In previous classes, we discussed ordering laboratory tests to help with our differential diagnosis. I thought I was falling behind the curve because I didn’t fully understand everything on a Lipid Panel, Thyroid Panel, or a CBC with a differential. Much to my surprise, we have an entire class devoted to it called Laboratory Diagnosis. We are taking it concurrently with Physical Diagnosis, a class in which we put all of our physical exams together such as observation, palpation, vitals, heart exam, lung exam, reflexes, muscle tests, sensory tests, and EENT exams.
As I have previously mentioned, I am now in the Clinical Sciences Phase. These classes are taking what we have previously done and looking at the bigger picture. We are learning to put it all together and look at all these tests clinically. I am extremely excited about this trimester because I am finally seeing the bigger picture.
The first week of Lab Diagnosis we went through the CBC with and without a differential. It is essentially a blood cell count, and when ordered with a differential, the breakdown of white blood cells are also included. Every state in the U.S. allows doctors of chiropractic to order or analyze blood tests. The first test we talked about is the CBC also known as the “Complete Blood Count.”
(Image Source: KnowYourBlood.com)
These abbreviations and values meant nothing to me before I started this program. I now understand what the abbreviations mean and what the values mean clinically. A CBC can help us determine macrocytic anemia due to a B12 or Folic Acid deficiency. It could also help us understand microcytic anemia such as iron deficiency. Obviously there are other tests to determine nutrient deficiencies such as a serum iron test, however the CBC gives a broad set of information, and it can help immensely when determining a patient’s condition. Doctors of chiropractic can easily address these nutrient deficiencies through nutritional counseling and supplementation, which is also within the chiropractic scope of practice.
In addition to lab diagnosis, I am taking Phlebotomy Lab. I am learning to read blood tests and how to draw blood in the same trimester. It certainly makes one more engaged when we are learning the theory behind a physical practice, and I am thankful the faculty at NUHS understands that aspect. In some states, DCs can perform blood draws, and we must perform a certain amount of draws for graduation and licensure. The count starts this trimester. In the first class we practiced tying the tourniquet on one another. We also practiced the blood draw procedure with cucumbers. After sticking and bandaging cucumbers all day, we called it a day. Next week we do our first blood draws on one another.
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