SLMC Clinical Chemistry Section

Spectrophotometry

MACHINE AND PRINCIPLES

Diazyme (for body fluids)

Principle:

Ion Selective Electrode

MACHINE AND PRINCIPLES

NovaPrime

Principle:

High Performance Liquid Chromatography (HPLC)

MACHINE AND PRINCIPLES

Arkray

Principle:

Spectrophotometry, Chemiluminescence Immunoassay (CLIA)

MACHINE AND PRINCIPLES

Siemens-Dimension EXL 200

Principle:

Flow Cytometry

MACHINE AND PRINCIPLES

Attelica DLC (Direct Load Chem)

Principle:

Chem-Spectrometry; Immuno-Chemiluminescence

MACHINE AND PRINCIPLES

Attelica SCI (Sample, Chem, Immuno)

Principle:

Chemiluminescent Microparticle Immunoassay (CMIA)

MACHINE AND PRINCIPLES

Architect

Principle:

Freezing point osmolality

MACHINE AND PRINCIPLES

Osmopro

Principle:

Diazyme (for body fluids)

MACHINE AND PRINCIPLES

Principle: Spectrophotometry

NovaPrime

MACHINE AND PRINCIPLES

Principle: Ion Selective Electrode

Arkray

MACHINE AND PRINCIPLES

Principle: High Performance Liquid Chromatography (HPLC)

Siemens-Dimension EXL 200

MACHINE AND PRINCIPLES

Principle: Spectrophotometry, Chemiluminescence Immunoassay (CLIA)

Attelica DLC (Direct Load Chem)

MACHINE AND PRINCIPLES

Principle: Flow Cytometry

Attelica SCI (Sample, Chem, Immuno)

MACHINE AND PRINCIPLES

Principle: Chem-Spectrometry; Immuno-Chemiluminescence

Architect

MACHINE AND PRINCIPLES

Principle: Chemiluminescent Microparticle Immunoassay (CMIA)

Osmopro

MACHINE AND PRINCIPLES

Principle: Freezing point osmolality

Wholeblood

SAMPLES

★ Glycohemoglobin (Hba1c) (Lavender top)

★ Tacrolimus, Cyclosporine, (Lavender top) Sirolimus

★ Troponin T (Quantitative) (Green top)

Plasma

SAMPLES

★ Lactate assay (gray top)

★ PlasmaAmmonia(green top)

★ NT-ProBNP(green top)

★ High Sensitive Troponin I (green lithium heparin top)

Serum (Red and Yellow Tubes)

SAMPLES

★ OGTT samples

★ 2Post Prandial Blood Sugar

★ Random Blood Sugar

★ Therapeutic Drug Monitoring (strictly red top) ↳ Cortisol, ↳ Vancomycin ↳ Gentamicin ↳ Carbamazepine ↳ Phenobarbital ↳ Phenytoin ↳ Valproic Acid ↳ Digoxin ↳ Methotrexate

★ Blood Alcohol, Homocysteine (red top)

Wholeblood

Lavender top

SAMPLES

Glycohemoglobin (Hba1c) (— top)

Wholeblood
Lavender top

SAMPLES

Tacrolimus

Wholeblood

Lavender top

SAMPLES

Cyclosporine

Wholeblood

Lavender top

SAMPLES

Sirolimus

Wholeblood

Green top

SAMPLES

Troponin T (Quantitative)

Plasma

Gray top

SAMPLES

Lactate assay

Plasma

Green top

SAMPLES

Plasma Ammonia

Plasma

Green top

SAMPLES

NT-ProBNP

Plasma

green lithium heparin top

SAMPLES

High Sensitive Troponin I

Serum (Red and Yellow Tubes)

SAMPLES

All routine Chemistry tests

Serum (Red and Yellow Tubes)

SAMPLES

OGTT samples

Serum (Red and Yellow Tubes)

SAMPLES

2 Post Prandial Blood Sugar

Serum (Red and Yellow Tubes)

SAMPLES

Random Blood Sugar

Serum (Red Tubes)

SAMPLES

Therapeutic Drug Monitoring

↳ Cortisol, ↳ Vancomycin ↳ Gentamicin ↳ Carbamazepine ↳ Phenobarbital ↳ Phenytoin ↳ Valproic Acid ↳ Digoxin ↳ Methotrexate

↳ Cortisol, ↳ Vancomycin ↳ Gentamicin ↳ Carbamazepine ↳ Phenobarbital ↳ Phenytoin ↳ Valproic Acid ↳ Digoxin ↳ Methotrexate

9 Therapeutic Drug Monitoring

Serum (Red Tubes)

SAMPLES

Blood Alcohol, Homocysteine

1 minute

Tourniquet: recommended — application

★ Reject and re-extract

★ Microcentrifuge

★ Process

What will you do if you receive a milky specimen?

★ Measure the total volume of urine

What is the first thing you should do if you receive a 24-hour metabolic urine?

★ Benzoylecgonine

Metabolites of cocaine

★ VLDL

Endogenous triglyceride

★ ACD

Not a liver enzyme

Acetaminophen

Paracetamol

Rivotril / Clonazepam

Benzodiazepine

Marijuana / THC

Cannabinoids

Shabu

Amphetamine

Tegretol

Carbamazepine

Ecstacy

MDMA

Shabu or Marijuana

Metamphetamine / THC

Opiates

Morphine

Dilantin

Phenytoin

NT Pro Brain Natriuretic Peptide

NT-PRO BNP

(Red and Yellow tubes)

Serum Samples

Plasma Samples

(centrifuge to obtain plasma)

Whole Blood Samples

(do not centrifuge)

Prioritize

PRE-ANALYTICS

Brain Attack (BAT), RRRTm Code Blue, Heart Team, ER and INPATIENT Samples

30 minutes – 1 hour

PRE-ANALYTICS

Turnaround time of BAT

1 – 2 hours

PRE-ANALYTICS

Turnaround time for ER and INPATIENT

Random Urine; Random Urine Alcohol

Routine 24 hr Urine

24 hr Metabolic Urine

URINE SAMPLES

Ascitic, Pleural, Pericardial, Peritoneal Fluid

CSF

BODY FLUIDS

1. Blood Samples: 1,5 ANHYDROGLUCITOL (GLYCOMARK) (either R or Y top) and AMIKACIN (Strictly RED TOP only)

2. 24 hour Metabolic Urine

SEND OUT SAMPLES TO SLMC GLOBAL CITY

20 uL

PROTINOL (RED) L, M, H

Osmopro

Control: 1x a day (whenever there is a request)

Serum/Plasma samples –

20 uL

RENOL (BLUE) L, H

Osmopro

Control: 1x a day (whenever there is a request)

Random Urine samples –

Name of Machine: ARKRAY

Principle: HIGH PERFOMANCE LIQUID CHROMATOGRAPHY (HPLC)

PROCESSING OF SAMPLES

HbA1c

Name of Machine:

Principle:

Name of Machine: MODEL 3320 OSMOMETER / OsmoPro

Principle: FREEZING POINT OSMOLALITY

PROCESSING OF SAMPLES

Serum and Random Urine Osmolality

Name of Machine:

Principle:

Name of Machine: NOVA PRIME

Principle: ION SELECTIVE ELECTRODE (ISE)

PROCESSING OF SAMPLES

IONIZED CALCIUM

Name of Machine:

Principle:

Name of Machine: ATELLICA SCI

Principle: CHEMILUMINESCENCE IMMUNOASSAY (CLIA) (direct)

PROCESSING OF SAMPLES

ROUTINE SAMPLES

Name of Machine:

Principle:

Name of Machine: ARCHITECT

Principle: CHEMILUMINESCENCE MICROPARTICLE IMMUNOASSAY (CMIA)

PROCESSING OF SAMPLES

TDM, Tacrolimus, Cyclosporine, Sirolimus

Name of Machine:

Principle:

IMg –

tissue development and heart function

ICa –

cancer and heart function

Check the stability of machine

Check the quality of reagents

Check the technical error or operator error

Reasons why we Calibrate:

COLORLESS

Color of Calibrator:

Yellow (from human serum)

QC Color

LIPOPHYLASE

Powdered Reagent:

Reconstituted

Powdered Reagent + Water =

iCa, iMg

Nova Prime

P: Direct Ion Selective Electrode

C: Nova Prime Control

S: Serum, Plasma, Urine (not advisable)

T: ?

C: Extend sure

T: HBA1C

Arkray

P: High Performance Liquid Chromatography

C: ?

S: Whole Blood

T: ?

Protinol (Red;Serum) Renol (Blue;Urine) 20ul

Serum and Random Urine Osmolality

P: Freezing Point Osmolality

C: ?

S: Serum and Urine

T:

C: 200ul, Solid Phase Receptacle
T: High Sensitivity Troponin I

VIDAS 3

P: Enzyme Linked Fluorescent Assay

C: ?

S: Plasma, Serum

T: ?

C: IA+, NBT (200uL control, 200uL diluent)

T: Cortisol, Vancomycin, Tacrolimus, Vitamin B12

Architect i2000 SR

P: Chemiluminescence Microparticle Immuno Assay

C: ?

S: Plasma, Serum, Whole Blood

T: ?

T: ADA (Adenosine Deaminase)

Diazyme O2 - Lite C270

P: Spectrophotometry

C:

S:

T: ?

C: InteliQ

T: Routine

Atellica SCI

P: Chemiluminescence Immunoassay (CLIA) - Direct

C: ?

S: Plasma, serum

T: ?

T: Lyphocheck (Lactate, CK-Total,) Liquicheck (CKMB, Ammonia)

EXL 200

P: Spectrophotometry

C: 100- 150 uL

S:

T: ?