Systematic approach in interpretation of

Clinical Biochemistry report

Dr Anuradha Patil
Professor
Biochemistry
Week I
Day 1
Sample Collection :

• Know different types of Vacutainer

• Know the broad categories of situations that may
result in test interference
• Know reasons for sample rejection
• Know Turn around time
Sample Collection :

Describe
 Plain Red:
- Additive: No additive
- Use: Total serum complement activity
Light Blue:
- Additive: Sodium Citrate (Anti-Coagulant)
- Use: Coagulation tests like prothrombin time, thrombin time, partial thromboplastin time
Dark Green:
- Additive: Sodium Heparin (Anti-Coagulant)
- Use: Chromosome testing, HLA typing, ammonia, lactate
Yellow:
- Additive: Acid-citrate-dextrose A (Anti-Coagulant)
- Use: Tissue Typing, HIV cultures, DNA studies
Pink:
- Additive: EDTA
- Use: Blood typing, HIV viral load
Pearl White:
- Additive: separating gel and EDTA
- Use: PCR for adenovirus, toxoplasma
Gray:
- Additive: Sodium Fluoride, Potassium Oxalate
- Use: Glucose and lactate assay
Test interference :

• Know the broad categories of situations that may

result in test interference (eg, incomplete tube fill,
hemolysis, lipemia, bilirubinemia, cross-reacting and
interfering substances
Test interference :
• Common interferences such as hemolysis, lipemia,
bilirubin, anticoagulant, and preservatives are tested
by the manufacturer
• Can be detected using a Kit (% of Hb, bilirubin) can
decide to accept or reject a sample
• Few interferences or that have known interferences
that can be compensated for by the instrument (e.g.,
using correction formulas)
Test interference :
• If specific interferences do affect the accuracy of the
test, it is essential that interferences can be flagged, in
order to appropriately deal with the results and
interpretation.
Sample rejection:
• Incorrect sample types received:
• Basic incorrect blood tube/other sample.
• Samples without the appropriate preservative (e.g.
acidified urine samples).
• Samples that are received ambient, when a frozen
sample is required.
• Samples that are received unprotected from light,
when they are required to be covered at the point of
venepuncture.
• Samples in incorrect containers (e.g. cervical cytology
must be a ThinPrep vial; urine cytology must be in a
uricite(presevative container).
Sample rejection:
• Insufficient sample received.
• No sample received.
• Labelling or form issues (mislabelled/unlabelled/no
forms/no clinical information).
• Clotted/haemolysed/lipaemic/icteric samples.
• Sample is broken or has leaked in transit.
• Stability time has been exceeded. Stability time is
test-dependent, and also refers to tests that can only
be carried out on certain days of the week.
Turnaround time:
Turnaround time:
• Does the analyte really require immediate turnaround
for optimal patient management
• Laboratory maintains a goal of a 10-minute
turnaround time(blood gas) from the sample receipt.
• Stat and other tests requiring a fast turnaround time
(TAT) are often collected in tubes containing heparin
anticoagulant
Thank you