Laboratory Diagnostic Pathways: Clinical Manual of Screening Methods and Stepwise Diagnosis

Contents
List of Authors
I General Information
	1 Introduction
		1.1 Definitions
			1.1.1 Legal Rulings
		1.2 Historical Development
		1.3 Diagnostic Strategies
			1.3.1 Stepwise Diagnosis or Profile Diagnosis
			1.3.2 Diagnostic Quality Criteria
			1.3.3 Stepwise Diagnosis during Screening of Clinically Unremarkable Persons
		1.4 Outlook
	2 Implementation
		2.1 Organizational Requirements in the Hospital
		2.2 Economic Impacts
		2.3 Implementation of Information Technology
II Specialist Section
	3 Practical Examples for Screening Examinations
		3.1 Internist Admissions Screening
		3.2 Acute Poisoning
			3.2.1 Acute Drug Intoxication
				3.2.1.1 Forms and Origins of Acute Drug Intoxication
			3.2.2 Toxidromes
				3.2.2.1 Anticholinergic Toxidrome
				3.2.2.2 Cholinergic Toxidrome
				3.2.2.3 Hallucinogenic Toxidrome
				3.2.2.4 Opiate/Opioid Toxidrome
				3.2.2.5 Sedative/Hypnotic Toxidrome
				3.2.2.6 Sympathomimetic Toxidrome
			3.2.3 Acute Poisoning of Unknown Origin
				3.2.3.1 Forms and Origins of Acute Poisoning of Unknown Origin
				3.2.3.2 Decision Tree for Acute Poisoning of Unknown Origin
		3.3 Extravascular Fluids
			3.3.1 Cerebrospinal Fluid Fistula Diagnostics
			3.3.2 Peritoneal Dialysis Diagnostics
			3.3.3 Chyle Diagnostics
			3.3.4 Urine Leakage Diagnostics
			3.3.5 Effusion Diagnostics
				3.3.5.1 Ascites
				3.3.5.2 Pleural Effusion
				3.3.5.3 Pericardial Effusion
	4 Practical Examples of Targeted Stepwise Diagnosis
		4.1 Endocrinology
			4.1.1 Thyroid Gland
				4.1.1.1 Hyperthyroidism
				4.1.1.2 Hypothyroidism
				4.1.1.3 Pre- and Post-analytical Principles
				4.1.1.4 Laboratory Analysis
			4.1.2 Adrenal Glands
				4.1.2.1 Cushing Syndrome
				4.1.2.2 Clarification of Cushing Syndrome
				4.1.2.3 Hypocortisolism
		4.2 Diabetes and Metabolism
			4.2.1 Diabetes Mellitus
				4.2.1.1 Diagnosis and Risk Assessment
				4.2.1.2 Gestational Diabetes Mellitus (GDM)
				4.2.1.3 Monitoring Diabetes Mellitus
			4.2.2 Lipid and Lipoprotein Metabolism
				4.2.2.1 Assessment of Cardiovascular Risk
				4.2.2.2 Differential Diagnosis of Lipid Metabolism Disorders
			4.2.3 Porphyrias
				4.2.3.1 Neurovisceral Attacks
				4.2.3.2 Photodermatoses
		4.3 Liver and Pancreatic Disorders
			4.3.1 Hepatobiliary Disorders
				4.3.1.1 Non-Alcoholic Fatty Liver Disease (NAFLD)
				4.3.1.2 Acute Viral Hepatitis
				4.3.1.3 Jaundice
			4.3.2 Pancreatic Diseases
				4.3.2.1 Acute Pancreatitis
				4.3.2.2 Chronic Pancreatitis
		4.4 Kidneys and Efferent Urinary Tract
			4.4.1 Ruling Out Disorders of the Kidneys and Efferent Urinary Tract
				4.4.1.1 Medical History and Clinical Picture
				4.4.1.2 Pre- and Post-analytical Principles of Laboratory Diagnost ics
				4.4.1.3 Basic Diagnostics
				4.4.1.4 Analysis
			4.4.2 Stepwise Diagnostics of the Glomerular Filtration Rate
				4.4.2.1 Stages of Chronic Renal failure
				4.4.2.2 Analysis and Calculation of the Glomerular Filtration Rate
			4.4.3 Stepwise Diagnostics of Proteinuria
				4.4.3.1 Forms of Proteinuria
				4.4.3.2 Decision Tree for Proteinuria
				4.4.3.3 Quantification of Proteinuria
				4.4.3.4 Further Diagnostics
				4.4.3.5 Biomarkers and Proteomics
			4.4.4 Stepwise Diagnostics of Hematuria
				4.4.4.1 Decision Tree for Hematuria
			4.4.5 Stepwise Diagnostics of Leukocyturia
				4.4.5.1 Decision Tree for Leukocyturia
				4.4.5.2 Further Diagnostics
				4.4.5.3 Tubulointerstitial Kidney Disorders
			4.4.6 Implementation of the Diagnostic Pathways in a Hospital and Laboratory Information System (HIS, LIS)
		4.5 Hematology – Introduction and Overview
			4.5.1 General Hematology
				4.5.1.1 Erythropoiesis
				4.5.1.2 Megakariopoiesis – Thrombopoiesis
				4.5.1.3 Leukopoiesis – Generation of Myeloid Cell Lines
				4.5.1.4 Lymphopoiesis
				4.5.1.5 Hematopoiesis Disorders
			4.5.2 Specialized Hematology – Pathologies, Disorders, Diagnosis, Differentiation
				4.5.2.1 Anemia
				4.5.2.2 Eosinophilia
				4.5.2.3 Hemolysis
				4.5.2.4 Monoclonal Gammopathy
				4.5.2.5 Leukocytosis
				4.5.2.6 Lymphocytosis
				4.5.2.7 Neutropenia
				4.5.2.8 Pancytopenia
				4.5.2.9 Polycythemia
		4.6 Coagulation disorders
			4.6.1 Diagnostic Pathways for Coagulation disorders
				4.6.1.1 Isolated aPTT Prolongation
				4.6.1.2 Isolated Quick Time Reduction
				4.6.1.3 Bleeding Diathesis
				4.6.1.4 Acute Venous Thromboembolism
				4.6.1.5 Heparin-induced Thrombocytopenia (Type 2 HIT)
				4.6.1.6 Thrombophilia
		4.7 Neurological Disorders
			4.7.1 Neurological Laboratory Diagnostics
				4.7.1.1 Characteristics of Neurological Laboratory Diagnostics
				4.7.1.2 Cerebrospinal Fluid Diagnostic Parameters
				4.7.1.3 Pre-analytics in Cerebrospinal Fluid Diagnostics
			4.7.2 Diagnostic Pathways and Procedures
				4.7.2.1 Clinical Spectrum and Underlying Guidelines from Clinical Professional Associations
				4.7.2.2 Acute Meningitis
				4.7.2.3 Opportunistic CNS Infections
				4.7.2.4 Suspected SAH/Bloody Cerebrospinal Fluid
				4.7.2.5 Radicular Syndromes
				4.7.2.6 Meningeal carcinomatosis
				4.7.2.7 Chronic Inflammatory CNS Disorders
				4.7.2.8 Inflammatory Cerebrospinal Fluid Syndrome of Unknown Origin
				4.7.2.9 Dementia Syndromes
				4.7.2.10 Wilson’s disease
			4.7.3 Authors and Working Group
				4.7.3.1 Spokesperson for the Working Group
				4.7.3.2 Members of the Working Group
				4.7.3.3 Objective of the Neurology Working Group
		4.8 Autoimmune disorders
			4.8.1 Rheumatoid Arthritis Diagnostics
				4.8.1.1 Diagnostic Scheme
				4.8.1.2 Additional Reflections on Differential Diagnosis
			4.8.2 Systemic Lupus Erythematosus
				4.8.2.1 Laboratory Diagnostics
				4.8.2.2 Reflections on Differential Diagnosis
		4.9 Allergy Diagnostics – Diagnostic Pathways
			4.9.1 Food Allergy Diagnostics
			4.9.2 Inhalation Allergy Diagnostics
			4.9.3 Insect Venom Allergy Diagnostics
			4.9.4 Drug Allergy Diagnostics
		4.10 Ejaculate Analysis and Quality Assurance in Male Fertility Laboratories
			4.10.1 Introduction
			4.10.2 Pre-analytics and Macroscopic Physical Examination of Ejaculate
			4.10.3 Microscopic Examination of Ejaculate
			4.10.4 Further Biochemical Testing of Ejaculate
			4.10.5 Quality Assurance in Ejaculate Analysis
Index