Clinical

 Chemistry  
 
Introduction  
− “Kline”  G.  for  “bed”;  Chemistry,  the  science  that  deals  with  the  elements,  compounds,  
and  chemical  structure  and  interaction  of  matter  
o It  is  a  basic  science  that  utilizes  the  specialty  of  chemistry  to  study  human  beings  
in  various  stages  of  health  and  disease  
o It  is  an  applied  science  when  analyses  are  performed  on  body  fluids  or  
specimens  to  provide  important  information  for  the  diagnosis  or  treatment  of  a  
disease  
− Refers  to  the  qualitative  and  quantitative  analysis  of  biochemical  substances  in  human  
specimens  for  diagnosis  and  prognosis  
− Serves  as  a  reflection  of  metabolic  processes  
 
Uses  of  Clinical  Chemistry  
1. Detection  of  Disease  
2. Confirm  or  reject  diagnosis  
3. Establish  a  prognosis  of  a  disease  
4. Patient  management  
5. Monitoring  or  follow-­‐up  therapy  
 
Scope  of  Clinical  Chemistry  
1. General  or  Routine  Chemistry  
2. Special  Chemistry  
3. Clinical  Endocrinology  
4. Toxicology  
5. Therapeutic  Drug  Monitoring  
 
Laboratory  Apparatus  and  Supplies  
 
I. Types  of  Glasswares  
a. Borosilicate  Glass  
− Most  common  encountered  in  volume  measurements,  and  
sterilization  
− Has  high  degree  thermal  resistance  (but  not  more  than  515  o  C)  
and  have  low  alkali  content  
− Includes  Pyrex,  and  Kimax  (brand  names)  
− Not  commonly  used  for  alkali  storage  
b. Alumina-­‐silicate  glass  
− More  chemically  strong  than  borosilicate  glass  
− Includes  Corex  
− Resist  clouding  and  scratching  
− Best  for  handling  strong  alkali  solutions  
c. Vycor/  High-­‐Silica  glass  
− Used  for  high-­‐thermal,  drastic  heat  shock  and  extreme  chemical  
treatment  with  acids  (except  hydrofluoric  acid)  and  dilute  alkali  
− Can  be  heated  up  to  900  oC  
d. Flint  glassware/  Soda-­‐lime  
− Made  up  of  soda-­‐lime  glass,  and  a  mixture  of  calcium,  silicon,  and  
sodium  oxide  
− Melts  at  high  temperature,  hence,  it  is  commonly  used  for  
disposable  materials  
e. Low-­‐actinic  
− Used  for  storing  photo-­‐labile  analytes  or  reagents  
Clinical  Chemistry   1  
Mr.  Olibrian  P.  Mallari,  RMT,  IMT,  MLS(ASCPi),  CPT(IMET)  
Saint  Louis  University  –  Department  of  Medical  Laboratory  Science  
 II. Types  of  Plasticwares  
a. Polyolefins  
− Noted  for  their  strength  and  resistance  to  elevated  temperature  
b. Teflon/  Polytetrafluoroethylene  
− Chemically  inert  and  widely  resistant  to  a  wide  range  of  
temperature  
c. Polycarbonate  glassware  
− Very  clear,  and  ideal  for  the  manufacture  of  a  graduated  
cylinder  and  centrifuge  tubes  
d. Polyvinyl  chloride  plastics  
− Soft  and  flexible  materials  used  frequently  in  the  manufacture  
of  tubings  
e. Polyethylene/  Polypropelyn  
− May  discolor  with  colored  reagents  
− Commonly  used  for  manufacturing  pipet  tips  
f. Calcium  carbonate  plastics  
− Derived  from  natural  chalk  and  lime  stone  
g. Tygon  
− Commonly  used  for  the  manufacture  of  tubings  
 
v Cleaning  of  Glass  and  Plasticwares  
1. Soaking  in  dilute  bleach  and  drying  in  an  oven  
2. Soaking  in  20%  nitric  acid  for  12-­‐24hours  
3. Soaking  in  acid  dichromate  (glasswares)  
4. For  blood  clots  –  10%  NaOH  
5. New  pipets  –  5%  HCl  or  5%  HNO3  
6. For  grease  –  organic  solvent/  50%  KOH  
7. For  permanganate  stain  –  50%  HCl  or  1%  Ferrous  sulfate  in  25%  Sulfuric  Acid  
 
III. Pipets  
ü Classes  of  Pipets:  
A. According  to  calibration  
1. To  Deliver  –  delivers  the  exact  amount  into  the  transferring  container;  
uses  distilled  water  as  calibrator  
2. To  Contain  –  holds  a  particular  volume  of  fluid  but  does  not  dispense  
the  exact  volume;  uses  mercury  as  its  calibrator  
B. According  to  Drainage  Characteristic  
1. Blowout  –  has  a  continuous  etched  ring  on  top  of  the  pipet;  transfers  
the  specific  volume  up  to  the  last  drop  
2. Self-­‐draining  –  absence  of  etched  rings;  liquid  is  allowed  to  drain  by  
gravity  
C. According  to  Type  
1. Volumetric  or  transfer  pipets  
− Calibrated  for  any  volume  measurement  
− Pipets  that  drain  freely  with  the  tip  touching  the  inner  surface  of  
the  vessel  
− It  is  indicated  by  a  frosted  ring  near  the  mouthpiece  
a. Volumetric  pipet  
− Used  for  non-­‐viscous  fluids  
− Self-­‐draining  
− The  small  amount  at  the  tip  should  not  be  blown  
 

2   Clinical  Chemistry  
Mr.  Olibrian  P.  Mallari,  RMT,  IMT,  MLS(ASCPi),  CPT(IMET)  
Saint  Louis  University  –  Department  of  Medical  Laboratory  Science  
 b. Ostwald  Folin  pipet  
− For  viscous  fluids  
c. Pasteur  pipet  
− Transfers  fluid  without  volume  consideration  
d. Automatic  pipet  
2. Graduated  or  measuring  pipet  
− Calibrated  for  one  total  volume  of  liquid    
− Does  not  dispense  the  exact  volume  
− Self  draining  
a. Serologic  pipet  –  with  graduations  at  the  tip;  commonly  used  
for  dilutions  or  reconstitution  of  reagents  
b. Mohr  pipet  –  without  graduations  at  the  tip  
c. Bacteriologic  
d. Ball,  Kolmer,  or  Kahn  
e. Micropipets  –  to  contain  pipets  (ex.  Sahli-­‐Hellige,  Lang-­‐Levy,  
RBC  and  WBC,  Kirk  and  Overflow)  
D. Mechanical  or  Automatic    
1. Air  Displacement  Pipet  
− Uses  a  piston  for  sucking  and  drawing  a  sample  to  a  disposable  
tip  
− The  piston  does  not  come  in  contact  with  the  fluid  
− Most  commonly  used  
2. Positive  Displacement  
− It  operates  by  moving  the  piston  in  the  pipet  tip  or  barrel  just  like  
a  hypodermic  syringe  
− It  does  not  require  a  tip  replacement  
3. Dispenser/Dilutor  Pipet  
− Obtains  the  liquid  from  a  common  reservoir  and  dispense  it  
repeatedly  
− It  combines  sampling  and  dispensing  functions  
 
IV. Balances  
1. Unequal-­‐Arm  Substitution  Balance  
− Commonly  used  in  the  laboratory  
− Operates  on  the  principle  of  removing  weight  
− Fixed-­‐mass  counter  weight  is  used  to  balance  weight  of  the  pan    
2. Magnetic  Force  Restoration  
− The  restoring  force  is  the  force  required  to  put  the  balance  back  
to  equilibrium  
3. Top-­‐loading  Balance  
− Weighing  large  masses  that  do  not  require  analytic  precision  
4. Electric  Balance  
a. Stain  gauge  load  cell  principle  
− Small  device  which  changes  electrical  resistance  
− Arranged  in  a  “Wheatstone  bridge”  
b. Electromagnetic  Force  
− Mass  is  directly  proportional  to  the  deflecting  force  
V. Buret  
− A  long  pipet-­‐like  instrument  with  a  stop  cock  at  the  end  
− Can  contain  25-­‐100  mL  of  fluid  
− Used  for  titration  
 
Clinical  Chemistry   3  
Mr.  Olibrian  P.  Mallari,  RMT,  IMT,  MLS(ASCPi),  CPT(IMET)  
Saint  Louis  University  –  Department  of  Medical  Laboratory  Science  
 VI. Laboratory  Vessels  
1. Erlenmeyer  Flask  –  wide  and  flat  bottom,  with  a  short  neck  
2. Florence  Flask  –  same  with  Erlenmeyer  Flask  but  has  a  spherical  
bottom  
3. Griffin  Beaker  –  flat  bottom,  straight  side,  opening  as  wide  as  the  flat  
base,  with  a  spout  at  the  tip  
4. Graduated  cylinder  –  long  cylindrical  tube  with  graduations  along  its  
side  
 
VII. Thermometer  
1. Liquid-­‐in-­‐glass  
− Uses  colored  liquid  or  mercury  
− Can  measure  200C  to  400oC  
− Should  not  have  bubble  separations  
− Uses  Gallium  for  calibration  (29.6oC)  
2. Electronic  Thermometer  or  Thermistor  Probe  
− Converts  temperature  to  resistance  
 
VIII. Waterbath  
− For  general  laboratory  use  
− Used  for  heating  substances  +  5oC  above  room  temperature    
− Uses  distilled  water  
IX. Centrifuge  
− Consists  of  a  head  rotor,  carrier,  and  a  shield  
− Calibrated  using  a  tachometer  
− Centrifugal  force  is  based  on:  Mass,  Speed,  and  Radius  
− Cleaning  should  be  performed  every  3  months  
 
Relative  Centrifugal  Force  (RCF)=  1.118x10-­‐5  x  r  x  (rpm)2  
Where:    
ü 1.118  x  10-­‐5  is  the  angular  velocity  constant  
ü r  is  the  radius  
ü (rpm)2  is  the  speed  of  revolutions  per  minute  
 
NOTE:  Kindly  read  the  link  below  regarding  the  History  of  Clinical  Chemistry  
http://www.ifcc.org/ifccfiles/docs/130304003.pdf  
 
 

4   Clinical  Chemistry  
Mr.  Olibrian  P.  Mallari,  RMT,  IMT,  MLS(ASCPi),  CPT(IMET)  
Saint  Louis  University  –  Department  of  Medical  Laboratory  Science