Proteins, enzymes and clinical utility (7/8) Flashcards
Describe analytic variability an give examples.
- How stable and robust the assay is.
- Accuracy and reliabilit of easuring analyte.
Example: XXXXXX
How is clinical validity determined?
- How reliable does the test correlate to the clinical condition?
- Accuracy of ability to diagnose, predict or measure clinicall condition.
Example:
Describe clinical utility.
- What difference does the test make.
- Ability to change patient management, outcome.
- Impact on cost of care.
Example: a patient is on life time medication and monitored regularly. The brand of medication is changed and the patients inflammator markers increase, the patient is in flare up. The test results reflect that the medication is not working.
Who are the QAA? And what do they do?
Quality Assurance Agency for Higher Education.
Provides subject benchmark statements for Higher Education.
What are expectations for a BMS graduate according to the QAA?
- The range of common methods used for the collection and analysis of clinicalsamples.
- Investigations of major body and organ systems - for example, renal functiontests, liver function tests, tumour marker tests, bone profile tests.
- The principles and applications of biochemical investigations used for screening, diagnosis, treatment and monitoring of disease.
- Therapeutic drug monitoring and investigation of substance abuse.
QAA statement: “The range of common methods used for the collection and analysis of clinicalsamples”
- Clinical samples: bood, plasma, serum CSF, vitreous humour.
- Collection; blood tubes, order of tubes, PIDs, transport.
- Analysis: biological factors, result interpretation, reporting results.
“Investigations of major body and organ systems - for example, renal functiontests, liver function tests, tumour marker tests, bone profile tests”
Renal:
Urea
Creatinine
Albumin
Bicarbonate
Sodium
Potassium
eGFR
“Investigations of major body and organ systems - for example, renal functiontests, liver function tests, tumour marker tests, bone profile tests”
Liver function tests:
ALT
AST
ALP
GGT
Bilirubin
Albumin
Prothrombin
“Investigations of major body and organ systems - for example, renal functiontests, liver function tests, tumour marker tests, bone profile tests”
Tumour markers
AFP
CEA
Antibodies
CA 15-3
CA 19-9
CA 125
CA 50
“Investigations of major body and organ systems - for example, renal functiontests, liver function tests, tumour marker tests, bone profile tests”
Bone profile
ALP
Calcium
Phosphate
Vitamin D
PTH
“The principles and applications of biochemical investigations used for screening, diagnosis, treatment and monitoring of disease”
Screening
PSA
CEA
HbA1c
“The principles and applications of biochemical investigations used for screening, diagnosis, treatment and monitoring of disease”
Diagnosis
Renal function
Liver function
Tumour markers
Bone profile
“The principles and applications of biochemical investigations used for screening, diagnosis, treatment and monitoring of disease”
Treatment
Direct monitoring
Indirect monitoring
Organ toxicity
“The principles and applications of biochemical investigations used for screening, diagnosis, treatment and monitoring of disease”
Monitoring
Kidney disease
Any chronic disease
QAA statement: “Therapeutic drug monitoring and investigation of substance abuse”
Drug monitoring
Immunosuppressants
Antiepileptics
Cholesterol lowering
Thyroxine
Metformin
Chemotherapeutics
Methadone
“Therapeutic drug monitoring and investigation of substance abuse”
Substance abuse
Alcoholism
Overdose
Opiates
Cannabinoids
Amphetamines
Cocaine
Legal highs
Which blood tube would you use for an enzyme test?
Plasma whole blood EDTA
monitor the organ instead of the drug -nephrotoxic drugs will monitor kidney.
hepatotoxic, the liver will be monitored.
Vitreous humour
useful in post mortem process - can monitor glucose levels, wbc will continue to metabolise gllucose post death and deplete the glucose.
potatssium will leach out post mortem, via the vitreous humour.
eg proof of cause of death with diabti deaths to measure time of death with drop of glucose levels.
EDTA contains ca which sucks
@1412
why is the order of the tube important when taking a blood test
edta tubes contain chemicals which will affect the sample and the analytes thata re being tested.
What is a D-Dimer
Name some chronic diseases monitored by the clinical biochem department
dMT2
Which factors can impact on the correct result?
see side 8
Explain the acronym NEQUAS and what it is used for.
@1439
New biomarkers
@1441
when would sesnsitivity, specificity and efficiency tests be used?
if a new test for new bioarkers was being developed for a disease.
