Practical Clinical Biochemistry: Methods and Interpretations Ranjna Chawla
INDEX
Page numbers followed by f refer to figure and t refer to table
A
Abnormal
blood levels of albumin or immunoglobulins 254
constituents of urine 73
curves 218
Absorption
spectra of hemoglobin 89f
spectroscopy 94
Acetic acid 4
Acid
base balance 131
burns 4
phosphatase 155, 168, 170
procedure 171t
Acidic urine 70
Acquired immunodeficiency syndrome 2, 317
Acrolein test 61f
Acute
allograft rejection 133
coronary syndrome 119
encephalitis 260
glomerulonephritis 132
hepatitis immunological panel 337
infection 230
leukemia 153
meningitis 260
myocardial infarction 117, 288
nephritis 69
pancreatitis 142, 179
pyelonephritis 133
tubular necrosis 69, 133
Addison's disease 285
Adsorption chromatography 269
Adult onset diabetes 208
Agglutination 304
AIDS 2
Alanine aminotransferase 8
Albumin-globulin ratio analysis 161t
Alcoholic liver disease 291f
Alkali burns 4
Alkaline
copper reduction method 205
for determining blood glucose concentration 207t
phosphatase 8, 155, 168
estimation 169t
procedure 169t
tartrate 206
urine 70
Alkaptonuria 271
Alpha
fetoprotein 152, 156
lipoprotein 231
Amino acid disorders 270
Aminonaphthol sulfonic acid 248
Ammonia 31, 32
Ammonium
hydroxide 39
molybdate 248
Amylase 32, 179
Amylopectin 50
Analbuminemia 162
Androgenic steroid treatment 147
Antigen detection in HIV 321
Anuria 69
Apolipoproteins 232
Ascorbic acid 32, 83
saturation test 81, 82f
Aspartate aminotransferase 8, 120
Assessment of
hydration 40
thyroid function and interpretation 146
Atomic
absorption spectroscopy 283
emission spectrophotometer 282f
B
Bacterial meningitis 260
Band pass of spectrophotometer 98f
Barfoed's test 47, 48
Barrier layer cells 99
Basal acid output 64
Basic structure of atom 311
Bence-Jones proteins 74
Benedict's
method for urinary producing sugars 84
qualitative reagent contains 46
quantitative reagents 84
test 45, 48, 50, 77, 86
Benzidine test 77
Berthelot reaction 189
Beta lipoproteinemia 230
Bicarbonate 77
Bilateral renal stones 69
Bile
pigments 75
salts 76
Bilirubin 32
standards 181
Biosynthesis of uric acid from purine 203f
Biuret
reaction 57
test 56, 265
Blood 76
gas analyzer 287
lipids 226
sugar 77, 204
transfusion reaction 69
urea and urea clearance 189
Body water compartments 295f
Bone disease 170
Boric acid 4
Breast cancer 153
Bromination test 61
Bromosulphthalein test 32, 108
Bronchial adenoma 153
B-type natriuretic peptide blood test 121
Buffered starch solution 179
Buffering action of hemoglobin 291f
Burkitt's lymphoma 153
C
Calcium 32
Calculation of
LDL cholesterol 231
urea concentration through calibration curve 191t
Calibration curve 96, 160, 161, 172, 175, 191, 195, 201, 207, 228, 248, 252
Capillary electrophoresis 276
Caraway's method 199, 200t
Carbohydrate antigen 154
Carboxyhemoglobin 87, 89, 91
Carcinoembryonic antigen 152, 157
Carcinoma of pancreas 180
serum lipase 142
Cardiac
failure 289
function tests 116
injury panel 336
troponins 119
Causes of
decreased anion gap 296
hyperbilirubinuria 75
increased anion gap 296
insulin resistance 209
Cellulose acetate electrophoresis 277f
Cerebellar hemangioma 153
Cerebrospinal fluid 31, 36, 259, 260
Cervical carcinoma 153
Cholecystokinin-stimulation test 140
Cholesterol
concentration estimation 228t
crystals 62f
Chronic
glomerulonephritis 132
pancreatitis 180
renal failure 288
Cirrhosis of pancreas 180
Classification of
analyzers 102
hyperglycemia disorders 208
Cloned enzyme donor immunoassay 332
Color reactions for proteins 55
Colorimeter 97, 100
Colorimetric
method 233, 247
technique 256
Colors and complementary colors of visible spectrum 98t
Combined respiratory and metabolic acidosis 289
Components of
atomic absorption spectrophotometer 284f
flame photometer 282f
Composition of
Benedict's quantitative reagents 84
normal urine 68
pancreatic juice 138
Concentration of electrolytes in plasma 296f
Copper
sulfate solution 206
sulphate 46
Coproporphyrin 36
Coronary heart disease 116, 234
Corrected creatinine clearance 196
Cortisone stressed glucose tolerance test 220
Coulometric method 256
C-peptide serum and urine 221
Creatinine
clearance 196
standard stock 194
Cyanmethemoglobin
method for hemoglobin 91
standard 91
D
Degenerative disorders 259
Denaturing polyacrylamide gels 276
Detection of thyroid antibodies 148
Determination of
albumin 160
aminotransferases 174
amylase 140
bilirubin 140
blood urea 189
chloride 263
free and total acidity 64
globulins 261
glucose 262
HDL cholesterol 230
inorganic phosphate in
serum 247
urine 250
LDL cholesterol 231
lipase 140
methemalbumin 142
pH 42
serum
amylase 141
bilirubin 181, 182
chloride 256
creatinine 194
triglycerides 232
urate 199
total
and direct bilirubin 182
protein 261
serum calcium 251
urate in urine 202
Diabetes mellitus 85, 133
Diabetic
ketoacidosis 288
panel 336
Diacetyl monoxime method 190f
Diarrhea 69
Dilution test 132
Diphenylcarbazone indicator 257
Direct
chemiluminescence 333
reading instruments 282
study methods for pancreas 139
vision spectroscope 88
Disc electrophoresis 278
Disodium phenylphosphate 168
Disseminated intravascular coagulation 156
Double
beam spectrophotometer 100
diffusion technique 301
Drabkin's reagent 91
Dubin-Johnson syndrome 184
Duodenal
drainage 37
ulcer 65
E
Early stages of glomerulonephritis 69
Ehrlich's
reagent 76
test for urobilinogen 76
Electrochemiluminescence 158
Electrofocusing gels 275
Electromagnetic spectrum 97f
Electrophoresis 275
Electrophoretic pattern of human blood 276f
Elevation of maternal serum 157
Endocrine gland 138
Enzymatic
colorimetric method 189
method 189, 200, 228, 232
spectrophotometric method 190
Enzyme
amplified chemiluminescence method 333
immunoassay procedure 309f
linked
immunoelectrotransfer blot technique 321f
immunosorbent assays 156, 308
multiplied immunoassay technique 332
Epstein-Barr virus 153
Estimation of sugar in urine 85f
Euthyroid sick syndrome 147
Exclusion chromatography 270
Exocrine
enzymes of pancreas 139f
gland 138
hormones of pancreas 138t
Extended oral glucose tolerance test 220
External
quality control program 25
secretion of pancreas 139
Extrahepatic cholestasis 184
F
Familial hypobetalipoproteinemias 230
Fehling
solution 47
test 47
Ferricyanide method 207
Fevers 69
Fibrosarcoma 153
First-aid and emergency treatment in laboratory 4
Flame photometer 281
Fluorescence polarization immunoassay 332
Fluorescent antibody technique 307f
Foam test 76
Folin's phosphomolybdic acid reagent 206
Fouchet's test 75
Free fatty acid 120
Frequently sampled intravenous glucose tolerance test 220
Fructokinase 86
Fructosamine 223
Fructose 86
Functions of pancreas 138
G
Galactose 86
Gamma-glutamyl transferase 155
Gamma-glutamyl-transpeptidase 8
Gas-liquid chromatography 331
Gastric
carcinoma 65, 153
juice analysis 63
Geiger-Müller counter 315, 315f
Gel diffusion test 301f
Gerhardt's ferric chloride test 75
Gestational diabetes 209
Glacial acetic acid 82
Glass photoemissive tubes 99
Glomerular filtration rate 130, 196
Glucagon 223
Glucose 85, 120
hexokinase method 205
oxidase peroxidase method 205
tolerance test 217, 219
Glutamate dehydrogenase method 190
Glutamic-oxaloacetic transaminase 174
Glutamine formula 114f
Glycerol phosphate oxidase 233
Glycogen 50
metabolism 112f
Glycosylated hemoglobin 222
Gmelin's test 76
Grave's disease 148
Greasy spot test 266
Guaic test 77
H
Half saturation with ammonium sulphate 52
Hay's sulfur test for bile salts 76
Heart disease 176
Heat
and acetic acid test 265
coagulation test 74, 266
Heavy metal
ions 53
poisoning 54
Heller's test 75
Hemochromogen 88, 90
Hemoglobin 87, 89, 91
Hemolytic jaundice 230
Heparin 11
Hepatic
jaundice 184
panel 335
Hepatitis
A total antibody 110
B
core antigen 111
surface antigen 110
virus 110, 111
C virus 111
D virus 112
delta antibody 112
E virus 112
virus 110
Hepatocellular carcinoma 153
High
density lipoprotein cholesterol 226
pressure liquid chromatography 330
HIV antibody tests 319
Hodgkin's disease 153
Homocysteine 119
Hopkins-Cole
reaction for tryptophan 58
test 57
Human
chorionic gonadotropin 152
immunodeficiency virus 2, 317
papilloma virus 153
Humanization of milk 265
Hydroxybutarate dehydrogenase 8
Hypercalcemia 253, 296
Hypercholesterolemia 229
Hyperglycemia 207
Hyperkalemia 284
Hypermagnesemia 296
Hypernatremia 284
Hyperphosphatemia 249, 296
Hyperproteinemia 297
Hypersulfatemia 296
Hypertension panel 335, 336
Hyperthyroidism 147, 230
Hyperthyroxemia panel 337
Hypertriglyceridemia 297
Hyperuricemia 201
Hypoalbuminemia 296
Hypocalcemia 253, 296
Hypocholesterolemia 230
Hypokalemia 285
Hypomagnesemia 296
Hyponatremia 284
Hypophosphatemia 249, 296
Hyposthenuria 132
Hypothyroid panel 336
Hypouricemia 202
I
Immunoelectrophoresis 301, 302f
Immunofixation
electrophoresis 303
in agarose gel 303
Impaired glucose tolerance 218
In vitro measurement of radioisotopes 316
Indirect
stimulation of pancreas 141
study methods for pancreas 141
Indocyanine green 108
Injuries caused by broken glass 5
Inorganic phosphate 8
Instructions for collection of urine sample 67
Insulin
antibodies 221
receptor antibodies 221
resistance type
A 209
B 209
Interfering substances 160, 201, 229
Internal
quality control program 25
standard instruments 282
Intracellular fluid 295
Intracranial neoplasms 153
Intrahepatic cholestasis 184
Iodine
reaction 50
reagent 178
Ion exchange chromatography 269
Ionic composition 260
Ionized calcium 254
Islet cell antibody 221
Isoelectric focusing 275
Isotonic sodium sulfate 206
J
Jaffe's
alkaline picrate method 194
reaction 195
test 72
Juvenile onset diabetes mellitus 208
K
Ketoacidosis 296
Ketone bodies 75, 120
L
Laboratory tests for secondary hypertension 124t
Lactalbumin 264
Lactate dehydrogenase 119, 155
Lactic
acid 63
acidosis 288, 296
Lactose 86, 264
Lag type of tolerance curve 219
L-alanine 174
Lambert-Beer's law 95
L-ascorbic acid 81
L-aspartate 174
LDH isoenzymes 33
Liebermann-Burchard test 62
Lipids 31, 33, 264
Lipoprotein 231
electrophoresis 34
Liquid
chromatography mass spectrometry 331
scintillation counting 313
Litmus paper 43
Liver
and biliary tract diseases 170
disease 176
function tests 107
Low density lipoprotein cholesterol 230t
Lung cancer 153
Lymphoproliferative disorders 153
M
Maclean's test 63
Macroamylasemia 180
Malabsorption syndrome 230
Malignancy panel 337
Malignant
hypertension 77
lymphoma 153
Maple syrup urine disease 271
Mass spectrometry 331
Massive parenchymatous liver damage 230
Maturity onset diabetes of young 209
Maximal acid output 64, 65
Measurement of
binding proteins 146
hormones in plasma 146
osmolality and osmolarity 40
radioactivity 313
Measuring
glucose concentration through calibration curve 207t
uric acid concentration through calibration curve 201t
Medullary carcinoma thyroid 153
Mercuric nitrate solution 257
Mercurimetric method 257
Mesenchymal sarcomas 153
Metabolic
acidosis 288
alkalosis 288
Methemalbumin 88, 92
Methemoglobin 87, 90, 92
Method of
carrying Lundh test 141
carrying out test 217
taking blood specimen 9, 9f
Microscopic hematuria 77
Milk analysis 264
Million's test 57, 58
Minor burns 4, 5
Mixed hyperbilirubinemia 184
Molar solutions 38
Molisch test 45, 46f, 48, 50, 58, 266
Molybdic acid reagent 248
Monitor renal dialysis efficacy 40
Multinodular goiter 148
Multiple
myeloma 153
test analysis 106
Mutant insulin 209
Myocardial infarction 117, 117f
Myoglobin 88, 92, 117
N
Nasopharyngeal carcinoma 153
Neisseria meningitidis 261
Neonatal hypocalcemia 254
Nephrotic syndrome 132, 147
Nessler's method 189
Neural tube defect 157
Neuroblastoma 153
Ninhydrin test 56, 57
Nitroprusside acetic acid test 72
Nonenzymatic method 190f, 233
for cholesterol estimation 227
Nonisotopic immunoassays 146
Nonseminomatous
germ cell 153
testicular tumor 153
Normal glucose tolerance curve 218t
Nucleosides 156
O
Obstructive jaundice 184
Odometric method 178
Odor 70
Oliguria 69
Oncofetal antigens 152
Oral glucose tolerance test 217
Organic
albuminuria 74
solvents 53
Osazone formation test 48
Osteoporosis panel 337
Ovarian cancer 153
Oxalates 11
Oxygen saturation 32
Oxyhemoglobin 87, 88
P
Pancreas and colon cancer 153
Pancreatic
carcinoma 153
enzymes 155
function tests 138
panel 336
Pancreozymin-stimulation test 140
Paper strips 77
Papillary and follicular thyroid carcinoma 148
Paraproteinemia 297
Parathyroid
hormone 149
panel 336
Particle enhanced turbidimetric inhibition immunoassay 331
Partition chromatography 269
Pasteurization and sterilization of milk 265
Pepsin 63
Peptidase 139
Peptones 55
Pernicious anemia 230
Phenylhydrazine test 48
Phenylketonuria 271
Pheochromocytoma 153
Phosphatase acid 34
Phosphate
buffer 178
excretion 250
Phosphohexose isomerase 155
Phosphorus in blood 247
Phosphotungstic acid 200
reduction test 72
Photoconductive cells 99, 100
Photoemissive tubes 99
Photometric determination of alkaline phosphatase 169
Photomultiplier tube 99, 100, 100f
Photosensitive detectors 99
Physical examination of
milk 265
urine 67, 68
Picric acid 194
test 72
Pituitary hormone assay 337
Plasma
osmolality 39, 40
potassium concentration 284
TSH 147
Poisoning 5
Polyacrylamide gel disc electrophoresis 278f
Polyamines 156
Polyclonal gamma globulinemia 297
Polycystic kidney diseases 77
Polymerase chain reaction 322
Polyuria 69
Post-exposure prophylaxis 5
Postrenal uremia 191
Potassium
excretion 131
ferrocyanide 84
thiocyanate 84
Prehepatic jaundice 183
Preparation of hemin crystals 90
Prerenal uremia 191
Preservation of
blood sample 13
sample for estimation of ketone 80
Primary
hepatitis viruses 110
hypothyroidism 147
Procedure for
cholesterol estimation 228t
serum
bilirubin determination 182t
creatinine determination 194t
determining serum urate 200t
measuring urea through non-enzymatic method 190t
Prognostic sign 325
Proinsulin 221
Proportioning pump 104
Prostate
acid phosphatase 153
cancer 153
carcinoma 153
specific antigen 153, 154
Protein 34, 73, 264
Pulmonary panel 337
Q
Qualitative
analysis of gastric juice 63
tests of
cholesterol 62
lipids 60
Quantitative
determination of hemoglobin 90
estimation of albumin 161
R
Radioactive iodine uptake 147
Radioimmunoassay methods 308
Radioimmunometric assays 331
Random access autoanalyzers 102
Reaction of
disaccharides 48
polysaccharides 48
Reagents ferricyanide-cyanide reagent 91
Regurgitation jaundice 184
Renal
carcinoma 153
glycosuria 85, 219
panel 335
tubular acidosis 288
uremia 191
Respiratory
acidosis 288
alkalosis 288
distress in newborn 289
Retention jaundice 183
Ring test 301
Rothera's
nitroprusside test 75
test 77
Rotor syndromes 184
S
Saccharogenic method 178
Sakaguchi
reaction 57
test for guanidine group 58
Salicylate poisoning 296
Salkowaski
test 72
reaction 62
Salt
of ethylenediaminetetra-acetic acid 11
precipitation test 266
Saponification 60
Scales used in photoelectric colorimeters 95f
Schiff's test 72
Scleroprotein 55
Secondary
hepatitis viruses 110
hypothyroidism 147
Secretin-stimulation test 139
Seliwanoff's test 47
Serum
alkaline
and acid phosphatase 168
phosphatase estimation 168
aminotransferases 174
amylase 178
bilirubin 181
calcium 251
chloride 256
creatinine 194
inorganic phosphorus 247
protein
analysis 160t
electrophoresis 34
total proteins and albumin-globulin ratio 159
uric acid 199
Severe
barbiturate poisoning 289
burns 4
edema 69
infections 85
liver and pancreatic diseases 85
malnutrition 230
Sickle cell anemia 77
Single
beam
and double beam optical path 98
spectrophotometer 100
radial immunodiffusion 301, 302f
test analysis 106
Small cell carcinoma lung 153
Sodium
bicarbonate 168, 169
carbonate 4, 46, 168
chloride and magnesium 260
citrate 46, 84
dodecyl sulfate-polyacrylamide gel electrophoresis 275
excretion 131
fluoride 11
hydroxide 39, 169, 171, 194
hypochlorite 6
tungstate 194, 200, 206
Solution of acetic acid 4
Spectral techniques 94
Spectrophotometer 97, 100
Spectrophotometric method 232, 249
Spectroscopic study of pigments 88
Squamous cell carcinoma 153
Standard
amino acid mixtures 271
bicarbonate 287
chloride solution 257
curve 96
deviation 20
phosphate solution 248
pyruvate 175
uric acid solution 200
Starch solution 178
Steroid receptor analysis 156
Stimulation using exogenous hormones 139
Stock
biuret reagent 159
standard solution 206
Storage of
blood sample 13
combined electrode 44
glass electrode 44
HIV positive samples 323
Structures of allopurinol and uric acid 203f
Sulfhemoglobin 88, 92
Sulfonamide therapy 69
Sulfosalicylic acid test 75
Sulfuric acid 194, 247
Sulfur test 57
Systemic lupus erythematosus 133
T
Tartrate-iodide solution 159
TDM technologies 330
Terminal
deoxynucleotidyl transferase 155
deoxyribonucleotidyl transferase 155
Test for
ammonia 71
bile pigments 75
blood and hemoglobin 77
calcium 71
carbohydrates 45
chloride 71
coronary heart disease 116
creatinine 72
inorganic
constituents 71
phosphorus 71
ketone bodies 75
lipids 60
organic
constituents 72
phosphorus 58
proteins 74
reducing sugar in urine 73
starch and dextrins 50
sulfate 71
unsaturation 61
urea 72
uric acid 72
Testicular tumor 153
Therapeutic
drug monitoring 329
monitoring of lithium 285
Thyroglobulin 148
synthetic defect 148
Thyroid
aplasia 148
cancer 149
carcinoma 153
function tests 145
panel 336
scanning 147
stimulating hormone 35, 145
Thyroidectomy 148
Thyroiditis 148
Thyroxine binding globulin 148
Titration of gastric juice with NaOH 64t
Titrimetric method 257
Torch panel 337
Total
acidity 64
insulin 221
Toxemia of pregnancy 74
Transport of blood sample 13
Trichloroacetic acid 247
Triglycerides 232
Trophoblastic tumor 153
Tubeless
gastric analysis 65
pancreatic function test 143
Tuberculous meningitis 260
Tumor 259
associated antigens 156
markers 151
Types of
dysfunctions 131
electrophoresis 275, 276
flame photometers 282
material used for quality control 19
methods used in TDM testing 330
possible acid-base disturbances 288
Typical scintillation counter 314f
U
Unconjugated hyperbilirubinemia 183
Units of radioactivity measurements 311
Upper reference limit 120
Uremia 296
Urinary
ascorbic acid 81
creatinine 196
finding in jaundice 185
reducing sugars 84
urea 192
Urine
chloride 258
concentration or dilution 131
for microalbumin 223
osmolality 41
values 36
Urobilinogen 76
Use of
exogenous thyroid hormone 148
standard and/or calibration curve 161, 169, 171, 175, 191, 195, 201, 228, 248, 252
V
Various parts of flame photometer 282
Vascular disorders 259
Viral
hepatitis 2
meningitis 260
nephropathy 133
Virus
hemagglutination inhibition test 305f
isolation 322
W
Warning rule 23
Water test 132
Weight per unit
volume 38
weight 38
Western blot test 322f
Westguard
multi-rule QC procedure 23f
rules 23
X
Xanthoproteic
reaction 57
test 56
Z
Zollinger-Ellison syndrome 65
Zone electrophoresis 277
×
Chapter Notes

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Practical CLINICAL BIOCHEMISTRY Methods and Interpretations
Practical CLINICAL BIOCHEMISTRY Methods and Interpretations
Fourth Edition
Ranjna Chawla PhD Senior Biochemist GB Pant Hospital New Delhi, India
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Practical Clinical Biochemistry: Methods and Interpretations
First Edition : 1995
Second Edition : 1999
Third Edition : 2003
Reprint : 2006, 2008
Fourth Edition : 2014
9789350909423
Printed at
Preface to the Fourth Edition
I feel deeply indebted to all of you for giving such a tremendous response to the earlier editions of this book. It has been my sincere effort to keep on serving through each new edition.
It gives me great pleasure to introduce the fourth edition of the book titled Practical Clinical Biochemistry: Methods and Interpretations. Keeping in view the latest developments, the book has been thoroughly revised and updated. The salient features of the present revised edition comprise of the following:
For better comprehension, the book has been written in simple, clear and easy-to-understand language. The book will equip the students with basic knowledge of applied practical biochemistry. Any suggestion and constructive comments for improvement of the book will always be welcomed. Please send your suggestions through e-mail to ranjnachawla@yahoo.com
Ranjna Chawla
Preface to the First Edition
Modern medicine is rapidly advancing and laboratory research work has provided the perfect backdrop to the process. Laboratory tests and investigations have become the mainstay of today's clinical practice so much so that the emphasis seems to be shifting from the study of patients to the study of investigative data. The importance of laboratory investigations in diagnostic and prognostic studies and thus in patient care cannot be underestimated.
In the ever-expanding field of biochemistry, it is imperative to keep abreast of the latest developments. As a student and teacher of biochemistry, I have always felt the need for a complete and comprehensive book on practical biochemistry. This book is an outcome of the experience gained by me after having worked in various laboratories at different capacities. The subject has been discussed in a lucid manner in the various chapters brought out in this book. In order to encourage a sense of participation and to instill in the laboratory workers the importance of laboratory results in the evaluation of various diseases, 115 case reports have been included at the end of last chapter. These case reports correlate biochemical findings to the medical interpretation. Recent areas of concern, such as automation, AIDS, quality control, radioisotopes and immunology, have been elaborately dealt with, so that the book would also serve medical undergraduates, teachers of biochemistry and practitioners of medical sciences.
I hope that this effort will be appreciated by all those concerned with practical biochemistry. I welcome constructive criticism and suggestions for the further improvement of this book.
Ranjna Chawla