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CLINICAL CHEMISTRY > INTRODUCTION TO CLINICAL CHEMISTRY > Flashcards

INTRODUCTION TO CLINICAL CHEMISTRY Flashcards

1
Q

Clinical chemistry tests measure ____ of substances (ions, molecules, complexes in body fluids.

A

concentrations or activities

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2
Q

This is a Quantitative science section in laboratory medicine that primarily quantity or counts the CONCENTRATION of the different analytes in the body and specifically with the substances such as whole blood, plasma, serum, urine, and cerebrospinal fluid in our system.

A

Clinical Chemistry

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3
Q

Clinical chem entails 3 factors in laboratory, what are those?

A

handling, maintenance, and troubleshooting

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4
Q

Machines are called

A

automated analyzers

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5
Q
  • It is a branch of laboratory medicine that is concerned with the ____ in body fluids to facilitate the diagnosis of diseases.
A

quantitative measurement of analytes

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6
Q

– substances that we measure are called

A

analytes

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7
Q

give an example of analytes

A

Proteins
Enzymes
Metabolites (sugar and lipids)
Drugs
Ions,
salts,
minerals (calcium, potassium, sodium, etc.)

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8
Q

Clinical importance of protein allows us to diagnose and check the status of what organ

A

liver

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9
Q

why do high presence of protein in blood shows possible damaged of liver?

A

associated to liver disorders as most of the proteins are synthesized by the liver

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10
Q

what is the importance of enzyme in cc?

A

To detect organ damage

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11
Q

What is the importance of metabolites (sugar and lipids ) in CC?

A

Increase in cases of sedentary lifestyle. Also, Metabolites are usually high if there’s metabolic syndromes

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12
Q

What is the importance of drugs in CC?

A

it will measure a concentration of drugs

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13
Q

A method that will measure the concentration of drugs is called ___

A

TDM - therapeutic drug monitoring

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14
Q

what is the most common body fluid in cc?

A

blood

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15
Q

What type of blood sample will you expect in CC section?

A

Serum

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16
Q
  • The methods to measure these substances are carefully designed to provide accurate assessments of the concentrations

Where does the method come from?

A

Derived from the reference method

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17
Q

is a method of acceptable accuracy and precision

All the analytes have undergone different studies and they all have their own reference method

A

reference method

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18
Q

clinical chem can be a science, service, and industry

  • as a ___, it links the knowledge of general chemistry, organic chemistry, and biochemistry with an understanding of human physiology–
A

science

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19
Q

clinical chem can be a science, service, and industry

  • as a ___, it produces objective evidence from which medical decisions may be made
A

service

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20
Q

clinical chem can be a science, service, and industry

  • as an ___, clinical laboratories are businesses, which operate under the regulations and practices that guide commerce in the United States.
    Clinical chem can open a clinical laboratory
A

industry

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21
Q

what are the scope of cc

A

computers
biochemistry
instrumentation
pharmacology’
endocrinology
immunology
toxicology/forensic toxicology
analytical chemistry

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22
Q

scope of clinical chemistry that is also called laboratory information system

A

computers

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23
Q

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

A

laboratory infomation system

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24
Q

one of the scopes of the clinical chem that is Dealing with the four fundamental biomolecules

A

biochemical

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25
Q

what are the 4 fundamental biomolecules

A

lipids, protein, glucose, nucleic acid

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26
Q

one of the scope of clinical chem that is focused in

A

Automations, Machines, and the way we troubleshoot. – Analyzer

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27
Q

one of the scope of clinical them that is focused on drugs

A

pharmacology

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28
Q
  • The branch of physiology and medicine concerned with endocrine glands and hormones.
    e.g. measure the level of the hormones
A

endocrinology

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29
Q

one of the scope in cc

The toxic substances in the body could also trace them.
e.g. blood alcohol level testing

A

TOXICOLOGY/ FORENSIC TOXICOLOGY

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30
Q

Deals with the measurement also of
 different substances
 Different measurement
 Different apparatus

A

analytical chemistry

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31
Q

2 types of test in Clinical Chem

A

 Core test and specialized test

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32
Q

type of test in clinical chem that is
 Routinely being ordered or done
 They are very easy to perform

A

core test

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33
Q

a core test: glucose
is one of the testing diagnosis for what health condition?

A

Diagnosis of Diabetes Mellitus

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34
Q

what are the test we can conduct in glucose?

A
  • Fasting blood sugar or FBS
  • Random blood sugar (RBS)
  • (HbA1c)Hemoglobin A1C or Glycosylated hemoglobin
  • Glycated albumin or fructosamine
  • Oral glucose tolerance test
  • 2 hour postprandial test
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35
Q

a glucose test that is Requiring 6-8 hours of fasting

A

fasting blood sugar or FBS

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36
Q

a glucose test that Does not require fasting//can measure anytime of the day

A

random blood sugar or RBS

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37
Q

 Measure of the average blood glucose level – average of 3 months period

A
  • (HbA1c)Hemoglobin A1C or Glycosylated hemoglobin
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38
Q

 Measure of the average blood glucose level – average of 17-21 days period

A
  • Glycated albumin or fructosamine
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39
Q

 A confirmatory test for gestational diabetes mellitus

A
  • Oral glucose tolerance test
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40
Q

how many blood collection does oral glucose tolerance test need?

A

3-4 times blood collection

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41
Q

 Measures how well your body metabolizes sugar

A
  • 2 hour postprandial test
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42
Q

blood sample needed for a glucose test that needs fasting

A

fbs - serum

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43
Q

blood sample needed for a glucose test that is related to fbs but doesn’t need fasting

A

rbs - serum

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44
Q

blood sample needed for a glucose test that measures the average blood glucose level in an average of 3 months

A

HbA1c - WHOLE BLOOD

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45
Q

blood sample needed for a glucose test that measures the average blood glucose level in an average of 17-21 days

A

whole blood for* Glycated albumin or fructosamine

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46
Q

blood sample needed for a glucose test that is for the confirmatory test for gestational dm

A

serum for oral glucose tolerance test

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47
Q

blood sample for a glucose test that measure how well your body metabolize sugar

A

serum for 2 hr post prandial test

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48
Q
  • Test that detects the status of the kidney
A

renal function test

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49
Q

renal function test detects the ability of the kidney to what?

A

to excrete, reabsorb, concentrates

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50
Q
  • They are being done in order for us to test for the function of your kidney
A

renal function test

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51
Q

 termed as Renal blood flow test or NPN’s (non-protein nitrogens)

A

urea- creatinine- uric acid

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52
Q

give the tests under liver or hepatic function panel

A

bilirubin test, TPAG, ALP, AST, ALT,

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53
Q

3 bilirubin test

A

b1, b2, and tb

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54
Q

which bilirubin test is the indirect bilirubin

A

b1

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55
Q

which bilirubin test is the DIRECT bilirubin

A

b2

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56
Q

how do we compute for the TB or the total bilirubin test?

A

adding b1 and b2

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57
Q

what does TPAG stands for

A

total protein, albumin/globulin

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58
Q

ALP test stands for

A

alkaline phosphatase

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59
Q

AST test stands for

A

Aspartate Aminotransferase/ aspartate transaminase /

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60
Q

AST or Aspartate Aminotransferase/ aspartate transaminase is also known as

A

SGOT

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61
Q

ALT test stands for

A

Alanine aminotransferase/ Alanine Transaminase/

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62
Q

ALT test – Alanine aminotransferase/ Alanine Transaminase/ is also known as

A

SGPT

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63
Q

are alp, ast, and alt enzymes or electrolytes?

A

enzymes

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64
Q

lipid profile consists of how many test test?

A

Constitute of 4-5 test

65
Q

give the example of tests under the lipid profile

A

 Total cholesterol test (Lipid)
 Triglyceride/ TAG or triacylglycerol (Lipid)
 HDL – high density lipoprotein (lipoprotein)
 LDL – low density lipoprotein (lipoprotein)
 Very low lipoprotein (lipoprotein)

66
Q

examples of test under enzymes

A

amylase, lipase, creatine kinase

67
Q

enzyme test that are primarily used for the diagnosis of acute pancreatitis

A

amylase and lipase

68
Q

enzyme test that is employed for the diagnosis of Myocardial Infarction (heart attack

A

creatine kinase

69
Q

test for this one is the assessment for the body hydration and most commonly they are routinely ordered by the doctor

A

electrolytes

70
Q

give some hormone test under the specialized test

A

t3, t4, tsh, ft3 and ft4

T3- triiodothyronine (found in thyroid gland)
T4- thyroxine (found in thyroid gland)
Tsh – thyroid stimulating hormone found in hypothalamus

71
Q

tests under specific protein

A

 C reactive protein
 Immunoglobulins
 Ceruloplasmin

72
Q

marker of wilson’s disease

A

ceruloplasmin

73
Q

what are the example of trace elements test

A

vitamin and drug tests

74
Q

can we test vitamin c under a specialized test?

A

no

75
Q

we can only test which vitamin?

explain the principle

A

 We can only test Vit D as it’s related to calcium and parathyroid hormone

76
Q

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

A

vancomycin

77
Q

common analytes in cc

Ions, Salts, and Minerals, give the examples under this one

A

 Sodium,
 Potassium,
 Calcium
 Chloride
 CO2,
 Lead
 Iron

78
Q

common analytes in cc

Small Organic Molecules
*Metabolites

give the examples under this one

A

 Glucose
 Cholesterol
 Uric acid

79
Q

common analytes in cc

Small Organic Molecules
therapeutic drugs
give the examples under this one

A

 Vancomycin
 Theophylline
 Digoxin

80
Q

common analytes in cc

Small Organic Molecules
Toxicology
give the examples under this one

A

 Alcohol
 Salicylate
 Acetaminophen

81
Q

common analytes in cc

Small Organic Molecules
Drugs of Abuse
give the examples under this one

A

 Cocaine Alcohol
 Salicylate
 Acetaminophen

 Barbiturates
 Amphetamine

82
Q

common analytes in cc

LARGE Organic Molecules
*Transport Proteins
give the examples under this one

A

 Albumin
 Transferrin
 Haptoglobin

83
Q

common analytes in cc

LARGE Organic Molecules
*Enzymes
give the examples under this one

A

 Lipase
 Amylase
 Creatinine Kinase

84
Q

common analytes in cc

LARGE Organic Molecules
* *Specific Proteins
give the examples under this one

A

 Immunoglobulins
 C-reactive proteins
 Complement

85
Q

common analytes in cc

LARGE Organic Molecules
* *Diabetes Marker
give the examples under this one

A

 Hemoglobin A1c
 HbA1c

86
Q
  • Most common specimen in Clinical chemistry
A

BLOOD

87
Q

why basilic is the last option?

A

Because it’s near the brachial artery

88
Q

what re the 3 forms of blood/

A

whle blood, plasma and serum

89
Q

a form of blood that is actually the blood which contains all the formed elements and the liquid portion

A

whole blood

90
Q

– Liquid portion of non-clotted Blood that contains Anticoagulant

A

PLASMA

91
Q

what is present in the plasma but absent in serum?

A

Fibrinogen

92
Q

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 ___.

A

venipuncture

93
Q

the next common sample aide from the blood?

A

urine

94
Q

a sample used for evaluating kidney functions and tests that look at waste products excreted by kidneys

A

urne

95
Q

 For Chemistry testing, _____urine is usually used to test metabolites (urea, creatinine, excretions rates may vary by the time of the day)

A

24-hour

96
Q

What method of collection is very important in urine collection under CC lab?

A

24-hour urine collection

97
Q

What are the clinical chemistry test we can conduct in 24 hour urine sample?

A

 Creatinine clearance
 24 hr urine protein
 Urine electrolytes test

98
Q

What is the greatest source of error in any clearance test?

A

 Improperly timed specimen collection as it needs to be a 24-hr collection

99
Q

is clear and colorless fluid surrounding the brain and spinal cord

A

CEREBROSPINAL FLUID

100
Q

its function is to * To lubricate and provides the nutrients for the brain and spinal cord

A

CEREBROSPINAL FLUID

101
Q
  • Csf is produced in the
A

choroid plexus

102
Q
  • Method of Collection of csf
A

o Lumbar Puncture / Spinal Tap/ lumbar tap
- collected on 3-4 to 4-5 lumbar/vertebral space

103
Q

csf is intended for the diagnosis of

A

Intended for Diagnosis of Meningitis and Neurological problems or diseases

104
Q

how many tubes are used in csf?

A

3-4 tubes

105
Q

1st tube used in clinical chem is for

A

Clinical Chemistry, Immunology and Serology

106
Q

how much percentage does glucose constitute in csf?

A

60-70%

107
Q

how much mg/dl does protein constitute in csf?

A

Protein – 15-45mg/dL

108
Q

the 2nd tube used for csf is for

A

Microbiology/Bacteriology

109
Q

the 3rd tube used for csf is for

A

hematology

110
Q

the 4th tube used for csf is for

A

Specialized section: Histopathology or Immunoserology
 Cell cytology
 For cancers

111
Q

they are called the “serous fluid”

A

PLEURAL FLUID
PERICARDIAL FLUID
PERITONEAL

112
Q

serous fluid Found in Lung cavity

A

PLEURAL FLUID

113
Q

manner of collection of PLEURAL FLUID

A

Thoracentesis

114
Q

serous fluid found in Heart

A

PERICARDIAL FLUID

115
Q

PERICARDIAL FLUID ‘s manner of collection

A

Pericardiocentesis

116
Q

serous * Found in Gastrointestinal

A

PERITONEAL FLUID

117
Q

PERITONEAL FLUID’s manner of collection

A

Paracentesis

118
Q

PERITONEAL FLUID is also called

A

ascitic fluid/ascites

119
Q

clinical chem test for serous fluid

A

 Protein
 Glucose
 LDH – lactate dehydrogenase

120
Q

other body fluids produced by the pregnant women which the site is on the amniotic sac

A

amniotic fluid

121
Q

MOC of amniotic fluid

A

Amniocentesis

122
Q

clinical chem test for amniotic fluid

A

 L/S ratio or lecithin sphingomyelin ratio
 Creatinine
 AFP or Alpha fetoprotein

123
Q

an amniotic cc test for the diagnosis of FLM (fetal lung maturity)

A

 L/S ratio or lecithin sphingomyelin ratio

124
Q

some doctors punctured the bladder – if there’s a high level of ____, there’s a cross contamination with the urine and amniotic fluid

A

creatinine

125
Q

amniotic test in cc that is - For the diagnosis of trisomy 21 or Down syndrome

A

 AFP or Alpha fetoprotein

126
Q

synovial fluid’s MOC

A

Arthrocentesis

127
Q

rejected specimens are those with :

A
  • Unlabeled, improperly labeled, mismatched specimen, insufficient quantity (QNS)
  • Incorrect collection tube
  • Underfilled /overfilled collection tube (with anticoagulant)
  • Hemolyzed
128
Q

in specimen labeling, there must be 2 identifies, what are those?

A

 Name
 Date of birth

129
Q
  • Specimen submitted must bear a completed request form (must include the following
A

 Name
 Age
 Date
 Time
 Test
 Sex
 Physician
 Diagnosis

130
Q

explain the principle under the underfilled collection tube AC

A

 Underfilled – not enough specimen or wrong ratio can cause dilution in sample
 WILL CAUSE FALSELY DECREASED VALUES

131
Q

explain the principle under the overfilled collection tube AC

A

 Overfilled – too much: susceptible to clot
 WILL CAUSE CLOTTING OF BLOOD

132
Q

one of the common error in specimen rejection

A

hemolyzed sample

133
Q

Hemolyzed samples are Unsuitable for tests such as:

A

 Potassium
 Magnesium
 Phosphorus
 Enzyme (ACP, LDH, AST)

134
Q

CONSEQUENCES OF SPECIMEN REJECTION

A
  1. Repeated specimen collection
  2. Delay in the analysis and reporting of result.
  3. Delay in the treatment of the patient
135
Q

according to college of American pathologist, ___ minutes of clinical treatment is being delayed if you have specimen rejection.

A

65 minutes

136
Q

LABORATORY WORKFLOW IN CLINICAL CHEMISTRY SECTION

A

 REQUISITION – 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

137
Q

– comparison of the previous result from the present result
Importance: for quality control or quality assurance

A

Delta checking

138
Q

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

A

Clinical Laboratory Improvement Amendments (CLIA) of 1988

139
Q

Two Levels of Regulations of the CLIA

A

Waived Tests an nonwaived tests

140
Q

one of the two level of the regulation from the clia

simple laboratory examinations and procedures that are cleared by the U.S. Food and Drug Administration (FDA) for home use
- Test that can be done at the comfort of or home without medtechs
- E.g. blood glucose

A

waived tests

141
Q

one of the two regulation of the clia

moderately and highly complex tests as defined by the requirements for operator skill, reagent preparation, and automation and the difficulty of interpretation of results. These are regulated under guidelines that cover quality standards for proficiency testing (PT), patient test management, quality control, personnel qualifications, and quality assurance.
- requires a skill and reagents and undergo proficiency testing.

A

non waived test

142
Q

comparison of one lab result to another lab result

A

proficiency testing

143
Q
  • In 1828, ____ (1800-82) found that urea, an ‘organic’ substance, could be synthesized in vitro without any ‘vital force’ or living organism.
A

Friedrich Wöhler

144
Q
  • ___ is the one who observed analyte
  • He introduced the concept of clinical chemistry
  • ## Before, they thought that the analytes inside the body can not be found outside
A

Friedrich Wöhler

145
Q

friedrich wohler
- They tried to boil ___ resulting to Urea

A

ammonium cyanate

146
Q

the first analyte that builds the foundation of clinical chemistry
- the discovery of ___ cancelled the concept of Vital force

A

urea

147
Q

___ –looked back on experiments of Antoine-Laurent de Lavoisier in pneumatic chemistry.

A

Henry Bence Jones

148
Q

a protein name was been coined from him, protein found in immunologic disorder

A

 Bence Jones

149
Q

–“few and scanty, indeed, are the rays of light which chemistry has flung on the vital mysteries.”

A

Robert James Graves (1796-1853

150
Q

complained that clinicians do not use their chemistry laboratory services except when needed for “luxurious embellishment for a clinical lecture.
 Clin chem is only for lectures.

A

Max Josef von Pettenkofer (1818-1901

151
Q

a year when *–urine test for diabetes and carbohydrate metabolism investigations started

A

1815

152
Q

first used the term “clinical chemical laboratory (klinisch chemischem Laboratorium)

A

Johann Joseph Scherer (1814-1869

153
Q

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. Peetersentitled Clinical Chemistry.

A

Donald D. van Slyke (1883-1971)

154
Q

He is also the founder of Modern Clinical Chemistry

A

Donald D. van Slyke

155
Q

a year or stage when Crude techniques but advances to understand the living material were made despite limitations.

  1. Discovery of starch, fats and some blood proteins were isolated and characterized
  2. Cholesterol in gall stones
  3. Chemical composition of urine
A

19th century

156
Q

invented the Technicon AutoAnalyzer

A

Dr. Leonard Skeggs

157
Q

year when the Radioisotopes were used in assay Scintillation counting devices

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

A

1970

158
Q
A

CLINICAL CHEMISTRY (15 decks)

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