Clinical Biochemistry Lecture 6 PDF

Problem: A 35 years old man has some pain in the back abdominal part. According to the lab result, the serum creatinine was 150 µmol/L and the 24h collected urine was 2160 mL with creatinine level 7.5 mmol/L calculate the creatinine clearance if you know the actual time for urine collection was 17 h...

Problem: A 35 years old man has some pain in the back abdominal part. According to the lab result, the serum creatinine was 150 µmol/L and the 24h collected urine was 2160 mL with creatinine level 7.5 mmol/L calculate the creatinine clearance if you know the actual time for urine collection was 17 hours? Ref rang (97-137 mL/min). Escherichia coli (E. coli) Many Escherichia coli (E. coli) bacteria exist in the environment and in the human gut. Most E. coli bacteria are harmless or cause mild cramping and diarrhea in infected people. However, some strains of E.coli bacteria can release toxin. These are referred to as shigatoxin-producing E. coli (also referred to as enterohemorrhagic E. coli [EHEC] and verotoxigenic E. coli [VTEC]). Gram negative, pink colored, small rod shape E. coli under light microscope Salmonellae Gram-negative, flagellated, anaerobic bacteria H or flagellar antigen includes the proteins that are found on the flagella of the bacteria They has three major antigens: O or somatic antigen on the surface of the outer membrane Vi antigen Present only in a few serovars Serovar or serotype: A subdivision of a species or subspecies distinguishable from other strains therein based on antigenic character Salmonellosis includes several syndromes 1. gastroenteritis Vomiting, Abdominal pain, diarrhea by S typhimurium and S enteritidis 2. enteric fevers Typhoid fever by S. typhi, S. paratyphi-A, and S. schottmuelleri 3. septicemia blood poisoning, that caused by bacteria or their toxins by S choleraesuis 4. asymptomatic carrier state people who are infected but show little or no symptoms of the disease and transmit to another people  Shigella They are gram negative, short rod, non motile (no H antigen) Contain capsule (K antigen) and (O) antigen Symptoms Abdominal cramps, vomiting bloody diarrhea Treatment Using antibiotics as ciprofloxacin or azithromycin. Examination of the stool for parasites amoebic liver abscess 1. Protozoa a. Entamoeba histolytica It is transmitted by the faeco-oral route. The cysts which contain four nuclei are indicative of an infective stage in humans It produces large, flask shaped ulcers. It may get complicated into amoebic liver abscess and amoebic lung abscess Trophozoite present in the tissue Cyst present in the Lumen of colon and in formed stool Amoebiasis can be present with no, mild, or severe symptoms. Symptoms may include lethargy, loss of weight, colonic ulcerations, abdominal pain, diarrhea, or bloody diarrhea (amoebic dysentery ) cysts have 3-4 nuclei, chromatoid body with typically blunted (rounded) ends trophozoites have a single nucleus with pseudopodium  b. Entamoeba coli Entamoeba coli is the only species in the genus encountered in humans with more than four nuclei in the cyst stage Chromatoid bodies (pointed ends) are seen less frequently than in E. histolytica nonpathogenic, although they have been found in the stool of patients presenting with diarrhea Entamoeba gingivalis considered nonpathogenic, but is found in about 95% of patients with gum disease and about 50% of patients with healthy gums Transmitted by usually Kissing no known cyst stage for Entamoeba gingivalis The trophozoite stage of E. gingivalis is morphologically similar to that of E. histolytica Entamoeba coli, harmless entamoeba Entamoeba gingivalis  Protozoa in stool Intestinal protozoa may be found in stools in their motile form(trophozoites) or as cysts. The trophozoites of protozoa are motile. either because of slow movements of the cell (amoebae); or because they have rapidly moving flagella (long whip-likethreads) or cilia (numerous short hairs) Trophozoites are chiefly found in: watery stools stools containing mucus soft formed stools