""

:
.

110 70 100
12 8 150 120 100
( )Physiological Hyperglycaemia
.
( 18 12) 70 60 100
" " ( .)Physiological Hypoglycaemia

() ( ):
( )Insulin
( )Anti-Insulin . ( )Glucagon
( )Adrenaline ( )Glucocorticoid ( )Growth Hormone
(.)Thyroxine

.
.
()
.

 ( )Diabetes Mellitus :
.

.

.

" ".

:
- ( :)Hyperglycaemic Coma

.
:
-1 .
-2 ( ) .
-3 .
-4 .

 ( )Ketones Bodies
( ) .

.

- ( :)Hypoglycaemic Coma

60 100
.
:
-1 .
-2 .
-3 .
-4 .

.


( 24)
.

() (:)Diabetes Mellitus


.

( )1 ( )Insulin Dependent Diabetes Mellitus

( :)IDDM

( )Type 40 30

( )IDDM .

( )2 ( Non- Insulin Dependent Diabetes

)Mellitus ( :)NIDDM
( )Type

.
.

( ) .

() :
-1 :
:

( ) ( )Fehling
( )Benedict .

( )Strips ( )Glucose Oxidase

.
( )Glucose Analyzer
( )Glucose Oxidase ( Oxygen
)Electrode
.

-2 ( :)Random Blood Glucose

.

-3 ( : )Fasting Blood Glucose

12 8
110 70 100
120 130
3 .

-4 ( Post Prandial Blood

:)Glucose
( 75 )

.
140 .

-5 ( )Glucose Tolerance Test

 ( :)GTT
.
12 8
75 ( 1 ) 3
.

110 70 130 120

2 3
" " ( )Insulin Shot
.

130 180
.

3 2
.

-6 ( Glycosylated Haemoglobin - HbA

)1c
() ( )Haem (
) A1c
%10 - 5
( .)HbA1c

( )HbA1c
120
%8 - 5
.

 -7 ( :)Fructosamine
20 - 15
.
( )Glycosylated Proteins
.

() :
-1 .
-2 .
-3 (
103 105 )
.
-4
.
-5 .
-6
.
-7 ( ).

Liver Function Tests

 :
. 1-
2-
. .
. 3-

: :
:) (

.
.

.
). 8 - 6 100 ( 80 - 60 /
.
:) (
.
) . 5.5 - 3.5 100 / ( 55 - 35 /
:

. -
. -
. -
. -
:
. -
. -

 . -
. -
. -
. -
:) (
:


.
) . 3.6 - 2 100 / ( 36 - 20 /
:
:
-
-
-
. -
:
:
-
-
-
-
:) (

.

.
) . 0.6 - 0.2 100 / ( 6 - 2 /
:
:
-

 -
-
:
:
-
-
-
-
-
: ( )
:

=

) ( - +
=

-

1
1

2
1

.
) A/G (
.

:

"
".

) (

_____

_____

30

_____

_____

_____

_____
_____ 1/8
_____
_____

_____

_____

_____





50
_____

60
_____


60
_____

_____ 120

_____

( )

_____

120

: )(2

 ) ( AST/GOT ) ( ALT/GPT ) ( Y.GT

.
: ( )

) ( ALT/GPT ) ( AST/GOT) (
.
. 45 / ) ( GPT
. 41 / ) (GOT
.
) ( GOT ) ( GPT
) ( GOT
.
. " " 6
( Y - GT) :) . (

30
25
. 50
: -
-
) ( -

: )(3
) (ALP) (

" "
.
(PH) 7

 71 - 24
/ ( 30) 350
/
:
: . -
-

-
. -
-
-
:
-
-
:) (


) ( ID - BIL
) ( D - BIL
.
) ( T- BIL
19 - 3.5 /
. 7 /
: :
-
" . "
-
" "
-
"
"

 " " " "

.
:
-
.
-

Kidney Function Tests

:

( Urea) : )(1

.
. ) ( NH3

%50

.
) 40 - 20 100 / ( 7 - 3.5 /
25 - 8 100 / ) Blood Urea Nitrogen ( BUN
) ( 8.9 - 0.9 /
40 - 20 100 / 15 - 5
. 100 / 20 - 5 100 /
:
:

:
:



Hepatic Coma

Hemodialysis
.
Starvation Malnutrition Cachexia

:

.
:

.

Creatinine : )(2

Phosphocreatine Anhydrous Creatine

. 24
) 1.5 - 0.5 100 ( 123 - 60 /
1.5 24 /
1.0 24 /

:
-
-
. 0.5 100 /

Creatinine Clearance Test: )(3

 24
. 24
140 - 90 /
125 - 80 /

: ) Creatinine Clearance (c
=C
Uc Tv
24 60 Sc

Uc
Sc
42 Tv
24
60
:
Water Depletion -
-
-

) Uric Acid ( ) ( )(4

Purine
Guanine. Adinine

.
7 - 3 100 ( 0.53 - 0.18 /
)
) . 6 - 2 ( 0.45 - 0.15 /
% 80
.
700 - 300 24 / ( 3.6 - 2.1 24 /
)
( ) ( )
24
.

 :
Gout -
Pre - Eclampsia &Eclampsia -
Leukaemia -
-
-
Glycogen Storage Disease - Type 1 -
-
Alcoholism -
:
-
. Probenicid Allpurinol -

:
Total Lipids :

(
) ( )

:
( Steroid) ) ( Waxes) ( Fatty Acids )(Triglyceride
) ( Terpenes

) ( Phospholipids ) (Triglyceride )( Cholesterol
) ( Fatty Acids

) 1000 - 450 100 / ( 10 - 4.5


.

 " CHO":) (

""
( Bile Acids) .
) ( Lipoproteins

.

. ()
:
-
-
-
-
-
:
-
-
-
-
:


.

:
100 / 120 - 230
100 / 120 - 240
100 / 140 - 260

1 - 20
21 - 30
31 - 40

 100 / 150 - 290

100 / 160 - 300

41 - 50
51 - 60

" TG" :) (

( ) ( Chylomicron % 90
) % 10
) ( Very Low Density Lipoprotein - VLDL
.

/
/
/
/

100 10 - 140
100 10 - 150
100 10 - 160
100 10 - 170

1 - 30
31 - 40
41 - 50
51 - 60

:
-
-
-
-
-
-
:
-
) LDL ( -
:
) ( Fatty Liver

 Lipoproteins Analysis :




:
) ( Chylomicrons -
) ( VLDL -
) ( LDL- Low Density Lipoproteins -
) ( HDL - High Density Lipoproteins -
:-

) ( HDL - High Density Lipoproteins) (

) ( - lipoprotein HDL
% 45 - % 25
HDL
HDL
.
HDL
HDL
. HDL
. HDL
) 40 100 / ( 0.83 2.5 / HDL

) (LDL- Low Density Lipoproteins) (

) ( - Lipoproteins
LDL % 50 - 05

. HDL LDL
) 180 100 / ( 3.88 - 0.5 / LDL
: LDL

 LDL Cholesterol (mg/dl) = Total Cholesterol - HDL CholesterolTriglyceride

5
400 mg/dl Triglyceride
: LDL
LDL Cholesterol (mmol/L) = Total Cholesterol - HDL CholesterolTriglyceride
22
:
Triglyceride
LDL Cholesterol
HDL Cholesterol
Total Cholesterol

35

35 - 55

55

45

45 - 65

65

190

150 - 190

150

________

________

________

5.9
. 4

3.8 - 5.9
3.1 - 4.6

3.8
3.1

HDL-Chol mg/100ml

LDL-Chol mg/100ml
LDL - Chol

) ( Bicarbonate )(1

) (Buffer

. ) (PH

 (Acid - Base - PH
)Balance
28 -23 /
:
PH ) ( Metabolic Alkalosis -

PH ) ( Respiratory Acidosis -

.
:
PH -
( Hyperventilation ) PH -

) ( Ammonia )(2

:
:

:

.
) 110 - 10 100 / ( 65 - 15 /
) ( Liver Bypass
( Portacaval
( ) ) Shunt
.
)( Starvation

) ( Pseudocholinesterase )(3

()
) ( Acetylcholinesterase
.
( )
) ( Acetylcholine
.
- 5 1.4 - 0.6 Pseudocholinesterase 25
12 37

( Organophosphorus
Compounds )

) ( Muscle Relaxant Pseudocholinesterase

) ( Succinylcholine

) ( Obesity
) ( Nephrosis

) ( ACP - Acid Phosphatase )(4

: ) ( Total Acid Phosphatse -

) ( Prostatic Acid Phosphatase -

.
11.5 - 2.5
5 - 2

. 7

( )

) ( Amylase )(5

300 - 100 /

,
:
-
4 - 3 40 - 20 40 - 2

-
-

-
) ( - -
:
-
-
-

 ( G6PDH ) Glucose 6- phosphate 6 )(6

)dehydrogenase

G6PDH
) ( NADPH
) (Ribose - Phosphate

NADPH : -
) ( Steroid Hormones -
) GSH ( ( G - S - S - G ) 2 ) ( Glutathione -
) ( Hydrogen Peroxide
( ) ( Ferrous
) Met- Haemoglobin

G6PDH

=

) ( Favism
.

:
) ( Whole Blood -
) ( Screening Test
-

) ( Myocardial Infarction
. 10 280 - 120

Sodium Na+



.
) ( Cation
.
145-135/


.
:

.
. %0.9

.
.
:
.

.
.
.
.

.
.
.
.
:

:
-
-

) ( ...

30

) (8

""
.

6

1

(

)

Potassium K+

.
5-3.5/
.
:
.

.
.
.

.
:
.
.
.
.
.
.
.

Chloride - CL


.
. 105 -95/


.
( )
.
( ) :
.

Calcium Ca++


.
). 10.3 -8.5 ( 2.6-2.1 /
() %45 50%
. () %5
:
-
-
-
-
-
:
-
"" -
-

 -
-
-
.
. 150 50 24 /



(

).

Inorganic Phosphorus

Coenzymez
ATP
) 7 4 100 ( 2.3 1.3 /
) 4.5 3 ( 1.5 1 /

.
:
-
-
"" -
-
:
-
-
-

 -
-
-

Magnesium - Mg++


.
) 3.5 1.8 100 / ( 1.75 0.9 /
:
-
-
-
-
-
:
-
-
-
-
-
-

Iron
(
Haemoprotein )
Mitochondria Respiratory Enzymes
. 4 %70
). 175-75 / ( 31.3-9 /



.
:
. Haemachromatosis :
. Haemasiderosis:
.
.
.
.
(
.)

Total Iron Binding Capacity - TIBC

410-250100 / ( 73-45 /) TIPC -%20

25%.
. %40-%30

.

.

:
.
.
). (
). (

). (
). (

Valporic Acid
Valproic acid
.

Glucorunic
Acid

.
.

50

100

100

.


.

.
Receptors
.

:
: )(RIA
)(EIA

Assay
Assay

Radio
Immuno

Enzyme
Immuno
) Fluorescence Immuno Assay (FIA -

Collection of Blood

Collection

Specimen

( )

Basal .
Condition
.
.

( )

.
Blood

of

Collection

....

%8
4 6 1
. 24 48
Capillary Puncture
Blood
Gases

: Syringe
Disposable

.
Nozzle
0.1 Tuberculin ( 20 1 )

(- 18
25) 20
.

 ()

Puncture.
%70
2- 1
.

Isotonic 15

Venipuncture

2

10 5

.
Puncture

Arterial

) Anticoagulants (



.


.

.
Acid Phosphatase
LDH Alkaline Phosphatase

.
Heparin 1

Cofactor

%20

. 110 /
. 0.2 /
Potassium Oxalates 2

20 10
10 2 %30
PH = 7.4
0.1. 10

Sodium Fluoride 3 -

 ( )
2 1 /
Glycolysis
4 12 200
. 1 100

. ( Urease )

)Ethylene Diamine Tetra Acetic Acid (EDTA

2 - 1 /
.



Pco2 Po2 PH
6 7
7 . 100 / ( 0.39/)

4 2
.
( 20-)


.

:
.

2-

4 -

6 -