Introduction to Clinical Biochemistry

Description

This book is a concise introduction to the common blood tests and concepts used in pathology. It is aimed for undergraduate students reading medicine, nursing and midwifery and subjects allied to health such as Biomedical Science. However, since the book uses “example boxes” to explain complex terms in lay language, it should also be accessible to patients and people with a non-clinical background but an interest in the subject. The book is written in an informal style and allows for signposted learning of a complex subject through the use of further reading boxes, making it a suitable revision guide.

Content

About the Author

Professional Qualifications and Memberships

Introduction to Clinical Biochemistry: Interpreting Blood Results

Preface

1. Laboratory tests: Interpreting Results
1.1 A typical blood sciences service
1.2 Variables that may affect a result: Analytical
1.2.1 Analytical sensitivity and specificity
1.3 Standards
1.4 Quality Control: Within batch, between batch, external
1.4.1 Within batch variation
1.4.1 Between batch variation
1.4.1 External quality control
1.5 Control Plots
1.6 Precision, Accuracy, Bias
1.7 Variables that will affect a result: Physiological
1.7.1 Blood collection and storage techniques
1.7.2 The difference between plasma and serum
1.7.3 A haemolysed sample
1.7.4 Reference ranges
1.7.6 Clinical sensitivity and specificity
1.8 Summary

2. Overview of tests
2.1 Summary

3. The blood cells and liquid component: Full Blood Count (FBCs)
3.1 Red Blood Cell Indices
3.1.1 Red Blood Cell Number
3.1.2 Haemoglobin
3.1.3 Mean Cell Volume
3.1.4 Haematocrit (HCT)
3.2 White Blood Cell Indices
3.2.1 White Blood Cell Number
3.2.2 White Cell Differential
3.2.3 Neutrophils
3.2.4 Lymphocytes
3.2.5 Basophils and Eosinophils
3.2.7 Blast Atypical cells
3.3 Clotting Indices
3.3.1 Platelet Number
3.3.2 Prothrombin Time
3.3.3 Partial thromboplastin time
3.3.4 International Normalised Ratio
3.3.5 D-Dimers
3.4 Summary

4. Autoimmune and inflammation
4.1 Inflammation and CRP
4.2 Plasma Viscosity
4.3 Erythrocyte Sedimentation Rate
4.4 The inflammation trilogy

5. Liver function test (LFTs) and Enzymes
5.1 Enzymes
5.1.1 Measuring an enzyme
5.1.2 Activation energy
5.1.3 Factors which affect enzyme rate
5.1.4 Factors which inhibit enzymes
5.1.5 Extracellular vs. Intracellular
5.1.5 Isoenzymes
5.2 Bilirubin
5.3 Liver Enzymes
5.3.1 Aspartate aminotransferase (AST)
5.3.2 Alanine Aminotransferase (ALT)
5.3.3 Gamma-glutamyl transferase (GGT)
5.3.4 Alkaline phosphatase (ALP)
5.4 Summary

6. Kidney function tests and electrolytes (U&Es)
6.1 Electrolytes
6.1.1 Sodium (Na)
6.1.2 Potassium (K)
6.2 Urea and Creatinine
6.3 Glomerular filtration rate (GFR)
6.4 Uric acid and gout
6.5 Summary

7. The bone and calcium (bone profile)
7.1 Corrected calcium
7.2 Calcium control
7.3 Bone diseases
7.3.1 Osteoporosis
7.3.2 Paget’s disease
7.3.3 Osteomalacia and rickets
7.3.4 Differentiating between bone diseases

8. Summary

Preface

This book is primarily aimed at undergraduate students reading medicine, nursing and midwifery and subjects allied to health. It will also be useful to professionals undergoing continuing professional development (CPD) or changing to an extended role who require a background covering physiology and pathology for haematology and biochemistry. Since the book uses “example boxes” to explain complex terms in lay language, it should also be accessible to patients and people with a non-clinical background but an interest in the subject. To facilitate this, each chapter has an introductory paragraph guiding the reader to the example boxes if needed and a summary section.

Chapter 1 examines how to interpret results, with the remaining broadly representing a section of the body or a disease type with chapter 9 as a summary. This should enable a read from cover to cover or equally as a reference with each chapter independent. As this book is an introduction to the area, you may be inspired for further training and reading. There are many excellent resources online, too many to list here, although I would recommend starting with your countries’ primary care provider organisation, respected charities, reputable training companies and higher education institutes for further information.

Study with the textbook using key concepts (these are the headings and sub headings). List the key concepts and attempt to write a few words about each section, and then refer back to the text book.

About the Author

Dr Graham Basten is Associate Head of the School of Allied Health Sciences at De Montfort University (UK). He holds a PhD from the UK government’s Institute of Food Research and has researched and lectured extensively over the past 10 years on clinical biochemistry, nutrition and folate at the Universities of Sheffield and Nottingham (UK). He is a De Montfort University Teacher Fellow and has been nominated for the Vice Chancellor’s Distinguished Teaching Award. As a senior lecturer in Clinical Chemistry, and as leader of the undergraduate Projects module, this expertise and experience is transferred to the concise introductory textbooks written for Book Boon.

Select research publications

1. Blood folate status and expression of proteins involved in immune function, inflammation, and coagulation: biochemical and proteomic changes in the plasma of humans in response to long-term synthetic folic acid supplementation. Duthie SJ, Horgan G, de Roos B, Rucklidge G, Reid M, Duncan G, Pirie L, Basten GP, Powers HJ. J Proteome Res. 2010 Apr 5;9(4):1941-50

2. Sensitivity of markers of DNA stability and DNA repair activity to folate supplementation in healthy volunteers. Basten GP, Duthie SJ, Pirie L, Vaughan N, Hill MH, Powers HJ. Br J Cancer. 2006 Jun 19;94(12):1942-7. Epub 2006 May 30

3. Associations between two common variants C677T and A1298C in the methylenetetrahydrofolate reductase gene and measures of folate metabolism and DNA stability (strand breaks, misincorporated uracil, and DNA methylation status) in human lymphocytes in vivo. Narayanan S, McConnell J, Little J, Sharp L, Piyathilake CJ, Powers H, Basten G, Duthie SJ. Cancer Epidemiol Biomarkers Prev. 2004 Sep;13(9):1436-43

4. Effect of folic Acid supplementation on the folate status of buccal mucosa and lymphocytes. Basten GP, Hill MH, Duthie SJ, Powers HJ. Cancer Epidemiol Biomarkers Prev. 2004 Jul;13(7):1244-9