Cc lec Flashcards by GLORIA VELEZ

studies or tests biochemical by-products and constituents; analytes such as metabolites

Clinical chemistry

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part of the metabolic process that is needed to test to determine normal levels/ any abnormal levels that can indicate a disease.

Biochemical by-products

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the substance measured in a test

Analyte

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Two types of testing:

Qulitative
Quantitative

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to detect the PRESENCE/ABSENCE of an analyte. (eg. Screening Tests for Drug Testing)

Qualitatively

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to measure the CONCENTRATION of an analyte. (eg. Confirmatory Tests for Drug Testing)

Quantitatively

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the fluid collected from the patient that is “NOT YET PROCESSED” (newly collected)

Specimen

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the fluid collected from the same patient that is “NOW PROCESSED OR CENTRIFUGED”

Serum

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involves all activities/procedures that are carried
but before the actual analysis or testing activities

PRE-ANALYTICAL TESTING

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Can affect the following analytes: ▪ Lipids
▪ Calcium ▪ Enzymes ▪ Proteins ▪ Drugs

POSTURE

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Best time for Collection: MORNING
▪ Pertains to the fluctuation that occurs during daytime

Diurnal rhythm

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Prior to phlebotomy can affect the following analytes:
Creatinine
Protein
Creatine kinase
Platelets
Wbc
Ast
Ldh
Aldolase
Sex hormones

Exercise

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Causes an increase in WBC counts, FI, FV, FVIII:c, and FXIII

Stress

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indicates increase in fatty foods consumption

Chylomicrons

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(Fasting) to correctly measure the EXOGENOUS source of substances

Diet

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Can affect false measurements
▪ If sample still cloudy/turbid after fasting,
it indicates a disease (lipid metabolism)
▪ LIPID: 12 hrs strict fasting
▪ FBS/Glucose: 6-8 hrs o If both: 10 hrs.
▪ Over fasting for glucose: false decrease
▪ Under fasting for lipids: false increase
▪ Prolonged Fasting:
o 48 hrs: Bilirubin
o 72 hrs: Plasma glucose 💻 hypoglycemia

Cbc test

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Prior to phlebotomy can affect the following analytes:

Smoking

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Increases WBC and cortisol

Smoking

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Increases Plasma Lactate, Urates, Triglycerides

Alcohol or ethanol consumotion

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Physiologic Interference

In vivo

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Peritoneal Fluid

Paracentesis

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Perxardiocentensis

Pericardial fluid

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Preferred specimen in urine

First morning midtsream ( routine urinalysis)

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Tests that require the specimen to be placed in ice water/ cold water

Plasma renin
Acid phosphatase
Blood ammonia

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SPECIMEN PROCESSING Three Phases

Pre centrifugation Centrifugation Post centrfugation

Always inspect tube labels and cracks ✓ Make sure that it’s balanced ✓ Make sure that the machine is regularly calibrated (Tachometer)

Pre centrifugation

Speed depends on the type of specimen ✓ Identify what speed first.

Centrifugation

Immediately transfer serum/plasma sample to a sterile tube

Post-centrifugation

Fundamental process in the preparation of standards, reagents, gravimetric analysis, or calibration of volumetric equipment requiring the use of analytical balances

Measurement of Mass

Requires the use of glass wares for the determination of the volume of the liquid reagents, samples or body fluids. o Pyrex (Borosilicate) ▪ Commonly used ▪ High degree of thermal resistance ▪ Low alkali content ▪ Free from heavy metals

Measurement of Volume

Temperature-dependent reaction, test, or procedures ▪ Enzyme measurements - E.g., as a biocatalyst, it needs to be optimally reacting as to the body temp (37degC)

Control of Temperature

Performed to remove excess water or solvent in the sample o There is better test for sensitivity because of accurate

Evaporation and Specimen Concentration

Depends on the measurement of the analytical response curve. o Analytical response curve: used for the determination of analytical sensitivity o Analytical Sensitivity: pertains to the smallest possible concentration of an analyte that can be measured in a test

Detection of Analytical Response

procedures or activities necessary after the actual measurement or analytical testing

POST ANALYTICAL TESTING

Software system that records, manages, and stores data for clinical laboratories → There is still physical documentation like logbooks, printed our results, etc.

Laboratory Information System

Specimen: depending on what type o Blood samples: freezing at -18decC or colder Freezing: can preserve the biochemical constituents. o Serum or Plasma: Refrigerator (only for 72hrs) o Urine: Refrigerator (only for 24hrs) → Lab Reports: unclaimed results are kept for 2 years o Transferred to the medical records after 2 yrs

Retention of Specimen and Laboratory Reports

b. Ultrapure Reagents → Suitable for techniques that require extremely pure chemicals → Molecular & Reference techniques → Atomic Absorption Spectrometry (AAS) → Enzyme immunoassay (EIA) - Molecular diagnostics MDx → Polymerase Chain Reaction

Ultrapore

High-performance liquid chromatography

HPLC or chromatographic

s used to a certain acceptable purity range of this reagent

Melting point analysis

type of organic reagent with some impurities

Practical grade

a type of organic reagent that approaches the purity level of a reagent grade type with some impurities

Chemically pure

This type of reagent is spectrally pure

Spectroscopic grade

The minimum purity level is at 99% → The purity level is determined by gas chromatography

Chromatographic grade

This is the ASC grade type → It is certified to contain impurities below certain levels established by ACS

Reagent grade

Purified by distillation process → Distillation process: ✓ There is heating process followed by cooling. ✓ Evaporation followed by condensation ✓ After cooling, the distilled water will be collected in a separate vessel

Disttilled water

Water is purified by Ion Exchange Resin → It could either be a cation or anion or mixed type → Ions are removed from water → Removal of Ion → Dissolved solids and dissolved gasses are also removed

Deionized water

It utilizes pressure to force water through a semi-permeable membrane → Applied pressure - membrane - pure water → After passing through the membrane, the water will be then purified → This does not remove dissolved gasses

Reverse Osmosis (RO) water

UV oxidation, sterilization, or ozone treatment → Used to destroy pathogens or microorganisms that can cause bacteria or disease → Destroys endotoxins, pyrogens

Ultrafiltration and nano filtered water

The one that is used in the preparation of reagents → Used in reagent grade type (AR, Ultrapure) → Prepared by initial filtration, followed by reverse osmosis, and then Deionization, and finally second filtration using 0.2 mm filter → 4 times to purify

Reagent grade water

For test methods requiring minimum interference => → Example: Trace Metal Analysis by Flame emission

Type I water

For analytical preparation → Reagent and Standard Preparation → Quality Control Preparation

Type II water

Warming components is necessary for analytical procedures and is accomplished by circulating water/ice baths or heating/cooling metal blocks. → Temperature monitoring → The temperature can directly affect the performance of the test and the result of the analysis 3. 2. GLASSWARES 3. → Laboratory supplies consisted of some type of glass ✓ Kimax® /Pyrex® (borosilicate): most preferred ✓ Corex® (aluminosilicate) ✓ High silica ✓ Vycor® (acid or alkali resistant) ✓ Low actinic (amber colored) ✓ Flint glass (lime soda) ®: registered trademark PLASTIC WARE → →

THERMOMETERS

Use of a colored liquid or mercury encased in plastic/glass material with a bulb at one end of the graduated stem o Not anymore used in the lab or hospital setting

Liquid-in-glass

Surface thermometer: at the side or top of incubators or heating ove

Liquid in glass

Fast reading with millisecond response time o Usually used in the laboratory to measure room temperature o Someforfreezer/refrigeratortemperature(thecordis inside, with the metal part) o 20-24degC–roomtemp

Electronic thermometer or thermistor probe

Used to determine and monitor body temperature

Digital thermometer

Asyntheticaromaticpolymer o Clear, hard, and brittle, and as a thermoplastic polymer it is in a solid glassy state o One of the most widely used plastics o Great for general sample storage and transport and is commonly used in lab supplies like test tubes, microplates, and petri dishes. o Disposablepetridishes

Polystyrene

Athermoplasticpolymer o Commonly used to manufacture plastic lab supplies like beakers, bottles, flasks, test tubes, and many others. o Different from polystyrene - Rugged and

Polypropylene

If high heat resistance opaque appearance

Autoclave

Used for viscous samples/fluids o Uses mercury as a calibrating medium o Proper use requires rinsing of the pipet with the final solution after content are delivered into the diluent (rinsing technique) o Rinsed since the viscous sample might have sticked to the walls o We use automatic pipettes now. As Hg, is a hazard.

According to Design or Calibration Marks

The separation of particles in a liquid solution based on on exposure to air difference in their ability to pass through a membrane → Not used in lab today → The micromolecules are separated from the macromolecules → Urea is a micromolecule (removed, separated), retained in the BALANCES: blood are protein which is a macromolecule

Dialysis