Introduction to Clinical Biochemistry

UNIKL MESTECH [CLINICAL LABORTORY SCIENCE SECTION]

Universiti Kuala Lumpur (UniKL) | Where Knowledge Is Applied and Dreams Realised
 Scope of Practice:

HDB 30404 CLINICAL BIOCHEMISTRY

 Scope of Practice: Clinical Laboratory
Scientist
As a member of healthcare team you are responsible to/for:
1. Assure test result reliability
• Produce accurate test result
• Correlate and interpret test data
• Assess and improve exists laboratory test method
• Design, evaluate and implement new method
2. Design and implement cost effective administrative procedures
(service & personnel)

HDB 30404 CLINICAL BIOCHEMISTRY

 Scope of Practice: Clinical Laboratory
Scientist (cont.)
3. Design, implement, evaluate education and continuous education
of laboratory personnel.
4. Develop and monitor Quality Assurance
• Quality Control
• Competence assurance of personnel
5. Promote awareness and understand service render to consumer,
public and health care personnel

HDB 30404 CLINICAL BIOCHEMISTRY

 Safety Regulation

HDB 30404 CLINICAL BIOCHEMISTRY

 Types of safety equipment necessary for
operation
 Personal protective equipment
 Fume hood
 Storage units
 Fire extinguishers
 Safety shower
 Eye washer
 Spill kits

HDB 30404 CLINICAL BIOCHEMISTRY

 Material Safety Datasheet
• Purpose: Allow proper identification of chemical within laboratory
• Identification of chemical
• Hazardous ingredients
• Physical data
• Fire and explosion data
• Reactivity data
• Spill, leak, and disposal procedure
• Personal protection information
• Special precautions and comments

HDB 30404 CLINICAL BIOCHEMISTRY

 Minimum requirement for “Safety Manual”
1. Basic rules and procedure.
2. Chemical procurement, distribution, and storage.
3. Environmental monitoring.
4. Housekeeping, maintenance and inspection.
5. Health hazards and medical treatment options.
6. Personal protective apparel and equipment.

HDB 30404 CLINICAL BIOCHEMISTRY

 Minimum requirement for “Safety Manual”
(cont.)
7. Records, including MSDSs
8. Requirements for sign and labels
9. Procedures and documentation for spills and accident
10. Requirement for training
11. Waste disposal

HDB 30404 CLINICAL BIOCHEMISTRY

 Workplace Hazardous Material Information
System

HDB 30404 CLINICAL BIOCHEMISTRY

 Workplace Hazardous Material Information
System

HDB 30404 CLINICAL BIOCHEMISTRY

 Clinical Chemistry

HDB 30404 CLINICAL BIOCHEMISTRY

 Introduction
• Branch of laboratory medicine in which chemical and biochemical
(metabolites) are applied to study a disease.
• Analysis are made on all types of body fluids
• Comprise over one-third of all hospital laboratory investigations.

HDB 30404 CLINICAL BIOCHEMISTRY

 Important of Clinical Chemistry test results

HDB 30404 CLINICAL BIOCHEMISTRY

 Biochemistry laboratory
• Core biochemistry
• Biochemical lab facilities provided in every hospitals
• Commonly requested test of value in many patients and on frequent basis.
• Specialized biochemistry
• Not every laboratory equipped to carry out all possible biochemical test
• Some test are needed in the diagnosis of rare diseases
• Urgent analysis (STATS)
• Allow direct access of results by requesting clinician

HDB 30404 CLINICAL BIOCHEMISTRY

 Core biochemical test Specialized test

Sodium,potassium,chloride, bicarbonate Hormones

Urea and creatinine Specific protein

Calcium and phosphate Trace elements

Total protein and albumin Vitamins

Billirubin and alkaline phosphatase Drugs

Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) Lipid and lipoprotein

Thyrosine and thyroid stimulating hormone DNA analysis

Y-glutamyl transpeptidase

Creatine Kinase

H+ PCO2 and PO2

Glucose

Amylase

HDB 30404 CLINICAL BIOCHEMISTRY

 Methods of Analyzing sample

HDB 30404 CLINICAL BIOCHEMISTRY

 Automation and
computerization

HDB 30404 CLINICAL BIOCHEMISTRY

 Clinical Chemistry process

HDB 30404 CLINICAL BIOCHEMISTRY

 Test kits (Rapid & Manual)

HDB 30404 CLINICAL BIOCHEMISTRY

 Specimen Collections

HDB 30404 CLINICAL BIOCHEMISTRY

 Variety of specimens
Specimens used for biochemical analysis
Venous blood, serum or plasma
Arterial Blood
Capillary blood
Urine
Feces
Cerebrospinal Fluid (CFS)
Sputum and Saliva
Tissue and cells
Aspirates, e.g.
- pleural fluids
- Acites
- Joint (synovial) fluid
- interstinal (duodenal)
- Pancreatic pseudocysts
Calculi

HDB 30404 CLINICAL BIOCHEMISTRY

 Specimens types
• Blood specimens
• Serum – supernatant without
fibrinogen and clotting factor
• Plasma – supernatant containing
fibrinogen and clotting factor
• Urine specimens
• Container may contains
• Blank, preservative, stabilizer
• Other specimens
• Body fluids, tissue
• Dangerous specimens
• Yellow sticker (biohazards)
• Hepatitis B, HIV

HDB 30404 CLINICAL BIOCHEMISTRY

 Sampling Errors
1. Blood Sampling technique
• Hemolysis
• Increase level of intracellular chemicals : potassium, phosphates, lactate dehydrogenase
(LD), and aspartate transaminase
• analytes such as creatinine kinase, glucose, and bilirubin, hemolysis will cause method
chemical interference
2. Prolonged stasis during venipuncture
• Plasma and small molecules (potassium diffuses to intestitial space
• Increase [plasma/serum]
• Protein and protein bound component falsely elevated (eg: calcium/thyrosine)
3. Insufficient sample
4. Errors in timing
• Fail to sample at specific time
• Chemical compounds are stable within plasma or serum in vitro for only a short time
• blood cells can continue to undergo cellular metabolic processes
• Affect the level of potassium, ammonia, lactate, bilirubin, glucose, CO2, sodium, urea,
and alkaline phosphatase

HDB 30404 CLINICAL BIOCHEMISTRY

 Sampling Errors (cont.)
6. Incorrect specimens container
7. Inappropriate sampling site
• Ex: Bruises area
8. Incorrect specimens storage
• Overnight storage will shows falsely high potassium, phosphate and red cell
enzyme.
9. Specimen contamination
• specimens from a patient receiving a saline infusion
• potassium and protein results may be nearly one-third lower with Sodium and
chloride results will be falsely elevated

HDB 30404 CLINICAL BIOCHEMISTRY

 Summary
• Understanding the scope of practice leads to good Clinical Laboratory
Scientist
• Laboratory safety regulations are important to protect those who work
and those who come to the lab.
• Clinical Lab test = question about patients health, Test result = answer
• Request form and specimens must be correctly labeled
• Sampling errors may invalidate result
• People behind the results
https://www.youtube.com/watch?v=b0j_DuDGJfw

HDB 30404 CLINICAL BIOCHEMISTRY

THANK YOU

UNIVERS ITI KUALA LUMPUR

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