Clinical Chemistry


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Clinical Chemistry

  1. 2. دورة التحاليل الطبية Prof. Dr. Faten Zahran تحت اشراف
  2. 3. Clinical Chemistry prepared by Dr. Akaber Tarek Biochemistry Department
  3. 4. Plasma & Serum <ul><li>Plasma </li></ul><ul><li>Blood + clotting factor </li></ul><ul><li>Formed elements. </li></ul><ul><li>Contain fibrinogen & pr-othrombin. </li></ul><ul><li>No thrombin is formed. </li></ul><ul><li>Serum </li></ul><ul><li>Blood – clotting factor. </li></ul><ul><li>Formed elements. </li></ul><ul><li>No fibrinogen& pr-othrombin. </li></ul><ul><li>Thrombin formed during clotting process . </li></ul>
  4. 6. Preparation of samples <ul><li>Serum : </li></ul><ul><li>Blood is taken in clean tube. </li></ul><ul><li>Put at 37 0 c for clotting. </li></ul><ul><li>Centrifuge the sample. </li></ul><ul><li>Use the supernatant that is “serum”. </li></ul><ul><li>Plasma: </li></ul><ul><li>Blood is taken on anticoagulant. </li></ul><ul><li>Mix well blood with anticoagulant. </li></ul><ul><li>Use the sample that is “plasma”. </li></ul>
  5. 8. <ul><li>To prevent hemolysis during vein puncture : </li></ul><ul><li>Never draw blood through a hematoma . </li></ul><ul><li>Remove the tourniquet as early as possible to decrease flow velocity and turbulence. </li></ul><ul><li>Do not remove the collection tube until full. </li></ul><ul><li>When mixing is required, gentle inversion is adequate. </li></ul>
  6. 9. Procedures of tests <ul><li>Take blood sample from patient in suitable tube. </li></ul><ul><li>Put the sample in water bath 37 0 c for coagulation. </li></ul><ul><li>Centrifuge the sample for 10 min. to obtain clear serum. </li></ul><ul><li>Carry out the procedures according kits. </li></ul><ul><li>Then make the calculation. </li></ul>
  7. 10. Liver Function Tests <ul><li>LFT used to detect, evaluated and monitor liver diseases or damage. </li></ul><ul><li>These include: </li></ul><ul><li>Total protein (albumin & globulins) </li></ul><ul><li>Albumin (main protein made by liver) </li></ul><ul><li>ALT or SGPT “alanine aminotranferase” </li></ul><ul><li>AST or SGOT “ aspartate aminotranferase” </li></ul><ul><li>ALP “alkaline phosphatase” </li></ul><ul><li>Bilirubin (total & direct) </li></ul><ul><li>GGT, LDH, PT (pro-thrombin time) </li></ul>
  8. 12. <ul><li>ALT is an enzyme found mostly in the liver; smaller amounts of it are also in the kidneys, heart, and muscles. </li></ul><ul><li>ALT test detects liver injury “More Specific”. </li></ul><ul><li>Very high levels of ALT due to acute hepatitis. </li></ul><ul><li>AST is an enzyme found mostly in the heart and liver, and to a lesser extent in other muscles. </li></ul><ul><li>AST not specific. </li></ul><ul><li>Very high levels of AST due to acute hepatitis. </li></ul>ALT AST
  9. 13. <ul><li>ALP is an enzyme found in high concentrations in bone and in the liver. Smaller amounts of ALP are found in the placenta. </li></ul><ul><li>ALP is not specific for liver diseases. </li></ul><ul><li>GGT is an enzyme found mainly in the liver. </li></ul><ul><li>It is the most sensitive liver enzyme in detecting bile duct problems. </li></ul><ul><li>A rise in GGT can occur even when there is no identifiable cause that is related to liver diseases. </li></ul>ALP GGT
  10. 14. <ul><li>The total protein test is a rough measure of all of the protein in the plasma portion of your blood. </li></ul><ul><li>Total protein measures the combined amount of two classes of proteins, albumin and globulin. </li></ul><ul><li>Low total protein levels suggest liver disease. </li></ul><ul><li>A/G ratio is normally slightly over 1 </li></ul><ul><li>A low A/G ratio may reflect overproduction of globulins underproduction of albumin . </li></ul><ul><li>Albumin is the most abundant protein in the blood plasma. </li></ul><ul><li>Low albumin levels can suggest liver diseases, inflammation, shock, malnutrition & kidney diseases. </li></ul><ul><li>High albumin levels usually reflect dehydration. </li></ul>Total Protein Albumin
  11. 15. Bilirubin <ul><li>Bilirubin is an orange-yellow pigment found in bile. </li></ul><ul><li>RBCs normally degrade after 120 days in the circulation. At this time, hemoglobin (the red-colored pigment of red blood) breaks down into bilirubin. </li></ul><ul><li>Unconjugated bilirubin is carried to the liver, where sugars are attached to it, producing conjugated bilirubin. </li></ul><ul><li>When bilirubin levels are high, a condition called Jaundice. </li></ul>
  12. 16. Kidney Function Tests: <ul><li>KFT used to evaluate and monitor kidney diseases or damage & the effectiveness of the treatment. </li></ul><ul><li>These include: </li></ul><ul><li>Urea & BUN “blood urea nitrogen” </li></ul><ul><li>Creatinine and creatinine clearance. </li></ul><ul><li>Uric acid. </li></ul>
  13. 17. Lipid profile <ul><li>Lipid profile includes: </li></ul><ul><li>1)Total lipids 2) Triglycerides </li></ul><ul><li>3) Cholesterol 4) HDL </li></ul><ul><li>5) LDL </li></ul><ul><li>These tests must be carried out after 12-15 fasting due the high molecular weight of lipid molecules and the prolonged digestion and metabolism. </li></ul>
  14. 18. Blood Glucose <ul><li>Blood glucose level is one of the most important test in the lab. </li></ul><ul><li>Glucose is very essential for all body activities. </li></ul><ul><li>This includes: </li></ul><ul><li>RBS “random blood sugar” </li></ul><ul><li>FBS “fasting blood sugar” </li></ul><ul><li>PPS “post-prondial blood sugar” </li></ul>