May 21, 2024  
2020-2021 Course Catalog 
    
2020-2021 Course Catalog [ARCHIVED CATALOG]

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MLT 242 - Clinical Chemistry

Credits: 8
Lecture Hours: 6
Lab Hours: 4
Practicum Hours: 0
Work Experience: 0
Course Type: Open
Study and analysis of electrolytes, proteins, lipids, enzymes, hormones, drugs and various other biochemical compounds found in the human body. Test results are correlated with patients’ conditions. Laboratory math, statistics and quality control are presented.
Prerequisite: Grade of C or better in MLT 115  and MLT 120 . Successful completion of the following courses: BIO 164  or equivalent; CHM 122  or equivalent and CHM 132  or equivalent
Competencies
  1. Assess laboratory safety and quality control.
    1. Identify safety and precaution labels and signs.
    2. Disinfect work area.
    3. Wear appropriate personal protective equipment.
    4. Practice correct hand-washing technique.
    5. Dispose of biohazardous waste.
    6. Protect self, student-patient, and clinical patients from transmission of infectious disease.
    7. Perform appropriate error correction and documentation.
    8. Determine factors that affect procedures and results.
  2. Demonstrate professional conduct.
    1. Demonstrate interpersonal communication skills with patients, other health care professionals, and the public.
    2. Practice confidentiality.
    3. Follow written and verbal instructions.
    4. Demonstrate ethical time management.
    5. Choose workplace-appropriate clothing and jewelry.
    6. Recognize the responsibilities of other laboratory and health care personnel, interacting with them with respect to their jobs and patient care.
    7. Demonstrate workplace basic skills of listening, writing, leadership, and time management.
    8. Practice written and oral communication skills.
    9. Create a team atmosphere in laboratory functions.
  3. Evaluate proper specimen collection and transport.
    1. List types of transport tubes and preservatives.
    2. List special transport conditions
    3. State rationale for each type
    4. Identify criteria for specimen collection.
  4. Choose laboratory equipment typical of the clinical chemistry area.
    1. Perform pipetting.
    2. Demonstrate good dexterity in use of clinical laboratory equipment.
    3. Follow procedure.
    4. Prepare reagents and controls for tests.
    5. Calibrate instruments to perform tests.
  5. Perform laboratory math.
    1. Convert units for laboratory values.
    2. Convert temperatures from one to another using Fahrenheit, Celsius and Kelvin.
    3. Prepare solutions of a given molarity.
    4. Perform calculations using molarity, normality, percent weight/volume, and percent volume/volume.
    5. Calculate the dilution facto(s) for simple and serial dilution schemes.
    6. Perform simple, serial and doubling dilutions.
    7. Calculate results from supplied data.
    8. Calculate results from obtained data.
  6. Compare and contrast instrumentation methods.
    1. Compare four basic categories of measurement technics with examples of methods for each category.
    2. Describe the principle of various lab instrumentation.
  7. Perform Spectrophotometry.
    1. Describe the principle of absorbance spectrophotometry and define Beer’s law.
    2. Name the observed colors of visible spectrum and the corresponding wavelenths.
    3. Graph standard curve as absorbance and transmittance.
    4. Calculate concentration using Beer’s Law.
    5. Given lab exercise correctly use spectrophotometer by setting wavelength and identifying transmittance and absorption.
  8. Evaluate Quality Assurance in daily laboratory functions.
    1. Define the Key terms for Quality Control and Quality Assurance.
    2. Define calibration, linearity, and control parameters.
    3. List possible sources of error and differentiate between random error and systemic error.
    4. State methods used to obtain patient reference ranges.
    5. Evaluate findings and clinical data to asses test results and procedures.
    6. Evaluate laboratory findings and quality control data to assess test results and procedures.
    7. Calculate the mean, standard deviation and coefficient of variation.
    8. Differentiate between specificity and sensitivity.
    9. Evaluate the statistical significance of accuracy and precision.
    10. Prepare Levey-Jennings and quality control charts.
    11. State what percentages are associated with 1SD, 2SD and 3SD in a normal frequency curve.
    12. Recognize Westgaard’s Rules on controls, and state when a run should be rejected.
  9. Demonstrate judgment and decision making skills.
    1. Analyze laboratory findings to recognize common procedural and technical problems.
    2. Evaluate laboratory findings to take corrective action according to predetermined criteria.
    3. Analyze laboratory findings to check for sources of error.
    4. Evaluate laboratory findings to recognize and report the need for additional testing.
  10. Categorize Lab Operations.
    1. Discuss regulatory agencies and their impact on lab operations.
    2. Recognize common lab information system formats and uses.
    3. Differentiate between internal and external quality assurance and give examples of each.
    4. Define sources of error as pre-analytical, analytical, or post-analytical.
    5. State methods used to obtain patient reference ranges.
  11. Asses water balance and osmolarity.
    1. Describe how water balance is maintained in the body including negative and positive water balances.
    2. Define a situation where there would be an increased or decreased osmolality, and describe the body’s compensation for it.
    3. Discuss the influences of water and mineral metabolism on the pH and electrolyte balance in the body.
    4. Define a situation where there would be an increased osmolality, and describe the body’s compensation for it.
    5. Define a situation where there would be a decreased osmolality, and describe the body’s compensation for it.
    6. Given the concentration of sodium, glucose and blood urea nitrogen, calculate the osmolality.
    7. Describe principles and perform osmometry
  12. Asses Electrolytes and anion gap.
    1. Discuss the principle of tests used to measure electrolytes.
    2. Identify the primary extracellular cation and the primary extracellular cation.
    3. Identify the electrolyte that plays a major role in the regulation of water balance.
    4. State how hemolysis affects the potassium concentration.
    5. Identify major functions of the following electrolytes: sodium, potassium and chloride.
    6. Define chloride shift and discuss the mechanisms involved.
    7. Recognize the reference ranges for sodium, potassium and chloride.
    8. For each of the main electrolytes (sodium, potassium and chloride), list conditions in which there would be an increase or decrease in the electrolyte.
    9. List conditions in which there would be an increase or decrease in the anion gap.
    10. State the principles of the tests used to measure sodium, potassium and chloride.
    11. Describe the condition of cystic fibrosis and state the methods of lab evaluation.
  13. Evaluate Blood Gasses.
    1. Contrast acids and bases in terms of pH and hydrogen ions.
    2. Mathematically define pH.
    3. State the body’s major buffering systems and describe their function.
    4. Write the Henderson-Hasselbalch equation.
    5. State the normal ratio of carbonic acid to bicarbonate.
    6. Describe how CO2 is eliminated from the body.
    7. Describe the significance of the hemoglobin-oxygen dissociation curve
    8. Define a left shift and right shift on the hemoglobin-oxygen dissociation curve.
    9. Discuss methodology and instrumentation for performing blood gas determinations.
    10. Describe the patient conditions and compensatory mechanisms.
    11. List normal values of pH, PCO2, pO2, and Bicarbonate, and recognize sources of error.
  14. Evaluate Body fluids.
    1. Identify the source, physiologic purpose and clinical use of testing of body fluids.
    2. Differentiate between and transudate and an exudate.
    3. Discuss the diagnostic use for gastric analysis.
    4. Discuss amniotic fluid function and testing.
    5. State lab methods for evaluating Body fluids and correlate lab values to common disorders or conditions.
  15. Incorporate kidney structure and function with tests of Renal disease and disorders.
    1. Identify the anatomy of the kidney.
    2. List main renal functions.
    3. Describe the process of glomerular filtration and concentration of urine with conservation of water and salt.
    4. Describe the different hormonal processes that promote the concentration of urine and conservation of water and salt.
    5. State conditions in which an increased or decreased osmolality is seen and compensatory mechanisms.
    6. State the principle of the test, reference ranges, and significance of abnormal values for renal tests.
    7. Discuss the metabolism of Creatinine, BUN, and uric acid.
    8. List pre-renal, renal and post-renal causes of acute/chronic renal failure.
    9. Discuss EPO and its role in renal diseases.
    10. Identify methodology and reference ranges for microalbumin and explain its relationship to protein/creatinine ratio in diabetes.
    11. Perform creatinine, blood urea nitrogen (BUN), and uric acid procedures, calculate the creatinine clearance, corrected creatinine clearance, and give significance.
    12. Match each test to the appropriate methodology.
  16. Explain enzyme theory.
    1. Discuss the equation: E+ S « ES « P + E.
    2. Classify enzymes according structure and the International Union of Biochemistry (IUB).
    3. Recognize the Michaelis-Menton calculation.
    4. Discuss the different factors affecting the rate of an enzymatic reaction.
    5. Discuss zero-order kinetics.
    6. Explain how enzymes are used to evaluate body function.
    7. Discuss the effect of cofactors, activators, inhibitors and coenzymes on reactions.
    8. Describe specimen collection for tests of enzyme analysis.
    9. Describe enzymatic methods differentiating between fixed time assays and continuous monitoring assays.
    10. Perform enzyme methods.
    11. Define international unit of enzyme activity.
  17. Describe the functions and assesment of the liver.
    1. List metabolic functions of the liver.
    2. Discuss the basic disorders of the liver and what laboratory tests may be performed to diagnose them.
    3. Outline the formation and catabolism of bilirubin.
    4. State the normal values for total bilirubin, conjugated bilirubin and unconjugated bilirubin.
    5. Explain the principle of bilirubin tests.
    6. Describe the disorders of hyperbilirubinemia.
    7. Calculate Bilirubin values using T Bilirubin, Conjugated, and Uncojugated.
    8. Perform and explain the principles and reference ranges for liver enzymes.
    9. Recognize source of error.
    10. Differentiate the various types of Hepatitis.
  18. Evaluate Porphyrins, Iron, and Myoglobin in associated disease and disorders.
    1. Outline the biochemical pathway of porphyrin and heme synthesis.
    2. Correlate the porphyrin disease states with clinical laboratory data.
    3. Discuss the structure and clinical significance of myoglobin in the body.
    4. List the physiological functions of iron and describe its absorption and transport in the body.
    5. Describe changes in the analytes: ferritin, serum iron, and IBC in correlation with pathological conditions.
  19. Asses Proteins and Amino Acids in function and associated disorders.
    1. List functions of proteins.
    2. Name the primary and secondary sites of synthesis of proteins.
    3. List normal values and sources of error in protein measurements.
    4. Describe the principle of electrophoresis.
    5. List the five (5) main categories (or bands) on cellulose agarose gel using electrophoretic methods.
    6. Identify the bands of protein separated in protein electrophoresis.
    7. Discuss general causes of abnormal serum protein concentrations and aminoapathies.
    8. Describe and compare methodologies used in the analysis of total protein and albumin.
    9. Differentiate the types of proteinuria and describe methods of identification.
    10. Describe the diseases associated with alterations in cerebrospinal fluid (CSF) proteins.
    11. Perform albumin and total serum proteins.
  20. Compare and Contrast Cardiac and Muscle diseases.
    1. Discuss myocardial infarction and the events of acute coronary syndrome.
    2. List proteins and enzymes that are routinely measured in serum to assess myocardial disease, and state the time periods for the expected enzyme elevations following myocardial infarction.
    3. List proteins and enzymes that are routinely measured to assess striated muscle tissue damage.
    4. Recognize reference ranges and test methodology for cardiac markers
    5. Calculate a CK relative index.
    6. Describe the use of BNP in CHF.
    7. Discuss re-perfusion and the role of thrombolytic agents in treating MI patients.
    8. Recognize normal and abnormal LDH isoenzyme patterns.
    9. Describe the mechanisms of plaque formation in arteries.
    10. Discuss causes and symptoms of other cardiac disorders.
    11. Perform CK and LD tests
    12. Recognize appropriate specimens for cardiac markers and time intervals.
  21. Evaluate the metabolism of Lipids and relationship to disease and disorders.
    1. List the four (4) major classifications of lipoproteins and state the main constituent of each of the four (4) major classifications of lipoproteins.
    2. Explain briefly the metabolism of lipids including absorption, esterification, transport, and storage.
    3. List the four (4) major classifications of lipoproteins from smallest to largest, and from the most dense to least dense.
    4. Describe how lipids are transported in both the endogenous and exogenous pathways.
    5. State the desirable, borderline and high risk ranges for lipoproteins.
    6. List instances in which an increased or decreased concentration lipids will be found.
    7. Discuss the incidence and types of lipid and lipoprotein abnormalities.
    8. Explain principle of cholesterol procedures including sources of error and normal values.
    9. Perform cholesterol, HDL, LDL procedures and calculation.
  22. Discuss chemical analysis of cerebrospinal fluid and other body fluids and secretions.
    1. Describe the formation and function of Cerebrospinal fluid and other body fluids and secretions.
    2. Discuss the diagnostic use for gastric analysis.
    3. Differentiate between transudates and exudates and list two tests performed on the each.
    4. Discuss amniotic fluid function and testing.
  23. Describe clinical toxicology.
    1. List the functions of a toxicology lab
    2. Explain pharmokinetics.
    3. Explain the reason for therapeutic drug monitoring (TDM).
    4. Describe the principles of immunologic, chromatography and spectrophotometric techniques.
  24. Discuss disorders of carbohydrate metabolism.
    1. Explain normal carbohydrate metabolism.
    2. Describe the roles of insulin, glucagon, epinephrine, cortisol, somatotropin, thyroxine and growth hormone in regulating extracellular glucose concentration.
    3. List diseases associated with hyperglycemia and hypoglycemia.
    4. Name main ketones; list those normally found in blood.
    5. Provide examples of “fasting” and “reactive” hypoglycemia.
    6. Briefly describe diabetes insipidus.
    7. State the reference range for a fasting blood glucose level.
    8. Perform chemical and enzymatic glucose procedures.
    9. Perform analysis of glycosylated hemoglobin.
    10. State the diagnostic importance, patient preparation, procedure, and normal and abnormal values of the glucose tolerance test.
    11. Describe the other glucose tests: urine glucose, two-hour postprandial and glycosylated hemoglobin.
  25. Assess Pancreatic and GI functions and lab tests.
    1. Describe the anatomy of pancreas and characterize the endocrine and exocrine functions.
    2. List the major disease groups and correlate them with lab measurements.
    3. Outline the functions and anatomy of a normal digestive tract.
    4. List major pathological conditions and causes for these conditions.
    5. Describe diagnostic tests used for diagnosis of GI pathological conditions.
    6. Recognize reference ranges and methodologies for amylase and lipase.
    7. Preform amylase and lipase test.
  26. Evaluate Bone Disease and lab results.
    1. List three (3) forms of plasma calcium.
    2. Describe calcium regulation.
    3. List three (3) organs that play a major role in calcium regulation.
    4. List three (3) hormones that play a major role in calcium regulation.
    5. List the normal values, causes for decreased values and causes for increased values for calcium phosphate and magnesium.
    6. Discuss the relationship between alkaline phosphatase (ALP), calcium and phosphate and bone disorders.
    7. Correlate laboratory results for the trace elements, hormones and enzymes with osteoporosis, osteomalacia, Rickets and Paget’s disease.
    8. Perform Calcium, Phosphorous and Magnesium.
  27. Discuss Trace elements and vitamins.
    1. List the trace elements and state their clinical significance.
    2. Discuss serum iron, total iron binding capacity, ferritin and transferrin.
    3. Relate the tests that can be used to evaluate iron status.
    4. Discuss iron deficiency disorders.
    5. Correlate the disease state or patient status with a trace element excess or deficit.
    6. Perform Iron and calculate TIBC.
    7. List the biochemical parameters used to monitor nutritional status.
    8. Recognize reference ranges and methodologies for nutritional markers.
  28. Categorize Endocrinology and Thyroid Function with Target organs and lab results.
    1. State the functions of the endocrine system.
    2. Describe the location of the major hormones produced endocrine glands.
    3. List sources, functions and targets of assigned hormones.
    4. Discuss the difference between primary and secondary hormone disorders.
    5. Explain the mechanism of hormone action and control.
    6. Relate the expected laboratory results associated with disease states.
    7. Discuss the laboratory evaluation of infertility.
  29. Evaluate Cancers by their Tumor markers.
    1. Describe an ideal tumor marker.
    2. List commonly used chemical and cellular markers. State their clinical significance.
    3. Recognize methodologies for performing tumor markers.
  30. Structure toxicology by class, method and antidote.
    1. Explain the purpose of drug screening and pharmacokinetics.
    2. Name the classes and examples of drugs.
    3. Name some of the antidotes used in drug-overdose management.
    4. Discuss the difference between qualitative and quantitative tests in toxicology.
    5. Perform and explain procedure for multiple drug screening for trauma.
    6. Perform and explain procedure for alcohol method.
  31. Describe clinical therapeutic drug monitoring(TDM).
    1. Explain pharmokinetics.
    2. Explain the reason for therapeutic drug monitoring (TDM).
    3. Describe three (3) routes of drug administration and the disposition of a drug in the body.
    4. Describe first-pass elimination.
    5. Describe the various drug classification.
    6. Relate when peak and trough drug levels should be drawn.
    7. Describe the principles of immunologic and spectrophotometric techniques.



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