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Introduction To The Clinical Chemistry

This document provides an introduction to clinical chemistry, including definitions of clinical chemistry, accuracy, and precision. It outlines the objectives and uses of biochemical tests, types of tests including discretionary, profile, dynamic function, screening, and metabolic work-up tests. The document discusses clinical chemistry sub-specialties and types of specimens, with examples such as serum, plasma, urine, and cerebrospinal fluid. It provides details on common clinical chemistry tests and the format of a test request form.

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265 views

Introduction To The Clinical Chemistry

This document provides an introduction to clinical chemistry, including definitions of clinical chemistry, accuracy, and precision. It outlines the objectives and uses of biochemical tests, types of tests including discretionary, profile, dynamic function, screening, and metabolic work-up tests. The document discusses clinical chemistry sub-specialties and types of specimens, with examples such as serum, plasma, urine, and cerebrospinal fluid. It provides details on common clinical chemistry tests and the format of a test request form.

Uploaded by

Sasa Abass
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Introduction to Clinical

Chemistry
Rajaa Salah Eldeen Khogaly
MSc in clinical chemistry
Objectives:-
By the end of this lecture the students should
understand the following:-
Definition of Clinical Chemistry.
The Concept of Accuracy and precision.
Uses of biochemical tests.
Types of Biochemical tests.
Clinical chemistry sub-specialties.
Types of specimens for biochemical tests.
Contents of the test request form.
Definition of Clinical Chemistry: -
Clinical Chemistry (also known as

chemical pathology, clinical biochemistry


or medical biochemistry) it is branch of
clinical pathology that is generally
concerned with the analysis of body fluids
to provide biochemical information for the
management of patients.
Such information will be of value only if it

is accurate and precise so that can be used


to guide clinical decision making.
Accuracy: -
defined as
closeness
of an
estimated
value to
the true
value.
Precision: -
defined as
agreement
between
replicate
measurements.
Uses of Biochemical Tests: -
Biochemical tests are used in:
1. Screening: detection of subclinical disease.
2. Diagnosis: confirmation or rejection of
clinical diagnosis.
3. Monitoring: natural history or response to
treatment.
4. Prognosis: information regarding the likely
outcome of disease.
Types of Biochemical Tests: -
1. Discretionary or on-off tests: biochemical
tests that are designed to answer specific
questions e.g. does the patient have
increased blood glucose?
2. Biochemical profile: these tests based on
the fact more useful information on the
patient disease status can obtained by
analysing more constituents than one e.g.
LFT (liver function tests).
3. Dynamic function tests: these tests are
designed to measure the body’s response to
external stimulus e.g. oral glucose tolerance
test.
4. Screening: these tests are commonly used to
identify inborn error of metabolism.
5. Metabolic work-up tests: programmed
intensive investigations carried out to
identify the endocrinological disorders.
Clinical chemistry sub-specialities: -
A large clinical laboratory will accept samples
for up to about 700 different tests.
This large array of tests can be further sub-
categorised in to sub-specialities of:
I. General or routine chemistry
II. Special Chemistry
III. Clinical endocrinology
IV. Toxicology and therapeutic drug monitoring.
Types of specimens for chemical analysis: -
Whole blood, serum, plasma, but mostly on

Serum or Plasma.
Urine – 24 hours urine.

Others – Cerebrospinal fluid, synovial fluid

and others.
Serum is the yellow watery part of blood that
is left after blood has been allowed to clot and
blood cells have been removed.

Plasma is in essence the same as serum, but is


obtained by centrifuging the blood without
clotting.
Common clinical chemistry tests include:
I. Electrolytes and Minerals.
II. Renal Function Tests
III. Liver function Tests
IV. Cardiac Markers
V. Tests of the Blood disorders (Vit B12)
VI. Miscellaneous (glucose, uric acid)
The test request format: -
Patient’s name, sex, and age
Clinic/address
Name of requesting doctor and telephone
number
Clinical Diagnosis/problem
Test(s)
Type of specimen
Date and time of sampling
Relevant treatment.
References: -
Clinical Chemistry principles, procedures,
correlations (Bishop)
Clinical Chemistry (William J Marshall)

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