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Role of the Biochemistry Department

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Unit 15 - Role of the Pathology Service Assignment 1 - The Biochemistry Department Role of the Biochemistry Department Clinical biochemistry (chemical pathology or clinical chemistry) is the area of pathology that analyses body fluids namely blood and urine. The biochemistry department uses analytical chemical tests to measure important biological chemicals in these fluids to help in the diagnosis and treatment of disease in patients. The Biochemistry Department carries out many types of blood tests. Blood contains a variety of cells suspended in a fluid called plasma. Dissolved in the plasma are many substances, such as electrolytes, nutrients, vitamins, clotting factors, hormones, enzymes and antibodies. Testing and measurement of these different substances help in the diagnoses of many diseases. For example, blood and urine glucose analysis can be used in the diagnoses of the disease diabetes. Measurement of blood cholesterol or triglyceride levels in patients with cardiovascular problems can help in the diagnoses of heart disease. Blood carries these substances to different parts of the body. By analysing its contents biochemists can help to assess the health of major organs or organ systems, including the heart, lungs and respiratory system. For example, blood tests can determine how well the liver, kidney and lungs are functioning and whether there is any infection or inflammation. Examples of How does the Biochemistry Department help with diagnosis of disease? a) Blood Glucose Tests Diabetes Mellitus is a disease where the body is unable to regulate the amount of glucose in the blood properly. It develops when the body no longer responds adequately (becomes resistant) to the natural hormone insulin, or when production of insulin is too low. The body needs insulin to help cells absorb glucose, where it is then converted into energy. ...read more.


Electrons are produced in this reaction and are transferred from the blood to the electrodes. The size of the resulting current is proportional to the concentration of glucose in the specimen and is converted to a blood glucose concentration value displayed on the monitor. c) Glucose Hexokinase BGMs Some BGMs use the reflectometric hexokinase method. When blood is applied to the reagent strip, glucose is phosphorylated to glucose-6-phosphate. This is later oxidized with concurrent reduction of NAD. The NADH formed is directly proportional to the amount of glucose present in the sample. Then the NADH, in the presence of another enzyme, reduces the dye and a coloured product is produced. When the test strip is inserted into the BGM, the photometer measures the light reflected and uses an algorithm to calculate the glucose concentration and displays the result. Equipment needed: Blood Glucose Monitor BGM compatible glucose test strip Lancet Test for Blood Glucose Two blood glucose tests should be carried out on the patient to measure: a) The fasting blood glucose level (blood collected after an 8 to 10 hour fast) b) Oral glucose tolerance test (OGTT). The patient must drink a glucose drink and another glucose test performed two hours after. To carry out the blood glucose test 1. Switch on the BGM. 2. Prick the patients fingertip with the lancet and squeeze to push out a drop of blood. 3. Touch the drop of blood to the reagent pad on the glucose test strip. Capillary action will draw the blood onto the pad. 4. Insert the glucose test strip into the BGM and wait for the glucose concentration reading. Blood Glucose Levels and Their Meanings High levels of glucose usually indicate diabetes but other diseases and conditions can also result in a raised blood glucose. ...read more.


Total cholesterol results and their meanings are shown in the following table: Total Blood Cholesterol (mg/dL) Meaning Less than 200 Desirable range -low risk of heart disease 200 to 239 Borderline-high- at fair risk of having heart disease. A lipid profile test will allow the doctor to know which cholesterol level is high - LDL cholesterol (bad cholesterol) or HDL (good cholesterol). Over 240 High cholesterol - at high risk of heart disease. Expect a lipid profiling test. Cholesterol lowering medication along with a low cholesterol diet will be prescribed. Abnormally high levels of blood cholesterol may indicate the following: � Atherosclerosis � Biliary cirrhosis, which is scarring and blockage of the bile ducts � diet high in cholesterol, saturated fats, calories, or transfats � Familial hyperlipidemia, a condition in which high blood lipids run in a family � Heart attack � High stress � Hypothyroidism or an underactive thyroid gland � Lack of exercise � Nephritic syndrome, which is a kidney disease resulting in loss of protein in the urine � Overweight or obesity � Uncontrolled diabetes Abnormally low levels of cholesterol may indicate the following: � Hyperthyroidism or an overactive thyroid gland � Liver disease � Malabsorption or inadequate absorption of nutrients from the intestines � Malnutrition There is some debate about whether very low cholesterol is bad. Low cholesterol is often seen when there is an existing problem like malnutrition, liver disease, or cancer. However there is no evidence that low cholesterol causes any of these problems. The Cholesterol test is not always used to diagnose or monitor a disease but is also used to estimate the risk of developing heart disease. High blood cholesterol has been associated with artery hardening, heart disease and an increased risk of heart attacks. Therefore, cholesterol testing is considered a routine part of preventive health care. ...read more.

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