Chemical Tests
Iron in hemoglobin in Blood
Iron is stored in the Liver
1.
Kidney
• Serum Creatinine
- best test for overall kidney function
- Increased in cell destruction (radiation
and chemotherapy
Bilirubin then kidney produce urobilin
(urine pigment)
2. Liver
o
Total Bilirubin
- Hemoglobin Catabolism
- not affected by diet and hormone
levels
- Increased in excessive RBC
breakdown (hemolytic anemia
or impaired liver function)
- Muscle metabolism
- Rises when kidney function is impaired
- gallstone obstructions
- tumors
URINE: is the ultrafiltrate of blood
•
Blood Urea Nitrogen
- surplus amino acid converted to Urea
and excreted by the kidneys as a waste
product
If anemia, high bilirubin
Bilirubin in liver produce stercobilin
(poop pigment)
- Protein metabolism
- influenced by diet or hormone
o
- in healthy individuals they can
found in the liver and bone.
- not as good indicator as Creatinine
- Increased in Kidney disease, Protein
diet, steroids
- can also be a marker for
placenta, bone, intestine
-Decreased in starvation, pregnancy
and low diet
•
- increased in liver tumors and
lesions
Uric Acid
- Purine metabolism (Adenine and
Guanine)
- breakdown of nucleic acids
- Non Protein nitrogen
- Increased in kidney disease
- Commonly used to diagnose Gout
(gouty arthritis) precipitated uric acid
crystals
Alkaline phosphatase
- increased in hepatitis
o
Alanine aminotransferase
- old name: SGPT (Serum
Glutamic Pyruvic Transaminase)
- Liver’s specific enzyme
- 10x increase in cirrhosis,
infections
-100x in viral/toxic hepatitis
Chemical Tests
•
Aspartate aminotransferase
- SGOT ( Serum Glutamic Oxaloacetate
Transaminase)
- can also be in skeletal and cardiac
muscle
- Increased in liver disease
•
•
•
- Cardiac Troponin T
– tropomyosin binding unit
- Cardiac Troponin C
- calcium-binding subunit
Myoglobin
AST
LDH
- Increased in heart attack
4. Lipid Metabolism Tests
• Cholesterol
•
Gamma Glutamyl Transferase (GGT)
- present in all tissues
- skeleton for many hormones
- should be >200mg/dL in adults
- LDL and HDL
- should be monitored and
regulated to avoid
atherosclerotic plaques
- Increased in Alcoholism
- Monitor patients with hepatitis and
cirrhosis
•
Lactate dehydrogenase (LDH)
- can also be in WBC, Platelets, Cardiac
Muscle, Skeletal Muscle
- non-specific marker of inflammation
- C-reactive Protein
- Erythrocyte Sedimentation Rate
3. Cardiac
• Creatine Kinase
- diagnose and monitor heart attack
- CK- MB or CK-2
•
Triglycerides
- main storage of lipids, 95% in
fat tissue
- Hyperlipidemia (high levels of
triglycerides)
- may increase heart attack
5. Carbohydrate metabolism
• Glucose
- regulated by insulin (pancreas)
CK-BB or 1 – brain
CK-MM or 3 – skeletal muscle
•
Troponin
- present in heart muscle
- accurate indicator of heart attack than
CK
- Cardiac Troponin I
for contraction of heart muscle
-insulin: increase
glucose intake and
normalize blood
sugar level
Chemical Tests
6. Thyroid
• Thyroid-Stimulating hormone
- inverse relationship to thyroid
function
- The higher the TSH, the lower T3 and
T4
•
•
T3- Thyroxine
T4- Triiodothyronine
Low T3 T4-Hypothyroidism (underactive)
High T3 T4- Hyperthyroidism (overactive)
Chemical Tests
Panels- set of tests grouped to look at problems
in body systems
2 most used general screening panels:
1. Basic Metabolic Panel (Chem 7)
- an initial broad medical screening tool
of:
•
•
•
Kidney (Crea and BUN)
Electrolyte (Na, K, Cl)
Fluid Balance
(Bicarbonate)
2. Comprehensive Metabolic Panel (Chem
14)
- test general health of patient
- not used to follow the course of a
disease or treatment
Problems of Kidney can be assessed
through:
- Electrolyte Panel
NA, K, Cl, CO2
- specifically tests electrolytes
Electrolytes are electrically charged
which means that they can conduct
electrical impulses.
- Imbalance of electrolytes can be
dangerous
- Common cause of electrolyte
imbalance: dehydration
- body needs impulses to make muscles
contract