Clinical Chemistry

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Text of Clinical Chemistry

  • 1.

2. Prof. Dr. Faten Zahran 3. Clinical Chemistry prepared by Dr. Akaber Tarek Biochemistry Department 4. Plasma & Serum

  • Plasma
  • Blood + clotting factor
  • Formed elements.
  • Contain fibrinogen & pr-othrombin.
  • No thrombin is formed.
  • Serum
  • Blood clotting factor.
  • Formed elements.
  • No fibrinogen& pr-othrombin.
  • Thrombin formed during clotting process .

5. 6. Preparation of samples

  • Serum :
  • Blood is taken in clean tube.
  • Put at 37 0c for clotting.
  • Centrifuge the sample.
  • Use the supernatant that isserum.
  • Plasma:
  • Blood is taken on anticoagulant.
  • Mix well blood with anticoagulant.
  • Use the sample that is plasma.

7. 8.

  • 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.
  • These include:
  • Total protein (albumin & globulins)
  • Albumin (main protein made by liver)
  • ALT or SGPT alanine aminotranferase
  • AST or SGOT aspartate aminotranferase
  • ALP alkaline phosphatase
  • Bilirubin (total & direct)
  • GGT, LDH, PT (pro-thrombin time)

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  • 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.
  • AST not specific.
  • 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.
  • These include:
  • Urea & BUN blood urea nitrogen
  • Creatinine and creatinine clearance.
  • Uric acid.

17. Lipid profile

  • Lipid profile includes:
  • 1)Total lipids 2) Triglycerides
  • 3) Cholesterol4)HDL
  • 5) LDL
  • 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.
  • This includes:
  • RBSrandom blood sugar
  • FBS fasting blood sugar
  • PPSpost-prondial blood sugar

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