Essentials of CLINICAL PATHOLOGY
Essentials of CLINICAL PATHOLOGY
Third Edition
Shirish M Kawthalkar MBBS MD (Pathology)
Associate Professor Department of Pathology Government Medical College
Nagpur, Maharashtra, India
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Essentials of Clinical Pathology
First Edition: 2010
Reprint 2012; 2017
Second Edition: 2018
Third Edition: 2023
9789356961616
Printed at
In the third edition of Essentials of Clinical Pathology, I have continued to modify the content based on rapidly changing health care environment. This edition is not an all-inclusive book on medical laboratory science but is a balance between curriculum and commonly performed laboratory tests in clinical pathology. This book is written mainly for undergraduate and postgraduate students of pathology and for medical laboratory technology. As technology is rapidly evolving, students of medicine and health care professionals are faced with a constantly changing armamentarium of diagnostic laboratory tests. Judicious use of laboratory tests cost-effectively improves quality of patient care by objective determination of presence/absence of disease, extent of disease, prognosis, and monitoring effectiveness of therapy. The aim of this book is to provide medical students and students of medical laboratory technology basics as well as most recent information in medical laboratory science which will be of help in their examinations and also for pathologists in their day-to-day practice.
Any errors in this book are the responsibility of the author and the author would appreciate being notified when such errors are detected.
At Jaypee Brothers Medical Publishers (P) Ltd, I have been ably guided and supported by Shri Jitendar P Vij (Group Chairman), Shri Ankit Vij (Managing Director), and their fantastic team whose patience and professionalism have made the whole process an enjoyable journey.
I am thankful to Respected Dr. Raj Gajbhiye, Dean, Govt. Medical College, Nagpur and Dr Archana Deshpande, Professor and Head, Department of Pathology, Govt. Medical College, Nagpur for their encouragement and support.
At home, my mother, who sadly passed away recently, greatly influenced the righteous, truthful, and honest choices I have made. My father and my wife, Dr Anjali have been unstinting in their support and encouragement. I am grateful to have an amazing and incredible family comprising also of my sons Dr Ameya and Dr Ashish, my daughter in law Dr Mrunmayee, and my beloved twin grand-daughters Veeha and Viaana.
Shirish M Kawthalkar
Preface to the First Edition
The major aims of this book are discussion of: (i) use of laboratory tests in the investigation and management of common diseases, and (ii) basic biochemical and pathological principles underlying the application of laboratory tests. The book has been written keeping in mind mainly the curricula of undergraduate students of pathology. It should also prove to be appropriate for postgraduate residents and students of medical laboratory technology. The laboratory tests that are demonstrated to and performed by medical students in pathology practical class and during university examination are given in more detail. To keep pace with new knowledge and advances, principles of currently performed techniques in clinical laboratory practice have also been outlined. Most of the chapters are followed by reference ranges and critical values for ready access. Critical values or action values are those laboratory results that require immediate attention of the treating clinician. While interpreting results of laboratory tests, it is necessary to follow two fundamental rules of laboratory medicine: (i) diagnosis should never be made from a single abnormal test result (since, it is affected by a number of preanalytical and analytical factors), and (ii) try to arrive at a single diagnosis (rather than multiple diagnoses) from all the abnormal test results obtained.
Clinical pathology is the second major subdivision of the discipline of pathology after anatomic pathology. It is concerned with laboratory investigations for screening, diagnosis, and overall management of diseases by analysis of blood, urine, body fluids, and other specimens. The specialties included under the discipline of clinical pathology are clinical chemistry, hematology, blood banking, medical microbiology, cytogenetics, and molecular genetics. However, scope of this book does not allow microbiology and genetics to be included in this book.
I must appreciate and recognize the unstinting support of my parents, my beloved wife Dr Anjali, and my two children, Ameya and Ashish during preparation of this book. I am thankful to Dr HT Kanade, Dean, Government Medical College, Akola; Dr Smt Deepti Dongaonkar, Dean, Government Medical College, Nagpur; Dr BB Sonawane, Professor and Head, Department of Pathology, Government Medical College, Akola, and Dr WK Raut, Professor and Head, Department of Pathology, Government Medical College, Nagpur, for encouraging me in undertaking this project for the benefit of medical students.
I express my thanks to Shri Jitendar P Vij and his outstanding team of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for undertaking to publish this book, being patient with me during the preparation of the manuscript, and bringing it out in an easy-to-read and reader-friendly format.
Although I have made every effort to avoid any mistakes and errors, some may persist and feedback in this regard will be highly appreciated.
Shirish M Kawthalkar