CLIN CHEM Flashcards
It is the branch of medical science involved in the analysis of biological materials , usually bodily fluids, to provide diagnostic results on the state of human body
Clinical Chemistry
Basic analytical Techniques
Spectrophotometry
Nephelometry
Turbidimetry
Electrophoresis
Flame emission spectrophotometry
Atomic absorption spectrophotometry
The measurement of the intensity of light at selected wavelengths
Spectrophotometry
A useful analytical tool to determine the concentration of colored material in a solution
Spectrophotometry
Uses prisms or gratings to isolate a narrow range of wavelength of light
Spectrophotometry
2 kinds of light that spectrophotometry employs
Visible Light
Invisible Light
VISIBLE LIGHT
Ultraviolet light = < 400 nm
INVISIBLE LIGHT
Infrared light = > 700 nm
scatter light
Monochromator
amount of color changed
Cuvette
amount of light
Digital Display
Not commonly used
Light scattered by an unknown substance is
measured at right angles
Nephelometry
Depends on wavelength and particle size
Nephelometry
Measures the amount of light blocked
(absorbance) by a suspension of particles
Turbidimetry
Depends on particle size and concentration
Turbidimetry
Charged molecules moves at different rates when pulled through an electrical field
Electrophoresis
Cations (positively charged ions) will move to ____
cathode (negative electrode)
Anions (negatively charged ions) will move to ____
anode (positive electrode)
Measures light emitted by excited atoms
Measures electrolytes
Flame Emission Spectrophotometry
Certain elements give off a characteristic light after excited atoms return to ground state
Flame Emission Spectrophotometry
– intense yellow flame
Sodium
violet flame
Potassium
– brick red flame
Calcium
Measures light absorbed by ground state atoms
Atomic Absorption Spectrophotometry
Routinely used to measure the concentrations
of trace metals
Atomic Absorption Spectrophotometry
the usual light source employed in atomic absorption spectrophotometry
Hollow cathode lamp
Routinely tested clinical chemistry assays
Blood glucose
Blood lipid profile
Kidney (renal) function tests
Liver function test
Cardiac function test
the primary source
of energy for humans
Glucose (carbohydrates)
Short-term storage sites of glucose
Liver and Skeletal
muscles
Long-term storage sites of glucose
Adipose tissues
low sugar level
Hypoglycemia
high sugar level
Hyperglycemia
Defect in the beta cells of the pancreas
DIABETES MELLITUS
Leads to a decrease in the production of insulin (a hormone necessary to maximize the utilization of glucose for energy production)
DIABETES MELLITUS
excessive urination
Polyuria
excessive thirst
Polydipsia
excessive eating
Polyphagia
TESTS TO BE DONE: DIABETES MELLITUS
- 6 – 8 hours fasting prior to blood collection
Fasting blood sugar (FBS)
TESTS TO BE DONE: DIABETES MELLITUS
- extracting capillary blood
Random blood sugar (RBS)
TESTS TO BE DONE: DIABETES MELLITUS
- pregnant women - ingest glucose - extract blood-
- For pregnant women to rule out cases of gestational diabetes
Oral glucose tolerance test (OGTT)
TESTS TO BE DONE: DIABETES MELLITUS
- collected after 2 hours
2-hour post-prandial blood sugar (2HPPBS)
TESTS TO BE DONE: DIABETES MELLITUS
- Monitoring tool for long-term diabetes
- To determine if diabetes has been existing for several months already (long-term diabetes)
- It reflects the average blood glucose over a three-month period
Glycosylated hemoglobin (HBA1C)
Glycosylated hemoglobin (HBA1C) is measured through
affinity chromatography
organic substances characterized by their general insolubility in water a
Lipids
Regarded as fat
Lipids
1 gram of lipid = _kcal of heat
9
secondary energy source
lipids
Important constituent of cell membrane
lipids
Classifications of lipids
Fatty acids
Triglycerides (Triacyglycerol)
Cholesterol
Phospholipids
Lipoproteins
Simplest form of lipids but not routinely measured
Fatty acids
lipids solid at room temperature
saturated
lipids that are liquid at room temperature.
Unsaturated
Good fats
unsaturated
neutral fats consisting of fatty acids and glycerol
Triglycerides (Triacyglycerol)
Act as the storage form of lipids in the human body
Triglycerides (Triacyglycerol)
When serum samples turned turbid from blood collected after a meal, it is due to the presence of __________
Triglycerides
prevents turbidity
fasting
An example of a steroid alcohol
Cholesterol
Necessary for the production of various hormones, vitamin D, and even bile salt which is necessary for fat digestion
Cholesterol
Measurement is usually requested in conjunction of _____
CVD - Cardiovascular Disease
Most abundant form of lipids but not routinely measured
Phospholipids
Phospholipids: 70%
lecithin
Phospholipids: 20%
sphingomyelin
Phospholipids: 10%
cephalin
an important parameter to determine fetal-lung maturity
Used to evaluate the safety of a pre-term delivery
Lecithin/sphingomyelin (L/S) ratio
Lipid transporters
Lipoproteins
Classified based on their density or through electrophoresis
Generally, as protein content increases, the lipid content decreases, making it smaller but denser
Lipoproteins
Types of Lipoproteins
HDL
VLDL
LDL
CHYLOMICRONS
alpha-lipoprotein
HDL (High Density Lipoprotein)
“good cholesterol”
alpha-lipoprotein
Transports cholesterol back to the liver for the synthesis of bile salts and very low density lipoprotein (VLDL)
alpha-lipoprotein
Smallest but the heaviest
alpha-lipoprotein
High levels of HDL suggest decreased risk of developing ________
atherosclerosis
Smallest but the heaviest type of lipoprotein
HDL
Pre-beta lipoprotein
VLDL
Transports endogenous triglycerides to the muscle and adipose cells
VLDL
Beta-lipoprotein
“bad cholesterol”
LDL
Transports cholesterol to peripheral tissues
LDL
Increased levels suggest risk of developing atherosclerosis
LDL
Transport exogenous triglycerides to adipose tissue and cells
Chylomicrons
Increased amount of lipids
Can be genetic
lipemia
Person did not undergo fasting
Chylomicrons
paired organs considered as the body’s major “waste sweeper”
Kidneys
functional unit of kidneys
Forms urine
Nephron
Nephron forms urine through four major process:
Glomerular filtration
Tubular reabsorption
Tubular secretion
Tubular concentration
Waste product of muscle metabolism
Derived from creatine phosphate (stored in the muscles and is used for energy)
CREATININE
Waste product of protein catabolism
90% is excreted in the urine
BLOOD UREA NITROGEN (BUN)
Elevation of blood urea nitrogen
Azotemia
Elevation of blood urea nitrogen
If accompanied by renal failure, it is termed _________
uremia
Starvation, pregnancy and a low protein diet
Low BUN
high protein diet, after administration of steroids and kidney diseases
High BUN
Used to check how well the kidneys are working
GLOMERULAR FILTRATION RATE (GFR)
Estimates how much blood passes through the glomeruli each minute
GLOMERULAR FILTRATION RATE (GFR)
Recommended for:
CKD caused by diabetes
Family history of kidney diseases
Frequent UTI
Heart disease
High blood pressure
Urinary blockage
GLOMERULAR FILTRATION RATE (GFR)
much more accurate than BUN
No need to collect urine sample
Renal Scan
Organ responsible for the synthesis of many organic substances
Liver
Detoxifies the body against noxious substances
Liver
Brownish yellow substance found in the bile
Produced when the liver breaks down old red blood cells
BILIRUBIN
Removed from the body through the stool (feces)
Gives stool its normal color
BILIRUBIN
Water-insoluble bilirubin
Toxic bilirubin and its accumulation in the brain may lead to kernicterus
B1 or indirect or unconjugated bilirubin
Water-soluble bilirubin
Eliminated in the urine and makes it appear dark-yellow
B2 or direct or conjugated bilirubin
SGOT – Serum Glutamic Oxaloacetic Transaminase
Tissue sources: liver, heart, skeletal muscle, kidney, pancreas, brain, spleen and lungs
Aspartate aminotransferase (AST)
SGPT – Serum Glutamic Pyruvic Transaminase
Tissue sources: liver, heart, skeletal muscle, kidney and pancreas
Considered as a liver-specific enzyme and is increased in cases of hepatic disorders
Alanine aminotransferase (ALT)
Helps identify the cause of hepatic disorders
De Ritis Ratio (ALT/AST ratio)
Useful in the diagnosis of bone and liver diseases
Alkaline Phosphatase (ALP)
Useful in the diagnosis of chronic alcoholism resulting in liver damage
Gamma-glutamyl transferase (GGT)
Useful in the assessment of insecticide and pesticide poisoning
Cholinesterase
Measures the total amount of protein in the blood
TOTAL SERUM PROTEIN TESTS
Made mainly in the liver
Helps keep the blood from leaking out of the blood vessels
Helps carry some medicines and other substances through the blood
Important for tissue growth and healing
Albumin
Group of proteins in the bloodstream that help regulate the function of the circulatory system
Globulin
Refers to the low total protein level in the blood
Hypoproteinemia
Suggestive of liver disorders, kidney disorders or a disorder in which protein is not digested or absorbed properly
Hypoproteinemia
Refers to the high total protein level in the blood
Hyperproteinemia
May be seen with chronic inflammation or infections such as viral hepatitis or HIV
Hyperproteinemia
Test of plasma clotting activity
PROTHROMBIN TIME (PT)
Reflects the activity of vitamin K-dependent clotting factors synthesized by the liver
PROTHROMBIN TIME (PT)
Reflects the activity of vitamin K-dependent clotting factors synthesized by the liver
PROTHROMBIN TIME (PT)
To evaluate whether one’s heart is healthy or not
Patient’s who experienced episodes of myocardial infarction as manifested by chest pain
Cardiac Function tests
Most sensitive and specific test for myocardial damage
Isoforms of the proteins T and I are specific to myocardium
Expected to peak 12 hours after infarction
Troponin test
Along with troponin, ordered as a cardiac biomarker to help diagnose or rule out a heart attack
Increase later than troponin but not specific and will not stay elevated for long as troponin
Myoglobin
Rise: 2 – 3 hours ;
Peak: 8 – 12 hours ;
Normalized: 24 hours
Myoglobin
A biomarker indicative of an inherent cancerous condition
Tumor markers
tumor marker are also called…
special chemistry tests
tumor marker are also called…
special chemistry tests
tumor marker are also called…
special chemistry tests
tumor marker are also called…
special chemistry tests
tumor marker are also called…
special chemistry tests
tumor marker are also called…
special chemistry tests
tumor marker are also called…
special chemistry tests
hepatocellular carcinoma
AFP (Alpha-fetoprotein)
gastrointestinal cancer
CEA (Carcinoembryonic antigen)
prostate cancer
PSA (Prostate Specific Antigen)
gestational trophoblastic disease
hCG (Human Chorionic Gonadotropin)
neuroendocrine tumor
NSE (Neuron Specific Enolase)
ovarian cancer
CA 125
pancreatic cancer
CA 19-9
breast cancer
CA 15-3
medullary thyroid carcinoma
Calcitonin
smooth muscle carcinoma
Desmin
