basic principles in clinical biochemistry - mohsin al-saleh · basic principles in clinical...
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ìBasicPrinciplesinClinicalBiochemistryByMohsinAl-Saleh
• Objectives:
• Defineclinicalbiochemistry.• Describetheusesofbiochemicaltests.• Describetheroutinetestsdoneinclinicalchemistry.• Describesampleanalysisandinterpretationofresults.• Highlighttheimportanceofroutineclinicalchemistrytestsinthediagnosis,prognosis,monitoringandscreeningfordisease.• Describespecialchemistrytestandcorrelatelabresultswithdiseasestates.
ClinicalBiochemistry
ì Also known as chemical pathology, clinical chemistry, and ormedicalbiochemistry.Itsanareawhichconcernedgenerallyintheanalysisofbodyfluids.Forexample;serum,plasma,urine,whole blood, CSF, sweat, and others. For diagnostic andtherapeutic purpose. Wide variety of techniques (chemicalprocesses) used to analyze substances like; substrates,enzymes,proteins,ions,aminoacids,cholesterols,etc.
UsesofBiochemicalTest
SomeofmostCommonClinicalBiochemistryProfiles/Tests/Markers
KidneyFunctionTest(Kidney) SerumProteinElectrophoresis(MM)
LiverFunctionTest(Liver) UrineProteinElectrophoresis(MM)
BoneProfile(Bonemineralization) MSUDProfile(InbornErrorsofMetabolism)
LipidProfile(Heart) PKUProfile(InbornErrorsofMetabolism)
CardiacMarkers(Heart) AminoAcidsProfile(InbornErrorsofMetabolism)
SweatTests(InbornErrorsofMetabolism) Stoneanalysis(Kidney)
FertilityTests(Hormones) IronProfile
TherapeuticDrugsMonitoring(Drug) CatecholaminesTest
DrugofAbuseTest(Toxicology) Porphyrins/PBGTest
RoutineBiochemicalTests
SomeofRoutineClinicalBiochemistryTests
KidneyFunctionTest Na+,K+,Cl-,ureaandcreatinine
LiverFunctionTest ALT,AST,ALP,Alb,Tbili,andtotalprotein
BoneProfile ALP,phosphate,Ca2+,Alb,andAlbCoRCa
LipidProfile Tchol,LDL,HDL,VLDL,andTriglycerides
CardiacMarkers CK,CKMB,andTroponin(I)
TherapeuticDrugsMonitoring Benz,TCA,ACETO,etc
DrugofAbuseTest Morphine,Tramadol,Cocaine,etc
IronProfiles S-IronandTransferrin
Sampleanalysis
ì Itvariesfromsampletosample(types).Orfromtesttotest
ì Somesamplesrequiresimmediaterunningandsomemaystore
ì Dependsalsoonspecificsamplecollectioncriteria
ì Dependsonpatientsdiagnosis
ì Typesofclinicalbiochemistrytest(screening,definitive,confirmatory)
ì Analytesnature(stability)e.g.bloodgas
Interpretationofresults
ì Dependsontypeofdata
ì TAT
ì Typeofthetest(screening,definitive,andconfirmatory)
ì Severityofpatientcondition(disease)
ì BMS(Professionalism)
ì Profiletesting
Interpretationofresults
ì TypesofData(Results):
1. QualitativeResults(+/-)
2. Semi-QuantitativeResults(Fractionor%)
3. Quantitativeresults(e.g.concentration)
ImportanceofRoutineClinicalChemistryTests
ì DiagnosticTest:Isaprocedureperformtoconfirm,ordeterminethepresenceofdisease inan individual suspectedofhaving thediseaseusuallyfollowingthereportsofsymptoms.(Troponin/Glu)
ì PrognosticTest:Isusedtopredictapatient’slikelihoodofdevelopingadisease.(Freelambda/KappaRatio)
ì MonitoringTest:Testdoneonknownpatientconditionforfollowinguptheresultsattimelybasis.(HBA1c,SPE)
ì ScreeningTest:Helpstoidentifypeoplewithincreaseriskforadiseasebeforetheyhavesymptoms.
SpecialChemistryTests
SpecialChemistryTestingatSQUH
MSUDProfilePKUProfile
QualitativeandQuantitativeAminoAcidsProfilesPlasmaandUrineCatecholamines
StoneAnalysisTotalPorphyrinsScreeningtest
PBGToxicologyTesting