Clinical Chemistry - Review Questions on Liver Function Test (LFT)

1. _____________________________________________ The enzyme responsible for the conversion of heme to biliverdin. 2. _____________________________________________ The enzyme responsible for the conversion of B1 to B2. 3. _____________________________________________ The carrier protein for B1 to the liver. 4. _____________________________________________ B1 is conjugated with this substance in the liver. 5. _____________________________________________ The liver converts ethanol to this substance. 6. _____________________________________________ Amino acids are converted to this substance in the liver. 7. _____________________________________________These cells act as macrophages in the liver. 8. _____________________________________________ It connects the liver to the diaphragm. 9. _____________________________________________Name the 2 mechanisms by which the liver detoxifies substances. 10. _____________________________________________ 11. _____________________________________________The amount of bile produced every day. 12. _____________________________________________The major bile pigment. 13. _____________________________________________The amount of bilirubin produced daily. 14. _____________________________________________Normal value for TB. 15. _____________________________________________Normal value for B2. 16. _____________________________________________These cells would carry B1 inside the liver. 17. _____________________________________________ This substance prevents B1 from leaving the liver. 18. _____________________________________________Bilirubin is converted to this substance in the small intestines by the action of bacteria. 19. _____________________________________________The answer to no. 18 is converted further to this substance which gives the color of the reagent. 20. _____________________________________________In the urine, some bilirubin is converted to this substance. 21. _____________________________________________ Conversion factor of Bilirubin 22. _____________________________________________ Formula for TB. 23. Three sources of bilirubin_________________________ 24. _____________________________________________ 25. _____________________________________________ ESSAY: 1. ILLUSTRATE HOW B1 AND B2 ARE FORMED (10 pts) 2. NAME 5 SYNONYMS EACH FOR B1 AND B2 (10 pts.)

Check next week for the correct answers.

Answers to Review Questions in Thyroid Function and Abnormalities

1.    How are T3 and T4 formed?

T3 is formed from the combination of 1 diidothyronine and 1 monoiodothyronine, while T4 is formed by the combination of 2 diiodothyronine molecules.

2.    What's more biologically active between T3 and T4?

Although total T4 is more elevated in the blood stream, T3 is more biologically active because it has more free forms than T3. The free forms are responsible for the activity of the hormone in the body.

3.    What would be a more reliable test between T3 and T4 to test Thyroid Function?

Both can be performed, including TSH to determine thyroid function.

4.    What other tests can be performed for TFT (Thyroid Function Test)?

TSH test and T3 uptake test. Also, FT3, FT4.

5.    What abnormalities can result from insufficient or elevated T3 and T4?

Hyperthyroidism – elevated T3 and T4; decreased TSH
Hypothyroidism – low T3 and T4; increased TSH

REVIEW QUESTIONS: For HCG Testing

REVIEW QUESTIONS: For HCG Testing

1.    In the quantitative test, why is there a need to test a 24 hr. urine specimen?

2.    How can you detoxify urine in patient's preparation for HCG determination?

3.    What are the causes of false positive and false negative results?

4.    What normal condition gives positive results to HCG?

5.    In the quantitative determination of HCG why do you have to prepare serial dilution of the urine samples.

ANSWERS WILL BE POSTED NEXT WEEK,

Review on Thyroid Gland and Abnormalities Slide Show

The thyroid gland is found at the neck portion of the human body. It is the major metabolic gland because it secretes the primary metabolic hormones, T3 and T4. Without Triidothyronine and Thyroxine, your body won't be able to develop properly. See if you can answer these questions first, before proceeding to the slides.Write your answers on a sheet of paper, so you can check them later.

Review Questions in Thyroid Function and Abnormalities

1. How are T3 and T4 formed?
2. What's more biologically active between T3 and T4?
3. What would be a more reliable test between T3 and T4 to test Thyroid Function?
4. What other tests can be performed for TFT (Thyroid Function Test)?
5. What abnormalities can result from insufficient or elevated T3 and T4?

 Now, Let's see if your answers are correct. Check here for the answers to Thyroid Function Test

Answers will be posted next week.

Med Tech Research Topics

Med Tech Research topics seem to be difficult to formulate because there are studies on almost any topic. In searching for thesis topics for medical technology, you have to evaluate first your field of interest. Is it Microbiology, Immunology-Serology, Parasitology, Clinical Chemistry, Hematology, Clinical Microscopy, or Blood Banking?

Laboratory Pipets

From there, you have to find a missing aspect, or needed information that people would want to know. It doesn’t need to be complex. A simple study done reliably is more significant than a complex study conducted halfheartedly.

Your study must be able to give answers to existing questions, or add new information to current facts. Don’t copy titles or content to avoid being charged with plagiarism. Conduct your own study and learn, while discovering new knowledge. If there are studies that needed more in-depth research, then you can also do a follow-up research.

Examples of General Med Tech Research Topics are:

1. Correlations of Blood Substances to each other; example: cholesterol and uric acid; HDL and potassium

2. Quality Control parameters and confirmatory methods

3. Laboratory Waste Disposal of big hospitals (Choose one and research how they dispose of their garbage) Find the answer to whatever inadequacies they have in their system.)

4. Research on the accuracy of a new method

5. Study the bioactivity of specific plants (you can base this on folklore, but use empirical/scientific methods to confirm the claims)

6. Compare the efficacy of certain drugs against a common disease

7. Conduct a records’ survey/review of certain aspects and analyze them. This should be within the span of several years.

8. Create a new laboratory method or machine for testing certain substances. You can also visit the following sites to read more about Med Tech Research topics and thesis titles.

Topics for Medical Technology Research Papers 

Student Thesis Titles

Silliman University Ranks 1 in Med Tech Research Paper

You may also want to conduct community surveys on what common problems regarding health do the residents have experienced.

Go to the library and browse past and ongoing research papers.

Go online and surf. Read other research papers/studies.

Visit hospitals and laboratories, and find out what problems they encounter. Find the answers to these problems.

Take note that your research must be able to contribute something substantial to your profession or to the allied medical field, or to society in general.

Good luck.

What is the Difference between Urine Creatinine and Serum Creatinine? Know Your Lab Test

Patients undergoing kidney assessment ask the difference between urine creatinine and serum creatinine. Although both tests are done in the laboratory, they differ in many aspects. It is important to know each of them so that you can prepare correctly during your laboratory visit.

What sample is used for the test of Urine Creatinine and Serum Creatinine?

The first difference between urine creatine and serum creatine is the sample used for the test. Obviously, urine creatinine requires you to collect urine sample. However, this is not the same as the routine urinalysis that you know. Since the test measures the amount of creatinine, you need to carefully collect your urine sample for 24 hours.

 If you are not informed about this difference between urine creatinine and serum creatinine, you might not be able to bring your sample correctly. Urine 24-hour collection means placing all your pee in a single container for the next 24 hours, including the whole day and night. The laboratory usually provides you with the appropriate vessel with preservatives in it to keep your urine stable during the whole collection.

If it is not provided, you can use a clean bottle and keep the urine in a cooler to prevent bacterial decomposition. To ensure that you get the correct difference between urine creatinine and serum creatinine, record the time you started your collection, collect all urine and end on the same time the following day. Be sure not to spill any urine and do not miss out any portion of it. For serum creatinine, blood is the sample required.

Your medical technologist collects blood from you so there is no much hassle involved on your part. On the day of your examination, just go to the laboratory and have yourself prepared for the blood extraction. There is no need to fast since there is no difference between urine creatinine and serum creatinine in terms of patient preparation. Just expect a slight but tolerable pain during the needle insertion.

If you have allergies to latex, fear of needle, fainting tendencies or any other concerns, verbalize them to your health care provider.

Why is serum creatinine and urine creatinine requested?

The indication for the request is another important difference between urine creatinine and serum creatinine. Serum creatinine measures the amount of the substance in the blood. Levels coincide with kidney damage. This is the reason why doctors request for the test for assessment of kidney functions.

However, it is not requested on its own because it is not highly sensitive in diagnosing early stages of kidney problems. Most physicians also request other kidney function tests like Blood Urea Nitrogen. Urine creatinine is requested to get what is called as the Glomerular Filtration Rate (GFR).

It represents how well the kidneys are able to clear substances in the body. In easier terms, it tells you the filtration ability of your organs. Remember your anatomy class in school? Your teacher told you that kidneys filter the blood and remove toxic substances through the urine. Those substances include creatinine.

By measuring urine creatinine, your doctor can have a rough assessment on how good are your organs in cleaning your blood. However, a single test does not lead to a definite diagnosis. Your health care provider confirms it by requesting additional tests.

What is the NORMAL VALUE for urine creatinine and serum creatinine?

Because there is a difference between urine creatinine and serum creatinine, their normal values also differ. Each laboratory can set their reference range but the slight differences usually do not matter. Generally, the values are set based on gender. Women have lower levels compared with men because they have a lower muscle mass. Serum creatinine is 0.6 to 1.1 mg/dL in women and 0.7-1.3 mg/dL in men.

What is creatinine?

Now that you know the difference between urine creatinine and serum creatinine, your next goal is to know what creatinine is all about. Creatine is a byproduct of muscle metabolism and it is constantly being removed from the body through the urine.

Everyone has creatinine in their blood but abnormal rise is see in kidney problems. But apart from this, the difference between urine creatinine and serum creatinine occurs during muscle injury, diet rich in protein and meat, and use of some drugs.

Thus, it is important that you inform your health care provider if you are taking any drugs or you are on a special diet. During the interpretation on the difference between urine creatinine and serum creatinine, your doctor also considers your age and body size. These variables also affect the normal values and thus, may affect the interpretation.


Overall, apart from the sample used and normal values, the difference between urine creatinine and serum creatinine is not critical. For as long as you follow your doctor’s order during the test, you are sure that you will get the most accurate results.

Dilution Lab Problems and Solutions (Answers)

Dilution Lab Problems and Solutions (Answers)

In the laboratory, you are often asked to prepare dilutions of solutions. These dilution lab problems can sometimes leave you grasping for solutions. Well, fret no more, in this post, simple dilution problems are given with the corresponding answers below. I hope you enjoy this learning process.

Instructions:

For the following problems, identify the given and the unknown. State what formula could be used, and show your computations.

1.    How do you prepare a 1:4 dilution of HCl?
2.    What’s the volume of diluent (NSS) needed to prepare a 1:5 serum dilution with a total of 5 mL?
3.    How do you prepare a Normal Saline Solution (NSS)?
4.    What is the resulting dilution for each tube in this serial dilution?

Tube No.    Volume of stock standard solution in mL    Volume of diluent in mL    Resulting Dilution
1           
2           
3           

5.    How much volume do you need to prepare a 5 ml of a 1:10 dilution?


ANSWERS

1.    How do you prepare a 1:4 dilution of HCl?

A 1:4 dilution indicates that there for every 1 part of the solute, there are 3 parts of the solvent. 4 indicate the total of the parts of the solute and the solvent. The solute is HCl (hydrochloric acid) and the solvent would be distilled water.

The easiest method is to assume that I part = 1 mL (milliliter), hence, 1 part is = 1mL HCl

If 1 part = 1 mL
Hence:
3 parts = 3 mL

When you add the parts, the total is 4, hence, the dilution 1:4

So, to prepare 1:4 dilution, you add 1 mL of HCL to 3 mL of distilled water.


2.    What’s the volume of diluent (NSS) needed to prepare a 1:5 serum dilution with a total of 5 mL?

NSS or Normal Saline Solution is also 85% saline. This is also very simple to solve, since 5 is the total of the solute and diluent parts, you can assume that 1 part = 1 mL.

So, 4 parts is required to complete the 5 parts.

Since 1 part =1 mL
So, 4 parts = 4 mL

Since the total volume is also 5 mL, then by adding 1 mL of serum + 4 mL of NSS; you, therefore, need 4 mL of NSS to prepare the dilution.

3.    How do you prepare a serum dilution of 1:3, if your available serum is only 0.25 mL?

1:3 – indicates 1 part of serum + 2 parts of diluent

Since the available solute or serum volume is only 0.25 mL, you have to equate this to 1 part of the dilution.

Hence, if 1 part = 0.25 mL

Therefore, 2 parts diluent = 0.25 mL x 2 parts = 0.50 mL

Hence, to prepare a serum dilution of 1:3, you can add:
0.25 mL of serum + 0.50 mL of diluent.

1 part + 2 parts = 3 parts

So, the dilution is 1:3


4.    What is the resulting dilution for each tube in this serial dilution?

Tube No.    Volume of standard solution in mL    Volume of diluent in mL    Resulting Dilution
1    0.5 (pure stock soln.)    1     1:3
2    0.5 from tube #1    1    1:9
3    0.5 from tube #2 (mix and discard 0.5 mL)    1    1:27

5.    How much volume do you need to prepare a 5 ml of a 1:10 dilution of standard solution?
1:10 dilution indicates what?

Yes, it indicates that 1 part of standard stock solution is added to 9 parts of diluent.

You can do the easiest method by adding 1 mL of the standard stock solution plus 9 mL of the diluent.

However, since the total volume is stated, which is 5 mL, you have to determine how many parts would the solution consists of.

You can divide 5 mL by 10, to determine the volume of each part.

Hence, 5/10 = 0.5 mL

So, you can now equate 1 part with 0.5 mL
The 9 parts diluent would therefore be = 9 x 0.5 = 4.5 mL

So, you add 0.5 mL standard stock solution to 4.5 mL diluent to come up with a 5 mL total volume of 1:10 standard dilution.

There you go! It’s relatively easy, if you always remember that the dilution factor (DF) is the total of 1 part of the solute and the designated parts of the solvent.

If I say the DF is 5, I’m also stating that the dilution is 1:5. So, there are 1 part of solute + 4 parts of solvent.  

For 1:9

There is one part of solute + 8 parts of the solvent


Dilution is different from ratio because in ratio the numbers remain the same. You don’t add them. Unlike in dilution, you add the parts of the solute plus parts of the solvent.

If you’re performing serial dilution, remember to multiply the previous dilution of the tube from where you got the solute.

Good luck with your laboratory math during your exams or when you’re working.

Questions for laboratory math in Clinical Chemistry

Questions for laboratory math in Clinical Chemistry

Instructions

•    Read each question carefully before answering
•    Follow the procedures of problem solving
o    Determine the given
o    What is asked? (unknown)
o    Connect the given with the unknown using a formula
•    Atomic weights:
o    Na = 23
o    Cl = 35.5
o    Ca = 40
o    H = 1
o    O = 16
o    S = 32

•    Valences 
o    NaCl = 1
o    H2SO4 = 2
o    CaCl = 2
o    HCl = 1

1.    You have weighed 90 grams of sodium chloride (NaCl) in dissolved it to a total volume of 500 ml in a volumetric flask. Determine the following:
a.    Percent solution
b.    Normality
c.    Molarity

2.    If you were to prepare a total volume of 150 ml of the following stock solutions from a 50 mg/dL standard, how would you do it? Show volume of diluent and stock solution.
a.    40 mg/dL
b.    30 mg/dL
c.    20 m/dL
d.    10 mg/dL
ANSWERS WILL BE PUBLISHED NEXT WEEK.

ANSWERS TO CASE ANALYSIS in Clinical Chemistry

ANSWERS TO CASE ANALYSIS in Clinical Chemistry

Laboratory tests are performed on a 50-year old lean woman during an annual physical check-up. She has no family history of diabetes or any history of elevated glucose levels during pregnancy. Her laboratory results are the following:
FBS = 90 mg/dL
Cholesterol = 140 mg/dL
HDL = 40 mg/dL
TAG = 90 mg/Dl
THE ANSWERS ARE THE CHOICES THAT ARE IN BLACK LETTERS

QUESTIONS:
1.    The probable diagnosis of the patient is:
    a. myocardial infarction
    b. gestational diabetes
    c. hypercholesterolemia
    d. hyperlipoproteinemia    e. NIL – APPARENTLY, THE RESULTS ARE NORMAL

2.    What are the risk factors that would indicate a potential risk of this patient developing diabetes?
    1. increased cholesterol value
    2. increased TAG value
    3. decreased HDL value
    4.  increased LDL value
    5. NIL

    a. 1         b. 1 & 2    c. 1,2 & 3    d. 1, 2, 3 & 4     e. NIL

3.    What would be the proper follow-up tests for this patient?
    a. Repeat FBS and OGTT
    b. Repeat TAG, Chole, HDL    c. Repeat all tests
    d. Repeat all tests and OGTT
    e. NIL
4.    In this specific case, what would be the most significant test for DM?
    a. 2 HPPT
    b. FBS
    c. OGTT
    d. RBS
    e. NIL
5.    Using the Friedewald formula, the LDL value of a patient with the following results is:
TC = 150 mg/dL, TAG = 90 mg/dL, and HDL = 36 mg/dL:a.    96 mg/dL
b.    102.69 mg/dL
c.    375 mg/dL
d.    24 mg/dL
e.    NIL
Friedewald formula: Explanation

The Friedewald formula (FF) is an estimation of LDL-c level. It utilizes the following values:

Total Cholesterol (TC), Triglycerides (TG), and high-density lipoprotein cholesterol (HDL-c)

The FF is:

LDL-c (mg/dL) = TC (mg/dL) − HDL-c (mg/dL) − TG (mg/dL)/5

Example is above:

Substituting the given data, you will get:

LDL-c = (150 - 36) - (90/5)

LDL-c = (150 -36) - 18

LDL-c = 96 mg/dL
6.    The reason why the value of glucose is 10-15% lower in whole blood than serum and plasma is:
    a. Glycolysis is more predominant in plasma
    b. Gluconeogenesis occurs only in serum and plasma    c. Red blood cells consume glucose
    d. Glucose is contained mostly in serum
    e. NIL
7.    The value of 110 traditional units of cholesterol in SI units is:
    a. 1.10 mmol/L
    b. 220 mg/dL
    c. 11.0 mmol/L
    d. 6.105 mmol/L    e. NIL  - 110 mg/dl  = 2.8446 mmol/l
           
   
NOTES:

To convert from mg/dL (Traditional units) to mmol/L (SI units)

For total, HDL, and LDL cholesterol divide mg/dL by 38.67

Example 110 mg/dL to SI units

110 mg/dL/38.67 = 2.8846 mmol/L

For triglycerides divide mg/dL by 88.57

Example 150 mg/dL to SI units

 150 mg/dL/88.57 = 1.69357 mmol/L

To convert from mmol/L to mg/dL

For total, HDL, and LDL cholesterol multiply mmol/L by 38.67

Example 2.0 mmol/L to traditional units (mg/dL)

2.0 mmol/L * 38.67 = 77.34 mg/dL

For triglycerides multiply mmol/L by 88.57

Example 3.2 mmol/L to traditional units (mg/dL)

3.2 mmol/L * 88.57 = 283.424 mg/dL
8.    The normal value of TP in SI units is:
    a. 3.2 – 8.5 g/dL
    b. 3.5 – 6.2 g/L    c. 32 – 85 g/L OTHER BOOKS SAY IT’S 60 – 80 g/L
    d. 3.3 – 5.3 g/dL
    e. NIL
9.    In protein measurements, Nessler’s reagent is:
    a. double iodide of potassium and mercury
    b. double ions of mercury and iodine
    c. mercury, iodine and potassium
    d. bonds between an anion and a cation
    e. NIL
10.    The following are methods for cholesterol determination, except:
    a. Van Handel and Zilversmit
    b. Pearson McGavak
    c. Schoenheimer and Sperry
    d. Sperry and Webs
    e. NIL
11.    The serum proteins are the following, EXCEPT:
    a. albumin
    b. globulin    c. fibrinogen
    d. immunoglobulin    e. NIL

12.    When testing for OGTT, the following precautions should be observed, EXCEPT:
    a. The patient should not be ambulatory
    b. The patient should eat only 150 grams of carbohydrates daily for 3 days prior to the test
    c. The patient should fast for 8-12 hours
    d. Strenuous exercise should be avoided
    e. NIL

CASE ANALYSIS in Clinical Chemistry

CASE ANALYSIS in Clinical Chemistry

Laboratory tests are performed on a 50-year old lean woman during an annual physical check-up. She has no family history of diabetes or any history of elevated glucose levels during pregnancy. Her laboratory results are the following:
FBS = 90 mg/dL
Cholesterol = 140 mg/dL
HDL = 40 mg/dL
TAG = 90 mg/dL

QUESTIONS:
1.    The probable diagnosis of the patient is:
    a. myocardial infarction
    b. gestational diabetes
    c. hypercholesterolemia
    d. hyperlipoproteinemia
    e. NIL

2.    What are the risk factors that would indicate a potential risk of this patient developing diabetes?
    1. increased cholesterol value
    2. increased TAG value
    3. decreased HDL value
    4.  increased LDL value
    5. NIL

    a. 1         b. 1 & 2    c. 1,2 & 3    d. 1, 2, 3 & 4     e. NIL

3.    What would be the proper follow-up tests for this patient?
    a. Repeat FBS and OGTT
    b. Repeat TAG, Chole, HDL
    c. Repeat all tests
    d. Repeat all tests and OGTT
    e. NIL

4.    In this specific case, what would be the most significant test for DM?
    a. 2 HPPT
    b. FBS
    c. OGTT
    d. RBS
    e. NIL

5.    Using the Friedewald formula, the LDL value of a patient with the following results is:
TC = 150 mg/dL, TAG = 90 mg/dL, and HDL = 36 mg/dL:
a.    96 mg/dL
b.    102.69 mg/dL
c.    375 mg/dL
d.    24 mg/dL
e.    NIL

6.    The reason why the value of glucose is 10-15% lower in whole blood than serum and plasma is:
    a. Glycolysis is more predominant in plasma
    b. Gluconeogenesis occurs only in serum and plasma
    c. Red blood cells consume glucose
    d. Glucose is contained mostly in serum
    e. NIL

7.    The value of 110 traditional units of cholesterol in SI units is:
    a. 1.10 mmol/L
    b. 220 mg/dL
    c. 11.0 mmol/L
    d. 6.105 mmol/L
    e. NIL

8.    The normal value of TP in SI units is:
    a. 3.2 – 8.5 g/dL
    b. 3.5 – 6.2 g/L
    c. 32 – 85 g/L
    d. 3.3 – 5.3 g/dL
    e. NIL

9.    In protein measurements, Nessler’s reagent is:
    a. double iodide of potassium and mercury
    b. double ions of mercury and iodine
    c. mercury, iodine and potassium
    d. bonds between an anion and a cation
    e. NIL

10.    The following are methods for cholesterol determination, except:
    a. Van Handel and Zilversmit
    b. Pearson McGavak
    c. Schoenheimer and Sperry
    d. Sperry and Webs
    e. NIL

11.    The serum proteins are the following, EXCEPT:
    a. albumin
    b. globulin
    c. fibrinogen
    d. immunoglobulin
    e. NIL

12.    When testing for OGTT, the following precautions should be observed, EXCEPT:
    a. The patient should not be ambulatory
b. The patient should eat only 150 grams of carbohydrates daily for 3 days prior to the test
    c. The patient should fast for 8-12 hours
    d. Strenuous exercise should be avoided
    e. NIL

ANSWERS CAN BE READ HERE.