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Questions and Answers
What type of determination primarily assesses kidney functioning through analysis of substances in blood and urine?
What type of determination primarily assesses kidney functioning through analysis of substances in blood and urine?
Which of the following substances would be assessed using qualitative determination?
Which of the following substances would be assessed using qualitative determination?
In which category would the determination of sodium (Na) levels fall?
In which category would the determination of sodium (Na) levels fall?
Which of the following describes quantitative determination?
Which of the following describes quantitative determination?
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Qualitative determination can be important for evaluating which of the following conditions?
Qualitative determination can be important for evaluating which of the following conditions?
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What condition is characterized by the total suppression of urine excretion?
What condition is characterized by the total suppression of urine excretion?
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In which of the following situations could anuria be observed?
In which of the following situations could anuria be observed?
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Which poison is specifically mentioned as a potential cause of anuria?
Which poison is specifically mentioned as a potential cause of anuria?
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Which of the following treatments is associated with anuria?
Which of the following treatments is associated with anuria?
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Anuria is an indication of potential issues related to which organ?
Anuria is an indication of potential issues related to which organ?
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What is the effect of bacterial growth on the composition of urine?
What is the effect of bacterial growth on the composition of urine?
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Which of the following is a direct consequence of ammonia liberation in urine?
Which of the following is a direct consequence of ammonia liberation in urine?
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What biochemical process changes the pH of urine from acidic to basic?
What biochemical process changes the pH of urine from acidic to basic?
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Which biochemical substance primarily leads to the increase in urine pH during bacterial growth?
Which biochemical substance primarily leads to the increase in urine pH during bacterial growth?
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In what way does bacterial action affect the acidic nature of urine?
In what way does bacterial action affect the acidic nature of urine?
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What is the primary purpose of collecting a catheterized sample?
What is the primary purpose of collecting a catheterized sample?
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In what situation is a catheterized sample typically collected?
In what situation is a catheterized sample typically collected?
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Which method is not suitable for collecting a urine sample in cases of anuria?
Which method is not suitable for collecting a urine sample in cases of anuria?
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What condition does 'anuria' refer to?
What condition does 'anuria' refer to?
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Why might total urinary excretion be measured?
Why might total urinary excretion be measured?
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Which condition is most likely to be associated with hyperphosphatemia?
Which condition is most likely to be associated with hyperphosphatemia?
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Which of the following is related to hypophosphatemia?
Which of the following is related to hypophosphatemia?
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What condition can lead to hyperphosphatemia in normal children?
What condition can lead to hyperphosphatemia in normal children?
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Which of these conditions is commonly associated with hypoparathyroidism?
Which of these conditions is commonly associated with hypoparathyroidism?
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Which of the following vitamin deficiencies is most likely to cause hypophosphatemia?
Which of the following vitamin deficiencies is most likely to cause hypophosphatemia?
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Which condition is characterized by excessive destruction of red blood cells?
Which condition is characterized by excessive destruction of red blood cells?
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What condition results from the increased absorption of iron from the gastrointestinal tract?
What condition results from the increased absorption of iron from the gastrointestinal tract?
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Which condition is associated with decreased utilization of iron in the body?
Which condition is associated with decreased utilization of iron in the body?
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In which condition is there an increased release of iron from the body’s stores?
In which condition is there an increased release of iron from the body’s stores?
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Which of the following scenarios leads to enhanced iron absorption in the digestive system?
Which of the following scenarios leads to enhanced iron absorption in the digestive system?
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Study Notes
Clinical Biochemistry I (MTML 311)
- Course: Clinical Biochemistry I
- Course Code: MTML 311
- Semester: 5th
- Lecturer: Dr.rer.med/ Saleh Bilgasem
- Year: 2024
Clinical Biochemistry
- Clinical biochemistry is a division of medical biochemistry
- It deals with physiological and unnatural chemical measurements in bodily fluids (blood, urine, etc.)
- Includes qualitative and quantitative analyses
Purpose of Clinical Chemistry Tests
- Applied biochemistry to diagnose conditions
- Measures various chemical constituents in bodily fluids
- Qualitative and quantitative analyses are performed on blood, urine, and other bodily fluids.
- Determination of urea, creatinine, and other inorganic substances (Na, K, Ca, Cl) can help diagnose diseases.
- Methods can be manual, kit-based, or automated.
Types of Specimens for Chemical Analysis
- Whole blood, serum, or plasma are common specimens
- Serum is the most common, collected in tubes without anticoagulants to allow clotting.
- Urine: often collected over 24 hours
- Other specimens: Pleural fluid, cerebrospinal fluid (CSF)
Obtaining Blood Samples
- Capillary blood: from a finger or thumb (used for hematological analysis - RBC, WBC counts, Hb etc)
- Arterial blood: for blood gas analysis (CO2, O2, HCO3, pH etc). Restricted
- Venous blood: for analysis of various chemical constituents (glucose, urea, cholesterol, etc.)
Avoiding Hemolysis
- Clean and dry syringe and needle
- Apply minimum constriction to the arm
- Allow slow and steady blood flow into the syringe
- Remove needle before expelling blood into the tube
- Gentle rotation when anticoagulant is present
Anticoagulants
- Heparin: Convenient, does not alter blood constituents, acts as antithrombin preventing thrombin and fibrin formation
- Sodium and potassium oxalate: Form insoluble complex with calcium preventing coagulation
- Ammonium oxalate: (3 parts ammonium oxalate + 2 parts potassium oxalate) used for hematological investigations
- Sodium citrate: Does not precipitate calcium but ionizes it. Used in 3 mg/ml blood.
- Sodium fluoride: Preservative for glucose measurements. Acts as a weak anticoagulant. Inhibits glycolysis enzymes (e.g., Enolase) (2mg/ml blood)
- Ethylene diamine tetraacetic acid (EDTA) preserves cellular components in blood samples. Chelates calcium needed for clotting (2mg/ml blood)
Protein Precipitants
- Used in clinical chemistry analysis to remove proteins from serum for preparation of protein-free filtrate (PFF)
- Common precipitants include:
- Trichloroacetic acid
- Alkaline zinc salt
- Organic solvent
Urine
- Urine is an ultrafiltrate of blood, filtered and excreted by the kidneys
- Terms to describe urine volume:
- Polyuria: increased daily urine output
- Oliguria: decreased daily urine output
- Anuria: complete suppression of urine output
Changing Urine Constituents
- Bacterial growth can convert urea to ammonia, altering pH
- Yeast can affect glucose content, making samples unsuitable for glucose determination
- Phosphate and uric acid may precipitate in alkaline or cold urine, respectively
Urine Sample Processing
- Chemical examination (sugar, protein, acetone, bilirubin, etc.)
- Macroscopic examination (color, odor, specific gravity, transparency)
- Microscopic examination (casts, pus, RBCs, crystals, etc.)
Urine Samples
- Different types of urine samples: Random, Timed, Catheterized, Bacteriological considerations
- Normal constituents: Urea, ammonia, creatinine, uric acid, amino acids, salts, and minerals
Abnormal Urine Constituents
- Albuminuria: presence of albumin in urine, often due to stress, exercise, or underlying conditions
- Glycosuria: presence of glucose in urine, indicative of diabetes mellitus
- Ketonuria: presence of ketone bodies in urine, often during periods of low carbohydrate intake or increased fat metabolism.
- Bilirubinuria: presence of bilirubin in urine, often indicative of liver or gallbladder problems
- Hematuria: presence of RBCs in urine, which can be from a variety of conditions
Electrolytes
- Electrolytes are distributed in body fluids
- Cations: Na, K, Ca, Mg
- Anions: Cl, HCO3, H2PO4, HPO4, SO4, protein
- Major cation in extracellular and intracellular fluids are different
Sodium (Na+)
- Important for acid-base balance, blood osmotic pressure, cell permeability
- Clinical significance: Normal serum sodium levels (135-148 mmole/L).
- Hyponatremia: Decreased levels
- Hypernatremia: Increased levels
Potassium (K+)
- Major intracellular ion, important for muscle function, nerve impulse transmission, osmotic pressure, and enzyme activation.
- Clinical significance: Normal serum potassium levels (3.5-5 mmole/L).
- Hyperkalemia: Increased levels
- Hypokalemia; Decreased levels
Phosphorus
- Important for bone mineralization, energy transfer (ATP), etc.
- Clinical significance: Normal serum phosphorus levels (2.4-4.5 mg/dL).
- Hyperphosphatemia: Increased levels
- Hypophosphatemia: Decreased levels
Iron (Fe)
- Part of hemoglobin and myoglobin. Important in oxygen transport and regulation of cell growth and differentiation
- Clinical significance: increased or decreased iron levels are related to corresponding conditions like hemolytic anemia
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Description
This quiz covers the fundamentals of Clinical Biochemistry I, focusing on physiological and chemical measurements in bodily fluids. Students will explore the purpose of clinical chemistry tests and the types of specimens used in analysis. Prepare to test your knowledge on biochemical analysis techniques and their applications in diagnosing diseases.
