Biomedical Laboratory techniques

GENERAL PART Laboratory tests: definition, type, reasons for the request. The units of measurement. Stages of the analytic process. Pre-analytical phase: summary of the main pre-analytical steps (in particular interfering substances in the analyzes) and pre-analytical variability. Analytical phase: the analytical process. Analytical variability: characteristics of measurement techniques, analytical error. Biological variability and goals of precision and accuracy, quality control. Post-analytical phase: biological variability and reference values. The diagnostic logic in laboratory medicine: sensitivity, specificity and predictive value of laboratory tests. MAIN ISSUES Enzymatic determinations and their clinical use. Determination of the catalytic activity of plasma enzymes. Enzymatic kinetics. Factors affecting the plasma concentration of enzymes. Role of enzymes in clinical diagnosis. Enzymograms and Isoenzymes. Creatine kinase (CK) and lactic dehydrogenase (LDH) isoenzymes Biomarkers of myocardial damage. Biochemical alterations in acute myocardial infarction. Clinical use of early and late markers: myoglobin, CK-MB, Troponin I and T. Alterations of lipid metabolism - Summary of the structure of lipoproteins, apolipoproteins. Exogenous metabolism and endogenous metabolism of lipoproteins. Laboratory determination of total cholesterol, HDL-cholesterol and LDL-cholesterol. Enzymatic determination of triglycerides. Methods of determination of lipoproteins. Dyslipidemias: classification and evaluation. Atherosclerosis and main risk factors. Role of LDL-cholesterol and HDL-cholesterol in atherosclerosis Laboratory tests for the identification of subjects with high cardiovascular risk: apoproteins, homocysteine, lipoptotein (a).

"Biochimica Clinica e Medicina di Laboratorio", Marcello Ciaccio e Giuseppe Lippi; EdiSES "Metodologie biochimiche e biomolecolari", Mauro Maccarone; Zanichelli