prepared by Dr. Akaber Tarek Biochemistry Department Clinical Chemistry prepared by Dr. Akaber Tarek Biochemistry Department Clinical Chemistry prepared by Dr. Akaber Tarek Biochemistry Department

Plasma & Serum Plasma Plasma  Blood + clotting factor  Formed elements.  Contain fibrinogen & pr-othrombin.  No thrombin is formed. Serum Serum  Blood – clotting factor.  Formed elements.  No fibrinogen& pr- othrombin.  Thrombin formed during clotting process.

Preparation of samples Serum: BBBBlood is taken in clean tube. PPPPut at 370 c for clotting. CCCCentrifuge the sample. Use the supernatant that is “serum”. Plasma: Blood is taken on anticoagulant. Mix well blood with anticoagulant. Use the sample that is “plasma”.

TTTTo prevent hemolysis during vein puncture: NNNNever draw blood through a hematoma. RRRRemove the tourniquet as early as possible to decrease flow velocity and turbulence. DDDDo not remove the collection tube until full. WWWWhen mixing is required, gentle inversion is adequate.

Procedures of tests  Take blood sample from patient in suitable tube.  Put the sample in water bath 37 0 c for coagulation.  Centrifuge the sample for 10 min. to obtain clear serum.  Carry out the procedures according kits.  Then make the calculation.

Liver Function Tests  LFT used to detect, evaluated and monitor liver diseases or damage.  These include:  Total protein (albumin & globulins)  Albumin (main protein made by liver)  ALT or SGPT “alanine aminotranferase”  AST or SGOT “ aspartate aminotranferase”  ALP “alkaline phosphatase”  Bilirubin (total & direct)  GGT, LDH, PT (pro-thrombin time)

 ALT is an enzyme found mostly in the liver; smaller amounts of it are also in the kidneys, heart, and muscles.  ALT test detects liver injury “More Specific”.  Very high levels of ALT due to acute hepatitis.  AST is an enzyme found mostly in the heart and liver, and to a lesser extent in other muscles.  AST not specific.  Very high levels of AST due to acute hepatitis. ALT AST

 ALP is an enzyme found in high concentrations in bone and in the liver. Smaller amounts of ALP are found in the placenta.  ALP is not specific for liver diseases.  GGT is an enzyme found mainly in the liver.  It is the most sensitive liver enzyme in detecting bile duct problems.  A rise in GGT can occur even when there is no identifiable cause that is related to liver diseases. ALP GGT

 The total protein test is a rough measure of all of the protein in the plasma portion of your blood.  Total protein measures the combined amount of two classes of proteins, albumin and globulin.  Low total protein levels suggest liver disease.  A/G ratio is normally slightly over 1  A low A/G ratio may reflect overproduction of globulins underproduction of albumin.  Albumin is the most abundant protein in the blood plasma.  Low albumin levels can suggest liver diseases, inflammation, shock, malnutrition & kidney diseases.  High albumin levels usually reflect dehydration. Total Protein Albumin

Bilirubin  Bilirubin is an orange-yellow pigment found in bile.  RBCs normally degrade after 120 days in the circulation. At this time, hemoglobin (the red-colored pigment of red blood) breaks down into bilirubin.  Unconjugated bilirubin is carried to the liver, where sugars are attached to it, producing conjugated bilirubin.  When bilirubin levels are high, a condition called Jaundice.

Kidney Function Tests: KKKKFT used to evaluate and monitor kidney diseases or damage & the effectiveness of the treatment. TTTThese include: Urea & BUN “blood urea nitrogen” Creatinine and creatinine clearance. Uric acid.

Lipid profile  Lipid profile includes: 1)Total lipids 2)Triglycerides 3) Cholesterol 4) HDL 5) LDL  These tests must be carried out after fasting due the high molecular weight of lipid molecules and the prolonged digestion and metabolism.

Blood Glucose  Blood glucose level is one of the most important test in the lab.  Glucose is very essential for all body activities.  This includes: 1)RBS “random blood sugar” 2)FBS “fasting blood sugar” 3)PPS “post-prondial blood sugar”