CLIN CHEM Flashcards by Kyra Catedral

It is the branch of medical science involved in the analysis of biological materials , usually bodily fluids, to provide diagnostic results on the state of human body

Clinical Chemistry

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Basic analytical Techniques

Spectrophotometry
Nephelometry
Turbidimetry
Electrophoresis
Flame emission spectrophotometry
Atomic absorption spectrophotometry

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The measurement of the intensity of light at selected wavelengths

Spectrophotometry

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A useful analytical tool to determine the concentration of colored material in a solution

Spectrophotometry

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Uses prisms or gratings to isolate a narrow range of wavelength of light

Spectrophotometry

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2 kinds of light that spectrophotometry employs

Visible Light
Invisible Light

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VISIBLE LIGHT

Ultraviolet light = < 400 nm

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INVISIBLE LIGHT

Infrared light = > 700 nm

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scatter light

Monochromator

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amount of color changed

Cuvette

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amount of light

Digital Display

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Not commonly used
Light scattered by an unknown substance is
measured at right angles

Nephelometry

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Depends on wavelength and particle size

Nephelometry

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Measures the amount of light blocked
(absorbance) by a suspension of particles

Turbidimetry

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Depends on particle size and concentration

Turbidimetry

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Charged molecules moves at different rates when pulled through an electrical field

Electrophoresis

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Cations (positively charged ions) will move to ____

cathode (negative electrode)

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Anions (negatively charged ions) will move to ____

anode (positive electrode)

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Measures light emitted by excited atoms
Measures electrolytes

Flame Emission Spectrophotometry

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Certain elements give off a characteristic light after excited atoms return to ground state

Flame Emission Spectrophotometry

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– intense yellow flame

Sodium

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violet flame

Potassium

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– brick red flame

Calcium

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Measures light absorbed by ground state atoms

Atomic Absorption Spectrophotometry

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Routinely used to measure the concentrations of trace metals

Atomic Absorption Spectrophotometry

the usual light source employed in atomic absorption spectrophotometry

Hollow cathode lamp

Routinely tested clinical chemistry assays

Blood glucose Blood lipid profile Kidney (renal) function tests Liver function test Cardiac function test

the primary source of energy for humans

Glucose (carbohydrates)

Short-term storage sites of glucose

Liver and Skeletal muscles

Long-term storage sites of glucose

Adipose tissues

low sugar level

Hypoglycemia

high sugar level

Hyperglycemia

Defect in the beta cells of the pancreas

DIABETES MELLITUS

Leads to a decrease in the production of insulin (a hormone necessary to maximize the utilization of glucose for energy production)

DIABETES MELLITUS

excessive urination

Polyuria

excessive thirst

Polydipsia

excessive eating

Polyphagia

TESTS TO BE DONE: DIABETES MELLITUS - 6 – 8 hours fasting prior to blood collection

Fasting blood sugar (FBS)

TESTS TO BE DONE: DIABETES MELLITUS - extracting capillary blood

Random blood sugar (RBS)

TESTS TO BE DONE: DIABETES MELLITUS - pregnant women - ingest glucose - extract blood- - For pregnant women to rule out cases of gestational diabetes

Oral glucose tolerance test (OGTT)

TESTS TO BE DONE: DIABETES MELLITUS - collected after 2 hours

2-hour post-prandial blood sugar (2HPPBS)

TESTS TO BE DONE: DIABETES MELLITUS - Monitoring tool for long-term diabetes - To determine if diabetes has been existing for several months already (long-term diabetes) - It reflects the average blood glucose over a three-month period

Glycosylated hemoglobin (HBA1C)

Glycosylated hemoglobin (HBA1C) is measured through

affinity chromatography

organic substances characterized by their general insolubility in water a

Lipids

Regarded as fat

Lipids

1 gram of lipid = _kcal of heat

secondary energy source

lipids

Important constituent of cell membrane

lipids

Classifications of lipids

Fatty acids Triglycerides (Triacyglycerol) Cholesterol Phospholipids Lipoproteins

Simplest form of lipids but not routinely measured

Fatty acids

lipids solid at room temperature

saturated

lipids that are liquid at room temperature.

Unsaturated

Good fats

unsaturated

neutral fats consisting of fatty acids and glycerol

Triglycerides (Triacyglycerol)

Act as the storage form of lipids in the human body

Triglycerides (Triacyglycerol)

When serum samples turned turbid from blood collected after a meal, it is due to the presence of __________

Triglycerides

prevents turbidity

fasting

An example of a steroid alcohol

Cholesterol

Necessary for the production of various hormones, vitamin D, and even bile salt which is necessary for fat digestion

Cholesterol

Measurement is usually requested in conjunction of _____

CVD - Cardiovascular Disease

Most abundant form of lipids but not routinely measured

Phospholipids

Phospholipids: 70%

lecithin

Phospholipids: 20%

sphingomyelin

Phospholipids: 10%

cephalin

an important parameter to determine fetal-lung maturity Used to evaluate the safety of a pre-term delivery

Lecithin/sphingomyelin (L/S) ratio

Lipid transporters

Lipoproteins

Classified based on their density or through electrophoresis Generally, as protein content increases, the lipid content decreases, making it smaller but denser

Lipoproteins

Types of Lipoproteins

HDL VLDL LDL CHYLOMICRONS

alpha-lipoprotein

HDL (High Density Lipoprotein)

“good cholesterol”

alpha-lipoprotein

Transports cholesterol back to the liver for the synthesis of bile salts and very low density lipoprotein (VLDL)

alpha-lipoprotein

Smallest but the heaviest

alpha-lipoprotein

High levels of HDL suggest decreased risk of developing ________

atherosclerosis

Smallest but the heaviest type of lipoprotein

HDL

Pre-beta lipoprotein

VLDL

Transports endogenous triglycerides to the muscle and adipose cells

VLDL

Beta-lipoprotein “bad cholesterol”

LDL

Transports cholesterol to peripheral tissues

LDL

Increased levels suggest risk of developing atherosclerosis

LDL

Transport exogenous triglycerides to adipose tissue and cells

Chylomicrons

Increased amount of lipids Can be genetic

lipemia

Person did not undergo fasting

Chylomicrons

paired organs considered as the body’s major “waste sweeper”

Kidneys

functional unit of kidneys Forms urine

Nephron

Nephron forms urine through four major process:

Glomerular filtration Tubular reabsorption Tubular secretion Tubular concentration

Waste product of muscle metabolism Derived from creatine phosphate (stored in the muscles and is used for energy)

CREATININE

Waste product of protein catabolism 90% is excreted in the urine

BLOOD UREA NITROGEN (BUN)

Elevation of blood urea nitrogen

Azotemia

Elevation of blood urea nitrogen If accompanied by renal failure, it is termed _________

uremia

Starvation, pregnancy and a low protein diet

Low BUN

high protein diet, after administration of steroids and kidney diseases

High BUN

Used to check how well the kidneys are working

GLOMERULAR FILTRATION RATE (GFR)

Estimates how much blood passes through the glomeruli each minute

GLOMERULAR FILTRATION RATE (GFR)

Recommended for: CKD caused by diabetes Family history of kidney diseases Frequent UTI Heart disease High blood pressure Urinary blockage

GLOMERULAR FILTRATION RATE (GFR)

much more accurate than BUN No need to collect urine sample

Renal Scan

Organ responsible for the synthesis of many organic substances

Liver

Detoxifies the body against noxious substances

Liver

Brownish yellow substance found in the bile Produced when the liver breaks down old red blood cells

BILIRUBIN

Removed from the body through the stool (feces) Gives stool its normal color

BILIRUBIN

Water-insoluble bilirubin Toxic bilirubin and its accumulation in the brain may lead to kernicterus

B1 or indirect or unconjugated bilirubin

Water-soluble bilirubin Eliminated in the urine and makes it appear dark-yellow

B2 or direct or conjugated bilirubin

SGOT – Serum Glutamic Oxaloacetic Transaminase Tissue sources: liver, heart, skeletal muscle, kidney, pancreas, brain, spleen and lungs

Aspartate aminotransferase (AST)

SGPT – Serum Glutamic Pyruvic Transaminase Tissue sources: liver, heart, skeletal muscle, kidney and pancreas Considered as a liver-specific enzyme and is increased in cases of hepatic disorders

Alanine aminotransferase (ALT)

Helps identify the cause of hepatic disorders

De Ritis Ratio (ALT/AST ratio)

Useful in the diagnosis of bone and liver diseases

Alkaline Phosphatase (ALP)

Useful in the diagnosis of chronic alcoholism resulting in liver damage

Gamma-glutamyl transferase (GGT)

Useful in the assessment of insecticide and pesticide poisoning

Cholinesterase

Measures the total amount of protein in the blood

TOTAL SERUM PROTEIN TESTS

Made mainly in the liver Helps keep the blood from leaking out of the blood vessels Helps carry some medicines and other substances through the blood Important for tissue growth and healing

Albumin

Group of proteins in the bloodstream that help regulate the function of the circulatory system

Globulin

Refers to the low total protein level in the blood

Hypoproteinemia

Suggestive of liver disorders, kidney disorders or a disorder in which protein is not digested or absorbed properly

Hypoproteinemia

Refers to the high total protein level in the blood

Hyperproteinemia

May be seen with chronic inflammation or infections such as viral hepatitis or HIV

Hyperproteinemia

Test of plasma clotting activity

PROTHROMBIN TIME (PT)

Reflects the activity of vitamin K-dependent clotting factors synthesized by the liver

PROTHROMBIN TIME (PT)

Reflects the activity of vitamin K-dependent clotting factors synthesized by the liver

PROTHROMBIN TIME (PT)

To evaluate whether one’s heart is healthy or not Patient’s who experienced episodes of myocardial infarction as manifested by chest pain

Cardiac Function tests

Most sensitive and specific test for myocardial damage Isoforms of the proteins T and I are specific to myocardium Expected to peak 12 hours after infarction

Troponin test

Along with troponin, ordered as a cardiac biomarker to help diagnose or rule out a heart attack Increase later than troponin but not specific and will not stay elevated for long as troponin

Myoglobin

Rise: 2 – 3 hours ; Peak: 8 – 12 hours ; Normalized: 24 hours

Myoglobin

A biomarker indicative of an inherent cancerous condition

Tumor markers