SUMMARY ALL SUBJECTS

CENTRIFUGATION (SPIN)
CLINIAL CHEMISTRY MICROBIOLOGY CM

TEST SPIN TIME TEST SPIN TIME TEST SPIN TIME

GENERAL 1000-2000G RCF 10 MINUTES

HDL 1500G 10-30 MINS

HEMATOLOGY IS/BB HISTOPATH

TEST SPIN TIME TEST SPIN TIME TEST SPIN TIME

FICOLL-HYPAQUE 4003 X G 30 MINUTES

SUMMARY ALL SUBJECTS| 1

 MEDICATIONS AFFECTING THE ANALYSIS
CC MICROBIOLOGY CM
DRUG ANALYTE NOTES DRUG ANALYTE NOTES DRUG ANALYTE NOTES
AFFECTED AFFECTED AFFECTED

NICOTINE INC: GLUCOSE SMOKING

INC: GGT, TAG CHRONIC

ALCOHOL
DEC: GLUCOSE CONSUMPTION

INC: LIVER &

MORPHINE OR MEPERIDINE PANCREATIC OPIATES
ENZYMES

DIURETICS DEC: K & NA

INC: GLUCOSE
PRERENAL AZOTEMIA
THIAZIDE-TYPE
SECONDARY TO THE
MEDICATIONS DECREASE IN BLOOD
VOLUME.

PATIENTS
WARFARIN, RECEIVING
PHENOBARBITAL, INC.: GGT LEVELS ENZYME-
PHENYTOIN. INDUCING
DRUGS

FALSE INC. SERUM FOR PAIN

MORHPINE/OPIATES
AMS RELIEFS

SALICYLATES, DIURETICS,
ANTICONVULSANTS, ORAL
AFFECT OGGT
CONTRACEPTIVES, AND
CORTICOSTEROIDS

THIAZIDE DIURETICS HYPOKALEMIA

HEMATOLOGY IS/BB HISTOPATH

DRUG ANALYTE NOTES DRUG ANALYTE NOTES DRUG ANALYTE NOTES
AFFECTED AFFECTED AFFECTED

SUMMARY ALL SUBJECTS| 2

 SAMPLE PROCESSING (INTERVAL) & STORAGE IF DELAYED

CLINICAL CHEMISTRY MICROBIOLOGY CM

TEST INTERVAL STORAGE IF DELAYED TEST INTERVAL STORAGE TEST INTERVAL STORAGE

4C FOR 8 HOURS
GENERAL WITHIN 4 HOURS
-20C FOR LONGER PERIODS

4C FOR 8 HOURS
ALIQUOT ASAP
-20 IN SAMPLES NOT STABLE AT 4C

DEPROTEINIZATION
AMINO ACID WITHIN 30 MINS. OF
-20 OR -40C
ANALYSIS SAMPLE
COLLECTION

CREATININE REF AFTER

FROZEN (4 DAYS)
(URINE) COLLECTION

WITHIN 20 MINUTES
AMMONIA (CENTRI) FROZEN AT -20C (2-3 DAYS)
(0 TO -4C)

CK WITHIN 24 HOURS REF TEMP

ALP ASAP
2 DAYS AT RT
FROZEN OR ACIDIFIED TO A PH
ACP ASAP LOWER THAN 6.5

GLUCOSE REF TEMP/

W/I 1 HOUR
(SERUM) SODIUM FLOURIDE PRESERVE

IONIZED
W/I 30 MINS. RT
CALCIUM

HEMATOLOGY IS/BB HISTOPATH

TEST INTERVAL STORAGE

TEST INTERVAL STORAGE COMPLEMENT FROZEN OR TEST INTERVAL STORAGE

1-2 HOURS
COMPONENT DRY ICE

IMS 2-8C 72 HOURS

ASAP
(GENERAL) -20C IF LONGER

FLOW BLOOD: RT (20-25C)

BLOOD: W/I 3O HRS.
CYTOMETRY TISSUE: RT OR 4C

SUMMARY ALL SUBJECTS| 3

 SAMPLE STORAGE

CLINICAL CHEMISTRY MICROBIOLOGY CM

CAN BE STORED CAN BE STORED CAN BE STORED

TEST TEMPERATURE TEST TEMPERATURE TEST TEMPERATURE
FOR: FOR: FOR:

URIC ACID
3-5 DAYS REF TEMP
(BLOOD)
AMMONIA 2-3 DAYS FROZEN AT -20C
CREATINE 7 DAYS 4C
KINASE 1 MONTH -20C
LDH (SERUM) 2 DAYS RT
LDH
24 HOURS 25C
(ISOENZYMES)

7 DAYS 4C
CK (DARK)
1 MONTH 20C
AST 3-4 DAYS REF TEMP
ALT 3-4 DAYS 4C
GGT 1 WEEK 4C
2 DAYS
ACP 4C
(ACIDIFIED)

1 WEEK RT
LPS 3 WEEKS 4C
2 MONTHS FROZEN

AMS
1 WEEK RT
(SERUM &
2 MONTHS 4C
URINE)

HEMATOLOGY IS/BB HISTOPATH

CAN BE STORED CAN BE STORED CAN BE STORED

TEST TEMPERATURE TEST TEMPERATURE TEST TEMPERATURE
FOR: FOR: FOR:

SUMMARY ALL SUBJECTS| 4

ANALYTES AFFECTED BY CELLULAR METABOLISM
✓ GLUCOSE
✓ ALDOSTERONE
✓ CALCITONIN
✓ ENZYMES
✓ PHOSPHORUS

SUMMARY ALL SUBJECTS| 5

 PATIENT PREPARATION (CLINICAL CHEMISTRY)
A. PRE-ANALYTICAL VARIABLES (FACTORS CONTRIBUTING TO VARIATON OF RESULTS)
EXERCISE
TRANSIENT INCREASE LONG TERM INCREASE HORMONES FIST CLENHING
INC. DEC.
EXERCISE AMMONIA
ALDOLASE
PROLACIN FSH
POTASSIUM (1MMOL/L)
AST LACTATE (NO TOURNIQUET, & CLENCH
FATTY ACID GH LH
CK FIST)
LACTATE ESTROGEN
LDH PHOSPHATE
TESTOSTERONE
FASTING
BASIC METABOLIC PANEL BASAL STATE COLLECTION
BUN GLUCOSE
CREATININE LIPIDS
CARBON DIOXIDE LIPOPROTEINS
GLUCOSE ELECTROLYTES
SODIUM
FASTING POTASSIUM
CHLORIDE
CALCIUM
FASTING (48 HOURS) FASTING (72 HOURS)
INCREASE SERUM BILIRUBIN MALE
INCREASE PLASMA TAG
FEMALE
DECREASE GLUCOSE BY 45 MD/DL
DIET
ATKINS DIET (HIGN PROTEIN, LOW
HIGH PROTEIN DIET CAFFEINE INCREASE IN OBESE PATIENT
CARBS)
DIET INCREASE: INCREASE: INCREASE: GLUCOSE
BUN BUN GLUCOSE TAG
CREATININE URINE KETONES LDL
CORTISOL
POSTURE/POSITION
DESCRIPTION SUPPINE TO SITTING/STANDING SITTING TO SUPPINE STANDING TO SUPPINE
1. PREFFERED POSITION – UPRIGHT INCREASE: INCREASE: DECREASE:
POSITION OR SUPINE (LYING) FOR 15-20 1. ALBUMIN 1. BUN 1. CHOLESTEROL
MINS. BEFORE BLOOD COLLECTION 2. ALDOSTERONE 2. CALCIUM 2. TAG
POSTURE/POSITION 2. 30 MINS. OF STANDING – INC. 3. CALCIUM 3. IRON 3. LIPOPROTEINS
POTASSIUM 4. ENZYMES 4. LIPIDS 4. EXTRAVASCULAR WATER TRANSFER
3. RENIN PLASMA LEVEL – HIGHER WHEN 5. CONSTRICTION OF BLOOD VESSELS 5. PROTEINS TO VASCULAR SYSTEM
STANDING 6. SHIFTING OF WATER AND
ELECTROLYTES INTO TISSUE CAUSING
HEMOCONCENTRATION
TOURNIQUET APPLICATION
INCREASE DUE TO PROLONGATION DECREASE LEVELS
AMMONIA PH
TOURNIQUET ALBUMIN (PROTEINS) VENOUSE PO2
APPLICATION CHOLESTEROL
ENZYMES
LACTATE
POTASSIUM

SUMMARY ALL SUBJECTS| 6

 TOBACCO SOKING
INCREASE DECREASE
AMMONIA VITAMIN B12
UREA
LACTATE
GLUCOSE
URINARY 5-HIAA
TOBACCO SMOKING CHOLESTEROL
TAG
INSULIN
GH
CATECHOLAMINE
CORTISOL
ALCOHOL INGESTION
INCREASE DECREASE
GGT GLUCOSE
TAG
ALCOHOL INGESTION LACTATE
URATE
STRESS & DRUGS
INCREASE STRESS DRUGS
1. ALBUMIN • MEDICATIONS AFFECTING PLASMA VOLUME CAN AFFECT: PROTEIN, BUN, IRON, CALCIUM
2. GLUCOSE • TDM SPX COLLECTION SHOULD BE SCHEDULED ACCORDING TO THE TIME OF LAST DOSE
STRESS & DRUGS 3. LACTATE HEPATOTOXIC DRUGS DIURETICS OPIATES
4. TOTAL CHOLESTEROL
INCREASE: DECREASE: INCREASE:
5. ACTH
LIVER FUNCTION ENZYME SODIUM LIVER & PANCREATIC ENZYMES
6. CORTISOL
POTASSIUM
7. CATHECOLAMINES
8. PROLACTIN
B. PHYSIOLOGIC VARIATION
AFFECTED BY AGE (INCREASE) AFFECTED BY GENDER (INCREASE) RECENT FOOD INTAKE
1. ALBUMIN MALE FEMALE INCREASE DECREASE
2. ALP 1. ALBUMIN 1. CHOLESTEROL 1. GLUCOSE 1. ALP
3. CHOLESTEROL 2. ALP 2. HDL 2. TAG 2. AMYLASE
4. PHOSPHORUS 3. BUN 3. IRON 3. GASTRIN 3. CHLORIDE
4. BUA 4. FREE CALCIUM 4. POTASSIUM
5. CREATININE 5. PHOSPHORUS
6. CHOLESTEROL
C. TESTS AFFECTED BY DIURNAL VARIATION
LOWER AT NIGHT AFTERNOON VARIATION PEAK TIME LEVEL
ACTH INCREASE DECREASE CORTISOL
PEAK: 4-6 AM
ALDOSTERONE LOW: 8PM-12AM
(PTAG) (CAPAI)
INSULIN PEAK: 4-8AM
PLASMA RENIN ACTIVITY
1. PTH 1. CORTISOL PROLACTIN
8-10PM
2. TSH 2. ACTH
PEAK: EARLY TO LATE MORNING
3. ACP 3. PLASMA RENIN IRON
4. GH 4. ALDOSTERONE (DEC. UP TP 30% DURING THE DAY)
5. INSULIN CALCIUM 4% DEC. IN SUPPINE

SUMMARY ALL SUBJECTS| 7

 FACTORS TO CONSIDER IN ANALYTE PROCESSING (CLINICAL CHEMISTRY)
HEMOLYSIS
1. USING TOO SMALL NEEDLE
2. PULLING A SYRINGE PLUNGER ACK TOO FAST
3. EXPELLING BLOOD STRONGLY TO THE TUBE
CAUSES OF HEMOLYSIS
4. FORCING BLOOD FROM SYRINGE TO TUBE
5. SHAKING OR MIXING THE TUBE VIGOROUSLY
6. PERFORMING BLOOD COLLECTION BEOFRE ALCOHOL HAS DRIED
PHOSPHATE CATECHOLAMINE LPS
HEMOLYSIS MAGNESIUM CK
EFFECTS OF HEMOLYSIS AST & ALT K EFFECTS OF
(PMAAALICK) ACP & ALP TOTAL PROTEIN HEMOLYSIS
INCREASE ALBUMIN BILIRUBIN (FALSELY LOW)
LDH CHOLESTEROL
IRON
GGT
NOT AFFECTED BY
AMS (EXCEPT PEROXIDE)
HEMOLYSIS SODIUM (NA)
FAILURE TO SEPARATE BLOOD
AFTER 24 HOURS
AFTER 6 HOURS WITHIN 30 MINUTES
(INCREASE DUE TO MOVEMENT OF WATER INTO
(UNSTABLE) (LEAST STABLE)
CELLS, RESULTING IN HEMOCONCENTRATION)
FAILURE TO 1. TOTAL BILIRUBIN 1. CHLORIDE 1. POTASSIUM
SEPARATE BLOOD 2. ELECTROLYTES 2. C-PEPTIDE 2. PHOSPHORUS
3. UREA 3. ALBUMIN 3. GLUCOSE
4. ALBUMIN 4. BICARBONATE
5. TOTAL PROTEIN 5. IRON
6. NITROGEN 6. TOTAL PROTEIN
7. HDL, LDL, CHOLESTEROL
MISCELLANEOUS
IV FLUID CONTAMINATION TRAUMATIC DRAW (INCREASE) SHIFT IN ELECTROLYTES
INCREASE DECREASE 1. POTASSIUM 1. FALSE INC. IN K
1. GLUCOSE (10% 1. UREA 2. MYOGLOBIN 2. DEC. IN NA.
MISCELLANEOUS CONTAMINATION 2. CREATININE 3. CK
WITH 5% DEXTROSE
INCREASE BY 500
MG/DL)
2. NA, K, CL
TYPE OF SAMPLE THAT MAY INTERFERE TESTING
ICTERIC SAMPLE (EXCESS BILIRUBIN IN BLOOD) LIPEMIC SAMPLE (EXCESS LIPIDS IN BLOOD)
TYPES OF SAMPLE 1. ALBUMIN 1. UREA
MAY INTERFERE THE 2. CHOLESTEROL 2. URATE
3. GLUCOSE 3. BILIRUBIN
TEST 4. TOTAL PROTEIN 4. TOTAL PROTEIN
5. AMYLASE
6. CK

SUMMARY ALL SUBJECTS| 8

 SAMPLE REQUIREMENTS
FASTING SPECIMENS CHILLING DURING TRANSPORT PHOTOSENSITIVE ANALYTE
REQUIRED DOES NOT REQUIRED REQUIRED NOT REQUIRED 1. BILIRUBIN
1. TAG & LDL (12-14 HOURS) 1. CHOLESTEROL 2. BETA-CAROTENE
1. AMMONIA 9. POTASSIUM 3. FOLATE
2. FBS (8-10 NOT EXCEED 16 HOURS) 2. HDL 2. BLOOD GAS (ICE
3. 2-HOUR PPBS 4. PORPHYRINS
SLURRY 15 MIN) 5. VIT. A & B6
SAMPLE 4. OGTT (8-12) OR (10HR NOT >16 HR) 3. CATHECHOLAMINES 6. CREATININE KINASE (CK)
5. C-PEPTIDE TEST
REQUIREMENTS 6. GASTRIN
4. GASTRIN
5. LACTIC ACID
7. INSULIN 6. RENIN
8. INORGANIC PHOSPHORUS 7. PTH
9. AMMONIA 8. PYRUVATE CALCIUM
10. GH
11. PROLACTIN
12. ADH (8-12)
13. CATHECHOLAMINES (E,N,D)
14. AMINO ACID ANALYSIS
15. SERUM IRON?
SAMPLE DIFFERENCES
WHOLE BLOOD FASTING GLUCOSE • 10,11-15% LOWER THAN PLASMA
VENOUS BLOOD GLUCOSE • 7 MG/DL LOWER IN CAPILLARY BLOOD
GLUCOSE MEASUREMENT BY REDUCTION METHOD • 5-15 MG/DL HIGHER THAN ENZYMATIC METHOD
SAMPLE 10% CONTAMINATION WITH 5% DEXTROSE • INCREASE GLUCOSE BY 500 MG/DL OR MORE
DIFFERENCES RATE OF GLYCOLYSIS (GLUCOSE)
• AT ROOM TEMP: 7MG/DL PER HOUR
• AT 4C(REF): 2 MG/DL PER HOUR
CHOLESTEROL & TAG • 3% LOWER IN SERUM
TOTAL PROTEIN & ALBUMIN • 10% HIGHER IN HEALTHY INDIVIDUALS
TOTAL PROTEIN OF PLASMA • 0.2-0.4 G/DL HIGHER IN SERUM DUE TO FIBRINOGEN LEVEL.
PANIC/CRITICAL VALUES
(TEST RESULTS THAT INDICATE A POTENTIALLY LIFE THREATENING SITUATION)
PANIC
LIFE THREATENING VALUES/REPORT IMMEDIATELY STAT
VALUES/CRITICAL
SODIUM PHOSPHORUS GLUCOSE IN DIABETIC KETOACIDOSIS POTASSIUM
VALUES POTASSIUM TOTAL CO2 AMYLASE IN SUSPECTED PANCREATITIS BLOOD GASES
CALCIUM TOTAL BILIRUBIN (NEONATES) CK IN SUSPECTED MYOCARDIAL INFARCTION SOME DRUG LEVELS (THEOPHYLLINE)
MAGNESIUM BLOOD GASES HEMATOCRIT
COLLECTION TUBES
TUBES THAT PRODUCE PLASMA TUBES THAT PRODUCE SERUM
• EDTA • RED TOP
COLLECTION TUBES • OXALATE • SST TUBE (YELLOW)
• CITRATE
• HEPARIN
• LITHIUM HEPARIN – MOST COMMONLY USED IN CHEMISTRY TEST;
CARDIAC BYPASS SURGERY
DIET
PURINE RICH FOODS (URIC ACID) LIVER, KIDNEY, SWEET BREADS, SHELLFISH, HERRING, SARDINES, YEAST, LEGUMINOUS VEGETABLES
RICH IN VMA/HMMA
BANANA, VANILLA, TEA,COFFEE
DIET (OH-3-METOXYMANDELIC ACID)
RICH IN SEROTONIN BANANA, PINEAPPLE, TOMATO,AVOCADO
RICH IN POTASSIUM BANANAS, DRIED FRUITS, NUTS, BRAN CEREALS, AND ORANGE JUICE
RICH IN IRON RED MEAT, LEGUMES, DARK LEAFY VEGETABLES

SUMMARY ALL SUBJECTS| 9

 HISTORY
CC MICROBIOLOGY CM
1. STAT – (LATIN-STATIN) MEANS IMMEDIATELY
2. PHLEBOTOMY – TO CUT A VEIN
3. HORMONES – GREEK “HORMON” MEANS TO SET IN
MOTION
4. PITUITARY GLAND – “TO SPIT MUCUS”
“UNDERGROWTH”
HEMATOLOGY IS/BB HISTOPATH/MTLE
1. VACCINATION - LATIN VACCA = COW
ORIGIN OF TERMS 2. ATTENUATION - CHANGE
3. OPSONINS - GREEK WORD MEANING “TO PREPARE FOR
EATING.”
IS 4. ANAPHYLAXIS – WITHOUT PROTECTION
5. ASTHMA – “PANTING” OR “BREATHLESSNESS.”
6. “HORROR AUTOTOXICUS,” -“FEAR OF SELF-
POISONING.”
7. LUPUS – ’’WOLF LIKE’’
BB

IMPORTANT ACRONYMS
AACC AMERICAN ASSOCIATION FOR CLINICAL CHEMISTRY
CAP COLLEGE OF AMERICAN PATHOLOGISTS
CLIA CLINICAL LABORATORY IMPROVEMENT AMENDMENTS (88)
CLSI CLINICAL LABORATORY AND STANDARDS INSTITUTE (FORMERLY NCCLS)
NCCLS NATIONAL COMMITTEE FOR CLINICAL LABORATORY STANDARDS
CMS CENTERS FOR MEDICARE AND MEDICAID SERVICES
CLINICAL
FDA FOOD AND DRUG ADMINISTRATION
CHEMISTRY
TJC THE JOINT COMMISSION
JCAHO THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS (FORMER TJC)
NACB NATIONAL ACADEMY OF CLINICAL BIOCHEMISTRY
OIVD OFFICE OF IN VITRO DIAGNOSTIC DEVICE EVALUATION AND SAFETY
IFCC INTERNATIONAL FEDERATION OF CLINICAL CHEMISTRY AND LABORATORY MEDICINE
NCEP NATIONAL CHOLESTEROL EDUCATION PROGRAM

SUMMARY ALL SUBJECTS| 10

 ERRORS & PROCESSES IN THE LABORATORY
TYPE OF ERROR DESCRIPTION EXAMPLE WESTGARD RULE
✓ MISLABELING A SAMPLE
✓ PIPETTING ERRORS
✓ IMPROPER MIXING OF SAMPLES & REAGENT
• ERROR THAT DOES NOT OCCUR IN REGULAR PATTERN
RANDOM ERROR ✓ VOLTAGE FLUCTUATIONS NOT 13S OR R4S
• NO TREND OR MEANS OF PREDICTING IT
COMPENSATED FOR BY THE INSTRUMENT
CIRCUITRY
✓ TEMPERATURE FLUCTUATIONS
✓ IMPROPER CALIBRATION (SHIFT)
• RECURRING ERROR INHERENT IN TEST PROCEDURE ✓ DETERIORATION OF REAGENT (TREND)
SYSTEMATIC ERROR • SEEN AS A TREND OR SHIFT IN DATA ✓ SAMPLE INSTABILITY 22S, 41S, 10X
• LEFTMOST VALUE CONTAINS AN EVEN NUMBER ✓ INSTRUMENT DRIFT OR CHANGES IN
STANDARD MATERIALS
PRE-ANALYTICAL ANALYTICAL POST-ANALYTICAL
• SELECTION AND IMPLEMENTATION OF ASSAY RELATIVE • LAB. STAFF COMPETENCY • ACCURACY IN TRANSCRIPTION & FILLING OF RESULTS
TO PATIENT NEED • ASSAY & INSTRUMENT SELECTION • CONTENT & FORMAT OF LABORATORY & NARRATIVE REPORT
CLINICAL • PATIENT IDENTIFICATION & IMPLEMENTATION • ASSAY VALIDATION (INCLUDING • REFERENCE INTERVAL & THERAPUTIC RANGE
CHEMISTRY • SPECIMEN COLLECTION TECHNIQUE AND APPARATUS LINEARITY,ACCURACY,PRECISION,ANALYTICAL • TIMELINESS IN COMMUNICATING CRITICAL VALUES
• SPECIMEN TRASPORT, PREPARATION & STORAGE LIMITS,SPECIFICITY) • PATIENT & PHYSICIAN SATISFACTION
• MONITORING OF SPECIMEN COLLECTION • INTERNAL QUALITY CONTROL • TAT
• EXTERNAL QUALITY ASSESSMENT • COST ANALYSIS
PRE-ANALYTICAL PHASE (PRE-EXAMINATION) ANALYTICAL PHASE (EXAMINATION) POST-ANALYTICAL PHASE (POST-EXAMINATION)
• TEST ORDER ACCURACY • ACCURACY OF POINT OF CARE TESTING • CRITICAL VALUE REPORTING
• PATIENT IDENTIFICATION • CERVICAL CYTOLOGY/BIOPSY CORRELATION • TURNAROUND TIME
• BLOOD CULTURE CONTAMINATION
PRE-ANALYTICAL TEST SYSYTEM ANALYTICAL TEST SYSYTEM POST-ANALYTICAL TEST SYSYTEM
• ADEQUACY OF SPECIMEN INFORMATION • DIABETES MONITORING • CLINICIAN SATISFACTION
• HYPERLIPEDIMIA SCREENING • CLINICIAN FOLLOW-UP
TREND SHIFT
REAGENT DETERIORATION IMPROPER INSTRUMENT CALIBRATION
6 OR MORE CONSECUTIVE VALUES THAT CONTINUE TO EITHER INCREASE OR DECREASE BOTH INCREASE OR DECREASE
CROSSES MEAN 6 OR MORE CONSECUTIVE VALUES DISTRIBUTED ON 1 SIDE OF THE MEAN
GRADUAL CHANGE IN THE CONTROL SAMPLE & RESULTS ABRUPT CHANGE FROM THE ESTABLISHED AVERAGE VALUE

SUMMARY ALL SUBJECTS| 11

 ORDER/FREQUENCY SUMMARY
PURITY OF REAGENTS
(FROM MOST TO LEAST ULTRAPURE> ANALYTIC GRADE> CHEMICALLY PURE> USP> COMMERCIAL GRADE
PURE)
POLYACRYLAMIDE GEL
ELECTROPHORESIS SMALL-PORE SEPARATION GEL > LARGE-PORE SPACER GEL> LARGE-PORE GEL CONTAINING THE SAMPLE
(BOTTOM TO TOP)
ANODE TO ORIGIN HDL – VLDL – LDL – CHYLOMICRONS
ELECTROPHORESIS
ORIGIN TO ANODE CHYLOMICRONS – LDL – VLDL – HDL
NPN’S IN PLASMA
(HIGHEST TO LOWEST
UREA > AMINO ACIDS > URIC ACID > CREATININE > CREATINE > AMMONIA
CONC)
DEC. CONCENTRATION
MIGRATION
(FROM MOST TO LEAST ANODIC) LDH 1 > LDH 2 > LDH 3 > LDH 4 > LDH 5
FASTEST TO SLOWEST
LACTATE
SERA OF HEALTHY INDIVIDUAL
DEHYDROGENASE LDH 2 > LDH 1 > LDH 3 > LDH 4 > LDH 5
(MOST TO LEAST)
(LDH)
HEAT STABILITY
LDH 2 > LDH 3 > LDH 1 > LDH 4 > LDH 5
(FROM MOST HEAT STABLE TO LABILE)
*LDH 5 LOSS ACTIVITY AT 4C
DEC. CONCENTRATION
MIGRATION
CLINICAL (FROM MOST TO LEAST ANODIC) (MOST ANODAL) CK-BB > CK-MB > CK-MM (LEAST ANODAL)
CHEMISTRY FASTEST TO SLOWEST
ENZYMES
CREATINE KINASE SERA OF HEALTHY INDIVIDUAL
CK-MM > CK-MB > CK-BB
(CK) (MOST TO LEAST)
HEAT STABILITY
(FROM MOST HEAT STABLE TO LABILE) CK-MM > CK-MB > CK-BB
DEC. CONCENTRATION
MIGRATION
(FROM MOST TO LEAST ANODIC) LIVER > BONE > PLACENTA > INTESTINE
ALKALINE
FASTEST TO SLOWEST
PHOSPHATASE
HEAT STABILITY PLACENTA > INTESTINE > LIVER > BONE
(ALP)
(FROM MOST HEAT STABLE TO LABILE) *PLACENTAL ALP RESIST HEAT DENATURATION AT 65°C FOR 30
DEC. CONCENTRATION MINUTES
ACTION OF INSULIN • INCREASES GLYCOGENESIS AND GLYCOLYSIS: GLUCOSE → GLYCOGEN → PYRUVATE → ACETYL-COA
• INCREASES GLYCOGENOLYSIS: GLYCOGEN → GLUCOSE
CARBOHYDRATES ACTION OFGLUCAGON
• INCREASES GLUCONEOGENESIS: FATTY ACIDS → ACETYL-COA → KETONE, PROTEINS → AMINO ACIDS
GLUCOSE LEVELS • WHOLE BLOOD > VENOUS BLOOD > CAPILLARY & ARTERIAL BLOOD
ANODE TO ORIGIN (ANODE+ TO CATHODE-) HDL – VLDL – LDL – CHYLOMICRONS (ORIGIN)
ORDER OF MIGRATION
ORIGIN TO ANODE CHYLOMICRONS – LDL – VLDL – HDL
LIPIDS & LIPOPROTEINS

SUMMARY ALL SUBJECTS| 12

 CLASSICAL PATHWAY:
RECOGNITION UNIT C1s-C1r-C1r-C1s
IMS-COMLEMENT
(SEQUENCE BINDING)

IS/BB

SUMMARY ALL SUBJECTS| 13

 PRECURSORS
CLINICAL CHEMISTRY
PRECURSOR ANALYTE
HISTIDINE HISTAMINE
TRYPTOPHAN SEROTONIN & MELATONIN
PROTEINS PROLINE HYDROXYPROLINE
TYROSINE EPINEPHRINE, NOREPINEPHRINE, DOPAMINE, THYROXINE.
HOMOCYSTEINE. METHIONINE
CLINICAL
MONOCYTE MACROPHAGE
CHEMISTRY

ACUTE PHASE REACTANTS

ACUTE PHASE REACTANTS
(THEY ARE INCREASE IN SERUM W/I DAYS FF. TRAUMA OR EXPOSURE TO INFLAMMATORY NEGATIVE ACUTE PHASE REACTANTS
AGENTS)
ALPHA 1 ANTITRYPSIN (AAT) FACTOR VII • ALBUMIN
ALPHA1 ACID GLYCOPROTEIN FERRITIN • TRANSFERRIN
(OROSOMUCOID)
CLINICAL CHEMISTRY FIBRINOGEN
ALPHA1 ANTICHYMOTRYPSIN (A1-ACT;A1X)
ALPHA1 ACID GLOBULIN HAPTOGLOBIN
CERULOPLASMIN HEMOPEXIN
CRP IMMUNOGLOBULIN
COMPLEMENT PROTEINS SERUM AMYLOID A PROTEIN
MANNOSE BINDING PROTEIN

IMPORTANT RATIOS
UREA NORMAL BUN:CREATININE RATIO • 10:1 & 20:1
CLINICAL CHEMISTRY

SUMMARY ALL SUBJECTS| 14