San Pedro College Davao

12 C Guzman Street, Davao City, Davao Del Sur

CLINICAL CHEMISTRY I FINALS PRACTICAL REPORT

A Learning Experience Laboratory requirement presented to the faculty of

School of Medical Laboratory Science

In partial fulfilment of the Clinical Chemistry I for the

Degree of Bachelor Science in Medical Laboratory Science

Presented by: Carl Adrian C. Cataag, Medical Laboratory Science 2F

Laboratory Instructor: Mr. Gianleri V. Nor, RMT

II. INTRODUCTION

Specific Learning Objectives (Albumin, Total and Direct Bilirubin):

 Properly understand the contents of the package insert and perform the assay
 Correctly perform venipuncture to acquire samples for the assay
 Exhibit proper procedure when after reading the package insert
 Demonstrate proper handling of reagent blank, standard, and sample
 Interpret if the Albumin levels of the sample acquired are normal or not based on the
reference range prescribed in the package insert
III. NARRATIVE REPORT – Albumin / Total Bilirubin (Date: May 04, 2022)

After doing a few assays, such as Total Protein and fasting samples (Glucose and Lipid
Profile), we were already getting the general idea as to how we would perform the remaining
package inserts. Once the class had begun, and Sir Leri had provided the instructions, the class
performed venipuncture upon one another in order to acquire serum samples for the package
insert (red top tubes were used). 2ml of blood was required so at least 3cc syringes were used
(although some used 5cc in case of the need for backup samples). As the class goes on,
among my fellow members in Group 6, Joshua Otagan and Johannah Tomines were the ones
who took blood samples from me (as I volunteered), but in turn, I only took a sample from Mr.
Otagan. After acquiring the blood samples, the group waited for the samples to clot. After
clotting, the samples were centrifuged for 10 minutes. I was one of the members who performed
the assay on the Albumin, while the rest of the members did Total Bilirubin (Direct Bilirubin was
performed by the requesting group as instructed, using the same sample as TB).

After centrifugation, the hemolyzed samples were then discarded, and the serum of the non-
hemolyzed blood samples were then extracted by us through the use of a micropipette. We
used a micropipette of 10-100 µL (microliters) with yellow tips (for the sample and standard),
and a 100-1000 µL with blue tips were used (for the reagent). Based on the package insert,
1000µL of reagent blank is to be prepared for Tube #1 (Distilled Water), and 10 µL of standard
and serum was required for Tubes #2 (Standard) and #3 (Sample), respectively. As the
package insert had stated, 1000µL of reagent is to be added with 10µL of standard for Tube 2,
and another 1000µL of reagent and 10uL of sample for Tube 3. The contents of the tubes were
then mixed, and due to the reaction of the albumin reagent to the sample and standard, the
contents of the tubes displayed colorations. The colorations of tubes were as follows: Tube 2
had a green coloration, and Tube 3 had a darker green coloration after mixing, whereas Tube 1
had a yellow-greenish complex due to it only having the reagent blank. The mixed samples
were then placed into the Vchem analyzer in order to be incubated for 1 minute in 30°C.
After the incubation of our respective samples, the tubes were removed from the analyzer.
Blanking was also done (pumping of distilled water) to avoid carrying-over of the different
samples of our classmates. Once done, the samples are then pumped into the analyzer in order
to record the results. As the recording of the results finished, our classmates then tried to
measure the absorbance of the standard and sample against the reagent blank. The result of
the sample was also compared to the reference range. Looking at the result of the sample, the
range was around 3.40 to 5.50, and the sample displayed a slight elevation (5.85). The results
of the sample are as follows in the table below:

SAMPLE ID 0010

TEST NAME ALB (Albumin)

ABSORBANCE 1.1947

RESULT 5.85 ↑ (Slightly elevated)

UNIT g/dL

REFERENCE RANGE: LOW 3.40

REFERENCE RANGE: HIGH 5.50

TEST DATE: 04/05/2023 (DD/MM/YY) or MAY 4 2023 (MM/DD/YY)

As we observed in the result, it is slightly elevated, and increased levels of albumin are seen in
dehydration. However, it is still close to the normal range, so it is not of concern yet unless a
spike of result is displayed by the analyzer. Once there is a spike or decline in results, it could
be either the reagent used is expired, or the patient has abnormally high or abnormally low
albumin levels, but in this case, it is only slightly increased.
IV. Conclusion and Overall Insights

All the package inserts had different methods and it may seem easy to execute with the
proper instructions. However, when we were performing these assays, these actually took time
as we had to extract blood, wait for the clotting to set, then wait for another while due to
centrifugation, and perform the assay proper. When performing the assay, the members and I
had to make sure that the samples will not hemolyze, as it takes time to extract blood from them
again. Proper handling of the apparatus (micropipettes, tips, tubes) and handling of the sample,
reagent, and standard must be observed as well. It is quite difficult to commit a mistake during
the assay because you have to come back to the first step again, and the class time is only
limited (and how much more in real-life scenarios).

To perform any assay with no difficulties, it is suggested to thoroughly read the package insert,
and ask the Clinical Instructor for clarifications and such. Always prepare a backup plan when a
mistake is committed in order to compensate for the mishaps (such as preparing extra blood
samples in case of hemolysis). When done right, one can easily interpret results, and even
correct errors when performing assays or any related procedures. Since we are still learning on
how to perform assays, it is best to work together with your group and cooperate thoroughly in
order to make things much lighter. Overall, it was great learning something new every day for
our future profession and to help the people in need by learning what needs to be done.

Group photo: Taken by Ms. Luyao

Clinical Chemistry 1 – Laboratory (Group 6) with

Clinical Instructor Gianleri V. Nor, RMT

V. GENERAL LEARNINGS ALL OVER THE

SEMESTER

Clinical Chemistry is crucial to the medical setting as this is where the diagnosis, treatment,
and monitoring of patients and their diseases, take place. As a 2 nd year MLS student, Clinical
Chemistry 1 has given me a good foundation of laboratory medicine, and how laboratory
professionals cater to their patients in order to diagnose and treat diseases. Being part of the
Clinical Chemistry section is a critical aspect, as we have to be precise with our procedures and
results. I learned about instrumentation, spectrophotometry, chromatography, immunoassays,
electrophoresis, and such. Despite the difficulty, understanding the principles, advantages,
limitations, and applications of these techniques has broadened my knowledge of how specific
analytes are measured and analyzed in patient samples. Clinical Chemistry requires
collaboration amongst the hospital workers and it emphasized the interdisciplinary nature of
healthcare. As I hopefully move forward to CC2, I hope that I will be better prepared for the
continuation of learning in this course. Lastly, despite the tough experiences we’ve had
throughout the course, I would like to thank my groupmates and Sir Leri for making this
experience a memorable one.