CHEMICAL PATHOLOGY

Chemical Pathology not only brings together science and medicine, it relates to all the medical specialities. Chemical Pathologists are frequently consulted about further investigation or management of patients found to have biochemical abnormalities on 'routine' testing. They frequently have to deal with investigating patients with dyslipidaemias, diabetes and hypertension, review ward patients receiving artificial nutrition, discuss the introduction of a new diagnostic test with consultant colleagues, review the quality of the laboratory's analytical service and manage research projects of trainees. (Adapted from Dr William Marshall.) Under application of biochemical techniques can be listed the following: • Diagnosis: tests can be used to help differentiate between various possibilities in the differential diagnosis based on the initial history and examination when the patient first presents. • Screening: detection of disease before it is clinically evident, e.g. testing all infants at birth for a specific inherited disease (phenylketonuria, thyroid deficiency) • Monitoring: following the progression of disease processes, checking against adverse drug effects (e.g. hypokalaemia with diuretic therapy), or response to therapy (glucose levels in diabetes mellitus). • Prognosis: providing information on disease susceptibility, e.g