CLINICAL CHEMISTRY LECTURE

LESSON 1: Introduction to Clinical Chemistry LABORATORY MATHEMATICS

MAIN PURPOSE OF CLINICAL  Units of Measurement
CHEMISTRY  SI or Systeme International
d’Unites – the current unit
 To facilitate the correct performance of analytic adopted today
procedures that yield accurate and precise  This system is devised to provide
information, aiding patient diagnosis and the global scientific community w/
treatment. a uniform method of describing
* In order to achieve this the clinical laboratory physical quantities
scientist should be able to correctly use basic  Based on the metric system
supplies and equipment and posses understanding of  Classification:
fundamental concepts critical to any analytic 1) Basic unit
procedure 2) Derived units

I’M A MEDTECH * A laboratory result consists of two components:

eg 100 mg/dl – first component represents the
 clinical laboratory scientist, or medical number related to the actual test value and the
technologist second is a label to identify the unit
* -seven basic unit: length (meter), mass
 A healthcare professional who (kilogram), time, electric current, thermodynamic
performs chemical, hematological, immunologi tempt, amount of subs, luminous intensity
c, microscopic, and bacteriological diagnostic ** -derivative or a mathematical function describing
analyses on body fluids  one of the basic units
 Medical laboratory scientists work in clinical
laboratories at hospitals, physician's offices, TEACH HOW THEY CAN EXPRESS mL to L. 1
reference labs, biotechnology labs and non- x10-3 L= 1,000L MOVING THE DECIMAL
clinical industrial labs. PLACE TO THE RIGHT

ROLES AND DUTIES OF MEDICAL  For Length

TECHNOLOGIST 1 km= 1000 m
1 inch- 2.54 cm
 Preparing cultures of tissue samples 1 meter- 39.37 inch
 Establishing and monitoring programs that 1 km- 0.62 mile
ensure data accuracy 1ft= 12 in
 Microscopically examining slides of bodily 1yard= 3 ft
fluids  For Mass
 Cross-matching blood for transfusions 1 kg= 2.2 lbs
 Chemically analyzing blood or urine for toxic 1kg= 1000 gm
components 1 lb= 453.6 gm
 Analyzing lab reports for accuracy 1 metric ton= 2200 lbs
 Operating and calibrating equipment 1 ton= 2000 lbs
 Delivering test results to physicians, researchers  For Volume
or patients 1 L= 1000 mL= 1000.028 cm3 = 0.03552 ft3
 Collecting and studying blood samples to 1 gallon= 3. 785 L
determine morphology 1mL= 1 cm3
1 ounce= 30 mL
1 tsp= 5 mL= 90 drops
1tbsp= 15 mL

GUGUA NATIONAL COLLEGES- BSMT3

 For Pressure
1 atm= 76 cm Hg= 760 torr= 14.7
psi= 101,325 Pascal
CHEMICALS
 Varying grades of purity of Analytical
Chemicals:
 Analytic reagent (AR) - -they are
suited for most analytic laboratory
procedure
 Ultrapure, Chemically pure(CP) -
they have put through additional
purification steps for use in specific
procedures as chromatography, atomic
absorption, immunoassay, molecular
diagnostic, standardization, or other
tech that require extremely pure
chemicals
 United States Pharmacopeia (USP)
and National Formulatory (NF) -
they are use to manufacture drugs;
their only criteria to not to be injurious
to individuals , they may be pure
enough for use in most chemical
procedures
 Technical or commercial grade -
FOR MANufacturing purposes only
 Organic reagents Grades of Purity:
 CP- approaches the purity level of
reagent grade chemicals
 Spectroscopic- spectrally pure
 Chromatographic- minimum purity
of 99% determined by GC
* Other than this OSHA requires manufacturer to
indicate the lot number plus any physical or
biologic health hazard and precautions needed for
the safe use and storage of any chemical
-a manufacturer is also require to give
MSDS
REFERENCE MATERIAL
1) Primary standard - highly purified chemical
to (* it can be measured directly to produce a
substance of exact known concentration * they
have a purity tolerance of 100 +/- 0.02%) *
Primary standard are accurately prepared, have
known conc, and certified by professional org
STANDARD REFENRENCE MATERIAL (*
since there is no biologic constituents available
GUGUA NATIONAL COLLEGES- BSMT3
that have the same tolerance of primary, the
NIST certified the use of STANDARD
REFERENCE MATERIAL
 Certified by IUPAC
 This materials may not have the same
purity as that of the a primary standard
 They are use to verify calibration or
accuracy bias assessment of certain
reagents and machine
2) Secondary standard - substance of lower
purity
 Its concentration is determined by
comparison from the primary standard
 Its composition cannot be determined
WATER SPECIFICATION
 Tap water is not suitable for laboratory
application (*- water that has been distilled; it is
purified to remove almost all organic materials,
by the process distillation (water is boiled and
vaporized)
 Reagent grade water - required water for
laboratory use (*-water that was purified by
ionization; tp remove most of the ions, organic
material may be present; this type of water is
purified from previously treated water; produce
using either cation exchange resin followed by
replace of removed ions by hydroxyl or
hydrogen ion)
 Divided into 6 categories
*-reverse osmosis; it pumps water across
semipermeable membrane; it uses pressure to force
water through a semipermeable membrane
producing a water that reflects a filtered product of
original water; this may also be use in pretreatment
of water
OTHER WAYS TO PURIFY WATER:
 ultrafiltration (or nanofiltration) - excellent
in removing particulate matter, microorganism
and any pyrogens or endotoxins
 ultraviolet light, sterilization, ozone
treatment- this 3 can destroy bacteria but may
leave residual products
CATEGORIES OF REAGENT GRADE
WATER
1) clinical laboratory reagent water (CLRW)
2) special reagent water (SRW) Solute - substance that is dissolve in solvent. In
clinical lab it is called analyte.
3) Instrument feed water
Solvent - where the analyte is dissolved
4) water supplied by manufacturer
2. Molarity (M) - number of moles per 1L of
5) autoclaved and wash water solution
6) commercially bottled purified water - Express as moles/liter (mol/L)
TYPES OF CATEGORIZING FOR WATER
PURITY:
Reagent grade water are made through distillation,
ion exhcnage, reverse osmosis and UV oxidation
Specification for water application:
- microbial count, pH, resistivity, silicate,
particulate matter, and organics
1mole= to gram molecular weight
- each category has acceptable limits
3. Molality (m) - amount of solute per 1kg of
 Type I - type I is suitable for routine laboratory solvent
use; used for test methods that requires
minimum interference; - Expressed as moles per
kilogram (mol/kg)
 Type II - acceptable for most analytic process
including reagent, quality control and standard
preparation, maintain water storage to ensure
minimum chemical or bacterial contamination
 Type III - autoclaved wash water; good for
cleaning of lab glasswares not for reagent
analysis
4. Normality - number of grams equivalent weights
SOLUTION PROPERTIES per 1L of solution (* used in titration and chemical
reagent classification)
1. Concentration - can be express as:
1.1 Percent solution - expressed as equal
parts per 100 or amount of solute per 100 units of
solution.
Three expression:
w/w
OTHER TERMS RELATED TO
v/v= g/dL CONCENTRATION:
w/v  Terms for extent of saturation:
 Diluted - little solute; lower solute
concentration per volume of
solvent

GUGUA NATIONAL COLLEGES- BSMT3

  Concentrated - large quantity of
solute
CLINICAL LABORATORY SUPPLIES
 Saturated - excess undissolved
solutes particles  THERMOMETERS/TEMPERATURES

 Supersaturated - greater LABORATORY GLASSWARES

concentration than saturated
solution

COLLIGATIVE PROPERTIES
 Behavior of particles or solutes in solution
a) osmotic pressure - it’s the pressure that oppose
osmosis when a solvent flows through a
semipermeable membrane to establish
equilibrium between compartments of differing
concentration A. Florence Flask
b) vapor Pressure - pressure at w/c the liquid B. Volumetric Flask
solvent is in equilbirium in water vapor
C. Beaker
c) freezing point - temperature at w/c the vapor
pressure of the solid and liquid phases are the D. Graduated Cylinder
same
E. Buret
d) boiling point - temperature at w/c the vapor
pressure of the solvent reaches one atmosphere F. Crucible and cover
G. Analytical balance
PH AND BUFFERS
 pH is the hydrogen ion concentration in a PIPETS
solution (* pH - the small “p” it’s a operational I. Design
that means “negative logarithm of” or “inverse
log of” that substance)  To contain (TC)
pH= log{1/H}  To deliver (TD)
 Buffers are weak acid and base II. Drainage characteristic
 A buffer’s capacity to minimize changes in pH  Blowout
is related to the dissociation characteristics of
weak acid or weak base in the presence of its  Self draining
respective salt (* unlike for strong acid and
base which dissociate almost completely, the
dissociation constant of weak acid/base tends to
be very small, meaning little dissociation
occurs)

GUGUA NATIONAL COLLEGES- BSMT3

 SEPARATION TECHNIQUES
 CENTRIFUGATION SPECIMEN CONSIDERATION
- technique used for the separation of  Types of Samples
particles from a solution according to their size,  Whole blood, serum or plasma
shape, density, viscosity of the medium and rotor  Arterial blood sample
speed  Sample Processing
 Can a medtech reject a sample?
 What is the first thing to do upon the arrival of
the sample in the laboratory?

PRECAUTIONS AFTER SAMPLE

COLLECTION
 samples should be analyzed within 4 hrs
 Should be properly cupped and kept from areas
of rapid airflow, light and heat
 Should you delay the analysis, samples should
be stored at ref tempt
 FILTRATION
- method for separating an insoluble solid SAMPLE VARIABLES
from a liquid
- The liquid that passes through the
filter paper is called the filtrate FACTORS SAMPLE OF
ANALYTE AFFECTED

Age Albumin, ALP,

phosphorus cholesterol

Gender Albumin, ALP, crea,

uric acid

Diurnal variation Inc AM- ACTH,

cortisol, Fe aldosterone
INC PM- ACP, growth
hormone, PTH, TSH
 S
 DIALYSIS Day to day ingestion >/= 20% ALT, bilirubin,
- separation of suspended colloidal particles Fe, TSH, TAG
from dissolved ions or molecules of small
dimensions (crystalloids) by means of their unequal Recent food ingestion Inc: glucose, insulin,
rates of diffusion through the pores of TAG, gastrin, iCa
semipermeable membranes Dec: Cl, Phosphorus, K,
AMY, ALP

Posture Inc (standing): albumin,

cholesterol, aldosterone
Ca

GUGUA NATIONAL COLLEGES- BSMT3

 CHAIN OF CUSTODY
 Tamper proof seal
 Patient and witness should identify the sample
 Any individual in contact with the sample must
document receipt of the sample, condition of
the sample at the time of receipt
 Date and time sample was received

RESULTS REPORTING
 Minimum Elements of Patients Report
Recording
 Name and address of lab performing
the analysis and reference lab (if any)
 Px name & identification number or
unique identifier
 Name of physician or person ordering
the test
 Date and time of spx collection
 Date & time of releasing of result
 Spx source or type
 Test results & units of measurement
 Reference range
 Comments relating to the sample

GUGUA NATIONAL COLLEGES- BSMT3