Professional Documents
Culture Documents
CLINICAL BIOCHEMISRY
[LAB MANUAL[
CONTENTS
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Exp #
EXPIREMENT-1
EXPIREMENT-2
EXPIREMENT-3
EXPIREMENT-4
Exp/Practical title
Introduction to Clinical Laboratories
- Laboratory Work Flow cycle
- Phlebotomy equipments
-Identification of Blood Collection Tubes &Preparation of Blood Plasma
and Serum
Retic. Count
- Preparation of Blood Film
-Blood staining
Liver Function Tests
-Measurement of Serum ALT &AST
Liver Function Tests
--Measurement of Serum Bilirubin (Total, direct &indirect)
EXPIREMENT-5
EXPIREMENT-6
EXPIREMENT-7
lipid Profile
- Measurement of Serum Total cholesterol, Measurement of Serum LDLC, Measurement of Serum HDL-C,-Measurement of Serum TG
Diabetic Profile Tests
Measurement of Blood Glucose
Routine Urine Analysis &
EXPIREMENT-8
EXPIREMENT-9
EXPIREMENT-11
EXPIREMENT-12
EXPIREMENT-13
EXPIREMENT-14
Lab-1
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suspected
diagnosis.
The
1) Clinical pathology
2) Hematology
3) Clinical biochemistry
4) Clinical microbiology
5) Serology
6) Blood bank
7) Histology and cytology
Functions:
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conditions can:
1) Reveal the cause of the disease
2) Screen easy diagnosis
3) Suggest effective treatment
4) Assist in monitoring progress of pathological condition
5) Help in assessing response to treatment
Disinfection:
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general
all-purpose
Phlebotomy equipments:
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to:
Hemolysis
means
liberation
of
Specimen collection:
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tubes
may
contain
additional
which
is
strong
LIGHT BLUE
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-sodium citrate.
-coagulation (clotting) studies.
-must be completely filled
-must be inverted immediately after filling
GREEN
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inverted
several
times
after
times
after
Black
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be
inverted
several
collection
GRAY
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collection
ROYAL BLUE
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is
designed
to
contain
no
contaminating metals
-Trace element and toxicology studies
YELLOW
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10
-contains no additives.
-Tests
for
antibodies
and
drugs
often
require these.
Gold
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11
Blood:
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kinds
of
Leukocytes
(lymphocytes,
monocytes,neutrophils,eosinophils,basophils)
-After
centrifugation
of
blood,
the
blood
12
Blood plasma:
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protein,
of
which
there
are
three
clot
contains
coagulation
proteins,
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Blood serum:
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14
1-Draw
blood
from
patient.
Select
vacutainer
with
an
appropriate anticoagulant.
2- Mix well with anticoagulant.
3- Allow to stand for 10min.
4- Centrifuge the sample to speed separation and affect a
greater packing of cells.
5- The supernatant is the plasma which can be now collected
for testing purposes or stored (-20C to -80C) for subsequent
analysis or use.
Procedure of Serum preparation:
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anticoagulant.
2- Allow to stand for 20-30min for clot formation.
3- Centrifuge the sample to speed separation and affect a
greater packing of cells. Clot and cells will separate from clean
serum and settle to the bottom of the vessel.
4- The supernatant is the serum which can be now collected by
dropper or pipette for testing purposes or stored (-20C to 80C) for subsequent analysis or use.
15
References:
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Springhouse,
Penn.
Intermed
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Lab-2
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Reticulocyte (Retic.)Count
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Staining:
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is
immature
RBCs.
typically
about
blood
day
in
the
stream
before
Reticulocyte count:
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Diagnosis:
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12 x 75 mm disposable tube
Glass slides
Disposable pipettes
Microscope
New Methylene Blue
SPECIMEN:
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1. Mix equal volume of whole blood and New Methylene Blue in a glass
or plastic tubes.
2. Incubate the mixture at 37 C for 20 minutes.
3. Resuspend the cells by gentle mixing.
4. Make a blood film of the mixture.
5. Examine the film under oil immersion.
6. Count
one
thousand
RBCs
while
tallying
the
number
reticulocytes.
3
of
Results:
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of
RBCs
decreases
(thus the
hematocrit
decreases),
the
A low reticulocyte count indicates that the bone marrow is not producing a
normal number of red blood cells. Low production may be caused by a
lack of vitamin B 12 , folic acid, or iron in the diet; or by an illness affecting
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the bone marrow (for example, cancer). Further tests are needed to
diagnose the specific cause.
The reticulocyte count rises when the bone marrow makes more red cells
in response to blood loss or treatment of anemia.
References:
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www.wikipedia.org
www.medicaldesign.com
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Lab Report
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Patient Name:
Age/Sex:
Patient ID:
Sample Date:
Doctor Name:
Test Date:
BIOCHEMISTRY REPORT
DESCRIPTION
RESULT
UNIT
REFERNCE RANGE
------------
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EXAMINED BY:
DATE/ TIME:
Lab-3
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ALT&AST
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1-storing glycogen (fuel for the body) which is made from sugars.
2-helping to process fats and proteins from digested food.
3-making proteins that are essential for blood to clot (clotting factors).
4-processing many medicines which you may take.
5- helping to remove poisons and toxins from the body.
Liver function tests:
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i.
ii.
iii.
-ALT is the enzyme produced within the cells of the liver. The level
of ALT abnormality is increased in conditions where cells of the liver
have been inflamed or undergone cell death. As the cells are
damaged, the ALT leaks into the bloodstream leading to a rise in
the serum levels. Any form of hepatic cell damage can result in an
elevation in the ALT. ALT is the most sensitive marker for liver cell
damage.
physicians
in
assessing
the
etiology
of
liver
enzyme
abnormalities.
Alkaline Phosphatase (ALP):
2- Total proteins.
3
3- Immunological studies
4- Prothrombin time (PT)
5- Liver biopsy, ultrasound scan, other types of scan, etc,
may be needed to clarify the cause of a liver disorder,
and/or to monitor its progress.
Lab practices:
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Pyruvate + NADH + H
LDH
Glutamate + Pyruvate
Lactate + NAD
Normal: 6 37 U/L.
Interfering Factors:
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Lab Report
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Patient Name:
Age/Sex:
Patient ID:
Sample Date:
Doctor Name:
Test Date:
BIOCHEMISTRY REPORT
DESCRIPTION
RESULT
UNIT
REFERNCE RANGE
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EXAMINED BY:
DATE/ TIME:
Lab-4
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I-Production:
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carrier mechanism
III. Conjugation of bilirubin and secretion into bile:
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UDP-glucuronyltransferase
conjugates
bilirubin
with
Total and direct bilirubin levels can be measured from the blood,
but indirect bilirubin is calculated from the total and direct bilirubin.
Types of Bilirubin:
Bilirubin is present in plasma as:
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Jaundice:
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1. Prehepatic jaundice
2. Hepatic jaundice
3. Posthepatic jaundice
4
Prehepatic jaundice
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Results from:
Defective conjugation.
Posthepatic jaundice
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Lab practices:
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Principle:
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the
normal
precautions
required
for
handling
laboratory
reagents.
Procedure:
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Direct
Blank
R1
100 l
100 l
100 l
R2
25 l
25 l
----
Saline
----
1ml
1ml
R3
1ml
----
----
Sample
100 l
100 l
100 l
Serum:
Total Bilirubin up to 1.1mg/dl (18.8mol/l)
Direct Bilirubin up to 0.25mg/dl (4.3mol/l)
References:
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Lab Report
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Patient Name:
Age/Sex:
Patient ID:
Sample Date:
Doctor Name:
Test Date:
BIOCHEMISTRY REPORT
DESCRIPTION
RESULT
UNIT
REFERNCE RANGE
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EXAMINED BY:
DATE/ TIME:
Lab-5
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There are several blood tests that can aid in evaluating kidney
function. These include:
1-Blood urea nitrogen test (BUN).
2-Creatinine test.
3-Measurement of the blood levels of other elements regulated in part by
the kidneys can also be useful in evaluating kidney function. These
include sodium, potassium, chloride, bicarbonate, calcium, magnesium,
phosphorus, protein, uric acid, and glucose.
I-Measurement of BUN:
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High BUN levels can indicate kidney dysfunction, but because blood
urea nitrogen is also affected by protein intake and liver function,
the test is usually done in conjunction with a blood creatinine, a
more specific indicator of kidney function.
A high BUN value can mean
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1-kidney disease
2-Blockage of the urinary tract (by a kidney stone or tumor)
3- Low blood flow to the kidneys caused by dehydration or heart
failure.
4-Many medicines may cause a high BUN.
5-A high BUN value may be caused by a high-protein diet, tissue
damage (such as from severe burns), or from bleeding in the
gastrointestinal tract.
A low BUN value may be caused by
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1- Test tubes
2- 10 ml pipettes
3- 0.1 ml serologic pipette
4- Measuring cylinder
5- Water-bath
6- Stopwatch
7- Spectrophotometer
Samples:
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Standard
Blank
WR(ml)
Serum(l)
50
-----
-----
Std(l)
-----
50
------
DW(l)
-----
-----
50
Mix well and place in boiling water bath for exactly 15 minutes.
Cool immediately and after 5 minutes read the absorbance at 520 nm.
Calculations:
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1-40 years: 7-12 mg/dl -Gradual slight increase occurs over 40y
Organized by: Lecturer: Sharifa A. Al-Ghamdi
Teaching Assistant: Ashwag A. Bukhari
References:
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Marsh, W., Fingerhut, B. and Miller, H. (1965), Clin. Chem. 11, 624.
Lab Report
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Patient Name:
Age/Sex:
Patient ID:
Sample Date:
Doctor Name:
Test Date:
BIOCHEMISTRY REPORT
DESCRIPTION
RESULT
UNIT
REFERNCE RANGE
------------
----------
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EXAMINED BY:
DATE/ TIME:
Lab-6
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Creatinine test:
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A BUN test may be done with a blood creatinine test. Blood urea nitrogen
(BUN) and creatinine tests can be used together to find the BUN-tocreatinine ratio (BUN: creatinine).
BUN-to-creatinine ratio 10:120:1
High BUN-to-creatinine ratio occur with sudden (acute) kidney failure.
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A blockage in the urinary tract (such as a kidney stone) can cause a high
BUN-to-creatinine ratio.
A very high BUN-to-creatinine ratio may be caused by bleeding in the
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digestive tract
or respiratory tract.
Creatinine clearance:
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accuratly,
creatinine
clearance
Cockroft-Gault formula:
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Lab Practices:
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R1
Picric acid
17.5 mmol/L
Picric Reagent
R2
Sodium hydroxide
0.29 mol/L
Creatinine-aqueous
primary standard
2 mg/dL
Alkaline Reagent
Creatinine CAL
Precautions:
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1. Assay conditions:
Wavelength: . . . . . . . . . . . . . . . . . 492 nm (490-510)
Cuvette: . . . . . . . . . . . . . . . . . . . . . . . . 1 cm. light path
Temperature. . . . . . . . . . . . . . . . . . . . . 37C / 15-25C
2. Adjust the instrument to zero with distilled water
3-Pipette into a cuvette:
Blank
Standard
Sample
Standard l
----
100
----
Sample l
----
----
100
WR ml
6. Calculate: A= A 2 A 1 .
Calculation:
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If the results obtained were greater than linearity limit, dilute the sample
1/2 with NaCl 9 g/L and multiply the result by 2.
References:
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1. Murray R.L. Creatinine. Kaplan A et al. Clin Chem The C.V. Mosby Co.
St Louis. Toronto. Princeton 1984; 1261-1266 and 418.
2. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press,
1995.
3. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC 2001.
4. Burtis A et al. Tietz Textbook of Clinical Chemistry, 3rd ed AACC 1999.
5. Tietz N W et al. Clinical Guide to Laboratory Tests, 3rd ed AACC 1995.
Lab Report
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Patient Name:
Age/Sex:
Patient ID:
Sample Date:
Doctor Name:
Test Date:
BIOCHEMISTRY REPORT
DESCRIPTION
RESULT
UNIT
REFERNCE RANGE
------------
----------
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EXAMINED BY:
DATE/ TIME:
Lab-7
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Lipid Profile
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together
to
determine
risk
of
(TC),
low-density
lipoprotein
LDL less than 100 mg/dL if you have heart disease or diabetes.
LDL less than 130 mg/dL if you have 2 or more risk factors.
3- Cholesterol:
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hormones
that
are
essential
for
development,
growth
and
High Risk: Cholesterol above 240 mg/dL is considered high risk. The
doctor may order a lipid profile (as well as other tests) to try to
determine the cause of high cholesterol.
Important note:
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1-It is not necessary to fast when you have a cholesterol test. Cholesterol
does not change in response to a single meal. Cholesterol does change in
response to changes in long term patterns of eating like changing from
a high fat diet to a low fat diet but it takes several weeks to see
changes in blood cholesterol in response to changes in diet.
2-Cholesterol is high during pregnancy. Women should wait at least six
weeks after the baby is born to have cholesterol measured.
3-Some drugs that are known to increase cholesterol levels include
anabolic steroids, beta blockers, epinephrine, oral contraceptives and
vitamin D.
4-Triglyceride(TG):
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The specimen is stable for a week at 2 - 80C and at least for 3 months
at -200C.
Lab practices:
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In
the
last
reaction,
hydrogen
peroxide
(H 2 O 2 )
R
reacts
with
4-
PO 2 O 2
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1. Assay conditions:
Wavelength: . . . . . . . . . . . . . .. . . 505 nm (500-550)
Cuvette: . . . . . . . . . . . . . . . . . . . . .. 1 cm light path
Temperature . . . . . . . . . . . . . . . .. . . . .37C /15-25C
2. Adjust the instrument to zero with distilled water.
3. Pipette into a cuvette:
Blank
standard
Sample
Standard l
----
10
-----
Sample l
----
-----
10
R ml
I-Cholesterol:
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Risk evaluation:
Norma-----------less than 200 mg/dl
Borderline-------200-239 mg/dl
High risk-----------higher than 240 mg/dl
II-Triglyceride:
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Men-----------40-160 mg/dl
Women---------------35-135mg/dl
Measuring range:
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1. Naito H.K. Cholesterol. Kaplan A et al. Clin Chem The C.V. Mosby Co.
St Louis. Toronto. Princeton 1984; 1194-11206 and 437.
2.
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Lab Report
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Patient Name:
Age/Sex:
Patient ID:
Sample Date:
Doctor Name:
Test Date:
BIOCHEMISTRY REPORT
DESCRIPTION
RESULT
UNIT
REFERNCE RANGE
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EXAMINED BY:
DATE/ TIME:
Lab-8
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Diabetic Profile
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Diabetes
mellitus
metabolic
is
disorders
group
that
of
requires
education
to
prevent
of
long
term
complications.
- It is characterized by hyperglycemia
and
abnormal
carbohydrate
defects
in
protein,
metabolism
insulin
fat
due
secretion,
and
to
i.e.,
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person whose pancreas does not make any insulin (type 1 diabetes) has a
low level of insulin and C-peptide. A person with type 2 diabetes has a
normal or high level of C-peptide.
Normal value: Fasting ..0.51-2.72ng/ml
Blood glucose:
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at least 8 hours. It often is the first test done to check for diabetes.
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diabetes in a person.
How to Prepare?
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Normal values vary from lab to lab, depending on the test method
used.
Normal Values:
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Glycohemoglobin A1c:4.5%-5.7%
Total glycohemoglobin:5.3%-7.5%
Sample collection:
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decrease
in
serum
glucose
is
Lab Practices:
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1. Assay conditions:
Wavelength: . . . . . . . . . . . . . .. . 505 nm (490-550)
Cuvette: . . . . . . . . . . . . . . . . . . . . .. 1 cm light path
Temperature. . . . . . . . . . . . . . . . . . . 37C / 15-25C
2. Adjust the instrument to zero with distilled water.
3. Pipette into a cuvette
Blank
Standard
Sample
Standard l
-----
10
-----
Sample l
-----
-----
10
WR ml
4. Mix and incubate for 10 min at 37C or 15-20 min at room temperature
(15-25C).
5. Read the absorbance (A) of the samples and standard, against the
Blank. The colour is stable for at least 30 minutes.
6
Calculations:
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1. Kaplan L.A. Glucose. Kaplan A et al. Clin Chem The C.V. Mosby Co. St
Louis. Toronto. Princeton 1984; 1032-1036.
2. Trinder P. Ann Clin Biochem 1969; 6: 24-33.
3. www.webmed.com.
Lab Report
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Patient Name:
Age/Sex:
Patient ID:
Sample Date:
Doctor Name:
Test Date:
BIOCHEMISTRY REPORT
DESCRIPTION
RESULT
UNIT
REFERNCE RANGE
------------
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EXAMINED BY:
DATE/ TIME:
Lab-9
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Urine:
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primary
Urine Analysis:
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- If not assayed within these time limits, several changes will occur.
- The urine container must be sterile if the urine is to be cultured.
3
This
microchemistry
analysis
within
The
color
change
I- Physical Characteristics:
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- Colour intensity of urine correlates with concentration, the darker the colour,
the more concentrated is the sample.
1- Amber yellow---------> Urochrome (derivative
urobilin, the end product of bilirubin degradation
a pigment found in normal urine.
2- Colourless-------> Reduced concentration.
2- Transparency:
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Increased
acidity
in
urine-------->
Diabetes
mellitus
and
some
medications.
- The urine must be fresh (why?), owing to the marked tendency of urine
to be alkaline on standing as a result of ammonia liberation.
6- Specific Gravity (SG):
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1- Urea:
- 1ml urine + 3ml NaOCL (sodium hypochlorite) =======>Evolution of
N 2 gas.
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3- Creatinine:
- 1ml urine + drops of sat. Picric acid + drops of NaOH 10%
========> deep red colour of creatinine ppt.
- On acidifying with HCL, the colour changes to yellow.
4- Chloride:
- 1ml urine + drops dil. HNO 3 add 1 ml AgNO 3 =====> white ppt of
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5- Phosphate:
- 1ml urine + 1ml conc. HNO 3 + 1ml ammonium
molybdate=====>Yellow colour.
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6- Carbonate:
- 1ml urine + drops conc. HCL =======> Effervescence
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7- Ammonia:
- Make the urine just alkaline with NaOH. Close the tube with a cork
containing another side tube dipped in Nessler's reagent. Heat the urine
and then notice the evolving of NH 3 in Nessler's reagent Detect NH 3 by
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its odour.
- 1ml urine + 1ml phenol + 1ml NaBr =======> Blue color.
8- Sulphates:
- 1ml urine + 2 drops conc. HCL + few drops BaCL 2 =======> White
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ppt of BaSO 4 .
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www.webmd.com
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Lab report
Age/Sex:
Patient ID:
Sample Date:
Doctor Name:
Test Date:
URINE ANALYSIS
MACROSCOPIC EXAMINATION:
Amount
Color
Aspect
SG
pH
Nitrite
Protein
Glucose
Ketones
Urobilinogen
Bilirubin
Blood
Leucocytes
EXAMINED BY:
DATE/ TIME:
Lab-10
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blood,
bilirubin,
urobilinogen,
nitrite,
and
leukocyte
A reagent strip is an inert plastic strip onto which reagentimpregnated test pads are bonded. Chemical reactions take place
when the strip is wetted in a urine sample. These reactions result in
a color change that can be visually or mechanically assessed. By
comparing the color change observed to the color chart supplied by
the strip manufacturer, the laboratorian can determine qualitative
results for each entity.
1. In concentration (mg/dl)
2. As small, moderate, or large
3. Using the plus system (1+, 2+, 3+, 4+)
4. As positive, negative, or normal
Procedure:
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strip
against the
edge
of
the
urine
Proteinuria:
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The majority of proteins found in the urine arise from the blood.
Organized by: Lecturer: Sharifa A. Al-Ghamdi
Teaching Assistant: Ashwag A. Bukhari
------
Normal = Negative
Glucosuria:
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Ketonuria:
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to
the
increased
concentration
of
ketoacids
which
can
U1T
U1T
Abnormal
nutritional
conditions,
including
starvation,
fasting,
Vomiting
frequently
over
long
period
of
time,
including
Special considerations
1TU
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Special diets may alter test results. For example, a diet consisting
that
may
cause
false
positive
measurements
include
glucocorticoids.
In healthy persons, ketones are formed in liver and completely
Bilirubin (Bile):
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Urine leucocytes:
The
esterase
method
is
used
to
detect
Urine nitrite test is another dipstick test used for screening for
bacteria. Normal urine does not contain nitrites, but in the presence
Specimens
should
microscopically.
be
examined
macroscopically
and
They
may
be
pathogenic
also.
Apart
from
this,
Procedure:
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1.
2.
3.
4.
drop
of
resuspended
The
sediment
is
first
RBCs
WBCs
Epithelia cells
Blood
RBC cast
Ca oxalate crystal
Lab Practices:
- Collect urine in a clean container.
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10
Lab report
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Age/Sex:
Patient ID:
Sample Date:
Doctor Name:
Test Date:
URINE ANALYSIS
MACROSCOPIC EXAMINATION:
Amount
Color
Aspect
SG
pH
Nitrite
Protein
Glucose
Ketones
Urobilinogen
Bilirubin
Blood
Leucocytes
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MICROSCOPIC EXAMINATION:
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EXAMINED BY:
DATE/ TIME:
11
Lab-11
Quantitative Determination of Urine Protein
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Proteinuria:
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Microalbuminuria
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Significance:
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in diabetes mellitus
in hypertension
Lab practices:
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Principal:
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Protein react in acid solution with pyrogallol red and molybdate to form a
colored complex.
The intensity of the color formed is proportional to the protein
concentration in the sample.
Reagents:
Pyrogallol red --------50mmol/L
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Sodium molybdate------0.04mmol/L
Protein (standard)------1mg/L
Sample:
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Standard
Test
Standard l
----
20
----
Sample l
----
----
20
BCG ml
Calculations:
A (sample)/A (standard) x 1000 (Standard conc.) X Vol. (L) 24h urine=
mg protein /24h.
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Normal Values:
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Lab report
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Age/Sex:
Patient ID:
Sample Date:
Doctor Name:
Test Date:
URINE ANALYSIS
MACROSCOPIC EXAMINATION:
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Test
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Concentration
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NV
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Protein /24h
-----------------
<100mg/24h
Albumin/24
--------------
<30mg/24h
Comment:
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EXAMINED BY:
DATE/ TIME:
Lab-12
Quantitative Determination of Urine Uric acid
Uric acid (UA): and its salt are the end products of purine metabolism.
- Purines such as adenosine and guanine from the breakdown of ingested
nucleic acids or from tissue destruction are converted into UA mainly in
the liver.
- UA is then transported by the plasma from the liver to the kidney,
where it is filtered by glomerulus.
- In the urine at pH levels < 5.75, uric acid is the predominant form and
frequently appears as uric acid crystals.
Why the test is performed?
The most common reason for measuring uric acid levels is for evaluation,
diagnosis, and treatment of kidney stones. With progressive renal
insufficiency, there is retention in blood of urea, creatinine and uric acid.
Patients with gout may also be evaluated using this test, since a
significant number of patients with gout develop uric acid kidney stones.
What abnormal results mean?
Abnormal results are indicated as follows:
Greater-than-normal urinary uric acid levels may indicate:
Metastatic cancers
Gout
Chronic glomerulonephritis
Lead poisoning
Lab practices:
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POD
The intensity of the red color formed is proportional to the uric acid
concentration in the sample.
Sample:
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- Urine (24 h): Stability 4 days at 15-25C, pH >8. Dilute sample 1/50 in
distilled water. Mix. Multiply results by 50 (dilution factor);
If urine is cloudy; warm the specimen to 60C for 10 min to dissolve
precipitated urates and uric acid. Do not refrigerate.
Procedure:
1. Assay conditions:
U
WR ml
Standard l
Sample l
Blank
1
---------
Standard
1
25
-----
Test
1
----25
BIBLIOGRAPHY
1. Schultz A. Uric acid. Kaplan A et al. Clin Chem The C.V. Mosby Co. St
Louis. Toronto. Princeton 1984; 1261-1266 and 418.
2. Fossati P et al. Clin Chem 1980;26:227-231.
3. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press,
1995.
4. Tietz N W et al. Clinical Guide to Laboratory Tests, 3rd ed AACC 1995.
3
Lab report
U
Age/Sex:
Patient ID:
Sample Date:
Doctor Name:
Test Date:
URINE ANALYSIS
MACROSCOPIC EXAMINATION:
U
Test
U
Concentration
U
------------
NV
U
250-270mg/dL/24h
Comment:
U
EXAMINED BY:
DATE/ TIME:
Lab-13
Quantitative Determination of Urine Creatinine&
U
Creatinine Clearance
Creatinine Clearance:
U
As mentioned
before
in
lab-6
next
morning
emptying
the
Procedure:
U
Sample:
U
Urine: Dilute sample 1/50 with distilled water. Mix. Multiply results by 50
(dilution factor); Creatinine stability: 7 days at 2-8C.
Calculations:
U
1.73
A
U
1. Assay conditions:
Wavelength: . . . . . . . . . . . . . . . . . 492 nm (490-510)
Cuvette: . . . . . . . . . . . . . . . . . . . . . . . . 1 cm. light path
Temperature. . . . . . . . . . . . . . . . . . . . . 37C / 15-25C
2. Adjust the instrument to zero with distilled water
3-Pipette into a cuvette:
Blank
Standard
Sample
Standard l
----
100
----
Sample l
----
----
100
WR ml
6. Calculate: A= A 2 A 1 .
Calculation:
R
Male------10-20 mg/Kg/24h
Female------8-18 mg/Kg/24h
Linearity:
U
1. Murray R.L. Creatinine. Kaplan A et al. Clin Chem The C.V. Mosby Co.
St Louis. Toronto. Princeton 1984; 1261-1266 and 418.
2. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press,
1995.
3. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC 2001.
4. Burtis A et al. Tietz Textbook of Clinical Chemistry, 3rd ed AACC 1999.
5. Tietz N W et al. Clinical Guide to Laboratory Tests, 3rd ed AACC 1995.
Lab report
U
Age/Sex:
Patient ID:
Sample Date:
Doctor Name:
Test Date:
URINE ANALYSIS
MACROSCOPIC EXAMINATION:
U
Test
U
Creatinine /24h
Serum creatinine
CrC
Concentration
U
------------
NV
U
250-270mg/dL/24h
------------
0.6-1.1mg/dl
--------------
8-18 mg/kg/24
Comment:
U
EXAMINED BY:
DATE/ TIME:
Lab-14
U
Cerebrospinal fluid, CSF, is collected via the (LP) lumbar puncture. Most
commonly today, specimen tubes are marked very clearly for the tests to
be performed on that numbered specimen. The sterility of the specimen
must also be maintained.
Cerebrospinal Fluid Examinations:
U
I-Appearance:
U
-Normal CSF is crystal clear, with the appearance and viscosity of water.
- Turbidity is graded from 1+ (slightly cloudy) to 4+ (very cloudy) and
may be caused by the following conditions
1. :increased RBC's - red color
2. increased WBC's - cloudy
3. increased protein - cloudy
4. severe jaundice - slightly yellow
5. old blood - slightly yellow
The above abnormalities are easily detected, usually. The RBC's and
WBC's may both be present in many inflammatory conditions. Appearance
then, can be a good indicator of the type of problem present and can lay
suspect certain pathological conditions.
II-Glucose:
U
CSF glucose levels are usually 1/2 of the serum glucose values (approx.
50-100 mg). The main pathologies occur when the CSF glucose is lower
than normal. Decreased levels (45 mg and lower), are seen in meningitis,
meningeal carcinoma and sometimes in intracranial hemorrhage.
III-Protein:
U
Normal levels of protein are 15-40 mg. Some disorders which can cause
an increase in protein can also cause an increase in the WBC count as
well. The following list of disorders can cause increased protein in the
CSF; some also cause a corresponding elevation in WBC's:
1. brain tumors
2. some diabetics
3. multiple sclerosis
4. syphilis
IV- Cell Count:
U
child
newborn
premature
infant
V-Culture:
U
This test for CSF serology can have great clinical significance. Many times
when the blood serology test is negative, the CSF test is positive. An
example of this is: tertiary syphilis; where the serum test turns negative
with time. There are also other times when the CSF test will be negative
and the serum test will be positive. Each case must be evaluated
individually. If syphilis is suspected, a CSF serology may be done in the
presence of negative blood serology report from the lab.
VII-Soluble Amyloid Beta Protein Precursor:
U
The presence of the amyloid beta protein in the senile plaques of the
brain is a hallmark of Alzheimer's Disease, leading researchers to believe
that this protein may be responsible for the disease's neurotoxic effects.
Although amyloid is found in the CSF of healthy people, it is found in
3
Knight, JA: Advances in the analysis of cerebral spinal fluid. Am Clin Lab
Sci 27:93, 1997.
Smith S, Forman D: Laboratory analysis of cerebrospinal fluid. Clin Lab
Sci 7(4):32-38, 1994.
Important Note:
U
The tests presented in this note are some of the most commonly used
tests in most hospitals today. There are other special tests which can be
performed on these fluids, blood, urine and spinal fluid, but usually just
for rare conditions. There are also many other body fluids which may be
tested. These include, but are not limited to:
synovial fluid, Pericardial fluid, pleural fluid, sweat, urogenital secretions,
sputum, gastric acid, peritoneal fluid, fecal lipids, bile, semen, amniotic
fluid, and many others.
4
Patient Name:
Age:
years
Patient ID:
Sex: Male
Female
Clinical History:
Diagnosis:
Date: /
/
Routine
State
Investigation Required:
BLOOD BANK
1001
1002
1003
1004
1005
1006
Whole Blood
Anti-body Screening
BL.GR + RH ABO
Coombs Test Direct
Coombs Test Indirect
Cross Matching
HEAMTOLOGY /
COAGULATION
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
Protein C
Protein S
Prothrombin Time (PT)
Reticulocyte Count
Sickling Test
Sudan Black
Thrombin Time
2033 D-Dimer
CLINICAL CHEMISTRY
3001
3002
3003
3004
3005
3006
3007
3007
3008
3009
3010
3011
3012
3013
3014
3015
3016
3017
3018
3019
3020
3021
3022
3023
3024
3025
A.G. Ratio
Acid phosphatase
Albumin
Albumin & Globulin
Alkaline Phosphatase
Ammonia
Amylase
Bicarbonate
Bilirubin Direct & Total
Blood Gases & Ph (ABG)
C.K. (CPK)
C.K.M.B.
Calcium
Carbon Dioxide
Cholesterol
Cholesterol (HDL)
Cholesterol (LDL)
CHOLINESTERASE
Creatinine
Creatinine Clearance
CSF Glucose
CSF Protein
Electrolyte Chloride (Cl)
Electrolyte Sodium (Na)
Electrolyte Potassium (K)
Protein Electrophoresis
3026 Hb Electrophoresis
3027 -GT (G.G.T.)
3028 G6PD (Quantitative)
3029 Glucose RBS
3030 Glucose FBS
3031 Glucose PPBS
3032 Glucose Total Tolerance
(OGTT)
3033 Glycosalyted Hb
3034 Iron
3035 L.D.H.
3036 Lipase
3037 Magnesium
3038 Microalbuminuria
3039 Occult Blood in Stool
3040 Osmolality (Urine, blood)
3041 Phosphorus
3042 Pregnancy Test (urine)
3043 Pregnancy Test (Serum)
3044 SGOT
3045 SGPT
3046 Semen Fructose
3047 Stone Analysis
3048 Stool Analysis
3049 T.I.B.C
3050 Total Proteins
3051 Triglycerides
3052 Urea (BUN)
3053 Urea Clearance
3054 Uric Acid
3055 Uric Acid Clearance
3056 Urine Analysis
3057 Urine Albumin
3058 OGTT Screening
3059 OGTT Conformation
3060 Lactic Acid