Cc Flashcards by Loui Mojica

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

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What are the analytes

Protein, enzymes, metabolite (sugar and lipids), drug, ions, salt, minerals (calcium, potassium, sodium)

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Monitor effect of treatment by noting changes in specific parameters

Clinical chemistry

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is a quantitative science and It is concerned with measurement of amounts of biologically
important substances (called analytes) in body fluids.

Clinical chemistry

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Clinical chemistry that measurement of amounts of biologically
important substances of

Analytes

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The methods to measure these substances are carefully designed
to provide accurate assessments of the concentrations.

Clinical chemistry

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The results that are obtained from such measurements are
compared to reference intervals or an Medical Decision Level (MDL) to provide diagnostic and clinical meaning for the values.

Clinical chemistry

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a science, a service and an industry

Clinical chemistry

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it links the knowledge of general chemistry, organic chemistry, and biochemistry with an understanding of human physiology

Science

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it produces objective evidence from which medical decisions may be made

Service

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clinical laboratories are businesses, which operate under the regulations and practices that guide commerce in the United States.

Industry

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Scope of Clinical Chemistry:

Computers
Biochemistry
Instrumentation
Pharmacology
Endocrinology
Immunology
Toxicology
Analytical Chemistry

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computer is Also known as

Laboratory information system

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connecting) the patient information, the details in a laboratory information system or computer “Technology” we are dealing with the incorporation of different laboratory identifiers or identifications to the technology or computer.

Laboratory information system

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Biochemistry Dealing with the four fundamental biomolecules:

Lipids
Protein
Nucleic acid
Glucose

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Automations, Machines, and the way we troubleshoot

Instrumentation

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Also known as the drugs

Pharmacology

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The branch of physiology and medicine concerned with endocrine lands and hormones.

Endocrinology

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Test in clinical chemistry

Immunology

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The toxic substances in the body could also trace them.

Toxicology

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Deals with the measurement also of different substances

Analytic chemistry

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Clinical test: core test is

Routinely/common: easy to perform

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Core test involves

Glucose (diagnose of diabetes mellitus)
Renal function test (urea, creatinine, uric acid)
Liver/hepatic function panel (biliburin, albumin, total protein, alkaline phosphate, aspartate aminotransferase, alanine transaminase
Lipid profile ( total cholesterol, triglycerides, high density lipoproteins, low density lipoprotein)
Enzymes ( analytes, lipase and creatinine kinase)
Electrolytes (sodium, potassium, chlorine)

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In order to assess the liver function.

Liver/hepatic function panel

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are primarily used for the diagnosis of Acute Pancreatitis (Bangungot)

Amylase and lipase

employed for the diagnosis of Myocardial Infarction (heart attack)

Creatinine kinase

To assess the fluid of the body and they are all routinely ordered by the Doctor

Electrolyte

Hormones, specific proteins, trace elements, vitamins, drugs, and lipoprotein - Less frequently performed - Cost prohibitive - Usually sent out to bigger laboratories with strict preparation guideline

Specialized test

Specialized test involve

Vitamins (vitamin D) and drugs (vancomycin)

an antibiotic that is Used to treat Gram-positive cocci and test multidrug-resistant cocci, also assesses the level of ___________ inside the human body.

Vancomycin

Most common specimen in Clinical chemistry

Blood

Most common specimen in Clinical chemistry

Blood

Method of collection: Venipuncture Adult: Infant:

A. ADULT: Venipuncture in the Vein (median Antecubital Fossa) B. INFANT: Heel prick Method - SITE: Median Antecubital Fossa

Form of blood

Whole blood Plasma Serum

It's actually the blood which contains all the formed elements and the liquid portion

Whole plasma

Whole blood formed elements

RBC WBC PLATELETES

Whole blood liquid portion

Plasma Serum

Liquid portion of non-clotted Blood that contains Anticoagulant

Plasma

Liquid portion of clotted blood and Collected in Yellow/Red tube (most common in cc)

Serum

the act of drawing a blood sample from a blood vessel. For clinical chemistry testing blood is usually drawn from a vein, typically a vein in the arm or back of the hand. Collecting blood from a vein is called venipuncture. The medical professional drawing the blood sample is called a

Phlebotomist

Use for evaluating kidney functions and test that look at waste products excreted by kidneys

Urine

Use for evaluating kidney functions and test that look at waste products excreted by kidneys

Urine

METHOD OF COLLECTION: urine

Midstream clean catch

For Chemistry testing _______________ is usually used to test metabolites

24 hour urine test

is clear and colorless fluid surrounding the brain and spinal cord

Cerebrospinal fluid

Method of Collection: csf

Doctors only Lumbar Puncture / Spinal Tap

collected on ________ to_________ lumbar space

3-4 to 4-5 lumbar space

Csf intended for

Diagnosis of Meningitis and Neurological problems or diseases

COLLECTION IS DONE USING 3 -4 TUBES 1ST TUBE: 2ND TUBE: 3RD TUBE: 4TH TUBE:

1ST TUBE: Clinical chemistry 2ND TUBE: Microbiology/Bacteriology 3RD TUBE: Hematology 4TH TUBE: Specialized section: Histopath or Immunoserology

OTHER BODY FLUIDS

1.PLEURAL FLUID 2.PERICARDIAL FLUID 3.PERITONEAL FLUID 4.AMNIOTIC FLUID 5.SYNOVIAL FLUID

PLEURAL FLUID Found in: Manner of collection:

Found in Lungs Manner of collection: Thoracentesis

PERICARDIAL FLUID Found in: Manner of collection:

Found in: Heart Manner of collection: Pericardiocentesis

PERITONEAL FLUID Found in: Manner of collection:

Found in: Gastrointestinal Manner of collection: Paracentesis

AMNIOTIC FLUID produce by: Manner of collection:

produce by: Pregnant women Manner of collection: Amniocentesis

AMNIOTIC FLUID produce by: Manner of collection:

produce by: Pregnant women Manner of collection: Amniocentesis

SYNOVIAL FLUID Reduces friction when you move your: Manner of collection:

Reduces friction when you move your: joints Manner of collection: Arthrocentesis

Fluids Typically Used For Clinical Chemistry Tests

Blood (whole blood, serum or plasma) Urine Cerebrospinal fluid (CSF Amniotic fluid Saliva Synovial fluid (fluid that is found in joint cavities) Pleural fluid (from the sac surrounding the lungs) Pericardial fluid (from the sac surrounding the heart) Peritoneal fluid (also called ascitic fluid; from the abdomen)

SPECIMEN REJECTION CRITERIA

Unlabeled, improperly labeled, mismatched specimen, Insufficient quantity (QNS), Incorrect collection tube

SPECIMEN CRITERIA: must have at least two

Name date of Birth

CONSEQUENCES OF SPECIMEN REJECTION

1. REPEATED SPECIMEN COLLECTION 2. DELAY IN THE ANALYSIS AND REPORTING OF RESULT 3. DELAY IN THE TREATMENT OF THE PATIENT

LABORATORY WORKFLOW IN CLINICAL CHEMISTRY SECTION

REQUESITION - Request from the Doctor SPECIMEN COLLECTION TRANSPORT AND PROCESSING RESULT TRANSMISSION/DELTA CHECKING/REPEAT TESTING - Done by Pathologist INTERPRETATION OF RESULT - Done by attending physicians

quality standards for all clinical laboratories to ensure accuracy, reliability and timeliness of patient test results regardless of where the test was performed and defines clinical laboratories broadly

Clinical and laboratory improvements amendment of 1988

simple laboratory examinations and procedures that are cleared by the U.S. Food and Drug Administration (FDA) for home use

Waived test

moderately and highly complex tests as defined by the requirements for operator skill, reagent preparation, and automation and the difficulty of interpretation of results.

Nonwaived test

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)

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)

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. Published a book in 1932 along with John P. Peeters entitled Clinical Chemistry. He is also the founder of Modern Clinical Chemistry.

Donald D. van Slyke (1883-1971)

Crude techniques but advances to understand the living material were made despite limitations.

19th century

invented the Technicon AutoAnalyzer

Dr. Leonard Skeggs

- Radioisotopes were used in assay Scintillation counting devices

1970

Incorporation or linkage of computers to laboratory

1. Equipment ability for data processing monitoring of data produced 2. ensured accuracy 3. correlations and relationships with previous information (Delta check)