MLT 241 - Clinical Chemistry I

1. Associate routine chemistry test results and body functions with disease states or conditions while recognizing discrepancies between manual and automated test results and patient symptoms.
2. Analyze and interpret results of quality control samples and perform quality assurance procedures during chemistry testing.
3. Demonstrate the importance of proper specimen collection and handling requirements of samples to be analyzed.
4. Demonstrate good interpersonal skills and ability to accept assistance and constructive criticism while maintaining professional and courteous working relationships with fellow students and instructors.
5. Demonstrate ability to follow written and oral instructions and spend adequate time needed to complete and master assignments and testing techniques using manual or automated equipment while following universal precautions. Must also be willing to repeat procedures if necessary.

Course Objectives

1. Name the different units of measure.
2. Define and state uses of three types of chemistry testing standards.
3. Explain cleaning procedures and categorize grades of H2O.
4. Define the following terms associated with solutions: Solvent, solute, concentration, percent, normality, molarity, and density.
5. Differentiate types of pipets and relate to TC and TD.
6. Explain the calibration of pipets.
7. Explain the characteristics of glassware used in lab.
8. Explain the principle of the various instruments utilized in a clinical chemistry lab.
9. Define universal precautions as related to bloodborne pathogens.
10. List and discuss safe practices within the clinical lab.
11. Explain the different types of clinical specimens.
12. List and discuss the different types of blood collection.
13. Name the different factors that affect samples.
14. Explain what makes a specimen acceptable or unacceptable.
15. Explain the rules for determining significant figures.
16. Express concentration of solutions in % x/v, % w/w, and % u/v.
17. Define and calculate molarity and normality of a solution.
18. Calculate conversions between units of measurement.
19. Explain how to prepare a designated serum dilution and determine the dilution of a given tube in a serial dilution.
20. Explain rules of how to appropriately round numeric data using appropriate significant figures.
21. Define the terms “standard” and “control.”
22. List the criteria for the selection of control material.
23. Calculate: mean, median, mode, %CV, standard deviation.
24. Differentiate between accuracy and precision, random and systematic error.
25. Given data on control material, create a Levey-Jennings chart.  Be able to identify a trend or shift.
26. Analyze data on a Levey-Jennings chart and determine where the Westgard Rules have been violated.
27. Explain the roles of the kidney.  Including reabsorption of sodium, glucose, water and urea.
28. Define the 3 processes of Homeostasis and define.
29. List and anatomically locate the Component of the Urinary System and Nephron.
30. Explain pathophysiology in the following renal diseases: Glomerulonephritis, tubular renal disease, acute and chronic renal failure.
31. List and define the nonprotein nitrogen analytes.
32. State the principles and precautions of procedure used to measure the NPN analytes.
33. Explain the source, metabolism, and clinical significance of the NPN analytes.
34. Explain Creatinine Clearance.  Perform calculations and relate to normal kidney functions.
35. Explain procedures used to assess glomerular filtration and tubular function.
36. Discuss how each of the Nonprotein nitrogens are synthesized and the diseases they correlate with.
37. Define acid, base, pH, and buffer.
38. Explain the three major buffering systems in the body and how they work.
39. Explain the respiratory and renal regulation of acid/base balance.
40. Define and discuss the processes involved in maintaining the acid-base balance.
41. Discuss disease states related to acid-base imbalances and their associated lab findings. 
42. Discuss proper specimen collection for blood gas samples.
43. Discuss procedures and components of blood gas analyses.
44. Differentiate between ICF and ECF.
45. Explain the importance of water balance in the body and the processes it involves.
46. Define and calculate the osmolality and osmolality gap and explain the significance of an increased osmolality gap.
47. Define and calculate the anion gap and explain the significance of abnormal results.
48. Define Electrolytes and list the major electrolytes of the ICF and ECF.
49. Explain the activation and function of the renin-angiotensin system.
50. Discuss the physiologic functions of calcium and how its plasma concentration is regulated so closely.
51. Discuss the relationship between calcium and phosphate concentrations and the effect of PTH, vitamin D and calcitonin on plasma phosphate concentration.
52. State the major pathophysiologic conditions associated with disorders of calcium metabolism and know which tests are not commonly used for diagnosis.
53. Discuss the functions and metabolism of magnesium.  Discuss the causes and symptoms of hypo- and hypermagnesemia.
54. Discuss the role, function, and reason for monitoring zinc levels.
55. Define enzyme and explain the structure including the terms activators, coenzymes.
56. Identify the factors influencing reactions.
57. Explain the mechanism of enzyme action.
58. Compare fixed time and continuous monitoring methods of measuring enzymes and the advantages of continuous monitoring.
59. Explain how enzymes can be used to measure other analytes in the lab.
60. For the following enzymes, be able to discuss the source, appropriate sample for analysis, methodology, and clinical significance: CK & Isoenzymes, LD and Isoenzymes, AST, ALT, ALP, GGT, acid phosphatase, amylase, and lipase.
61. List and describe the three main classes of carbohydrates.
62. Discuss carbohydrate digestion, absorption, and transport to cells and metabolic pathways.
63. Explain the effects of hormones on glucose.
64. Discuss the effects of abnormal hormonal regulation, name the diseases, and discuss the signs of untreated disease.
65. Discuss the laboratory methods used to diagnose and monitor blood glucose pathways and abnormal disease states.
66. Name additional diseases related to abnormal hormonal regulation.
67. Compare different types of glucose methodologies.
68. List the different lipid structures and their principle function.
69. Explain how lipids are transported in both the endogenous and exogenous pathway.
70. Discuss the clinical significance of increased levels of lipids.
71. Discuss the different treatment options for increased levels.
72. Discuss the classifications and laboratory assessment of hyperlipoproteinemia.
73. List the methodologies for cholesterol, triglycerides, HDL, LDL, and lipoprotein electrophoresis.
74. Calculate LDL-C values.
75. Interpret the results of cardiac biomarker assays in the diagnosis of an acute myocardial infarction and congestive heart failure.
76. Discuss the clinical significance of BNP and NT-proBNP lab results.
77. Discuss the clinical significance of Troponin levels and other various lab tests to determine risk stratification of patients with heart disease.
78. Explain the structure and metabolism of amino acids.
79. List 5 specific serum proteins and three physiologic functions.
80. Discuss protein synthesis and the location.
81. Explain the process of protein degradation.
82. Explain the multiple functions of protein.
83. Explain the purpose and steps involved in performing electrophoresis.
84. Discuss the fractions of electrophoresis and the pathological abnormalities.
85. Associate the serum protein electrophoresis patters with the disease state.
86. Discuss the methodology of TP, ALB, and CRP.
87. Explain the significance of CSF/Serum Protein ratios.
88. Explain the difference between exudate and transudate.
89. Discuss the structure of the liver.
90. Discuss the physiology and metabolic functions.
91. Explain the metabolism of bilirubin and urobilinogen.
92. Define, classify, and discuss the causes of jaundice.
93. Summarize and differentiate the different forms of bilirubin.
94. Explain the methodology of the lab procedures used in the evaluation of liver functions.
95. Define Hepatitis and identify the 3 types.
96. Identify the tests for evaluating hepatic dysfunction.