Clinical Chemistry FREDRICKSON-LEVY CLASSIFICATION OF

HYPERLIPOPROTEINEMIAS
Total Cholesterol Values TAG CM VLDL LDL Chole
Desirable <200 Type
Borderline 200-239 I
High ≥240
Type
LDL Cholesterol Values IIa
Optimal <100
Near optimal 100-129 Type
Borderline 130-159 IIb
High 160-189
Very high ≥190
Type
HDL Cholesterol Values III
Low risk >59 or >60
High risk <40
Type
TAG Values IV
Normal <150
Borderline 150-199
Type
High 200-499
V
Very high ≥500

FRIEDEWALD FORMULA
TAG <400 LDL= TC –(HDL + TAG/5)
TAG TC LDL HDL
TAG >400 LDL= TC –(HDL + TAG x 0.16) Hyperapobeta N

Hemolytic Anemia /
Intravascular Fam. Hypertri N
hemolysis (HH)
Fam. Hyperchol N Slight
Haptoglobin
Hemopexin

Inflammation / Analphalipo X
Infection (PAT)
Prealbumin
Hypoalphalipo
Albumin
Transferrin
Abetalipo X X

Nephrotic Syndrome Hypobetalipo N

(AAT)
Alpha-1 acid glycoprotein APO B-100 APO B-48
(Orosomucoid) Hyperapobeta INC
Albumin Fam. Hypertri N
Transferrin Abetalipo X
Hypobetalipo X X

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CARDIAC MARKERS
RISE PEAK RETURN TO NORMAL

TROP T 3-4 hrs 10-24 hrs 10-14 days

TROP I 3-6 hrs 14-20 hrs 5-10 days
MYO 1-3 hrs 5-12 hrs 18-30 hrs
CK 4-6 hrs 12-24 hrs 1-2 days
AST 6-8 hrs 48 hrs 4-5 days
LD 8-10 hrs 70 hrs 7-12 days

ELECTROLYTES (Determination)
SODIUM Zinc Uranyl Acetate= yellow
FEP= yellow
ISE= GLASS electrode
POTASSIUM Sodium Cobaltnitrire= violet
ISE= VALINOMYCIN electrode
CALCIUM Titration= CLARK & COLLIP method
AAS= autoanalyzer w/ OCPC DYE
MAGNESSIUM Titration= TITAN YELLOW
CALMAGITE
METHYL THYMOL BLUE
AAS
ISE= FREE/IONIZED
CHLORIDE Titration= SCHALES & SCHALES = violet
Chloridometer= COTLOVE
Colorimetric= reddish colored (SKEGGS mtd)
BICARBONATE Titration
Computation
IRON 1. Remove ferritin by HCl
2. Reduce ferric to ferrous by Ascorbic acid/ Glycolic acid
3. Add dye –ferrozine, tripyridyl triazine
iPO4 FISKE-SUBBAROW method
= PO4 + molybdic acid = COLORLESS polymolybdic acid (reduced by SnCl2) =
MOLYBDENUM BLUE

EXTRAcellular INTRAcellular
Na + K- pH directly prop HCO3
Cl + PO4 - pH indirectly prop CO2

ENZYMES (Determination)
ALT Fixed Endpoint= REITMAN FRANKEL
AST Kinetic= KARMEN MTD
ACP Electrophoresis
CHEMICAL INHIBITION
: serum + Cu = remove RBC ACP; PAP remaining is measured using BODANSKY
Mtd
-Prostate ACP: (-) Cu, (+) Tartrate
-RBC ACP: (+) Cu, (-) Tartrate
CK Electrophoresis
ALP Electrophoresis

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 AMS SACCHAROGENIC MTD
LPS CHERRY KRANDALL= turbidity w/ H20 = TAG

PROTEINS (Determination)
TAG Titrametric (FA) = titrated w/ std. NaOH
Turbidimetric (TAG) = disappearance of TAG
Chemical mtd (Glycerol) = Formaldehyde + Chromotropic = PINK
ALB ALB + Na2So3 / Na2SO4 / Methanol = precipitate Globulin,
UREA DIRECT: Urea + DAM = yellow
INDIRECT: Kjeldahl-Nessler = yellow
ENZYMATIC: Urease-Nessler = yellow
Urease-Berthelot = blue indophenol

CAUSE
ACIDOSIS ALKALOSIS
METABOLIC HCO3 excretion HCO3 reabsorption
RESPIRATORY Hypoventilation Hyperventilation

COMPENSATION
ACIDOSIS ALKALOSIS
METABOLIC Hyperventilation Hypoventilation
RESPIRATORY HCO3 reabsorption HCO3 excretion

“Very Pretty Christina Aguilera Met Her True Fans”

GLYCOGEN STORAGE DISEASE ENZYME DEFICIENT
Ia – Von Gierke Glucose 6 phosphatase
II – Pompe Amylo -1,4 glucosidase / acid maltase
III – Cori-Forbes Amylo- 1,6 glucosidase / debrancher enzyme
IV – Andersen Amylopectinase / glycogen branching enzyme
V – McArdle Muscle phosphorylase
VI – Hers Liver glycogen phosphorylase
VII – Tarui Phosphofructokinase
XI – Fanconi-Bickel Glycogen transporter 2
0 Glycogen synthetase

MAJOR CLASSES OF PLASMA PROTEINS

ELECTROPHORETIC CHON CHOLESTEROL CHOLESTEROL TAG PHOSPHOLIPID
PATTERN (%) (%) ESTERS (%) (%) (%)
CM Origin 1-2 1-3 2-4 80-95 3-6
VLDL Pre-beta 6-10 4-8 16-22 45-65 15-20
LDL Beta 18-22 6-8 45-50 4-8 18-24
HDL alpha 45-55 3-5 15-20 2-7 26-32

PROTEIN ELECTROPHORESIS
PREALBUMIN Prealbumin
ALBUMIN Albumin
ALPHA 1 All with “Alpha 1” & GC globulin
ALPHA 2 Ceruloplasmin, Haptoglobin, Alpha 2-macroglobulin
(CHAm)

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 BETA Transferrin, Beta 2-microglobulin, Complement, Hemopexin, Fibrinogen, LDL,
(TBCHemFiLVC) VLDL, CRP
GAMMA Immunoglobulins, CRP (others)

ACTIVATORS (ENZYMES) ENZYME KINETICS

AMS Calcium, Chloride ZERO Order dependent on ENZYME conc.
CK Magnessium FIRST Order dependent on SUBSTRATE conc.
LDH Zinc

Calcium directly prop Vitamin D & PTH

Calcium indirectly prop Calcitonin & Phosphate

MULTIPLE SCLEROSIS MULTIPLE MYELOMA

Cancer of plasma cell Autoimmune disorder
Inc. IgG Anti-Myelin sheath
Bence Jones Protein (Urine) Oligoclonal bands (CSF)

CUSHING’S DISEASE CUSHING’S SYNDROME ADDISON’S DISEASE

Inc. cortisol Inc. cortisol Dec. cortisol
Inc. ACTH Dec. ACTH Dec. aldosterone

You can do it, RMT! Philippians 4:13

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