Week 6: Bood Chemistry Flashcards
what are some pre analytical factors that can affect quality of test results
Collection procedure - correct needle size - fill tubes in correct order - store correctly - visually inspect Labeling, handling, shipping Patient variables (ex. fasting) Equipment difficulties
What are some reasons why we would run a clinical chemistry profile
screen for disease
assess pre surgical risk
distinguish between differential diagnosis
assess severity of existing disease
monitor progression/response to therapy
identify patterns that suggest dysfunction
What are some things we can do as techs to ensure quality control and accurate results from a chemistry analyzer?
Proper calibration Routine maintenance (ex. software update) Running daily controls Blanking methods Monitor for deterioration of reagents Monitor condition of analyzer
With chemistry, what type of sample do we usually look at?
Serum
What are plasma proteins produced and what are some of their function?
Primarily in the liver
structural component of all cells, organs, and tissues osmotic pressure enzymes buffers hormones clotting defense transport molecules
what is total plasma protein
all proteins including fibrinogen
what is total serum protein
all proteins excluding clotting factors
Protein concentrations are affected by:
hepatic synthesis
altered protein breakdown or excretion
dehydration or over hydration
what are some methods we can use to test protein concentration
refractometric method
biuret method
You run a test and the Albumin levels are below normal range.
What is the medical name for this condition?
What would our concern be?
Hypoproteinemia
liver disease, renal disease, diet, intestinal function
What are Globulins?
How do you calculate Globulins
Complex group of proteins
- Alpha globulins (come from liver)
- Gamma globulins (antibodies)
concentration= TP - Albumin
What is A:G ratio
Albumin to Globulin ratio
its the first indication of protein abnormalties
A/G= A:G value
What is a hepatobiliary assay
tests for liver and gallbladder function
What is ALT and where would we find it?
Alanine Aminotransferase (enzyme in the cytoplasm of hepatocytes)
liver cells, renal cells, cardiac muscle, skeletal muscle, and the pancreas
When would we see an increase of ALT
within 12hrs of hepatocyte damage
peaks within 12 - 48 hrs
What is AST and where would we find it
and when could we see an increase in this
Aspartate Aminotransferase (Enzyme in hepatocytes)
liver cells, erythrocytes, cardiac muscle, skeletal muscle, kidneys, and the pancreas
levels may rise after exercise or IM injection (not just liver damage)
What is AP?
Where is it found?
Alkaline Phosphatase
present in bone, cartilage, intestine, placenta, and hepatobiliary system cells
What is Bilirubin
what do assays help determine:
derived from breakdown of hemoglobin in the spleen
Cause of jaundice
Hepatocellular damage
Bile duct injury/obstruction
Erythrocyte destruction
Where would we find Bile acids?
When would we see elevated bile acids?
Liver - gallbladder - duodenum
when any process impairs hepatocellular, biliary, or enterohepatic circulation
What factors would affect testing of bile levels
inadequate fasting
spontaneous gallbladder contraction
prolonged fasting (over 12hrs)
Diarrhea
Where would we find cholesterol?
what condition do we test cholesterol for?
produced primarily in the liver
Hypothyroidism
Hyperadrenocorticism
Diabetes mellitus
Nephrotic syndrome
What is BUN?
What factors can show an increase in BUN levels?
Blood Urea Nitrogen (Urea comes from protein breakdown)
Contamination (ex. staph)
Dehydration
Diet (high protein)
What turns creatine into serum creatinine?
Muscle metabolism
What are the divisions of pancreas function
Exocrine (digestive enzymes)
Endocrine (insulin)
What is function of amylase?
where is it produced?
what caused an increase?
breakdown of starch
primarily in the pancreas
pancreatic disease, enteritis, intestinal obstruction, intestinal perforation
What is the function of Lipase?
Where is it produced?
Lipase and amylase are typically measured together and if amylase is increased then lipase should be increased. I amylase is increased but lipase is not where is this probably coming from?
break down fat
pancreas-specific
intestines
What is the function of Trypsin
break down protein
What is Serum TLI?
Decreases with…
Increases with…
Serum trypsin-like immunoreactivity
decreases with functional pancreas mass
increases with lower glomerular filtration rate
What is Serum PLI?
We use this to test for what condition?
Serum pancreatic lipase immunoreactivity
pancreatitis
What are the major function of electrolytes?
What is a testing method?
What can cause an error in testing?
Maintain water balance
Osmotic pressure
Muscular and nervous function
Acid-base regulation
Electrochemical (ion specific)
lipemia
What are the cations of electrolytes
What are the anions of electorlytes
Sodium, potassium, magnesium
Chloride, Bicarbonate
What is CK?
Where is it primarily found?
What can cause an increase?
Creatine Kinase
primarily from striated muscle (skeletal and cardiac)
also found in brain
damage to muscle causes an increase in CK
What can cause an increase in Lactate (Lactic acid)
Hypoxia, hypoperfusion and peritonitis
What is Fructosamine
what can cause an increase
reaction of glucose bound to protein
persistent hyperglycemia
What is the glucose tolerance testing rule out?
diabetes mellitus
what is the insulin tolerance test for?
differentiates the cause of diabetes mellitus
Why do we do a ACTH stimulation
test for suspected hypo - or hyperandrenocorticism
What does a high dose dexamethasone suppression test for?
What does a low dose dexamethasone suppression test for?
high dose - differentiates pituitary from adrenal causes (helps determine treatment)
low dose - hyperadrenocorticism
what is T4?
Cholesterol is often elevated with a ____functional thyroid gland.
Thyroxin- tests thyroid function
Hypo
