Clinical Laboratory Methods
MEDT 5227
Chemistry Objectives
Objectives:
Upon completion of lecture, discussion, case studies and laboratory, the student will be able to:
Quality Control and CLIA Regulations
1.
2.
3.
4.
5.
Explain the importance of QC in the lab
Define sensitivity, specificity, shift, trend, precision , accuracy and reliability
Describe the 6 aspects of quality control
Classify procedures according to the CLIA regulations
List the Quality Assurance requirements mandated in the CLIA regulations
Carbohydrates
1.
Differentiate types of diabetes by clinical symptoms and laboratory data
Type 1
Type 2
Gestational diabetes
Impaired glucose tolerance
2.
Relate expected laboratory results and clinical symptoms to the following metabolic complications of
diabetes:
Ketoacidosis
Hyperosmolar coma
3.
Describe the used of hemoglobin A1C and microalbumin in the long term monitoring of diabetes
Lipids and Cardiac Risk
1.
2.
Discuss cholesterol, LDL cholesterol, HDL cholesterol, lipoproteins and triglycerides as predictors of
cardiovascular risk
Calculate a LDL cholesterol, given total cholesterol, triglyceride and HDL results
Enzymes
1.
Discuss the use of enzymes as laboratory aids in the following disorders:
Myocardial infarction (LD, CK, AST, LD-1, CKMB)
Hepatocelluar disease (AST, ALT)
Hepatobiliary disease ALP, GGT)
Degenerative bone disease (ALP)
Pancreatitis (amylase, lipase)
Prostatic carcinoma (ACP, PSA)
Dengerative muscle disease
Cardiac Function
1.
2.
3.
Discuss the changes in total serum CK, LD, and AST after acute myocardial infarction.
Interpret serum enzyme studies in patients with suspected acute myocardial infarction
CK and CKMB
LD and LD-1
Describe the clinical usefulness of myoglobin and troponin versus CK markers in assessing acute
myocardial injury.
Hepatic Function
1.
2.
Identify laboratory tests commonly used to diagnose renal disease
Correlate expected results in pre-hepatic (hemolytic jaundice), intrahepatic (hepatitis and cirrhosis),
and posthepatic (obstructive jaundice) related disorders for the following tests:
Serum and urine bilirubin (total, conjugated, unconjugated)
Urine and stool urobilinogen
Enzymes (AST, ALT, Alkaline Phosphatase, GGT)
Renal Function
1.
2.
3.
4.
Identify laboratory tests commonly used to diagnose renal disease:
BUN (urea)
Creatinine
Creatinine Clearance
Ammonia
Discuss the sensitivity and specificity of serum creatinine and BUN as renal function tests.
Correlate kidney function tests with clinical findings in:
Glomerulonephritis
Nephrotic Syndrome
Renal tubular acidosis
Renal failure - acute and chronic
Renal transplants
Correlate uric acid values with advanced chronic renal failure and gout.
Electrolytes and Acid-base Balance
1.
2.
3.
4.
5.
6.
Identify the major electrolytes found in the body and the relative distribution of each.
Calculate an anion gap given a set of electrolyte values.
Describe the use of a measured and calculated osmolality result.
Calculate an osmolality given a set of laboratory results.
Identity the normal HCO3/H2CO3,
Describe the laboratory parameters (pH, pCO2, and HCO3) for the following acid/base disorders:
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
Parathyroid Function and Calcium Metabolism
1.
2.
Using PTH and calcium assay results, differentiate between
Hypoparathyroidism (primary vs secondary)
Hyperparathyrodism (primary vs secondary)
Vitamin D levels
Correlate serum alkaline phosphatase (ALP) with bone disorders.
Thyroid Function
1.
2.
Using T3, T4 and TSH levels, differentiate between:
Hyperthyroidism (primary, secondary and tertiary)
Hypothyroidism (primary, secondary and tertiary)
Describe the factors that affect thyroid binding globulin levels.
Tumor Markers
1.
Explain the value of specific tumor markers for diagnostic and treatment of patients with
prostatic cancer (PSA, fecal occult blood)
2.
Define the following terms as they relate to tumor markers: diagnostic sensitivity, diagnostic
specificity, positive predictive value, negative predictive value