Introduction to Clinical Chemistry Flashcards
It is a branch of laboratory medicine that is concerned with the quantitative measurement of analytes in body fluids to facilitate the diagnosis of diseases.
Clinical Chemistry
What are the analytes?
Proteins
Enzymes
Metabolites
Drugs
Ions
Salts
Minerals
Clinical Chemistry is a _____ Science
Quantitative
Clinical Chemistry is concerned with measurement of amounts of biologically
important substances called _____ in body fluids.
Analaytes
The results that are obtained from such measurements of a Clinical Chemistry Test are compared to reference intervals or an _____ to provide diagnostic and clinical meaning for the values.
Medical Decision Level (MDL)
Clinical Chemistry serves as a _____ because it links the knowledge of General Chemistry, Organic Chemistry, and Biochemistry with an understanding of Human Physiology
Science
Clinical Chemistry serves as a _____ because it produces objective evidence from which medical decisions may be made
Service
Clinical Chemistry serves as a _____ because clinical laboratories are businesses, which operate under the regulations and practices that guide commerce in the
United States.
Industry
Scope of Clinical Chemistry
Computers
Biochemistry
Instrumentation
Pharmacology
Endocrinology
Immunology
Toxicology
Analytical Chemistry
List down the Core Test done in the Clinical Chemistry Section:
Glucose
Renal Function Test
Liver/Hepatic Function Panel
Lipid Profile
Enzymes
Electrolytes
What is detected on the Glucose Testing in Clinical Chemistry?
Diagnosis of Diabetes Mellitus
What is detected on the Renal Function Tests in Clinical Chemistry?
Urea
Creatinine
Uric Acid
What is detected on the Liver/Hepatic Function Panel in Clinical Chemistry?
Bilirubin
Albumin
Total Protein
ALP
AST
ALT
What is detected on the Lipid Profile in Clinical Chemistry?
Total Cholesterol
Triglyceride
HDL
LDL
What test is done to diagnose heart diseases and stroke?
Lipid Profile Test
What is detected on the Enzyme Testing in Clinical Chemistry?
Amylase
Lipase
Creatinine Kinase
What is detected on the Electrolyte Testing in Clinical Chemistry?
Na (Sodium)
K (Potassium)
Cl (Chlorine)
List down the Specialized Test in Clinical Chemistry Section:
Hormones
Specific Proteins
Trace Elements
Vitamins
Drugs
Lipoprotein
What type of test is less frequently performed, cost prohibitive, and is usually sent out to bigger laboratories with strict preparation guideline?
Specialized Test
Example of Metabolites Small Organic Molecules:
Glucose
Cholesterol
Uric Acid
Example of Therapeutic Drugs Small Organic Molecules:
Vancomycin
Theophylline
Digoxin
Example of Toxicology Small Organic Molecules:
Alcohol
Salicylate
Acetaminophen
Example of Drugs of Abuse Small Organic Molecules:
Cocaine
Barbiturates
Amphetamine
Classifications under the Small Organic Molecules:
Metabolites
Therapeutic Drugs
Toxicology
Drugs of Abuse
Classification under Large Molecules:
Transport Proteins
Enzymes
Specific Proteins
Diabetes Marker
Example of Transport Proteins Large Molecules:
Albumin
Transferrin
Haptoglobin
Example of Enzymes Large Molecules:
Lipase
Amylase
Creatinine Kinase
Example of Specific Proteins Large Molecules:
Immunoglobulins
C-reactive Proteins
Complement
Example of Diabetes Marker Large Molecules:
Hemoglobin
A1c
HbA1c
Most common specimen used in the Clinical Chemistry:
Blood
Method of Collection of Blood in Adult
Venipuncture
Method of Collection of Blood in Infants
Heel Prick
Skin Prick
Site of collection of Blood in Adults
Anticubital Fossa
Median - 1st Choice
Cephalic - 2nd Choice
Basilic - 3rd Choice
Site of collection of Blood in Infants
Plantar Heel for Heel Prick
Forms of Blood:
Whole Blood
Plasma
Serum
It is the act of drawing a blood sample from a blood vessel.
Phlebotomy
Collecting blood from a vein is called _____
Venipuncture
The medical professional drawing the blood sample is called a _____
Phlebotomist
Next most common specimen used in the Clinical Chemistry Section
Urine
This is used for evaluating kidney functions and test that look at waste products excreted by kidneys.
Urine
Method of Collection of Urine
Midstream Clean Catch Specimen
For Chemistry Testing, what type of urine specimen is usually used?
24 Hour Urine
Clear and colourless fluid surrounding brain and spinal cord
Cerebrospinal Fluid
Method of Collection of CSF
Lumbar Puncture or Spinal Tap (usually collected on the 3rd to 4th or 4th to 5th Lumbar Vertebrates)
The first tube in the CSF is intended for _____
Clinical Chemistry and Immunology
The second tube in the CSF is intended for _____
Microbiology
The third tube in the CSF is intended for _____
Hematlogy
The 4th tube in the CSF is intended for _____
Specialized Section Histopathology
Immunology Serology
How many tubes are collected in the CSF for testing?
4 tubes
CSF Glucose:
60-70% of Plasma Glucose
CSF Protein:
15-45 mg/dl
Fluid found in the lungs is called _____
Pleural Fluid
Pleural Fluid is collected through the process called _____
Thoracentesis
Fluid found in the heart is called _____
Pericardial Fluid
Pericardial Fluid is collected through the process called _____
Pericardiocentesis
Fluid found in the gastrointestinal tract is called _____
Peritoneal Fluid
Peritoneaal Fluid is collected through the process called _____
Paracentesis
Fluid produced by pregnant women is called _____
Amniotic Fluid
Amniotic Fluid is collected through the process called _____
Amniocentesis
Fluid that lubricates the joints is called _____
Synovial Fluid
Synovial Fluid is collected through the process called _____
Arthrocentesis
Peritoneal Fluid is also called _____
Astic Fluid
How is a specimen rejected:
Unlabeled
Improperly Labeled
Mismatched Specimen
Insufficient Quantity (QNS)
A specimen must have at least 2 identifiers which are the _____ and _____
Name
Date of Birth
Specimen submitted must bear a completed request form which includes:
Name
Age
Date
Time
Test
Sex
Physician
Diagnosis
Specimen Rejection Criteria:
Incorrect Collection Tube
Underfilled/Overfilled Collection Tube (With Anticoagulant)
Hemolyzed Sample
Consequences of Specimen Rejection:
- Repeated Specimen Collection
- Delay in the Analysis and Reporting of Result
- Delay in the Treatment of the Patient
Laboratory Workflow in Clinical Chemistry Section:
- Requisition
- Specimen Collection
- Transport and Processing
- Result Transmission/Delta Checking/Repeat Testing
- Interpretation of Result
Quality standards for all clinical laboratories to ensure accuracy, reliability and timeliness of patient test results regardless of where the test was performed
Clinical Laboratory Improvement Amendments (CLIA) of 1988
Defines Clinical Laboratories broadly
Clinical Laboratory Improvement Amendments (CLIA) of 1988
Two levels of Regulations in Clinical Laboratory Improvement Amendments (CLIA) of 1988
- Waived Tests
- Nonwaived Tests
Simple laboratory examinations and procedures that are cleared by the U.S. Food and Drug Administration (FDA) for home use
Waived Tests
Moderately and highly complex tests as defined by the requirements for operator skill, reagent preparation, and automation and the difficulty of interpretation of results. These are regulated under guidelines that cover quality standards for proficiency testing (PT), patient test management, quality control, personnel qualifications, and quality assurance.
Nonwaived Tests
Found that urea, an ‘organic’ substance, could be synthesized in vitro without any ‘vital force’ or living organism.
Friedrich Wöhler
In what year did Friedrich Wöhler found that urea, an ‘organic’ substance, could be synthesized in vitro without any ‘vital
force’ or living organism.
1828
Looked back on experiments of Antoine- Laurent de Lavoisier in Pneumatic Chemistry.
Henry Bence Jones
“Few and scanty, indeed, are the rays of light which chemistry has flung on the vital mysteries.”
Robert James Graves (1796-1853)
Complained that clinicians do not use their chemistry laboratory services except when needed for “luxurious embellishment for a clinical lecture.”
Max Josef von Pettenkofer (1818-1901)
On what year does the urine test for diabetes and carbohydrate metabolism investigations started?
1815
First used the term “clinical chemical laboratory” (klinisch chemischem Laboratorium)
Johann Joseph Scherer (1814-1869)
An outstanding clinical chemist able to give an excellent interpretation of analytical results obtained from in body fluids.
Donald D. van Slyke (1883-1971)
Donald D. van Slyke (1883-1971) published a book in _____ (year) with _____ (name) entitled _____.
1932
John P. Peeters
Clinical Chemistry
The founder of Modern Clinical Chemistry
Donald D. van Slyke (1883-1971)
What was discovered in the 19th Century?
- Discovery of starch, fats, and some blood proteins were isolated and characterized
- Cholesterol in gall stones
- Chemical composition of urine
Invented the Technicon AutoAnalyzer
Dr. Leonard Skeggs
On what year does the Radioisotopes were used in assay Scintillation counting devices?
1970
How does the Computers correlate to the laboratory?
- Equipment ability for data processing monitoring of data produces
- Ensured accuracy
- Correlation and relationships with previous information (Delta Check)