CC LAB NOTES (MIDTERM)
 SMOKING
 ACUTE EFFECT- INCREASED HEMATOCRIT,HEMOGLOBIN, ELEVATED
PLASMA CATECHOLAMINES, CORTISOL, TRIGLYCERIDES,
CHOLESTROL, CO, COAGULATION FACTORS, PLATELETS
 CAN CAUSE INFLAMMATION THAT COULD LEAD TO CHANGES IN
CERTAIN BLOOD MARKERS
(C REACTIVE PROTEIN (CRP) , & WBC COUNT)
 NICOTINE- CAN AFFECT CARDIOVASCULAR SYSTEM (INCREASED
HEART RATE AND BLOOD PRESSURE)
 CARBON MONOXIDE- BINDS TO HEMOGLOBIN IN RBC REDUCING
IT’S ABILITY TO CARRY OXYGN. CAN ALTER THE COMPOSITION OF
BLOOD AND MAY AFFECT INTERPRETATION OF CERTAIN BLOOD TEST.
( SMOKING IS NOT ALLOWED PRIOR TO BLOOD EXTRACTION)
 POLYCYTHEMIA VERA
- TYPE OF BLOOD CANCER
-BONE MARROW MAKES TOO MANY RBCs
 CHRONIC EFFECTS- ELEVATED WBC, MCV, CARBOXYHEMOGLOBIN
 INFLAMMATORY MARKERS:
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INTERLEUKIN 6 (IL-6)
CRP (C REACTIVE PROTEIN
TRIGLYCERIDES
BLOOD LIPIDS
CHOLESTEROL
 PLATELET- CLOT FORMATION
CAMATURA, KS.
CC LAB NOTES (MIDTERM)
 STRESS & ANXIETY
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VASOCONSTRICTION & HEMOCONCENTRATION
ALTERATION OF ACID-BASE BALANCE
FALSELY ELEVATED TRIGLYCERIDES
INCREASE IN SERUM LACTATE - LIMITED OXYGEN (ANAEROBIC
GLYCOLYSIS)
RELEASE OF ADRENAL CORTISOL- STRESS HORMONE
(HYPOTHALAMIC PITUITARY ADRENAL AXIS)
HYPOTHALAMUS- RELEASE OF CORTICOTROPIN RELEASING
HORMONE (CRH)
CRH TRAVELS TO PITUITARY GLANDS AND STIMULATES
ADRENOCORTICOTROPIC HORMONE (ACTH)
ACTH THROUGH BLOOD STREAM TO ADRENAL GLANDS- SITUATED
ON TOP OF KIDNEYS
 A PERSON HAS 2 ADRENAL GLANDS
( ADRENAL CORTEX & ADRENAL MEDULLA)- FOUND IN KIDNEYS
 ADRENAL CORTEX - STEROIDS
 ADRENAL MEDULLA- CATECHOLAMINES (EPINEPHRINE &
NOREPINEPHRINE)
 DRUGS OR MEDICATION
 IN VIVO- WITHIN THE LIVING (BLOOD IN BLOOD VESSELS)
 IN VITRO- OUTSIDE OF THE LIVING ( GROWTH OF BACTERIA,
CLOTTING OF BLOOD)
 HEMODILUTION- removing red blood cells to lower the hematocrit
 DRUG-DRUG INTERACTIONS- different drugs taken together at the
same time
CAMATURA, KS.
CC LAB NOTES (MIDTERM)
 METABOLIC REGULATION- metabolic pathways are regulated both
anabolic ( constructive) and catabolic (simple)
 ALTERED COAGULATION
- AMPOTHERICIN (anti fungal drugs)
- KANAMYCIN ( anti fungal drugs)
- LANOXIN (cardiac arrythmia drugs)
- LITHIUM ( manic depressive drugs)
-CORTISOL IS TAKEN BETWEEN 8-10 AM
 NEPHROTOXIC- KIDNEY
 HEPATOTOXIC- LIVER
 TOURNIQUET- 2 MINS
 MORE THAN 3 MINS LEADS TO HEMOCONCENTRATION
 INCREASE IN SERUM CHOLESTEROL, IRON, TRIGLYCERIDES, CALCIUM,
TOTAL PROTEIN DUE TO VENOUS STASIS.
 PREGNANCY
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DECREASE IN PROTEIN LEVELS DUE TO HEMODILUTION
EDEMA
PHYSIOLOGICAL CHANGES
PRE EXISTING CONDITIONS (KIDNEY & LIVER DSE)
COLLECTION OF SPECIMENS
1. KNOWLEDGE IN THE DISTRIBUTION & CONCENTRATION OF EACH
METABOLITE IN EACH OF THE BODYFLUIDS.
2. A KNOWLEDGE OF THE BIOLOGICAL FORM OF THE METABOLITE
BEING ANALYZED AND STUDIED.
3. A KNOWLEDGE OF BIOSYNTHESIS, UTILIZATION, AND HOMEOSTATIC
REGULATION OF EACH METABOLITE TO ACCOUNT FOR BIOLOGICAL
VARIABILITY DUE TO BIOLOGICAL RYTHMICITY, STRESS, AND
FEEDBACK CONTROL OF THE LEVELS OF METABOLITE.
CAMATURA, KS.
CC LAB NOTES (MIDTERM)
TYPES OF BIOLOGICAL SPECIMENS FOR CHEMICAL DETRMINATION
 WHOLE BLOOD- all components of blood (rbc, wbc, platelet, plasma
protein)
 ALBUMIN- helps maintain blood volume and pressure
 GLOBULINS- plays a role in immunity
 FIBRINOGEN- crucial in the blood clotting process
 SERUM- liquid portion of the blood. (clot)
 PLASMA- liquid portion of blood that remains when blood cells are
removed. (55%)
1. URINE- waste product produced by the kidneys as they filter the
blood to remove excess waste products and maintain the body’s
balance of water, electrolytes, and other substances.
NORMAL RANGE: 800mL to 2,000mL per day (0.8-2 liters)
AVERAGE: 1,200mL (1.2 liters)
2. CEREBROSPINAL FLUID (CSF)- ultrafiltrate of plasma 2/3)
3. AMNIOTIC FLUID- assess fetal lung maturity, congenital heart dse,
hemolytic dse, genetic defects & gestational age.
4. PLEURAL- lungs
5. PERITONEAL- stomach
6. SYNOVIAL- joints
7. GASTRIC JUICE
8. BLOOD & BLOOD DERIVATIVES (whole blood, plasma, serum)
9. DUODENAL CONTENTS
CAMATURA, KS.
CC LAB NOTES (MIDTERM)
BLOOD
- most common biologic specimen used in chemical determination in
clinical chemistry
- rbc, wbc, platelet, & others (SOLID) 2 parts/quarts
- oxygen & carbon dioxide (GASES)
- water, urea, uric acid, creatinine, amino acids (LIQUID) 3 parts/quarts
BLOOD SAMPLE COLLECTION
1) SKIN/ CAPILLARY PUNCTURE- blood collection from capillaries
underneath the skin
2) ARTERIAL PUNCTURE- collection of blood from artery
3) VENIPUNCTURE- collection of blood from a vein
BASIC STEPS IN BLOOD COLLECTION
I. IDENTIFY THE PATIENT
II. POSITIONING THE PATIENT (sitting & lying down)
III. SUPPLIES/ MATERIALS
CAPILLARY(SKIN) PUNCTURE
- blood collected by capillary puncture is used in micro-determination
useful among infants
- substitute for arteial blood in the determination of pH of blood gases.
- useful in obese patients, patients with thrombotic tendencies and in
patients with severe burns
 Site of puncture: palmar of fingertips, plantar of toes (infants),
earlobe, plantar of heels (infants)
 Sites to be avoided: edematous areas( swollen),
cyanotic(purplish/blue), scarred areas, traumatized areas
 Advantages: accessible to the operator, easier to manipulate,
smearing
 Disadvantages: small amount of blood, hemolysis
 Procedures: select a finger, milk, cleanse, grip, quick stabbing stroke,
wipe 1st drop of blood,apply pressure to punctured area.
CAMATURA, KS.
CC LAB NOTES (MIDTERM)
ARTERIAL PUNCTURE
- measures blood gases ( partial pressure of oxygen & carbon dioxide &
pH)
- syringes containing heparin are used because of he pressure in arterial
blood vessel
 RADIAL ARTERY is the primary arterial site.
 ALLEN’s TEST
 Factors affecting results: excess anticoagulants, air bubbles, cooling,
time, clots
 Hazards: hematoma, arteriospasm (transient reflex constriction of
artery), thrombosin
 Site of puncture: radial artry, femoral, brachial, scalp artery,
catherization of ambilical cord
CAMATURA, KS.