CLINICAL CHEMISTRY

• Clinical Chemistry - the most automated section in the laboratory and has instruments that are computerized which can perform single or multiple tests from small samples
• AREAS IN CLINICAL CHEMISTRY

  • General/Automated chemistry
  • Electrophoresis
  • Toxicology
  • Immunochemistry
• Serum - the specimen wherein tests are primarily performed and are collected in gel barrier tubes
• Serums can also be collected in these tubes:

  • Red
  • Green
  • Grey
  • Royal blue
• Serum and plasma are collected through centrifugation and must be performed within 1-2 hours of collection
• Clinical chemistry are also performed in:

  • Plasma
  • Urine
  • Other bodily fluids
• Specimens of concern:

  • Hemolyzed specimen
  • Icteric specimen
  • Lipemic specimen
• Hemolyzed specimen- appear red due to the hemoglobin released from RBCs
• Icteric Specimen - Appear yellow because of excess bilirubin
• Lipemic specimen - appear cloudy because of increased lipids
• Fasting samples should be drawn from patients who have not eaten for 8-12 hours
• Samples must be allowed to clot fully before testing
• Alanine aminotransferase (ALT) - Elevated levels indicate liver disorders
• Albumin- Decreased levels indicate kidney or liver disorders or malnutrition
• Alcohol - Elevated levels indicate intoxication
• Alkaline phosphatase - Elevated levels indicate liver or bone disorders
• Ammonia - Elevated levels indicate severe liver disorders
• Amylase - Elevated levels indicate pancreatitis
• Arterial Blood Gases (ABGs)- Determine acidity/alkalinity and oxygen/CO2 in blood.
• Aspartate aminotransferase- Elevated levels indicate myocardial infarction/ liver disorders
• Bilirubin- Elevated levels indicate liver and hemolytic disorders
• Blood urea nitrogen (BUN) - Elevated levels indicate kidney disorders
• Brain natriuretic peptide (BNP) - Elevated levels indicate congested heart failure
• Calcium (Ca) - mineral associated with bone, musculoskeletal, and endocrine disorders
• Cholesterol - elevated levels indicate coronary risk
• Creatine Kinase (CK)- elevated levels indicate myocardial infarction and muscle damage
• Creatine Kinase isoenzymes - determine the extend of muscle and brain damage (elevated in myocardial infarction).
• Creatinine - elevated levels indicate kidney disorders (C)
• Creatine clearance- Urine and serum test to measure glomerular filtration rate.
• Drug screening - detects drug abuse and monitors therapeutic drugs
• Electrolytes (CO2, Cl, Na, K) - evaluates fluid balance
• Gamma-glutamyltransferase (GGT)- elevated levels indicate kidney disorders
• Glucose- elevated levels indicate diabetes mellitus
• Glucose tolerance test- determines diabetes mellitus or hypoglycemia
• Haptoglobin - used to evaluate hemolytic anemia and certain chronic disease
• Hemoglobin AC - monitors diabetes mellitus
• Hemoglobin (Hgb) electrophoresis - detects abnormal hemoglobin
• High density lipoprotein - asses coronary risk
• Iron - decreased levels indicate iron deficiency anemia
• lactic dehydrogenase - elevated levels indicate myocardial infarction/lung/liver disorders