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Clinical Biochemistry.pptx

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Clinical Biochemistry.pptx

This ppt will give you an idea about the basic phases of a clinical biochem lab, its requirements, details about vacutainers and the additives. Finally will give an idea about the significance of the clinical biochemistry branch in health care.

This ppt will give you an idea about the basic phases of a clinical biochem lab, its requirements, details about vacutainers and the additives. Finally will give an idea about the significance of the clinical biochemistry branch in health care.

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Clinical Biochemistry.pptx

  1. 1. Clinical Biochemistry Dr Sarath Krishnan M P MBBS Junior Resident 2 Department of biochemistry All India Institute of Medical Sciences, Rishikesh-249203
  2. 2. What will we do?  Medical biochemistry.  Concerned with analysis of body fluids. 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 2
  3. 3. Body fluids 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 3 Body Fluid Investigation Performed Method of Collection WHOLE BLOOD Blood gases, Urea Glucose Obtained by arterial or venipuncture; collected with anticoagulants like heparin; PLASMA Enzymes, Metabolites Electrolytes Blood with anticoagulants centrifuged at 2000 rpm; the supernatant is plasma SERUM Enzymes Metabolites Electrolytes Blood collected in a plain glass container, without any anticoagulant, centrifuged at 2000 rpm after clotting, the supernatant is serum URINE Glucose, Proteins Bile salts & pigments, Blood, Steroids Directly passed into a glass container, sometimes a catheter is introduced into the bladder CEREBRO- SPINAL FLUID Glucose, Protein, Chloride Lumbar puncture from subarachnoid space GASTRIC JUICE HCl, Blood Aspiration by Ryle’s tube SEROUS FLUIDS Proteins Needle puncture to the serous space (E.g.,Pleural, Peritoneal) SWEAT Chloride Soaked into a filter paper
  4. 4. Clinical Biochemistry process 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 4
  5. 5. Phases 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 5
  6. 6. Ideal Requisition form contains… 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 6 (Name of Hospital)
  7. 7. Collection And Transportation of Specimens 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 7
  8. 8. Things needed for phlebotomy 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 8
  9. 9. Blood Collection Accessories 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 9
  10. 10. Blood Collection Accessories 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 10
  11. 11. Blood Collection Accessories 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 11
  12. 12. 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 12 Top Color Additives Principle Uses Lavender/Purple EDTA -The strongest anti-coagulant Ca+2 chelating agent - To preserve blood cellscomponents Hematology Blood bank (ABO) HbA1C (Glycated Hb) Light Blue SodiumCitrate Ca+2 chelating agent PT: Prothrombin Time PTT: Partial Thromboplastin Time Green Sodium Heparin orLithium Heparin Heparin binds to Thrombin and inhibitsthe second step in the coagulation cascade (Prothrombin Thrombin) Fibrinogen Fibrin Enzymes Hormones Electrolytes (Na+, K+, Mg+, Cl-) Black Sodium Citrate Ca+2 chelating agent ESR (Erythrocyte Sedimentation Rate) Gray Sodium Fluoride + Potassium Oxalate Glycolysis inhibitorAnti- Coagulant Glucose tests Royal Blue Heparin Na- EDTA Anti-Coagulant Tube should not becontaminated with metals Toxicology Trace Elements and metals Yellow ACD (Acid- Citrate Dextrose) Anti-Coagulant DNA StudiesPaternity Test HLA Tissue Typing HLA (Human Leukocyte Antigen)
  13. 13. 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 13 Top Color Additives Principle Uses Red Sometimes it has gel or silicon atthe bottomof tube toreduce hemolysis Enhancing the formation of blood clot - Serology - Antibodies - Hormones - Drugs - Virology - Chemistry - Blood cross matching before blood transfusion Gold It has gel at the bottom of the tube to separate serum from the blood Serum separating from the blood through the gel in the tube Serology Chemistry
  14. 14. Order of Draw 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 14 Blood Draw Order Tube Color Description 1 Color Varies Blood Cultures 2 Light Blue Sodium Citrate 3 Red Clot Activator 4 Gold SST 5 Light Green Lithium Heparin 6 Dark Green Sodium Heparin 7 Lavender EDTA 8 Gray Sodium Fluoride 9 Yellow ACD Solution
  15. 15. Phlebotomy and its step 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 15
  16. 16. 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 16
  17. 17. Common site  Median Cubital vein Avoid  IV line  Mastectomy  Scarring  Hematoma 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 17
  18. 18. Rejection Criteria For Specimens I. Hemolyzed Specimen II. Lipemic Sera III. Mislabeled/Wrongly Labeled Specimen IV. No Requisition Form 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 18
  19. 19. Turn Around Time  Time taken from receipt of Specimen in Lab to dispatch of the report out from lab  For most of the Clinical Biochemistry Stat investigations TAT is 2 to 4 hours.  Same day Specimens Received, Analyzed and Reports Dispatched. 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 19
  20. 20. Functional Instrumentations  Fully Automated Chemical Analyzers  Chemiluminescence Immuno Assay Analyzer  Electrolyte Analyzers  Blood Gas Analyzers 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 20
  21. 21. Routine Biochemical Investigations  Blood Glucose {Fasting, Post prandial and Random}  Non Protein Nitrogenous Substances - Urea ,Uric Acid, Creatinine.(KFT)  Serum and urinary Proteins-Total Proteins, Albumin (LFT)  Lipids-Tri Acyl Glycerol, Cholesterol, Lipoproteins  Enzymes-AST,ALT,GGT,ALP(LFT)  Bilirubin-Total ,Direct, Indirect (LFT)  Electrolytes- ( Na, K)  Minerals-( Ca, P, Mg, Lithium)  Blood- pH, Anion Gap,pO2,pCO2,Bicarbonates. 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 21
  22. 22. Normal values of important biochemical parameters 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 22
  23. 23. Significance Of Clinical Biochemistry Laboratory Results Reported with Reference Range  Diagnosis  Treatment  Prognosis  Screening  Research Data for Publication 25-11-2022 Dr Sarath Krishnan M P/Dept of Biochemistry/AIIMS Rishikesh 23
  24. 24. Thank you  25-11-2022 24

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