Clinical Chemistry Blog Notes 20

The 24hr Precept

2009-09-10T04:50:00.000-07:00

this photo was taken at the AUFMC conference room, Shane missing. Hehe

Preceptorship, this is one event every Medtech student looks forward to. This is the 24-hr duty which is done prior to internship. Finally, after 3 and a half years, I have reached the precept. When Sir Ryan announced to us that we were finally embarking on that journey, I had butterflies in my stomach. I did not know what I was feeling. I was happy and sad at the same time! I was happy because finally, this is it, the moment I have been long waiting for, and sad because I have been attached too much to school that I don't want to leave it anymore.

Anyway, I had a very very unique experience during our precept. Everything was so different, and I reminded myself that this is it, this is the real world, there is no more turning back. It was hard adjusting to the environment and the people, but it was FUN! I even had the chance to release results and wander through the empty halls of the hospital in the weee hours of the morning. Yes, that was fun, although I should say, it was a bit creepy! Especially in the 2nd flr of the AUFMC lab(micro section), it was so deserted, but hey, I had the courage to stay there. Thanks to Jim and Eryll. Hahaha.:) Its nice to have boys as friends, because you know they are always a bit braver than yourself. Tick tock tick tock, all of us were waiting for 8am, the time we can go home and sleep! It was hard sleeping at the hard wood of the conference table, what a challenge that was. We were given those fold-a-ble beds but we had to take turns, unfortunately, you first had to compete with Ethel to be given a chance to sleep on those beds. Haha. 24hrs was long! But as time passed by, we were given the chance to go bonding with my precept groupmates. That is one of the joyous moments I will never trade for anything in this world. I will never forget our non-stop eating, our kwentohans, and the many many laughs we shared.

This experience is not only educational, but also it gave us a chance to develop a special bond amongst us groupmates, a memory we will never forget. :)

♥XOXO, jelz

Caught in the middle

2009-09-09T21:18:00.000-07:00

DO YOU AGREE THAT DRUG TESTING SHOULD BE A REQUIREMENT FOR SCHOOL ADMISSION?...
This is one question that is easy to answer, yes ofcourse! But the hard question is WHY?
Why require drug testing? This is to ensure safety of students inside the campus. Also, it sets a standard, that the school is prestigious enough not to accept drug-users. Drugs can cause many adverse effects to the person using it, may it be physically, mentally or socially. It can change one person in many ways. Having a drug user as a student and part of the school isn't a good idea, they can serve as influences to non-users to become potential users, this is in relation to the rampant issue of "peer-pressure." Furthermore, it can be done just as a formality thingy but there's nothing to lose for the part of the school and the incoming students if this is implemented, if you are drug-free why contradict it, right?. :)

BUT WHAT IF IT WAS NOT A REQUIREMENT?
If drug testing isn't a requirement in school, it can also be good in some perspectives. It can give a chance for drug users to go to school, knowing that they will now be apprehended on their choice of being users. People are entitiled to freedom, what if it was their choice to be users? Should they be deprived from learning or going to school? This issue may violate their freedom..

Think about it... Its a very good thought to ponder. Yes, using drugs is bad.. But will you deprive a problematic user from wanting to learn? Will you deprive a user of education?...

Pens up, lets check your answers.

2009-09-05T23:13:00.000-07:00

1-5. When can blood be used as a specimen? Identify 5 tests.

Blood can be used in a wide array of Chemistry studies, as well as Hematological studies.

FBG
BUN
Bilirubin
Uric Acid
Testing for Insulin levels

6. What is the specimen of choice in testing for Insulin levels?

Blood, serum preferred and heparinized blood can be used.

7 & 8. Give 2 other tests that can be used in testing for Insulin levels.

Fasting Plasma Glucose (FPG)
Casual Plasma Glucose (CPG)

9 & 10. What are the two preferred collection tubes to be used in testing for Insulin and Glucose tests?

Red-topped tube
Grey-topped tube

Case Study:

A pregnant woman has been complaining of having a problem when urinating. She consulted the doctor and has been suspected to have UTI. She was sent to the laboratory for some tests. Will blood be used as a specimen of choice in her situation? If yes, explain. If no, what is the specimen to be used?

ANSWER: No, blood cannot be used as a specimen of choice in this situation. It is because, she has been suspected to have UTI, and in testing for this urine will be the specimen of choice.

Brain Cells Activator :)

2009-08-25T20:30:00.000-07:00

1-5. When can blood be used as a specimen? Identify 5 tests.

6. What is the specimen of choice in testing for Insulin levels?

7 & 8. Give 2 other tests that can be used in testing for Insulin levels.

9 & 10. What are the two preferred collection tubes to be used in testing for Insulin and Glucose tests?

Lets keep those brain cells functioning with this case analysis:

When is blood used as a specimen?

2009-08-16T08:13:00.000-07:00

When is blood used as a specimen?

Blood is the specimen of choice for most Clinical Chemistry studies, such as FBG (Fasting Blood Glucose), Bilirubin, BUN (Blood Urea Nitrogen), Uric Acid, and the list goes on and on....

Can blood be used to test Insulin levels?
In testing for Insulin levels, blood is the specimen of choice. The blood sample is drawn from a fasting patient, serum preferred and heparinized blood can be used.

In conjunction with testing for Insulin levels, Fasting Blood Glucose (FBG), Fasting Blood Sugar (FBS), Fasting Plasma Glucose (FPG), and Casual Plasma Glucose (CPG) are also done to determine the sugar level status or if the patient is diabetic or not. This is in relation that Insulin is a regulator of the blood sugar level. These tests make use of vein-drawn blood samples which are then placed in a red or grey-top.

Without any need for professional training, one can monitor his or her glucose level in your own personal home with the use of a portable blood glucose analyzer. The test is called Self- Monitoring of Blood Glucose (SMBG) Testing. Blood is still the specimen of choice for this test, but instead of a 5ml blood sample, only capillary blood is needed because it only needs a minute amount of blood. Capillary blood can be attained by doing a skin puncture on yourself with the use of an automatic lancet. Preferred puncture sites include: fingertips(preferred site), forearm, bicep area, palm of hand, and sometimes calf.

What collection tubes can be used to collect the blood for the Insulin and Glucose tests?
Red-topped tube --this contains no anti-coagulants, it can be used to prepare serum

Gray-topped tube --this tube contains potassium oxalate and sodium fluoride, this is preferred for glucose level testing & glucose tolerance levels

**the above photo shows the AUTHOR and OWNER of this blog, who definetely does NOT LOOK LIKE A SPLOG ;P, performing capillary puncture on a patient.

IT IS HARD TO REMAIN SILENT DESPITE ALL THE BAD THINGS SAID ABOUT US, IT IS HARD TO KEEP MUM ABOUT ALL THE ISSUES, SO I WANT TO SAY THANK YOU TO THOSE WHO TRYING TO PULL US DOWN BECAUSE

"INTRIGUES WILL NOT BE SAID UNLESS WE ARE NOT INTERESTING, AND TWO IF THEY ARE NOT WORTH TALKING ABOUT."

SO I GUESS WE ARE INTERESTING AND WORTH TALKING ABOUT HUH? THANK YOU FOR THE ATTENTION. HAHA. SEEMS LIKE YOU HAVE WASTED MUCH OF YOUR TIME ON US, THANK YOU. YOU HAVE JUST MADE US MORE CONFIDENT TO FACE ALL OF YOU IN DEFENSE OF OUR MENTOR. AND FOR THE RECORD, IF SHE FORCED US TO VOTE, THEN WE SHOULD HAVE VOTED FOR HER. BUT OUR VOTES SPEAK FOR THAT. PEACE Y'ALL.

WE STAND BY YOU, OUR MOTHER.......

Insulin Video

2009-07-12T01:40:00.000-07:00

CREDITS TO: http://www.youtube.com/goinsulin

Answers to Quiz

2009-06-30T05:50:00.000-07:00

Let us review the quiz................. :)

1. Insulin is a hormone that has effects on the body's metabolism.

2. Insulin stores glucose in the blood as glycogen.

3. When testing for insulin RIA is used to give a quantitative assay.

4. Is fasting required prior to testing? YES or NO.

5. Insulin stops the usage of fat as an energy source.

A -- increased insulin level

B -- decreased insulin level

6. A Insulinoma

7. A untreated Type 2 Diabetes mellitus

8. B severe Type 1 Diabetes mellitus

9. A Acromegaly

10. A Cushing's Syndrome

Case Study

1. Other tests such as OGTT (Oral Glucose Tolerance test), FBS (Fasting Blood Sugar), RBS (Random Blood Sugar) could be used to diagnose increased sugar levels, like diabetes, which is the cause of the positive Benedict's and Fehling's tests.

2. Other tests Other tests such as OGTT (Oral Glucose Tolerance test), FBS (Fasting Blood Sugar), RBS (Random Blood Sugar) could be used to diagnose increased sugar levels, like diabetes. In this specific case, diabetes mellitus is diagnosed from the given laboratory tests.

Quiz: Insulin

2009-06-16T06:22:00.000-07:00

**lets keep your brain cells working with this Insulin quiz.:)

1. _______ is a hormone that has effects on the body's metabolism.

2. Insulin stores glucose in the blood as ________.

3. When testing for insulin RIA is used to give a ___________ assay.

4. Is fasting required prior to testing? YES or NO.

5._______ stops the usage of fat as an energy source.

A -- increased insulin level
B -- decreased insulin level

6. Insulinoma

7. untreated Type 2 Diabetes mellitus

8. severe Type 1 Diabetes mellitus

9. Acromegaly

10. Cushing's Syndrome

Case Study( 5pts per case)

Case 1

Marco, a teenager loves to eat and is a little overweight. Lately he noticed that he urinates more frequently, thirsts and hungers more frequently than he usually did, and had lower back pain. He decided to visit the doctor. He was subjected to lab tests, the results are as follows:

Urinalysis

(+) Benedict's Test

(+) Fehling's Test

Protein - trace

What other tests should be done? Why? What brings about a positive Benedicts and Fehling's test?

Case 2

A 60 year old lady subjected herself to laboratory tests, the results are as follows:

RESULTS:

FBS: 215

HDL: 20.47

LDL: 100.36

BUN: 12

What other tests should be done? What can be diagnosed from these results?

Insulin

2009-06-01T05:25:00.000-07:00

INSULIN

What is Insulin?

Insulin is defined as “a hormone that has extensive effects on metabolism and other body functions, such as vascular compliance. Insulin causes cells in the liver, muscle, and fat tissue to take up glucose from the blood, storing it as glycogen in the liver and muscle, and stopping use of fat as an energy source.” (Wikipedia 2009)

Photo by: http://www.chemlin.net/news/2006/oct2006/human-insulin-degrading-enzyme.htm

Testing for Insulin Levels

Testing for insulin is done using a radioimmunoassay that gives a quantitative analysis of serum insulin levels.

Patient Preparation:

Patient should fast from all foods and fluids except water for 10-12 hours prior to testing.

Procedure and Posttest Care:

Obtain 5mL of blood from a fasting person, serum is preferred. Observe standard precautions.

Instruct patient that he/she may resume from his/her usual activities after the test.

Interfering Factors:

Oral hypoglycemic agent ingestion or injection causes elevated insulin levels.

Oral contaceptives and other drugs cause falsely elevated values.

Recently administered radioisotopes affect test results.

In the second to third trimester of pregnancy, there is a relative insulin resistance with a progressive decrease of plasma glucose and immunoreactive insulin.

Agitation and stress.

Hemolysis due to rough handling of the sample.

Reference Values:

NORMAL:

Immunoreactive
Adults: 0-35 IU/mL or 0-243 pmol/L

Children: 0-10 IU/mL or 0-69 pmol/L

Free
Adults: 0-17 IU/mL or 0-118 pmol/L

Children (prepubertal): 0-13 IU/mL or 0-90 pmol/L

Clinical Implications:

Increased insulin levels:

Insulinoma
Type 2 diabetes mellitus, untreated

Acromegaly

Cushing's syndrome

Endogenous administration of insulin (factitious hypoglycemia)

Obesity (most common cause)

Pancreatic islet cell hyperplasia

2. Decreased insulin levels:

Type 1 diabetes mellitus (severe)
hypopituitarism

References:

A Manual of Laboratory and Diagnostic Tests 7th Edition By: Frances Fischbach
Prof. Guide to Diagnostic Tests
http://wikipedia.com

ALOHA!

2009-05-26T21:55:00.001-07:00

welcome! :) hello world.