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Semester 2 > Clinical Chemistry > Flashcards

Clinical Chemistry Flashcards

(75 cards)

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1
Q

Clinical Chemistry: Definition

A

biochemical analysis of bodily fluids for diagnostic and therapeutic purposes

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2
Q

Homeostatic Disorders:

A

acid-base balance
fluid and electrolyte balance

Homeostatic disorders are conditions where the body’s internal environment, or homeostasis, is disrupted, leading to various health problems

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3
Q

Endocrine Disorders:

A

hypersecretion
hyposecretion
hormone resistance

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4
Q

Inherited / Genetic Disorders:

A

Inherited / Genetic Disorders:
enzyme deficiency
receptor deficiency

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5
Q

Nutritional Disorders:

A

Nutritional Disorders:
nutrient deficiency
nutrient excess

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6
Q

Homeostatic Disorders

A

Syndrome of inappropriate antidiuretic hormone ADH release (SIADH) is a condition defined by the unsuppressed release of antidiuretic hormone (ADH) from the pituitary gland or nonpituitary sources or its continued action on vasopressin receptors.

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7
Q

Blood Fluid Homeostasis

A

flowchartr

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8
Q

Syndrome of Inappropriate ADH Secretion (SIADH)

A

Causes:
malignancy eg lung cancer ( the state or presence of a malignant tumour)
drugs eg chloropropamide

Consequence:
inappropriate ADH secretion

Clinical: (Observation)
low urine output
low blood sodium (hyponatraemia)

Treatment:
restrict water intake
treat underlying cause

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9
Q

Endocrine Disorders

A

Diabetes Mellitus

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10
Q

Blood Glucose Regulation

A

Flowchart

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11
Q

Diabetes Mellitus causes treatments clinical and treatment

A

Causes:
inadequate insulin secretion
insulin resistance

Consequence:
high blood glucose

Clinical:
polyuria / polydipsia
eye disease
kidney damage
delayed wound-healing
infections
nervous tissue damage
heart attacks / stroke

Treatment:
insulin therapy
dietary

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12
Q

Inherited / Genetic Disorders

A

Glucose-6-Phosphatase Deficiency

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13
Q

Glucose-6-Phosphatase Deficiency Causes consequence treatment clinical

A

Cause:
genetic defect

Consequence:
glucose-6-phosphatase deficiency

Clinical:
hypoglycaemia
hepatomegaly
lactic acidosis

Treatment:
frequent intake of glucose

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14
Q

Nutritional Disorders

A

Vitamin D Deficiency

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15
Q

Vitamin D deficiency Causes consequence treatment clinical sources function

A

Sources:
food
skin (by action of sunlight)

Functions:
absorption of calcium
absorption of phosphate

Causes:
dietary deficiency
lack of sunlight
malabsorption

Consequence:
decreased bone mineralisation

Clinical:
bone pain
loss of height
bone deformation
rickets (children)
osteomalacia (adults)

Treatment:
vitamin D supplementation
treat cause

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16
Q

Concept of Disease

A

Cause ➡ Disease
- Signs, symptoms, Biochemical, cellular, Microbial

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17
Q

Patient Investigation

A

1) Clinical History
2) Clinical examination
3) Provisional diagnosis
4) Diagnostic services - Medical physics, Radiology,
5) PATHOLOGY- haematology, histopathology, microbiology, biochemistry

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18
Q

Pathology Services

A

1) Medical Microbiology
2) Haematology / Transfusion Science
3) Cellular Pathology (Histopathology)
4) Immunology
5) Virology
6) Clinical Biochemistry
- clinical chemistry
- chemical pathology
- medical biochemistry

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19
Q

Role of Biochemical Tests nd examples of the diseases they find

A

Diagnosis:
diabetes mellitus

Screening: (healthcare professionals assess healthy individuals to detect potential diseases or conditions before they cause symptoms)
phenylketonuria

Monitoring Treatment:
diabetes mellitus

Prognosis: (an opinion, based on medical experience, of the likely course of a medical condition.)
renal failure

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20
Q

Biochemistry Laboratory

Test repertoire

A

A “test repertoire” refers to the collection or selection of tests that a laboratory or medical facility is capable of performing. It’s essentially the “menu” of diagnostic tools available for use.

Test Repertoire:

core tests
eg electrolytes, urea, glucose, bilirubin

specialised tests
eg trace elements, vitamins, drugs

emergency tests
eg blood gases, salicylate, paracetamol

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21
Q

Biochemistry lab Workload:

A

specimens per day: 200-400

tests per specimen: 1-10

tests per year: ~500,000

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22
Q

Biochemistry lab sections

A

Sections:

reception
automated
emergency
metabolic
endocrine
toxicology
paediatric
specialized / manual
computing
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23
Q

Biochemistry Laboratory specimens

A

Specimens:

venous blood (plasma / serum)
arterial blood
urine
faeces
cerebrospinal fluid
gastrointestinal fluid
kidney stones
tissues / cells
saliva

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24
Q

Biochemistry Laboratory staff

A

Medical: Chemical Pathologists

Scientific: Clinical Scientists

Technical: Biomedical Scientists

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25
Biochemistry Laboratory Career grades
Career grades: Medical Scientific Technical consultant consultant BMS 4 senior registrar principal BMS 3 registrar senior BMS 2 senior HO trainee BMS 1 trainee
26
Biochemistry Laboratory staff roles
Staff Roles: technical / routine clinical validation clinical liaison research / development clinical eg diabetes / lipid clinics management / administration teaching / training
27
What do biochemical investigations do?
Biochemical investigations assist clinical decision making but do not replace them
28
Process of Getting a Test Result
1) Clinical question 2) Request form with clinical data 3) Patient sampled 4) Transit to lab 5) Reception and id 6) Analysis 7) Quality control 8) Collation 9) Interpretation 10) Reporting 11) Biochemical answer
29
What is internal quality control
Internal Quality Control (IQC) is a process where a laboratory continuously monitors its own operations and results to ensure the reliability of test results before they are released to patients
30
What is external quality control
External Quality Control (EQC), also known as External Quality Assessment (EQA) or proficiency testing, evaluates laboratory testing results by comparing them to those of other laboratories, ensuring accuracy and reliability.
31
What is meant by accredition
Medical accreditation demonstrates that healthcare providers have undergone a rigorous process to ensure high-quality services, delivered by competent staff in safe environments, and is a key tool for supporting commissioning decisions and improving patient care.
32
Analytical Methods Purpose
Purpose: - To measure biological analytes in pathology specimens - Results help in diagnosis, screening, prognosis and monitoring treatment
33
Analytical Method: Meaning
Analytical Method: a set of instructions which describe the procedure, materials and equipment necessary to obtain a result
34
Calibration: Meaning
Calibration: The process of relating the value indicated on the scale of an instrument or analytical device to the quantity required to be measured
35
Standard: Meaning
Standard: A material or solution with which the sample is compared in order to determine a result
36
Blank: Meaning
Blank: This is treated exactly as a sample or standard but does not contain the analyte to be measured and used to zero instruments
37
Control: Meaning
Control: A material or solution which contains a known quantity of the analyte of interest and is used for quality control purposes
38
What should Analytical Methods have
- Reliability - Practicality
39
Analytical Methods: Reliability The test results obtained are subject to what?
Test results obtained subject to: - analytical variation - biological variation
40
What is Accuracy
Accuracy: this is the ability of a method to give results which are close to the true value of the substance being measured
41
What is precision
Precision: this is the ability of a method to provide the same value every time the method is used to measure a particular analyte in the same specimen
42
What is the meaning of sensitivity
Sensitivity: this is the ability of a method to detect small amounts of the analyte
43
What is meant by limitation of detection
Limit of Detection: the smallest amount of the analyte that can be distinguished from the blank
44
What is meant by specificity
Specificity: this is the ability of a method to detect only the test substance
45
Biological Variation meaning
Biological variation refers to the natural differences observed within and between individuals of the same species, whether those differences are caused by genetic factors or environmental influences.
46
Biological variation Affected by?
Affected by: sex age diet time of day posture stress exercise menstrual cycle drugs
47
Analytical Methods: Practicality# What are the methods assessed for?
speed cost skill requirements dependability safety
48
2 Types of Techniques
Separation chromatography electrophoresis Detection colorimetric: spectrophotometry immunoassay: radioimmunoassay enzyme-linked immunoassay
49
Separation Techniques Purpose
- to separate out analyte of interest from a mixture - to check purity of analyte of interest
50
Separation Techniques: Principle
TABLE CHECK
51
Chromatography: Principle What is the stationary or mobile phase
Dual phase technique: stationary phase: solid liquid mobile phase: liquid gas
52
What is Partition or distribution coefficient (Kd):
concentration in mobile phase/ = Kd concentration in stationary phase
53
2 Types of chromatography
- planar chromatography - column chromatography
54
Thin Layer Chromatography
Principle: - differences in adsorption of analytes Procedure: - sample application - development - detection Advantages: - speed - cost - simplicity Disadvantages: - not quantitative
55
Column Chromatography Principle
Principle: mobile phase passes through stationary phase and analytes separated separation based on differences in charge, size or shape separated components leave column in eluant and collected
56
Column Chromatography Procedure
Procedure: sample application running of column sample collection
57
Electrophoresis: Principle
Separation due to differences in migration of charged molecules in response to an applied electric field
58
Electrophoresis formula and how is mobility determined
Electrophoretic mobility (µ) is determined by charge to mass ratio: µ = qE/ r q = net molecular charge r = molecular radius E = field strength
59
Factors affecting electrophoresis:
net charge on molecule size of molecule voltage of electric field
60
Types of Support Medium: Inert Cellulose acetate:
Cellulose acetate: provides physical support does not absorb proteins separation based on charge density
61
Types of Support Medium: Porous Agarose:
Agarose: gel with pores of variable size separation based on molecular size good resolution
62
Electrophoresis: Procedure
sample application electrophoresis of sample using kit staining of separated components
63
Spectrophotometry: Principle
Molecules in solution absorb light of a characteristic wavelength
64
What is Beer-Lambert Law
Beer-Lambert Law: absorption of light by molecules in solution is related to their concentration and length of light path through absorbing medium: A = Ecl A = absorbance E = molar absorption coefficient (Lmol-1 cm-1) c = concentration (mol/L or g/L) l = light path (usually 1 cm)
65
Colorimetric Methods: Requirements
analyte should absorb light of specific wavelength or be converted to substance that can pure analyte required for standards wavelength of light at which there is maximum absorbance is determined relationship between absorbance and concentration must obey Beer-Lambert law
66
Colorimetric Methods: Advantages
speed low cost automation wide application
67
Using Colorimeters
1: switch on at least 10 minutes before use to allow instrument to warm up and stabilise 2: set the correct wavelength 3: use the same cuvette for blank, standards and samples 4: do not overfill cuvette ie more than 2/3 the way up 5: gently wipe outside of cuvette to clean and dry
68
Using Colorimeters 2
6: no air bubbles or particulate matter should be present in solutions 7: insert cuvettes correctly with their polished (transparent) surface facing the light path 8: zero the instrument with the blank 9: measure absorbance of standards starting with the lowest concentration first and highest last 10: check instrument is set to zero by inserting blank at regular intervals
69
Using Colorimeters 3
11: if method obeys Beers law then use linear part of graph to determine unknowns drawing line of best fit 12: if values for unknowns do not fall on linear part of graph then dilute original solutions, repeat analysis and multiply new unknowns by dilution factor
70
Colorimeter: Components
Lamp Lens Monochromator Sample Cuvette Detector Amplifier Readout
71
Application of Colorimetry: Renal Disease
associated with a decline in functioning nephrons decreased removal of waste products decreased removal of creatinine causes build-up of serum creatinine creatinine reacted with chemical reagents eg picrate to give coloured products that absorb light serum creatinine measurements useful in prognosis of renal failure
72
Application of Electrophoresis: Multiple Myeloma
malignant proliferation of plasma cells in bone marrow cells from a single clone make identical immunoglobulins immunoglobulins detected as a discrete paraprotein band on electrophoresis used for diagnosis of multiple myeloma
73
Application of Column Chromatography: Diabetes Mellitus
defective production or action of insulin causes hyperglycaemia hyperglycaemia responsible for acute symptoms hyperglycaemia responsible for chronic complications hyperglycaemia causes excessive glycation of haemoglobin measurement of glycated haemoglobin by column chromatography used to monitor treatment of diabetes mellitus
74
Application of TLC: Phenylketonuria
inherited absence of phenylalanine hydroxylase inability to convert phenylalanine to tyrosine phenylalanine therefore accumulates and is toxic to developing brain lack of tyrosine results in lack of thyroid hormones, catecholamines and melanin high serum phenylalanine detected by TLC used for screening of PKU
75

Semester 2 (18 decks)

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