Practical Clinical Biochemistry: Methods and Interpretations Ranjna Chawla
INDEX
Page numbers followed by f refer to figure and t refer to table.
A
Abetalipoproteinemia, congenital 264
Absorption
defective 268
spectroscopy 112
Acanthosis nigricans 238
Accidental skin 2
Acetic acid 4
use of 82
Acetoacetate 90, 227
amount of 290
Acetone 90, 273
trace of 167
Achlorhydria 80
Acid 54
base
balance 154
disturbances, types of 323
imbalance 324t
normal values of 323t
status 327, 329
burns 4
conjugated 54
phosphatase 16, 180, 195, 198
procedure 199t
radicals 290
reagent 218
solution 4, 127
strong 1
use of 82
Acidic agents, precipitation by 66
Acidic conditions 218
Acidic solution 54
Acidosis 332
Acquired immunodeficiency syndrome 2, 13, 353
development of 361
diagnosis of 361
disease, advanced 356
early detection of 363
positive 361
virus 3
Acridinium ester 370
Acrolein test 75, 75f
Acute coronary artery syndrome, manifestation of 145
Acute myocardial infarction 136, 137, 148, 323
diagnosis of 136
Acute pancreatitis 165, 167, 206, 207
attack of 285
diagnosis of 167
Addison’s disease 291
Adenosine
diphosphate 150
triphosphate 150
in situ, regeneration of 150
Adrenal function 346
Adrenalin 147
Adrenocorticotropic hormone 15, 19
Adsorption 308
chromatography 303, 308
Agammaglobulinemia, X-linked 344
Agarose gel 310, 338f
Agglutination 339
passive 356
tests 364
Alanine transaminase 16, 147
Albumin 16, 28, 65, 66, 68, 73, 314
abnormal blood levels of 286
Albuminuria 89
Alcohol 67, 212, 384
acts 67
intoxications 52
on heart, effect of 146
Alcoholism 264, 356
Aldosterone production 291
Alimentary tract 219
Alkali 1, 54
burns 4
compounds of 315
syndrome 286
Alkaline
copper reduction method 234, 236t
medium, creatinine in 222
phosphatase 180, 195, 199, 200, 343, 379, 382
estimation 197t
isoenzymes of 386
photometric determination of 197
procedure 196t
tartrate 235
urine 84
Alkaptonuria 305
Allopurinol 232
drug 232
structures of 228f, 232f
Alpha-1 antitrypsin 341
Alpha-cell 161
Alpha-fetoprotein 178
appearance of 182
elevated levels of 182
Alpha-lipoprotein 262
levels 152
Alpha-particle emission 348
Alveolitis 387
American College of Cardiology Foundation 141
American Diabetes Association 243
American Heart Association 141
Amino acids 382
carboxy-terminal fragments of 380
deamination of 217
disorders 304
essential 307
fate of 243
identification of 306f
missing 307
mixtures, standard 306
separation of mixture of 304
Aminotransferases, determination of 201
Ammonia 37, 153, 217
ions 218
test for 86
Ammonium
fluoride 57
hydroxide 51
sulfate 65
Amniotic fluid 8, 11
Amplification 358
Amylase 180, 205, 206
activity 207
determination of 163
Amyloclastic methods 207
Amylopectin 61, 63
Amylose 63
Analytical sigma metric equation, standard 414
Anemia 372, 373, 377, 378
abnormalities suggestive of 378
aplastic 377
causes of 376, 377
chronic hemolytic 230
depends, treatment of 377
diagnosis of 373
forms of 372
hemolytic 372, 378
kinds of 378
normocytic 376
profile 372
severe 198
source of 378
symptoms of 375, 377
types of 376
Angiography, coronary 145
Angiotensin-converting enzyme 147
measuring 147
Animal digestive enzymes gelatin 68
Anion gap 330, 331, 331f, 332
Anorexia 156, 158
Antiarrythmics 366
Antibiotics 366
large doses of 331
Antibody
coated solid 343
enzyme conjugate 343, 369
interaction of 335, 341
Anticoagulants 20
Antidiuretic hormone, stimulate secretion of 334
Antiepileptic
drugs 371
monitoring 367
normal therapeutic range of 367
therapies 367
Antigen
antibody
bound 335
complex 335
precipitate 338
reaction, measurement of 340
detection 358
test 355
interaction of 335, 341
particles carrying 339
Anti-human Immunodeficiency Virus
Drugs Act 362
therapy 362
Anti-human transferrin antibodies 375
Anti-islet cell antibody, detection of 245
Antineoplastics 366
Anti-rejection drugs 366
Antiresorptive agents 381
Antiretroviral therapy 359
Anti-rubella virus 344
Antiserum, nonlabeled 342
Anti-soluble transferrin receptor antibodies 375
Antithyroglobulin, significance of 174
Antithyroid antibodies 175
Anti-toxoplasma gondii 344
Anuria 83, 157
Apolipoprotein 262
measurements 136
studies 262
Apotransferrin 374
loss of 374
Appetite, loss of 156, 158, 159, 332
Arginine vasopressin 53
Arsenomolybdic acid reagent 235
Arterial blood 323, 324f, 327
total CO2 of 327
Artery disease, coronary 145
Ascorbate, determination of 99
Ascorbic acid 99, 100
interference level of 100
quantities of 100
saturation test 98, 98f
Aspartate aminotransferase 136, 139
determination, procedure for 202, 202t
estimation of 202t
Aspartate transaminase 147
Aspirin 377
Asthma 387
bronchial 323
Atherosclerosis, risk of 262
Atom, basic structure of 347
Atomic absorption 112
spectrophotometer, components of 315f
spectroscopy 317
technique 318
Atomic emission spectrophotometer 316f
Atomic number 347
Atomic structure 347
Atomic weight 347
Attacks, hysterical 324
Autoanalyzer method 288
Autoimmune disorders 378
Automated analytic tests 424
Autosomal recessive defect 198
Azido thymidine 363
B
Bacteria 37, 296, 390
Bacterial enzyme B-galactosidase 370
Bar coding technology 123
Barbiturate poisoning, severe 324
Barfoed’s reagent 60
Barfoed’s test 60, 61
Basal acid output 78, 79
Batch analyzer 120
Batch reactors 66
Beall’s list 406
Beer’s law 114
Beer-Lambert law 428
Bence-Jones proteins 90
Benedict’s method 101
Benedict’s quantitative reagents, composition of 101
Benedict’s reaction 59
Benedict’s reagent 60, 101, 102
Benedict’s solution 59
Benedict’s test 58, 59, 59f, 61, 63, 76, 301
Benzene 74
ring system 71
Benzidine test 93
Berthelot reaction 217
Beta-cell 161
Beta-globulins 338
Beta-hydroxybutyric acid 90
Beta-particle emission 348
B-galactosidase catalyzes 369
Bicarbonate 54, 322, 325, 330, 331
chloride 37
specimen’s determination of 163
standard 322
Bicholestadiene monosulfonate 76
Biclonal gammapathies 338
Bile 77
acids 215
capillaries 211
duct obstruction 127
pigments 90
tests for 91
salt 92, 214
deficiency of 268
Biliary tract diseases 197
Bilirubin 43, 131, 214, 226, 227
conjugated 208, 209, 213
determination of 163
increase in 132
reagent, total 210
standards 208
total 209
unconjugated 209
urobilinogen cycle 212, 212f
Binding proteins, measurement of 170
Biochemical bone markers 384
uses of 385
Biochemical parameters 157
Biochemical tests 95, 131, 157, 272
rationale of 426
Biological fluids
collection of 10
preservation of 10
Biological system, general rule of 353
Biuret reaction 69
Biuret test 69, 300
Bladder schistosomiasis 89
Bleeding, causes of 377
Blind study, single and double 392
Blood 77, 92, 157, 381
and hemoglobin, tests for 93
brain barrier 295
capillary 18, 233
cells 242
chemical composition of 18
clotting, defects of 376
collection 5, 257
system 13
count, complete 373
examination 134
filtering procedure 378
for lithium estimation, collection of 320
gas 43
analyzer 322
constituents 323t
parameters 322
glucose
concentration 8
estimate 233
glucose level 95, 244, 245, 254
metabolic sources of 131
hemoglobin 109
hormone studies 175
in urine, presence of 92
lead analysis 321
lipid 256
profile, therapy for lowering 277
loss, chronic 373
normal values for 325
pH 93, 328
value of 328
phosphorus in 279
pressure
diastolic 239
systolic 239
sample 15, 19, 256
precautions for taking 11
preservation of 14
storage of 14, 15
transport of 14, 15
specimen 8
color of 106
method of taking 10
spillage 6
sugar 93, 233
abnormalities of 233
levels, range of 249t
range of 43
test, special 376
transfusion 335, 373, 378
sample tested for 364
urea 217, 225
nitrogen 141, 219, 226, 332
determination of 217
vomiting of 131
Blot technique 357
Body cells 426
Body electrolyte-water balance 333
Body fluids 5
composition 330
placenta 5
Body mass, reduced lean 387
Body water
compartments 330f
total 330, 333
Boiling alcohol 74
Bone
densitometry 384
density, power plate increases 385
disease 197, 199, 387
excessive demineralization of 385
formation 385
markers 381
sensitive marker of 386
gamma-carboxyglutamate protein 382
markers 379
marrow 1
disease 378
iron store 376
matrix protein synthesized 382
metabolism 385
mineral density 379, 383, 385
remodeling 384
resorption markers 383
sialoprotein 383, 384
specific alkaline phosphatase 379, 385
turnover markers 379, 381
advantages of 385
Boric acid 4
Brain 242, 292
function 375
tissue 2
Breast
cancer 380
milk 2
Bromination test 75
Bromine water test 301
Bromsulphthalein
standard solution of 127
test 8, 16, 43, 126
Bronchitis, chronic 323
Bronchodilators 366
B-type natriuretic peptide 140
Buffer 284
concentration of 312
solution 314
Bull’s-eye chart 416f
Burns
minor 5
severe 5
Butyrate 273
C
Caffeine 384
Calcitonin 281
Calcium 28, 37, 43, 197, 293
assay 37
binding protein 382
complex 284
levels, over total 385
reacts 283
standard 284
test for 86, 300
Calculi 97
types of 97
Calibration
curve 199, 219, 223, 230, 236, 258, 280, 284
frequency of 423
Calomel electrode, standard 55
Calorimetric method 279
Calorimetric technique 288
Cancer 182
tissue 198
treatment of 183
Caraway’s method 229, 229t
Carbamazepine 341, 367
Carbohydrate 58, 243, 271
antigen 179
metabolism 249
disordered 165
test for 58, 301, 302
unknown 63
Carbon
dioxide 37, 218
content 43
monoxide 43, 108
tetrachloride 1, 212
Carbonic acid, small amount of 326
Carboxyhemoglobin 17, 105, 108, 109, 111
color of 108
from oxyhemoglobin, test to 108
Carboxy-terminal propeptides 382
Carcinoembryonic antigen 177, 178, 182
Carcinoma, hepatocellular 178
Cardiac function tests 135
Cardiac injury 143t
Cardiac stress, biomarker of 140
Cardiac troponin 138, 149
T exhibits 149
Cardiovascular disease 152, 176
Cataract formation 242
Catecholamine 146
assays 147
Cefoxitin 226, 227
Celiac disease 268, 376, 377, 381, 387
Cell
antigens 335
content 293
growth, regulating 387
of origin 161
Cellular markers 181
Cellulose 39, 343
acetate
electrophoresis 311f
membranes 313f
Central nervous system 324
disturbances of 292
over dosage of 323
Centrifuge tube 427
Cerebral tumors 324
Cerebrospinal fluid 3, 8, 48, 292, 293, 358
components of 41t
sample, parameters in normal 294
Ceruloplasmin 43, 341
Chemical
carcinogens produce cancer 183
reaction 124
spills 7
stimulus 78
Chemiluminescent 183, 370
assay methods 370
immunoassay 181
method 370
Chemotherapy functions 183
Chest pain, history of 145
Chloride 153, 331
determination of 296
excretion in urine 291
ions 289
reabsorption of 290
solution, standard 289
specific ion electrode method 288
test for 86
urinary excretion of 291
Chlorine odor 7
Chloroform 5, 74, 427
Chloropenol red 369
Chlorpromazine 198
Cholecystectomy 265
Cholecystogram 265
Cholecystokinin-stimulation test 163
Cholestasis
extrahepatic 211
intrahepatic 211
Cholesterol 17, 28, 76, 239, 257, 430
concentration estimation 258t
crystals 76f
formation of 76
diet, low 274
esters 258
estimation
enzymatic method for 258
non-enzymatic method for 257
procedure for 258t
total 265
level 172, 266, 273
lowering drugs 277
metabolism 267, 269
oxidase 259
qualitative tests of 76
test for 301
total 260t
value 266
Cholic acid 215
Chromaffin cells 147
Chromatography
exchange 308, 304
partition 303
thin layer 308
type of 308
Chromogen 284
Chromoprotein 109
Chronic disease 372, 377
Chronic inflammatory diseases 387
Chronic obstructive pulmonary
disease 387
disorder 329
Chronic pancreatitis 207
diagnosis of 165
Chronic renal failure 221, 230, 323
acidosis of 290
Chylomicrons 257
Cirrhosis 204
Clinical Laboratories Improvement Act 413
Clinical Laboratory Reagent Water Specification 38
Coagulum, presence of 293
Cockcroft-Gault formula 225
Coils, mixing 122
Collagen
breakdown products 181
cross-linked telopeptide 383
type I 382
College of American Pathologists 37
Colloids 36
Colon 320
carcinoma of 178
Colonoscopy 377, 378
Color coded vacutainer tubes 13
Color reagent 202, 218
Colorimeter 115, 118, 123
Coma 94
severe 325
state 93
Combined respiratory and metabolic
acidosis 324
alkalosis 324
Common analytical technique 112
Conjugation, defective 211
Copeptin 143
Copper sulfate 59
solution 235
Coproporphyrin 47
Coronary artery disease, risk factors for premature 152
Cortisol 240
binding globulin 345
levels, type of 19
storage form of 346
Costochondral junction, swelling of 199
Coulometric method 288, 289
C-peptide serum 252
C-reactive protein 142, 287
test 381
Creatinine 17, 28, 141, 222
clearance 222, 224
estimation 223
reference range for 224t
test 226
estimation of 223
forms 223
kinase 17
phosphate, expense of 137
picrate complex 227
reference range for 224t
tests for 87
value 157, 227
Crigler-Najjar syndrome 211
Crohn’s disease 268, 387
Cupric ion 69
Cushing’s syndrome 249, 291
Cuvettes, different types of 119
Cyanmethemoglobin
method 109
standard 109
Cyclic amp, generation of 285
Cystatin-C 143, 159
Cystine stones 97
Cystinuria 97
Cytomegalovirus 14
Cytoplasm containing proteins 426
Cytotoxic drugs 212
D
Dam method 218
Dawn phenomenon 241
Death, high risk of 359
Degenerative disorders 292
Dehydration
secondary to 94
severe 84
sign of 242
Dehydroepiandrosterone test 381
Delta cell 161
Deoxyribonuclease 162
Deoxyribonucleic acid 426
steps to isolate 427
synthesis of 353
Deoxyribonucleotidyl transferase, terminal 180
Dextrins 63
types of 63
Diabetes 240, 242, 394
adult-onset 238
gestational 238, 387
insipidus 155, 241
symptom of 241
management of 239
mellitus 237, 237f, 241, 247, 260, 264, 273
complications of 245
juvenile-onset 237
long-standing 156
testing for 245
uncontrolled 90, 332
tests for diagnosis of 251
type 2 160
uncontrolled 273
Diabetic ketoacidosis 96, 224, 226, 323
Diacetyl monoxime method 218
Diarrhea 242
suffering from 94
Diazo blank 208
Diazo reagent 208
Diazotized sulfanilic acid 209
Dichromate test 76
Dideoxycytidine 363
Dideoxyinosine didanosine 363
Dideoxythymidine 363
Dideoxynucleoside 363
Dietary amino acid 381
Diethanolamine 284
Differential leukocyte count 296
Digestion, defective 268
Digoxin 370
Dihydroxyvitamin D 380, 386
Diphenyloxazole 350
Direct bilirubin 209
reagent 210
Direct vision spectroscope 106
Directorate General of Health Services Program 28
Disaccharide 104
reactions of 61
Disk electrophoresis 312
Dissolve sodium bicarbonate 235
Diuretic therapy 141
Double beam
method 117
optical path 116
spectrophotometer 119
Double blind method 392
Double diffusion technique 336
Drabkin’s reagent, readymade 109
Drugs 366
particle-bound 369
therapy 393
time for monitoring 367
toxicity, rule out 364
Dubin-Johnson syndrome 127, 211
Dunstan’s test 76
Duodenal drainage 48
Duodenal ulcer 79
Dysfunctions, types of 154
Dyspnea 239
E
Ehrlich’s test for urobilinogen 91, 215
Electrochemiluminescence 182, 183
principle of 184
results of 174
Electrode deionization 40
Electroimmunodiffusion test 425
Electrolyte 10, 41
analyzers 429
balance 331
concentration of 331f, 429
Electromagnetic spectrum 115f
Electron capture 348
Electrophoresis 256, 309, 313f
capillary 310
moving boundary 310
types of 309, 310
Emission flame photometer 318
Encephalitis 292, 293, 324
Endocrine diseases 146
Endocrine tests 47
Endothelial microparticles 142
Endpoint colorimetric method 283
Energy, amount of 318
Enzymatic method 217, 229, 263
Enzymatic reactions 230
Enzymatic spectrophotometric method 218
Enzyme 10, 41, 137, 180
Enzyme activities 202
activity, unit of 43
acts 217
aldolase 147
amplified chemiluminescence method 370
assays 145
concentration 49
creatine kinase 136
defects of 376
deficiencies, congenital 250
glycerol phosphate oxidase 263
group of 201
hexokinase catalyzes 234
immunoassay 36, 39, 170, 358, 364
procedure 344f
levels 132
linked immunoassays 356
linked immunosorbent assay 181, 343, 344, 355, 382
tests 356
linked immunosurveillance assay 364
measurement of 381
multiplied immunoassay technique 369
phenylalanine hydroxylase 305
reverse transcriptase 354
Epilepsy, treatment of 276
Epinephrine 147, 240
Epstein-Barr virus 178
Erythrocyte 16t, 334
membrane 15
microparticles 142
Erythropoiesis 211
Erythropoietic cells, iron requirement of 375
Escherichia coli 133
Estrogen
measure levels of 381
total 384
Ethanol
ingestion 264
metabolism of 325
Ether 74
Ethosuximide 367
Ethylene glycol 209
Ethylenediaminetetraacetic acid, salts of 12
Eukaryotic cells 426
composed of 426
Euphoria, feelings of 366
Euthyroid sick syndrome 172
Exocrine gland 161
Extracellular fluid 52, 283, 330
Extrahepatic obstruction 198
Eyes, yellowness of 213
F
Fallopian tube origin, amylase of 207
Fasting blood glucose
normal 237
zero-hour 247
Fasting plasma cholesterol concentration 271
Fat
large amount of 272
test for 299
unsaturated 430
Fatty acids 240
essential 268
test for presence of 301
unsaturated 75
Fatty liver 127, 268
results in 325
Fecal occult blood test 377
Fehling’s reaction 59
Fehling’s reagent contains 60
Fehling’s solution
A 60
B 60
Fehling’s test 59, 60, 301
Femoral artery 10
Fenugreek seeds 275
Ferric chloride-acetic acid reagent 257
Ferric iron 373
Ferric thiocyanate 288
method 332
Ferricyanide 236
method 236
Ferritin 179, 373, 374
estimation method 374
level test 377
Fetus 172
Fever 224, 239, 324
Fibrinogen 65
Flame photometer 315, 315f
maintenance of 317
parts of 316
principle 315
types of 316
Flu, attack of 356
Fluorescent antibody technique 342f
Fluorochrome-labeled proteins, use of 341
Fluorometer, typical 343f
Fluorometric immunoassays 370
Fluvastatin 277
Foam test 91
Folate 372, 376
naturally good source of 376
Folic acid 37
deficiency anemia 372
Folin’s method 235
Folin’s phosphomolybdic acid 235
reagent 235
Follicle-stimulating hormone 344
Fouchet’s test 91
Free acidity 78
determination of 78
Free cholesterol 259
Free cortisol test 381
Free fatty acid 130, 140
Fructokinase 103, 245
Fructosamine 253
Fructose 103
1-phosphate aldolase 103
Fully-automated total iron-binding capacity measurement method 374
Fungi 362
G
Gag gene 354
Galactitol 94
Galactonate 94
Galactose 103
1-phosphate uridyltransferase 94
Galectin-3 141, 143
Gallbladder bile 215
Gallstones 214
formation, preventing 214
different types of 215
treating 265
Gamma 348
counters 352
globulins, types of 133
glutamyl transferase 180
glutamyl transpeptidase 125
radiation, usual of 349
ray emission 348
ray striking 350
Gas 37
chromatography 308, 346
ionization chamber, use of 350
liquid chromatography 304, 368
Gastric
carcinoma 79
juice
analysis 77, 79
composition of 80
qualitative analysis of 77
titration of 78t
Gaucher’s disease 199
Geiger-Müller
counter 349, 350, 351f
tube 350
Gel diffusion test 336f
Gelatin 68, 73
particle agglutination test 364
Genetic diseases 232
Gerhardt’s ferric chloride test 90
Gestational diabetic curve 249
Gilbert’s syndrome 127, 211
Glame photometer, components of 316f
Gland, endocrine 161
Glass
electrode 55
storage of 56
membrane 55
photoemissive tubes 118
Gliadin, test for 301
Globulin 239
determination of 295
Glomerular dysfunctions 154t
Glomerular filtration
measure 153
rate 10, 154, 224
reflects 220
Glomerular function 153
tests of 153
Glomeruli, abnormality of 221
Glomerulonephritis 89
Glucagon 15, 240, 253
Glucocorticoids 384, 387
Glucose 8, 17, 28, 103, 140, 226, 244, 293, 332
concentration, measuring 236t
determination of 295
dietary supply of 276
energy requirements of 245
fate of 243
fructose 62f
hexokinase method 234
level 296
metabolism 139
oxidase method
advantages of 246
disadvantages of 246
oxidase peroxidase method 234
reaction of 248f, 255f
reducing property of 233
tolerance test 10, 247, 248f, 249, 250
factors affecting 250
Glucuronates 103
Glucuronyltransferase conjugates bilirubin 208
Glutamate
dehydrogenase 218
method 218
production 218
Glutamine formula 133f
Glutaraldehyde 3
Gluten sensitivity tests 381
Glycerol
phosphate oxidase 263
qualitative tests for 75
Glycocholic acid 215
Glycogen metabolism 131f
Glycoprotein 178, 354, 354f
Glycosuria, alimentary 88
Glycosylation 245
Gmelin’s test 91
Good prognostic sign 361
Gout 230
primary 230
secondary 230
treatment of 232
Granulomatous inflammation 127
Graph’s origin 416
Graves’ disease 172
Greasy spot test 301
Growth
differentiation factor 15 143
hormone 344
Guaiac test 93
H
Haptoglobin 309, 341
Harding’s B solution 235
Harm free radicals 267
Hashimoto’s thyroiditis 172, 342
Hay’s sulfur test 77, 92
Head of pancreas, tumor of 163
Healthcare interventions, effects of 390
Heart
aerobic metabolism of 139
disease 145, 182, 260t, 290
coronary 135, 263, 264
failure
chronic 141
symptoms 140
Heat
and acetic acid test 299
and acid, precipitation by 66
coagulation test 89
Heating bath 123f
Heavy metal poisoning 67
Heavy nuclides decay 348
Helicobacter bacteria 80
Helicobacter pylori 80, 250
Helium, nuclei of 348
Heller’s test 90
Hemagglutination 340
inhibition of 340
test, passive 364
Hematemesis 131
Hematocrit 332, 333
Hematology, routine 364
Hematuria 83, 93
microscopic 93
Hemin crystals, preparation of 108
Hemochromogen 106, 108
Hemoconcentration 165
Hemoglobin 17, 105, 107, 109, 111, 237, 255, 332, 372, 376
abnormal 309
absorption spectra of 107f
buffering action of 326f
concentration, fall of 375
defects of 376
detection of 106
estimate glycated 252
forms of 111
glycosylated 252, 255
inherited disorders of 377
levels of 111, 230
molecules 373
native 105
quantitative determination of 108
reason for decrease in 132
Hemoglobinate 54
Hemoglobinuria 83
nocturnal 109
Hemolysis 12, 19, 210
Hemorrhage 224
Henderson-Hasselbalch equation 327
Heparin 12
Hepatic enzymes, activity of 125
Hepatic tumors
primary 204
secondary 204
Hepatitis
A 2
total antibody 128
virus 128
B 3
antigen, detection of 343
core antigen 129
surface antigen 129
vaccination 356
virus 128, 129
Be antigen 129
C virus 130
delta antibody 130
E virus 130
infective 212
markers 128
specific immunoglobulin M 2
viruses
primary 128
secondary 128
Hexokinase 245
High-density lipoprotein cholesterol, estimation of 256
High-energy electromagnetic radiation 348
High-performance liquid chromatography 37, 92
High-polyunsaturated fatty acid 269
High-pressure liquid chromatography 367, 368
Histogram, special type of 421
Hoarseness 175
Hodgkin’s disease 178
Homocysteine 138
levels of 138
test 381
Hopkins-Cole
reaction 71
test 69
Hormone 161, 381, 387
antidiuretic 53, 241
assays 345
calcitonin 175
cholecystokinin-pancreozymin 162
coated red cells 339
in plasma, measurement of 170
luteinizing 344
measuring intact 380
nonlabeled 342
Horseradish peroxidase 181, 343
Human amylases catalyze random cleavage 205
Human biological fluids 369
Human blood 311
electrophoretic pattern of 311f
Human chorionic gonadotropin 178, 344
Human immunodeficiency virus 2, 13, 22, 353, 354, 365
antibody tests 356
antigen 361
diagnosis of 358
disease, end stage 361, 363
fractionation of 356
gene
function of 353f, 354
structure of 353f, 354
genome 354
infected blood 5
infection
diagnosis of 356, 364
possibility of 356
resistant to 363
unusual feature of 354
isolation of 358
positive
samples, storage of 359
therapy of 363
subunits
binding of 356
separation of 357
viral antigen, detection of 361, 363
Human insulin over animal insulin, advantages of 245
Human papillomavirus 178
Human transferrin forms 375
Hydration, assessment of 52
Hydrochloric acid 1, 57, 127
Hydrogen 2
lamp 115
peroxide 3, 234
Hydroxides 1
Hydroxyapatite 384
Hydroxyproline 383
urinary excretion of 181
Hydroxypyridinium cross-links collagen 383
Hydroxyvitamin D 380, 386
Hyperactivity, endocrine 103
Hyperbilirubinemia
mixed 211
unconjugated 210
Hyperbilirubinuria, causes of 91
Hypercalcemia 285, 332
causes of 285
differential diagnosis of 286
Hyperchloremia 290
Hypercholesterolemia 237f, 259
Hyperglycemia 237, 237f
disorders, classification of 237
Hyperkalemia 319
Hyperlipidemia 270
Hyperlipoproteinemia
primary 259
type I 271
Hypermagnesemia 332
Hypernatremia 53, 319
Hyperparathyroidism 199, 285
diagnosis of 200
Hyperphosphatemia 281, 331
Hyperproteinemia 332
Hypersulfatemia 331
Hypertension 135, 146, 387, 394
secondary 146t
cause of 146
Hyperthyroidism 103, 171, 172, 374, 384
Hypertonic solution 334
Hypertriglyceridemia 332
Hypertrophy, early 160
Hyperuricemia 230
Hypervitaminosis D 281
Hypoalbuminemia 331f, 332
Hypocalcemia 285, 331
neonatal 287
Hypochlorhydria 80
Hypochlorite, fresh solution of 6
Hypochlorous acid 6
Hypocholesterolemia 260, 271
Hypoglycemia 130, 296
fasting 239
true 240
Hypoglycemic episodes 239
Hypokalemia 141, 319
Hypolipoproteinemia 271
Hypomagnesemia 331
Hyponatremia 53, 319
Hypoparathyroidism 281, 285
Hypophosphatemia 281, 332
Hypopituitarism 171
Hyposthenuria 155
Hypothermia 323
Hypothesis 388, 389
Hypothyroid hormone levels, low 175
Hypothyroidism 260, 264, 376
incidence of 174
primary 171
Hypotonic solution 334
Hypotriacylglycerolemic effect 275
Hypouricemia 231
Hypoxanthine 231
analog of 231
I
Immunoassay 37, 409
immunoassay-based markers 379
technique 355
Immunodiffusion
method of 425
test 425
Immunoelectrophoresis 336, 337f
Immunofixation 338f
electrophoresis 338
Immunofluorescence test 355
Immunoglobulins 178, 286, 309
classes 339
production 342
Immunoturbidimetric method 369
Indian Association of Pathologists and Microbiologists 29
Indian Citation Index 404
Indocyanine green 126
Infection
greater risk of 80
hazards 2
prevalence of 128
severe 103
Infertility 387
Infiltration, malignant 199
Inflammation, direct effects of 387
Inflammatory bowel disease 376, 387
Injury, metabolic response to 219
Inorganic constituents, tests for 86
Inorganic ions 153, 426
Inorganic phosphate 8
determination of 279, 282
Inorganic phosphorus 17, 281
primary regulators of 281
test for 86, 300
Insulin 244, 251
antibodies 246, 251
dependent diabetes
mellitus 94, 237, 251
dosage of 251
independent tissues 242
resistance, causes of 238
therapy 281
total 251
Intensive care unit 286
Internal Quality Control Program 28
International Federation of Clinical Chemistry and Laboratory Medicine 382
International Osteoporosis Foundation 382
Interstitial fluid 330, 333
Intestinal tract, lower portion of 214
Intestines 377
Intracellular fluid 52, 330, 331f
Intracorpuscular pigment 105
Inulin 224
Iodine
reaction 63
reagent 206
solution 206
test 301, 302
Ion 37
exchange chromatography 303
selective electrode 428, 429
Ionized calcium 286, 379, 384
Iron 17
binding capacity
total 373, 374
unsaturated 373, 374
deficiency
anemia 372, 377
chronic 374
estimation, principle of 373
intake 373
profile 373
storage protein ferritin 373
test for 301
therapy 373
Irritation, causes of 377
Ischemia 145
Islet cell antibody 251
Isoamyl alcohol 427
Isoelectric focusing 310
principle of 314
Isoenzymes 139, 178, 309
Isotonic sodium sulfate 235
Isotope 347
counting equipment 342
labeled hormone complexing, quantity of 342
measurement of 347
use of 347
J
Jaffe’s alkaline picrate method 222
Jaffe’s chromogen 223
Jaffe’s reaction 222224
Jaffe’s test 87
Jaundice 83
differential diagnosis of 125
hemolytic 214
hepatic 211, 215
onset of 128
posthepatic 211
prehepatic 210
regurgitation 211
retention 210
serum enzyme in 125
stages of 204
types of 131, 211t, 212t
urinary finding in 212
Jendrassik, method of 209
K
Kanban cards, use of 409
Kappa chain protein 341
Karmen unit 202
Keratin 68
Ketoacidosis 331
Ketohexoses 60
Ketone 330
bodies 82, 90, 93, 140, 153
formation 241
methods of 96
secondary 273
tests for 90
Ketonemia 237f
Kidney 1, 155
disease 221, 223, 372, 384
end-stage 386
function 426
tests 153
Kinetic method 223
King-Armstrong units 43
Kupffer cells 208
Kwashiorkor 198
L
Lactalbumin 298
Lactate
amount of 290
dehydrogenase 136, 139
isoenzyme, measurement of 139
Lactic acidosis 323, 331, 331f
Lactoglobulin 298
Lactose 63, 103, 299
and maltose, shapes of osazone for 63f
leads, ingestion of 104
test for 300
Lambda chain proteins 341
Lambert-Beer’s law 113
Large glucose load, dispose of 10
Lassitude, feelings of 110
Latex agglutination test 364
Lead poisoning 321
Lecithin-cholesterol acyltransferase 262
Lemon juice 4
Leukemia 230, 232
Leukemic infiltration 127
Leukocyte 142
count, total 296
number of 297
Levey-Jennings
chart, inspection of 424
graph 24
plot 23t, 24, 25f
Liebermann-Burchard test 76
Light-scattering particles, creation of 369
Limb vessels, gangrene of 245
Linoleic acid 268
Lipase 162, 180
determination of 163
Lipid 74, 299
analysis 257
content 429
in plasma, measurement of principal 135
levels 270
respond quite 257
metabolism 244
profile, patterns of 270
qualitative tests of 74
test for 74, 301
Lipoprotein 152, 262, 278
associated phospholipase A2 142
cholesterol, low-density 260t
electrophoresis 45
oxidized low-density 278
protective high-density 266
Liquid chromatography 308, 368
tandem-mass spectrometry 92
Liquid scintillation 352
counting 349
Lithium 28
concentration 370
heparin 382
intoxication 320
therapeutic monitoring of 320
use of 317
Litmus paper 55
Liver 1, 197
cell necrosis 212
cirrhosis of 127, 132, 314, 391
advanced 132
disease 125, 132, 204, 231
alcoholic 326f
patient with 132
possibility of 126
relation to 126
serum enzyme in 125
severe 103
fibrosis of 268
function test 36, 125, 145
Kupffer cells of 208
performs numerous metabolic 125
Lloyd’s reagent 222
Lottery method 394
Lovastatin 277
Low phosphate excretion 282
Low plasma
albumin 159
sodium 290
Low serum iron values 373
Lumbar puncture 296
Lundh test, method of carrying 164
Lung
cancer, types of 380
inflammation 387
Lymphoid cells 335, 342
Lymphoma, malignant 178
Lymphosarcoma 230
M
Maclean’s reagent 78
Maclean’s test 78
Macroamylase 207
Macroamylasemia 207
Macro-CK creatine kinase 151
Macrocytic anemia 376
Macroglobulinemia 314
Macrophages, population of 355
Magnesium 37, 293, 380
chloride solution 260
deficiency 380
Malabsorption 376
syndrome 268
Malignant cells, proliferation of 366
Maltose 63
Mancini method 425
Maple syrup urine disease 305
March hemoglobinuria 109
Mass spectrometry 346, 368
Maturity-onset diabetes of young 238
Maximal acid output 78, 79
Medical Council of India 401
Medium-chain fatty acid 267
Meningitis 292
acute 293
bacterial 293, 296, 297
type of 297
Mental state 10
Mercuric nitrate solution 289
Mercurimetric method 289
Meta-analysis 400
Metabolic acidosis 239, 323, 324, 331
presence of 94
Metabolic acids 325
Metabolic alkalosis 323, 324
Metabolic diseases, potential presence of 331
Metabolic imbalance 332
Metabolic syndrome 387
Metabolism, small molecule 154
Metabolites 41
principle of 146
Metal ions, precipitation by heavy 66
Metanephrine 147
Metastasis, presence of 177
Metastatic carcinoma 127
Methemalbumin 106, 110
determination of 165
Methemoglobin 105, 108, 110, 111
Methionine, metabolism of 381
Methylene bisacrylamide 312
Microcytic anemia 376
Mid-regional pro-adrenomedullin 143
Migration rate 337
Migration, factors influencing rate of 311
Milk
analysis 298
casein, chief protein of 298
chemical analysis of 299
humanization of 299
of human and cow, percentage composition of 298t
pasteurization of 299
physical examination of 299
sterilization of 299
Million’s test 70, 71
Mineral
constituents 299
deficiency 175
test for 300, 301
Molar solutions 50
Molarity 50, 333
Molecular testing 39
Molecules 325, 368
will form, types of 335
Molisch reagent 58
Molisch’s test 58, 58f, 59f, 61, 63, 73, 302
Molybdic acid reagent 280
Monochromators 115
Monoclonal antibodies 136
Monocyte
phenotype 142
population of 355
Monomer, concentration of 309
Monospecific antibody 338
Monospecific antiserum 337
Monounsaturated fatty acids 269
Mosaic plagiarism 406
Mouth-to-mouth respiration 361
Mucin 69, 178
Mucus 77
membrane, inflammation of 157
secreting villous papilloma 320
Muddy sclera 213
Multigravida women 356
Multiple tests affected 423
Muscle
atrophy, secondary 224
contains 147
dystrophies, congenital 224
strength 385
Muscular dystrophy 204
Muscular hypertrophy, congenital 224
Mutant insulin 238
Myeloma, multiple 178, 314
Myeloperoxidase 142
Myocardial fibrosis, biomarker of 141
Myocardial infarction 136f, 137t, 144, 245, 324
development of 270
diagnostic indicators of 136
history of 270
Myoglobin 106, 110, 136, 147, 149
assays, value of 137
estimation 137
molecules 373
toxic 150
Myoglobinemia 149
Myoglobinuria 149
Myositis 224, 387
Myotonia congenita 224
Myxedema 260
Myxoviruses 340
N
Naphthalenesulfonic acid 170
Narcotic over dosage 323
National Accreditation Board for Testing and Calibration Laboratories 35
National AIDS Control Organization 6
Naturopathy, clinical efficacy of 389
N-benzoyl-l-tyrosyl-p-aminobenzoic acid test 166
Nebulizer 316
Nelson’s arsenomolybdic acid 235, 236
Neopterin 360, 364
levels of 360
Nephelometer, basic components of 341f
Nephelometric assays 341
Nephelometry 341
Nephritis 387
chronic 290
Nephropathy 160
Nephrotic syndrome 89, 159, 259, 264, 270, 285, 314
Nervous system abnormality 271
Nessler’s method 217
Nessler’s reagent 217
Neurological disturbances 272
Neurology 399
Neuron specific enolase 178
Neuropathy, inflammatory 387
Neutron, nucleus composed of 347
Nicotinamide adenine dinucleotide 234
Niemann-Pick diseases 272
Ninhydrin 71
reacts 71
test 69, 71
Nippe’s fluid 108
Nitric acid 1
Nitrocellulose strips 357
Nitrogen 37
excretion 242
Nitrogenous waste products, retention of 221
Nitroprusside acts 217
Nitroprusside test 87
Nitroprusside-acetic acid test 87
Noncollagenous markers 383, 384
Noncovalent intermolecular forces 335
Nondietary amino acid 381
Nonenzymatic method 218, 218t, 264
Noninsulin-dependent diabetes 241
mellitus 237, 251
characteristics of 238
Noninvasive tests 145
Nonisotopic immunoassays 170
Nonparametric statistics, sample size for 396
Nonparticle-bound drug 369
Nonprobability sampling 393, 395
Nonproportional quota sampling 395
Nonprotein nitrogen 230
Nonrandomized control trials 389, 390
Nonrandomized trial 390
design 390
Nonseminomatous germ cell 178
Noradrenalin 147
Norepinephrine 147
Notoriously error-prone 362
Noxious exposures 390, 391
N-terminal
assays 380
propeptides 382
N-terminal-pro-brain natriuretic peptide 143
Nuclear species 347
Nuclease 180
Nucleic acid binding assays 39
Nucleosides 181
Nuclide 347
Null hypothesis 389
Nutrient deficiencies 426
Nutrition, poor 387
O
Oakley-Fulthorpe procedure 425
Obesity 264
reason of 268
Obstruction, intrahepatic 198
Obstructive jaundice 211, 260
resulting in 214
O-cresolphthalein complexone 283
Odor 84
Oligoclonal band 338
Oliguria 83
Omega-3 fatty acids 430
supplements 278
Omega-6 fatty acids 430
Omega-6 to omega-3 fatty acids, ratio of 275
Oncofetal
antigens 178
proteins 182
Opaque sealed envelopes, use of 392
Operational process specifications charts 417
Ophthalmology 399
Opportunistic infection 359
OPSpecs chart 417f
Optical density 243
Oral contraceptives 251
Oral glucose tolerance 247
test 250, 253
Oral hypoglycemic agents 251
Organelles 426
Organic albuminuria 89
Organic constituents 82
tests for 87
Organic contamination 36, 37
Organic fluorescent substance 349
Organic phosphorus, test for 73
Organic renal disease 104
Organic solvent, addition of 66
Organic solvents 1
precipitation by 66
Oropharyngeal candidiasis 362
Osazone 62f
crystals, shape of 102
formation 61, 62
test 61
test 300
Osmolality 53, 333
in plasma, normal reference range of 334
out of 53
Osmolarity 52, 53, 333
out of 53
Osmometer 333, 334
Osmosis, reverse 38, 40
Ossification 379
Osteitis deformans 197
Osteocalcin 384
levels 382
use of 386
Osteogenic sarcoma 197
Osteomalacia 197
Osteoporosis 379
causes of 384
diagnosis of 384
monitoring of 384
prone to 385
role of exercise in preventing 385
O-toluidine 234
Ouchterlony double diffusion 425
Ouchterlony test 425
Oudin procedure 425
Ovarian cancer 392
Oxalates 12
Oxidative rancidity 276
Oxidative stress 142
Oxygen 37
saturation 43
Oxyhemoglobin 105, 107, 325
Oxyhemoglobinate 54
P
Packed cell volume 12
Paget’s disease 197, 199, 286, 382
suffering from 200
Pain
abdominal 271, 133, 332
acute bilateral 157
angina 144
Paired and unpaired tests 393
Pancreas
carcinoma of 165, 207
cirrhosis of 207
direct study methods for 162
exocrine
enzymes of 162f
hormones of 161t
external secretion of 161, 162
functions of 161
indirect
stimulation of 164
study methods for 164
internal secretions of 161
Pancreatic chymotrypsin splits 166, 167
Pancreatic diabetes 167
Pancreatic disease 103
tests in 162
Pancreatic enzymes 180
Pancreatic fistula 323
Pancreatic function tests 161
Pancreatic juice 54
chemical characteristics of 161
composition of 161
Pancreatic polypeptide 161
Pancreozymin-stimulation test 163
Pandy’s solution 295
Paper chromatography 304, 306f
Paper strips 93
Paracetamol 212
Paralysis 245
Parametric statistics, sample sizes for 396
Paraproteinemia 332
Paraproteins, low levels of 338
Parasite, blood smear for 296
Parasitic infections 372
Parathyroid
disorders, management of 379
gland 380
hormone 15, 281, 379, 380, 385
measurement of 380
related protein 380
Parenchymatous liver damage, effect of 266
Pareto chart 421
Peak concentration testing 367
Pentoses 103
Pepsin 78
Peptidase 162
Peptide assays 383
Peptide bonds 166, 383
Peptone 69, 73
Pericardial fluid 11
Perinatally exposed infants 361
Pernicious anemia 230
Peroxidase, presence of 259
Peroxides 2
Persistent generalized lymphadenopathy 355
Personal protective equipment 3
pH 84, 299
blood values of 325
causes 332
determination of 54, 55
electrode 57
electrometric determination of 56f
helpful to body 80
measurement, primary standards for 322
meter
modern 55
operation of 55
paper 55
significance of 54
values 54
low 54
Pharmacy controlled 392
Phenobarb 341
Phenol
solution 196
standard 196
Phenylacetate 307
Phenylalanine 307
Phenylhydrazine test 61
Phenylketonuria 305, 307
classical 307
Phenyllactate 307
Phenyl-oxazolylbenzene 350
Phenylpyruvate 307
Phenytoin 341, 367
Phosphate 330
acute shift of 281
buffer 54, 205
excretion 282
part 281
solution, standard 280
Phosphaturia 282
Phosphodiester linkage 363
Phosphoenolpyruvate 234
Phospholipids, oxidized 142
Phosphorus 197, 199, 380
concentration 280t
estimation in blood, procedure for 280t
inorganic 45, 47
Phosphotungstate 261
method 231
reagent 260
Phosphotungstic acid 229
reduction test 87
Photocells 117
Photocolorimeter, essential parts of 115
Photoconductive cells 118
Photoelectric colorimeters 113f, 114
Photoluminescence 183
Photometer 112
Photometric instruments, types of 115
Photomultiplier tube 118, 118f, 349
Photons 350
Photosensitive detectors 117
Physical test 74
Picric acid 2, 66
test 87
Pipette misadjustment 423
Plagiarism 406
detection 406
Plasma 11, 14, 16t, 18, 234, 305, 306, 330
amylase 206, 207
calcium 283
cells 342, 344
constituents 8, 9t
creatinine 226
level 226
determinations 154
drug concentrations 367
insulin 238
interstitial fluid 331f
lipoproteins, families of 135t
osmolality 51, 52
osmolarity 332, 333
calculated 333
measures 333
potassium concentration 319
proteins 10
concentration of 333
sample 428
serum instead of 136
sodium concentration 319
specific gravity 332
thyroid-stimulating hormone 171
visual inspection of 257
Plasmapheresis 378
Plasminogen 152
Plastic microwell coated 358
Platelet 142
Plavix 377
Pleural fluid 11
Pleural metastatic tumors 352
Plus serum iron 374
Pneumococci, typing of 336
Pneumonitis 239
Pol gene 354
Polyacrylamide gel
disk electrophoresis 312f
electrophoresis 356
Polyamines 181
Polyclonal anti-HIV antibody 358, 361
Polyclonal gammaglobulinemia 332
Polycystic ovarian disease 387
Polycythemia 230
Polydipsia, compulsive 84
Polymerase chain reaction 37, 358, 426
test 355, 358
Polymerase enzyme, addition of 358
Polymyositis 204
Polysaccharides, reactions of 61
Polyspecific antiserum 337
Polystirene beads 361
Polystyrene latex 339
Polyunsaturated fats 269, 430
heating of 275
Polyunsaturated fatty acids, effect of 269
Polyuria 83, 239, 241
Porphobilinogen 91
analysis of 92
Postprandial plasma glucose level 244
Postrenal uremia 219
Poststomach surgery 250
Postural hypotension 332
Posture 8
Potassium 28, 45, 293, 318, 331, 426
deficiency, symptoms of 426
excretion 154
ferrocyanide 101
hydrogen sulfate 75
mercuric iodide 217
thiocyanate 101
Potential infectivity 129
Pravastatin 277
Precipitation test 336
Precision 32
Predominant cation 330
Pre-eclampsia diabetes 387
Pregnancy, toxemia of 89
Pregnancy-related complications 387
Premature infants 272
Pre-packaged foods 430
Prerenal azotemia 226
Prerenal uremia 219
Primidone 367
Procollagen, type I 382
Progesterone 344
Prognostic sign 361
Proinsulin 251
Prolactin 344
Prophylaxis, post-exposure 6
Proprotein convertase 142
Prospective cohort study 391
Prostate
acid phosphatase 178
cancer 178
carcinoma 178
enlargement of 220
specific antigen 177, 179
Protein 65, 66, 68, 89, 179, 298, 330
abnormal 429
color reaction of 68, 69t
decreases 67
determination of 341
free filtrate 289
general reactions of 69
glycosylated 248f
increases, solubility of 67
levels of 428
precipitation reactions for 65
synthesis 131
test for 89, 299, 301, 302
total 46
trace of 97
unknown 73
Protein-protein interactions 67
Proteinuria 95
degree of 97
mechanism of 95, 96f
Proteolytic enzymes 68
Protons
nucleus composed of 347
plus neutrons 347
Pruritus 156
Pseudohyponatremia 429
Psychiatric examination 157
Pulmonary fibrosis 323
Purine metabolism 228
Pyelonephritis 89
Pyrexia 219
Pyridinium compounds 383
Pyridinoline and deoxypyridinoline, measurement of 383
Pyridoxal phosphate correlates 204
Q
Quality control
data, monitoring 24
material, type of 21
procedure, multirule 25
sample 24
type of material used for 21
Quality goal index 424
Quality requirement chosen 420
Quasi-experimental design, type of 390
Quenching gas 351
R
Radial immunodiffusion 136, 425
Radiation detection, method of 350
Radioactive decay 348
rate of 349
Radioactive iodine 171, 369
Radioactive material 352
Radioactivity
amount of 348
measurement 349
units of 347
principles of 348
Radioimmunoassay 136, 170, 342, 382, 386
introduction of 347
Radioimmunometric assays 368
Radioiodine labeled hormone competes 342
Radioisotopes
applications of 351
in vitro measurement of 351
uses of 351
Random access autoanalyzers 120
Random numbers, table of 394
Randomized controlled
clinical trial, type of 392
trial 391, 389, 390
Rapid heartbeat 375
Reagent
1-amino-2-naphthol-4-sulfonic acid 279
composition 210
ferricyanide–cyanide reagent 109
handling 124
manufacturer 412
solution 30
Receptor molecule 354
Rectum 320
Red blood cell 12, 372, 373
count, total 376
fragility 376
inherited abnormalities of 372
production 375, 377
total amount of 372
Red cell 339
agglutination of 340
destruction 373
folate 376
from plasma 15
protoporphyrin level 376
synthesis 373
volume of 12
Relaxing bronchial smooth muscle 366
Renal analytes 141
Renal azotemia 226
Renal clearance, reduced 137
Renal dialysis efficacy, monitor 53
Renal disease 97, 146, 387
stages of 160
Renal excretion 320
Renal failure 226
acute 221
advanced 285
concentration test of 155
end-stage 160
undergoing dialysis 157
Renal function
evaluation of 157
grading of 221
tests 160
markers of 159
Renal glycosuria 103, 104, 249, 250
Renal insufficiency 281
Renal lesion, microscopic 160
Renal losses 320
Renal medulla 242
Renal tubular
acidosis 323
disease 320
function, signs of impaired 155
Renal uremia 219
Renin-angiotensin system, components of 147
Represent drug over dosage 367
Research hierarchy 399
Research hypothesis 389
Research methods 388
Research objectives 389
Research question 388, 389
Research reporting guidelines 399
Research work 388
Respiratory acidosis 323, 324
Respiratory alkalosis 323, 324
Respiratory care 393
Respiratory compensation, partial 94
Respiratory depression 325
Respiratory distress
in newborn 324
syndrome, causes of 272
Respiratory failure 329
Reticulocyte
count helps 377
levels of 377
Reticuloendothelial system 208
Retinal protein, glycosylation of 245
Retroviral gene, typical 354
Rheumatoid arthritis 372, 374
management of 389
Rheumatoid factor, presence of 356
Rhombic shaped crystal 76
Ribonuclease 162, 180
Rickets 197, 200
Rickety rosary 199
Ring test 336
Rochelle’s salt 60
Rocket immunoelectrophoresis 338
Rothera’s nitroprusside test 90
Rothera’s test 93
Rotor syndrome 211
Rutherford’s planetary model of atoms 347
S
Saccharogenic
analysis 205
method 205, 207
Saffola 268
Sakaguchi reaction 70
Sakaguchi test for guanidine group 71
Salicylate 251
Salicylate poisoning 324, 331
Saline, normal 206
Saliva 2, 8, 54, 381
hormone testing in pregnancy 345
sample 345
difficulties 345
Salivary estriol spikes 345
Salivary gland disease 207
Salivary testosterone levels, elevated 346
Salkowaski test 76, 87
Salmonellae 339
Sample
collection 359, 386
cuvettes 116
delivery 123
dilution 317
handling 123
information required 367
instability 386
preparation 123
type of 16t, 18
Sarcoidosis 286
Saturate serum transferrin 374
Saturated fat 430
Saturated fatty acids 269
long-chain 275
Scholarly article 400
Scintillation counting 349
Sclera, yellowness of 214
Scleroprotein 68
Sclerosis, multiple 387, 394
Scurvy 198
Secretin-stimulation test 162
Secretory phospholipase 142
Seliwanoff’s test 60, 61f
Semiautoanalyzers 120
Semiconscious condition 156
Semi-quantitative analysis 96
Sensitivity 31
evaluates 31
Sepsis 224
Septicemia 324
Sequencing gels 310
Sequential analysis 124
Seroconversion 356, 364
process of 361
Serum 2, 4, 11, 18, 218, 234
acid phosphatase determination 199
albumin 126, 239, 426
alkaline phosphatase 126
activity, estimation of 197
estimation 195
highest levels of 197
aminotransferases 201
amylase 205, 207
determination of 164
estimation 205
analytes 136
and urinary urate values 231
aspartate aminotransferase 131
bilirubin 208, 211
determination of 208, 209, 209t
direct 214
levels 126
total 214
bone 382
calcium 283
chronic elevation of 286
determination of 284t
levels of 199
normal 285
chloride 288
concentrations, elevated 290
determination of 288
overestimation of 332
cholesterol 239
concentration 375
creatinine 225
concentration of 223, 223t
determination 222, 223t
normal 223
electrolytes 134
enzyme 201
activities 137t
ferritin levels 179
folate 376
glucose estimation 236
hydroxyproline 383
inorganic phosphorus 279
iron 373
lactate dehydrogenase 139
lipase, determination of 165
lipid levels 259
lipoprotein levels 259
lithium 320, 321t
low values of 204
myoglobin
determinations 149
elevation of 137
osteocalcin 382
phosphorus 280
plasma, components of 41t
potassium 426
preferred over plasma 18
protein 309
components, variety of 342
electrophoresis 46, 313f
separation of 310
represents maximum concentration 127
samples 345
sodium 426
underestimation of 332
total alkaline phosphatase 381
total proteins 158
transaminases 126
transferrin receptor 373, 375
triglyceride 239
determination of 263
values 264
urate
determination of 229
estimation 231
procedure of determining 229t
urea 157
estimation 219
uric acid 228
visual inspection of 257
Sex hormone 384
binding globulin 345
Sexual contact 365
SI unit 41
systems 43
Sickle cell
anemia 378
crisis 332
disease 332
Sigma beyond six, quantification of 414t
Sigma metric 411t, 422, 423
benefits of 423
practicing 420
run size nomogram 418f
scale 410
zones superimposed 416
Sigma value 414
Simultaneous treatments 393
Simvastatin 277
Single beam spectrophotometer 119
Single blind researchers 392
Single nucleotide polymorphism 40
Single radial immunodiffusion 336, 337f
Six sigma 414, 419
aim of 409
benefits 419
level 408
limitations 420
methods 419
metrics 415f
Skeletal muscle
damage 147
diseases of 204
Snowball sampling 395
Sodium 28, 37, 318
barbitone solution 163
carbonate 4, 59
chloride 293
solution 294
citrate 59, 101
dodecyl sulphate 428
excretion 154
fluoride 12, 13
hydroxide 51, 202
solution 127, 163
hypochlorite 3
solution 6, 359
nitrite 209
volume of 216
potassium tartrate 60
tungstate 229, 235
Solubility test 75
Somatostatin 161
Somatotropin 240
Somogyi’s effect 241
Somogyi’s method, disadvantages of 207
Somogyi’s phenomenon 241
Somogyi’s units 43
Sophistication, degree of 114
Sorbitol, accumulation of 242
Soy proteins 274, 276
Specimen collection
and preservation 81
and storage 138
Spectral techniques 112
Spectrophotometer 115, 118
Spectrophotometric method 201, 280
Spermatozoa 150
Spinal column 292
Spinal fluid 296
Spleen
enlarged 378
Gaucher’s disease of 199
removal surgery 378
Splenectomy 378
Starch 61
and dextrins, tests for 63
hydrolysis 301
solution 205
Statistical methods 398
Statistical quality control 412
Steroid drugs 250
Steroid hormone metabolites 346
Steroid receptor analysis 181
Sterols 76
Stock calcium standard 284
Stock standard 196
solution 236
Stock urea standard 218
Stomach 377
Stool color 211
Streptococci, typing of 336
Streptococcus 109
Stress 273
inhibition 148
Sudden death 273
Sugar in urine, estimation of 102f
Sulfanilic acid 208, 209
Sulfasalazine 372
Sulfate 37, 330
test for 86
Sulfhemoglobin 106, 110, 111
Sulfhydryl compounds 99
Sulfonylureas act 241
Sulfosalicylic acid 294
test 90
Sulfur
reaction 72
test 70
Sulfuric acid 1, 279
Swallowing, trouble 175
Synovitis 352
Synthesis 126
Synthetic cholesterol-free formula diet 265
Systematic random sampling 394
T
T cells 2, 360
system 345
Tartrate-resistant acid phosphatase 383, 384
Taurocholic acid 215
Tears 2
Technician’s time 408
Testicular tumor 178
Testosterone, measure levels of 381
Tetracycline 212
Tetramethylethylenediamine 312
Thalassemia 378
Theophylline 341
Therapeutic drug
assay 344
monitoring 39, 366
technologies 368
testing 370
testing, type of 368
Thiazide diuretics 251, 286
Thiosemicarbazide 218
Third party controls 36
Thorium 115
Throat swab 296
Thrombosis 142t
Thymol, use of 82
Thyroglobulin 172
molecule 169
Thyroid 351
antibodies, detection of 172
carcinomas 352
fine-needle aspiration biopsy of 175
follicular cells 169
function
assessment of 170
test 146, 169, 381
hormones 47
estimation of 174
levels of 174
production of 169
related hormones, measuring 169
stimulating hormone 47, 169, 344, 381
tumor, size of 175
Thyroid-stimulating
hormone
estimation of 170
levels of 175
immunoglobulin, presence of 172
Thyrotropin
quantitative determination of 170
releasing hormone 169
Thyroxine binding
globulin 47
proteins 172
Tissue
grafting 335
specificity 382
Tolerance curve, lag type of 249
Tolerance test 250
Total calcium, corrected value of 287
Total protein, determination of 294
Total serum calcium
determination of 283
estimation of 283
Toxic
hepatitis 127
states 219
substances 1
Toxicity
suspected 367
symptoms 381
Toxicology 39
Toxins 390
screening for 52
Toyota production system 408
Trans fat 430
disadvantages of 430
Trans fatty acids 269
Transaminases 201
Transcellular fluid 330, 333
Transferrin 341, 373, 375
bound circulating iron, amount of 373
bound iron 373
genetic variants of 309
receptor, genetic absence of 375
saturation 373, 375
Transmembrane proteins 354
Transmission, modes of 365
Trauma 293
Trichloroacetic acid 66, 279
Triglyceride 8, 18, 135, 257, 263
concentration 262
digestion of 267
Triglyceridemia 264
Trigonella foenum-graecum 275
Triiodothyronine 169
Troponin 148
C 149
I 143, 149
importance of 148
T 143, 149
level indicates 149
Trypsin 180
determination of 163
Tubeless gastric analysis 79
Tubeless pancreatic function test 166
Tuberculous meningitis 293
Tubular dysfunctions 154t
Tubular excretion, inhibition of 231
Tubular function
measurement of 154
tests of 154
Tubular reactors 67
Tumor 292
antigens 335
benign 147
cell lines 360
malignant 373
markers 46, 176
confirmation 177
methodology for 181
monitoring 177
necrosis factor 287
Tungstic acid 222, 229
Turbidimetric inhibition immunoassay, particle enhanced 369
Turbidimetric method 207
Turbidimetric procedures 207
Turbidimetry measures 340
Tyrosine 307
U
Ulcerative colitis 387
Ultracentrifugation 256
Ultrafiltration 40
Ultraviolet
B 387
light 115
preferred to 115
Unity interlaboratory program 422
Unstable angina pectoris 149
Upper respiratory catarrh 157
Urea 18, 28, 217
clearance 217, 220
calculations 220
interpretation 221
technique 220
concentration increases 221
excretion of 217
test for 87
to decrease turbidity 283
Uremia 331
Uremic sera 237
Urethra resulting 89
Urethral stricture 220
Uric acid 18, 23, 153, 231, 232
biosynthesis of 232f
concentration, measuring 230t
formation of 232
solution 229
standard 229
structures of 228f, 232f
tests for 87
Uricase methods 231
Urinalysis abnormalities 155t
Urinary amylase 133
Urinary ascorbate 99
Urinary ascorbic acid 98
Urinary calcium 379
Urinary creatinine 87, 224
Urinary free deoxypyridinoline 383
Urinary hydroxyproline 383, 384
Urinary pyridinium collagen 383, 384
Urinary system diseases, common 155t
Urinary total pyridinoline 383
Urinary tract infection, severe 89
Urinary urate 231
Urinary urea 220
Urine 2, 11, 252, 305, 328
abnormal constituents of 88
analysis 100
bile pigments 214
bilirubin 211
chemistry of normal 86
chloride 290
color, physical examination of 82
components of 41t
composition of normal 82
concentration 154
contains, normal 82
density of 221
dipstick 95
examination 133
excretion of 220
for microalbumin 253
metanephrine test, total 147
osmolality 53
osmometry 53
physical examination of 81
potassium 318
reducing
substances in 102
sugars in 101
sample 81, 346
collection of 81
difficulties of 346
precautions before analyzing 81
preservatives for 82
turbidity in 85
sodium 318
sugar 242
test
for reducing sugar in 88
in multistix 100
urobilinogen 211
values 47
Urobilinogen 91
colorless 216
Uterine fibroids 378
V. cholerae 333
Vacutainers 13
Vagina, secretions of 89
Vaginal fluid 2
Valproic acid 341, 367
Vanillylmandellic acid 147
Vasculitis 387
Venous blood 10
Venous stasis 8
Verbatim report 406
Vibrio cholera, stool test for 333
Video capsule endoscopy 377
Viral antigen reference bands 361
Viral drug resistance, analysis of 365
Viral hepatitis 2, 127, 128
A 212
B 134
Viral meningitis 293
Viral replication 129
Virus
culture 358
test 355
hemagglutination inhibition test 340f
isolation 358, 361, 363
test 355
Visual examination 176
Visual procedures 166
Vitamin 278
A
anticancerous 182
deficiencies 372
B12 372, 373, 375, 378
deficiency 378
B9 372, 373
C 100
D 384, 387
insufficient dietary intake of 384
metabolites 281
role of 387
status 379
synthesize 384
total requirement for 387
toxic levels of 381
toxicity, indicator of 380
D2 380, 386
D3 384, 386
biosynthesis of 380
deficiency 175
anemia 377
sign of 387
status 204
supplements counter 138
von Gierke’s disease 130, 264
W
Warning rule 26
Waste
disposed 5
product 222
Water
balance 154
contaminants interfere 36
elimination 156
excessive loss of 84
purification technologies 39, 40
purity 39
quality 36
soluble bilirubin glucuronides 208
test 155
Watson-Schwartz test 92
Western blot 355357
for confirmation 364
immunofluorescence test 355
test 358f, 356, 361, 363
Westgard multirule quality control 25, 25f
Westgard rules 25, 408, 415, 419
White blood
cells 12
use of 428
World Health Organization 28, 267
X
Xanthine
oxidase 232
stones 97
Xanthinuria 97
Xanthoproteic reaction 69
Xanthoproteic test 71
X-ray tests 377
Y
Yoga
and naturopathy treatments, effect of 389
clinical efficacy of 389
Z
Zero-point calibration 56
Zidovudine 363
Zinc 37
protoporphyrin 321
Zirconium, oxides of 115
Zollinger-Ellison syndrome 79
Zone electrophoresis 311
Z-score 33
×
Chapter Notes

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Practical Clinical BIOCHEMISTRY Methods and Interpretations
Practical Clinical BIOCHEMISTRY Methods and Interpretations
(As per revised MCI curriculum)
Fifth Edition
Ranjna Chawla PhD Senior Biochemist (Scientist E) Department of Biochemistry Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER) New Delhi, India
Jaypee Brothers Medical Publishers (P) Ltd
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Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.
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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
Fifth Edition : 2020
9789389188769
Printed at
Preface to the Fifth Edition
It gives me immense pleasure to present fifth edition of the book titled Practical Clinical Biochemistry: Methods and Interpretations. The book has been revised with addition of topics as per latest Medical Council of India (MCI) guidelines for undergraduate curriculum. Additional chapters like Lean Six Sigma Approach for Clinical Laboratories, Anemia Profile, Bone Markers, Components Associated with Research Work and its Publication, etc. have been added. I am hopeful that this book will not only equip undergraduates with basic facts of the subject but will also help postgraduate students in keeping abreast with the latest knowledge. Coverage of such topics and knowledge of the latest development will match the standards required for postgraduate students. To bridge the gap between clinicians and clinical laboratories, more than 400 Case Reports/Viva Questions have been added at the end of each chapter. This will not only increase the knowledge of students but also will evoke interest of students in the subject.
Enormous appreciation of the earlier editions has always given me motivation to update this book with the latest developments. My sincere thanks to my husband Shri Vinod Kumar Chawla, without whose support writing book and its consistent improvement would not have been possible. My sincere thanks to my daughters Pragya Chawla, Aparna Shah, son-in-law Rushabh Nitin Shah and grandson Shravan Shah who always have been my constant source of inspiration. Heartfelt thanks are also due towards my in-laws Ms Kamlesh Chawla and Mr HB Chawla, who had always been my pillar of strength and always been there whenever I needed them. With great sense of gratitude, I dedicate my book to my parents Late Ms Swarn Vohra and Late Mr BK Vohra. It is with their efforts and blessings that I have reached so far.
Constructive criticism for improvement of book is always welcome. Please send your suggestions and feedback through e-mail to ranjna7c@gmail.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