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Introduction to

Clinical Chemistry
Sections of Clinical
Laboratory
Anatomic Pathology
Histopathology
Clinical Pathology
Serology
Microbiology
Clinical Chemistry
Hematology
Clinical Microscopy
Blood Bank
Clinical Chemistry
Laboratory
Concerned with the analysis of
biochemical byproducts in biological fluids
1. Pure Blood Chemistry
Lipids, Carbohydrates and Protein
2. Enzymology
Enzymes
3. Endocrinology
Hormones
4. Toxicology
Drugs of abuse, Heavy metals, Poison, etc.
Clinical Chemistry
Laboratory

Reagents

Serum
(sample)
Clinical Chemistry
Laboratory
Clinical Chemistry Laboratory
Basic Principles
and Practices
Basic Principles and
Practices
A. Units of Measure
B. Reagents
C. Clinical Laboratory Supplies
D. Basic Separation Techniques
E. Laboratory Mathematics and
Calculations
F. Specimen Considerations
A. Units of Measure

Components of quantitative
laboratory results
1. Number
2. Unit (based on the SI system)
A. Units of Measure

Quantitative laboratory results


1. Substance concentration
e.g, moles
2. Mass of substance
e.g., mg/dL, g/dL, g/L, mEq/L, and IU
Basic Principles and
Practices
A. Units of Measure
B. Reagents
C. Clinical Laboratory Supplies
D. Basic Separation Techniques
B. Reagents

Commercially Prepared
Reagents
B. Reagents
B. Reagents
B. Reagents

1. Chemicals
2. Reference Materials
3. Water Specifications
B. Reagents

1. Chemicals
a. Analytical Grade (AR)
b. Ultrapure Reagent
c. Chemically pure (CP)
d. United States Pharmacopeia (USP) and
National Formulary (NF) Grade
e. Technical or commercial grade
B. Reagents

1. Chemicals
a. Analytical Grade (AR)
Suitable for most analytic procedures
Carry designations as AR or ACS and For
Laboratory Use or ACS standard-Grade
Reference materials
B. Reagents

1. Chemicals
b. Ultrapure chemicals
Suitable for techniques that require
extremely pure chemicals (e.g. AAS, EIA,
MDx)
Carry designations of HPLC or
chromatographic
B. Reagents

1. Chemicals
c. Chemically pure (CP)
Impurity limitations are not stated
Preparation is not uniform
Not recommended for clinical laboratories.
B. Reagents

1. Chemicals
d. USP and NF Grade
Used to manufacture drugs
Purity standards are based on the
criterion of not being injurious to man.
B. Reagents

1. Chemicals
e. Technical or commercial grade
Used for manufacturing
B. Reagents

1. Chemicals
2. Reference Materials
3. Water Specifications
4. Solution Properties
B. Reagents

2. Reference Materials
a. Primary standard
Substance of exact known concentration
and purity.
b. Secondary standard
Substance of lower purity with concentration
determined by comparison with a primary
standard.
B. Reagents

1. Chemicals
2. Reference Materials
3. Water Specifications
4. Solution Properties
B. Reagents

3. Water Specifications
a. Distilled water
b. Deionized water
c. Reverse Osmosis (RO) water
d. Ultrafiltration and nanofiltered water
e. Reagent grade water
B. Reagents
B. Reagents

3. Water Specifications
a. Distilled water
Purified by distillation
B. Reagents

3. Water Specifications
b. Deionized water
Water purified by ion exchange (anion or
cation exchange risen) with some/all ions
removed
Remove dissolved solids and dissolved
gases.

Ion exchange risen


B. Reagents

3. Water Specifications
c. Reverse Osmosis (OS) water
Uses pressure to force water through a semi
permeable membrane.
Does nor remove gases.
B. Reagents

3. Water Specifications
d. Ultrafiltration and nanofiltered water,
UV oxidation, sterilization
or ozone treatment
Particulate Micro-
matter organisms

Removes
or
destroys

Pyrogens Endotoxins
B. Reagents

3. Water Specifications
e. Reagent grade water
Obtained by initial filter, followed by RO,
deionization and a 0.2 mm filter.
B. Reagents

3. Water Specifications (Grades of


water)
1. Type I water
For test methods requiring minimum interference
trace metal analysis by FES and AAS
Gas, pH, enzyme and electrolyte analysis
2. Type II water
For analytical preparations
reagent, QC and standard preparation
3. Type III/autoclave wash water
Glassware washing
Basic Principles and
Practices
A. Units of Measure
B. Reagents
C. Clinical Laboratory Supplies
D. Basic Separation Techniques
C. Clinical Laboratory
Supplies
1. Thermometers
2. Glasswares
3. Dessicators and disiccants
4. Balances
C. Clinical Laboratory
Supplies
1. Thermometers/Temperature
Warming components is necessary for
analytical procedures and is accomplished
by circulating water/ice baths or
heating/cooling metal blocks.
C. Clinical Laboratory
Supplies
1. Thermometers/Temperature
a. Liquid-in-glass
b. Electronic thermometer or thermistor
probe
c. Digital thermometer
C. Clinical Laboratory
Supplies
1. Thermometers
a. Liquid-in-glass
Use of a colored liquid or mercury encased
in plastic/glass material with a bulb at one
end a graduated stem

Partial Immersion

Total
Immersion
C. Clinical Laboratory
Supplies
1. Thermometers/Temperature
a. Liquid-in-glass
a. Total Immersion
b. Partial Immersion
c. Surface thermometer

Partial Immersion

Total Immersion
C. Clinical Laboratory
Supplies
1. Thermometers/Temperature
a. Liquid-in-glass
a. Total Immersion
b. Partial Immersion
c. Surface thermometer for incubators or
heating oven

Surface Heating block


C. Clinical Laboratory
Supplies
1. Thermometers/Temperature
b. Electronic thermometer or thermistor
probe
Fast reading with millisecond response time
C. Clinical Laboratory
Supplies
1. Thermometers/Temperature
c. Digital thermometer
C. Clinical Laboratory
Supplies
1. Thermometers/Temperature
2. Glasswares and Plasticware
3. Dessicators and disiccans
4. Balances
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
Glass ware - laboratory supplies
consisted of some type of glass
i. Kimax /Pyrex (borosilicate)
ii. Corex (aluminosilicate)
iii. High silica
iv. Vycor (acid or alkali resistant)
v. Low actinic (amber colored)
vi. Flint glass (lime soda)
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
Plastic ware are usually disposable lab
supplies
Example of commonly used resins:
i. Polystyrene
ii. Polyethylene
iii. Polypropylene
iv. Tygon
v. Telon Tygon
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
a. Laboratory vessels
b. Pipets
c. Burets
d. Syringes
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
a. Laboratory vessels
i. Class A volumetric flask
ii. Erlenmeyer flasks and Griffin beaker
iii. Graduated cylinder
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
a. Laboratory vessels
i. Class A volumetric flask
Calibrated to hold one exact of liquid (TC)

Volumetric flask
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
a. Laboratory vessels
ii. Erlenmeyer flasks and Griffin beaker
Hold different volume
Used in reagent preparation

Erlenmeyer flask Griffin beaker


C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
a. Laboratory vessels
iii. Graduated Cylinder
Used to measure volumes of liquid
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
a. Laboratory vessels
b. Pipets
c. Burets
d. Syringes
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
b. Pipets
Glass or plastic utensils used to transfer
liquids
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
b. Pipets
Classification of Pipet According to Design or
Calibration Marks
i. To contain (TC)
ii. To deliver (TD)
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
b. Pipets
Classification of Pipet According to Design or
Calibration Marks
i. To contain (TC)
Used for viscous samples
Uses mercury as calibrating medium
Proper use requires rinsing of the pipet with
the final solution after content are delivered
into the diluent (rinsing technique)
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
b. Pipets
Classification of Pipet According to Design or
Calibration Marks
ii. To Deliver (TD)
Used for non-viscous samples
Uses distilled water as calibrating medium
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
b. Pipets
Classification of Pipet According to Design or
Calibration Marks
ii. To Deliver (TD)
Blowout pipet with etched ring or two
small, close continuous ring. The last drop of
fluid need to be blown
Self-draining without marking. Drains
completely.
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
b. Pipets
Classification of Pipet According to Use
i. Measuring or graduated pipets
ii. Volumetric or Transfer pipet
iii. Mechanical or Automatic pipet
iv. Micro pipet
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
b. Pipets
Classification of Pipet According to Use
i. Measuring or graduated pipets
Graduated uniformly along its length
Designed to deliver any amount within its
capacity

Serological pipet Mohr Pipet


C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
b. Pipets
Classification of Pipet According to Use
i. Measuring or graduated pipets
I. Serolic pipet
Has graduation marks to the tip
Generally a blowout pipet
II. Mohr Pipet
No graduation marks to the tip
Self draining
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
b. Pipets
Correct operation of glass pipet

2. Wipe off
outside of pipet
1. Use with gauze
mechanical
suction
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
b. Pipets
Correct operation of glass pipet

3. Adjust the meniscus;


read meniscus at the
bottom of the curved
liquid
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
b. Pipets
Classification of Pipet According to Use
ii. Transfer pipet
(Designed to transfer one volume)
I. Ostwald-Folin pipet
For viscous fluids (blow out pipet)
II. Volumetric pipet
For aqueous solutions (self draining)
III. Pasteur pipets
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
b. Pipets
Classification of Pipet According
to Use
ii. Transfer pipet

Volumetric Pipet Ostwald-Folin


Pipet
Size Larger Smaller
Location of Located at the Located closer to
the bulb center the
(symmetrical) delivery tip
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
b. Pipets
Classification of Pipet According to Use
ii. Transfer pipet
(Designed to transfer one volume)
I. Ostwald-Folin pipet
II. Volumetric pipet
III. Pasteur pipets
No calibration marks
For transferring fluids without consideration
of a specific volume
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
b. Pipets
Classification of Pipet According to Use
iii. Automatic pipets
Micropet deliver amount <1ml
Macropipet deliver amount >1ml
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
b. Pipets
Types of pipets
iii. Automatic pipets
Air displacement
The piston
does not come in

contact the liquid


Positive displacement
The piston moves in the tip
and comes in contact
with the liquid
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
b. Pipets
Types of pipets
iii. Automatic pipets

Positive
Dilutor / Dispenser Air
displacement displacement
C. Clinical Laboratory
Supplies
(a) Serological

(b) Mohr

(c) Volumetric

(d)Ostwald-Folin

(e) Micropipet
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
a. Laboratory vessels
b. Pipets
c. Burets
d. Syringes

For dispensing liquid


during titration
C. Clinical Laboratory
Supplies
2. Glassware and Plasticware
a. Laboratory vessels
b. Pipets
c. Burets
d. Syringes

Used to transfer small volumes in


blood gas analysis, chromatography
or electrophoresis
C. Clinical Laboratory
Supplies
1. Thermometers
2. Glasswares and Plasticware
3. Dessicators and Desiccants
4. Balances
C. Clinical Laboratory
Supplies
3. Dessicators and Desiccants
Uses hygroscopic substance that take
up water/moisture on exposure to air.
C. Clinical Laboratory
Supplies
1. Thermometers
2. Glasswares and Plasticware
3. Dessicators and Desiccants
4. Balances
C. Clinical Laboratory
Supplies
4. Balances
1. Electronic Top-loading balance
2. Analytical Balance
C. Clinical Laboratory
Supplies
4. Balances
1. Electronic Top-loading balance
used for knowing the mass of the
test sample with greater
quantity.
Used for preparative
experiments.
C. Clinical Laboratory
Supplies
4. Balances
2. Analytical balance
for preparation of
primary standards
With sliding transparent
doors
Measure exact mass but
with lower capacities
(operating ranges 0.01
mg to 160 g)
Basic Principles and
Practices
A. Units of Measure
B. Reagents
C. Clinical Laboratory Supplies
D. Basic Separation Techniques
Basic Principles and
Practices
D. Basic Separation Techniques
1. Centrifugation
2. Filtration
Basic Principles and
Practices
D. Basic Separation Techniques
1. Centrifugation
a process in which a centrifugal force is used
to separate solid matter from a liquid
suspension

Floor Model Bench Top


Basic Principles and
Practices
D. Basic Separation Techniques
1. Centrifugation
Consist of head/rotor (attached to the
shaft of the motor), carrier and shields.

Swinging Bucket / Angled


Swing type rotor
Basic Principles and
Practices
D. Basic Separation Techniques
1. Centrifugation
The speed/centrifugal force is expresses by:
1. Revolution per minute (RPM)
2. Relative centrifugal force (RCF) or gravities (g)
Basic Principles and
Practices
D. Basic Separation Techniques
1. Centrifugation
Centrifuged must be properly balanced and
free from excessive vibrations.
Basic Principles and
Practices
D. Basic Separation Techniques
2. Filtration
Paper, cellulose, polyester fibers and column
materials
Thank You!

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