the practical information they need to assess costs, allowing them to do their job more efficiently and effectively.
- Statistical methods coverage provides you with information critical to the practice of clinical chemistry.
- Internationally recognized chapter authors are considered among the best in their field.
- Two-color design highlights important features, illustrations, and content to help you find information easier and faster.
- NEW! Internationally recognized chapter authors are considered among the best in their field.
- NEW! Expert Consult features fully searchable text, quarterly content updates, clinical case studies, animations, podcasts, atlases, biochemical calculations, multiple-choice questions, links to Medline, an image collection, and audio interviews. You will now enjoy an online version making utility of this book even greater.
- UPDATED! Expanded Molecular Diagnostics section with 12 chapters that focus on emerging issues and techniques in the rapidly evolving and important field of molecular diagnostics and genetics ensures this text is on the cutting edge and of the most value.
- NEW! Comprehensive list of Reference Intervals for children and adults with graphic displays developed using contemporary instrumentation.
- NEW! Standard and international units of measure make this text appropriate for any user — anywhere in the world.
- NEW! 22 new chapters that focus on applications of mass spectrometry, hematology, transfusion medicine, microbiology, biobanking, biomarker utility in the pharmaceutical industry and more!
- NEW! Expert senior editors, Nader Rifai, Carl Wittwer and Rita Horvath, bring fresh perspectives and help ensure the most current information is presented.
- UPDATED! Thoroughly revised and peer-reviewed chapters provide you with the most current information possible.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Tietz Textbook of Clinical Chemistry and Molecular Diagnostics | i | ||
| Copyright Page | ii | ||
| Dedication | iii | ||
| Associate Editors | iv | ||
| Reviewers | v | ||
| Contributors | vii | ||
| Contributors to Expert Consult | xvi | ||
| Foreword | xvii | ||
| Preface | xviii | ||
| Table Of Contents | xix | ||
| I Basics of Laboratory Medicine | 1 | ||
| 1 Clinical Chemistry and Molecular Diagnostics | 2 | ||
| Abstract | 2 | ||
| Background | 2 | ||
| Content | 2 | ||
| Introduction | 2 | ||
| Looking Back | 3 | ||
| Training in Clinical Chemistry | 3 | ||
| Expanding Boundaries Defined by Technology | 3 | ||
| How Is Clinical Chemistry Practiced? | 5 | ||
| Guiding Principles of Practicing the Profession | 6 | ||
| Confidentiality of Genetic Information | 6 | ||
| Confidentiality of Patient Medical Information | 6 | ||
| Allocation of Resources | 6 | ||
| Codes of Conduct | 6 | ||
| Publishing Issues | 7 | ||
| Conflicts of Interest | 8 | ||
| What Is in This Textbook? | 8 | ||
| References | 8 | ||
| 2 Statistical Methodologies in Laboratory Medicine | 10 | ||
| Abstract | 10 | ||
| Background | 10 | ||
| Content | 10 | ||
| Assay Selection Overview | 10 | ||
| Medical Need and Quality Goals | 10 | ||
| Analytical Performance Criteria | 11 | ||
| Other Criteria | 11 | ||
| Basic Statistics | 13 | ||
| Frequency Distribution | 13 | ||
| Population and Sample | 13 | ||
| Probability and Probability Distributions | 13 | ||
| Parameters: Descriptive Measures of a Population | 14 | ||
| Statistics: Descriptive Measures of the Sample | 14 | ||
| Random Sampling | 14 | ||
| The Gaussian Probability Distribution | 14 | ||
| Student t Probability Distribution | 15 | ||
| Nonparametric Statistics | 15 | ||
| Categorical Variables | 16 | ||
| Technical Validity of Analytical Assays | 16 | ||
| Calibration | 16 | ||
| Trueness and Accuracy | 17 | ||
| Precision | 18 | ||
| Example | 18 | ||
| Precision Profile | 18 | ||
| Linearity | 19 | ||
| Analytical Measurement Range and Limits of Quantification | 20 | ||
| Analytical Sensitivity | 20 | ||
| Analytical Specificity and Interference | 20 | ||
| Qualitative Methods | 20 | ||
| Diagnostic Accuracy Measures | 20 | ||
| Agreement Between Qualitative Tests | 21 | ||
| Example | 21 | ||
| Assay Comparison | 22 | ||
| Basic Error Model | 22 | ||
| Measured Value, Target Value, Modified Target Value, and True Value | 22 | ||
| Calibration Bias and Random Bias | 23 | ||
| Assay Comparison Data Model | 24 | ||
| Comparison of a Routine Assay With a Reference Measurement Procedure | 24 | ||
| Comparison of Two Routine Assays | 24 | ||
| Preliminary Practical Work in Relation to a Method Comparison Study | 24 | ||
| Planning a Method Comparison Study | 24 | ||
| Distribution of Differences Plot (DoD Plot) | 25 | ||
| Nonparametric Approach | 25 | ||
| Parametric Approach | 26 | ||
| Relative Distribution of Differences Plot (Rel DoD Plot) | 27 | ||
| Verification of Distribution of Differences in Relation to Specified Limits | 29 | ||
| Difference (Bland-Altman) Plot | 29 | ||
| A Caution Against Incorrect Interpretation of Paired t-Tests in Method Comparison Studies | 30 | ||
| Regression Analysis | 31 | ||
| Error Models in Regression Analysis | 31 | ||
| Deming Regression Analysis and Ordinary Least-Squares Regression Analysis (Constant Standard Deviations) | 32 | ||
| Computation Procedures for Ordinary Least-Squares Regression and Deming Regression | 34 | ||
| Evaluation of the Random Error Around an Estimated Regression Line | 34 | ||
| Interpreting SDy·x (SD21) With Random Errors in Both x1 and x2 | 34 | ||
| Assessment of Outliers | 34 | ||
| The Correlation Coefficient | 35 | ||
| Regression Analysis in Cases of Proportional Random Error | 36 | ||
| Testing for Linearity | 36 | ||
| Nonparametric Regression Analysis (Passing-Bablok Procedure) | 37 | ||
| Interpretation of Systematic Differences Between Methods Obtained on the Basis of Regression Analysis | 37 | ||
| Example of Application of Regression Analysis (Weighted Deming Analysis) | 37 | ||
| Discussion of Application of Regression Analysis | 38 | ||
| Monitoring Serial Results | 39 | ||
| Traceability and Measurement Uncertainty | 40 | ||
| Traceability | 40 | ||
| The Uncertainty Concept | 41 | ||
| The Standard Uncertainty (ust) | 41 | ||
| Example of Direct Assessment of Uncertainty on the Basis of Measurements of a Commutable Certified Reference Material | 41 | ||
| Example of Direct Assessment of Uncertainty on the Basis of a Method Comparison Study With a Reference Measurement Procedure Using Patient Samples | 42 | ||
| Indirect Evaluation of Uncertainty by Quantification of Individual Error Source Components | 43 | ||
| Example. | 44 | ||
| Uncertainty in Relation to Traditional Systematic and Random Error Classifications | 44 | ||
| Diagnostic Accuracy of Laboratory Tests | 45 | ||
| Diagnostic Accuracy of a Test in Isolation | 45 | ||
| Diagnostic Accuracy, Sensitivity, and Specificity | 45 | ||
| Confidence Intervals of Diagnostic Accuracy, Sensitivity, and Specificity | 45 | ||
| Clinical Example: Accuracy of d-Dimer Test in Diagnosis of Deep Venous Thrombosis | 46 | ||
| Receiver Operating Characteristic Curves | 46 | ||
| Selection of Cutoff Value in Case of Quantitative Index Tests | 47 | ||
| Posterior Probabilities (Predictive Values) | 48 | ||
| Likelihood Ratios and Odds Ratios | 48 | ||
| Comparison of Diagnostic Accuracy of Two Tests in Isolation | 48 | ||
| Shortcomings of Diagnostic Accuracy Studies of Tests in Isolation | 49 | ||
| Diagnostic Accuracy of a Test in the Clinical Context | 50 | ||
| Clinical Example: Added Value of d-Dimer Testing in the Diagnosis of Suspected Deep Venous Thrombosis | 50 | ||
| Diagnostic Accuracy of Combinations of Diagnostic Tests: Receiver Operating Characteristic Area | 53 | ||
| Reclassification Measures | 54 | ||
| Predictiveness Curve | 55 | ||
| Decision Curve Analysis | 55 | ||
| Test Evaluation Beyond Diagnostic Accuracy | 57 | ||
| How Does Testing Yield Health(care) Benefits? | 57 | ||
| The Working Pathway | 57 | ||
| Comparative Tests: Treatment Studies to Quantify the Impact of Tests | 58 | ||
| Linked-Evidence Approaches to Quantify the Impact of Tests | 59 | ||
| Selected References | 59 | ||
| References | 60.e1 | ||
| 3 Quality Management in the Medical Laboratory | 61 | ||
| Abstract | 61 | ||
| Background | 61 | ||
| Content | 61 | ||
| Introduction | 61.e1 | ||
| Purpose and Scope of a Medical Laboratory | 61.e1 | ||
| Defining Quality in the Medical Laboratory | 61.e1 | ||
| Evolution of the Approach to Quality Management | 61.e1 | ||
| Quality Management Systems | 61.e2 | ||
| Standards and Guidelines for the Medical Laboratory | 61.e2 | ||
| ISO and the Development of ISO 15189 | 61.e2 | ||
| CLSI-QMS Guidelines | 61.e2 | ||
| Quality Management Systems and the Process Model | 61.e3 | ||
| ISO 15189 and CLSI-QSE Compared | 61.e3 | ||
| The Key Components of Quality Management Systems for Medical Laboratories | 61.e4 | ||
| Management Responsibility | 61.e4 | ||
| Quality Management System | 61.e5 | ||
| Resource Management | 61.e6 | ||
| Examination Processes | 61.e6 | ||
| Evaluation and Continual Improvement | 61.e6 | ||
| Accreditation and Regulation | 61.e6 | ||
| Accreditation or Certification? | 61.e6 | ||
| Accreditation and Regulation of Medical Laboratories | 61.e6 | ||
| An International Model | 61.e6 | ||
| Alternative Models | 61.e8 | ||
| Approaches to Quality Management | 61.e8 | ||
| Principles of Quality Management | 61.e8 | ||
| Customer Focus | 61.e9 | ||
| Leadership | 61.e9 | ||
| Involvement of People | 61.e9 | ||
| Process Approach | 61.e10 | ||
| System Approach to Management | 61.e11 | ||
| Continual Improvement | 61.e12 | ||
| Factual Approach to Decision Making | 61.e12 | ||
| Measures and Quality Indicators. | 61.e12 | ||
| Understanding Variation. | 61.e14 | ||
| Cost of Quality (Including Waste). | 61.e14 | ||
| Nonconforming Events and Risk Management. | 61.e15 | ||
| Mutually Beneficial Supplier Relationships. | 61.e15 | ||
| Summary of Useful Quality Management Tools and Resources | 61.e15 | ||
| Organizational Quality and Business Excellence Frameworks | 61.e17 | ||
| References | 61.e18 | ||
| 4 Specimen Collection and Processing | 62 | ||
| Abstract | 62 | ||
| Background | 62 | ||
| Content | 62 | ||
| Introduction | 62 | ||
| Patient Identification | 62 | ||
| Types of Specimens | 62 | ||
| Blood | 63 | ||
| Venipuncture | 63 | ||
| Preliminary Steps. | 63 | ||
| Location. | 64 | ||
| Preparation of the Site. | 65 | ||
| Timing. | 65 | ||
| Venous Occlusion. | 65 | ||
| Order of Draw for Multiple Blood Specimens. | 65 | ||
| Collection With Evacuated Blood Tubes. | 65 | ||
| Blood Collection With a Syringe. | 66 | ||
| Completion of Collection. | 67 | ||
| Venipuncture in Children. | 68 | ||
| Skin Puncture | 68 | ||
| Arterial Puncture | 69 | ||
| Anticoagulants and Preservatives for Blood | 70 | ||
| Heparin. | 70 | ||
| Ethylenediaminetetraacetic Acid. | 70 | ||
| Sodium Fluoride. | 71 | ||
| Citrate. | 71 | ||
| Acid Citrate Dextrose. | 71 | ||
| Oxalates. | 71 | ||
| Iodoacetate. | 71 | ||
| Influence of Site of Collection on Blood Composition | 71 | ||
| Collection of Blood From Intravenous or Arterial Lines | 72 | ||
| Hemolysis | 72 | ||
| Urine | 72 | ||
| Timed Urine Specimens | 73 | ||
| Collection of Urine From Children | 74 | ||
| Urine Preservatives | 74 | ||
| Feces | 74 | ||
| Other Body Fluids | 75 | ||
| Bronchoalveolar Lavage | 75 | ||
| Chorionic Villus Sampling | 75 | ||
| Buccal Cells | 75 | ||
| Solid Tissue | 76 | ||
| Hair and Nails | 76 | ||
| Handling of Specimens for Analysis | 76 | ||
| Maintenance of Specimen Identification | 76 | ||
| Preservation of Specimens | 77 | ||
| Add-on Requests | 77 | ||
| Separation and Storage of Specimens | 78 | ||
| Transport of Specimens | 78 | ||
| Conclusion | 79 | ||
| Multiple Choice Questions | 80.e1 | ||
| Answers | 80.e1 | ||
| References | 80 | ||
| 5 Preanalytical Variation and Preexamination Processes | 81 | ||
| Abstract | 81 | ||
| Background | 81 | ||
| Content | 81 | ||
| Introduction | 81 | ||
| Historical Perspective | 81 | ||
| The Preanalytical Phase Today | 82 | ||
| Influencing and Interference Factors | 82 | ||
| II Analytical Techniques and Applications | 198 | ||
| 12 Principles of Basic Techniques and Laboratory Safety | 199 | ||
| Abstract | 199 | ||
| Background | 199 | ||
| Content | 199 | ||
| Concept of Solute and Solvent | 199.e1 | ||
| Expressing Concentrations of Solutions | 199.e1 | ||
| Units of Measurement | 199.e1 | ||
| International System of Units | 199.e1 | ||
| Standardized Reporting of Test Results | 199.e2 | ||
| Laboratory Logical Observation Identifiers, Names, and Codes System | 199.e2 | ||
| Nomenclature, Properties, and Units | 199.e2 | ||
| Applications | 199.e3 | ||
| Chemicals | 199.e3 | ||
| Reagent Grade Water | 199.e3 | ||
| Preparation of Reagent Grade Water | 199.e3 | ||
| Distillation. | 199.e3 | ||
| Ion Exchange. | 199.e3 | ||
| Reverse Osmosis. | 199.e3 | ||
| Ultraviolet Oxidation. | 199.e4 | ||
| Quality, Use, and Storage of Purified Water | 199.e4 | ||
| Testing for Water Purity | 199.e4 | ||
| Reagent-Grade or Analytical Reagent-Grade Chemicals | 199.e4 | ||
| Ultrapure Reagents | 199.e4 | ||
| Reference Materials | 199.e4 | ||
| Primary Reference Materials | 199.e4 | ||
| Secondary Reference Materials | 199.e4 | ||
| Standard Reference Materials | 199.e5 | ||
| Certified Reference Materials | 199.e5 | ||
| Basic Techniques and Procedures | 199.e6 | ||
| Volumetric Sampling and Dispensing | 199.e6 | ||
| Pipettes | 199.e6 | ||
| Transfer and Measuring Pipettes. | 199.e6 | ||
| Transfer Pipettes. | 199.e7 | ||
| Measuring Pipettes. | 199.e7 | ||
| Pipetting Technique. | 199.e7 | ||
| Micropipettes. | 199.e7 | ||
| Semiautomatic and Automatic Pipettes and Dispensers. | 199.e7 | ||
| Volumetric Flasks | 199.e8 | ||
| Centrifugation | 199.e10 | ||
| Types of Centrifuges | 199.e10 | ||
| Principles of Centrifugation | 199.e10 | ||
| Operation of the Centrifuge | 199.e10 | ||
| Operating Practice | 199.e10 | ||
| Measurement of Radioactivity | 199.e11 | ||
| Basic Concepts | 199.e11 | ||
| Radioactive Decay. | 199.e11 | ||
| Alpha Decay. | 199.e11 | ||
| Beta Decay. | 199.e11 | ||
| Electron Capture. | 199.e12 | ||
| Gamma Radiation and Internal Conversion. | 199.e12 | ||
| Activity and Half-Life. | 199.e12 | ||
| Units of Radioactivity | 199.e12 | ||
| Specific Activity | 199.e12 | ||
| Detection and Measurement of Radioactivity | 199.e12 | ||
| Autoradiography. | 199.e12 | ||
| Gas-Filled Detectors. | 199.e12 | ||
| Scintillation Counting. | 199.e12 | ||
| Crystal Scintillation Detector. | 199.e12 | ||
| Liquid Scintillation Detector. | 199.e13 | ||
| Gravimetry | 199.e13 | ||
| Principles of Weighing | 199.e13 | ||
| Types of Balances | 199.e13 | ||
| Double-Pan Balance. | 199.e13 | ||
| Single-Pan Balance. | 199.e13 | ||
| Electronic Balance. | 199.e13 | ||
| Analytical Weights | 199.e13 | ||
| Thermometry | 199.e14 | ||
| Controlling Hydrogen Ion Concentration | 199.e14 | ||
| Procedures for Processing Solutions | 199.e14 | ||
| Dilution | 199.e14 | ||
| Evaporation | 199.e15 | ||
| Lyophilization | 199.e15 | ||
| Filtration | 199.e15 | ||
| Safety | 199.e15 | ||
| Safety Program | 199.e15 | ||
| Safety Equipment | 199.e16 | ||
| Safety Inspections | 199.e16 | ||
| Plans for the Clinical Laboratory | 199.e16 | ||
| Chemical Hygiene Plan | 199.e16 | ||
| Exposure Control Plan | 199.e17 | ||
| Tuberculosis Control Plan | 199.e17 | ||
| Pandemic Plan | 199.e17 | ||
| Ergonomics Program | 199.e17 | ||
| Hazards in the Laboratory | 199.e18 | ||
| Identification of Hazards | 199.e18 | ||
| Biological Hazards | 199.e18 | ||
| Chemical Hazards | 199.e20 | ||
| Hazards From Volatiles. | 199.e20 | ||
| Hazards From Compressed Gases. | 199.e21 | ||
| Electrical Hazards | 199.e21 | ||
| Fire Hazards | 199.e21 | ||
| References | 199.e22 | ||
| 13 Optical Techniques | 200 | ||
| Abstract | 200 | ||
| Background | 200 | ||
| Content | 200 | ||
| Nature of Light | 200 | ||
| Spectrophotometry | 201 | ||
| Basic Concepts | 201 | ||
| Beer’s Law: Relationship Among Transmittance, Absorbance, and Concentration | 202 | ||
| Application of Beer’s Law | 202 | ||
| Instrumentation | 203 | ||
| Components | 203 | ||
| Light Sources. | 203 | ||
| Incandescent, Arc, and Cathode Lamps. | 203 | ||
| Laser Sources. | 204 | ||
| Spectral Isolation. | 204 | ||
| Filters. | 204 | ||
| Prisms and Gratings. | 205 | ||
| Selection of a Wavelength Isolation Device. | 205 | ||
| Cuvets. | 205 | ||
| Photodetectors. | 206 | ||
| Photomultiplier Tubes. | 206 | ||
| Photodiodes. | 206 | ||
| Readout Devices. | 206 | ||
| Performance Parameters | 207 | ||
| Wavelength Calibration. | 207 | ||
| Spectral Bandwidth. | 207 | ||
| Stray Light. | 208 | ||
| Photometric Accuracy. | 208 | ||
| Multiple-Wavelength Readings. | 208 | ||
| Reflectance Photometry | 208 | ||
| Flame Emission and Inductively Coupled Plasma Spectrophotometry | 208 | ||
| Atomic Absorption Spectrophotometry | 209 | ||
| Basic Concepts | 209 | ||
| Instrumentation | 209 | ||
| Interferences in Atomic Absorption Spectrophotometry | 210 | ||
| Spectral Interferences | 210 | ||
| Nonspectral Interferences | 210 | ||
| Fluorometry | 210 | ||
| Basic Concepts | 210 | ||
| Time Relationships of Fluorescence Emission | 211 | ||
| Relationship of Concentration and Fluorescence Intensity | 211 | ||
| Fluorescence Polarization | 212 | ||
| Instrumentation | 212 | ||
| Components | 213 | ||
| Excitation Source. | 213 | ||
| Xenon Lamp. | 213 | ||
| Lasers. | 213 | ||
| Light-Emitting Diode. | 213 | ||
| Excitation and Emission Monochromators. | 213 | ||
| Cuvet. | 213 | ||
| Photodetectors. | 214 | ||
| Visual Observation. | 214 | ||
| Photomultiplier Tube. | 214 | ||
| Charge-Coupled Detector. | 215 | ||
| Performance Verification | 215 | ||
| Types of Fluorometers and Spectrofluorometers | 215 | ||
| Ratio-Referencing Spectrofluorometer. | 215 | ||
| Time-Resolved Fluorometer. | 215 | ||
| Flow Cytometer. | 216 | ||
| Hematofluorometer. | 217 | ||
| Limitations of Fluorescence Measurements | 217 | ||
| Inner Filter Effects | 217 | ||
| Concentration Quenching | 217 | ||
| Light Scattering | 217 | ||
| Cuvet Material and Solvent Effects | 218 | ||
| Sample Matrix Effects | 218 | ||
| Temperature Effects | 218 | ||
| Photodecomposition | 218 | ||
| Phosphorescence | 218 | ||
| Chemiluminescence, Bioluminescence, and Electrochemiluminescence | 219 | ||
| III Analytes | 372 | ||
| 28 Amino Acids, Peptides, and Proteins | 373 | ||
| Abstract | 373 | ||
| Background | 373 | ||
| Content | 373 | ||
| Introduction | 373 | ||
| Amino Acids | 374 | ||
| Basic Biochemistry | 374 | ||
| Amino Acid Supply and Transport | 376 | ||
| Amino Acid Metabolism | 377 | ||
| Amino Acid Concentrations | 379 | ||
| Analysis of Amino Acids | 379 | ||
| Peptides | 380 | ||
| Peptide Bond | 380 | ||
| Peptide Heterogeneity and Analysis | 380 | ||
| Clinically Relevant Peptide Systems | 381 | ||
| Pro-Opiomelanocortin System | 381 | ||
| Natriuretic Peptides | 381 | ||
| Hepcidin | 381 | ||
| Angiotensins | 381 | ||
| Endothelins | 382 | ||
| Vasopressin | 382 | ||
| Glutathione | 382 | ||
| Proteins | 382 | ||
| Physical Properties of Proteins | 383 | ||
| Protein Formation | 384 | ||
| Folding | 384 | ||
| Targeting | 384 | ||
| Posttranslational Modifications | 385 | ||
| Fatty Acylation | 385 | ||
| Phosphorylation | 385 | ||
| Prenylation | 385 | ||
| Glycosylphosphatidylinositol Anchor | 385 | ||
| γ-Carboxylation | 385 | ||
| Glycosylation | 385 | ||
| Sulfation | 386 | ||
| Hydroxylation | 386 | ||
| Nitrosylation | 386 | ||
| Protein Catabolism | 386 | ||
| Protease Families | 386 | ||
| Serine Proteases. | 386 | ||
| Cysteinyl Proteases. | 386 | ||
| Aspartyl Proteases. | 386 | ||
| Metalloproteases. | 387 | ||
| The Ubiquitin-Proteasome System | 387 | ||
| Proteins in Human Serum and Plasma | 388 | ||
| Abundant Components of the Circulating Proteome | 389 | ||
| Prealbumin (Transthyretin) | 389 | ||
| Albumin | 389 | ||
| α1-Antitrypsin | 389 | ||
| Ceruloplasmin | 390 | ||
| Haptoglobin | 390 | ||
| Transferrin | 390 | ||
| β2-Microglobulin | 390 | ||
| C-Reactive Protein | 391 | ||
| Complement | 391 | ||
| Immunoglobulins | 392 | ||
| Individual Immunoglobulins and Light Chains | 393 | ||
| Immunoglobulin G. | 393 | ||
| Immunoglobulin M. | 393 | ||
| Immunoglobulin A. | 393 | ||
| Immunoglobulin D. | 393 | ||
| Immunoglobulin E. | 393 | ||
| Free Immunoglobulin Light Chains. | 394 | ||
| Clinical Utility of Immunoglobulin Measurement. | 394 | ||
| Immunoglobulin Deficiency. | 394 | ||
| Polyclonal Hyperimmunoglobulinemia. | 394 | ||
| Monoclonal Immunoglobulins (Paraproteins). | 395 | ||
| Acute Phase Response | 395 | ||
| Methods for Analyzing Proteins | 395 | ||
| Determination of Total Protein | 395 | ||
| Kjeldahl Method. | 396 | ||
| Biuret Method. | 396 | ||
| Direct Optical Methods. | 396 | ||
| Dye-Binding Methods. | 396 | ||
| Lowry (Folin-Ciocalteu) Method. | 397 | ||
| Refractometry. | 397 | ||
| Light-Scattering Methods. | 397 | ||
| Variables Affecting Measured Protein Concentrations. | 397 | ||
| Immunochemical Techniques for Specific Proteins | 397 | ||
| Electrophoresis | 397 | ||
| Serum Protein Electrophoresis. | 397 | ||
| Immunofixation Electrophoresis. | 399 | ||
| Capillary Electrophoresis. | 399 | ||
| Western Blotting. | 399 | ||
| Mass Spectrometry. | 400 | ||
| Proteins in Other Body Fluids | 400 | ||
| Saliva | 400 | ||
| Cerebrospinal Fluid | 400 | ||
| Total Protein in Cerebrospinal Fluid. | 401 | ||
| Permeability of the Blood–Brain Barrier. | 401 | ||
| Intrathecal Protein Synthesis. | 401 | ||
| Peritoneal and Pleural Fluids | 402 | ||
| Fecal Material | 402 | ||
| Selected References | 403 | ||
| References | 403.e1 | ||
| 29 Serum Enzymes | 404 | ||
| Abstract | 404 | ||
| Background | 404 | ||
| Content | 404 | ||
| Introduction | 404 | ||
| Diagnostic Enzymology | 404 | ||
| Factors Affecting Enzyme Concentrations in Blood | 404 | ||
| Leakage of Enzymes From Cells | 404 | ||
| Efflux of Enzymes From Damaged Cells | 405 | ||
| Altered Enzyme Production | 406 | ||
| Clearance of Enzymes | 406 | ||
| Selection of Enzyme Tests | 406 | ||
| Muscle Enzymes | 408 | ||
| Creatine Kinase | 408 | ||
| Clinical Significance | 409 | ||
| Methods for Determination of Creatine Kinase Activity | 410 | ||
| Reference Intervals | 411 | ||
| Methods for Separation and Quantification of Creatine Kinase Isoenzymes | 411 | ||
| Aldolase | 411 | ||
| Clinical Significance | 411 | ||
| Methods for Measurement of Aldolase Activity | 411 | ||
| Reference Intervals | 412 | ||
| Liver Enzymes | 412 | ||
| Aminotransferases | 412 | ||
| Clinical Significance | 412 | ||
| Methods for Measurement of Transaminase Activity | 414 | ||
| Reference Intervals | 414 | ||
| Glutamate Dehydrogenase | 415 | ||
| Clinical Significance | 415 | ||
| Methods for Determination of Glutamate Dehydrogenase Activity | 415 | ||
| Reference Intervals | 415 | ||
| Alkaline Phosphatase | 415 | ||
| Clinical Significance | 416 | ||
| Methods for Determination of Alkaline Phosphatase Activity | 417 | ||
| Reference Intervals | 417 | ||
| Methods for Separation and Quantification of Alkaline Phosphatase Isoenzymes | 417 | ||
| 5′-Nucleotidase | 419 | ||
| Clinical Significance | 419 | ||
| Methods for Determination of 5′-Nucleotidase Activity | 419 | ||
| Reference Interval | 419 | ||
| γ-Glutamyltransferase | 419 | ||
| Clinical Significance | 420 | ||
| Methods for Determination of γ-Glutamyltransferase Activity | 420 | ||
| Reference Intervals | 421 | ||
| Glutathione S-Transferase | 421 | ||
| Clinical Significance | 421 | ||
| Methods for Determination of Glutathione S-Transferase | 421 | ||
| Reference Interval | 421 | ||
| Pancreatic Enzymes | 421 | ||
| Lipase | 421 | ||
| Clinical Significance | 422 | ||
| Methods for Measuring Lipase Activity | 422 | ||
| Reference Intervals | 424 | ||
| Amylase | 424 | ||
| Clinical Significance | 424 | ||
| Methods for Determination of α-Amylase Activity | 425 | ||
| Reference Interval | 426 | ||
| Analytical Methods and Reference Intervals for Amylase Isoenzymes | 426 | ||
| Trypsin | 426 | ||
| Clinical Significance | 427 | ||
| Trypsin-1 (Cationic Trypsin). | 427 | ||
| Trypsin-2 (Anionic Trypsin). | 427 | ||
| Methods for Determination of Trypsin | 427 | ||
| Bone Enzymes | 427 | ||
| Alkaline Phosphatase (Bone Isoform) | 427 | ||
| Clinical Significance in Bone Disease | 428 | ||
| Methods for Determination of Bone Alkaline Phosphatase | 428 | ||
| Reference Intervals | 428 | ||
| Acid Phosphatase (Tartrate-Resistant 5b Isoform) | 428 | ||
| Clinical Significance | 429 | ||
| Methods for Determination of Tartrate-Resistant Acid Phosphatase | 429 | ||
| Reference Intervals | 429 | ||
| Miscellaneous Enzymes | 429 | ||
| Lactate Dehydrogenase | 429 | ||
| Clinical Significance | 430 | ||
| Methods for Determination of Lactate Dehydrogenase Activity | 430 | ||
| Reference Intervals | 431 | ||
| Methods for Separation and Quantification of Lactate Dehydrogenase Isoenzymes | 431 | ||
| Cholinesterase | 431 | ||
| Clinical Significance | 431 | ||
| Methods for Determination of Serum Cholinesterase Activity | 432 | ||
| Reference Intervals | 432 | ||
| Lipoprotein-Associated Phospholipase A2 | 433 | ||
| Clinical Significance | 433 | ||
| Methods for Determination of Lipoprotein-Associated Phospholipase A2 | 433 | ||
| Selected References | 433 | ||
| References | 434.e1 | ||
| 30 Enzymes of the Red Blood Cell | 435 | ||
| Abstract | 435 | ||
| Background | 435 | ||
| Content | 435 | ||
| Introduction | 435.e1 | ||
| Embden-Meyerhof Pathway | 435.e1 | ||
| Hexokinase | 435.e1 | ||
| Glucose-6-Phosphate Isomerase | 435.e5 | ||
| Phosphofructokinase | 435.e5 | ||
| Aldolase | 435.e5 | ||
| Triosephosphate Isomerase | 435.e6 | ||
| Phosphoglycerate Kinase | 435.e6 | ||
| Pyruvate Kinase | 435.e6 | ||
| Lactate Dehydrogenase | 435.e7 | ||
| Hexose Monophosphate Pathway | 435.e7 | ||
| Glucose-6-Phosphate Dehydrogenase | 435.e7 | ||
| 6-Phosphogluconate Dehydrogenase (Decarboxylating) (EC 1.1.1.44) | 435.e8 | ||
| Transketolase | 435.e8 | ||
| Rapoport-Luebering Shunt | 435.e8 | ||
| Glutathione Pathway | 435.e9 | ||
| Glutamate Cysteine Ligase | 435.e9 | ||
| Glutathione Synthetase | 435.e9 | ||
| Glutathione Reductase | 435.e9 | ||
| Glutathione Peroxidase | 435.e10 | ||
| Purine–Pyrimidine Metabolism | 435.e10 | ||
| Pyrimidine-5′-Nucleotidase-1 | 435.e10 | ||
| Adenylate Kinase | 435.e10 | ||
| Adenosine Deaminase | 435.e11 | ||
| Methemoglobin Reduction | 435.e11 | ||
| Cytochrome B5 Reductase | 435.e11 | ||
| Detection of Hereditary Red Blood Cell Enzyme Deficiencies | 435.e11 | ||
| Methods | 435.e12 | ||
| Method Summary for Determination of Glucose-6-Phosphate Dehydrogenase | 435.e12 | ||
| IV Molecular Diagnostics | 926 | ||
| 44 Principles of Molecular Biology | 927 | ||
| Abstract | 927 | ||
| Background | 927 | ||
| Content | 927 | ||
| Historical Developments in Genetics and Molecular Biology | 927 | ||
| Molecular Biology Essentials | 928 | ||
| Nucleic Acid Structure and Function | 929 | ||
| Structure of Deoxyribonucleic Acid | 929 | ||
| Types of Deoxyribonucleic Acid | 931 | ||
| Molecular Composition of Ribonucleic Acid | 931 | ||
| Structure of Ribonucleic Acid | 931 | ||
| Ribonucleic Acids Associated With Protein Production | 931 | ||
| Human Chromosome | 931 | ||
| Central Dogma of Molecular Biology | 932 | ||
| Deoxyribonucleic Acid Replication | 932 | ||
| Deoxyribonucleic Acid Repair | 933 | ||
| Mechanisms | 933 | ||
| Deoxyribonucleic Acid Modification Enzymes | 934 | ||
| Gene Structure | 934 | ||
| Ribonucleic Acid Transcription and Splicing | 934 | ||
| Translation | 935 | ||
| Epigenetics | 938 | ||
| Deoxyribonucleic Acid Methylation | 938 | ||
| Chromatin Conformation Regulation | 938 | ||
| Noncoding Ribonucleic Acids | 939 | ||
| Understanding Our Genome | 939 | ||
| Selected References | 940 | ||
| References | 941.e1 | ||
| 45 Genomes and Variants | 942 | ||
| Abstract | 942 | ||
| Background | 942 | ||
| Content | 942 | ||
| Introduction | 942 | ||
| Human Genome | 942 | ||
| Variations in Specific Populations | 943 | ||
| Nonhuman Genomes | 944 | ||
| Primates | 944 | ||
| Rodents | 945 | ||
| Fungi | 946 | ||
| Bacteria | 946 | ||
| Viruses | 947 | ||
| DNA That Codes for RNA but Not Protein | 948 | ||
| Variation in the Human Genome | 948 | ||
| Single Nucleotide Variants | 949 | ||
| Copy Number Variation (Gains and Losses) | 949 | ||
| Fusions | 950 | ||
| Short Tandem Repeats | 950 | ||
| Transposable Elements and Their Genetic Fossils | 950 | ||
| Human Epigenetic Alterations | 950 | ||
| ENCODE Project | 951 | ||
| Nomenclature | 952 | ||
| Small Variants | 952 | ||
| Large Structural Variants | 953 | ||
| Naming Genes | 954 | ||
| Databases | 954 | ||
| Informatics | 955 | ||
| Selected References | 957 | ||
| References | 957.e1 | ||
| 46 Nucleic Acid Isolation | 958 | ||
| Abstract | 958 | ||
| Background | 958 | ||
| Content | 958 | ||
| History of Nucleic Acid Preparation Tools | 958.e1 | ||
| Steps Involved in NA Preparation | 958.e1 | ||
| Lysis | 958.e1 | ||
| Protein Removal | 958.e2 | ||
| Separation Techniques | 958.e2 | ||
| Concentration | 958.e4 | ||
| Storage | 958.e5 | ||
| Impact of Sample Matrix on Nucleic Acid Preparation | 958.e5 | ||
| Human Sample Complexity | 958.e5 | ||
| Blood | 958.e5 | ||
| Paraffin Embedded Tissue With Fixatives | 958.e5 | ||
| DNA Versus RNA | 958.e6 | ||
| Processing Throughput | 958.e6 | ||
| Batch Size | 958.e6 | ||
| Speed | 958.e6 | ||
| Specific Applications | 958.e6 | ||
| Inherited Disorders and Pharmacogenetics | 958.e6 | ||
| Oncology | 958.e7 | ||
| Pathogens | 958.e7 | ||
| Low Concentration | 958.e7 | ||
| Flexibility for Different Matrices | 958.e7 | ||
| RNA | 958.e7 | ||
| Integrated Nucleic Acid Preparation | 958.e7 | ||
| Microfluidics | 958.e7 | ||
| Nucleic Acid Quality and Quantity | 958.e7 | ||
| Purity | 958.e7 | ||
| Inhibitors | 958.e7 | ||
| Yield | 958.e7 | ||
| Methods to Measure Nucleic Acid Quality and Quantity | 958.e8 | ||
| Ultraviolet Absorbance | 958.e8 | ||
| Fluorescent Staining of Nucleic Acids | 958.e8 | ||
| Summary of Methods | 958.e8 | ||
| Conclusion | 958.e8 | ||
| References | 958.e10 | ||
| 47 Nucleic Acid Techniques | 959 | ||
| Abstract | 959 | ||
| Background | 959 | ||
| Content | 959 | ||
| Introduction | 959 | ||
| Nucleic Acid Preparation | 960 | ||
| Nucleic Acid Fragmentation | 962 | ||
| Bisulfite Treatment for Methylation Analysis | 962 | ||
| Amplification Techniques | 962 | ||
| Polymerase Chain Reaction—Target Amplification | 963 | ||
| Details of the PCR Process | 963 | ||
| Polymerase Chain Reaction Kinetics | 964 | ||
| Polymerase Chain Reaction Optimization | 966 | ||
| Primer Design | 966 | ||
| Polymerase Chain Reaction Contamination, Inhibition, and Controls | 967 | ||
| Multiplex Polymerase Chain Reaction and Nested Polymerase Chain Reaction | 967 | ||
| Asymmetric Polymerase Chain Reaction | 967 | ||
| Selective Amplification of Sequence Variants by Polymerase Chain Reaction | 968 | ||
| Detection Limits of Polymerase Chain Reaction | 968 | ||
| Digital Polymerase Chain Reaction | 968 | ||
| Additional Target Amplification Methods | 969 | ||
| Transcription-Based Amplification Methods | 969 | ||
| Loop-Mediated Amplification Methods | 970 | ||
| Strand Displacement Amplification | 970 | ||
| Variants of Polymerase Chain Reaction That Do Not Require Heat Denaturation | 970 | ||
| Whole-Genome and Whole-Transcriptome Amplification | 970 | ||
| Signal and Probe Amplification Methods | 970 | ||
| Branched-Chain DNA: Signal Amplification | 970 | ||
| Serial Invasive Amplification: Signal Amplification | 970 | ||
| Rolling Circle Amplification: Probe Amplification | 971 | ||
| Endpoint Quantification in Amplification Assays | 971 | ||
| Detection Techniques | 971 | ||
| Nucleic Acid Probes | 971 | ||
| Indirect Detection of Hybridized Probes | 971 | ||
| Fluorescent Labels | 971 | ||
| Electrochemical Detection | 972 | ||
| Discrimination Techniques | 972 | ||
| Electrophoresis | 972 | ||
| Polymerase Chain Reaction Product Length | 973 | ||
| Restriction Fragment Length Polymorphism | 973 | ||
| Polymerase Chain Reaction/Restriction Fragment Length Polymorphisms | 973 | ||
| Conformation-Sensitive Scanning Techniques | 974 | ||
| Dideoxy-Termination Sequencing (Sanger Sequencing) | 974 | ||
| Single Nucleotide Extension | 975 | ||
| Oligonucleotide Ligation | 975 | ||
| Multiplex Ligation-Dependent Probe Amplification | 975 | ||
| Alternatives to Electrophoresis | 976 | ||
| Pyrosequencing | 976 | ||
| Mass Spectrometry | 976 | ||
| High-Performance Liquid Chromatography | 978 | ||
| Hybridization Assays | 978 | ||
| Thermodynamics | 978 | ||
| Kinetics | 979 | ||
| Probes | 979 | ||
| Cloned Probes. | 979 | ||
| Polymerase Chain Reaction–Generated Probes. | 979 | ||
| Oligonucleotide Probes. | 979 | ||
| Estimating Melting Temperature of Oligonucleotide Probes. | 980 | ||
| Purity of Labeled Oligonucleotide Probes. | 980 | ||
| Examples of Hybridization Assays | 980 | ||
| Solid Phase Hybridization | 980 | ||
| Dot Blot and Line Probe Assays. | 980 | ||
| Medium-Density Arrays. | 980 | ||
| Microarrays. | 980 | ||
| In Situ Hybridization. | 982 | ||
| Single-Copy Visualization. | 983 | ||
| Solution Phase Hybridization: Real-Time Polymerase Chain Reaction and Melting Analysis | 983 | ||
| Dyes and Probes. | 983 | ||
| Detection and Quantification in Real-Time PCR | 985 | ||
| Detection. | 985 | ||
| Quantification. | 985 | ||
| Accuracy and Precision. | 986 | ||
| Melting Analysis | 987 | ||
| Homogeneous Single Nucleotide Variant Typing | 987 | ||
| High-Resolution Melting Analysis | 989 | ||
| Massively Parallel Sequencing | 990 | ||
| Sequencing From Clones | 990 | ||
| Emulsion Polymerase Chain Reaction. | 990 | ||
| Bridge Amplification. | 991 | ||
| Sequencing by Synthesis | 991 | ||
| Pyrosequencing. | 991 | ||
| Semiconductor Sequencing. | 992 | ||
| Reversible Terminators. | 992 | ||
| Sequencing by Ligation | 992 | ||
| Single-Molecule Sequencing | 993 | ||
| Real-Time Single Molecule Sequencing With Fluorescent Nucleotides. | 994 | ||
| Nanopore Sequencing. | 994 | ||
| Selected References | 994 | ||
| References | 994.e1 | ||
| 48 Molecular Microbiology | 995 | ||
| Abstract | 995 | ||
| Background | 995 | ||
| Content | 995 | ||
| Introduction | 995 | ||
| Viral Syndromes | 995 | ||
| Human Immunodeficiency Virus 1 | 995 | ||
| Hepatitis | 998 | ||
| Hepatitis C Virus | 998 | ||
| Hepatitis B Virus | 1001 | ||
| Transplant Recipients | 1003 | ||
| Cytomegalovirus | 1003 | ||
| Epstein-Barr Virus | 1004 | ||
| BK Virus | 1005 | ||
| Sexually Transmitted Infections | 1006 | ||
| Chlamydia trachomatis and Neisseria gonorrhoeae | 1006 | ||
| Trichomonas vaginalis | 1008 | ||
| Herpes Simplex Virus | 1009 | ||
| Human Papillomavirus | 1009 | ||
| Respiratory Tract Infections | 1011 | ||
| Viruses | 1011 | ||
| Mycobacterium tuberculosis | 1013 | ||
| Bordetella pertussis | 1014 | ||
| Bloodstream Infections | 1015 | ||
| Positive Blood Culture Identification | 1015 | ||
| Direct Pathogen Detection | 1017 | ||
| Central Nervous System | 1017 | ||
| Herpes Simplex Virus | 1017 | ||
| Enterovirus | 1018 | ||
| Gastroenteritis | 1019 | ||
| Clostridium difficile | 1019 | ||
| Gastrointestinal Pathogen Panels | 1020 | ||
| Antibacterial Drug Resistance | 1021 | ||
| Human Microbiome and Metagenomics | 1022 | ||
| Future Directions | 1023 | ||
| Selected References | 1023 | ||
| References | 1024.e1 | ||
| 49 Genetics | 1025 | ||
| Abstract | 1025 | ||
| Background | 1025 | ||
| Content | 1025 | ||
| Diseases With Mendelian Inheritance | 1025 | ||
| Autosomal Recessive Disorders | 1025 | ||
| Cystic Fibrosis | 1025 | ||
| Spinal Muscular Atrophy | 1030 | ||
| Nonsyndromic Hearing Loss and Deafness | 1031 | ||
| Autosomal Dominant Diseases | 1032 | ||
| Huntington Disease | 1032 | ||
| Marfan Syndrome | 1036 | ||
| Multiple Endocrine Neoplasia | 1037 | ||
| X-Linked Diseases | 1039 | ||
| Duchenne Muscular Dystrophy | 1039 | ||
| Fragile X Syndrome | 1042 | ||
| Rett Syndrome | 1046 | ||
| Complex Diseases | 1046 | ||
| Thrombophilia | 1047 | ||
| Hereditary Pancreatitis | 1049 | ||
| Hereditary Breast and Ovarian Cancer | 1050 | ||
| Inherited Colon Cancer | 1053 | ||
| Lynch Syndrome | 1054 | ||
| Familial Adenomatous Polyposis | 1057 | ||
| Mitochondrial DNA Diseases | 1058 | ||
| Leber Hereditary Optic Neuropathy | 1060 | ||
| Leigh Syndrome | 1060 | ||
| Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-Like Episodes | 1060 | ||
| Myoclonic Epilepsy Associated With Ragged Red Fibers | 1061 | ||
| Kearns-Sayre Syndrome | 1061 | ||
| Imprinting | 1061 | ||
| Prader-Willi and Angelman Syndromes | 1061 | ||
| Expanded Carrier Screening | 1063 | ||
| Massively Parallel Sequencing | 1064 | ||
| Whole-Exome Sequencing | 1065 | ||
| Cytogenomics | 1066 | ||
| Reporting of Test Results | 1067 | ||
| Laboratory Regulation | 1070 | ||
| Selected References | 1070 | ||
| References | 1071.e1 | ||
| 50 Solid Tumor Genomics | 1072 | ||
| Abstract | 1072 | ||
| Background | 1072 | ||
| Content | 1072 | ||
| Considerations for Solid Tumor Genomics | 1072 | ||
| Sampling and Preservation Methods | 1072 | ||
| Staining and Selection of Tumor Cells | 1073 | ||
| Genomic Analysis of Solid Tumors | 1074 | ||
| Background | 1074 | ||
| Large-Scale Discovery Efforts | 1074 | ||
| Pre-Massively Parallel Sequencing Approaches to “Hotspot” Characterization | 1075 | ||
| RNA-Based Approaches | 1075 | ||
| Massive Parallel Sequencing of Solid Tumor Samples | 1075 | ||
| Whole Genome Sequencing | 1076 | ||
| Selective Enrichment by Hybridization Capture | 1077 | ||
| Multiplex Polymerase Chain Reaction Approach | 1077 | ||
| RNA Sequencing of Solid Tumor Isolates | 1077 | ||
| Detection of Cancer Mutations in Body Fluids | 1078 | ||
| Interpreting Somatic Alterations in a Clinical Context | 1079 | ||
| Prognostic Interpretation | 1079 | ||
| Diagnostic Interpretation | 1079 | ||
| Challenges of Variants of Unknown Significance | 1079 | ||
| Challenges of Off-Label Indications | 1080 | ||
| Importance of Tissue Biology | 1080 | ||
| Summary and Concluding Remarks | 1080 | ||
| Selected References | 1080 | ||
| References | 1081.e1 | ||
| 51 Genetic Aspects of Hematopoietic Malignancies | 1082 | ||
| Abstract | 1082 | ||
| Background | 1082 | ||
| Content | 1082 | ||
| Recurrent Translocations and Structural Chromosomal Abnormalities | 1082 | ||
| Lymphoid Disorders | 1083 | ||
| B-Lymphoblastic Leukemia/Lymphoma | 1083 | ||
| T-Lymphoblastic Leukemia/Lymphoma | 1085 | ||
| Burkitt Lymphoma | 1085 | ||
| Follicular Lymphoma | 1085 | ||
| Diffuse Large B-Cell Lymphoma | 1086 | ||
| Mantle Cell Lymphoma | 1086 | ||
| Extranodal Marginal Zone Lymphoma (MALT Lymphoma) | 1086 | ||
| Multiple Myeloma | 1086 | ||
| Anaplastic Large Cell Lymphoma | 1087 | ||
| Myeloid Disorders | 1087 | ||
| Acute Myeloid Leukemias | 1087 | ||
| Chronic Myelogeneous Leukemia | 1090 | ||
| Myelodysplastic Syndromes | 1090 | ||
| Myeloid and Lymphoid Neoplasms With Eosinophilia and Abnormalities of PDGFRA, PDGFRB, or FGFR1 | 1090 | ||
| Test Applications | 1091 | ||
| Cytogenetics | 1091 | ||
| Fluorescence in Situ Hybridization | 1092 | ||
| Single Nucleotide Polymorphism Array | 1092 | ||
| Polymerase Chain Reaction | 1092 | ||
| Gene Mutations in Hematopoietic Malignancies | 1093 | ||
| Mechanisms | 1093 | ||
| Myeloid Diseases | 1093 | ||
| Signal Transduction Pathways: Disease-Specific Signaling Mutations | 1094 | ||
| JAK2 | 1095 | ||
| KIT | 1095 | ||
| CSF3R | 1096 | ||
| FLT3 | 1096 | ||
| CALR | 1096 | ||
| Mutations in Epigenetic Regulators | 1097 | ||
| DNMT3A | 1097 | ||
| TET2 | 1098 | ||
| IDH1 and IDH2 | 1098 | ||
| Mutations in the RNA Spliceosome | 1098 | ||
| Mutations in the Cohesin Complex | 1099 | ||
| Mutations in Myeloid Transcription Factors and Chromatin Modifiers | 1099 | ||
| TP53 | 1100 | ||
| NPM1 | 1100 | ||
| Lymphoid Diseases | 1100 | ||
| Mature B-Cell Lymphoproliferative Disorders | 1100 | ||
| Hairy Cell Leukemia | 1101 | ||
| Lymphoplasmacytic Lymphoma | 1101 | ||
| Diffuse Large B Cell Lymphoma | 1101 | ||
| Chronic Lymphocytic Leukemia | 1101 | ||
| Mature T and NK Cell Lymphoproliferative Disorders | 1102 | ||
| B/T Lymphoblastic Leukemia/Lymphoma | 1102 | ||
| Acquired Drug Resistance Mutations | 1102 | ||
| Laboratory Techniques for the Detection of Single-Gene Variants | 1103 | ||
| Massively Parallel Sequencing for Somatic Variants in Hematopoietic Malignancies | 1103 | ||
| Role of Genetic Regulatory Mechanisms in Hematopoietic Malignancies | 1104 | ||
| Methylation Patterns | 1104 | ||
| Micro RNA Expression Patterns | 1104 | ||
| Gene Expression Profiling | 1104 | ||
| Clonality Testing in Hematopoietic Malignancies | 1105 | ||
| Lymphoid Clonality Testing | 1105 | ||
| V(D)J Recombination in Normal B- and T-Lymphocytes | 1106 | ||
| Identification of Clonal Rearrangements in the Workup of Lymphoid Malignancies | 1107 | ||
| Myeloid Clonality Testing | 1107 | ||
| Test Applications | 1108 | ||
| Southern Blotting | 1108 | ||
| Polymerase Chain Reaction | 1108 | ||
| Massively Parallel Sequencing | 1108 | ||
| Conclusion | 1110 | ||
| Selected References | 1110 | ||
| References | 1110.e1 | ||
| 52 Circulating Tumor Cells and Circulating Tumor DNA | 1111 | ||
| Abstract | 1111 | ||
| Background | 1111 | ||
| Content | 1111 | ||
| Circulating Tumor Cells | 1113 | ||
| Circulating Tumor Cells: Historical Background | 1113 | ||
| Circulating Tumor Cells: Analytical Techniques | 1113 | ||
| General Overview | 1113 | ||
| The CellSearch System | 1114 | ||
| Isolation/Enrichment Systems for CTC Analysis | 1117 | ||
| Label-Dependent CTC Isolation/Enrichment Systems | 1117 | ||
| Positive Selection. | 1117 | ||
| Negative Selection. | 1118 | ||
| Flow Cytometry–Based Technologies. | 1118 | ||
| Label-Independent CTC Isolation/Enrichment Systems | 1118 | ||
| Systems Based on Density. | 1118 | ||
| Systems Based on CTC Size. | 1118 | ||
| Separation Based on the Electric Charge of CTCs. | 1119 | ||
| Microfluidic Systems for CTC Isolation/Enrichment. | 1119 | ||
| In Vivo Systems for CTC Isolation/Enrichment. | 1120 | ||
| CTC Analysis: Detection and Molecular Characterization | 1123 | ||
| Image-Based Approaches. | 1123 | ||
| Molecular Assays. | 1124 | ||
| PCR-Based Assays. | 1125 | ||
| Fluorescence in Situ Hybridization and RNA in Situ Hybridization. | 1125 | ||
| Protein Analyses on CTCs (EPISPOT Assay). | 1125 | ||
| Single-Cell Analysis of CTCs. | 1126 | ||
| CTCs: “A Window to Metastasis” | 1127 | ||
| Epithelial and Mesenchymal Transitions of CTCs | 1127 | ||
| CTCs and Cancer Stem Cells | 1128 | ||
| CTCs: Clinical Significance, Molecular Characterization, and Its Impact on Individualized Treatment of Cancer Patients | 1129 | ||
| Breast Cancer | 1129 | ||
| Clinical Significance of CTCs in Metastatic Breast Cancer. | 1129 | ||
| Clinical Significance of CTCs in Early Breast Cancer. | 1129 | ||
| Molecular Characterization of CTCs in Breast Cancer and Its Impact on Individualized Treatment. | 1130 | ||
| HER-2. | 1130 | ||
| Endocrine Treatment. | 1130 | ||
| EMT and Stem Cell Markers on CTCs. | 1130 | ||
| Apoptosis and Clinical Dormancy on CTCs. | 1130 | ||
| DNA Methylation in CTCs. | 1130 | ||
| Prostate Cancer. | 1131 | ||
| Clinical Significance of CTCs in Metastatic Prostate Cancer. | 1131 | ||
| Clinical Significance of CTCs in Early Prostate Cancer. | 1131 | ||
| Molecular Characterization of CTCs in Prostate Cancer and Its Impact on Individualized Treatment. | 1131 | ||
| Colorectal Cancer | 1132 | ||
| Clinical Significance of CTCs in Metastatic Colorectal Cancer. | 1132 | ||
| Clinical Significance of CTCs in Early Colorectal Cancer. | 1132 | ||
| Molecular Characterization of CTCs in Colorectal Cancer and Its Impact on Individualized Treatment. | 1132 | ||
| Lung Cancer | 1132 | ||
| Clinical Significance of CTCs in Non–Small Cell Lung Cancer. | 1132 | ||
| Clinical Significance of CTCs in Small Cell Lung Cancer. | 1132 | ||
| Molecular Characterization of CTCs in Lung Cancer and Its Impact on Individualized Treatment. | 1133 | ||
| Cutaneous Melanoma | 1133 | ||
| Clinical Significance of CTCs in Cutaneous Melanoma. | 1133 | ||
| Molecular Characterization of Isolated CTCs From Melanoma Patients. | 1133 | ||
| Ovarian Cancer | 1134 | ||
| Pancreatic Cancer | 1134 | ||
| Head and Neck Cancer | 1134 | ||
| Hepatocellular Carcinoma | 1134 | ||
| Bladder Cancer | 1134 | ||
| Circulating Tumor DNA | 1135 | ||
| Origin and Function of ctDNA | 1135 | ||
| Types of ctDNA | 1135 | ||
| Isolation of ctDNA | 1135 | ||
| Quantification of ctDNA | 1135 | ||
| Massive Parallel Sequencing | 1136 | ||
| Plasma Versus Serum for ctDNA | 1136 | ||
| Tumor-Specific ctDNA Mutations | 1137 | ||
| Gene Amplification in ctDNA | 1138 | ||
| Copy Number Variation in ctDNA | 1138 | ||
| Microsatellite Instability and Loss of Heterozygosity in ctDNA | 1138 | ||
| Methylated ctDNA | 1138 | ||
| Noncoding ctDNA | 1140 | ||
| Viral ctDNA | 1140 | ||
| ctDNA Integrity | 1141 | ||
| Half-Life of ctDNA | 1141 | ||
| ctDNA Detection by Single-Marker Versus Multimarker Approach Assays | 1141 | ||
| ctDNA in Clinical Oncology Trials | 1142 | ||
| Future Challenges for ctDNA Analysis | 1142 | ||
| Combined Discussion of CTC and ctDNA | 1142 | ||
| Comparison Between CTCs and ctDNA | 1142 | ||
| Quality Control and Logistic Issues of CTCs and ctDNA | 1142 | ||
| Liquid Biopsy Versus Tumor Biopsy | 1143 | ||
| CTCs and ctDNA Combined as Companion Blood Biomarkers | 1143 | ||
| Conclusions | 1144 | ||
| Selected References | 1144 | ||
| References | 1144.e1 | ||
| 53 Circulating Nucleic Acids for Prenatal Diagnostics | 1145 | ||
| Abstract | 1145 | ||
| Background | 1145 | ||
| Content | 1145 | ||
| Brief Overview of the Early Developments of Prenatal Genetic Diagnostics | 1145 | ||
| Strategies to Mitigate Risks of Invasive Prenatal Diagnosis | 1145 | ||
| Maternal Age | 1145 | ||
| Serum Biochemistry Screening | 1146 | ||
| First Trimester Screening | 1146 | ||
| Noninvasive Fetal DNA Analysis | 1146 | ||
| Fetal Cells in Maternal Blood | 1146 | ||
| Cell-Free Fetal DNA in Maternal Plasma | 1146 | ||
| The Biology of Circulating Cell-Free Fetal Nucleic Acids in Maternal Plasma | 1146 | ||
| Diagnostic Applications of Circulating cffDNA | 1147 | ||
| Fetal Sex Assessment for Sex-Associated Disorders | 1147 | ||
| Fetal Rhesus D Status Determination | 1148 | ||
| Fetal Chromosomal Aneuploidy Screening | 1148 | ||
| Methodological Approaches | 1148 | ||
| Clinical Implementation | 1150 | ||
| Discordant Results | 1150 | ||
| Single-Gene Diseases | 1151 | ||
| Noninvasive Fetal ‘Omics | 1151 | ||
| Analytical Aspects | 1152 | ||
| Maternal Blood Sample Collection and Processing | 1152 | ||
| Circulating Cell-Free Fetal DNA Analysis | 1153 | ||
| Measuring the Fetal DNA Fraction | 1153 | ||
| Massively Parallel Maternal Plasma DNA Sequencing | 1154 | ||
| Conclusion | 1154 | ||
| Selected References | 1154 | ||
| References | 1155.e1 | ||
| 54 Pharmacogenetics | 1156 | ||
| Abstract | 1156 | ||
| Background | 1156 | ||
| Content | 1156 | ||
| Principles of Pharmacogenetics | 1156.e1 | ||
| Drug Response | 1156.e1 | ||
| Pharmacokinetics | 1156.e2 | ||
| Pharmacodynamics | 1156.e4 | ||
| Implementation of Pharmacogenetics | 1156.e4 | ||
| Logistics of Pharmacogenetics in a Clinical Setting | 1156.e5 | ||
| Specimens | 1156.e5 | ||
| Analytical Strategies | 1156.e7 | ||
| Targeted Testing | 1156.e7 | ||
| Whole Exome/Genome | 1156.e7 | ||
| Genome-Wide Association Studies | 1156.e8 | ||
| Gene Dose (Copy Number) | 1156.e8 | ||
| Haplotyping | 1156.e8 | ||
| Reporting | 1156.e8 | ||
| Clinical Interpretation | 1156.e8 | ||
| Specific Examples of Pharmacogene Associations | 1156.e9 | ||
| Associations With Pharmacokinetics | 1156.e9 | ||
| Drug Metabolizing Enzymes | 1156.e9 | ||
| Cytochrome P450 2D6 (CYP2D6). | 1156.e11 | ||
| Tamoxifen Application. | 1156.e11 | ||
| Codeine Application. | 1156.e13 | ||
| Antidepressant Application. | 1156.e13 | ||
| Cytochrome P450 2C9 (CYP2C9). | 1156.e13 | ||
| Cytochrome P450 2C19 (CYP2C19). | 1156.e14 | ||
| Clopidogrel Application. | 1156.e15 | ||
| Antidepressant Application. | 1156.e15 | ||
| Cytochrome P4503A Family. | 1156.e15 | ||
| Tacrolimus Application. | 1156.e15 | ||
| Dihydropyrimidine Dehydrogenase. | 1156.e15 | ||
| Fluoropyrimidine Application. | 1156.e16 | ||
| N-Acetyltransferases (NAT1 and NAT2). | 1156.e16 | ||
| Clinical Applications. | 1156.e18 | ||
| Rasburicase Application. | 1156.e19 | ||
| Thiopurine S-Methyltransferase. | 1156.e19 | ||
| Thiopurine Application. | 1156.e19 | ||
| UDP-Glucuronyltransferase 1A1. | 1156.e19 | ||
| Irinotecan Application. | 1156.e20 | ||
| Drug Transporters | 1156.e20 | ||
| Adenosine Triphosphate (ATP)-Binding Cassette Transporters. | 1156.e20 | ||
| Solute Carrier Organic Anion-Transporters. | 1156.e20 | ||
| Simvastatin Application. | 1156.e21 | ||
| Associations With Pharmacodynamics | 1156.e21 | ||
| Vitamin K Epoxide Reductase Complex 1 | 1156.e21 | ||
| Warfarin Application. | 1156.e21 | ||
| Cystic Fibrosis Transmembrane Conductance Regulator | 1156.e22 | ||
| Ivacaftor Application. | 1156.e23 | ||
| Human Leukocyte Antigen Complex | 1156.e23 | ||
| Clinical Applications. | 1156.e23 | ||
| Future Directions | 1156.e24 | ||
| References | 1156.e24 | ||
| 55 Identity Testing | 1157 | ||
| Abstract | 1157 | ||
| Background | 1157 | ||
| Content | 1157 | ||
| Short Tandem Repeats and Amelogenin | 1157.e1 | ||
| The Analytical Process | 1157.e2 | ||
| Sample Collection | 1157.e2 | ||
| Extraction | 1157.e2 | ||
| Quantification | 1157.e3 | ||
| Polymerase Chain Reaction Amplification | 1157.e3 | ||
| Capillary Electrophoresis and Data Analysis | 1157.e3 | ||
| Y–Short Tandem Repeats | 1157.e4 | ||
| Mitochondrial DNA | 1157.e4 | ||
| Touch Samples and DNA Mixtures | 1157.e6 | ||
| Single Nucleotide Polymorphisms | 1157.e6 | ||
| Quality Assurance | 1157.e7 | ||
| Statistical Interpretation | 1157.e7 | ||
| Rapid DNA | 1157.e8 | ||
| Massively Parallel Sequencing | 1157.e9 | ||
| Short Tandem Repeats | 1157.e9 | ||
| Mitochondrial DNA | 1157.e9 | ||
| Single-Nucleotide Polymorphisms | 1157.e9 | ||
| Legal Issues | 1157.e9 | ||
| Parentage and Kinship | 1157.e10 | ||
| Other Clinical Applications of DNA Identity Markers | 1157.e11 | ||
| Verification of Sample | 1157.e11 | ||
| Prenatal Testing | 1157.e11 | ||
| Bone Marrow Transplantation (Chimerism) | 1157.e11 | ||
| Loss of Heterozygosity | 1157.e11 | ||
| References | 1157.e12 | ||
| V Pathophysiology | 1158 | ||
| 56 Nutrition | 1159 | ||
| Abstract | 1159 | ||
| Background | 1159 | ||
| Content | 1159 | ||
| Introduction: The Scope of Clinical Nutrition | 1159.e1 | ||
| Nutrient Requirements | 1159.e1 | ||
| A Classification of Nutrients | 1159.e1 | ||
| Macronutrients | 1159.e3 | ||
| Carbohydrate | 1159.e3 | ||
| Function and Sources | 1159.e3 | ||
| Homeostasis | 1159.e3 | ||
| Deficiency | 1159.e3 | ||
| Excess | 1159.e3 | ||
| Assessment of Status | 1159.e3 | ||
| Dietary Fiber | 1159.e4 | ||
| Fat | 1159.e4 | ||
| Function and Sources | 1159.e4 | ||
| Homeostasis | 1159.e4 | ||
| Deficiency | 1159.e4 | ||
| Excess | 1159.e4 | ||
| Assessment of Status | 1159.e4 | ||
| Essential Fatty Acids | 1159.e4 | ||
| Other Fats | 1159.e5 | ||
| Protein | 1159.e5 | ||
| Function and Sources | 1159.e5 | ||
| Homeostasis | 1159.e5 | ||
| Deficiency | 1159.e5 | ||
| Excess | 1159.e5 | ||
| VI Hematology and Coagulation | 1731 | ||
| 71 Hemostasis | 1732 | ||
| Abstract | 1732 | ||
| Background | 1732 | ||
| Content | 1732 | ||
| Hemostasis | 1732.e1 | ||
| Platelets | 1732.e1 | ||
| Plasma Components | 1732.e1 | ||
| Coagulation | 1732.e1 | ||
| Regulation of Coagulation | 1732.e2 | ||
| Fibrinolysis | 1732.e4 | ||
| von Willebrand Factor | 1732.e4 | ||
| Blood Vessels and Endothelium | 1732.e5 | ||
| Test Methods for Evaluation of Primary Hemostasis | 1732.e6 | ||
| Automated Platelet Counting | 1732.e6 | ||
| Manual Platelet Counting and Platelet Light Microscopy | 1732.e7 | ||
| Platelet Structure by Platelet Transmission Electron Microscopy | 1732.e8 | ||
| Global Platelet and Vascular Function | 1732.e9 | ||
| Bleeding Time. | 1732.e9 | ||
| Platelet Function Analyzer (PFA-100 and PFA-200). | 1732.e9 | ||
| Platelet Aggregation and Secretion | 1732.e9 | ||
| Platelet Aggregation Studies. | 1732.e9 | ||
| Platelet Secretion Studies. | 1732.e10 | ||
| Platelet Support of Plasma Coagulation | 1732.e11 | ||
| Platelet Contractile Function | 1732.e11 | ||
| Platelet Receptors and Function Using Flow Cytometry | 1732.e11 | ||
| Platelet Adhesion and von Willebrand Factor | 1732.e11 | ||
| Ristocetin-Induced Platelet Aggregation Assay. | 1732.e11 | ||
| von Willebrand Factor and Ristocetin Cofactor Assay. | 1732.e11 | ||
| von Willebrand Factor–Collagen-Binding Assay. | 1732.e11 | ||
| von Willebrand Factor GPIb Binding Assays (VWF:Ab, VWF: GPlbR, VWF:GPIbM). | 1732.e11 | ||
| von Willebrand Factor–Factor VIII Binding Activity. | 1732.e12 | ||
| von Willebrand Factor Antigen Assays (VWF:Ag). | 1732.e12 | ||
| von Willebrand Factor Multimer Assay. | 1732.e12 | ||
| Evaluation of Antiplatelet Medication | 1732.e13 | ||
| Platelet Aggregation. | 1732.e13 | ||
| PFA-100. | 1732.e13 | ||
| VerifyNow. | 1732.e13 | ||
| Clinical Application of Tests for Platelet Disorders | 1732.e13 | ||
| Inherited Platelet Disorders | 1732.e13 | ||
| Congenital Thrombocytopenia. | 1732.e13 | ||
| Surface Receptor Deficiency. | 1732.e13 | ||
| Signal Transduction Deficiency. | 1732.e13 | ||
| Storage-Pool Deficiency. | 1732.e14 | ||
| Acquired Platelet Disorders | 1732.e14 | ||
| Medication Effects. | 1732.e14 | ||
| Renal Failure. | 1732.e15 | ||
| Paraproteinemia. | 1732.e15 | ||
| Primary Bone Marrow Disorder. | 1732.e15 | ||
| von Willebrand Disease and Acquired von Willebrand Syndrome | 1732.e15 | ||
| Initial von Willebrand Disease Laboratory Testing. | 1732.e16 | ||
| Supplementary Testing. | 1732.e16 | ||
| General Considerations for Coagulation Testing | 1732.e17 | ||
| Preanalytic Variables for Coagulation-Based Assays | 1732.e17 | ||
| Optical Versus Mechanical End Point Detection | 1732.e18 | ||
| Chromogenic Assays | 1732.e18 | ||
| Test Methods for Secondary Hemostasis (Coagulation) | 1732.e18 | ||
| Prothrombin Time | 1732.e18 | ||
| Activated Partial Thromboplastin Time | 1732.e20 | ||
| Fibrinogen (Clauss and Derived Method) | 1732.e21 | ||
| Mixing Studies | 1732.e21 | ||
| Factor Assays | 1732.e23 | ||
| Factor Inhibitor Assays | 1732.e24 | ||
| Factor XIII Assays | 1732.e25 | ||
| Thrombin Time | 1732.e26 | ||
| Clinical Application of Laboratory Tests for Coagulation Disorders | 1732.e28 | ||
| Inherited Coagulation Disorders | 1732.e29 | ||
| Factor VIII Deficiency (Hemophilia A). | 1732.e30 | ||
| Factor IX Deficiency (Hemophilia B). | 1732.e31 | ||
| Monitoring Factor Concentrate Therapy (Hemophilia A and B). | 1732.e31 | ||
| Factor XI Deficiency (Hemophilia C). | 1732.e32 | ||
| Factor XIII Deficiency. | 1732.e32 | ||
| Acquired Coagulation Disorders | 1732.e32 | ||
| Liver Disease. | 1732.e33 | ||
| Vitamin K Deficiency. | 1732.e33 | ||
| Disseminated Intravascular Coagulation. | 1732.e33 | ||
| Test Methods and Their Clinical Application for Fibrinolysis | 1732.e34 | ||
| Thrombin Time | 1732.e34 | ||
| Fibrin and Fibrinogen Degradation Product Assays | 1732.e34 | ||
| d-Dimer Assays | 1732.e34 | ||
| Plasminogen Activator Inhibitor Type 1 Assays | 1732.e35 | ||
| α2-Antiplasmin | 1732.e35 | ||
| Plasminogen | 1732.e35 | ||
| Test Methods for Thrombosis | 1732.e35 | ||
| d-Dimer for Exclusion of Venous Thromboembolism | 1732.e36 | ||
| Test Methods and Their Clinical Application for Thrombotic Risk | 1732.e36 | ||
| Thrombophilia Testing | 1732.e36 | ||
| Activated Protein C Resistance Assays | 1732.e36 | ||
| Factor V Leiden Mutation Detection | 1732.e37 | ||
| Protein C Assays | 1732.e37 | ||
| Protein S | 1732.e38 | ||
| Antithrombin Assays | 1732.e38 | ||
| Prothrombin G20210A Detection | 1732.e39 | ||
| Factor VIII and von Willebrand Factor | 1732.e39 | ||
| Fibrinogen | 1732.e39 | ||
| Clinicopathologic Diagnosis of Other Thrombotic Disorders | 1732.e39 | ||
| Heparin-Induced Thrombocytopenia | 1732.e39 | ||
| Antiphospholipid Antibodies and Lupus Anticoagulant | 1732.e41 | ||
| ADAMTS13 Assay | 1732.e42 | ||
| Monitoring Anticoagulant Therapy | 1732.e42 | ||
| Unfractionated Heparin | 1732.e42 | ||
| aPTT for Monitoring Unfractionated Heparin. | 1732.e43 | ||
| Heparin Assays for Monitoring Unfractionated Heparin. | 1732.e44 | ||
| Thrombin Time for Monitoring Unfractionated Heparin. | 1732.e44 | ||
| Activated Clotting Time for Monitoring Unfractionated Heparin. | 1732.e44 | ||
| Low Molecular Weight Heparin | 1732.e44 | ||
| Fondaparinux | 1732.e45 | ||
| Parenteral Direct Thrombin Inhibitors | 1732.e45 | ||
| Direct Oral Anticoagulants | 1732.e45 | ||
| Direct Xa Inhibitor Assays. | 1732.e45 | ||
| Direct IIa Inhibitor Assays. | 1732.e46 | ||
| Therapy With Vitamin K Antagonists | 1732.e46 | ||
| Point of Care for Monitoring Vitamin K Antagonist Therapy. | 1732.e47 | ||
| Additional Readings | 1732.e48 | ||
| References | 1732.e48 | ||
| 72 Red Blood Cell Morphology and Indices With Clinical Chemistry Interface | 1733 | ||
| Abstract | 1733 | ||
| Background | 1733 | ||
| Content | 1733 | ||
| Automated Blood Counting Instruments: Historical Perspective | 1733.e1 | ||
| Peripheral Blood Smear Chemistry–Related Changes: Alterations in Blood Analytes Associated With or Causing Blood Count and Smear Abnormalities | 1733.e1 | ||
| Basophilic Stippling | 1733.e5 | ||
| Clinical Chemistry Laboratory Testing to Establish the Cause of Anemia | 1733.e6 | ||
| Interferences | 1733.e8 | ||
| Substances and Conditions That May Lead to Spurious Complete Blood Cell Results | 1733.e9 | ||
| Lipids | 1733.e9 | ||
| Ethylenediaminetetraacetic Acid | 1733.e9 | ||
| Clotted Sample | 1733.e9 | ||
| Overfilling the Test Tube | 1733.e9 | ||
| Cryoglobulins and Immunoglobulins | 1733.e9 | ||
| Hemolysis | 1733.e9 | ||
| Bilirubin | 1733.e9 | ||
| Glucose | 1733.e9 | ||
| Sodium | 1733.e9 | ||
| White Blood Cells | 1733.e9 | ||
| Hematology-Related Conditions or Diseases That May Lead to Spurious Chemistry Laboratory Findings | 1733.e9 | ||
| Immunoglobulins (Including Paraproteins and Polyclonal Immunoglobulins) | 1733.e9 | ||
| Hemolysis | 1733.e10 | ||
| Posttransfusion Blood Samples | 1733.e10 | ||
| Increased Blood Cell Counts (Leukocytosis, Erythrocytosis, and Thrombocytosis) | 1733.e10 | ||
| Acknowledgment | 1733.e10 | ||
| References | 1733.e10 | ||
| 73 Automated Hematology | 1734 | ||
| Abstract | 1734 | ||
| Background | 1734 | ||
| Content | 1734 | ||
| Introduction | 1734.e1 | ||
| Manual Methods | 1734.e1 | ||
| Wintrobe Calculations | 1734.e1 | ||
| Coulter Principle | 1734.e1 | ||
| Multichannel Instruments | 1734.e1 | ||
| Red Blood Cells | 1734.e2 | ||
| Manual Counting Methods | 1734.e2 | ||
| Automated Counting Methods | 1734.e2 | ||
| Red Blood Cell Parameters | 1734.e3 | ||
| Red Blood Cell Count | 1734.e3 | ||
| Hemoglobin | 1734.e3 | ||
| Hematocrit | 1734.e3 | ||
| Mean Corpuscular Volume | 1734.e3 | ||
| Mean Corpuscular Hemoglobin | 1734.e4 | ||
| Mean Corpuscular Hemoglobin Concentration | 1734.e4 | ||
| Red Cell Distribution Width | 1734.e4 | ||
| Nucleated Red Blood Cells | 1734.e4 | ||
| Red Blood Cell Fragments | 1734.e4 | ||
| Reticulocytes | 1734.e4 | ||
| Methods | 1734.e4 | ||
| Reticulocyte Parameters | 1734.e4 | ||
| Reticulocyte Count | 1734.e4 | ||
| Immature Reticulocyte Fraction | 1734.e5 | ||
| Reticulocyte Hemoglobin Content | 1734.e5 | ||
| Platelets | 1734.e6 | ||
| Methods | 1734.e6 | ||
| Impedance | 1734.e6 | ||
| Optical Scatter | 1734.e6 | ||
| Immunologic Techniques | 1734.e6 | ||
| Platelet Parameters | 1734.e6 | ||
| Platelet Count | 1734.e6 | ||
| Mean Platelet Volume | 1734.e6 | ||
| Platelet Distribution Width | 1734.e7 | ||
| Immature Platelet Fraction | 1734.e7 | ||
| White Blood Cells | 1734.e7 | ||
| Methods | 1734.e7 | ||
| Electrical Impedance | 1734.e7 | ||
| Radiofrequency Conductivity | 1734.e7 | ||
| Light Scatter | 1734.e7 | ||
| Cytochemistry | 1734.e7 | ||
| Fluorescent Labeling | 1734.e8 | ||
| Monoclonal Antibodies | 1734.e8 | ||
| Image Analysis | 1734.e8 | ||
| White Blood Cell Parameters and Flagging | 1734.e8 | ||
| Large Unstained Cells | 1734.e8 | ||
| Immature Granulocytes | 1734.e8 | ||
| Hematopoietic Progenitor Cells | 1734.e8 | ||
| Granularity Index | 1734.e8 | ||
| Lymphocyte Index | 1734.e9 | ||
| Leukocyte Viability | 1734.e9 | ||
| Selected Automated Hematology Analyzers | 1734.e9 | ||
| Sources of Error in Automated Hematology Instruments | 1734.e9 | ||
| Spurious Results in Red Blood Cells Indices | 1734.e9 | ||
| Red Blood Cell Count | 1734.e9 | ||
| Hemoglobin | 1734.e9 | ||
| Mean Corpuscular Hemoglobin Concentration | 1734.e10 | ||
| Mean Corpuscular Volume | 1734.e10 | ||
| Reticulocytes | 1734.e10 | ||
| Leukocyte Count | 1734.e10 | ||
| Platelet Count | 1734.e10 | ||
| References | 1734.e11 | ||
| VII Microbiology | 1735 | ||
| 74 Bacteriology | 1736 | ||
| Abstract | 1736 | ||
| Background | 1736 | ||
| Content | 1736 | ||
| Overview of the Laboratory’s Role in the Diagnosis of Bacterial Infections | 1736.e1 | ||
| Road to Bacterial Identification | 1736.e3 | ||
| Sequencing | 1736.e5 | ||
| Sequencing Basics | 1736.e10 | ||
| Basic Gene Structure and Sequencing Targets for Bacterial Identification | 1736.e10 | ||
| Overview of Chain-Termination DNA Sequencing | 1736.e10 | ||
| Potential Pitfalls of Sequence-Based Identification | 1736.e12 | ||
| Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) for Bacterial Identification | 1736.e13 | ||
| Basics of Bacterial Identification by MALDI-TOF MS | 1736.e13 | ||
| Bacterial Identification by MALDI-TOF MS | 1736.e14 | ||
| Overview of MALDI-TOF MS Performance | 1736.e14 | ||
| Gram-Positive Cocci | 1736.e15 | ||
| Gram-Positive Rods | 1736.e15 | ||
| Gram-Negative Bacilli and Coccobacilli | 1736.e15 | ||
| Enterobacteriaceae. | 1736.e15 | ||
| Glucose Non-Fermenting Organisms. | 1736.e15 | ||
| Fastidious Gram-Negative Bacilli. | 1736.e17 | ||
| Gram-Negative Diplococci | 1736.e18 | ||
| Anaerobes | 1736.e18 | ||
| Clinical Syndromes | 1736.e19 | ||
| Urinary Tract Infection | 1736.e19 | ||
| General Considerations | 1736.e19 | ||
| Resident Flora | 1736.e20 | ||
| Types of Infections | 1736.e20 | ||
| Etiology and Epidemiology | 1736.e20 | ||
| Laboratory Diagnosis | 1736.e20 | ||
| Specimen Collection and Transport | 1736.e20 | ||
| Blood Stream Infection (BSI) | 1736.e21 | ||
| General Considerations | 1736.e21 | ||
| Resident Flora | 1736.e21 | ||
| Types of Infections | 1736.e21 | ||
| Etiology and Epidemiology | 1736.e21 | ||
| Laboratory Diagnosis | 1736.e22 | ||
| Specimen Collection and Transport | 1736.e23 | ||
| Upper Respiratory Tract Infection | 1736.e23 | ||
| General Considerations | 1736.e23 | ||
| Resident Flora | 1736.e23 | ||
| Types of Infections | 1736.e24 | ||
| Etiology and Epidemiology | 1736.e24 | ||
| Laboratory Diagnosis | 1736.e24 | ||
| Specimen Collection and Transport | 1736.e25 | ||
| Lower Respiratory Tract Infection | 1736.e25 | ||
| General Considerations | 1736.e25 | ||
| Resident Flora | 1736.e25 | ||
| Types of Infections | 1736.e25 | ||
| Etiology and Epidemiology | 1736.e25 | ||
| Laboratory Diagnosis | 1736.e26 | ||
| Specimen Collection and Transport | 1736.e26 | ||
| Central Nervous System Infection | 1736.e26 | ||
| General Considerations | 1736.e26 | ||
| Resident Flora | 1736.e27 | ||
| Types of Infections | 1736.e27 | ||
| Etiology and Epidemiology | 1736.e27 | ||
| Laboratory Diagnosis | 1736.e28 | ||
| Specimen Collection and Transport | 1736.e28 | ||
| Ear Infections | 1736.e28 | ||
| General Considerations | 1736.e28 | ||
| Resident Flora | 1736.e28 | ||
| VIII Transfusion Medicine | 1742 | ||
| 80 Blood Groups, Pretransfusion Testing, and Red Blood Cell Transfusion | 1743 | ||
| Abstract | 1743 | ||
| Background | 1743 | ||
| Content | 1743 | ||
| ABO Blood Groups | 1743.e1 | ||
| Rh System | 1743.e2 | ||
| Kell, Kidd, Duffy, and MNSs Systems | 1743.e3 | ||
| Lewis, I/i, and P Antigens | 1743.e4 | ||
| Techniques for Blood Grouping and Antibody Identification | 1743.e5 | ||
| Serologic Techniques | 1743.e5 | ||
| Direct Antiglobulin Test (DAT or Direct Coombs Test) | 1743.e6 | ||
| Cross-Matching | 1743.e6 | ||
| Molecular Techniques | 1743.e7 | ||
| Immunohematologic Testing in the Prenatal Patient | 1743.e7 | ||
| Red Blood Cell Transfusion and Blood Management | 1743.e9 | ||
| Factors and Thresholds to Guide Allogeneic Transfusion Therapy | 1743.e9 | ||
| Preoperative Assessment of the Surgical Patient | 1743.e10 | ||
| Intraoperative and Postoperative Strategies to Reduce Allogeneic Transfusion | 1743.e10 | ||
| Transfusion in Sickle Cell Disease | 1743.e12 | ||
| Autoimmune Hemolytic Anemia and the “Incompatible Cross-Match” | 1743.e12 | ||
| Warm Autoantibodies and Warm Autoimmune Hemolytic Anemia (WAIHA) | 1743.e12 | ||
| The Direct Antiglobulin Test in AIHA | 1743.e13 | ||
| Transfusion Management of Warm Autoimmune Hemolytic Anemia | 1743.e13 | ||
| Drug-Induced Immune Hemolytic Anemia | 1743.e13 | ||
| References | 1743.e14 | ||
| 81 Blood Components, Blood Donor Screening, and Transfusion Reactions | 1744 | ||
| Abstract | 1744 | ||
| Volunteer Blood Donation | 1744.e1 | ||
| Ensuring Blood Safety | 1744.e1 | ||
| Reducing Infectious Risks | 1744.e1 | ||
| Bacteria | 1744.e1 | ||
| Infectious Disease Testing | 1744.e2 | ||
| Viral Agents | 1744.e3 | ||
| Human Immunodeficiency Virus | 1744.e3 | ||
| Human T-Lymphotropic Virus | 1744.e3 | ||
| Viral Hepatitis | 1744.e3 | ||
| Flavivirus | 1744.e4 | ||
| Cytomegalovirus | 1744.e4 | ||
| Parasitic Diseases | 1744.e4 | ||
| Malaria | 1744.e4 | ||
| Chagas Disease | 1744.e4 | ||
| Syphilis | 1744.e5 | ||
| Babesiosis | 1744.e5 | ||
| Prion Disease | 1744.e5 | ||
| Live Vaccines | 1744.e5 | ||
| Bacterial Contamination | 1744.e5 | ||
| Pathogen Inactivation | 1744.e6 | ||
| Reducing NonInfectious Risks | 1744.e6 | ||
| Malignancy | 1744.e6 | ||
| Medications | 1744.e6 | ||
| Anticoagulants | 1744.e6 | ||
| Aspirin and Antiplatelet Agents | 1744.e6 | ||
| Female Donors | 1744.e6 | ||
| Donor Reactions and Complications | 1744.e7 | ||
| Autologous Donation | 1744.e9 | ||
| Directed Donations | 1744.e9 | ||
| Blood Components | 1744.e10 | ||
| Whole-Blood Collection and Component Manufacturing | 1744.e10 | ||
| Anticoagulant/Preservative Solutions | 1744.e10 | ||
| Whole-Blood Collection | 1744.e10 | ||
| Component Manufacturing | 1744.e11 | ||
| Red Cells | 1744.e11 | ||
| Platelets | 1744.e12 | ||
| Plasma | 1744.e12 | ||
| Cryoprecipitate and Cryoprecipitate-Reduced Plasma Collection | 1744.e12 | ||
| Granulocyte Collection | 1744.e12 | ||
| Product Modifications | 1744.e12 | ||
| Washing and Volume Reduction | 1744.e13 | ||
| Irradiation | 1744.e13 | ||
| Leukoreduction | 1744.e13 | ||
| Transfusion Reactions | 1744.e13 | ||
| Acute Transfusion Reactions | 1744.e13 | ||
| Acute Hemolytic Transfusion Reaction | 1744.e13 | ||
| Transfusion-Related Acute Lung Injury | 1744.e15 | ||
| Transfusion-Associated Circulatory Overload | 1744.e15 | ||
| Transfusion-Transmitted Bacterial Infection | 1744.e15 | ||
| Febrile Nonhemolytic Transfusion Reactions | 1744.e16 | ||
| Urticarial Transfusion Reactions | 1744.e16 | ||
| Anaphylactic Transfusion Reactions | 1744.e16 | ||
| IgA Deficiency | 1744.e16 | ||
| Hypotensive Transfusion Reactions | 1744.e17 | ||
| Posttransfusion Purpura | 1744.e17 | ||
| Delayed Hemolytic Transfusion Reactions | 1744.e17 | ||
| Transfusion Associated Graft versus Host Disease | 1744.e17 | ||
| Red Cell Storage Lesion | 1744.e17 | ||
| Potassium | 1744.e17 | ||
| Storage Time and Outcomes | 1744.e18 | ||
| Other Complications of Transfusion | 1744.e18 | ||
| Hypothermia | 1744.e18 | ||
| Iron Overload | 1744.e18 | ||
| References | 1744.e18 | ||
| Appendix Reference Information for the Clinical Laboratory | 1745 | ||
| Abstract | 1745 | ||
| Background | 1745 | ||
| Content | 1745 | ||
| Overview | 1745 | ||
| Reference Information Tables and Figures | 1745 | ||
| Reference Value Distributions Across Pediatric Age†CALIPER Cohort. Canadian Laboratory Initiative on Pediatric Reference Intervals. CALIPER Publications: Colantonio et al. Clin Chem 2012 May;58(5):854–68; Konforte et al. Clin Chem 2013;59(8): 1215–27; Bailey et al. Clin Chem 2013;59(9):1393–405; Bevilacqua et al. Clin Chem 2014;60(12):1532–42; Raizman et al. Clin Chem Lab Med 2015;53(10):e239–43; Kelly et al. Clin Chim Acta 2015; 450:196–202. | 1818.e1 | ||
| Reference Value Distributions Across Pediatric, Adult, and Geriatric Age | 1818.e27 | ||
| Biochemical Markers‡Canadian Health Measures Survey. Adeli K et al. Clin Chem 2015;61(8);1049–1062; Adeli K et al. Clin Chem 2015;61(8); 1063–1074. | 1818.e27 | ||
| Hematological Markers§Canadian Health Measures Survey. Biochemical Markers. Adeli K et al. Clin Chem 2015;61(8);1049–1062; Adeli K et al. Clin Chem 2015;61(8);1063–1074. | 1818.e39 | ||
| Chapter Outline | 1790 | ||
| References | 1816 | ||
| Abbreviations | 1817 | ||
| Tietz Atlas of Biochemical Genetics: | e1 | ||
| Case 1 Propionic Acidemia 1 | e2 | ||
| Clinical History and Background | e2 | ||
| Diagnosis and Case Discussion | e3 | ||
| Case 2 Propionic Acidemia 2 | e5 | ||
| Clinical History and Background | e5 | ||
| Diagnosis and Case Discussion | e6 | ||
| Case 3 Methylmalonic Acidemia, mut Type | e8 | ||
| Clinical History and Background | e8 | ||
| Diagnosis and Case Discussion | e9 | ||
| Case 4 Methylmalonic Aciduria, cblA Type | e11 | ||
| Clinical History and Background | e11 | ||
| Diagnosis and Case Discussion | e12 | ||
| Case 5 Methylmalonic Acidemia, cblC Type | e14 | ||
| Clinical History and Background | e14 | ||
| Diagnosis and Case Discussion | e15 | ||
| Case 6 Succinyl-CoA Ligase Deficiency | e17 | ||
| Clinical History and Background | e17 | ||
| Diagnosis and Case Discussion | e18 | ||
| Case 7 Isovaleric Acidemia | e20 | ||
| Clinical History and Background | e20 | ||
| Diagnosis and Case Discussion | e21 | ||
| Case 8 3-Methylcrotonyl-CoA Carboxylase Deficiency | e23 | ||
| Clinical History and Background | e23 | ||
| Diagnosis and Case Discussion | e24 | ||
| Case 9 Short-Chain Acyl-CoA Dehydrogenase Deficiency | e26 | ||
| Clinical History and Background | e26 | ||
| Diagnosis and Case Discussion | e27 | ||
| Case 10 Glutaric Aciduria Type I | e29 | ||
| Clinical History and Background | e29 | ||
| Diagnosis and Case Discussion | e30 | ||
| Case 11 Glutaric Aciduria Type I (Low Excretor) | e32 | ||
| Clinical History and Background | e32 | ||
| Diagnosis and Case Discussion | e33 | ||
| Case 12 Glutaric Aciduria Type II | e34 | ||
| Clinical History and Background | e34 | ||
| Diagnosis and Case Discussion | e35 | ||
| Case 13 Ethylmalonic-adipic Aciduria | e37 | ||
| Clinical History and Background | e37 | ||
| Diagnosis and Case Discussion | e38 | ||
| Case 14 2-Hydroxyglutaric Aciduria | e40 | ||
| Clinical History and Background | e40 | ||
| Diagnosis and Case Discussion | e41 | ||
| Case 15 Tyrosinemia Type I | e43 | ||
| Clinical History and Background | e43 | ||
| Diagnosis and Case Discussion | e44 | ||
| Case 16 Alkaptonuria | e46 | ||
| Clinical History and Background | e46 | ||
| Diagnosis and Case Discussion | e47 | ||
| Case 17 Beta-Ketothiolase Deficiency | e49 | ||
| Clinical History and Background | e49 | ||
| Diagnosis and Case Discussion | e50 | ||
| Case 18 HMG-CoA Lyase Deficiency | e52 | ||
| Clinical History and Background | e52 | ||
| Diagnosis and Case Discussion | e53 | ||
| Case 19 Malonic Aciduria | e55 | ||
| Clinical History and Background | e55 | ||
| Diagnosis and Case Discussion | e56 | ||
| Case 20 Medium-Chain Acyl-CoA Dehydrogenase Deficiency | e58 | ||
| Clinical History and Background | e58 | ||
| Diagnosis and Case Discussion | e59 | ||
| Tietz Atlas of Electrophoretic Patterns | e61 | ||
| Case 1 Background | e62 | ||
| Interpretation and Learning Points | e63 | ||
| Acknowledgment | e63 | ||
| Case 2 Background | e64 | ||
| Interpretation and Learning Points | e65 | ||
| Acknowledgment | e65 | ||
| Case 3 Background | e66 | ||
| Interpretation and Learning Points | e67 | ||
| Acknowledgment | e67 | ||
| Case 4 Background | e68 | ||
| Interpretation and Learning Points | e69 | ||
| Acknowledgment | e69 | ||
| Case 5 Background | e70 | ||
| Interpretation and Learning Points | e71 | ||
| Acknowledgment | e71 | ||
| Case 6 Background | e72 | ||
| Interpretation and Learning Points | e73 | ||
| Acknowledgment | e73 | ||
| Case 7 Background | e74 | ||
| Interpretation and Learning Points | e75 | ||
| Acknowledgment | e75 | ||
| Case 8 Background | e76 | ||
| Interpretation and Learning Points | e77 | ||
| Acknowledgment | e77 | ||
| Case 9 Background | e78 | ||
| Interpretation and Learning Points | e79 | ||
| Acknowledgment | e79 | ||
| Case 10 Background | e80 | ||
| Interpretation and Learning Points | e81 | ||
| Acknowledgment | e81 | ||
| Case 11 Background | e82 | ||
| Interpretation and Learning Points | e83 | ||
| Acknowledgment | e83 | ||
| Case 12 Background | e84 | ||
| Interpretation and Learning Points | e85 | ||
| Acknowledgment | e85 | ||
| Case 13 Background | e86 | ||
| Interpretation and Learning Points | e87 | ||
| Acknowledgment | e87 | ||
| Case 14 Background | e88 | ||
| Interpretation and Learning Points | e89 | ||
| Acknowledgment | e89 | ||
| Case 15 Background | e90 | ||
| Interpretation and Learning Points | e92 | ||
| Acknowledgment | e92 | ||
| Case 16 Background | e93 | ||
| Interpretation and Learning Points | e95 | ||
| Acknowledgment | e95 | ||
| Case 17 Background | e96 | ||
| Interpretation and Learning Points | e97 | ||
| Acknowledgment | e97 | ||
| Case 18 Background | e98 | ||
| Interpretation and Learning Points | e99 | ||
| Acknowledgment | e99 | ||
| Cases 19 to 22 Background | e100 | ||
| Interpretation and Learning Points | e101 | ||
| Acknowledgment | e101 | ||
| References | e101 | ||
| Case 23 Background | e102 | ||
| Interpretation and Learning Points | e103 | ||
| Acknowledgment | e103 | ||
| Reference | e103 | ||
| Case 24 Background | e104 | ||
| Interpretation and Learning Points | e105 | ||
| Acknowledgment | e105 | ||
| Reference | e105 | ||
| Case 25 Background | e106 | ||
| Interpretation and Learning Points | e107 | ||
| Acknowledgment | e107 | ||
| Reference | e107 | ||
| Case 26 Background | e108 | ||
| Interpretation and Learning Points | e109 | ||
| Acknowledgment | e109 | ||
| Reference | e109 | ||
| Case 27 Background | e110 | ||
| Interpretation and Learning Points | e111 | ||
| Acknowledgment | e111 | ||
| Reference | e111 | ||
| Case 28 Background | e112 | ||
| Interpretation and Learning Points | e113 | ||
| Acknowledgment | e113 | ||
| Reference | e113 | ||
| Case 29 Background | e114 | ||
| Interpretation and Learning Points | e115 | ||
| Acknowledgment | e115 | ||
| Reference | e115 | ||
| Case 30 Background | e116 | ||
| Interpretation and Learning Points | e117 | ||
| Acknowledgment | e117 | ||
| Reference | e117 | ||
| Case 31 Background | e118 | ||
| Interpretation and Learning Points | e119 | ||
| Acknowledgment | e119 | ||
| Case 32 Background | e120 | ||
| Interpretation and Learning Points | e121 | ||
| Acknowledgment | e121 | ||
| Methods | e121 | ||
| References | e121 | ||
| Case 33 Background | e122 | ||
| Interpretation and Learning Points | e123 | ||
| Acknowledgment | e123 | ||
| Methods | e123 | ||
| References | e123 | ||
| Case 34 Background | e124 | ||
| Interpretation and Learning Points | e125 | ||
| Acknowledgment | e125 | ||
| Methods | e125 | ||
| References | e125 | ||
| Case 35 Background | e126 | ||
| Interpretation and Learning Points | e127 | ||
| Acknowledgment | e127 | ||
| Methods | e127 | ||
| References | e127 | ||
| Case 36 Background | e128 | ||
| Interpretation and Learning Points | e129 | ||
| Acknowledgment | e129 | ||
| Methods | e129 | ||
| Reference | e129 | ||
| Case 37 Background | e130 | ||
| Interpretation and Learning Points | e131 | ||
| Acknowledgment | e131 | ||
| Methods | e131 | ||
| References | e131 | ||
| Case 38 Background | e132 | ||
| Interpretation and Learning Points | e133 | ||
| Acknowledgment | e133 | ||
| Methods | e133 | ||
| Case 39 Background | e134 | ||
| Interpretation and Learning Points | e136 | ||
| Acknowledgment | e136 | ||
| Methods | e136 | ||
| Case 40 Background | e137 | ||
| Interpretation and Learning Points | e138 | ||
| Acknowledgment | e138 | ||
| Methods | e138 | ||
| Case 41 Background | e139 | ||
| Interpretation and Learning Points | e140 | ||
| Acknowledgment | e140 | ||
| Methods | e140 | ||
| Cases 42 to 44 Background | e141 | ||
| Case 42 | e141 | ||
| Case 43 | e142 | ||
| Case 44 | e142 | ||
| Interpretation and Learning Points | e143 | ||
| Acknowledgment | e143 | ||
| Methods | e143 | ||
| Reference | e143 | ||
| Case 45 Background | e144 | ||
| Interpretation and Learning Points | e145 | ||
| Method | e145 | ||
| Acknowledgment | e145 | ||
| Case 46 Background | e146 | ||
| Interpretation and Learning Points | e148 | ||
| Acknowledgment | e148 | ||
| Method | e148 | ||
| Case 47 Background | e149 | ||
| Interpretation and Learning Points | e150 | ||
| Acknowledgment | e150 | ||
| Method | e150 | ||
| Case 48 Background | e151 | ||
| Interpretation and Learning Points | e152 | ||
| Acknowledgment | e152 | ||
| Method | e152 | ||
| Case 49 Background | e153 | ||
| Interpretation and Learning Points | e154 | ||
| Acknowledgment | e154 | ||
| Method | e154 | ||
| Case 50 Background | e155 | ||
| Interpretation and Learning Points | e156 | ||
| Acknowledgment | e156 | ||
| Method | e156 | ||
| References | e156 | ||
| Case 51 Background | e157 | ||
| Interpretation and Learning Points | e158 | ||
| Acknowledgment | e158 | ||
| Method | e158 | ||
| Case 52 Background | e159 | ||
| Interpretation and Learning Points | e160 | ||
| Acknowledgment | e160 | ||
| Method | e160 | ||
| Case 53 Background | e161 | ||
| Interpretation and Learning Points | e162 | ||
| Acknowledgment | e162 | ||
| Method | e162 | ||
| Case 54 Background | e163 | ||
| Interpretation and Learning Points | e164 | ||
| Acknowledgment | e164 | ||
| Method | e164 | ||
| Case 55 Background | e165 | ||
| Interpretation and Learning Points | e166 | ||
| Method | e166 | ||
| Acknowledgment | e166 | ||
| Case 56 Background | e167 | ||
| Interpretation and Learning Points | e168 | ||
| Method | e168 | ||
| Acknowledgment | e168 | ||
| Case 57 Background | e169 | ||
| Interpretation and Learning Points | e170 | ||
| Method | e170 | ||
| Acknowledgment | e170 | ||
| Case 58 Background | e171 | ||
| Interpretation and Learning Points | e172 | ||
| Method | e172 | ||
| Acknowledgment | e172 | ||
| Case 59 Background | e173 | ||
| Interpretation and Learning Points | e174 | ||
| Method | e174 | ||
| Acknowledgment | e174 | ||
| Case 60 Background | e175 | ||
| Interpretation and Learning Points | e176 | ||
| Method | e176 | ||
| Acknowledgment | e176 | ||
| Case 61 Background | e177 | ||
| Interpretation and Learning Points | e178 | ||
| Method | e178 | ||
| Acknowledgment | e178 | ||
| Case 62 Background | e179 | ||
| Interpretation and Learning Points | e180 | ||
| Method | e180 | ||
| Acknowledgment | e180 | ||
| Case 63 Background | e181 | ||
| Interpretation and Learning Points | e183 | ||
| Acknowledgment | e183 | ||
| Case 64 Background | e184 | ||
| Interpretation and Learning Points | e186 | ||
| Acknowledgment | e186 | ||
| Case 65 Background | e187 | ||
| Interpretation and Learning Points | e189 | ||
| Acknowledgment | e189 | ||
| Case 66 Background | e190 | ||
| Interpretation and Learning Points | e192 | ||
| Acknowledgment | e192 | ||
| Case 67 Background | e193 | ||
| Interpretation and Learning Points | e195 | ||
| Acknowledgment | e195 | ||
| Case 68 Background | e196 | ||
| Interpretation and Learning Points | e198 | ||
| Acknowledgment | e198 | ||
| Case 69 Background | e199 | ||
| Interpretation and Learning Points | e201 | ||
| Acknowledgment | e201 | ||
| Case 70 Background | e202 | ||
| Interpretation and Learning Points | e203 | ||
| Acknowledgment | e203 | ||
| Case 71 Background | e204 | ||
| Interpretation and Learning Points | e206 | ||
| Case 72 Background | e207 | ||
| Interpretation and Learning Points | e209 | ||
| Methods | e209 | ||
| Acknowledgment | e209 | ||
| Case 73 Background | e210 | ||
| Interpretation and Learning Points | e212 | ||
| Methods | e212 | ||
| Acknowledgments | e212 | ||
| Case 74 Background | e213 | ||
| Interpretation and Learning Points | e215 | ||
| Methods | e215 | ||
| Acknowledgment | e215 | ||
| Case 75 Background | e216 | ||
| Interpretation and Learning Points | e218 | ||
| Methods | e218 | ||
| Acknowledgment | e218 | ||
| Case 76 Background | e219 | ||
| Interpretation and Learning Points | e221 | ||
| Methods | e221 | ||
| Acknowledgment | e221 | ||
| Case 77 Background | e222 | ||
| Interpretation and Learning Points | e224 | ||
| Methods | e224 | ||
| Acknowledgment | e224 | ||
| Case 78 Background | e225 | ||
| Interpretation and Learning Points | e227 | ||
| Methods | e227 | ||
| Acknowledgment | e227 | ||
| Case 79 Background | e228 | ||
| Interpretation and Learning Points | e230 | ||
| Methods | e230 | ||
| Acknowledgment | e230 | ||
| Case 80 Background | e231 | ||
| Interpretation and Learning Points | e233 | ||
| Methods | e233 | ||
| Acknowledgment | e233 | ||
| Case 81 Background | e234 | ||
| Interpretation and Learning Points | e236 | ||
| Methods | e236 | ||
| Acknowledgment | e236 | ||
| Case 82 Background | e237 | ||
| Interpretation and Learning Points | e239 | ||
| Methods | e239 | ||
| Acknowledgment | e239 | ||
| Case 83 Background | e240 | ||
| Interpretation and Learning Points | e242 | ||
| Methods | e242 | ||
| Acknowledgment | e242 | ||
| Case 84 Background | e243 | ||
| Interpretation and Learning Points | e245 | ||
| Methods | e245 | ||
| Acknowledgment | e245 | ||
| Case 85 Background | e246 | ||
| Interpretation and Learning Points | e248 | ||
| Methods | e248 | ||
| Acknowledgment | e248 | ||
| Case 86 Background | e249 | ||
| Interpretation and Learning Points | e251 | ||
| Methods | e251 | ||
| Acknowledgment | e251 | ||
| Case 87 Background | e252 | ||
| Interpretation and Learning Points | e254 | ||
| Methods | e254 | ||
| Acknowledgment | e254 | ||
| Case 88 Background | e255 | ||
| Interpretation and Learning Points | e257 | ||
| Methods | e257 | ||
| Acknowledgment | e257 | ||
| Case 89 Background | e258 | ||
| Interpretation and Learning Points | e260 | ||
| Methods | e260 | ||
| Acknowledgment | e260 | ||
| Case 90 Background | e261 | ||
| Interpretation and Learning Points | e263 | ||
| Methods | e263 | ||
| Acknowledgment | e263 | ||
| Case 91 Background | e264 | ||
| Interpretation and Learning Points | e266 | ||
| Methods | e266 | ||
| Acknowledgment | e266 | ||
| Case 92 Background | e267 | ||
| Interpretation and Learning Points | e269 | ||
| Methods | e269 | ||
| Acknowledgment | e269 | ||
| Case 93 Background | e270 | ||
| Interpretation and Learning Points | e272 | ||
| Methods | e272 | ||
| Acknowledgment | e272 | ||
| Case 94 Background | e273 | ||
| Interpretation and Learning Points | e275 | ||
| Methods | e275 | ||
| Acknowledgment | e275 | ||
| Case 95 Background | e276 | ||
| Interpretation and Learning Points | e278 | ||
| Methods | e278 | ||
| Acknowledgment | e278 | ||
| Case 96 Background | e279 | ||
| Interpretation and Learning Points | e281 | ||
| Methods | e281 | ||
| Acknowledgment | e281 | ||
| Case 97 Background | e282 | ||
| Interpretation and Learning Points | e284 | ||
| Methods | e284 | ||
| Acknowledgment | e284 | ||
| Case 98 Background | e285 | ||
| Interpretation and Learning Points | e287 | ||
| Methods | e287 | ||
| Acknowledgment | e287 | ||
| Tietz Clinical Vignettes: | e288 | ||
| Chapter 4 | e289 | ||
| Case 1 | e289 | ||
| Clinical History and Background | e289 | ||
| Diagnosis and Case Discussion | e290 | ||
| Case 2 | e291 | ||
| Clinical History and Background | e291 | ||
| Diagnosis and Case Discussion | e292 | ||
| Case 3 | e293 | ||
| Clinical History and Background | e293 | ||
| Diagnosis and Case Discussion | e294 | ||
| Case 4 | e295 | ||
| Clinical History and Background | e295 | ||
| Diagnosis and Case Discussion | e296 | ||
| Case 5 | e297 | ||
| Clinical History and Background | e297 | ||
| Diagnosis and Case Discussion | e298 | ||
| Case 6 | e299 | ||
| Clinical History and Background | e299 | ||
| Diagnosis and Case Discussion | e300 | ||
| Case 7 | e301 | ||
| Clinical History and Background | e301 | ||
| Diagnosis and Case Discussion | e302 | ||
| Case 8 | e303 | ||
| Clinical History and Background | e303 | ||
| Diagnosis and Case Discussion | e304 | ||
| Case 9 | e305 | ||
| Clinical History and Background | e305 | ||
| Diagnosis and Case Discussion | e306 | ||
| Case 10 | e307 | ||
| Clinical History and Background | e307 | ||
| Diagnosis and Case Discussion | e308 | ||
| Case 11 | e309 | ||
| Clinical History and Background | e309 | ||
| Diagnosis and Case Discussion | e310 | ||
| Case 12 | e311 | ||
| Clinical History and Background | e311 | ||
| Diagnosis and Case Discussion | e312 | ||
| Case 13 | e313 | ||
| Clinical History and Background | e313 | ||
| Diagnosis and Case Discussion | e314 | ||
| Case 14 | e315 | ||
| Clinical History and Background | e315 | ||
| Diagnosis and Case Discussion | e316 | ||
| Case 15 | e317 | ||
| Clinical History and Background | e317 | ||
| Diagnosis and Case Discussion | e318 | ||
| Chapter 14 | e319 | ||
| Case 1 | e319 | ||
| Clinical History and Background | e319 | ||
| Diagnosis and Case Discussion | e320 | ||
| Case 2 | e321 | ||
| Clinical History and Background | e321 | ||
| Diagnosis and Case Discussion | e322 | ||
| Case 3 | e323 | ||
| Clinical History and Background | e323 | ||
| Diagnosis and Case Discussion | e324 | ||
| Chapter 29 | e325 | ||
| Case 1 | e325 | ||
| Clinical History and Background | e325 | ||
| Diagnosis and Case Discussion | e326 | ||
| Case 2 | e327 | ||
| Clinical History and Background | e327 | ||
| Diagnosis and Case Discussion | e328 | ||
| Case 3 | e329 | ||
| Clinical History and Background | e329 | ||
| Diagnosis and Case Discussion | e330 | ||
| Case 4 | e331 | ||
| Clinical History and Background | e331 | ||
| Diagnosis and Case Discussion | e332 | ||
| Case 5 | e333 | ||
| Clinical History and Background | e333 | ||
| Diagnosis and Case Discussion | e334 | ||
| Case 6 | e335 | ||
| Clinical History and Background | e335 | ||
| Diagnosis and Case Discussion | e336 | ||
| Case 7 | e337 | ||
| Clinical History and Background | e337 | ||
| Diagnosis and Case Discussion | e338 | ||
| Case 8 | e339 | ||
| Diagnosis and Case Discussion | e340 | ||
| Case 9 | e341 | ||
| Diagnosis and Case Discussion | e342 | ||
| Case 10 | e343 | ||
| Diagnosis and Case Discussion | e344 | ||
| Case 11 | e345 | ||
| Diagnosis and Case Discussion | e346 | ||
| Case 12 | e347 | ||
| Clinical History and Background | e347 | ||
| Diagnosis and Case Discussion | e348 | ||
| Case 13 | e349 | ||
| Clinical History and Background | e349 | ||
| Diagnosis and Case Discussion | e350 | ||
| Case 14 | e351 | ||
| Clinical History and Background | e351 | ||
| Diagnosis and Case Discussion | e352 | ||
| Case 15 | e353 | ||
| Clinical History and Background | e353 | ||
| Diagnosis and Case Discussion | e354 | ||
| Case 16 | e355 | ||
| Clinical History and Background | e355 | ||
| Diagnosis and Case Discussion | e356 | ||
| Chapter 31 | e357 | ||
| Case 1 | e357 | ||
| Clinical History and Background | e357 | ||
| Diagnosis and Case Discussion | e358 | ||
| Case 2 | e359 | ||
| Clinical History and Background | e359 | ||
| Diagnosis and Case Discussion | e360 | ||
| Case 3 | e361 | ||
| Clinical History and Background | e361 | ||
| Diagnosis and Case Discussion | e362 | ||
| Case 4 | e363 | ||
| Clinical History and Background | e363 | ||
| Diagnosis and Case Discussion | e364 | ||
| Chapter 32 | e365 | ||
| Case 1 | e365 | ||
| Clinical History and Background | e365 | ||
| Diagnosis and Case Discussion | e366 | ||
| Case 2 | e367 | ||
| Clinical History and Background | e367 | ||
| Diagnosis and Case Discussion | e368 | ||
| Case 3 | e369 | ||
| Clinical History and Background | e369 | ||
| Diagnosis and Case Discussion | e370 | ||
| Case 4 | e371 | ||
| Clinical History and Background | e371 | ||
| Diagnosis and Case Discussion | e372 | ||
| Case 5 | e373 | ||
| Clinical History and Background | e373 | ||
| Diagnosis and Case Discussion | e374 | ||
| Case 6 | e375 | ||
| Clinical History and Background | e375 | ||
| Diagnosis and Case Discussion | e376 | ||
| Case 7 | e377 | ||
| Clinical History and Background | e377 | ||
| Diagnosis and Case Discussion | e378 | ||
| Case 8 | e379 | ||
| Clinical History and Background | e379 | ||
| Diagnosis and Case Discussion | e380 | ||
| Case 9 | e381 | ||
| Clinical History and Background | e381 | ||
| Diagnosis and Case Discussion | e382 | ||
| Case 10 | e383 | ||
| Clinical History and Background | e383 | ||
| Diagnosis and Case Discussion | e384 | ||
| Chapter 34 | e385 | ||
| Case 1 | e385 | ||
| Clinical History and Background | e385 | ||
| Diagnosis and Case Discussion | e386 | ||
| Case 2 | e387 | ||
| Clinical History and Background | e387 | ||
| Diagnosis and Case Discussion | e388 | ||
| Case 3 | e389 | ||
| Clinical History and Background | e389 | ||
| Diagnosis and Case Discussion | e390 | ||
| Case 4 | e391 | ||
| Clinical History and Background | e391 | ||
| Diagnosis and Case Discussion | e392 | ||
| Case 5 | e393 | ||
| Clinical History and Background | e393 | ||
| Diagnosis and Case Discussion | e394 | ||
| Case 6 | e395 | ||
| Clinical History and Background | e395 | ||
| Diagnosis and Case Discussion | e396 | ||
| Case 7 | e397 | ||
| Clinical History and Background | e397 | ||
| Diagnosis and Case Discussion | e398 | ||
| Case 8 | e399 | ||
| Clinical History and Background | e399 | ||
| Diagnosis and Case Discussion | e400 | ||
| Chapter 37 | e401 | ||
| Case 1 | e401 | ||
| Clinical History and Background | e401 | ||
| Diagnosis and Case Discussion | e402 | ||
| Case 2 | e403 | ||
| Clinical History and Background | e403 | ||
| Diagnosis and Case Discussion | e404 | ||
| Chapter 40 | e405 | ||
| Case 1 | e405 | ||
| Clinical History and Background | e405 | ||
| Diagnosis and Case Discussion | e406 | ||
| Case 2 | e407 | ||
| Clinical History and Background | e407 | ||
| Diagnosis and Case Discussion | e408 | ||
| Case 3 | e409 | ||
| Clinical History and Background | e409 | ||
| Diagnosis and Case Discussion | e410 | ||
| Case 4 | e411 | ||
| Clinical History and Background | e411 | ||
| Diagnosis and Case Discussion | e412 | ||
| Chapter 41 | e413 | ||
| Case 1 | e413 | ||
| Clinical History and Background | e413 | ||
| Diagnosis and Case Discussion | e414 | ||
| Case 2 | e415 | ||
| Clinical History and Background | e415 | ||
| Diagnosis and Case Discussion | e416 | ||
| Case 3 | e417 | ||
| Clinical History and Background | e417 | ||
| Diagnosis and Case Discussion | e418 | ||
| Case 4 | e419 | ||
| Clinical History and Background | e419 | ||
| Diagnosis and Case Discussion | e420 | ||
| Case 5 | e421 | ||
| Clinical History and Background | e421 | ||
| Diagnosis and Case Discussion | e422 | ||
| Chapter 57 | e423 | ||
| Case 1 | e423 | ||
| Clinical History and Background | e423 | ||
| Diagnosis and Case Discussion | e424 | ||
| Case 2 | e425 | ||
| Clinical History and Background | e425 | ||
| Diagnosis and Case Discussion | e426 | ||
| Case 3 | e427 | ||
| Clinical History and Background | e427 | ||
| Diagnosis and Case Discussion | e428 | ||
| Case 4 | e429 | ||
| Clinical History and Background | e429 | ||
| Diagnosis and Case Discussion | e430 | ||
| Case 5 | e431 | ||
| Clinical History and Background | e431 | ||
| Diagnosis and Case Discussion | e432 | ||
| Case 6 | e433 | ||
| Clinical History and Background | e433 | ||
| Diagnosis and Case Discussion | e434 | ||
| Chapter 59 | e435 | ||
| Case 1 | e435 | ||
| Clinical History and Background | e435 | ||
| Diagnosis and Case Discussion | e436 | ||
| Case 2 | e437 | ||
| Clinical History and Background | e437 | ||
| Diagnosis and Case Discussion | e438 | ||
| Case 3 | e439 | ||
| Clinical History and Background | e439 | ||
| Diagnosis and Case Discussion | e440 | ||
| Case 4 | e441 | ||
| Clinical History and Background | e441 | ||
| Diagnosis and Case Discussion | e442 | ||
| Case 5 | e443 | ||
| Clinical History and Background | e443 | ||
| Diagnosis and Case Discussion | e444 | ||
| Case 6 | e445 | ||
| Clinical History and Background | e445 | ||
| Diagnosis and Case Discussion | e446 | ||
| Case 7 | e447 | ||
| Clinical History and Background | e447 | ||
| Diagnosis and Case Discussion | e448 | ||
| Case 8 | e449 | ||
| Clinical History and Background | e449 | ||
| Diagnosis and Case Discussion | e450 | ||
| Case 9 | e451 | ||
| Clinical History and Background | e451 | ||
| Diagnosis and Case Discussion | e452 | ||
| Case 10 | e453 | ||
| Clinical History and Background | e453 | ||
| Diagnosis and Case Discussion | e454 | ||
| Case 11 | e455 | ||
| Clinical History and Background | e455 | ||
| Diagnosis and Case Discussion | e456 | ||
| Case 12 | e457 | ||
| Clinical History and Background | e457 | ||
| Diagnosis and Case Discussion | e458 | ||
| Case 13 | e459 | ||
| Clinical History and Background | e459 | ||
| Diagnosis and Case Discussion | e460 | ||
| Case 14 | e461 | ||
| Clinical History and Background | e461 | ||
| Diagnosis and Case Discussion | e462 | ||
| Case 15 | e463 | ||
| Diagnosis and Case Discussion | e464 | ||
| Case 16 | e465 | ||
| Clinical History and Background | e465 | ||
| Diagnosis and Case Discussion | e466 | ||
| Case 17 | e467 | ||
| Clinical History and Background | e467 | ||
| Diagnosis and Case Discussion | e468 | ||
| Case 18 | e469 | ||
| Clinical History and Background | e469 | ||
| Diagnosis and Case Discussion | e470 | ||
| Case 19 | e471 | ||
| Clinical History and Background | e471 | ||
| Diagnosis and Case Discussion | e472 | ||
| Case 20 | e473 | ||
| Clinical History and Background | e473 | ||
| Diagnosis and Case Discussion | e474 | ||
| Case 21 | e475 | ||
| Clinical History and Background | e475 | ||
| Diagnosis and Case Discussion | e476 | ||
| Case 22 | e477 | ||
| Clinical History and Background | e477 | ||
| Diagnosis and Case Discussion | e478 | ||
| Case 23 | e479 | ||
| Clinical History and Background | e479 | ||
| Diagnosis and Case Discussion | e480 | ||
| Chapter 60 | e481 | ||
| Case 1 | e481 | ||
| Clinical History and Background | e481 | ||
| Diagnosis and Case Discussion | e482 | ||
| Case 2 | e483 | ||
| Clinical History and Background | e483 | ||
| Diagnosis and Case Discussion | e484 | ||
| Case 3 | e485 | ||
| Clinical History and Background | e485 | ||
| Diagnosis and Case Discussion | e486 | ||
| Case 4 | e487 | ||
| Clinical History and Background | e487 | ||
| Diagnosis and Case Discussion | e488 | ||
| Case 5 | e489 | ||
| Clinical History and Background | e489 | ||
| Diagnosis and Case Discussion | e490 | ||
| Case 6 | e491 | ||
| Clinical History and Background | e491 | ||
| Diagnosis and Case Discussion | e492 | ||
| Case 7 | e493 | ||
| Clinical History and Background | e493 | ||
| Diagnosis and Case Discussion | e494 | ||
| Case 8 | e495 | ||
| Clinical History and Background | e495 | ||
| Diagnosis and Case Discussion | e496 | ||
| Case 9 | e497 | ||
| Clinical History and Background | e497 | ||
| Diagnosis and Case Discussion | e498 | ||
| Case 10 | e499 | ||
| Clinical History and Background | e499 | ||
| Diagnosis and Case Discussion | e500 | ||
| Case 11 | e501 | ||
| Clinical History and Background | e501 | ||
| Diagnosis and Case Discussion | e502 | ||
| Case 12 | e503 | ||
| Clinical History and Background | e503 | ||
| Diagnosis and Case Discussion | e504 | ||
| Case 13 | e505 | ||
| Clinical History and Background | e505 | ||
| Diagnosis and Case Discussion | e506 | ||
| Case 14 | e507 | ||
| Clinical History and Background | e507 | ||
| Diagnosis and Case Discussion | e508 | ||
| Case 15 | e509 | ||
| Clinical History and Background | e509 | ||
| Diagnosis and Case Discussion | e510 | ||
| Case 16 | e511 | ||
| Clinical History and Background | e511 | ||
| Diagnosis and Case Discussion | e512 | ||
| Case 17 | e513 | ||
| Clinical History and Background | e513 | ||
| Diagnosis and Case Discussion | e514 | ||
| Case 18 | e515 | ||
| Clinical History and Background | e515 | ||
| Diagnosis and Case Discussion | e516 | ||
| Case 19 | e517 | ||
| Clinical History and Background | e517 | ||
| Diagnosis and Case Discussion | e518 | ||
| Case 20 | e519 | ||
| Clinical History and Background | e519 | ||
| Diagnosis and Case Discussion | e520 | ||
| Case 21 | e521 | ||
| Clinical History and Background | e521 | ||
| Diagnosis and Case Discussion | e522 | ||
| Case 22 | e523 | ||
| Clinical History and Background | e523 | ||
| Diagnosis and Case Discussion | e524 | ||
| Case 23 | e525 | ||
| Clinical History and Background | e525 | ||
| Diagnosis and Case Discussion | e526 | ||
| Case 24 | e527 | ||
| Clinical History and Background | e527 | ||
| Diagnosis and Case Discussion | e528 | ||
| Case 25 | e529 | ||
| Clinical History and Background | e529 | ||
| Diagnosis and Case Discussion | e530 | ||
| Case 26 | e531 | ||
| Clinical History and Background | e531 | ||
| Diagnosis and Case Discussion | e532 | ||
| Case 27 | e533 | ||
| Clinical History and Background | e533 | ||
| Diagnosis and Case Discussion | e534 | ||
| Case 28 | e535 | ||
| Clinical History and Background | e535 | ||
| Diagnosis and Case Discussion | e536 | ||
| Case 29 | e537 | ||
| Clinical History and Background | e537 | ||
| Diagnosis and Case Discussion | e538 | ||
| Case 30 | e539 | ||
| Clinical History and Background | e539 | ||
| Diagnosis and Case Discussion | e540 | ||
| Case 31 | e541 | ||
| Clinical History and Background | e541 | ||
| Diagnosis and Case Discussion | e542 | ||
| Case 32 | e543 | ||
| Clinical History and Background | e543 | ||
| Diagnosis and Case Discussion | e544 | ||
| Case 33 | e545 | ||
| Clinical History and Background | e545 | ||
| Diagnosis and Case Discussion | e546 | ||
| Case 34 | e547 | ||
| Clinical History and Background | e547 | ||
| Diagnosis and Case Discussion | e548 | ||
| Case 35 | e549 | ||
| Clinical History and Background | e549 | ||
| Diagnosis and Case Discussion | e550 | ||
| Case 36 | e551 | ||
| Clinical History and Background | e551 | ||
| Diagnosis and Case Discussion | e552 | ||
| Case 37 | e553 | ||
| Clinical History and Background | e553 | ||
| Diagnosis and Case Discussion | e554 | ||
| Case 38 | e555 | ||
| Clinical History and Background | e555 | ||
| Diagnosis and Case Discussion | e556 | ||
| Case 39 | e557 | ||
| Clinical History and Background | e557 | ||
| Diagnosis and Case Discussion | e558 | ||
| Chapter 61 | e559 | ||
| Case 1 | e559 | ||
| Clinical History and Background | e559 | ||
| Diagnosis and Case Discussion | e560 | ||
| Case 2 | e561 | ||
| Clinical History and Background | e561 | ||
| Diagnosis and Case Discussion | e562 | ||
| Case 3 | e563 | ||
| Clinical History and Background | e563 | ||
| Diagnosis and Case Discussion | e564 | ||
| Case 4 | e565 | ||
| Clinical History and Background | e565 | ||
| Diagnosis and Case Discussion | e566 | ||
| Case 5 | e567 | ||
| Clinical History and Background | e567 | ||
| Diagnosis and Case Discussion | e568 | ||
| Case 6 | e569 | ||
| Clinical History and Background | e569 | ||
| Diagnosis and Case Discussion | e570 | ||
| Case 7 | e571 | ||
| Clinical History and Background | e571 | ||
| Diagnosis and Case Discussion | e572 | ||
| Case 8 | e573 | ||
| Clinical History and Background | e573 | ||
| Diagnosis and Case Discussion | e574 | ||
| Case 9 | e575 | ||
| Clinical History and Background | e575 | ||
| Diagnosis and Case Discussion | e576 | ||
| Case 10 | e577 | ||
| Diagnosis and Case Discussion | e578 | ||
| Case 11 | e579 | ||
| Diagnosis and Case Discussion | e580 | ||
| Case 12 | e581 | ||
| Clinical History and Background | e581 | ||
| Diagnosis and Case Discussion | e582 | ||
| Case 13 | e583 | ||
| Clinical History and Background | e583 | ||
| Diagnosis and Case Discussion | e584 | ||
| Case 14 | e585 | ||
| Clinical History and Background | e585 | ||
| Diagnosis and Case Discussion | e586 | ||
| Case 15 | e587 | ||
| Clinical History and Background | e587 | ||
| Diagnosis and Case Discussion | e588 | ||
| Case 16 | e589 | ||
| Clinical History and Background | e589 | ||
| Diagnosis and Case Discussion | e590 | ||
| Case 17 | e591 | ||
| Clinical History and Background | e591 | ||
| Diagnosis and Case Discussion | e592 | ||
| Chapter 62 | e593 | ||
| Case 1 | e593 | ||
| Clinical History and Background | e593 | ||
| Diagnosis and Case Discussion | e594 | ||
| Case 2 | e595 | ||
| Clinical History and Background | e595 | ||
| Diagnosis and Case Discussion | e596 | ||
| Chapter 63 | e597 | ||
| Case 1 | e597 | ||
| Clinical History and Background | e597 | ||
| Diagnosis and Case Discussion | e598 | ||
| Case 2 | e599 | ||
| Clinical History and Background | e599 | ||
| Diagnosis and Case Discussion | e600 | ||
| Case 3 | e601 | ||
| Clinical History and Background | e601 | ||
| Diagnosis and Case Discussion | e602 | ||
| Case 4 | e603 | ||
| Clinical History and Background | e603 | ||
| Diagnosis and Case Discussion | e604 | ||
| Case 5 | e605 | ||
| Diagnosis and Case Discussion | e606 | ||
| Case 6 | e607 | ||
| Clinical History and Background | e607 | ||
| Diagnosis and Case Discussion | e608 | ||
| Chapter 64 | e609 | ||
| Case 1 | e609 | ||
| Clinical History and Background | e609 | ||
| Diagnosis and Case Discussion | e610 | ||
| Case 2 | e611 | ||
| Clinical History and Background | e611 | ||
| Diagnosis and Case Discussion | e612 | ||
| Case 3 | e613 | ||
| Clinical History and Background | e613 | ||
| Diagnosis and Case Discussion | e614 | ||
| Case 4 | e615 | ||
| Clinical History and Background | e615 | ||
| Diagnosis and Case Discussion | e616 | ||
| Case 5 | e617 | ||
| Clinical History and Background | e617 | ||
| Diagnosis and Case Discussion | e618 | ||
| Case 6 | e619 | ||
| Clinical History and Background | e619 | ||
| Diagnosis and Case Discussion | e620 | ||
| Case 7 | e621 | ||
| Clinical History and Background | e621 | ||
| Diagnosis and Case Discussion | e622 | ||
| Case 8 | e623 | ||
| Clinical History and Background | e623 | ||
| Diagnosis and Case Discussion | e624 | ||
| Case 9 | e625 | ||
| Clinical History and Background | e625 | ||
| Diagnosis and Case Discussion | e626 | ||
| Case 10 | e627 | ||
| Clinical History and Background | e627 | ||
| Diagnosis and Case Discussion | e628 | ||
| Case 11 | e629 | ||
| Clinical History and Background | e629 | ||
| Diagnosis and Case Discussion | e630 | ||
| Case 12 | e631 | ||
| Clinical History and Background | e631 | ||
| Diagnosis and Case Discussion | e632 | ||
| Case 13 | e633 | ||
| Clinical History and Background | e633 | ||
| Diagnosis and Case Discussion | e634 | ||
| Case 14 | e635 | ||
| Clinical History and Background | e635 | ||
| Diagnosis and Case Discussion | e636 | ||
| Case 15 | e637 | ||
| Clinical History and Background | e637 | ||
| Diagnosis and Case Discussion | e638 | ||
| Case 16 | e639 | ||
| Clinical History and Background | e639 | ||
| Diagnosis and Case Discussion | e640 | ||
| Case 17 | e641 | ||
| Clinical History and Background | e641 | ||
| Diagnosis and Case Discussion | e642 | ||
| Case 18 | e643 | ||
| Clinical History and Background | e643 | ||
| Diagnosis and Case Discussion | e644 | ||
| Case 19 | e645 | ||
| Clinical History and Background | e645 | ||
| Diagnosis and Case Discussion | e646 | ||
| Case 20 | e647 | ||
| Clinical History and Background | e647 | ||
| Diagnosis and Case Discussion | e648 | ||
| Case 21 | e649 | ||
| Clinical History and Background | e649 | ||
| Diagnosis and Case Discussion | e650 | ||
| Case 22 | e651 | ||
| Clinical History and Background | e651 | ||
| Diagnosis and Case Discussion | e652 | ||
| Case 23 | e653 | ||
| Clinical History and Background | e653 | ||
| Diagnosis and Case Discussion | e654 | ||
| Case 24 | e655 | ||
| Clinical History and Background | e655 | ||
| Diagnosis and Case Discussion | e656 | ||
| Case 25 | e657 | ||
| Clinical History and Background | e657 | ||
| Diagnosis and Case Discussion | e658 | ||
| Case 26 | e659 | ||
| Clinical History and Background | e659 | ||
| Diagnosis and Case Discussion | e660 | ||
| Chapter 65 | e661 | ||
| Case 1 | e661 | ||
| Clinical History and Background | e661 | ||
| Diagnosis and Case Discussion | e662 | ||
| Case 2 | e663 | ||
| Clinical History and Background | e663 | ||
| Diagnosis and Case Discussion | e664 | ||
| Case 3 | e665 | ||
| Clinical History and Background | e665 | ||
| Diagnosis and Case Discussion | e666 | ||
| Case 4 | e667 | ||
| Clinical History and Background | e667 | ||
| Diagnosis and Case Discussion | e668 | ||
| Case 5 | e669 | ||
| Clinical History and Background | e669 | ||
| Diagnosis and Case Discussion | e670 | ||
| Case 6 | e671 | ||
| Clinical History and Background | e671 | ||
| Diagnosis and Case Discussion | e672 | ||
| Case 7 | e673 | ||
| Clinical History and Background | e673 | ||
| Diagnosis and Case Discussion | e674 | ||
| Case 8 | e675 | ||
| Clinical History and Background | e675 | ||
| Diagnosis and Case Discussion | e676 | ||
| Case 9 | e677 | ||
| Clinical History and Background | e677 | ||
| Diagnosis and Case Discussion | e678 | ||
| Case 10 | e679 | ||
| Clinical History and Background | e679 | ||
| Diagnosis and Case Discussion | e680 | ||
| Chapter 66 | e681 | ||
| Case 1 | e681 | ||
| Clinical History and Background | e681 | ||
| Diagnosis and Case Discussion | e682 | ||
| Case 2 | e683 | ||
| Clinical History and Background | e683 | ||
| Diagnosis and Case Discussion | e684 | ||
| Case 3 | e685 | ||
| Clinical History and Background | e685 | ||
| Diagnosis and Case Discussion | e686 | ||
| Case 4 | e687 | ||
| Clinical History and Background | e687 | ||
| Diagnosis and Case Discussion | e688 | ||
| Case 5 | e689 | ||
| Clinical History and Background | e689 | ||
| Diagnosis and Case Discussion | e690 | ||
| Case 6 | e691 | ||
| Clinical History and Background | e691 | ||
| Diagnosis and Case Discussion | e692 | ||
| Case 7 | e693 | ||
| Clinical History and Background | e693 | ||
| Diagnosis and Case Discussion | e694 | ||
| Case 8 | e695 | ||
| Clinical History and Background | e695 | ||
| Diagnosis and Case Discussion | e696 | ||
| Case 9 | e697 | ||
| Clinical History and Background | e697 | ||
| Diagnosis and Case Discussion | e698 | ||
| Case 10 | e699 | ||
| Clinical History and Background | e699 | ||
| Diagnosis and Case Discussion | e700 | ||
| Case 11 | e701 | ||
| Clinical History and Background | e701 | ||
| Diagnosis and Case Discussion | e702 | ||
| Chapter 67 | e703 | ||
| Case 1 | e703 | ||
| Clinical History and Background | e703 | ||
| Diagnosis and Case Discussion | e704 | ||
| Case 2 | e705 | ||
| Clinical History and Background | e705 | ||
| Diagnosis and Case Discussion | e706 | ||
| Case 3 | e707 | ||
| Clinical History and Background | e707 | ||
| Diagnosis and Case Discussion | e708 | ||
| Case 4 | e709 | ||
| Clinical History and Background | e709 | ||
| Diagnosis and Case Discussion | e710 | ||
| Case 5 | e711 | ||
| Clinical History and Background | e711 | ||
| Diagnosis and Case Discussion | e712 | ||
| Case 6 | e713 | ||
| Clinical History and Background | e713 | ||
| Diagnosis and Case Discussion | e714 | ||
| Case 7 | e715 | ||
| Clinical History and Background | e715 | ||
| Diagnosis and Case Discussion | e716 | ||
| Case 8 | e717 | ||
| Clinical History and Background | e717 | ||
| Diagnosis and Case Discussion | e718 | ||
| Case 9 | e719 | ||
| Clinical History and Background | e719 | ||
| Diagnosis and Case Discussion | e720 | ||
| Case 10 | e721 | ||
| Clinical History and Background | e721 | ||
| Diagnosis and Case Discussion | e722 | ||
| Case 11 | e723 | ||
| Clinical History and Background | e723 | ||
| Diagnosis and Case Discussion | e724 | ||
| Case 12 | e725 | ||
| Clinical History and Background | e725 | ||
| Diagnosis and Case Discussion | e726 | ||
| Chapter 68 | e727 | ||
| Case 1 | e727 | ||
| Clinical History and Background | e727 | ||
| Diagnosis and Case Discussion | e728 | ||
| Case 2 | e729 | ||
| Clinical History and Background | e729 | ||
| Diagnosis and Case Discussion | e730 | ||
| Case 3 | e731 | ||
| Clinical History and Background | e731 | ||
| Diagnosis and Case Discussion | e732 | ||
| Case 4 | e733 | ||
| Clinical History and Background | e733 | ||
| Diagnosis and Case Discussion | e734 | ||
| Case 5 | e735 | ||
| Clinical History and Background | e735 | ||
| Diagnosis and Case Discussion | e736 | ||
| Case 6 | e737 | ||
| Clinical History and Background | e737 | ||
| Diagnosis and Case Discussion | e738 | ||
| Chapter 70 | e739 | ||
| Case 1 | e739 | ||
| Clinical History and Background | e739 | ||
| Diagnosis and Case Discussion | e740 | ||
| Case 2 | e741 | ||
| Clinical History and Background | e741 | ||
| Diagnosis and Case Discussion | e742 | ||
| Case 3 | e743 | ||
| Clinical History and Background | e743 | ||
| Diagnosis and Case Discussion | e744 | ||
| Case 4 | e745 | ||
| Clinical History and Background | e745 | ||
| Diagnosis and Case Discussion | e746 | ||
| Case 5 | e747 | ||
| Clinical History and Background | e747 | ||
| Diagnosis and Case Discussion | e748 | ||
| Case 6 | e749 | ||
| Clinical History and Background | e749 | ||
| Diagnosis and Case Discussion | e750 | ||
| Case 7 | e751 | ||
| Clinical History and Background | e751 | ||
| Diagnosis and Case Discussion | e752 | ||
| Case 8 | e753 | ||
| Clinical History and Background | e753 | ||
| Diagnosis and Case Discussion | e754 | ||
| Case 9 | e755 | ||
| Clinical History and Background | e755 | ||
| Diagnosis and Case Discussion | e756 | ||
| Case 10 | e757 | ||
| Clinical History and Background | e757 | ||
| Diagnosis and Case Discussion | e758 | ||
| Case 11 | e759 | ||
| Clinical History and Background | e759 | ||
| Diagnosis and Case Discussion | e760 | ||
| Case 12 | e761 | ||
| Clinical History and Background | e761 | ||
| Diagnosis and Case Discussion | e762 | ||
| Tietz Biochemical Calculations | e763 | ||
| Question 1 | e763 | ||
| Answer | e764 | ||
| Question 2 | e765 | ||
| Answer | e766 | ||
| Question 3 | e767 | ||
| Answer | e768 | ||
| Question 4 | e769 | ||
| Answer | e770 | ||
| Question 5 | e771 | ||
| Answer | e772 | ||
| Question 6 | e773 | ||
| Answer | e774 | ||
| Question 7 | e775 | ||
| Answer | e776 | ||
| Question 8 | e777 | ||
| Answer | e778 | ||
| Question 9 | e779 | ||
| Answer | e780 | ||
| Question 10 | e781 | ||
| Answer | e782 | ||
| Question 11 | e783 | ||
| Answer | e784 | ||
| Question 12 | e785 | ||
| Answer | e786 | ||
| Question 13 | e787 | ||
| Answer | e788 | ||
| Question 14 | e789 | ||
| Answer | e790 | ||
| Question 15 | e792 | ||
| Answer | e793 | ||
| Question 16 | e794 | ||
| Answer | e795 | ||
| Question 17 | e797 | ||
| Answer | e798 | ||
| Question 18 | e800 | ||
| Answer | e801 | ||
| Notes: | e801 | ||
| Question 19 | e802 | ||
| Answer | e803 | ||
| Question 20 | e804 | ||
| Answer | e805 | ||
| Question 21 | e806 | ||
| Answer | e807 | ||
| Question 22 | e808 | ||
| Answer | e809 | ||
| Question 23 | e810 | ||
| Answer | e811 | ||
| Question 24 | e812 | ||
| Answer | e813 | ||
| Question 25 | e814 | ||
| Answer | e815 | ||
| Question 26 | e816 | ||
| Answer | e817 | ||
| Question 27 | e818 | ||
| Answer | e819 | ||
| Question 28 | e820 | ||
| Answer | e821 | ||
| Question 29 | e822 | ||
| Answer | e823 | ||
| Question 30 | e824 | ||
| Answer | e825 | ||
| Question 31 | e826 | ||
| Answer | e827 | ||
| Question 32 | e828 | ||
| Answer | e829 | ||
| Question 33 | e830 | ||
| Answer | e831 | ||
| Question 34 | e832 | ||
| Answer | e833 | ||
| Question 35 | e834 | ||
| Answer | e835 | ||
| Question 36 | e837 | ||
| Answer | e838 | ||
| Question 37 | e839 | ||
| Answer | e840 | ||
| Question 38 | e842 | ||
| Answer | e843 | ||
| Question 39 | e844 | ||
| Answer | e845 | ||
| Notes | e846 | ||
| Question 40 | e847 | ||
| Answer | e848 | ||
| Question 41 | e850 | ||
| Answer | e851 | ||
| Question 42 | e852 | ||
| Answer | e853 | ||
| Question 43 | e854 | ||
| Answer | e855 | ||
| Question 44 | e856 | ||
| Answer | e857 | ||
| Alternative Approach: | e858 | ||
| Question 45 | e859 | ||
| Answer | e860 | ||
| Question 46 | e861 | ||
| Answer | e862 | ||
| Question 47 | e863 | ||
| Answer | e864 | ||
| Question 48 | e865 | ||
| Answer | e866 | ||
| Question 49 | e867 | ||
| Answer | e868 | ||
| Question 50 | e869 | ||
| Answer | e870 | ||
| Question 51 | e871 | ||
| Answer | e872 | ||
| Question 52 | e873 | ||
| Answer | e874 | ||
| Question 53 | e875 | ||
| Answer | e876 | ||
| Question 54 | e877 | ||
| Answer | e878 | ||
| Question 55 | e879 | ||
| Answer | e880 | ||
| Question 56 | e881 | ||
| Answer | e882 | ||
| Question 57 | e883 | ||
| Answer | e884 | ||
| Question 58 | e885 | ||
| Answer | e886 | ||
| Question 59 | e887 | ||
| Answer | e888 | ||
| Question 60 | e889 | ||
| Answer | e890 | ||
| Question 61 | e891 | ||
| Answer | e892 | ||
| Question 62 | e893 | ||
| Answer | e894 | ||
| Question 63 | e895 | ||
| Answer | e896 | ||
| Question 64 | e898 | ||
| Answer | e899 | ||
| Question 65 | e900 | ||
| Answer | e901 | ||
| Question 66 | e903 | ||
| Answer | e904 | ||
| Question 67 | e905 | ||
| Answer | e906 | ||
| Glucose | e906 | ||
| Creatinine | e906 | ||
| Blood Urea Nitrogen (BUN) | e906 | ||
| Albumin : Creatinine Ratio | e906 | ||
| Question 68 | e907 | ||
| Answer | e908 | ||
| Question 69 | e909 | ||
| Immunoassay Method for Peptide-X | e909 | ||
| Answer | e910 | ||
| Question 70 | e911 | ||
| Answer | e912 | ||
| Question 71 | e913 | ||
| Answer | e914 | ||
| Question 72 | e915 | ||
| Answer | e916 | ||
| Question 73 | e917 | ||
| Answer | e918 | ||
| Question 74 | e919 | ||
| Answer | e920 | ||
| Question 75 | e921 | ||
| Answer | e922 | ||
| Question 76 | e923 | ||
| Answer | e924 | ||
| Question 77 | e925 | ||
| Answer | e926 | ||
| Question 78 | e927 | ||
| Answer | e928 | ||
| Question 79 | e929 | ||
| Answer | e930 | ||
| Question 80 | e931 | ||
| Answer | e932 | ||
| Question 81 | e933 | ||
| Answer | e934 | ||
| Question 82 | e935 | ||
| Answer | e936 | ||
| Question 83 | e937 | ||
| Answer | e938 | ||
| Abbreviations: | e938 | ||
| Method 1 | e938 | ||
| Method 2 | e939 | ||
| Question 84 | e940 | ||
| Method Details | e940 | ||
| Answer | e941 | ||
| Question 85 | e942 | ||
| Answer | e943 | ||
| Question 86 | e944 | ||
| Method | e944 | ||
| Result | e944 | ||
| Answer | e945 | ||
| Question 87 | e946 | ||
| Answer | e947 | ||
| Question 88 | e948 | ||
| Answer | e949 | ||
| Question 89 | e950 | ||
| Answer | e951 | ||
| Question 90 | e952 | ||
| Answer | e953 | ||
| Question 91 | e954 | ||
| Answer | e955 | ||
| Question 92 | e956 | ||
| Answer | e957 | ||
| Question 93 | e958 | ||
| Answer | e959 | ||
| Question 94 | e960 | ||
| Answer | e961 | ||
| Question 95 | e962 | ||
| Answer | e963 | ||
| Question 96 | e964 | ||
| Answer | e965 | ||
| Question 97 | e966 | ||
| Answer | e967 | ||
| Question 98 | e968 | ||
| Answer | e969 | ||
| Question 99 | e970 | ||
| Answer | e971 | ||
| Question 100 | e972 | ||
| Answer | e973 | ||
| Question 101 | e974 | ||
| Answer | e975 | ||
| Question 102 | e977 | ||
| Answer | e978 | ||
| Question 103 | e979 | ||
| Answer | e980 | ||
| Question 104 | e981 | ||
| Answer | e982 | ||
| Question 105 | e983 | ||
| Answer | e984 | ||
| Question 106 | e985 | ||
| Answer | e986 | ||
| Question 107 | e987 | ||
| Answer | e988 | ||
| Question 108 | e989 | ||
| Answer | e990 | ||
| Question 109 | e991 | ||
| Answer | e992 | ||
| Question 110 | e993 | ||
| Answer | e994 | ||
| Question 111 | e995 | ||
| Answer | e996 | ||
| Question 112 | e998 | ||
| Answer | e999 | ||
| Question 113 | e1000 | ||
| Answer | e1001 | ||
| Question 114 | e1003 | ||
| Answer | e1004 | ||
| Reference | e1005 | ||
| Question 115 | e1006 | ||
| Answer | e1007 | ||
| Question 116 | e1008 | ||
| Answer | e1009 | ||
| Question 117 | e1010 | ||
| Answer | e1011 | ||
| Question 118 | e1012 | ||
| Answer | e1013 | ||
| Question 119 | e1014 | ||
| Answer | e1015 | ||
| Question 120 | e1016 | ||
| Answer | e1017 | ||
| Question 121 | e1018 | ||
| Answer | e1019 | ||
| Question 122 | e1020 | ||
| Answer | e1021 | ||
| Method 1 | e1021 | ||
| Method 2 | e1021 | ||
| Method 3 | e1021 | ||
| Question 123 | e1023 | ||
| Answer | e1024 | ||
| Question 124 | e1025 | ||
| Answer | e1026 | ||
| Method 1 | e1026 | ||
| Method 2 | e1026 | ||
| Method 3 | e1026 | ||
| Question 125 | e1028 | ||
| Answer | e1029 | ||
| Question 126 | e1030 | ||
| Answer | e1031 | ||
| Question 127 | e1032 | ||
| Answer | e1033 | ||
| Question 128 | e1034 | ||
| Answer | e1035 | ||
| Question 129 | e1036 | ||
| Answer | e1037 | ||
| Question 130 | e1039 | ||
| Answer | e1040 | ||
| Question 131 | e1041 | ||
| Answer | e1042 | ||
| Question 132 | e1043 | ||
| Answer | e1044 | ||
| Question 133 | e1045 | ||
| Answer | e1046 | ||
| Question 134 | e1048 | ||
| Answer | e1049 | ||
| Question 135 | e1050 | ||
| Answer | e1051 | ||
| Question 136 | e1052 | ||
| Answer | e1053 | ||
| Tietz Teasers in Parasitology: The Bobbi Pritt Collection | e1055 | ||
| Question 1 | e1055 | ||
| Answer and Explanation | e1056 | ||
| Question 2 | e1057 | ||
| Background | e1057 | ||
| Answer and Explanation | e1058 | ||
| Question 3 | e1059 | ||
| Background | e1059 | ||
| Answer and Explanation | e1060 | ||
| Question 4 | e1061 | ||
| Background | e1061 | ||
| Answer and Explanation | e1062 | ||
| Question 5 | e1063 | ||
| Answer and Explanation | e1064 | ||
| Question 8 | e1065 | ||
| Answer and Explanation | e1066 | ||
| Question 9 | e1067 | ||
| Background | e1067 | ||
| Answer and Explanation | e1068 | ||
| Question 10 | e1069 | ||
| Answer and Explanation | e1070 | ||
| Question 11 | e1071 | ||
| Answer and Explanation | e1072 | ||
| Question 12 | e1073 | ||
| Answer and Explanation | e1074 | ||
| Question 13 | e1075 | ||
| Background | e1075 | ||
| Answer and Explanation | e1076 | ||
| Question 14 | e1077 | ||
| Background | e1077 | ||
| Answer and Explanation | e1078 | ||
| Question 15 | e1079 | ||
| Background | e1079 | ||
| Answer and Explanation | e1080 | ||
| Question 16 | e1081 | ||
| Background | e1081 | ||
| Answer and Explanation | e1082 | ||
| Question 17 | e1083 | ||
| Background | e1083 | ||
| Answer and Explanation | e1084 | ||
| Question 18 | e1085 | ||
| Background | e1085 | ||
| Answer and Explanation | e1086 | ||
| Question 19 | e1087 | ||
| Background | e1087 | ||
| Answer and Explanation | e1088 | ||
| Question 20 | e1089 | ||
| Background | e1089 | ||
| Answer and Explanation | e1090 | ||
| Question 22 | e1091 | ||
| Background | e1091 | ||
| Answer and Explanation | e1092 | ||
| Question 23 | e1093 | ||
| Background | e1093 | ||
| Answer and Explanation | e1094 | ||
| Question 25 | e1095 | ||
| Background | e1095 | ||
| Answer and Explanation | e1096 | ||
| Question 26 | e1097 | ||
| Background | e1097 | ||
| Answer and Explanation | e1098 | ||
| Question 27 | e1099 | ||
| Background | e1099 | ||
| Answer and Explanation | e1100 | ||
| Question 28 | e1101 | ||
| Background | e1101 | ||
| Answer and Explanation | e1102 | ||
| Question 29 | e1103 | ||
| Background | e1103 | ||
| Answer and Explanation | e1104 | ||
| Question 30 | e1105 | ||
| Background | e1105 | ||
| Answer and Explanation | e1106 | ||
| Question 32 | e1107 | ||
| Background | e1107 | ||
| Answer and Explanation | e1108 | ||
| Question 33 | e1109 | ||
| Answer and Explanation | e1110 | ||
| Question 34 | e1111 | ||
| Background | e1111 | ||
| Answer and Explanation | e1112 | ||
| Question 35 | e1113 | ||
| Answer and Explanation | e1114 | ||
| Question 36 | e1115 | ||
| Background | e1115 | ||
| Answer and Explanation | e1116 | ||
| Question 37 | e1117 | ||
| Background | e1117 | ||
| Answer and Explanation | e1118 | ||
| Question 38 | e1119 | ||
| Background | e1119 | ||
| Answer and Explanation | e1120 | ||
| Question 39 | e1121 | ||
| Background | e1121 | ||
| Answer and Explanation | e1122 | ||
| Question 40 | e1123 | ||
| Background | e1123 | ||
| Answer and Explanation | e1124 | ||
| Question 41 | e1125 | ||
| Background | e1125 | ||
| Answer and Explanation | e1126 | ||
| Question 42 | e1127 | ||
| Answer and Explanation | e1128 | ||
| Question 43 | e1129 | ||
| Background | e1129 | ||
| Answer and Explanation | e1130 | ||
| Question 44 | e1131 | ||
| Background | e1131 | ||
| Answer and Explanation | e1132 | ||
| Question 45 | e1133 | ||
| Background | e1133 | ||
| Answer and Explanation | e1134 | ||
| Question 46 | e1135 | ||
| Background | e1135 | ||
| Answer and Explanation | e1136 | ||
| Question 47 | e1137 | ||
| Background | e1137 | ||
| Answer and Explanation | e1138 | ||
| Question 48 | e1139 | ||
| Background | e1139 | ||
| Answer and Explanation | e1140 | ||
| Question 50 | e1141 | ||
| Background | e1141 | ||
| Answer and Explanation | e1142 | ||
| Question 51 | e1143 | ||
| Background | e1143 | ||
| Answer and Explanation | e1144 | ||
| Question 52 | e1145 | ||
| Background | e1145 | ||
| Answer and Explanation | e1146 | ||
| Question 53 | e1147 | ||
| Background | e1147 | ||
| Answer and Explanation | e1148 | ||
| Question 54 | e1149 | ||
| Background | e1149 | ||
| Answer and Explanation | e1150 | ||
| Question 55 | e1151 | ||
| Background | e1151 | ||
| Answer and Explanation | e1152 | ||
| Question 56 | e1153 | ||
| Background | e1153 | ||
| Answer and Explanation | e1154 | ||
| Question 57 | e1155 | ||
| Background | e1155 | ||
| Answer and Explanation | e1156 | ||
| Question 58 | e1157 | ||
| Background | e1157 | ||
| Answer and Explanation | e1158 | ||
| Question 59 | e1159 | ||
| Background | e1159 | ||
| Answer and Explanation | e1160 | ||
| Question 60 | e1161 | ||
| Background | e1161 | ||
| Answer and Explanation | e1162 | ||
| Question 62 | e1163 | ||
| Background | e1163 | ||
| Answer and Explanation | e1164 | ||
| Question 63 | e1165 | ||
| Background | e1165 | ||
| Answer and Explanation | e1166 | ||
| Question 64 | e1167 | ||
| Answer and Explanation | e1168 | ||
| Question 67 | e1169 | ||
| Background | e1169 | ||
| Answer and Explanation | e1170 | ||
| Question 68 | e1171 | ||
| Background | e1171 | ||
| Answer and Explanation | e1172 | ||
| Question 69 | e1173 | ||
| Background | e1173 | ||
| Answer and Explanation | e1174 | ||
| Question 70 | e1175 | ||
| Background | e1175 | ||
| Answer and Explanation | e1176 | ||
| Question 71 | e1177 | ||
| Background | e1177 | ||
| Answer and Explanation | e1178 | ||
| Question 72 | e1179 | ||
| Background | e1179 | ||
| Answer and Explanation | e1180 | ||
| Question 73 | e1181 | ||
| Background | e1181 | ||
| Answer and Explanation | e1182 | ||
| Question 74 | e1183 | ||
| Background | e1183 | ||
| Answer and Explanation | e1184 | ||
| Question 75 | e1185 | ||
| Background | e1185 | ||
| Answer and Explanation | e1186 | ||
| Question 76 | e1187 | ||
| Background | e1187 | ||
| Answer and Explanation | e1188 | ||
| Question 77 | e1189 | ||
| Background | e1189 | ||
| Answer and Explanation | e1190 | ||
| Question 78 | e1191 | ||
| Background | e1191 | ||
| Answer and Explanation | e1192 | ||
| Question 79 | e1193 | ||
| Background | e1193 | ||
| Answer and Explanation | e1194 | ||
| Question 82 | e1195 | ||
| Background | e1195 | ||
| Answer and Explanation | e1196 | ||
| Question 84 | e1197 | ||
| Background | e1197 | ||
| Answer and Explanation | e1198 | ||
| Question 85 | e1200 | ||
| Background | e1200 | ||
| Answer and Explanation | e1201 | ||
| Question 86 | e1202 | ||
| Background | e1202 | ||
| Answer and Explanation | e1203 | ||
| Question 88 | e1204 | ||
| Background | e1204 | ||
| Answer and Explanation | e1205 | ||
| Question 89 | e1206 | ||
| Background | e1206 | ||
| Answer and Explanation | e1207 | ||
| Question 90 | e1208 | ||
| Background | e1208 | ||
| Answer and Explanation | e1209 | ||
| Question 91 | e1210 | ||
| Background | e1210 | ||
| Answer and Explanation | e1211 | ||
| Question 92 | e1212 | ||
| Background | e1212 | ||
| Answer and Explanation | e1213 | ||
| Question 93 | e1214 | ||
| Background | e1214 | ||
| Answer and Explanation | e1216 | ||
| Question 95 | e1217 | ||
| Background | e1217 | ||
| Answer and Explanation | e1218 | ||
| Question 96 | e1219 | ||
| Background | e1219 | ||
| Answer and Explanation | e1220 | ||
| Question 97 | e1221 | ||
| Background | e1221 | ||
| Answer and Explanation | e1222 | ||
| Question 98 | e1223 | ||
| Background | e1223 | ||
| Answer and Explanation | e1224 | ||
| Question 99 | e1225 | ||
| Background | e1225 | ||
| Answer and Explanation | e1226 | ||
| Question 100 | e1227 | ||
| Background | e1227 | ||
| Answer and Explanation | e1228 | ||
| Question 102 | e1229 | ||
| Background | e1229 | ||
| Answer and Explanation | e1230 | ||
| Question 103 | e1231 | ||
| Background | e1231 | ||
| Answer and Explanation | e1232 | ||
| Question 104 | e1233 | ||
| Background | e1233 | ||
| Answer and Explanation | e1234 | ||
| Question 107 | e1235 | ||
| Background | e1235 | ||
| Answer and Explanation | e1236 | ||
| Question 110 | e1237 | ||
| Background | e1237 | ||
| Answer and Explanation | e1238 | ||
| Question 111 | e1239 | ||
| Background | e1239 | ||
| Answer and Explanation | e1240 | ||
| Question 112 | e1241 | ||
| Background | e1241 | ||
| Answer and Explanation | e1242 | ||
| Question 113 | e1243 | ||
| Background | e1243 | ||
| Answer and Explanation | e1244 | ||
| Question 114 | e1245 | ||
| Answer and Explanation | e1246 | ||
| Question 115 | e1247 | ||
| Answer and Explanation | e1248 | ||
| 1 Free-Living Amebae: Acanthamoeba species/Balamuthia mandrillaris | e1250 | ||
| Case 1 | e1250 | ||
| Case 2 | e1250 | ||
| Case 3 | e1252 | ||
| 2 Acanthocephalans | e1253 | ||
| Case 1 | e1253 | ||
| 3 Ascaris lumbricoides | e1254 | ||
| Case 1 | e1254 | ||
| 4 Babesia species | e1255 | ||
| Case 1 | e1255 | ||
| 5 Balantidium coli | e1257 | ||
| Case 1 | e1257 | ||
| Case 2 | e1257 | ||
| 6 Blastocystis hominis | e1260 | ||
| Case 1 | e1260 | ||
| 7 Brugia malayi | e1261 | ||
| Case 1 | e1261 | ||
| 8 Capillaria species | e1262 | ||
| Case 1 | e1262 | ||
| 9 Non-Parasitic Stool Objects | e1263 | ||
| Case 1 | e1263 | ||
| Case 2 | e1264 | ||
| 10 Clonorchis sinensis | e1265 | ||
| Case 1 | e1265 | ||
| Case 2 | e1265 | ||
| 11 Cyclospora cayetanensis | e1266 | ||
| Case 1 | e1266 | ||
| 12 Demodex species | e1267 | ||
| Case 1 | e1267 | ||
| 13 Bot Flies | e1268 | ||
| Case 1 | e1268 | ||
| Case 2 | e1268 | ||
| 14 Diphyllobothrium species | e1269 | ||
| Case 1 | e1269 | ||
| Case 2 | e1270 | ||
| 15 Dipylidium caninum | e1271 | ||
| Case 1 | e1271 | ||
| Case 2 | e1272 | ||
| Case 3 | e1273 | ||
| 16 Echinococcus species | e1274 | ||
| Case 1 | e1274 | ||
| Case 2 | e1275 | ||
| Case 3 | e1275 | ||
| 17 Entamoeba coli | e1276 | ||
| Case 1 | e1276 | ||
| 18 Entamoeba histolytica/Entamoeba dispar | e1277 | ||
| Case 1 | e1277 | ||
| Case 2 | e1277 | ||
| 19 Enterobius vermicularis (Pinworm) | e1278 | ||
| Case 1 | e1278 | ||
| Case 2 | e1278 | ||
| 20 Fasciola hepatica | e1279 | ||
| Case 1 | e1279 | ||
| 21 Giardia duodenalis (a.k.a., G. lamblia, G. intestinalis) | e1280 | ||
| Case 1 | e1280 | ||
| 22 Gordian Worm | e1281 | ||
| Case 1 | e1281 | ||
| 23 Hard Ticks | e1283 | ||
| Case 1 | e1283 | ||
| Case 2 | e1283 | ||
| Case 3 | e1284 | ||
| 24 Hookworm | e1285 | ||
| Case 1 | e1285 | ||
| Case 2 | e1285 | ||
| 25 Howell-Jolly Bodies | e1286 | ||
| Case 1 | e1286 | ||
| 26 Hymenolepis nana | e1288 | ||
| Case 1 | e1288 | ||
| 27 Iodamoeba buetschlii | e1289 | ||
| Case 1 | e1289 | ||
| 28 Leishmania species | e1290 | ||
| Case 1 | e1290 | ||
| Case 2 | e1291 | ||
| 29 Microsporidia | e1292 | ||
| Case 1 | e1292 | ||
| 30 Mosquitoes | e1293 | ||
| Case 1 | e1293 | ||
| Case 2 | e1293 | ||
| 31 Onchocerca volvulus | e1294 | ||
| Case 1 | e1294 | ||
| 32 Paragonimus species | e1296 | ||
| Case 1 | e1296 | ||
| 33 Pediculus humanus | e1298 | ||
| Case 1 | e1298 | ||
| Case 2 | e1298 | ||
| 34 Plasmodium species (Malaria) | e1299 | ||
| Case 1 | e1299 | ||
| Case 2 | e1300 | ||
| Case 3 | e1300 | ||
| Case 4 | e1301 | ||
| Case 5 | e1302 | ||
| Case 6 | e1302 | ||
| Case 7 | e1304 | ||
| Case 8 | e1305 | ||
| Case 9 | e1306 | ||
| 35 Pthirus pubis (Pubic Louse) | e1307 | ||
| Case 1 | e1307 | ||
| 36 Sarcocystis species | e1358 | ||
| Case 1 | e1358 | ||
| 37 Sarcoptes scabei | e1309 | ||
| Case 1 | e1309 | ||
| Case 2 | e1310 | ||
| Case 3 | e1310 | ||
| 38 Schistosoma species | e1312 | ||
| Case 1 | e1312 | ||
| Case 2 | e1312 | ||
| Case 3 | e1313 | ||
| Case 4 | e1314 | ||
| Case 5 | e1314 | ||
| 39 Strongyloides stercoralis | e1316 | ||
| Case 1 | e1316 | ||
| Case 2 | e1317 | ||
| 40 Taenia species | e1318 | ||
| Case 1 | e1318 | ||
| Case 2 | e1319 | ||
| 41 Toxocara species | e1320 | ||
| Case 1 | e1320 | ||
| 42 Toxoplasma gondii | e1322 | ||
| Case 1 | e1322 | ||
| Case 2 | e1322 | ||
| 43 Trichinella species | e1324 | ||
| Case 1 | e1324 | ||
| Case 2 | e1324 | ||
| 44 Trichuris trichiura (whipworm) | e1326 | ||
| Case 1 | e1326 | ||
| Case 2 | e1326 | ||
| Case 3 | e1328 | ||
| 45 Trypanosomes | e1329 | ||
| Case 1 | e1329 | ||
| Case 2 | e1329 | ||
| Case 3 | e1330 | ||
| 46 Tunga penetrans | e1331 | ||
| Case 1 | e1331 | ||
| 47 Wuchereria bancrofti | e1332 | ||
| Case 1 | e1332 | ||
| 48 Zoonotic Mite | e1334 | ||
| Case 1 | e1334 | ||
| Index | 1819 | ||
| A | 1819 | ||
| B | 1823 | ||
| C | 1825 | ||
| D | 1830 | ||
| E | 1832 | ||
| F | 1834 | ||
| G | 1836 | ||
| H | 1838 | ||
| I | 1841 | ||
| J | 1843 | ||
| K | 1843 | ||
| L | 1843 | ||
| M | 1845 | ||
| N | 1848 | ||
| O | 1849 | ||
| P | 1850 | ||
| Q | 1856 | ||
| R | 1856 | ||
| S | 1858 | ||
| T | 1861 | ||
| U | 1864 | ||
| V | 1865 | ||
| W | 1867 | ||
| X | 1867 | ||
| Y | 1867 | ||
| Z | 1867 |