Clinical chemistry

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Clinical chemistry (also known as chemical pathology and clinical biochemistry) is the area of clinical pathology that is generally concerned with analysis of bodily fluids. The discipline originated in the late 19th century with the use of simple chemical tests for various components of blood and urine. Subsequent to this, other techniques were applied including the use and measurement of enzyme activities, spectrophotometry, electrophoresis, and immunoassay. Most current laboratories are now highly automated to accommodate the high workload typical of a hospital laboratory. Tests performed are closely monitored and quality controlled. All biochemical tests come under chemical pathology. These are performed on any kind of body fluid, but mostly on serum or plasma. Serum is the yellow watery part of blood that is left after blood has been allowed to clot and all blood cells have been removed. This is most easily done by centrifugation, which packs the denser blood cells and platelets to the bottom of the centrifuge tube, leaving the liquid serum fraction resting above the packed cells. This initial step before analysis has recently been included in instruments that operate on the "integrated system" principle. Plasma is in essence the same as serum, but is obtained by centrifuging the blood without clotting. Plasma is obtained by centrifugation before clotting occurs. The type of test required dictates what type of sample is used. A large medical laboratory will accept samples for up to about 700 different kinds of tests. Even the largest of laboratories rarely do all these tests themselves, and some must be referred to other labs. This large array of tests can be further sub-categorised into sub-specialities of: General or routine chemistry - commonly ordered blood chemistries (e.g., liver and kidney function tests). Special chemistry - elaborate techniques such as electrophoresis manual testing methods. Clinical endocrinology - the study of hormones, and diagnosis of endocrine disorders. Toxicology - the study of drugs of abuse. Therapeutic Drug Monitoring - measurement of therapeutic medications blood levels to optimize dosage. Urinalysis - chemical analysis of urine for a wide array of diseases, along with other fluids such as CSF and effusions

     

Fecal analysis - mostly for detection of gastrointestinal disorders.

Clinical chemistry is defined in laymans language as the study of the substance in biological fluids most specifically blood, the methods and principles of determination, the intrinsic and extrinsic precautions, the normal levels and the clinical significance of abnormal values. It belongs to the same discipline as clinical toxicology, endocrinology, physical chemistry, qualitative chemistry, quantitative chemistry, organic chemistry, inorganic chemistry, general chemistry, and biochemistry. Clinical chemistry is tackled in three general topics for medical technology students. Clinical chemistry 1 is Pure Blood Chemistry including the following topics: Introduction to clinical chemistry, laboratory math, quality assurance, specimen collection, carbohydrates, lipids, proteins, renal functions tests, and liver function tests. Clinical chemistry 2 is Special Chemistry, which includes automation, blood gas analysis (BGA), electrolytes and enzymology. Blood gas analysis is very important in the maintenance of the acidity and alkalinity of blood. The determination has special precautions like an anaerobic collection and the use of dry heparin as an anticoagulant. Electrolytes, on the other hand, are very important substances too that the body has to maintain concentrations of. An elevation and decrease of the concentration levels indicates an existing pathologic condition. Clinical chemistry 3 includes Toxicology, endocrinology, and drug testing. Toxicology is the section that deals with toxins that affect man. These include heavy metals, over-dosage of prescribed drugs, prohibited drugs, strong acids, strong bases and many more. Drug testing is specifically for drugs of abuse and illegal drugs. For endocrinology, different hormones in the body are studied and are utilized to help in the diagnosis of diseases. Universities and colleges may differ a little bit from the topics included with each phase of clinical chemistry. What is important is that all of the topics are included and are discussed. Clinical chemistry also is one very important section in the clinical laboratory because it is here where the concentrations of various substances are determined. Normal levels of each substance have been established and this is the basis for interpreting whether the results or concentrations of the unknown substance is normal or not. It the values fall below or above the normal levels, and then there is an existing pathologic condition or disease in the person. That is why it is very important that all procedures starting from patient identification, to specimen collection, to assaying, to reporting and recording should be reliable. Correct diagnosis of the patients condition is very important to facilitate successful therapy.