CC Lab/Lec Supplemental

• Fundamental concepts in clinical chemistry:

  1. Appreciation of fundamental concepts in clinical chemistry

  2. Classification of biochemical substances based on nature, metabolism, reference ranges, and variables affecting analyses

  3. Correlation of test results with normal and pathologic conditions

  4. Utilization of technology and advancements in the field to enhance skills and knowledge

  5. Exploration of research opportunities and advanced learning from encountered cases and situations
• Skills in clinical chemistry:

  1. Calculation of basic laboratory mathematical problems

  2. Practice of quality assurance and laboratory safety in chemistry analysis

  3. Correct specimen collection and processing following standard guidelines

  4. Application of instrumentation concepts in the laboratory

  5. Adherence to school policies and procedures in clinical chemistry analysis

  6. Performance of laboratory assays for analyte concentration measurement

  7. Identification and resolution of common problems in the clinical laboratory

  8. Demonstration of punctuality in tasks as a clinical chemistry scientist and student

  9. Display of professional behavior and attitude

  10. Communication of knowledge on interactions among biochemical substances
• Attitudes in clinical chemistry:

  1. Identification of research and learning opportunities from encountered cases

  2. Effective teamwork for efficient laboratory outputs

  3. Appropriate behavior in interactions with patients, authorities, and colleagues during clinical chemistry analysis

  4. Adherence to school policies and procedures in clinical chemistry analysis
• Scope of Clinical Chemistry:

  • Analytical chemistry provides information on matter composition and structure
  • Biochemistry involves chemical and physicochemical processes like carbohydrates, lipids, enzymes, electrolytes, trace metals, proteins, and tumor markers
  • Instrumentation forms the basis for measurements in modern clinical chemistry labs
  • Toxicology deals with potential toxins, intoxicating substances, and prescription medications in the body
  • Endocrinology focuses on endocrine glands and hormones
  • Computers support clinicians in laboratory investigations and data processing
• Definition of terms in clinical chemistry:

  • Laboratory testing: Process in a clinical lab for diagnosis, treatment monitoring, prognosis, screening, or severity determination
  • Matrix: Human serum containing analytes in analytical methods
  • Analyte: Substance whose chemical constituents are identified and measured
  • Reference value: Value obtained by observing or measuring a specific quantity on a reference individual
• Overview of Clinical Chemistry:

  1. Quantitative science measuring biologically important substances (analytes) in body fluids

  2. Methods designed for accurate concentration assessments

  3. Provides biochemical information for patient management, guiding clinical decision-making
• Importance of Clinical Chemistry Analyses:

  • Confirming clinical suspicions and making diagnoses
  • Excluding diagnoses
  • Assisting in treatment selection, optimization, and monitoring
  • Providing prognoses
  • Screening diseases without clinical signs
  • Establishing and monitoring physiological disturbance severity
• Leading physiologists and physicians like Marie Francois Xavier Bichat, Johannes Muller, and Justus Baron von Leibig had differing beliefs in physiology
• Mechanists believed that life could be fully explained by chemical and physical principles alone
• Mechanists argued that man is not unique, as shown by the continuity between man and animals in Charles Darwin's 'Origin of Species'
• Antoine Francois de Fourcroy isolated urea from urine samples and advocated for chemical laboratories near wards for analysis
• Friedrich Wohler synthesized urea in vitro, bridging the gap between the 'organic' and 'inorganic' worlds
• Marcellin Berthelot synthesized organic compounds like ethanol and benzene in vitro from inorganic compounds
• Claude Bernard discovered that glycogen was formed by the liver, contradicting vitalism beliefs
• John Bostock observed the decrease in urea and albumin concentration in plasma as their concentration increased in urine
• William Prout was the first to connect chemistry and medical practice, advocating for its application in disease treatment
• Henry Bence Jones stressed the diagnostic value of chemistry and urged medical students to focus on it
• Thomas Hodgkin emphasized the relevance of chemical studies in clinical medicine and the importance of blood in disease
• Massachusetts General Hospital recognized the aid from organic chemistry and microscopy, establishing the position of "Chemist-Microscopist"
• Otto Knut Folin and Donald Dexter Van Slyke determined reference intervals, correlated variations with pathologic conditions, and elucidated metabolic pathways
• Max Jaffe developed the alkaline picrate method for determining creatinine concentration
• Early colorimetry was pioneered by Otto Knut Folin, involving the observation of colored product intensity after chemical reactions
• Spectrophotometry measures light absorbance at selected wavelengths, initiated by the Beckman DU Spectrophotometer
• Auto Analyzer is a continuous-flow instrument that reacts specimen and reagents to produce a measurable color density
• Centrifugal Analyzer, introduced by Norman Anderson, was the first clinical analyzer to incorporate a computer
• Sequential Multiple Analyzer with Computer (SMAC) can perform multiple tests on a clinical specimen
• Beckman Astra introduced automated pipetting technology, a common approach in clinical chemistry labs
• Basic laboratory principles include chemicals, standards, water specifications, laboratory vessels, glassware, plasticware, centrifuges, and thermometers
• Chemicals in the laboratory are classified into different grades based on their purity and intended use
• Analytical reagent grade chemicals are of very high purity and are used in most analytical laboratory procedures
• United States Pharmacopeia and National Formulary grade chemicals are not injurious to humans and are used in the production of drugs and food
• Laboratory grade chemicals are popular for educational applications, but their exact impurity levels are unknown
• Technical or commercial grade chemicals are primarily used for manufacturing and should not be used in the clinical laboratory
• Organic reagents can be chemically pure, spectroscopic grade, chromatographic grade, or reagent grade (ACS)
• Standards in the laboratory are essential for monitoring accuracy and precision of analytical measurements
• Primary standards are of the highest purity and have an exact known concentration
• Secondary standards are substances of lower purity whose concentration is compared to a determined primary standard
• Water in the laboratory is classified into different grades such as reagent grade water, which is suitable for reagent and standard preparation
• Reagent grade water can be obtained through processes like distillation, deionization, reverse osmosis, and ultrafiltration
• Different types of water, such as Type I, Type II, and Type III, have specific characteristics and uses in laboratory settings