LESSON 1: INTRO Flashcards
“Clinical” was derived from the greek word
kline
Clinical from the greek word kline meaning
bed
The Greeks noticed before 400 BC that ants are attracted to
“sweet urine.”
Greeks noticed before____ that ants are attracted to “sweet urine.”
400 BC
the famous Dublin physician that emphasized the clinical observation of patients and which significantly advanced the fields of physical diagnosis.
Robert James Graves
The term clinical chemistry was stated by _____ (1842–1896) of London Hospital when he used it as the title of his 1883 treatise
Charles Henry Ralfe
The first laboratory attached to a hospital was established in the year ____ at _____
1886 in Munich, Germany
The first laboratory attached to a hospital was established in 1886 in Munich, Germany, by _____
Hugo Wilhelm von Ziemssen.
In the United States, the first clinical laboratory was reported to be ___
The William Pepper Laboratory of Clinical Medicine
The William Pepper Laboratory of Clinical Medicine, established in what year
1895
The William Pepper Laboratory of Clinical Medicine was established in 1895 at _____ in Philidelphia
the University of Pennsylvania
- branch of laboratory medicine that focuses primarily on molecules.
Clinical chemistry
The tests we are performing in the clinical chemistry laboratory measures the concentration of
- biologically important ions (salts and minerals),
- small organic molecules and
- large macromolecules (primarily proteins).
building blocks of protein
amino acid
Clinical chemistry is a quantitative science that is concerned with measurement of amounts of biologically important substances called ____
analytes
- chemical constituents being identified and measured in clinical chemistry
analytes
The results of clinical chemistry tests are compared to reference intervals or a ______ to provide diagnostic and clinical meaning for the values.
medical decision level (MDL)
are translational researchers who are equipped for and capable of developing, evaluating, and validating biochemical and genetic assays for clinical use; they develop skills that are essential for new biomarker assays, reagent kits, and companion diagnostics.
Clinical chemists
provide interfaces between researchers, clinicians, the clinical laboratory, and the IVD industry (in-vitro diagnostics) and help to translate biomarker research into clinically meaningful decisions and actions.
Clinical chemists
Substances typically measured in serum are classified as:
a. Normally present with a function in circulation
b. Metabolites
c. Substances released from cells as a result of cell damage and abnormal permeability or abnormal cellular proliferation
d. Drugs and toxic substances
2 parts of the result
1.Number
2.unit
(actual value) – describes the numeric value
Number
defines the physical quantity or dimension such as length, time or volume.
unit
Complete metric system of unit measurement for scientist
SI - Systeme International d’ Unites adopted in 1960
SI classification:
- Basic
- Supplemental
- Derived
- Traditional units
ex. length(meter), mass(kgs), time(seconds), Electric current(ampere), Thermodynamic temperature(kelvin), Amt of substance(mole) luminous intensity(candela)
Basic
units that have not been classified as either basic or derived.
Ex. Minute, hour, liter, angstrom
Supplemental
related mathematically to the basic supplement unit
Ex. meters per second/ (m/s), frequency(hertz), force(newton), celcius (degress celcius), catalytst activity(katal)
Derived
not listed as basic SI units
Traditional units
QUANTITATIVE LAB RESULTS:
- Substance conc. Ex. Moles
- Mass of substance Ex. mg/dl, g/dl, mEq/l and IU.
set of values of a measured quantity obtained from a group of individuals (or a single individual) in a defined stated of health.
Reference values
*values expected for a healthy person
Reference values
the best available method for establishing the presence or absence of the target condition (the suspected condition or disease for which the test is to be applied). It can be a single test, or a combination of methods and techniques, including clinical follow-up of tested patients.
Reference Standard
test of interest/one test
Index Test
Group Reference values:
- Age
- Sex
- Pregnancy
Increased: serum bilirubin,mildly inc. GGT, GH, fetal Hgb, AFP and BUN values.
Decreased: serum carotene, ceruloplasmin, haptoglobin and cholesterol
Newborns until the 1st week of life
dramatic inc. in total WBC, and very low serum conc. of IgM and IgA.
Healthy Newborns
higher ALP, inorg PO4, LDH but lower serum cholesterol, creatinine, uric acid and total CHON values.
Pre-pubescent pediatric patient
higher serum values for ALP, cholesterol and PO4 Uric Acid.
Menopausal women
MEN, higher values for
Hgb, BUN, creatinine and uric acid
- Increase pro-coagulant and fibrinolytic factors, ALP
- Increase AST, LDH, cholesterol, triglycerides and uric acid.
- Low Hgb, serum albumin, BUN, calcium, glucose and protein.
Pregnancy
all necessary reagents and respective storage containers are prepackaged as a unit
Kit
- specifications for analytical reagent-grade chemicals.
- one the world’s largest scientific societies and premier home of chemistry proffesionals
American Chemical Society (ACS)
Grades of purity of chemicals:
- Analytical reagent (AR)
- Ultrapure (UP)
3.Chemically pure (CP)
4.United States Pharmacopeia (USP)
5.National Formulary (NF)
6.Technical or commercial grade
labels on these reagents either state the actual impurities for each chemical lot or the list maximum allowable impurities
Analytical reagent (AR)
label should reveal the percentage of impurities present and have either the initials “AR” or “ACS” or the term for laboratory use. (meet the specifications of ACS)
Analytical reagent (AR)
Suitable for use in most analytical laboratory. Procedures.
Analytical reagent (AR)
use in specific procedures such as chromatography, atomic absorption, fluorometry, immunoassays, molecular diagnostics, HPLC, standardization or other techniques that require pure chemicals.
Ultrapure (UP)
- Melting point analysis used to ascertain the acceptable purity range.
- Impurity limitations are not stated
- Preparation is not uniform
Chemically pure (CP)
(Grades of purity of chemicals:) Not recommended for clinical laboratories.
Chemically pure (CP)
-organization that sets the potency and purity of chemicals in order for them to considered pharmaceutical grade.
-use of manufactured drugs
United States Pharmacopeia (USP)
-chemicals may be pure enough for use in most chemical procedures but consider that their purity standards are not based on the needs of the laboratory and therefore, they may or may not meet all assay requirements
United States Pharmacopeia (USP)
same as USP
National Formulary (NF)
requires all manufacturers to clearly indicate the lot number plus the hazard and precaution needed for the safe use and storage of any chemical
Occupational Safety and Health Act (OSHA)
is a document that contains information on the potential hazards (health, fire, reactivity and environmental) and how to work safely with the chemical product.
Material Safety Data Sheet (MSDS)
is chemical reagent which has certain properties such as,
-Extremely pure
-Highly stable
-anhydrous
-Very high mol weight
-can be weighed
-easily readily available
-preferably non toxic
-should not be expensive
Primary Standard
purity tolerances for primary standards =
100 +/- 0.02% (*99.98%)
Uses of primary standard
-used to standardize volumetric solution
-used for standardization of titration solutions
-used for calibration of secondary standards
-used as reference to determine unknown concentrations or to calibrate analytical instruments.
is a solution in which the concentration of dissolved solute has been determined by reaction(titration) with primary standard solution.
Secondary Standard
Secondary Standard Uses
-used to standardize volumetric solutions
-used for standardization of titration solutions
-used for calibration of secondary standards
-used as reference to determine unknown concentrations or to calibrate analytical instrument
most frequent reagent used in the laboratory.
water
– used to remove particulate matter before any additional treatments
Prefiltration
filtration cartridges are composed of
glass, cotton, activated charcoal (removes organic materials and chlorine), and submicron filters (0.2mm)
Water Classification in terms of preparation:
Distilled water
Deionized water
RO water
Ultra Oxidation
- water purified by distillation
- purified to remove almost all organic materials .
-water is boiled , vaporized and condensed to purify or concentrate a substance - distillation of water can be more than once.
Distilled water
-water purified by ion exchange to produce mineral free deionized water.
-removes some or almost all ions
Deionized water
-it is neither pure nor sterile
- purified from previously pre-filtered or distilled water
-produced using either an anion or a cation exchange resin
Deionized water
-water purified by reverse osmosis, water is forced through a semipermeable membrane that acts as a molecular filter.
RO water
removes more than 90-99.99% of all the contaminants including minerals from the drinking water supply
RO water
use of UV radiation at the biocidal wavelength of 254 nm eliminates many bacteria and cleaves many ionizing organics that are then removed by deionization..
Ultra Oxidation
used in clinical chemistry, the purest type of water
Type I
- Generally suitable for routine lab use
-Should be used immediately
Type I
-Used for test methods requiring minimum interference and maximum accuracy and precision such as trace metals, ion and enzyme analysis. ( use w/ HPLC) High Performance Liquid Chromatography, and is a technique used to separate different constituents of a compound or mixture using high pressure to push solvents.
Type I
acceptable for general lab testing and most analytic requirements including reagent, quality control and standard preparation. Also known as general laboratory grade water
Type II
acceptable for glassware washing but not for analysis or reagent preparation
Type III /autoclave wash water
