Clinical Chemistry

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Clinical Chemistry

• Diane C. Jette
• BioMedica Diagnostics Inc.

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1940 Plus Analyzer

• Manual Photometer, simple to use.
• Range -0.2 to 2.5 absorbance units.
• Wavelengths 340, 405, 505, 545,and 600 nm.
• Onboard Printer and RS232 interface.
• Preprogrammed for over 50 assays.
• End-point and Kinetic assay capability.

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Chemistry Reagent Kits

• Wide range of tests available.
• Most reagents are liquid stable and ready for
  use.
• Simple procedures and fast turn-around.
• 1940 Plus preprogrammed for most commonly used
  tests.

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Indicator Enzymes

• Acid Phosphatase
• Alkaline Phosphatase
• Alanine Aminotransferase
• Aspartate Aminotransferase

• Amylase
• Creatine Kinase
• Gamma Glutamyl Transferase
• Lactate dehydrogenase
• Lipase

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Acid Phosphatase (ACP)

• Normal Range 2.5 to 11.3 U/L
• Increased levels of Prostate Acid Phosphatase in
  metastasized prostate cancer.
• Increased levels of non-prostate Acid Phosphatase
  with Pagets disease, hyperparathyroidism with
  skeletal involvement and in cancers which have
  invaded the bone.

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Alkaline Phosphatase (ALP)

• Normal Range 35 to 123 U/L
• Increased levels with liver and bone disease.
• Moderate elevations with Hodgkins disease,
  congestive heart failure, Fanconis syndrome,
  hyperparathyroidism, intestinal disease, and
  intra-abdominal bacterial infections.

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Alanine Aminotransferase (ALT)

• Normal Range 4 to 36 U/L
• Increased levels with hepatic necrosis such as
  cirrhosis, carcinoma, viral or toxic hepatitis,
  and obstructive jaundice.
• Increased levels also seen with extensive trauma
  and muscle disease, circulatory failure, shock,
  hypoxia, myocardial infarction and hemolytic
  disease.

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Aspartate Aminotransferase (AST)

• Normal Range 5 to 34 U/L
• Increased levels with damage or disease to heart,
  liver, skeletal muscle, kidney and erythrocytes
  tissues caused by myocardial infarction, viral
  hepatitis, liver necrosis, cirrhosis, and
  muscular dystrophy.

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Amylase (AMY)

• Normal Range 35 to 140 U/L
• Increased Levels with acute pancreatitis,
  pancreatic duct obstruction, intra-abdominal
  disease, mumps and bacterial parotitis.

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Creatine Kinase (CKN)

• Normal Range 0 to 160 U/L
• Increased levels with myocardial infarction 4 to
  6 hours after onset of pain and peaking at 18 to
  30 hours.
• Above normal levels with muscular dystrophy,
  hyperthyroidism, pulmonary infarction and acute
  cerebrovascular disease.

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Gamma GlutamylTransferase (GGT)

• Normal Range 8 to 54 U/L
• Increased levels with chronic alcoholism, liver
  disease, myocardial infarction with secondary
  liver damage, brain lesions, and Dilantin
  therapy.

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Lactate Dehydrogenase (LDH)

• Normal Range 80 to 285 U/L
• Increased levels with myocardial infarction 8 to
  12 hours after onset of pain with peak values at
  4 to 5 days.
• Moderate increase with liver disease, untreated
  pernicious anemia, megaloblastic anemia, renal
  disease, malignancy and muscular dystrophy.

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Lipase (LIP)

• Normal Range 0 to 62 U/L
• Increased levels with acute pancreatitis,
  abdominal lesions, perforated peptic ulcer,
  intestinal obstruction and acute peritonitis.

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Lipid Derivatives

• Apolipoprotein A-1
• Apolipoprotein B
• Cholesterol
• High Density Cholesterol
• Triglicerides

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Apolipoprotein A-1 (APA)

• Normal Range 107 to 206 mg/dL
• Decreased values may indicate risk of coronary
  artery disease
• Used with High Density Chloesterol, Cholesterol
  and Apolipoprotein B values

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Apolipoprotein B

• Normal Range 60 to 152 mg/dL
• Decreased values may indicate risk of coronary
  artery disease
• Used with High Density Chloesterol, Cholesterol
  and Apolipoprotein A1 values

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Cholesterol (CHO)

• Desired Range
• Borderline High 200 to 239 mg/dL
• High 240 mg/dL
• Indicator of liver function, intestinal
  absorption, risk of coronary heart disease,
  thyroid function and adrenal disease.

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High Density Cholesterol (HDL)

• Desired Range 35 mg/dL
• Decreased levels associated with increase risk of
  coronary heart disease or other atherosclerotic
  complications.

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Triglycerides (TRI)

• Normal Range 44 to 148 mg/dL
• Increased values with nephrotic syndrome,
  coronary heart disease, hypothyroidism, diabetes
  mellitus and liver disease.
• Decreased values with protein malnutrition,
  abetalipoproteinemia, hyperthyroidism and
  cachectic states.

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Indicator Metabolites

• Bilirubin
• Creatinine
• Glucose
• Hemoglobin

• Total Protein
• Albumin
• Urea Nitrogen (BUN)
• Uric Acid

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Albumin (ALB)

• Normal Range 3.5 to 5.3 g/dL
• Increased levels with dehydration.
• Decreased levels with liver disease, nephrotic
  syndrome, malnutrition and protein-losing
  enteropathies.

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Bilirubin (BIL)

• Normal Range Total 0.2 to 1.2 mg/dL
• Normal Range Direct 0 to 0.3 mg/dL
• Increased levels of Total Bilirubin associated
  with liver disease and hemolytic disorders.
• Increased levels of conjugated Bilirubin (Direct
  Bilirubin) associated with biliary obstruction
  and hepatocellular disease.

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Creatinine (CRT)

• Normal Range 0.4 to 1.4 mg/dL
• Increased levels with substantially impaired
  renal function.

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Glucose (GLU)

• Normal Range 70 to 107 mg/dL
• Increased levels with diabetes mellitus,
  hyperactive pituitary or adrenal glands.
• Decreased levels with insulin overdosage, insulin
  secreting tumors, myxedema, hypopituitarism,
  hypoadrenalism and abnormal glucose absorption.

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Hemoglobin (HEM)

• Normal Range 11 to 18 g/dL
• Increased values with polycythemia or
  dehydration.
• Decreased values with anemia.

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Total Protein

• Normal Range 6.2 to 8.5 g/dL
• Increased levels with dehydration or increase in
  one or more globular fractions.
• Decreased values associated with low Albumin
  levels.

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Urea Nitrogen (BUN)

• Normal Range 7 to 18 mg/dL
• Increased levels with renal disease, dehydration,
  diabetic coma, hypoadrenal crisis,
  gastrointestinal hemorrhage and circulatory
  collapse.
• Decreased levels with severe liver disease.

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Electrolytes

• Ammonia
• Calcium
• Carbon Dioxide
• Chloride
• Iron

• Magnesium
• Phosphorus
• Potassium
• Sodium

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Ammonia (AMN)

• Normal Range 11 to 35 ?mol/L
• Increased levels with Reyes syndrome, other
  forms of liver cell damage and impending hepatic
  coma.

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Calcium (CAL)

• Normal Range 8.5 to 10.0 mg/dL
• Increased levels with hyperparathyroidism,
  metastatic bone lesions and hypervitaminosis D.
• Decreased levels with hypoparathyroidism,
  rickets, steatorrhea, nephritis and
  calcium-losing syndrome.

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Carbon Dioxide (CAR)

• Normal Range 23 to 34 mmol/L
• Detection of acid-base imbalance.
• Increased levels with metabolic alkalosis and
  respiratory acidosis.
• Decreased levels with metabolic acidosis and
  respiratory alkalosis.

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Chloride (CHL)

• Normal Range 98 to 106 mEq/L
• Decreased levels with gastrointestinal or
  salt-losing nephritis, Addisons disease and
  metabolic acidosis.
• Increased levels with dehydration, nephritis,
  renal obstruction, congestive heart failure and
  Cushings syndrome.

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Iron (IRO)

• Normal Range 60 to 150 ?g/dL
• Increased levels with infectious hepatitis,
  hemochromatosis, hemosiderosis or terminal
  Hodgkins disease.
• Decreased levels with anemia, chronic infection
  or cancer.

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Magnesium (MAG)

• Normal Range 1.3 to 2.5 mEq/L
• Increased levels with uremia
• Decreased levels with malabsorption, treatment of
  diabetic coma, postoperative patients receiving
  intravenous fluids, chronic and acute alcoholism
  and delirium tremens, chronic renal disease,
  congestive heart failure, pancreatitis, lupus
  erythematosus and hyperthyroidism.

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Phosphorus (PHO)

• Normal Range 2.4 to 4.8 mg/dL
• Increased levels with chronic nephritis,
  hypoparathyroidism, hypervitaminosis D.
• Decreased levels with rickets, osteromalacia,
  hyperparathyroidism and during treatment of
  diabetic coma.

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Potassium

• Normal Range 3.4 to 5.3 mEq/L
• Elevated levels (hyperkalemia) with renal
  failure, dehydration, shock and adrenal
  insufficiency (Addisons disease)
• Decreasing levels with malnutrition, negative
  nitrogen balance, gastrointestinal fluid losses
  and hyper-activity of the adrenal cortex
  (Cushings Syndrome)

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Sodium (SOD)

• Normal Range 135 to 155 mEq/L
• Increased levels with excess water loss,
  hypergluco or mineralocorticoidism and inadequate
  water intake.
• Decreased levels with increased water intake, and
  dilutional hyponatremia due to cardiac failure,
  liver failure, nephrotic syndrome, or
  malnutrition.

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Uric Acid (URI)

• Normal Range 2.5 to 7.7 mg/dL
• Increasing levels with gout, leukemia.
  Polycythermia, familial idiopathic hyperuricemia,
  and conditions associated with decreased renal
  function.