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Clinical laboratory test
- 5. • HAEMATOLOGY TESTS • LIVER FUNCTION TESTS • KIDNEY FUNCTION TESTS • CARDIAC MARKERS • GTU QUESTIONS • REFERENCES FLOW OF PRSENTATION
- 8. BLOOD TESTS • Bleeding time : <8 minutes • Cloting time : 1-3 minutes • Prothrombine time: 8.5-10.5 seconds CAPILLARY PLATELETS THROMBOCYTOPENIA PLATELET DYSFUNCTION BLEEDING TIME INCREASE OTHER CAUSES OF ABNORMAL BLEEDING TIME • NSAIDS • ANTI-COAGULANTS CAPILLARY INJURY TISSUE FACTORE ACTIVATED X Ca+2 PROTHROMBINASE FACTORE V Ca+2 THROMBIN PROTHROMBIN FIBRINOGEN FIBRIN PROTHROMBINE TIME INCREASES • WARFARIN • DIMINISHES CLOTTING FACTORS DUE TO LIVER DISEASE • VITAMIN K DEFICIENCY CLOTTING TIME • UNFRACTIONATED HEPARIN THERAPY • FACTOR DEFICIENCY
- 10. BLOOD TESTS • MCV : 80-101 fl • MCHC : 31.5-34.5 mg/dl • MCV : MEAN CORPUSCULAR VOLUME NORMOCYTES MACROCYTES MICROCYTES • MCHC : MEAN CORPUSCULAR HEMOGLOBIN CONTENT NORMOCHROMIC MACROCHROMIC MICROCHROMICMCV NORMOCHROMIC MACROCHROMIC MICROCHROMIC NORMOCYTES MACROCYTESMICROCYTES MCHC
- 12. ESR: ERYTHROCYTE SEDIMENTATION RATE AFFECT BY: • IMMUNOGLOBULINS • FIBRINOGEN INDICATION OF INFLAMMATION APPLICATION: • UNEXPECTED FEVER • ARTHRITIS • MUSCLE SYMPTOMS • ESR : 0.10 mm/hr • BUN: 7-21 mg/dL • TRANSFERRIN : 1.7/3.4 gm/L • FERITIN : 30-400 ng/ml BLOOD TESTS
- 13. CHOLESTEROL : 160-200 mg/dL TRIGLYCERIDES : 50-150 mg/dL GLYCOSYLATED Hb : 5-6.5 % FASTING BLOOD SUGAR : 3.3-6 mmol/L PO2 : 8-10 mmHg PCO2 : 35-45 mmHg OTHER BLOOD TESTS
- 16. BLOOD EXAMINATION BUN : 7-21 mg/dl URIC ACID : 3.7-7 mg/dl Serum Creatinine : 0.8-1.3 mg/dl (men), 0.6-1 mg/dl (women) URIC ACID PURINES LIVER AND INTESTINE URIC ACID 65 % KIDNEY EXCRETION INTESTINEINDICATION: • RENAL FAILURE • RENAL DISEASES • GOUT CREATININE KIDNEY ARGININE GLYCINE GUANIDINO ACETATE CREATININE LIVER MUSCLE PHOSPHOCREATININE CREATININE MUSCLE • LOW SERUM CREATININE: LOW MUSCLE MASS • HIGH SERUM CREATININE: ACUTE KIDNEY INJURY, CHRONIC KIDNEY DISEASE KIDNEY
- 17. Creatinine clearance = (140-age)*weight in kg/ s.creatinine*72 GFR MEASUREMENT CREATININE KIDNEY FILTERED BY CAPSULE NOT ABSORB OR NOT SECRETED BY ANY OTHER PART OF NEPHRONE
- 18. GFR MEASUREMENT INULINE: C = -------- U*V P C = clearance. U = urinary concentration V = plasma concentration P = urine volume KIDNEY FILTERED BY CAPSULE NOT ABSORB OR NOT SECRETED BY ANY OTHER PART OF NEPHRONE KNOWN CONC. OF INULINE IS GIVEN IV ROUTE
- 20. SPLEEN SPLEEN SPLEEN SPLEEN SPLEEN SPLEEN BILIVERDIN BILIRUBIN BLOOD VESSELS A A A AA A LIVER BLOOD SINUSOIDAL MEMBRANE HEPATOCYTES AA A SMOOTH ENDOPLASMIC RETICULUM U U INTESTINE STOOL PIGMENT RBC BILIRUBIN
- 21. LIPIDS LIVER INJURY • PGA index • Prothrombine time • γ- glutamyl transferase • Apo1-A protein ALCOHOL • Cholesterol Acyltransferase • Lipoprotein lipases CHOLESTIC • Lipoprotein X
- 22. BLOOD SINUSOIDAL MEMBRANE HEPATOCYTES SOIDAL MEMBRANE ATOCYTES AST ALT ALT AST • HEPATOCELLULAR INJURY • ALCOHOLIC INDUCED INJURY • HEPATITIS AST/ALT
- 23. AST/ALT AMINO ACIDS GLUTAMATE KETOACIDS VIT. B6 ALCOHOL
- 24. ALBUMIN • SYNTHESIZED IN THE LIVER • MOST ABUNDANT PROTEIN • WATER SOLUBLE • DECREASED PRODUCTION (MAL NUTRITION, LOW PROTEIN DIET) • CIRRHOSIS OF LIVER • EXCESS EXCRETION BY KIDNEY • PROLONGE DIARHHOEA
- 25. CARDIAC MARKER TROPONIN COMPLEX OF THREE PROTEINS TROPOMYOSIN SUBUNIT+ INHIBITORY SUBUNIT+ CALCIUM BINDING SUBUNIT CA+2 ACTIN + MYOSININ CARDIAC MYOCYTES THIS PROTEIN BOUND TO MUSCLE FIBRES SO, MYOCARDIAL INFRACTION ITS RELEASED WITHIN 24 HOURS
- 26. REFERENCES • Gerard J. Tortora, Bryan Derrickson. “Principle of anatomy and physiology”. 12TH Edition. • Roger walker. “clinical pharmacy and therapeutics”. 5TH Edition. • Emedicine.Medscape.com
- 27. GTU QUESTIONS • DISCRIBE LIVER FUNCTION TESTS. • CLASSIFY ANEMIA. • DISCRIBE VARIOUS HAEMATOLOGICAL TESTS