DIAGNOSTICS
ClinicalChemistry
b
Learning Guide series
b b
, ABBOTT DIAGNOSTICS CL b b
INICAL CHEMISTRY EDUC b b
ATIONAL SERVICES b
INTENDEDb AUDIENCE
Thisblearningbguidebisbintendedbtobservebthebbasicbeducationalbneedsbofbne
wbmedicalblaboratorybscientistsbwhobarebenteringbthebfieldbofbclinicalblabo
ratorybmedicine.bAnyonebassociatedbwithbthebspecialtybofbclinicalbchemist
ryborbthebclinicalblaboratorybwillbfindbthisblearningbguidebofb interest.bTypi
calbreadersbwillbincludebmedicalblaboratorybtechniciansbandbmedicalbtechn
ologists,blaboratorybsupervisorsbandbmanagers,bnurses,blaboratorybsupport
bpersonnel bandbphysician bofficeblaboratory bpersonnel.
HOWb TOb USEb THISb LEARNINGb GUIDE
Tobofferbthebmostbbenefit,bthisblearningbguidebbeginsbeachbsectionbwith
banb Overviewb sob youb canb quicklyb reviewb itsb goalsb andb content.b Nextb isb a
bsetb ofb Learningb Objectives.b Theseb focusb onb theb keyb conceptsb presentedb
inb eachb section.b Thereb isb ab shortb Reviewb quizb atb theb endb ofb eachb section
designedbtobhelpbrecallbthebconceptsbintroduced.bIfbabquestionbisbansweredbi
ncorrectly,bthebappropriatebportionsbofbthebtextbmaybbebreviewedbbeforebm
ovingbtobthebnextbsection.
Abglossarybisbatbthebendbofbthisblearningbguidebforbquickbreference.bThereba
rebalsobreferencesbandbresourcesbdevotedbtobotherbrecommendedbreadingbfo
rbmorebdetailsbandbfurtherbstudy.
AUTHOR:
RobertabReed,bPh.D.
ABBOTTb EDITORS:
DavidbArmbruster,bPh.D.,bDABCC,b FACB,bDirector,bClinicalbChemistry
Kelleyb Cooper,b MTb (ASCP),b CLSb (NCA),b Globalb Clinicalb Chemistryb Marketing
LEbARbNbIbNbGbGbUbIbDbEb:b CbLIbNbIbCbALb CbHbEbMbIbSbTbRbY 2 TObTbHbEbTAbBbLbEb ObFb CObNbTbENbTbS
, FOREWORD
ClinicalbChemistrybisbanbexcitingbfieldbthatbcombinesbanalyticsbandbinstrumen
tationbwithbinformationbtechnologybandbmanagementbofbworkflow,bstaffbeffic
ienciesbandbhighbvolumebautomation.bThebfieldbisbever-
changingb andbdemandsbstaffbhavebskillsbinbthe bmethodologiesbandbtheirblimit
ations,
technologyb andb troubleshootingb equipment,b asb wellb asb managementb andb abilitybt
obadaptboperationsbtobevolvingbclinicalbneeds.bAtbthebheart,btheblaboratorybis
abservicebtobthebphysicianbprovidingbtestbresultsbthatbarebcriticalbtobdiagnosingb
andbmanagingbpatients.bBut,btheblaboratorybisbalsobabvitalbmemberbofbthebhea
lthcarebteambandbgetsbinvolvedbinbutilization,boperationalbefficienciesbandbim
provingbpatientboutcomes.bIbwasbhonoredbtobbebaskedbtobeditbthisbversionbofbth
ebClinicalbChemistrybLearningbGuide,basbIbhavebspentbnearlyb30byearsbinbthebclinic
alb laboratoryb mentoringb studentsb andb helpingb physiciansb meetb theb needsbofbthe
irbpatients.
ThisbLearningbGuidebisbanbessentialbprimerbtobthebbasicsbofbnotbonlybclinicalbch
emistrybbutblaboratorybmedicine.bItbtouchesbonbqualitybandbessentialsbofbthebme
thodologiesbwebutilizebinbthebdailybanalysisbofbspecimens.bAbwidebrangebofbclin
icalbdisciplines,bincludingbnursingbstudents,bresearchers, bmedicalbstudents,bresi
dents,blabbadministrators bandbgovernment binspectors basbwellbasbmedicalbtechno
logists,bmaybfindbthebcontentsbofbthisbguidebtobbebhelpfulbtobtheirbdailybworkban
dbanbexplanationbofbwhatbgoesbonbinbthebclinicalblaboratorybtobthosebthatbarebno
tbawarebofbthebscience.bIbhopebthatbyoubwillbfindbthisbguidebasbusefulbasbmybstud
entsbandbtechnologistsbhavebinbthebpast!
JamesbH.bNichols,bPh.D.,bDABCC,bFACBbProf
essorbofbPathology,bMicrobiologybandbImmunol
ogy
MedicalbDirectorbofbClinicalbChemistrybMedic
albDirector,bPoint-of-
CarebTestingbVanderbiltbUniversitybSchoolbofb
Medicine
4918DbTVCb(ThebVanderbiltbClinic)
b1301 bMedical bCenterbDrive bNashvi
lle,bTNb37232-5310
(615)b343-5708
FAXb(615)b343-9563
LEbARbNbIbNbGbGbUbIbDbEb:b CbLIbNbIbCbALb CbHbEb 3 TObTbHbEbTAbBbLbEb ObFb CObNbTb
MbIbSbTbRbY ENbTbS
, CONTENTS
INTRODUCTION
CLINICALb CHEMISTRYbLEARNINGb GUIDE .......................................................... 5
SECTIONb 1
INTRODUCTIONbTObCLINICALbCHEMISTRY ...................................................... 6
SECTIONb 2
PRINCIPLESb OFb MEASUREMENT ........................................................................ 18
SECTIONb 3
TESTINGb STRATEGIESb TOb SELECTb FORb Ab SPECIFICb ANALYTE .......................... 30
SECTIONb 4
ACCURACY ........................................................................................................ 41
SECTIONb 5
SOURCESb OFb ERROR ......................................................................................... 55
SECTIONb 6
COMMONbCLINICALbCHEMISTRYbTESTS ........................................................ 66
SECTIONb 7
TESTINGbINbCLINICALbPRACTICE...................................................................... 88
SECTIONb 8
UNITSbOFbMEASURE ........................................................................................ 105
APPENDIX
APPENDIXb A:b GLOSSARYb OFb TERMS ............................................................... 112
APPENDIXbB:bREFERENCES............................................................................ 115
APPENDIXb C:b CORRECTb RESPONSESb TOb REVIEWb QUESTIONS ..................... 116
LEbARbNbIbNbGbGbUbIbDbEb:b CbLIbNbIbCbALb CbHbEb 4
MbIbSbTbRbY
ClinicalChemistry
b
Learning Guide series
b b
, ABBOTT DIAGNOSTICS CL b b
INICAL CHEMISTRY EDUC b b
ATIONAL SERVICES b
INTENDEDb AUDIENCE
Thisblearningbguidebisbintendedbtobservebthebbasicbeducationalbneedsbofbne
wbmedicalblaboratorybscientistsbwhobarebenteringbthebfieldbofbclinicalblabo
ratorybmedicine.bAnyonebassociatedbwithbthebspecialtybofbclinicalbchemist
ryborbthebclinicalblaboratorybwillbfindbthisblearningbguidebofb interest.bTypi
calbreadersbwillbincludebmedicalblaboratorybtechniciansbandbmedicalbtechn
ologists,blaboratorybsupervisorsbandbmanagers,bnurses,blaboratorybsupport
bpersonnel bandbphysician bofficeblaboratory bpersonnel.
HOWb TOb USEb THISb LEARNINGb GUIDE
Tobofferbthebmostbbenefit,bthisblearningbguidebbeginsbeachbsectionbwith
banb Overviewb sob youb canb quicklyb reviewb itsb goalsb andb content.b Nextb isb a
bsetb ofb Learningb Objectives.b Theseb focusb onb theb keyb conceptsb presentedb
inb eachb section.b Thereb isb ab shortb Reviewb quizb atb theb endb ofb eachb section
designedbtobhelpbrecallbthebconceptsbintroduced.bIfbabquestionbisbansweredbi
ncorrectly,bthebappropriatebportionsbofbthebtextbmaybbebreviewedbbeforebm
ovingbtobthebnextbsection.
Abglossarybisbatbthebendbofbthisblearningbguidebforbquickbreference.bThereba
rebalsobreferencesbandbresourcesbdevotedbtobotherbrecommendedbreadingbfo
rbmorebdetailsbandbfurtherbstudy.
AUTHOR:
RobertabReed,bPh.D.
ABBOTTb EDITORS:
DavidbArmbruster,bPh.D.,bDABCC,b FACB,bDirector,bClinicalbChemistry
Kelleyb Cooper,b MTb (ASCP),b CLSb (NCA),b Globalb Clinicalb Chemistryb Marketing
LEbARbNbIbNbGbGbUbIbDbEb:b CbLIbNbIbCbALb CbHbEbMbIbSbTbRbY 2 TObTbHbEbTAbBbLbEb ObFb CObNbTbENbTbS
, FOREWORD
ClinicalbChemistrybisbanbexcitingbfieldbthatbcombinesbanalyticsbandbinstrumen
tationbwithbinformationbtechnologybandbmanagementbofbworkflow,bstaffbeffic
ienciesbandbhighbvolumebautomation.bThebfieldbisbever-
changingb andbdemandsbstaffbhavebskillsbinbthe bmethodologiesbandbtheirblimit
ations,
technologyb andb troubleshootingb equipment,b asb wellb asb managementb andb abilitybt
obadaptboperationsbtobevolvingbclinicalbneeds.bAtbthebheart,btheblaboratorybis
abservicebtobthebphysicianbprovidingbtestbresultsbthatbarebcriticalbtobdiagnosingb
andbmanagingbpatients.bBut,btheblaboratorybisbalsobabvitalbmemberbofbthebhea
lthcarebteambandbgetsbinvolvedbinbutilization,boperationalbefficienciesbandbim
provingbpatientboutcomes.bIbwasbhonoredbtobbebaskedbtobeditbthisbversionbofbth
ebClinicalbChemistrybLearningbGuide,basbIbhavebspentbnearlyb30byearsbinbthebclinic
alb laboratoryb mentoringb studentsb andb helpingb physiciansb meetb theb needsbofbthe
irbpatients.
ThisbLearningbGuidebisbanbessentialbprimerbtobthebbasicsbofbnotbonlybclinicalbch
emistrybbutblaboratorybmedicine.bItbtouchesbonbqualitybandbessentialsbofbthebme
thodologiesbwebutilizebinbthebdailybanalysisbofbspecimens.bAbwidebrangebofbclin
icalbdisciplines,bincludingbnursingbstudents,bresearchers, bmedicalbstudents,bresi
dents,blabbadministrators bandbgovernment binspectors basbwellbasbmedicalbtechno
logists,bmaybfindbthebcontentsbofbthisbguidebtobbebhelpfulbtobtheirbdailybworkban
dbanbexplanationbofbwhatbgoesbonbinbthebclinicalblaboratorybtobthosebthatbarebno
tbawarebofbthebscience.bIbhopebthatbyoubwillbfindbthisbguidebasbusefulbasbmybstud
entsbandbtechnologistsbhavebinbthebpast!
JamesbH.bNichols,bPh.D.,bDABCC,bFACBbProf
essorbofbPathology,bMicrobiologybandbImmunol
ogy
MedicalbDirectorbofbClinicalbChemistrybMedic
albDirector,bPoint-of-
CarebTestingbVanderbiltbUniversitybSchoolbofb
Medicine
4918DbTVCb(ThebVanderbiltbClinic)
b1301 bMedical bCenterbDrive bNashvi
lle,bTNb37232-5310
(615)b343-5708
FAXb(615)b343-9563
LEbARbNbIbNbGbGbUbIbDbEb:b CbLIbNbIbCbALb CbHbEb 3 TObTbHbEbTAbBbLbEb ObFb CObNbTb
MbIbSbTbRbY ENbTbS
, CONTENTS
INTRODUCTION
CLINICALb CHEMISTRYbLEARNINGb GUIDE .......................................................... 5
SECTIONb 1
INTRODUCTIONbTObCLINICALbCHEMISTRY ...................................................... 6
SECTIONb 2
PRINCIPLESb OFb MEASUREMENT ........................................................................ 18
SECTIONb 3
TESTINGb STRATEGIESb TOb SELECTb FORb Ab SPECIFICb ANALYTE .......................... 30
SECTIONb 4
ACCURACY ........................................................................................................ 41
SECTIONb 5
SOURCESb OFb ERROR ......................................................................................... 55
SECTIONb 6
COMMONbCLINICALbCHEMISTRYbTESTS ........................................................ 66
SECTIONb 7
TESTINGbINbCLINICALbPRACTICE...................................................................... 88
SECTIONb 8
UNITSbOFbMEASURE ........................................................................................ 105
APPENDIX
APPENDIXb A:b GLOSSARYb OFb TERMS ............................................................... 112
APPENDIXbB:bREFERENCES............................................................................ 115
APPENDIXb C:b CORRECTb RESPONSESb TOb REVIEWb QUESTIONS ..................... 116
LEbARbNbIbNbGbGbUbIbDbEb:b CbLIbNbIbCbALb CbHbEb 4
MbIbSbTbRbY
