Specialized Areas Of Medical Technology - Clinical Chemistry PDF

SPECIALIZED AREAS OF MEDICAL TECHNOLOGY CLINICAL CHEMISTRY CLIN. CHEMISTRY ★ includes basic chemical laboratory technique, chemical laboratory safety, ELECTROPHORESIS electrolytes and acid-base balance,...

SPECIALIZED AREAS OF MEDICAL TECHNOLOGY CLINICAL CHEMISTRY CLIN. CHEMISTRY ★ includes basic chemical laboratory technique, chemical laboratory safety, ELECTROPHORESIS electrolytes and acid-base balance, proteins, carbohydrates, lipids, enzymes, PRINCIPLES: metabolites, endocrine function, and Separates molecules (proteins, nucleic toxicology. acids) based on size and charge Crucial in diagnostic laboratories for analyzing proteins and dna especially in ANALYTICAL TECHNIQUES the context of diagnosing genetic SPECTROPHOTOMETRY disorders, cancers, and infectious diseases PRINCIPLES: Measures the absorbance of light by a TYPES: sample to determine concentration. 1. Gel Electrophoresis - Used for protein and DNA analysis and TYPES: separation. 1. UV-Vis Spectrophotometry 2. Capillary Electrophoresis - Measures absorbance in the ultraviolet - Offers higher resolution and faster and visible range. analysis. 2. Flame Photometry - Used in protein and nucleic acid analysis - Measures light emitted by excited atoms (used for sodium, potassium analysis). CHROMATOGRAPHY PRINCIPLES: Separates components in a mixture based on their affinity to a stationary phase and mobile phase Important for toxicology as this is ION-SELECTIVE ELECTRODE (ISE) essential in identifying toxins, drugs, PRINCIPLES: TYPES: Measures the concentration of specific 1. Gas-Chromatography ions in a sample using selective - GC membranes. - Analyzes volatile compounds. Important for monitoring electrolyte 2. High-Performance Liquid levels and managing conditions (kidney diseases and heart failure) and Chromatography - HPLC electrolyte imbalances - Used for non-volatile compounds. - Widely used in drug testing and COMMON IONS TESTED: metabolic analysis - Sodium (Na⁺) - Critical in pharmacology and toxicology - Potassium (K⁺) - Chloride (Cl⁻) for analyzing biological fluids - Calcium (Ca²⁺)  APPLICATIONS: - Toxicology - Drug testing - Metabolic profiling ADVANTAGES: - High sensitivity and specificity - Makes it ideal for drug testing, metabolic analysis, and detecting changing elements in biological samples ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA) PRINCIPLES: Uses antibodies to detect the presence of specific proteins, hormones, or other biomarkers. Powerful and widely used for detecting diseases For diagnosing infections, autoimmune diseases, and monitoring hormone levels TYPES: 1. Direct ELISA - Antigen is directly detected 2. Indirect ELISA - Detects antibodies in the sample. - Often used for immunological testing (HIV testing and Hepatitis testing) DIABETES-RELATED TESTS - FBG FASTING BLOOD Measures blood sugar levels GLUCOSE after fasting, used to diagnose diabetes. - OGTT ORAL GLUCOSE TOLERANCE Assesses glucose handling TEST after drinking a glucose solution. - HbA1c Reflects average blood glucose levels over the past HEMOGLOBIN 2-3 months, used for diabetes A1c management. MASS SPECTROMETRY (MS) Provides better picture of blood sugar control than the PRINCIPLES: daily glucose measurements Analyzes samples by ionizing chemical compounds and measuring their mass-to-charge ratios allowing identification of compounds in complex mixtures  ★ most common type of fat in your body. ★ come from foods, especially butter, oils, and other fats you eat. ★ also come from extra calories your body does not need right away. LIPOPROTEIN ★ round particles made of fat (lipids) and proteins that travel in your bloodstream to cells throughout your body. ★ Cholesterol and triglycerides are two types of lipids found in lipoproteins. LIPID PROFILE LIVER FUNCTION TESTS - Tests viral for assessing the risk of cardiovascular diseases (atherosclerosis, - fundamental in diagnosing liver diseases heart attack, and stroke) (hepatitis, cirrhosis, and liver cancer). - Can also help monitor the effects of TOTAL CHOLESTEROL medications that may cause liver toxicity ★ Measures the overall cholesterol level. - ALT ALANINE 1. High-Density Lipoprotein AMINOTRANSFERASE Elevated in liver damage or - HDL inflammation. - "Good" cholesterol, helps remove excess - AST cholesterol from the bloodstream ASPARTATE 2. Low-Density Lipoprotein AMINOTRANSFERASE Often elevated in liver or - LDL heart damage. - "Bad" cholesterol contributes to plaque - ALP buildup in arteries. ALKALINE 3. Very Low-Density Lipoprotein PHOSPHATASE Elevated in liver, bile duct, - VLDL or bone disease. - liver makes VLDL and releases it into your bloodstream. BILIRUBIN - particles mainly carry triglycerides to ★ High levels indicate liver dysfunction or tissues. hemolysis (breakdown of red blood cells). - similar to LDL cholesterol, but LDL ★ A product of RBC metabolism mainly carries cholesterol to your tissues ★ yellowish pigment that is made during instead of triglycerides. the breakdown of red blood cells. ★ Bilirubin passes through the liver and is eventually excreted out of the body. ★ Liver has the job to conjugate the bilirubin from RBC metabolism TRIGLYCERIDES ★ Type of fat in the blood, high levels indicate risk for heart disease.  KIDNEY FUNCTION TEST - CK-MB CREATININE KINASE - Essential for detecting and managing - MB Enzyme elevated during chronic kidney disease (CKD, acute heart muscle injury. kidney injury, etc.) - BNP B-TYPE NATRIURETIC CREATININE Indicator of heart failure PEPTIDE ★ Byproduct of muscle metabolism, high severity. levels indicate impaired kidney function. BLOOD UREA NITROGEN ★ BUN ★ Measures the amount of nitrogen in the blood, which reflects kidney function. ELECTROLYTE LEVELS ★ Sodium, Potassium, Chloride, and Bicarbonate are closely related to kidney health ENDOCRINE FUNCTION TEST THYROID FUNCTION TEST - Crucial for hormonal imbalances - These tests guide treatment for conditions (diabetes, adrenal insufficiency, and like graves disease and hashimoto’s parathyroid disorders) thyroiditis - TSH CORTISOL THYROID - ★ Measures the stress hormone, useful in STIMULATING hormone for diagnosing diagnosing Cushing’s syndrome or HORMONE hypothyroidism or adrenal insufficiency. hyperthyroidism. - T3 & T4 PARATHYROID HORMONE ★ PTH TRIIODOTHYRONINE Measures active thyroid ★ Regulates calcium levels, important in & THYROXINE hormones, essential for diagnosing parathyroid disorders. metabolism and growth regulation. INSULIN ★ Tests for insulin production and resistance, key in diabetes diagnosis. CARDIAC BIOMAKERS - Provide fast and accurate information essential for lifesaving interventions - Tnl, TnT Released during a heart TROPONINS attack, crucial for diagnosing acute myocardial infarction (heart attack).  ELECTROLYTE TEST - Important for diagnosing and managing conditions like dehydration, kidney disease, acid bases disturbances - Sodium and potassium imbalances are particularly concerning as they directly affect cardiac and neurological functions - Proper regulation of bicarbonate and chloride levels helps in detecting respiratory and metabolic imbalances (acidosis / alkalosis) LIVER ENZYMES - ALT SODIUM ALANINE ★ Critical for fluid balance and nerve Elevated in liver damage, AMINOTRANSFERASE function. particularly from hepatitis or cirrhosis. POTASSIUM - AST ★ Important for heart and muscle function, ASPARTATE imbalances can lead to arrhythmias. Found in the liver and heart, AMINOTRANSFERASE elevated in liver and muscle CHLORIDE damage. ★ Helps maintain acid-base balance - ALP ALKALINE BICARBONATE Elevated in liver disease, PHOSPHATASE ★ Regulates pH in the blood bone disorders, and bile duct obstructions. - GGT GAMMA-GLUTAMYL Elevated in liver disease, TRANSFERASE particularly due to alcohol or bile duct issues. - Essential for evaluating liver function in patient w suspected liver disease or those on hepatotoxic medications PANCREATIC ENZYMES Elevation suggests acute ENZYMES pancreatitis or other AMYLASE pancreatic diseases. ★ Proteins that catalyze biochemical reactions in the body. sensitive ★ Play a crucial role in metabolic pathways More specific to pancreatitis ★ Enzyme levels provide critical than amylase, increases in information to organ function and tissue cases of acute and chronic damage (elevated liver enzymes such as pancreatitis. LIPASE ALT and ast) that can lead to liver damage Specific making it the preferred test for PURPOSE OF ENZYME TESTS: confirming pancreatitis Diagnose diseases affecting specific organs (e.g., heart, liver, pancreas). - Monitoring these enzymes help in both Monitor disease progression and acute settings in and long term disease treatment effectiveness. management  MUSCLE ENZYMES AUTOMATION IN CLIN. CHEM - CK - Applied in streamlining diagnostics Elevated in muscle damage, (improving the efficiency and including conditions like effectiveness of the process of muscular dystrophy and identifying and diagnosing of diseases) CREATININE KINASE rhabdomyolysis. - Makes the process more organize, faster, and less complex Can be elevated in - Important for high volume laboratories myocardial infarction (heart ensuring that results are consistent and attack) reproducible while minimizing the risk of Measures muscle damage, human particularly in conditions like myopathies. BENEFITS: ALDOLASE ★ Increased speed and accuracy Often used along side w CK ★ Reduces human error. in the evaluation of ★ Can process large volumes of samples. neuromuscular disease AUTOMATED INSTRUMENTS: - These test are indicators of muscle 1. Chemistry analyzers damage ➔ Beckman coulter ➔ Siemens CARDIAC ENZYMES Integrated systems for simultaneous - CK-MB testing. Handle a large volume of lethal samples, CREATINE KINASE - increasing speed and accuracy Marker for heart muscle MB Reduces human error damage, used in diagnosing heart attacks. Highly specific and sensitive for cardiac injury, a key TROPONIN marker for myocardial infarction (heart attack). - LDH LACTATE Increases in heart, lung, or DEHYDROGENASE liver tissue damage. Less specific - CK-MB and troponin are vital for the early detection in management of acute coronary syndromes QUALITY CONTROL IN CLIN. CHEM PNEUMATIC TUBE SYSTEMS ★ Used to transport biological samples IMPORTANCE: quickly between departments in a ★ Ensures the reliability and accuracy of hospital or laboratories results. ★ propel cylindrical containers through networks of tubes by compressed air or TYPES OF QC: by partial vacuum. 1. INTERNAL QUALITY CONTROL ★ to deliver drugs, documents, and - Daily testing of known standards specimens to and from laboratories and 2. EXTERNAL QUALITY CONTROL nurses' stations. - Comparison with other labs. ★ Ensures timely diagnostics and quicker treatment decisions especially in emergency settings  ○ Higher chance of detecting light parasitemia and decreasing the time needed for reliable examination Buffy coat smear ○ Helpful in the detection of leishmania donovani, trypanosomes, and microfilariae PARASITOLOGY 2. BLOOD CONCENTRATION TECHNIQUE Knott’s concentration PARASITOLOGY ○ Blood + 2% Formalin = ★ Study of PARASITES Centrifuge (1500–2000 ★ Branch of biology concerned with the rpm for 2–5mins) phenomenon of dependence of one ○ Sediment: Check for living organism on another. Microfilaria – larval stage ★ Critical in diagnosing diseases that are of filarial parasites in the especially prevalent in tropical and blood subtropical regions, understanding the ○ Useful when low no. of life cycles of parasites and their microfilaria are present in interaction with human culture helps in the blood developing treatment and preventive ○ This enhances their measures for diseases like malaria, … visibility by concentrating them thru centrifugation Parasite ○ Formalin is used as a ★ Organisms that live on and obtain their fixative which helps to nutrients from another organism lyse the RBC and preserving the Host microfilariae for them to ★ The organism from which a parasite be seen under the obtains its nutrition and/ or shelter microscope EXAMINATION OF BLOOD 1. THICK AND THIN BLOOD SMEAR Thin ○ species identifications ○ Spread over the slide in a thin layer, yielding intact, non overlapping cellular elements Thick ○ Preferred for diagnosis bc it contains 16–30x more blood per microscopic field than the thin smear ○ Concentrated in a small area that is many cell layers deep  a. Giardia spp. (species) CONCENTRATION TECHNIQUES BASED ON: Performed on fresh / preserved specimens These make it more sensitive to detect larvae and egg - In a blood sample, these parasites are - Sedimentation found in: - the heavier parasites settle to the - Plasmodium - bottom as a result of gravity or - Babisha - infected RBC that centrifugation shows ring like structures - Formalin Ether Concentration - Trypanosoma - found in the Technique bloodstream that can be identified by their undilated - Floatation membrane and flagellum - lighter parasite cysts and eggs - Filaria - found in the rise to the surface of a solution of bloodstream, typically seen as high specific gravity elongated - For increased sensitivity - Brine Flotation EXAMINATION OF FECAL SPECIMENS 1. Wet mounts Direct Fecal Smear (NSS and Iodine) ○ Examines a wet, fresh stool sample under microscope ○ NSS (normal saline solution) – used to observe morphology Helminths - egg roundworms ○ Iodine - used to stain a. cysts and trophozoites b. Hookworm egg making them easier to c. Ascaris lumbricoides egg see d. Hookworm rhabditiform larvae 2. Concentration techniques e. Hymenolepis nana egg Aim to improve the no. of parasites in a smaller volume of HISTOPATHOLOGY stool, improving the chances of detection HISTOPATHOLOGY Formalin ether concentration ★ Derived from three Greek words: Zinc sulphate floatation ○ “Histos”- Tissues 3. Permanently stained smears ○ “Pathos”- Disease or suffering Involves fixing and staining stool ○ “Logos”- study samples to preserve the parasites ★ Used to describe the study and for long term examinations examination of abnormal tissues in aid Wheatley’s Trichrome Stain of identification and diagnosis Iron Hematoxylin Stain Modified Acid-Fast Stains 4. Culture Isolates and identify parasites from stool samples 5. Immunoassay (Antigen Detection) Uses antibody Detects parasite antigens using specific antibodies Often used for the rapid diagnosis of certain parasites: STEPS: microtome block holder, and the tissue is partially exposed. 1. Accessioning (Numbering) 9. Sectioning / Microtomy - the process of assigning an - the process of cutting the tissue identification code for the blocks into micro-thin slices of specimen to properly distinguish tissue ribbons using a microtome it from others without the use of 10. Staining the patient's name. - the process of coloring cellular 2. Fixation components of the tissue with a - the process of chemically variety of natural or synthetic preserving tissues and their dyes for the purpose of optically cellular constituents in a differentiating the various condition that is somewhat cellular and tissue constituents. similar to that occurring during 11. Mounting life. - the process of securing a - Preserving the tissue coverslip on top of a tissue slide Decalcification - removes calcium section to protect the tissue deposits, necessary for bone tissue section and facilitate the ease of 3. Dehydration handling and storage of the slide. - the process of removing excess 12. Labeling water from the tissue using a - the process of providing dehydrating agent, such as permanent specimen alcohol, prior to replacement by identification with printed or an impregnation medium, such as electronic scanned labels of the paraffin wax. prepared glass slides for proper 4. Clearing / Dealcoholization identification, indicating the - the process of completely specimen code/number that is removing the dehydrating agent similar to the code used, in (alcohol) in the tissue and accessioning. replacing it with a fluid that is soluble to the paraffin wax that will be used for tissue impregnation. 5. Infiltration / Impregnation - the process of permeating tissues with a solution or medium, such as paraffin wax, that will fill the natural spaces, holes/ cavities, and interstices to provide rigid support for the tissues. 6. Embedding - the process of forming a tissue CYTOLOGY block using a mold as a shaping device. PAPANICOLAOU / Pap’s Stain 7. Blocking ★ Part of exfoliative cytology - an optional process and is ★ Study normal and abnormal cells for the performed only when embedding evaluation of various infections, is performed in certain types of abnormal hormonal activities, and even embedding molds, such as the precancerous lesions Compound Embedding Unit. 8. Trimming / Facing - the process of cutting or removing excess wax from the tissue block. - Usually, a four-sided prism or truncated pyramid-opposite sides being parallel-is formed after trimming to fit the  CLINICAL MICROSCOPY EXAMINATION OF URINE SEDIMENTS CLINICAL MICROSCOPY ○ Microscope ★ Study of urine and other body fluids with ○ Detects the formed elements of the aid of microscopes and other urine. laboratory instruments. URINALYSIS Dipstick Urinalysis ★ performed in screening laboratories Basic (routine) Urinalysis ★ adds a microscopic examination of urine sediment to the reagent strip urinalysis BASIC (ROUTINE) URINALYSIS SPECIMEN EVALUATION ○ Specimen acceptability GROSS / PHYSICAL EXAMINATION ○ Color ○ Clarity Automated reagent strip readers ○ Odor ★ Uses spectrophotometric measurement ○ Specific gravity of light reflection ★ Uses the principle that light reflection from the test pads decreases in proportion to the intensity of color produced by the concentration of the test substance. Semi-automated ★ Still dependent on an operator for sample mixing, test strip dipping, and inputting of physical and microscopic result Term Fully automated Clarity ★ Add urine to the RGT strip, and clear No visible particle, automated urine cell analyzers mix, transparent aspirate, dilute and stain urine to hazy Few particles, print easily classify urine sediment particles seen through urine cloudy Many particulates, print blurred through urine turbid Print cannot be seen through urine milky May precipitate or be clotted CHEMICAL SCREENING ○ Reagent Strip