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Clinical Chemistry

Spectrophotmeter measures light transmitted, tungsten light source
Nephelometry measures light scattered, amount of scatter directly proportional to number and size of particles present
Turbidimetry measures light blocked, uses a spectrophotometer
Proteins made of amino acids linked together via a peptide bond
Protein degradation undergo deamination with formation of ammonia, then is converted to urea
Prealbumin indicator of nutritional status, decreased in liver disorders, inflammation, malignancy, poor nutrition
Albumin binds analytes for transport in blood including unconjugated bilirubin, calcium, magnesium, fatty acids, and drugs. Majorly contributes to osmotic pressure
Ablumin significance decreased in: liver disorders, GI disease, renal disease, starvation, malnutrition. Increased in: dehydration
AFP peaks at 13 weeks and declines at 34 weeks, increased in neural tube defects, spina bifida
Haptoglobin binds free gemoglobin, acute-phase reactant. Increased in inflammatory conditions, decreased in intravascular hemolysis
Transferrin transports iron, increased in iron-deficiency anemia
CRP acute-phase reactant, increased in: necrosis, rheumatic fever, inceftions, myocardial infaction, rheumatoid arthritis, gout
Biuret method cupric irons complexing with peptide bonds in alkaline medium to make purple-colored complex. directly proportional to number of poptide bonds present and reflects protein concentration
Kjeldahl reference method used to validate materials used with biuret method, nitrogen content of protein
Bence Jones protein seen in patients with multiple myeloma
Urine protein increased in glomerular dysfunction, multiple myeloma, Waldenstrom macroglobulinemia, nephrotic syndrome
Urine albumin range <30mg/day
CSF protein range 15-45mg/dL
PSA prostate cancer detection
AFP marker Increased in: hepatocellular carcinoma, nonmalignant disorders, viral hepatitis. Increased in pregnancy in: spina bifida. Decreased in pregnancy in: down syndrome.
CEA normally found on epi cells of fetal GI tract, increased in adenocarcinoma and colorectal carcinoma
hCG increased with trophoblastic tumors
CA 15-3 breast cancer
CA 125 ovarian cancer
CA 19-9 pancreatic, colorectal, lung, and gastric carcinomas
Urea major nitrogen-containing compound in blood, resulting from protein catabolism, is excreted by kidneys
Urea significance Increased in: renal failure, glomerular nephritis, urinary tract obstruction, congestive heart failure, dehydration. Decreased in: liver disease, vomiting, diarrhea, malutrition
Urea range 6-20mg/dL
Creatinine waste product of muscle contraction, regulated by kidney excretion
Creatinine significance increased in: renal disease and renal failure
Creatinine range M: 0.9-1.3mg/dL F:0.6-1.1mg/dL
Creatinine clearance used to assess GFR
CC range M:105 +-20 mL/min F:95 +-20 mL/min
Uric Acid major waste product of purine catabolism, regulated by kidneys
Uric Acid significance Increased in: gout, renal disorders, treatment of myeloproliferative disorders, lead poisoning. Decreased in: severe liver disease, tubular readsorption disorders, drug induced
Uric Acid range M:3.5-7.2mg/dL F2.6-6.0mg/dL
Ammonia produced from deamination of amino acids, converted to urea
Ammonia significance Increased in: hepatic failure and Reye syndrome
Ammonia range 11-32umol/L
Hyperglycemic fasting glucose of >100mg/dL
Hypoglycemic fasting glucose of <50mg/dL
Glycated/glycosylated hemoglobin (A1C) reflects blood glucose for past 2-3 months
Glycated/glycosylated hemoglobin (A1C) range 4-6%
Fructosamine reflects blood glucose for past 2-3 weeks
Fructosamine range 205-285umol/L
Plasma Glucose increased in diabetes mellitus, cushing disease
Plasma Glucose range Adult fasting: 74-99mg/dL
Lactate normal end product of glucose metabolism is pyruvate, however, this can be produced under condistions of oxygen deficit, precedes a change in blood pH
Lactate range 0.5-1.3mmol/L
Triglyceride one glycerol molecule with tree fatty acid molecules, comprise 95% of all fats stored, transported via chylomicrons and VLDL
Lipoproteins molecules that combine water insoluble dietary lipds and water soluble proteins so lipids can be transported
Chylomicrons largest lipoproteins and have lowest density, transport triglycerides, composed of 86% triglycerides
VLDL carry triglycerides, composed of 55% triglycerides
IDL formed from VLDL (modified in liver)
LDL major cholesterol carrier, bad cholesterol, composed of 50% cholesterol
HDL good cholesterol, composed of 50% protein, removes excess cholesterol from tissues and transports it to other catabolic sites (antiatherogenic effect)
Total Cholesterol range <200mg/dL
HDL range >60mg/dL
LDL range <100mg/dL
Triglyceride range <150mg/dL
HDL significance Increased in decreased risk of coronary artery disease. Decreased in increased risk of coronary artery disease.
LDL significance associated with artherosclerosis and coronary heart disease
Triglyceride significance Increased in: pancreatitis, alcoholism, obesity, hypothyroidism, nephrotic syndrome, Gaucher, Niemann-Pick
Enzymes proteins that function as biological catalysts
LD Elevated in: cardiac disorders, hepatic diseases, skeletal muscle diseases, hemolytic and hematologic disorders, and neoplastic disorders
LD range 100-225U/L
CK Increased in: cardiac disorders (AMI) and skeletal muscle disorders
CK-MB greater than 6% suggest AMI. Following AMI levels rise within 4-6hrs, peak at 12-24hrs, and return to normal within 2-3days
CK range M:15-160U/L F:15-130U/L
CK-MB range <6% of total CK, mass assay 0-5ng/mL
AST used to evaluate hepatocelluar disorders, skeletal muscle disorders, pulmonary emboli, and acute pancreatitis. Not used to diagnose AMI
AST range 5-30U/L
ALT used to evaluate hepatocellular disorders, more specific for liver disease than AST
ALT range 6-37U/L
ALP increased in: hepatobilary disease (due to obstructive disease) and bone disorders, increased more significantly than ALT and AST. Decreased in hypophosphatasia (due to lack of bone isoenzyme). Higher in children and in pregnancy
ALP range Adults:50-115U/L Children(4-15):54-369U/L
ACP Increased in prostate cancer, benign prostatic hypertrophy, bone disease, Paget disease, breast cancer with bone metastases, Gaucher disease, PLT damage
Total ACP range M:2.5-11.7U/L F:0.3-9.2U/L
GGT Increased in: hepatobilary diseases, higher levels seen in intra- and posthepatic bilary tract obstruction. normal in bone disease and pregnancy
GGT range M: up to 55U/L F: up to 38U/L
Amylase Increased in acute pancreatits (serum), mumps, perforated peptic ulcer, intestinal obstruction, mesenteric infarction, acute appendicitis
Amylase range 28-100U/L
Lipase Increased in acute pancreatitis (serum), perforated peptic ulcer, duodenal ulcers, intestinal obstruction
Lipase range up to 38U/L
G6PD Decreased in: deficiency
G6PD range 8-14U/g Hgb
Troponin complex of three proteins that bind to skeletal muscles and cardiac muscles to regulate muscle contraction, AMI indicator
Myoglobin increased in: skeletal muscle injuries, muscular dystrophy, AMI (early cases)
Myoglobin range M:30-90ng/mL F:<50ng/mL
Homocysteine increased in: arterial wall damage that precedes formation of plaques, indicator of arterial inflammation
Homocystein range 5-15umol/L
Markers for cholestasis ALP, GGT
Markers for hepatocellular necrosis ALT, AST, LD (most specific to least)
Bilirubin range for infants 2-6mg/dL
Bilirubin range for adults 0.2-1.0mg/dL
Osmolality number of dissolved particles in a solution
Cations positive charge
Anions negative charge
Major cation of extracellular fluid Na
Na range 136-145mmol/L
Major intracellular cation K
K range 3.4-5.0mmol/L
Major anion of extracellular fluid Cl
Cl range 98-107mmol/L
Second largest anion of extracellular fluid HCO3
HCO3 range 22-29mmol/L
Calcium Decreased levels cause muscle spasms or uncontrolled muscle contractions, controlled by PTH, VITD, and calcitonin
PTH stimulated by decreased in free calcium, activates osteoblasts in bone, increases tubular reabsorption of calcium in kidneys and stimulates hydroxylation of VITD
VITD obtained by diet or light exposure, converted to active form in kidneys, enhnaces calcium absorption in intestines
Calcitonin Inhibits VITD and PTH activity
Total calcium range 8.6-10.3mg/dL
Phosphorus increased in: renal failure, hypoparathyroidism, neoplastic diseases, lymphoblastic leukemia, intense exercise. Decreased in: diabetic ketoacidosis, hyperparathyroidism, asthma, alcoholism, malabsorption syndrome.
Magnesium increased in: renal failure and excess antacids. decreased in: GI disorders, renal diseases, hyperparathyroidism, drugs, diabetes mellitus with glycosuria, and alcoholism
Phosphorus range 2.5-4.5mg/dL
Magnesium range 1.7-2.4mg/dL
Transferrin range 200-360mg/dL
Ferritin reflects iron stores
Ferritin range M:20-250ng/mL F:10-120ng/mL
Normal blood pH 7.35-7.45
GH antagonistic effect to insulin in relationship to glucose metabolism, stimulates gluconeogenesis, promotes protein synthesis
Prolactin initiates and maintains lactation, effects reproduction through ovarian and testicular steroidogenesis, affects immune system
Prolactin range M:3.0-14.7ng/mL F:3.8-23.0ng/mL
FSH promotes growth of ovarian follicles and an increase in estrogen
LH triggers ovulation
TSH regulates synthesis and release of thyroid hormones, regulated by TRH
Created by: Ramin11
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