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• Cover
• Title Page
• Copyright Page
• Disclaimer
• Brief Contents
• Contents
• Dedication
• Foreword
• Preface
• New to This Edition
• Acknowledgments
• Contributors
• Ancillary Contributors
• Reviewers
• Chapter 1 Basic Principles and Practices of Clinical Chemistry
• Units of Measure
• Reagents
• Chemicals
• Reference Materials
• Water Specifications
• Solution Properties
• Concentration
• Colligative Properties
• Redox Potential
• Conductivity
• pH and Buffers
• Laboratory Equipment
• Heating Units
• Glassware and Plasticware
• Desiccators and Desiccants
• Balances
• Centrifuges
• Laboratory Mathematics and Calculations
• Significant Figures
• Logarithms
• Concentration
• Dilutions
• Simple Dilutions
• Serial Dilutions
• Water of Hydration
• Graphing and Beer’s Law
• Specimen Collection and Handling
• Types of Samples
• Sample Processing
• Sample Variables
• Chain of Custody
• Electronic and Paper Reporting of Results
• Wrap-Up
• References
• Chapter 2 Laboratory Safety and Regulations
• Laboratory Safety and Regulations
• Occupational Safety and Health Act
• Other Regulations and Guidelines
• Safety Awareness for Clinical Laboratory Personnel
• Safety Responsibility
• Signage and Labeling
• Safety Equipment
• Chemical Fume Hoods and Biosafety Cabinets
• Chemical Storage Equipment
• PPE and Hygiene
• Biologic Safety
• General Considerations
• Spills
• Bloodborne Pathogens
• Airborne Pathogens
• Shipping
• Chemical Safety
• Hazard Communication
• Safety Data Sheet
• OSHA Laboratory Standard
• Toxic Effects from Hazardous Substances
• Storage and Handling of Chemicals
• Radiation Safety
• Environmental Protection
• Personal Protection
• Nonionizing Radiation
• Fire Safety
• The Chemistry of Fire
• Classification of Fires
• Types and Applications of Fire Extinguishers
• Control of Other Hazards
• Electrical Hazards
• Compressed Gas Hazards
• Cryogenic Materials Hazards
• Mechanical Hazards
• Ergonomic Hazards
• Disposal of Hazardous Materials
• Chemical Waste
• Radioactive Waste
• Biohazardous Waste
• Accident Documentation and Investigation
• Wrap-Up
• Bibliography and Suggested Reading
• References
• Chapter 3 Quality Management in the Clinical Laboratory
• Basic Concepts
• Descriptive Statistics: Measures of Center, Spread, and Shape
• Measurement of Precision
• Descriptive Statistics of Groups of Paired Observations
• Measurement of Bias
• Inferential Statistics
• Quality Control and Quality Improvement
• QC Charts
• Operation of a QC System
• Multi-Rules Rule!
• Proficiency Testing
• Lean Six Sigma
• Quality Assessment
• Individual Quality Control Program (IQCP): An Option to Streamline QCP
• Reference Range Studies
• Establishing Reference Ranges
• Determining Whether to Establish or Transfer and Verify Reference Ranges
• Data Analysis to Establish a Reference Range
• Data Analysis to Transfer and Verify a Reference Range
• Method Evaluation
• Regulatory Aspects of Method Evaluation
• Allowable Analytical Error
• Method Evaluation Acceptance Criteria
• Diagnostic Efficiency
• Measures of Diagnostic Efficiency
• Wrap-Up
• Online Resources
• References
• Chapter 4 Analytic Techniques
• Spectrophotometry
• Beer’s Law
• Spectrophotometric Instruments
• Components of a Spectrophotometer
• Spectrophotometer Quality Assurance
• Atomic Absorption Spectrophotometry
• Fluorometry
• Fluorometry Instrumentation
• Fluorescence Polarization
• Advantages and Disadvantages of Fluorometry
• Chemiluminescence
• Turbidimetry
• Nephelometry
• Laser Applications
• Electrochemistry
• Galvanic and Electrolytic Cells
• Half-Cells
• Ion-Selective Electrodes
• pH Electrodes
• Gas-Sensing Electrodes
• Enzyme Electrodes
• Coulometric Titration
• Anodic Stripping Voltammetry
• Electrophoresis
• Procedure
• Support Materials
• Treatment and Application of Sample
• Detection and Quantitation
• Electroendosmosis
• Isoelectric Focusing
• Immunofixation Electrophoresis
• Capillary Electrophoresis
• Two-Dimensional Electrophoresis
• Osmometry
• Freezing Point Osmometer
• Newer Optical Techniques
• Chromatography
• Modes of Separation
• Chromatographic Procedures
• High-Performance Liquid Chromatography
• Gas Chromatography
• Mass Spectrometry
• Sample Introduction and Ionization
• Mass Spectrometer Analyzer
• Detector
• Applications of MS in the Clinical Laboratory
• Small Molecule Analysis
• Mass Spectrometry in Proteomics and Pathogen Identification
• Mass Spectrometry at the Point of Care
• Wrap-Up
• References
• Chapter 5 Clinical Chemistry Automation
• History and Evolution of Automated Analyzers
• Driving Forces and Benefits of Automation
• Steps in Automated Analysis
• Specimen Preparation and Identification
• Specimen Measurement and Delivery
• Reagent Systems and Delivery
• Chemical Reaction Phase
• Measurement Phase
• Signal Processing and Data Handling
• Additional Considerations for Automated Immunoassays
• Immunoassay Basics
• Turbidimetry and Nephelometry
• Labeled Immunoassays
• Total Laboratory Automation
• Pre-analytic Phase
• Analytic Phase
• Post-analytic Phase
• Future Trends in Automation
• Wrap-Up
• References
• Chapter 6 Proteins and Heme Derivatives
• Amino Acids
• Overview
• Basic Structure
• Metabolism
• Classification
• Aminoacidopathies
• Methods of Analysis
• Proteins
• Overview
• Basic Structure
• General Chemical Properties
• Synthesis
• Catabolism and Nitrogen Balance
• Hormonal Regulation of Protein Metabolism
• Classification
• Plasma Proteins
• Prealbumin
• Albumin
• Globulins
• Other Proteins of Clinical Significance
• Troponin
• Natriuretic Peptides
• Fibronectin
• Cross-Linked C-Telopeptide
• Cystatin C
• Plasma Total Protein Abnormalities
• Hypoproteinemia
• Hyperproteinemia
• Methods of Analysis
• Sample Requirements
• Total Protein
• Albumin
• Immunochemical Assays
• Electrophoresis
• Proteins in Other Body Fluids
• Urine
• Cerebrospinal Fluid
• Hemoglobin
• Synthesis and Degradation of Hemoglobin
• Myoglobin
• Heme
• Synthesis of Heme
• Disorders of Heme Biosynthesis
• Clinical Application
• Analytical Methods
• Wrap-Up
• References
• Chapter 7 Nonprotein Nitrogen Compounds
• Urea
• Biochemistry
• Clinical Application
• Analytical Methods
• Pathophysiology
• Uric Acid
• Biochemistry
• Clinical Application
• Analytical Methods
• Pathophysiology
• Creatinine/Creatine
• Biochemistry
• Clinical Application
• Analytical Methods
• Pathophysiology
• Ammonia
• Biochemistry
• Clinical Application
• Analytical Methods
• Pathophysiology
• Wrap-Up
• References
• Chapter 8 Enzymes
• General Properties and Definitions
• Enzyme Classification and Nomenclature
• Enzyme Kinetics
• Enzyme Catalysis
• Factors That Influence Enzymatic Reactions
• Measurement of Enzyme Activity
• Calculation of Enzyme Activity
• Measurement of Enzyme Mass
• Enzymes as Reagents
• Enzymes of Clinical Significance
• Creatine Kinase
• Lactate Dehydrogenase
• Aspartate Aminotransferase
• Alanine Aminotransferase
• Alkaline Phosphatase
• Acid Phosphatase
• γ-Glutamyltransferase
• 5’-Nucleotidase
• Amylase
• Lipase
• Glucose-6-Phosphate Dehydrogenase
• Macroenzymes
• Drug-Metabolizing Enzymes
• Wrap-Up
• References
• Chapter 9 Carbohydrates
• General Description of Carbohydrates
• Classification of Carbohydrates
• Stereoisomers
• Monosaccharides, Disaccharides, and Polysaccharides
• Chemical Properties of Carbohydrates
• Glucose Metabolism
• Fate of Glucose
• Regulation of Carbohydrate Metabolism
• Hyperglycemia
• Diabetes Mellitus
• Pathophysiology of Diabetes Mellitus
• Criteria for Testing for Prediabetes and Diabetes
• Criteria for the Diagnosis of Diabetes Mellitus
• Criteria for the Testing and Diagnosis of GDM
• Hypoglycemia
• Genetic Defects in Carbohydrate Metabolism
• Role of the Laboratory in Differential Diagnosis and Management of Patients with Glucose Metabolic Alterations
• Methods of Glucose Measurement
• Self-Monitoring of Blood Glucose
• Glucose Tolerance and 2-Hour Postprandial Tests
• Glycosylated Hemoglobin/HbA1C
• Ketones
• Albuminuria
• Islet Autoantibody, Insulin Testing and C-Peptide Testing
• Wrap-Up
• References
• Chapter 10 Lipids and Lipoproteins
• Lipid Chemistry
• Fatty Acids
• Triglycerides
• Phospholipids
• Cholesterol
• General Lipoprotein Structure
• Chylomicrons
• Very-Low-Density Lipoprotein
• Intermediate-Density Lipoproteins
• Low-Density Lipoproteins
• Lipoprotein (a)
• High-Density Lipoproteins
• Lipoprotein X
• Lipoprotein Physiology and Metabolism
• Lipid Absorption
• Exogenous Pathway
• Endogenous Pathway
• Reverse Cholesterol Transport Pathway
• Lipid and Lipoprotein Population Distributions
• National Cholesterol Education Program
• Dyslipidemia and Children
• National Heart, Lung, and Blood Institute
• Diagnosis and Treatment of Lipid Disorders
• Arteriosclerosis
• Hyperlipoproteinemia
• Hypercholesterolemia
• PCSK9
• Hypertriglyceridemia
• Combined Hyperlipidemia
• Lp(a) Elevation
• Non-HDL Cholesterol
• Hypobetalipoproteinemia
• Hypoalphalipoproteinemia
• Lipid and Lipoprotein Analyses
• Lipid Measurement
• Cholesterol Measurement
• Triglyceride Measurement
• Lipoprotein Methods
• HDL Methods
• LDL Methods
• Apolipoprotein Methods
• Phospholipid Measurement
• Fatty Acid Measurement
• Standardization of Lipid and Lipoprotein Assays
• Precision
• Accuracy
• Matrix Interactions
• CDC Cholesterol Reference Method Laboratory Network
• Analytic Performance Goals
• Quality Control
• Specimen Collection
• Wrap-Up
• References
• Chapter 11 Electrolytes
• Water
• Osmolality
• The Electrolytes
• Sodium
• Potassium
• Chloride
• Bicarbonate
• Calcium
• Magnesium
• Phosphate
• Lactate
• Anion Gap
• Electrolytes and Renal Function
• Wrap-Up
• References
• Chapter 12 Blood Gases, pH, and Buffer Systems
• Acid–Base Balance
• Maintenance of H+
• Buffer Systems: Regulation of H+ and the Henderson-Hasselbalch Equation
• Regulation of Acid–Base Balance: Lungs and Kidneys (Transport of Carbon Dioxide)
• Assessment of Acid–Base Homeostasis
• The Bicarbonate Buffering System
• Acid–Base Disorders: Acidosis and Alkalosis
• Determining Patient Acid–Base Status
• Oxygen and Gas Exchange
• Oxygen and Carbon Dioxide
• Oxygen Transport
• Assessment of a Patient’s Oxygen Status
• Hemoglobin–Oxygen Dissociation
• Measurement
• Blood Gas Analyzers: pH, pCO2, and pO2
• Measurement of pO2
• Measurement of pH and pCO2
• Types of Sensors
• Calibration
• Correction for Temperature
• Calculated Parameters
• Spectrophotometric Determination of Oxygen Saturation (Co-Oximetry)
• Quality Assurance
• Preanalytic Considerations
• Analytic Assessments: Quality Control and Proficiency Testing
• Wrap-Up
• References
• Chapter 13 Basic Endocrinology
• Hormone Classification
• Amine
• Peptide
• Protein
• Glycoprotein
• Steroid
• Fatty Acid
• Introduction to Hormones
• Growth Hormone (GH)
• Adrenocorticotropic Hormone (ACTH) and the Adrenal Cortical Hormones
• Follicle Stimulating Hormone and Luteinizing Hormone
• Prolactin (PRL)
• Androgens
• Progesterone
• Estrogens/Estradiol/Estriol
• Catecholamines
• Thyroid Hormone (T3, T4) and Thyroid Stimulating Hormone (TSH)
• Posterior Pituitary Hormones
• Calcitonin and Procalcitonin
• Parathyroid Hormone (PTH)
• Insulin
• Glucagon
• Gastrin and Secretin
• Human Chorionic Gonadotropin (hCG)
• Serotonin/5-hydroxyindolacetic Acid (5-HIAA)
• Hormone Metabolism
• Alcohol Consumption
• Adrenal Steroid Hormone Synthesis
• Mechanisms of Elimination
• Hormone Transport
• Solubility
• Carrier Proteins
• Micelles
• Feedback Mechanisms
• Negative Feedback Mechanisms
• Positive Feedback Mechanisms
• Primary, Secondary, and Tertiary Disorders
• Other Factors That Affect Hormone Levels
• Emotional Stress
• Time of Day
• Menstrual Cycle
• Menopause
• Food Intake/Diet
• Drugs
• Wrap-Up
• References
• Chapter 14 Thyroid Function
• The Thyroid
• Thyroid Anatomy and Development
• Thyroid Hormone Synthesis
• Protein Binding of Thyroid Hormone
• Control of Thyroid Function
• Actions of Thyroid Hormones
• Tests for Thyroid Function
• Thyroid-Stimulating Hormone
• Thyroxine (T4)
• Triiodothyronine (T3)
• Free Thyroxine (FT4)
• Free Triiodothyronine (FT3)
• Thyroglobulin Antibody
• Thyroperoxidase Antibody
• Thyrotropin Receptor Antibody
• Other Tools for Thyroid Evaluation
• Nuclear Medicine Evaluation
• Thyroid Ultrasound
• Fine-Needle Aspiration
• Disorders of the Thyroid
• Hypothyroidism
• Thyrotoxicosis
• Hyperthyroidism
• Toxic Adenoma and Multinodular Goiter
• Drug-Induced Thyroid Dysfunction
• Amiodarone-Induced Thyroid Disease
• Subacute Thyroiditis
• Nonthyroidal Illness
• Thyroid Nodules
• Wrap-Up
• References
• Chapter 15 Hypothalamic and Pituitary Function
• Embryology and Anatomy
• Functional Aspects of the Hypothalamic–Hypophyseal Unit
• Pituitary Tumors
• Hypophysiotropic or Hypothalamic Hormones
• Anterior Pituitary Hormones
• Growth Hormone
• Actions of GH
• Testing
• GH Excess
• GH Deficiency
• Prolactin
• Prolactinoma
• Other Causes of Hyperprolactinemia
• Clinical Evaluation of Hyperprolactinemia
• Management of Prolactinoma
• Idiopathic Galactorrhea
• Hypopituitarism
• Etiology of Hypopituitarism
• Treatment of Panhypopituitarism
• Posterior Pituitary Hormones
• Oxytocin
• Arginine Vasopressin
• Wrap-Up
• References
• Chapter 16 Adrenal Function
• Embryology and Anatomy
• The Adrenal Cortex
• Glucocorticoid Physiology
• Cortex Steroidogenesis
• Congenital Adrenal Hyperplasia
• Primary Aldosteronism
• Etiology
• Diagnosis
• Treatment
• Adrenal Insufficiency
• Symptoms
• Diagnosis
• Treatment
• Isolated Hypoaldosteronism
• Hypercortisolism (Cushing’s Syndrome)
• Etiology
• Diagnosis
• Treatment
• Adrenal Androgens
• Androgen Excess
• Diagnosis
• Treatment
• The Adrenal Medulla
• Embryology
• Biosynthesis, Storage, and Secretion of Catecholamines
• Metabolism and Excretion of Catecholamines
• Pheochromocytoma and Paraganglioma
• Epidemiology
• Clinical Presentation
• Diagnosis
• Result Interpretation
• Treatment
• Adrenal Incidentaloma
• Wrap-Up
• References
• Chapter 17 Gonadal Function
• The Testes
• Functional Anatomy of the Male Reproductive Tract
• Physiology of the Testicles
• Disorders of Sexual Development and Testicular Hypofunction
• Diagnosis of Hypogonadism
• Testosterone Replacement Therapy
• Monitoring Testosterone Replacement Therapy
• The Ovaries
• Early Ovarian Development
• Functional Anatomy of the Ovaries
• Hormonal Production by the Ovaries
• The Menstrual Cycle
• Hormonal Control of Ovulation
• Pubertal Development in the Female
• Precocious Sexual Development
• Menstrual Cycle Abnormalities
• Evaluation of Female Infertility
• Hirsutism
• Estrogen Replacement Therapy
• Wrap-Up
• References
• Chapter 18 Parathyroid Function
• Parathyroid Glands
• Parathyroid Hormone
• Vitamin D
• Effects of the Parathyroid Hormone
• GI Regulation
• Role of Kidneys
• Bone Physiology
• Parathyroid Disorders
• Primary Hyperparathyroidism
• Secondary Hyperparathyroidism
• Secondary and Tertiary Hyperparathyroidism in Renal Failure
• Familial Hypocalciuric Hypercalcemia
• Hyperthyroidism
• Addison’s Disease
• Medications That Cause Hypercalcemia
• Hypervitaminosis
• Parathyroid Hormone–related Protein
• Hypoparathyroidism
• Metabolic Bone Diseases
• Rickets and Osteomalacia
• Osteoporosis
• Wrap-Up
• References
• Chapter 19 Liver Function
• Anatomy
• Gross Anatomy
• Microscopic Anatomy
• Biochemical Functions
• Excretory and Secretory Functions
• Metabolism
• Detoxification and Drug Metabolism
• Liver Function Alterations During Disease
• Jaundice
• Cirrhosis
• Tumors
• Reye’s Syndrome
• Drug- and Alcohol-Related Disorders
• Assessment of Liver Function/Liver Function Tests
• Bilirubin
• Methods
• Urobilinogen in Urine and Feces
• Serum Bile Acids
• Enzymes
• Tests Measuring Hepatic Synthetic Ability
• Tests Measuring Nitrogen Metabolism
• Hepatitis
• Wrap-Up
• References
• Chapter 20 Cardiac Function
• Pathophysiology of Atherosclerosis
• Cardiac Ischemia, Angina, and Heart Attacks
• Markers of Cardiac Damage
• Initial Markers of Cardiac Damage
• Cardiac Troponins
• Myoglobin
• Cardiac Injury
• Cardiac Biomarkers in Heart Failure
• Diagnosis and Risk Stratification of Heart Failure
• Cardiac Troponins
• Markers of Coronary Heart Disease Risk and Plaque Instability
• C-Reactive Protein
• Homocysteine
• Markers of Pulmonary Embolism
• Use of d-Dimer Detection in PE
• Value of Assaying Troponin and BNP in Acute PE
• Coronary Heart Disease
• Wrap-Up
• References
• Chapter 21 Renal Function
• Renal Anatomy
• Renal Physiology
• Glomerular Filtration
• Tubular Function
• Elimination of Nonprotein Nitrogen Compounds
• Water, Electrolyte, and Acid–Base Homeostasis
• Endocrine Function
• Analytic Procedures
• Creatinine Clearance
• Estimated GFR
• Cystatin C
• β2-Microglobulin
• Myoglobin
• Albuminuria
• Neutrophil Gelatinase–Associated Lipocalin
• NephroCheck
• Urinalysis
• Pathophysiology
• Glomerular Diseases
• Tubular Diseases
• Urinary Tract Infection/Obstruction
• Renal Calculi
• Renal Failure
• Wrap-Up
• References
• Chapter 22 Pancreatic Function
• Physiology of Pancreatic Function
• Diseases of the Pancreas
• Tests of Pancreatic Function
• Cholecystokinin (CCK) Test
• Fecal Fat Analysis
• Fecal Enzymes
• Sweat Electrolyte Testing
• Serum Enzymes
• Tests of Gastric Secretion and Intestinal Function
• Wrap-Up
• References
• Chapter 23 Body Fluid Analysis
• Cerebrospinal Fluid
• Serous Fluids
• Pleural Fluid
• Pericardial Fluid
• Peritoneal Fluid
• Amniotic Fluid
• Hemolytic Disease of the Fetus and Newborn
• Neural Tube Defects
• Fetal Lung Maturity
• Phosphatidylglycerol
• Lamellar Body Counts
• Sweat
• Synovial Fluid
• Wrap-Up
• References
• Chapter 24 Pregnancy and Prenatal Testing
• Pregnancy
• Conception and Embryonic Development
• Fetal Development
• Delivery
• Transformation During Pregnancy
• Plasma Volume Increase
• Renin–Angiotensin–Aldosterone System
• Natural Decreases in Analytes
• Upregulation of Hormones and Steroids
• Increased Glomerular Filtration Rate
• Hyperventilation
• Endocrine
• Cholesterols
• Immune System
• Neuroactive Hormones
• Analytes for Maternal and Fetal Health Assessment
• Human Chorionic Gonadotropin
• α-Fetoprotein (AFP)
• Fetal Amniotic Fluid α-Fetoprotein
• Unconjugated Estriol
• Inhibin A
• The Triple and Quadruple Screen Test
• Acetylcholinesterase
• Pregnancy Associated Plasma Protein A (PAPP-A)
• Progesterone
• Glucose
• Fetal Fibronectin
• Common Diseases Associated with the Developing Fetus
• Neural Tube Defects
• Down Syndrome
• Trisomy 18
• Isoimmunization
• Preterm Delivery
• Common Diseases Associated with the Mother and Pregnancy
• Preeclampsia
• Hyperemesis Gravidarum
• Ectopic Pregnancy
• Analyte Deficiency
• Other Clinical Impairments
• Wrap-Up
• References
• Chapter 25 Therapeutic Drug Monitoring
• Pharmacokinetics
• Routes of Administration
• Drug Absorption
• Drug Distribution
• Free Versus Bound Drugs
• Drug Metabolism
• Drug Elimination
• Elimination Example
• Pharmacodynamics
• Specimen Collection
• Pharmacogenomics
• Cardioactive Drugs
• Digoxin
• Quinidine
• Procainamide and N-acetylprocainamide
• Disopyramide
• Antibiotics
• Aminoglycosides
• Gentamicin
• Tobramycin
• Amikacin
• Vancomycin
• Antiepileptic Drugs
• Primidone
• Phenobarbital
• Phenytoin and Free Phenytoin
• Valproic Acid
• Carbamazepine
• Ethosuximide
• Felbamate
• Gabapentin
• Lamotrigine
• Levetiracetam
• Oxcarbazepine
• Tiagabine
• Topiramate
• Zonisamide
• Psychoactive Drugs
• Lithium
• Tricyclic Antidepressants
• Clozapine
• Olanzapine
• Immunosuppressive Drugs
• Cyclosporine
• Tacrolimus
• Sirolimus
• Everolimus
• Mycophenolic Acid
• Antineoplastics
• Methotrexate
• Bronchodilators
• Theophylline
• Wrap-Up
• References
• Chapter 26 Toxicology
• Xenobiotics, Poisons, and Toxins
• Routes of Exposure
• Dose–Response Relationship
• Acute and Chronic Toxicity
• Analysis of Toxic Agents
• Toxicology of Specific Agents
• Alcohols
• Carbon Monoxide
• Caustic Agents
• Cyanide
• Metals and Metalloids
• Pesticides
• Toxicology of Therapeutic Drugs
• Salicylates
• Acetaminophen
• Toxicology of Drugs of Abuse
• Amphetamines
• Sedatives–Hypnotics
• Barbiturates
• Benzodiazepines
• Cannabinoids: Tetrahydrocannabinol (THC)
• Cocaine
• Opioids
• Tricyclic Antidepressants
• Methylenedioxymethamphetamine
• Phencyclidine
• Anabolic Steroids
• Wrap-Up
• References
• Chapter 27 Trace Elements, Toxic Elements, and Vitamins
• Trace and Toxic Elements
• Instrumentation and Methods
• Aluminum
• Arsenic
• Cadmium
• Chromium
• Copper
• Iron
• Lead
• Manganese
• Mercury
• Molybdenum
• Selenium
• Zinc
• Vitamins
• Overview
• Fat-Soluble Vitamins
• Water-Soluble Vitamins
• Wrap-Up
• References
• Bibliography
• Chapter 28 Tumor Markers
• Types of Tumor Markers
• Applications of Tumor Marker Detection
• Screening and Risk Assessment
• Prognosis
• Monitoring Effectiveness of Therapy and Disease Recurrence
• Laboratory Considerations for Tumor Marker Measurement
• Immunoassays
• High-Performance Liquid Chromatography
• Immunohistochemistry and Immunofluorescence
• Enzyme Assays
• Tumor Marker Tests
• α-Fetoprotein
• Cancer Antigen 125 (CA-125)
• Carcinoembryonic Antigen (CEA)
• Human Chorionic Gonadotropin (hCG)
• Prostate-Specific Antigen
• Cancer Antigen 15-3
• Carbohydrate Antigen 19-9 (CA 19-9)
• Immunoglobulin Free Light Chains
• Human Epididymis Protein 4 (HE4)
• Neuron-Specific Enolase (NSE)
• Wrap-Up
• Suggested Reading
• References
• Chapter 29 Point-of-Care Testing
• Laboratory Regulations
• Accreditation
• POCT Complexity
• Implementation
• Establishing Need
• POCT Implementation Protocol
• Personnel Requirements
• Quality Management
• Accuracy Requirements
• QC and Proficiency Testing
• POC Applications
• Informatics and POCT
• Wrap-Up
• References
• Chapter 30 Newborn and Pediatric Clinical Chemistry
• Developmental Changes from Neonate to Adult
• Respiration and Circulation
• Growth
• Organ Development
• Problems of Prematurity and Immaturity
• Pediatric Sample Collection and Handling
• Phlebotomy
• Preanalytic Concerns
• Choice of Analyzer
• Point-of-Care Analysis in Pediatrics
• Turnaround Time
• Evaluation of POCT Devices
• Device Limitations for Pediatric Use
• Regulation of Blood Gases and pH in Neonates and Infants
• Blood Gas and Acid–Base Measurement
• Regulation of Electrolytes and Water: Renal Function
• Disorders Affecting Electrolytes and Water Balance
• Development of Liver Function
• Physiologic Jaundice
• Energy Metabolism
• Diabetes
• Nitrogen Metabolism
• Nitrogenous End Products as Markers of Renal Function
• Liver Function Tests
• Calcium and Bone Metabolism in Pediatrics
• Hypocalcemia and Hypercalcemia
• Endocrine Function in Pediatrics
• Hormone Secretion
• Hypothalamic–Pituitary–Thyroid System
• Hypothalamic–Pituitary–Adrenal Cortex System
• Growth Factors
• Endocrine Control of Sexual Maturation
• Development of the Immune System
• Basic Concepts of Immunity
• Components of the Immune System
• Neonatal and Infant Antibody Production
• Immunity Disorders
• Genetic Diseases
• Cystic Fibrosis
• Newborn Screening for Whole Populations
• Diagnosis of Metabolic Disease in the Clinical Setting
• Drug Metabolism and Pharmacokinetics
• Therapeutic Drug Monitoring
• Toxicologic Issues in Pediatric Clinical Chemistry
• Wrap-Up
• References
• Chapter 31 Geriatric Clinical Chemistry
• The Aging of America
• Aging and Medical Science
• General Physiologic Changes with Aging
• Muscle
• Bone
• Gastrointestinal System
• Kidney/Urinary System
• Immune System
• Endocrine System
• Sex Hormones
• Glucose Metabolism
• Effects of Age on Laboratory Testing
• Muscle
• Bone
• Gastrointestinal System
• Urinary System
• Immune System
• Endocrine System
• Sex Hormones
• Glucose Metabolism
• Establishing Reference Ranges for the Elderly
• Preanalytical Variables Unique to Geriatric Patients
• Diseases Prevalent in the Elderly
• Age-Associated Changes in Drug Metabolism
• Absorption
• Distribution
• Metabolism
• Elimination
• Atypical Presentations of Common Diseases
• Geriatric Syndromes
• The Impact of Exercise and Nutrition on Chemistry Results in the Geriatric Population
• Wrap-Up
• References
• Appendix: Reference Range
• Glossary
• Index