Clinical Chemistry Laboratory
104 Questions
4 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary focus of clinical chemistry?

  • Analysis of bodily fluids to aid in the diagnosis of disease (correct)
  • Research on the causes of disease
  • Study of the structure of biological molecules
  • Development of new medical treatments

    • Which of the following is NOT a type of specimen used in clinical chemistry testing?

  • Tissue samples (correct)
  • Urine
  • Sweat
  • Blood (serum or plasma)

    • What is the main benefit of automation in clinical chemistry?

  • Improved safety for staff
  • Reduced medical errors (correct)
  • Increased specimen sample volume
  • Increased cost of testing

    • What is the third step in automated analysis?

    <p>Chemical reaction phase</p> Signup and view all the answers

    What is the basis of most automation in clinical chemistry?

    <p>Photometry</p> Signup and view all the answers

    What is the purpose of the chemical reaction phase in automated analysis?

    <p>To cause the sample to change color</p> Signup and view all the answers

    What is the first step in automated analysis?

    <p>Specimen collection and processing</p> Signup and view all the answers

    What is the benefit of reduced specimen sample volume in automation?

    <p>Less invasive procedures for patients</p> Signup and view all the answers

    What is the purpose of the measurement phase in automated analysis?

    <p>To measure the specimen's concentration</p> Signup and view all the answers

    What is the final step in automated analysis?

    <p>Data handling</p> Signup and view all the answers

    What is the main purpose of a spectrophotometer in automated analysis?

    <p>To measure the intensity of light at different wavelengths</p> Signup and view all the answers

    What is the result of a darker color in automated analysis?

    <p>Less light will pass through the sample</p> Signup and view all the answers

    What is the function of an osmometer in clinical chemistry?

    <p>To measure the concentration of solute particles per unit volume of solvent</p> Signup and view all the answers

    What is the end product of protein metabolism?

    <p>Urea</p> Signup and view all the answers

    What is the purpose of a fluorometer in clinical chemistry?

    <p>To analyze the wavelength distribution of fluorescence emitted by a sample</p> Signup and view all the answers

    What is the result of a high glucose level in the blood?

    <p>The liver removes excess glucose from the blood</p> Signup and view all the answers

    What is the difference between fasting blood glucose and random blood glucose?

    <p>Fasting blood glucose requires an 8-12 hour fast, while random blood glucose does not</p> Signup and view all the answers

    What is the purpose of a glucose tolerance test?

    <p>To diagnose and monitor diabetes</p> Signup and view all the answers

    What is the function of the liver in glucose metabolism?

    <p>To remove excess glucose from the blood and store it as glycogen</p> Signup and view all the answers

    What is the unit of measurement of the Olympus Chemistry Analyzer AU5400?

    <p>tests per hour</p> Signup and view all the answers

    What is the normal range for Fasting Blood Sugar?

    <p>3.9-6.1 mmol/L</p> Signup and view all the answers

    What is the purpose of the 2-hour postprandial blood glucose test?

    <p>To measure the glucose level after a meal</p> Signup and view all the answers

    What is the oral glucose tolerance test used for?

    <p>To diagnose Gestational Diabetes Mellitus</p> Signup and view all the answers

    What is the normal range for 2-hour postprandial blood glucose test?

    <p>3.6-8.8 mmol/L</p> Signup and view all the answers

    What is the purpose of the 50 gm glucose challenge?

    <p>To diagnose Gestational Diabetes Mellitus</p> Signup and view all the answers

    What is the normal range for Hemoglobin A1C?

    <p>4.4-6.4%</p> Signup and view all the answers

    What is the normal range for fasting blood glucose in Gestational Diabetes Mellitus?

    <p>3.9-6.1 mmol/L</p> Signup and view all the answers

    What is the purpose of the 2-hour postprandial blood glucose test in screening for type 2 diabetes?

    <p>To screen for type 2 diabetes when the fasting blood glucose is between 6.1-6.9 mmol/L</p> Signup and view all the answers

    What is the normal range for 1-hour glucose level in the 50 gm glucose challenge?

    <p>7.8-11.0 mmol/L</p> Signup and view all the answers

    Hemolysis has no effect on chemistry results.

    <p>False</p> Signup and view all the answers

    Point of care testing (POCT) is always performed in a centralized laboratory.

    <p>False</p> Signup and view all the answers

    Automation in clinical chemistry testing always requires a large sample volume.

    <p>False</p> Signup and view all the answers

    The quality control process in point of care testing is not as rigorous as in centralized laboratory testing.

    <p>False</p> Signup and view all the answers

    Hemolysis is a rare occurrence in clinical chemistry testing.

    <p>False</p> Signup and view all the answers

    Automation in clinical chemistry testing has no benefits in terms of turnaround time.

    <p>False</p> Signup and view all the answers

    Point of care testing machines are never used for therapeutic drug monitoring.

    <p>False</p> Signup and view all the answers

    Multiple-test panels by POCT are typically found in the laboratory, not in the ICU or ER.

    <p>False</p> Signup and view all the answers

    Hemolysis always causes a significant increase in troponin levels in laboratory results.

    <p>False</p> Signup and view all the answers

    Electrolytes are not one of the analytes that can be measured by multiple-test panels by POCT.

    <p>False</p> Signup and view all the answers

    Hemolysis has no effect on laboratory results, especially in chemistry tests.

    <p>False</p> Signup and view all the answers

    Glucose levels are typically decreased in laboratory results due to hemolysis.

    <p>False</p> Signup and view all the answers

    Portable instruments by POCT are not capable of measuring multiple tests simultaneously.

    <p>False</p> Signup and view all the answers

    Hemolysis has a moderate effect on haptoglobin levels in laboratory results.

    <p>True</p> Signup and view all the answers

    Hemolysis has a slight effect on phosphate levels in laboratory results.

    <p>True</p> Signup and view all the answers

    Delayed centrifugation is a cause of hemolysis.

    <p>True</p> Signup and view all the answers

    Poring blood from one tube to another does not affect the test results.

    <p>False</p> Signup and view all the answers

    Creatine clearance requires only a 24-hour urine specimen.

    <p>False</p> Signup and view all the answers

    Lipids are soluble in water.

    <p>False</p> Signup and view all the answers

    Low-density lipoprotein (LDL) is considered 'good' cholesterol.

    <p>False</p> Signup and view all the answers

    Myocardial injury can only occur as a result of acute events.

    <p>False</p> Signup and view all the answers

    Improper venipuncture collection is a type of IV contamination.

    <p>True</p> Signup and view all the answers

    Triglycerides are a type of protein.

    <p>False</p> Signup and view all the answers

    EDTA tubes are used for the collection of electrolytes to prevent errors.

    <p>False</p> Signup and view all the answers

    Hemolysis can contribute to decreased potassium levels in serum or plasma.

    <p>False</p> Signup and view all the answers

    Re-centrifugation of specimens in gel tubes can prevent errors in potassium measurement.

    <p>False</p> Signup and view all the answers

    The normal range for Hemoglobin A1C is 5.4-7.4%.

    <p>False</p> Signup and view all the answers

    Bicarbonate maintains the water balance in the body.

    <p>False</p> Signup and view all the answers

    Potassium is responsible for the transmission of nerve impulses.

    <p>True</p> Signup and view all the answers

    Chloride is an electrolyte that maintains the acid-base balance in the body.

    <p>False</p> Signup and view all the answers

    Hemoglobin A1C is a test done every 6 months on diabetics.

    <p>False</p> Signup and view all the answers

    Myoglobin is a late marker of injury to muscle tissue.

    <p>False</p> Signup and view all the answers

    Troponins are found in both cardiac and skeletal muscle.

    <p>True</p> Signup and view all the answers

    Creatine Kinase Myoglobin (CK-MB) is not cardio-specific.

    <p>False</p> Signup and view all the answers

    Elevation of CK-MB can be seen within 1-3 hours of onset of symptoms.

    <p>False</p> Signup and view all the answers

    Liver tests provide information about liver enzymes, proteins, and other markers that can indicate liver damage or inflammation.

    <p>True</p> Signup and view all the answers

    Troponins remain elevated in the blood for 1-4 days after MI.

    <p>False</p> Signup and view all the answers

    Myoglobin is a protein complex found only in cardiac muscle.

    <p>False</p> Signup and view all the answers

    Creatine Kinase Myoglobin (CK-MB) is an early marker of injury to muscle tissue.

    <p>True</p> Signup and view all the answers

    Match the following effects of hemolysis on chemistry results:

    <p>Slight change = Phosphate, total protein, albumin, magnesium, Calcium, alk phos Moderate change = ALT, CK, Iron Gross change = K, LD, AST No effect = Hemoglobin</p> Signup and view all the answers

    Match the following multiple-test panels by POCT with their typical location:

    <p>Electrolytes, urea, glucose, lactate = ICU or ER Hemoglobin, glucose, lactate = Laboratory Troponin, ALT, AST = ICU or ER Hemoglobin A1C, glucose, lipid = Laboratory</p> Signup and view all the answers

    Match the following tests with their respective purposes:

    <p>Pregnancy test = Detecting pregnancy Glucose tolerance test = Diagnosing diabetes 2-hour postprandial blood glucose test = Screening for type 2 diabetes 50 gm glucose challenge = Screening for Gestational Diabetes Mellitus</p> Signup and view all the answers

    Match the following analytes with their effects due to hemolysis:

    <p>Haptoglobin = Decreased Bilirubin = Decreased T4 = Decreased Phosphate = Increased</p> Signup and view all the answers

    Match the following POCT instruments with their characteristics:

    <p>Portable instrument = Can measure multiple tests simultaneously Handheld instrument = Found in the laboratory Multiple-test panel = Usually found in the ICU or ER POCT instrument = Requires a small sample volume</p> Signup and view all the answers

    Match the following tests with their respective specimens:

    <p>Glucose tolerance test = Blood Pregnancy test = Urine Urine test = Urine Hemoglobin A1C test = Blood</p> Signup and view all the answers

    Match the following effects of hemolysis on laboratory results:

    <p>Hemolysis = Breakdown of red blood cells Troponin = decreased Glucose = Decreased Hemoglobin =</p> Signup and view all the answers

    Match the following steps with the correct description of Glucometer operation:

    <p>Prepare the lancing device = Select the depth of penetration for blood collection Insert a test strip = Turn on the monitor and match the code number Obtain the drop of blood = Press the lancet device and collect the blood Discard the used test strip = Dispose of the test strip in a biohazard container</p> Signup and view all the answers

    Match the following tests with their respective frequencies:

    <p>Fasting blood glucose = Routinely 2-hour postprandial blood glucose test = Occasionally Glucose tolerance test = Rarely Pregnancy test = As needed</p> Signup and view all the answers

    Match the following quality control procedures with their correct descriptions:

    <p>Record control results = Documenting results on a specific type of document Review for consistency = Checking for acceptability of results Dispose of used lancet = Pressing the eject button and placing it in a sharps container Check code number display = Matching the code number on the test strip container</p> Signup and view all the answers

    Match the following electronic QC functionality with their correct descriptions:

    <p>Automatic turn on = The monitor turns on when a test strip is inserted Code number display = Matching the code number on the test strip container Sample area filling = Touching the drop of blood to the edge of the test strip Glucose result display = Displaying the result within a few seconds</p> Signup and view all the answers

    Match the following POCT tests with their correct descriptions:

    <p>Hemoglobin A1C = Point of Care Testing for glucose monitoring Cholesterol = Point of Care Testing for lipid measurement Pregnancy test = Point of Care Testing for urine or serum analysis Urinalysis = Point of Care Testing for kidney function analysis</p> Signup and view all the answers

    Match the following Urinalysis and Pregnancy testing procedures with their correct descriptions:

    <p>Collecting first morning specimen = Collecting urine with the highest concentration of hormone Refrigerating urine = Storing urine at a temperature up to 2 days Freezing urine = Storing urine at -20°C for 1 year Using a clean plastic container = Collecting urine in a sterile container</p> Signup and view all the answers

    Match the following Glucometer testing procedures with their correct descriptions:

    <p>Selecting the depth of penetration = Preparing the lancing device for blood collection Pressing the lancet device = Obtaining the drop of blood for testing Inserting a test strip = Starting the glucose testing process Discarding the used test strip = Disposing of the test strip in a biohazard container</p> Signup and view all the answers

    Match the following Point of Care Testing procedures with their correct descriptions:

    <p>POCT for Hemoglobin A1C = Point of Care Testing for glucose monitoring POCT for Cholesterol = Point of Care Testing for lipid measurement POCT for Urinalysis = Point of Care Testing for kidney function analysis POCT for Pregnancy testing = Point of Care Testing for urine or serum analysis</p> Signup and view all the answers

    Match the following Quality Control procedures with their correct descriptions:

    <p>Recording control results = Documenting results on a specific type of document Reviewing for consistency = Checking for acceptability of results Checking code number display = Matching the code number on the test strip container Disposing of used lancet = Pressing the eject button and placing it in a sharps container</p> Signup and view all the answers

    Match the following steps with the correct procedure in a non-gestational oral glucose tolerance test (OGTT):

    <p>Fasting blood sample collection = Step 2 50 gm glucose drink consumption = Step 3 2-hour post-load blood sample collection = Step 4 Patient fasting for 8-12 hours = Step 1</p> Signup and view all the answers

    Match the following with the correct purpose in Glucose Tolerance Testing:

    <p>Determining Gestational Diabetes Mellitus = 2-step approach with 50 gm glucose challenge Diagnosing Diabetes Mellitus = Non-gestational OGTT Screening for Diabetes = Fasting Blood Glucose test Monitoring Blood Glucose levels = Random Blood Glucose test</p> Signup and view all the answers

    Match the following with the correct blood glucose level measurement:

    <p>1 hour post-glucose challenge = 50 gm glucose challenge 2 hours post-glucose load = Non-gestational OGTT Fasting = Fasting Blood Glucose test Random = Random Blood Glucose test</p> Signup and view all the answers

    Match the following with the correct step in the 50 gm glucose challenge procedure:

    <p>Patient does not have to fast = Step 1 50 gm glucose drink consumption = Step 2 1 hour post-glucose challenge blood sample collection = Step 3 Labeling the blood sample = Step 4</p> Signup and view all the answers

    Match the following with the correct purpose in Gestational Diabetes Mellitus screening:

    <p>2-step approach with 50 gm glucose challenge = Gestational Diabetes Mellitus screening Non-gestational OGTT = Diagnosing Diabetes Mellitus Fasting Blood Glucose test = Screening for Diabetes Random Blood Glucose test = Monitoring Blood Glucose levels</p> Signup and view all the answers

    Match the following with the correct timing in the non-gestational OGTT procedure:

    <p>8-12 hours = Fasting period 5 minutes = Glucose drink consumption 2 hours = Post-load blood sample collection 1 hour = Fasting blood sample collection</p> Signup and view all the answers

    Match the following with the correct characteristic of the 50 gm glucose challenge:

    <p>Patient does not have to fast = Characteristic 1 50 gm glucose drink consumption = Characteristic 2 1 hour post-glucose challenge blood sample collection = Characteristic 3 Patient must finish the drink within 5 minutes = Characteristic 4</p> Signup and view all the answers

    Match the following clinical chemistry concepts with their respective definitions:

    <p>Enzyme = A biological molecule that catalyzes chemical reactions Hormone = A chemical messenger produced by glands Protein = A large biomolecule composed of amino acids Trace metal = A small amount of metal essential for biological functions</p> Signup and view all the answers

    Match the following point of care testing (POCT) concepts with their respective advantages:

    <p>Rapid results = Improved patient care Portability = Increased accessibility Ease of use = Reduced training requirements Multiple-test capability = Enhanced patient profiling</p> Signup and view all the answers

    Match the following clinical chemistry tests with their respective specimens:

    <p>Liver tests = Blood Hormone tests = Urine Protein tests = Blood or urine Pancreatic tests = Blood or stool</p> Signup and view all the answers

    Match the following clinical chemistry concepts with their respective effects on results:

    <p>Hemolysis = Interferes with laboratory results Lipids = Affects solubility in water Electrolytes = Impacts multiple-test panels Creatine clearance = Requires specific urine collection</p> Signup and view all the answers

    Match the following point of care testing (POCT) concepts with their respective quality control procedures:

    <p>Electronic QC functionality = Automated quality control checks Quality control process = Rigorous testing and validation Preanalytical errors = Errors occurring before testing Therapeutic drug monitoring = Regular testing and adjustment</p> Signup and view all the answers

    Match the following clinical chemistry tests with their respective applications:

    <p>Glucose tolerance test = Diagnosing gestational diabetes Fasting blood glucose = Screening for type 2 diabetes Hemoglobin A1C = Monitoring blood glucose control 2-hour postprandial blood glucose = Diagnosing type 2 diabetes</p> Signup and view all the answers

    Match the following clinical chemistry concepts with their respective effects on glucose levels:

    <p>Prolonged storage = Decreases glucose levels Lipemia = Interferes with glucose measurements Fasting = Decreases glucose levels Hemolysis = decreases glucose levels</p> Signup and view all the answers

    Match the following types of specimens with their respective characteristics:

    <p>Blood (serum or plasma) = Can be used to detect levels of enzymes, sugars, and protein Urine = Can be used for urinalysis and pregnancy testing Feces = Can be used for detecting gastrointestinal disorders CSF = Can be used for diagnosing neurological disorders</p> Signup and view all the answers

    Match the following steps in automated analysis with their respective descriptions:

    <p>Step 1 = Specimen collection and processing Step 2 = Specimen and reagent measurement and delivery Step 3 = Chemical reaction phase using photometry Step 4 = Measurement phase</p> Signup and view all the answers

    Match the following benefits of automation in clinical chemistry with their respective advantages:

    <p>Reduce of medical errors = Improved patient safety Reduce specimen sample volume = Less invasive procedures Improve safety for staff = Reduced risk of exposure to infectious diseases Faster Turn around time = Improved patient outcomes</p> Signup and view all the answers

    Match the following quality control procedures with their respective purposes:

    <p>Quality control process = To ensure accuracy and reliability of test results Hemolysis detection = To detect interference in test results Specimen collection and processing = To ensure proper handling and storage of specimens Instrument calibration = To ensure accurate instrument performance</p> Signup and view all the answers

    Match the following urinalysis characteristics with their respective descriptions:

    <p>Pregnancy testing = Can be used to detect pregnancy Urinalysis = Can be used to detect urinary tract infections Urine culture = Can be used to detect bacterial infections Urine chemistry = Can be used to detect kidney function</p> Signup and view all the answers

    Match the following glucometer operation characteristics with their respective descriptions:

    <p>Glucose measurement = Can be used to measure glucose levels Calibration = To ensure accurate instrument performance Quality control = To ensure accuracy and reliability of test results Data storage = To store glucose level data for future reference</p> Signup and view all the answers

    Study Notes

    Clinical Chemistry

    • Clinical chemistry is a branch of laboratory medicine that focuses on the analysis of bodily fluids, such as blood, urine, and other biological samples, to aid in the diagnosis, prognosis, and monitoring of disease and health conditions.
    • The clinical chemistry department of a laboratory is usually divided into three groups: Routine Chemistry, Routine Chemistry Urinalysis, and Special Chemistry.

    Types of Specimens

    • Blood (serum or plasma)
    • Urine
    • Feces
    • CSF (Cerebrospinal fluid)
    • Sweat
    • Hair

    Clinical Chemistry Testing

    • Clinical chemistry testing includes processes used to detect levels of enzymes, sugars, protein, and other substances in the blood to determine clinical conditions such as nutritional state, liver function, kidney function, and others.
    • Such testing is used to diagnose conditions such as diabetes, hyperlipemia, and arteriolosclerosis.

    Automation

    • Clinical chemistry was the first department to be automated.
    • Automation has many benefits, including:
      • Reduction of medical errors
      • Reduction of specimen sample volume
      • Improvement of safety for staff
      • Faster turnaround time

    Steps in Automated Analysis

    • Step 1: Specimen collection and processing
    • Step 2: Specimen and reagent measurement and delivery
    • Step 3: Chemical reaction phase
    • Step 4: Measurement phase
    • Step 5: Data handling

    Steps in Automated Analysis (Details)

    • Step 3: Most automation is based on photometry. A specimen is introduced into the instrument, mixed with reagents, and a chemical reaction occurs, changing the sample's color.
    • Step 4: The instrument measures the absorbance and gives a result.
    • Step 5: The results are read and checked if they fall within certain parameters.

    Example

    • Blood glucose testing: a chemical reaction produces a blue color, with darker blue indicating higher glucose levels and lighter blue indicating lower glucose levels.

    Types of Instruments

    • Spectrophotometer: measures the intensity of light at different wavelengths to determine the concentration of substances in a sample.
    • Fluorometer: measures the intensity and wavelength distribution of fluorescence emitted by a sample.
    • Osmometers: determines the osmolarity of biological fluids and solutions.

    Common Tests Done in Clinical Chemistry

    • Bilirubin: formed by Hgb breakdown, increased in liver damage.
    • Urea: end product of protein metabolism, excreted by the kidneys, increased in kidney damage.
    • Cholesterol and Triglyceride: measures lipids in the body.
    • Creatinine: metabolic waste, increased in kidney damage.
    • Drug analysis: determines the correct dosage of a drug.
    • Electrolytes: tests for electrolyte imbalance.
    • Glucose: tests for diabetes.
    • Hormones: various hormone tests.
    • Troponin: cardiac enzyme test.
    • Creatine kinases: muscle enzyme test.
    • LDH: enzyme test.
    • AST: liver enzyme test.

    Glucose

    • Glucose is a simple sugar formed when dietary carbohydrates are digested.
    • The liver removes excess glucose from the blood and stores it as glycogen.
    • When glucose is needed for energy, the liver converts glycogen back to glucose (glycogenolysis).

    Glucose Tests

    • Random glucose: taken at any time, no requirements.
    • Fasting Blood glucose (FBS): patient fasts for 8-12 hours, normal range is 3.9-6.1 mmol/L.
    • 2-hour postprandial blood glucose test (2 hr PC): taken exactly 2 hours after a meal, normal range is 3.6-8.8 mmol/L.
    • Oral Glucose Tolerance test (OGTT, GTT): used to diagnose and monitor diabetes.
    • HbA1c: measures the average blood glucose level over a 2-3 month period, normal range is 4.4-6.4%.

    Clinical Chemistry

    • Clinical chemistry is a branch of laboratory medicine that focuses on the analysis of bodily fluids, such as blood, urine, and other biological samples, to aid in the diagnosis, prognosis, and monitoring of disease and health conditions.

    Point of Care Testing (POCT)

    • POCT is a type of testing that can be performed at the bedside or near the patient.
    • It involves the use of portable instruments, some of which are handheld, to measure multiple tests, including electrolytes, urea, glucose, lactate, and hemoglobin.
    • These instruments are usually found in the ICU or ER and play an important role in life-threatening situations.

    Hemolysis

    • Hemolysis is the breakdown of red blood cells.
    • It can affect lab results, including phosphate, total protein, albumin, magnesium, calcium, alk phos, ALT, CK, iron, K, LD, AST, and troponin.
    • Hemolysis can cause changes in test results, ranging from slight to gross, depending on the degree of hemolysis.

    Liver Tests

    • Liver tests are a group of blood tests used to assess the health and function of the liver.
    • These tests provide valuable information about liver enzymes, proteins, and other markers that can indicate liver damage, inflammation, or dysfunction.

    Renal Function

    • Renal function refers to the physiological processes carried out by the kidneys, which play a crucial role in maintaining overall health and homeostasis within the body.
    • Tests used to assess renal function include urea, creatinine, uric acid, and creatine clearance.

    Lipids

    • Lipids are a diverse group of organic molecules that are insoluble in water but soluble in organic solvents.
    • They serve essential roles in cellular structure, energy storage, insulation, and signaling within the body.
    • Lipids play an important role in many metabolic processes, including hormone or hormone precursors, energy storage and metabolic fuel, structural and functional component in cell membrane, and insulation to allow conduction of nerve impulses or heat loss.

    Tests used for Lipids

    • Cholesterol
    • Triglycerides
    • Low density lipoprotein (LDL)
    • High density lipoprotein (HDL)

    Cardiac Disease - Myocardial Injury

    • Cardiac disease, particularly myocardial injury, refers to damage or impairment to the heart muscle (myocardium) due to various pathological processes.
    • Myocardial injury can occur as a result of acute events such as myocardial infarction (heart attack).
    • Tests used to diagnose a myocardial infarction or injury include myoglobin, troponins, and creatine kinase myoglobin (CK-MB).

    Electrolytes

    • Electrolytes are essential minerals or ions that are present in bodily fluids and tissues, including blood, urine, and intracellular fluid.
    • They carry an electrical charge and play critical roles in various physiological processes throughout the body.
    • The main electrolytes in the human body include sodium (Na+), potassium (K+), chloride (Cl-), calcium (Ca2+), magnesium (Mg2+), phosphate (PO43-), and bicarbonate (HCO3-).

    Problems with Potassium (K)

    • The concentration of K in RBC is about 20 times that in serum or plasma.
    • Hemolysis must be avoided when collecting potassium samples.
    • Technical errors that can contribute to elevated K include recentrifugation of specimens in gel tubes.

    Quality Control

    • All control results must be recorded on a document and reviewed for consistency and acceptability

    Single Testing

    Glucometer

    • Prepare the lancing device by selecting the depth of penetration to collect a drop of blood with the least amount of pain
    • Obtain the drop of blood by pressing the lancet device against the finger and pressing a button
    • Dispose of the used lancet by pressing the eject button and placing it in a sharps container
    • Insert a test strip, and the monitor will automatically turn on
    • The code number display must match the code number on the test strip container
    • Touch and hold the drop of blood to the edge of the sample area of the test strip until the sample area is filled
    • The glucose result will be displayed within a few seconds, and the used test strip must be discarded in a biohazard container

    Hemoglobin A1C

    • No specific details mentioned

    Cholesterol

    • Point of Care testing available

    Urinalysis

    • No specific details mentioned

    Pregnancy Tests

    • Pregnancy tests are Point of Care tests (POCT)
    • Many different types of kits available, testing both serum and urine
    • When using urine, a suitable time is required after fertilization to allow B-HCG to rise to a significant level
    • First morning specimen is required because it contains the highest concentration of the hormone
    • Must be collected in a clean plastic container
    • Can be refrigerated up to 2 days or frozen (-20°C) for 1 year

    Multiple-Test-Panels by POCT

    • Portable instruments can measure multiple tests, such as electrolytes, urea, glucose, lactate, and hemoglobin
    • Usually found in ICU or ER
    • Important in life-threatening situations

    Hemolysis

    • Hemolysis is the breakdown of red blood cells
    • Important to the laboratory because it affects lab results

    Effects of Hemolysis on Chemistry Results

    • Degree of change in analyte:
      • Slight change: Phosphate, total protein, albumin, magnesium, calcium, alk phos, haptoglobin, bilirubin
      • Moderate change: ALT, CK, Iron, T4
      • Gross change: K, LD, AST, Troponin, Glucose

    Screening Methods for Diabetes

    • 2 types of screening methods:
      • Non-Gestational Oral Glucose Tolerance test
      • Gestational Oral Glucose Tolerance test

    Procedure of a OGTT (Non-Gestational)

    1. Patient is given instructions to fast for 8-12 hours
    2. Collect a venous fasting blood sample (label the tube "fasting")
    3. Patient is given a drink containing 75g of glucose, which must be finished within 5 minutes
    4. Exactly 2 hours after the drink has been consumed, collect a venous blood sample (label "2h post load")

    Procedure to Determine Gestational Diabetes Mellitus

    • Recommended for all pregnant women between 24-28 weeks
    • 2-step approach:
      1. 50gm glucose challenge with a blood glucose level taken after 1 hour
      2. If the result is abnormal, perform a 3-hour OGTT

    50 gm Glucose Challenge

    1. Patient does not have to fast
    2. Patient is given 50g of glucose to drink, which must be finished within 5 minutes
    3. Exactly 1 hour after consuming the drink, collect a blood sample (label "1 hour")

    Other Testing

    Liver Tests

    • No specific details mentioned

    Enzymes

    • No specific details mentioned

    Pancreatic Testing

    • No specific details mentioned

    Hormone Testing

    • No specific details mentioned

    Protein

    • No specific details mentioned

    Other Tests

    • No specific details mentioned

    Therapeutic Drug Monitoring

    • No specific details mentioned

    Trace Metals

    • No specific details mentioned

    Point of Care Testing (POCT)

    Definition

    • Point of Care testing is a type of testing that can be performed at or near the site of patient care

    Advantages

    • No specific details mentioned

    Disadvantages

    • No specific details mentioned

    Preanalytical Errors

    • No specific details mentioned

    Quality Control

    • No specific details mentioned

    Machines

    • No specific details mentioned

    Hemolysis

    Definition

    • Hemolysis is the breakdown of red blood cells

    Effects on Chemistry Results

    • No specific details mentioned

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Unit 4 Clinical Chemistry_Diane Perry 1.0.ppt

    Description

    This quiz covers the basics of clinical chemistry, a branch of laboratory medicine that analyzes bodily fluids to aid in disease diagnosis and monitoring. Topics include the types of specimens, clinical chemistry departments, and more.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser