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Clin Path Quiz 10/11
Lecture 10: Clinical Chemistry
| Question | Answer |
|---|---|
| clinical chemistries | evaluation of chemical components of the blood; most tests are specific markers for problems in specific organs or body systems, measurements aid in diagnosis, treatment, and monitoring |
| chemical components | dissolved substances normally found in the blood, substances carried by the blood to specific organs, substances not normally found in the blood |
| 2 main categories of chemical components | physiologic function and enzymes |
| sample collection for clinical chemistry | same as CBC venipuncture procedure |
| what samples can be utilized in blood chemistry tests? | serum, heparinized plasma, heparinized WBCs, urine |
| blood collection tubes used for clinical chemistry | red top tube (serum), tiger top/camo tubes (serum), green top tubes (heparinized plasma/whole blood) |
| red top tubes | used for serum collection, NO anticoagulant |
| tiger top or camo tubes | used for serum collection, clot separator gel to physically separate serum from the clot |
| green top tubes | heparinized plasma or whole blood samples |
| how do you prepare a serum sample? | collect the blood and place in a tube without anticoagulant, allow blood to clot at room temperature for 15-30 minutes, centrifuge sample at 2000 rpms for 10 minutes to separate clot, carefully pipette the serum off the top, why transfer a clean container |
| why do you not allow the sample to sit when preparing a plasma sample? | the plasma is not supposed to clot |
| inaccurate results can be caused by | inappropriate anticoagulant use, delayed separation of serum/plasma from clot, plasma, serum sample discoloration, hemolysis, linearity |
| biggest example of inappropriate anticoagulant | usage of EDTA tubes |
| EDTA will lead to a falsely | decreased calcium and magnesium, increased potassium |
| always avoid ______ for chemistry testing | EDTA |
| delayed separation will | increase phosphorous and potassium and decrease blood glucose |
| plasma/serum discoloration | interferes with the light measurement used to detect enzyme activity; lipemia is the most likely coloration to interfere |
| solutions for lipemia | ultra-high speed centrifugation, refrigerate serum/plasmas (lipids will float to the top), fast animal overnight and recollect sample (only effective is lipemia is post-prandial) |
| hemolysis | in vitro or due to traumatic sample collection; RBCs contain enzymes as well at magnesium, phosphorous, potassium, all will be released into the blood causing false elevations |
| linearity | when results are above the max set value on analyzer; will show as too high to read or > (max set value) |
| solution to linearity | following instructions to further dilute the sample, which will be based on the machine |
| physiologic functions | measured at concentrations (mg/dL) |
| enzymes | INDICATE TISSUE INJURY; measured as activity, IU/L (international units per liter) |
| enzymology | organ tissues contain enzymes that assist in their normal function, these enzymes increase in serum or plasma following tissue injury to that organ; some enzymes are organ-specific, some are non-specific |
| isoenzymes | subfractions of enzymes that may be organ specific |
| causes of INCREASED enzymes | leakage from affected cells, induction of enzyme synthesis by affected cell, decrease in activation, clearance, or excretion of enzyme, absorption of maternal enzymes from colostrum ingestion in neonates |
| rule out test | high sensitivity, enzyme activity should increase following the selected disease occurrence, high incidence of TRUE POSITIVE results, few false negatives; SNOUT |
| rule in test | high specificity, enzyme activity should REMAIN LOW if the disease is not present, high incidence of TRUE NEGATIVE results, few false positives; SPIN |
Created by:
mkroon26
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