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Text of Clinical Chemistry
2. Prof. Dr. Faten Zahran 3. Clinical Chemistry prepared by Dr. Akaber Tarek Biochemistry Department 4. Plasma & Serum
- Contain fibrinogen & pr-othrombin.
- No fibrinogen& pr-othrombin.
- Thrombin formed during clotting process .
5. 6. Preparation of samples
- Blood is taken in clean tube.
- Put at 37 0c for clotting.
- Use the supernatant that isserum.
- Blood is taken on anticoagulant.
- Mix well blood with anticoagulant.
- Use the sample that is plasma.
- To prevent hemolysis during vein puncture :
- Never draw blood through a hematoma .
- Remove the tourniquet as early as possible to decrease flow velocity and turbulence.
- Do not remove the collection tube until full.
- When mixing is required, gentle inversion is adequate.
9. Procedures of tests
- Take blood sample from patient in suitable tube.
- Put the sample in water bath 37 0 c for coagulation.
- Centrifuge the sample for 10 min. to obtain clear serum.
- Carry out the procedures according kits.
- Then make the calculation.
10. Liver Function Tests
- LFT used to detect, evaluated andmonitor liver diseases or damage.
- Total protein (albumin & globulins)
- Albumin (main protein made by liver)
- ALT or SGPT alanine aminotranferase
- AST or SGOT aspartate aminotranferase
- Bilirubin (total & direct)
- GGT, LDH, PT (pro-thrombin time)
- ALT is an enzyme found mostly in the liver; smaller amounts of it are also in the kidneys, heart, and muscles.
- ALT test detects liver injury More Specific.
- Very high levels of ALT due to acute hepatitis.
- AST is an enzyme found mostly in the heart and liver, and to a lesser extent in other muscles.
- Very high levels of AST due to acute hepatitis.
ALT AST 13.
- ALP is an enzyme foundin high concentrations in bone and in the liver. Smaller amounts of ALP are found in the placenta.
- ALP is not specific for liver diseases.
- GGT is an enzyme found mainly in the liver.
- It is the most sensitive liver enzyme in detecting bile duct problems.
- A rise in GGT can occur even when there is no identifiable cause that is related to liver diseases.
ALP GGT 14.
- The total protein test is a rough measure of all of the protein in the plasma portion of your blood.
- Total protein measures the combined amount of two classes of proteins, albumin and globulin.
- Low total protein levels suggest liver disease.
- A/G ratio is normally slightly over 1
- A low A/G ratio may reflect overproduction of globulins underproduction of albumin .
- Albumin is the most abundant protein in the blood plasma.
- Low albumin levels can suggest liver diseases, inflammation, shock, malnutrition & kidney diseases.
- High albumin levels usuallyreflectdehydration.
Total Protein Albumin 15. Bilirubin
- Bilirubin is an orange-yellow pigment found in bile.
- RBCs normally degrade after 120 days in the circulation. At this time, hemoglobin (the red-colored pigment of red blood) breaks down into bilirubin.
- Unconjugated bilirubin is carried to the liver, where sugars are attached to it, producing conjugated bilirubin.
- When bilirubin levels are high, a condition calledJaundice.
16. Kidney Function Tests:
- KFT used to evaluate andmonitor kidney diseases or damage & the effectiveness of the treatment.
- Urea & BUN blood urea nitrogen
- Creatinine and creatinine clearance.
17. Lipid profile
- 1)Total lipids 2) Triglycerides
- These tests must be carried out after12-15 fasting due the high molecular weight of lipid molecules and the prolonged digestion and metabolism.
18. Blood Glucose
- Blood glucose level is one of the most important test in the lab.
- Glucose is very essential for all body activities.
- PPSpost-prondial blood sugar