CCHM321 LEC
➡ eg. immunoglobulins, creatine proteins,
Overview of Clinical Chemistry 1
Introduction to Clinical Chemistry
• Clinical – Greek word “ Kline” meaning bed
• Chemistry- the science that deals with the elements,
their compounds and the chemical structure and
interaction of matter
• Clinical Chemistry- is the area of chemistry that is
generally concerned with quantitative and qualitative
analysis of bodily fluids for diagnostic and therapeutic
purposes.
• The discipline originated in the late 19th century with
the use of simple chemical reaction tests for various
components of blood and urine.
• In the many decades since, other techniques have
been applied as science and technology have
advanced, including the use and measurement of
E n z y m e A c t i v i t i e s , S p e c t r o p h o t o m e t r y,
Electrophoresis, and Immunoassay.
• There are now many blood tests and clinical urine
tests with extensive diagnostic capabilities
Clinical Chemistry
• a quantitative science that is concerned with
measurement of amounts of biologically important
substances (called analytes) in body fluids.
• a science, a service and an industry
• as a science, it links the knowledge of general
chemistry, organic chemistry, and biochemistry with
an understanding of human physiology
• as a service, it produces objective evidence from
which medical decisions may be made
• as an industry, clinical laboratories are
businesses, which operate under the regulations
and practices that guide commerce in the country.
• Generally the primary purpose of us doing clinical
chemistry is that we use this to perform analytic
procedure that yield accurate and precise
information and that will aid in the patient
diagnoses and treatment.
Common Analytes in the Clinical Chemistry
Laboratory
• Ions, Salts, and Minerals
‣ eg. sodium, potassium, calcium, chloride, CO2,
lead, iron and etc.
• Small Organic Molecules
๏ Metabolites
➡ eg. glucose, cholesterol, uric acid
๏ Therapeutic Drugs
➡ eg. vancomycin, theophylline, digoxine
๏ Toxicology
➡ eg. alcohol, salicylate, acetaminophen
๏ Drugs of Abuse
➡ eg. cocaine, barbiturates
• Large Molecules
๏ Transport Proteins
➡ eg. albumin, transferin, haptoglobin
๏ Enzymes
➡ eg. lipase, amylase, creatinine kinase
๏ Specific Proteins
WEEK 2 1
complement
๏ Diabetes Marker
➡ eg. HBA1c or Hemoglobin A1c
Fluids Typically Used for Clinical Chemistry Tests
• Blood, Urine, Cerebrospinal Fluid, Amniotic Fluid,
Saliva, Synovial Fluid, Pleural Fluid, Pericardial
Fluid, and Peritoneal Fluid
Regulatory Guidelines that Define the Practice of
Clinical Chemistry
• Clinical Laboratory Improvement
Amendments (CLIA) of 1988
- quality standards for all clinical laboratories to
ensure accuracy, reliability and timeliness of
patient test results regardless of where the
test was performed
Two Levels of Regulations
a. Waived Tests
- simple laboratory examinations and
procedures that are cleared by the U.S. Food
and Drug Administration (FDA) for home use.
- eg. pregnancy test
b. Non-waived Tests
- moderately and highly complex tests as
defined by the requirements for operator skill,
reagent preparation, automation and the
difficulty of interpretation of results.
- These are regulated under guidelines that
cover quality standards for proficiency testing
(PT), patient test management, quality control,
personnel qualifications, and quality
assurance.
- PT or proficiency testing monitors accurate
outcome
Occupational Safety and Health Act (OSHA)
- provide guidelines for safe operation of testing
processes regulations include guidelines for
operating safety equipment and identifying,
handling and storing chemical hazards
Purpose of Clinical Chemistry MLS/Medical
Technologist
• perform analytical procedures that yields accurate
and precise information, aiding in patient diagnosis
and treatment
• correctly use basic supplies and equipment
• possesses an understanding of fundamental
concepts critical to any analytic procedure
Scope of Practice: General Services Provided
by Clinical Laboratory Scientists / Medical
Technologists
1. Assuring reliable test results that contribute to the
prevention, diagnosis, prognosis, and treatment of
physiological and pathological conditions.
This assurance requires
A. Producing accurate test results. with the aid of
proficiency test (PT)
B. Correlating and interpreting test data.
CCHM321 LEC WEEK 2 2
C. Assessing and improving existing laboratory test
methods. Derived Unit
D. Designing, evaluating, and implementing new • derivative or a mathematical function describing
methods. one of the basic units
2. Designing and implementing cost-effective
administrative procedures for laboratories, including
their services and personnel.
3. Designing, implementing, and evaluating processes
for education and continued education of laboratory
personnel.
4. Developing and monitoring a quality assurance
system to include
A. Quality control of services.
B. Competence assurance of personnel.
5. Promoting an awareness and understanding of the
services they render to the consumer, the public,
and other health-care professionals.
Non - SI

LABORATORY MATHEMATICS
UNIT OF MEASUREMENT
TWO COMPONENTS:
1. Number related to the actual test value
2. A label identifying the units
Système International d'Unités (SI)
- adopted internationally in 1960
- preferred in scientific literature and clinical
laboratories
- the only system employed in many countries
- to have a standard method of describing physical Significant Figures
quantities • minimum number of digits related to express a
- based on the metric system value in scientific notation without losing
➡eg. kilo, hecto, deca, gram, milli, micro, nano,
accuracy
pico

Basic Unit RULES:

1. All nonzero numbers are significant.eg. 814.2= 4
2. All zeros between nonzero numbers are
significant. eg. 1001 = 4
3. All zeros to the right of the decimal are not
significant when followed by a nonzero number.
eg. 0.000641 = 3
4. All zeros to the left of the decimal are not
significant. (leading zeros).
5. Zeros following a decimal point are considered
significant. (trailing zeros).
CCHM321 LEC WEEK 2 3
6. Trailing zeros to the right of the decimal ARE Percent Solution – volume/volume
significant. Problem:
7. Trailing zeros in a whole number with the What is the percent by volume in a solution that
decimal shown ARE significant. eg. 540. = 3 contains 350 mL of rubbing alcohol 500 mL of
8. Trailing zeros in a whole number with no decimal
shown are NOT significant. eg. 540 = 2
Practice:
1.0.004 = 1
2.0.500 = 3
3.0.20 = 2
4.0.00330 = 3
5.1.237 = 4
6.1110. = 4
REPORTING OF REFERENCE RANGES
• Newborn Infant
• Infants
• Pediatric
Percent Solution solution?
REMEMBER: first decimal only even though it’s a Percent Solution – weight/volume
whole number because that is the standard Problem:
What is the % w/v of a solution that has 7.5 g of
sodium chloride diluted to 100 mL with deionized

Percent Solution – weight/weight

Problem:
A saline solution with a mass of 355 g has 36.5 g of
NaCl dissolved in it.
What is the mass/mass percent concentration of the
solution? water?
Molarity
- Molarity, also known as molar concentration, is
defined as the number of moles of solute present in
a given number of litres of solution, or moles per
litre.
- Remember that 1 mol of a substance is equal to the
gmw (gram molecular weight) of that substance
Problem:
Calculate the molarity of a sugar solution if 4 liters of
the solution contains 8 moles of sugar?

Problem:
What is the percent by mass of rubbing alcohol in a
solution that contains 275 g of rubbing alcohol in 500
g of solution?
CCHM321 LEC WEEK 2 4
Problem:
What is the molarity of a solution containing 5 moles Normality (Eq/L or mmol/L)
of solute in 250 milliliters of solution? - number of gram equivalent weights per 1 L of
solution.
- Equivalent weight is equal to the gmw of a
substance divided by its valence. (GMW/Valence)
- Valence is the number of units that can combine
with or replace 1 mole of hydrogen ions for acids
and hydroxyl ions for bases and the number of
electrons exchanged in oxidation–reduction
reactions.
- Number of replicate H ions for acid, OH for bases.
VALENCE
• ACIDS – count the number of Hydrogen ions
• BASES – count the number of Hydroxide ions
• SALTS – multiply the absolute value of the ions

Problem:
Calculate the molarity of a solution prepared by
dissolving 23.7 grams of KMnO4 into enough water to
make 750 mL of solution.
Problem:
Calculate the equivalent weight of the following:
1.H2SO4 – GMW: 98 = 98/2 = 49.0
2.NaCl – GMW: 58.5 = 58.5/1 = 58.5
3.NaOH – GMW: 40 = 40/1 = 40
Problem:
Calculate the normality of NaOH solution formed by
dissolving 0.2g NaOH to make 250 ml solution

Problem:
What is the normality of 0.1381 M NaOH?
CCHM321 LEC WEEK 2 5
• eg. 250mL of water = 25mL-> aliquot
Volume, Concentration
Problem:
What volume is needed to make 500 mL of a 0.1 M
solution of Tris buffer from a solution of 2M Tris
buffer?
• Trisaminomethane = buffering component that
maintains pH
Identify the known values:
Concentration of initial substance (C1) = 2M
Volume of the product (V2) = 500mL
Concentration of the product (C2) = 0.1M
Problem:
What volume is needed to make 500 mL of a 0.1 M
solution of Tris buffer from a solution of 2M Tris
buffer?
Identify the known values: Problem:
(V1) = ? How would you make a 1:250 dilution in 500 mL?
(C1) = 2M
(V2) = 500mL
(C2) = 0.1M

TYPES OF DILUTION
- 3 of the most commonly performed processes/
procedures dealing with concentrations of
something that is unknown.
•Simple Dilution
•Serial Dilution
•Doubling Dilution
Dilutions Simple Dilutions
• Represents the ratio of concentrated or stock Example: A specimen is diluted by combining 3 mL of
material to the total final volume of a solution serum with 21 mL of Saline. What is the dilution of the
• Consists of the volume or weight of the concentrate serum?
plus the volume of the diluent Solution. Read the problem carefully and calculate
Dilution factor the dilution.
• Ratio of concentrated or stock solution to the Note: Volume units must be the same when
total solution volume calculating dilutions.
• The relationship of the dilution factor to 3 mL (parts serum)
concentration is an inverse one + 21 mL (parts saline)
• Increase dilution factor, decrease concentration. ________________________
• DF is the denominator 24 mL (total parts)
• To determine the dilution factor: Dilution = 3 mL ÷ 24 mL
- Simply take the concentration needed and 3 mL 24 mL
divide by the stock concentration, leaving it in —— ÷ ———— = 1:8
a reduced fraction form. 3 mL 3 mL
Problem: Serial Dilutions
What is the dilution factor if you add a 0.1 mL aliquot Example: A serum specimen was successively diluted
of a specimen to 9.9 mL of diluent? 1:2, 1:2, and 1:2 with saline. What is the final dilution
• Aliquot is a carefully measured volumes from the of the specimen?
stock solution.
CCHM321 LEC WEEK 2 6
Solution. When determining the final dilution of a
series of dilutions use each dilution as a multiplicative
factor. The resulting product is the final dilution.
_1_ x _1_ x _1_ = _1_ or equivalently, 1:8
2 2 2 8
Example: If a 1/8 dilution of the stock solution is made
followed by a 1/6 dilution what is the final dilution.
Solution: When determining the final dilution of a
series of dilutions use each dilution as a multiplicative
factor. The resulting product is the final dilution.
_1_ x _1_ = _1_ or equivalently, 1:48
8 6 48

Doubling Dilutions
Example: Doubling dilution 6 times.
1st dilution = 1 /2
2nd dilution = 1 /2 x 1 /2 = 1/4
3rd dilution = 1/4 x 1 /2 = 1/8
4th dilution = 1/8 x 1 /2 = 1/16
5th dilution = 1/16 x 1 /2 - 1/32
6th dilution = 1/32 x 1 /2 = 1/64 or 1:64
This results in a series of dilutions, each a doubling
dilution of the previous one