First Module

67問 • 2年前

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Biologically important substance

Analytes

Clinical Chemistry is a _________________ because you will be concerned with the measurements of biologically important substances(Analytes) in body fluids.

Quantitative science

Common Analytes in the Clinical Chemistry Laboratory

Ions, salts and minerals, Small organic molecules, Large Macromolecules

Ions, Salts and Minerals

Potassium, Sodium, Calcium, Chloride, Phosphorus, Carbon dioxide, Lead, Iron

Metabolites

Glucose, Cholesterol, Urea, Lactic acid, Bilirubin, Creatinine, Tryglycerides, Ammonia, Cystatin C

Therapeutic Drugs

Vancomycin, Theophylline, Digoxin, Phenytoin, Valproic Acid

Toxicology

Alcohol, Salycylate, Acetaminophen

Drugs of Abuse (DOA)

Cocaine, Barbiturates, Amphetamines, Opiates, Cannabinoids

Trasport Proteins

Albumin, Haptoglobin, Ferritin

Enzyme

Lipase, Anylase Alanine, Aminotransferase, Aspartate Aminotransferase, Alkaline Phosphatase, Lactate Dehydrogenase, Creatine Kinase

Defense Proteins

Immunoglobulins, Complement C3, Complement C4

Lipoproteins

High Density Lipoprotein, Low Density Lipoprotein, Lipoprotein (a)

Protein

Hemoglobin A1c, C - Reactive protein

Large Macromolecules

Transport proteins, Enzyme, Defense proteins, Lipoproteins, Protein

May be done when neonates(newborn) are suffering from jaundice or patience who have problems with their liver

Bilirubin

Is routinely done in the laboratory

Creatinine

May not be routinely done; it is associated with liver problems

Ammonia

These are given to patients( administration of antibiotics such as vancomycin).

Therapeutic drugs

Therapeutic drugs for asthmatic patients

Theophylline

Therapeutic drugs for the heart

Digoxin

Therapeutic drugs for mental/psychological disorders

Penythoine

Level for drunk patients

Alcohol

Are drugs that are associated with overdose(under toxicology).

Salicylate, Acetaminophen

Are requested if thr patient is severely anemic

Trasferin, Asperitin

Are secreted(at an abnormal amount) by cell in times of injury or cellular destruction.

Enzymes

Associated with immune systems; some laboratories would have this under clinical chenistry but some would have it under immunology

Defense proteins

Are run together with cholesterol and tryglyceride

Lipoproteins

Is usually run together with glucose for determination of diabetes

Hemoglobin A1c

A test associated with Rheumatoid Arthritis and other immune disorders

CRP

Substance being run together to determinr the condition of the patient

Combination of test (panels)

Electrolyte Panel

Sodium, Potassium, Chloride, Carbon dioxide

Hepatic Panel (Liver Profile)

Albumin, Total protein, Alkaline, Phosphatase, Alanine, Aminotransferase, Asparate aminotransferase, Total bilirubin, Direct bilirubin

Comprehensive Metabolic Profile

Sodium, Potassium, Chloride, Carbon dioxide, Glucose, Creatinine, Urea, Calcium, Total protein, Albumin, Alanine, Aminotransferase, Alkaline phosphatase, Total bilirubin

Basic Metabolic Panel

Sodium, Potassium, Chloride, Carbon dioxide, Glucose, Creatinine, Urea

Lipid Profile

Total cholesterol, LDL cholesterol, HDL cholesterol, Trigylcerides

Combination of Tests (Panels)

Electrolyte panel, Hepatic panel, Comprehensive metabolic profile, Basic metabolic panel, Lipid profile

The most common biologic fluid collected for clinical laboratory testing

Blood

Where is blood usually contained after being drawn from a vein?

Evacuated tube

It is convenient if you have several test because you can change the tube that would be required for a particular analyte, as syringe limits you according to its capacity.

Vacutainer set

How many ml of blood can you only collect from a baby patient

1 ml of blood

The difference in fluid characteristics are termed as?

Matrix differences

Other biological fluids used for testing aside from blood

Urine, Saliva, Cerebrospinal fluid, Amniotic fluid, Synovial fluid, Pleural fluid, Peritoneal fluid, Pericardial fluid

It is the ideal specimen for clonical chemistry because it has a few interferenfes when compwre with plasma.

Serum

Presence of Plasma means that there is an _________________.

Anticoagulant

True/False: Clotting require atleast 10-30 minutes at room temperature

True

Silica speeds the clotting process compared to no activator

Silica clot activator

Speed clotting profess significantly to produce serum in several minutes. Used mostly for urgent(STAT) testing.

Thrombin

Prefered plasma sample for most chemistry test/ not suitable when testing for lithium

Lithium heparin

Used when testing for lithium. Not suitable when testing for sodium

Sodium heparin

EDTA stands for

Ethylene Diamine Tetra Acetic acid

A sodium or potassium salt which is cassionally used for some chemistry tests and typically used for hematology

EDTA

For glucose testing. It inhibits metabolism of glucose by white blood cells

Sodium fluoride

COLLECTION TUBES(Based on the order of draw)

Light Blue, Red, Green, Lavender/purple, Gray, Brown and royal blue, Gold and tiger

Common Metabolites

Glucose, Cholesterol, Urea

Specialized Metabolites

Lactic acid, Bilirubin, Creatinine

•contain sodium citrate, which chelates calcium and inhibits coagulation • Used for coagulation studies because it is easily reversible.

Blue-top tube

•Contain no anticoagulants or preservatives •Red-top tubes are used for collecting serum -10-15 minutes is required to allow blood to clot before centrifuging -Used for blood bank specimens, some chemistries

Red-top tube

•contain either the Na, K, or lithium (Li) salt of heparin. Most widely used •anticoagulant for chemistry tests. I - Should not be used for Na, K or Li measurement - Can effect the size and integrity of cellular blood components and not recommended for hematology studies -Heparin accelerates the action of antithrombin III, which inhibits thrombin, so blood does not clot (plasma) -The advantage of plasma is that no time is wasted waiting for the specimen to clot

Green-top tube

•contain the K salt of ethylenediaminetetraacetic acid (EDTA), which chelates calcium (essential for clot formation) and inhibits coagulation • Used for hematology, and some chemistries • Cannot be used for K or Ca tests

Lavender-top tube

• Used for Glucose measurement. • After blood collection, glucose concentration decreases significantly because of cellular metabolism •Gray-top tubes contain either: - Sodium fluoride Ind potassium oxalate, or - Sodium iodoacetate •Both preservatives stabilize glucose in plasma by inhibiting enzymes of the glycolytic pathway - NaF/oxalate inhibits enolase - lodoacetate inhibits glucose-3-phosphate dehydrogenase

Gray-top tube

are specially cleaned for trace metal studies

Brown-top tube, Royal blue-top tube

Tubes that are used for lead (Pb) analysis

Brown-top tube

Tubes that are used for other trace element studies (acid washed)

Royal blue-top tube

•contain a gel that forms a physical barrier between the serum and cells after centrifugation • No other additives are present Gel barrier may affect some lab tests

Gold-top tube, Tiger-top tube

•found at virtually all hospitals •operates 24h day 7 days a week to •provide theessential most requested tests •Highly automated environment •Instruments with Multi-analyte capabilities

Core lab facility

•less frequently ordered tests •labour intensive and often manual methods •generally non-stat tests (result not required immediately)

Special chemistry

Instruments located outside of chemistry laboratory such as CCU, ER, ICU or satellite centre (clinic)

Point of care testing

Translation(Pre-finals)

MAHATHIR ALPHA · 55問 · 2年前

Translation(Pre-finals)