1 | Clinical Chemistry Prelim
CLINICAL CHEMISTRY PRELIMS - Increased sex hormones such as:
o testosterone (21%)
Chapter 2: Patient Preparation o androstenedione (25%)
o luteinizing hormone (25%)
Analytical procedures performed in the Clinical
Chemistry Laboratory involves three important phases, Fasting
namely:
• The suggested fasting period for assay of common
1. patient preparation
blood metabolites is 8 to 14 hours.
2. specimen collection and processing
3. production of the report. • In case lipid profile (cholesterol and triglycerides) is
performed, it is necessary to fast between 12 to 14
For a reliable laboratory result, important precautions hours because the hypertriglyceridemia produced
must be considered when doing each phase. Analysis of by intake of meals is normally cleared only until 8
metabolites in the blood starts with patient preparation. hours after eating.
There are factors inherent with the patient that will • After eating, all analytes are increased except
significantly affect the result of the assay. inorganic phosphate.
Exercise Prolonged fasting usually affects the following:
Among the transient (temporary or immediate) effects o Increase in bilirubin by 240% after 48 hrs
of exercise are: o Increase in plasma triglyceride (TAG), glycerol,
and FFA but no change in cholesterol after 72
1. Immediate fall and subsequent increase in free hrs
fatty acids o Decrease in plasma glucose (~45 mg/dL after
- To maintain the glucose level to normal, there is 72 hrs)
utilization of free fatty acid (FFA) present in the
plasma. Subsequently, triglyceride stores in the
Diet
adipose tissues are mobilized resulting in increased
FFA.
2. Increased alanine (180%) • Among the physiologic effects that occur after
- Alanine which is the major gluconeogenic amino eating are:
acid is released from muscle proteins by o Increased potassium (K) and TAG
proteolysis. (chylomicrons)
o Increase alkaline phosphatase (ALP) intestinal
3. Increase lactate (300%) isoenzyme
- released by the exercising muscle. Lactate is
brought to the liver and is converted into glucose to • Hypertriglyceridemia (presence of high amounts of
maintain the glucose level to normal. triglycerides in the blood) is normal after eating.
• Chylomicrons which carry exogenous triglyceride
• These increases are a result of heightened accumulate in the blood. They remain there until
metabolic activity during exercise they are cleared by the lipoprotein lipase.
• Long-term effects of exercise are usually seen as • The intestinal isoenzyme of ALP also increases in
changes in the levels of certain enzymes activity after meals, especially in Lewis- positive
particularly those seen in the muscles. secretors and type O or B patients.
• Blood concentrations of sex hormones are also
affected. Among the long-term changes noticeable
are
o Increased creatinine kinase (CK),
o aldolase,
o aspartate aminotransferase (AST)
o lactate dehydrogenase (LD
Prepared by: Joshua S. Manong
CLINICAL CHEMISTRY PRELIMS - Increased sex hormones such as:
o testosterone (21%)
Chapter 2: Patient Preparation o androstenedione (25%)
o luteinizing hormone (25%)
Analytical procedures performed in the Clinical
Chemistry Laboratory involves three important phases, Fasting
namely:
• The suggested fasting period for assay of common
1. patient preparation
blood metabolites is 8 to 14 hours.
2. specimen collection and processing
3. production of the report. • In case lipid profile (cholesterol and triglycerides) is
performed, it is necessary to fast between 12 to 14
For a reliable laboratory result, important precautions hours because the hypertriglyceridemia produced
must be considered when doing each phase. Analysis of by intake of meals is normally cleared only until 8
metabolites in the blood starts with patient preparation. hours after eating.
There are factors inherent with the patient that will • After eating, all analytes are increased except
significantly affect the result of the assay. inorganic phosphate.
Exercise Prolonged fasting usually affects the following:
Among the transient (temporary or immediate) effects o Increase in bilirubin by 240% after 48 hrs
of exercise are: o Increase in plasma triglyceride (TAG), glycerol,
and FFA but no change in cholesterol after 72
1. Immediate fall and subsequent increase in free hrs
fatty acids o Decrease in plasma glucose (~45 mg/dL after
- To maintain the glucose level to normal, there is 72 hrs)
utilization of free fatty acid (FFA) present in the
plasma. Subsequently, triglyceride stores in the
Diet
adipose tissues are mobilized resulting in increased
FFA.
2. Increased alanine (180%) • Among the physiologic effects that occur after
- Alanine which is the major gluconeogenic amino eating are:
acid is released from muscle proteins by o Increased potassium (K) and TAG
proteolysis. (chylomicrons)
o Increase alkaline phosphatase (ALP) intestinal
3. Increase lactate (300%) isoenzyme
- released by the exercising muscle. Lactate is
brought to the liver and is converted into glucose to • Hypertriglyceridemia (presence of high amounts of
maintain the glucose level to normal. triglycerides in the blood) is normal after eating.
• Chylomicrons which carry exogenous triglyceride
• These increases are a result of heightened accumulate in the blood. They remain there until
metabolic activity during exercise they are cleared by the lipoprotein lipase.
• Long-term effects of exercise are usually seen as • The intestinal isoenzyme of ALP also increases in
changes in the levels of certain enzymes activity after meals, especially in Lewis- positive
particularly those seen in the muscles. secretors and type O or B patients.
• Blood concentrations of sex hormones are also
affected. Among the long-term changes noticeable
are
o Increased creatinine kinase (CK),
o aldolase,
o aspartate aminotransferase (AST)
o lactate dehydrogenase (LD
Prepared by: Joshua S. Manong
