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