Subject: Chemistry and Immunology
Hi guys!
I'm posted to Biology and Immunology for this week:)
Basically in the bio/immuno section, we handle samples that requires chemistry and immunology testing. Upon receiving the samples, we are to sort them into different catergories and send them to respective machines for testing.
The categories are:
1) Chemistry
2) Immunology
3) Mixed
Chemistry
Types of tests:
Tchol, HDL, Tg, Chol, CO2, Glu, K, Na, Cl, TP, ALT, AST, GGT, alb, glob, ratio(A/G), T-Bil, Ca, Phos, CPR Quant/latex, HS CRP, Amylase, UA, APO-A, APO-B, D-Bil, Fe, D-Dimer, Mg
Those highligted in green are normal tests requested.
Here we test the sample under a machine called ModP. These samples are easy to handle as we only need to load them in the machine, press START and wait for the results that will be shown on the computer:)
Those highlighted in purple, they are samples we have to take note of.
ModP will not be able to detect them hence we use a more specialized machine Cobas501.
For Cobas501, it is able to detect all type of chemistry tests.
So why don't we just use Cobas for all chemistry tests?
It is because Cobas is a much smaller machine than ModP... Hence ModP is usually used as it is able to process more speicmens.
Immunology
Type of tests:
TSH, FTy, FT3, CA, CEA, PSA, Testro, HIV, FSH, LH, Prolactin, Progesterone, Ferretom, Abs, Ag, HAV, HBeAg, Afp, Trop T, CK-MB, B-hCG, anti-HBe, anti-HBC, anti-HBCIgM, anti-HCV, anti-EBV, anti-dsDNA, Rubella-IgG
Similarly to chemistry, there are samples that we run normally and others that we must take note of.
For normal tests requested, we use modEAO
For specialized tests, we use Eles2010. These samples we have to run maunally, where we have to key into the machine what specific tests to perform.
Mixed
The tests requested consist of both type! So samples are run in respective machines.
All samples are run in plain tubes except D-dimer where it is run in sodum citrate tube.
The procedures above are the general tests we perform. However we also handle other cases like:
-Oral Glucose Tolerance Test(OGTT)
test for: diabetes
sample: fasting glucose, 1st he glucose and 2nd hr glucose
machine used: modP
tube used: fluoride tube
-HbAIC (more specific test for diabetes)
machine used: D10
tube used: EDTA tube
-Micoalbumin(Quanti)
test for: urine(normal/abonormal)
uses: Clinitex and urine strips
-G6PD
test: manually perform on test strip and looked under long wave
results: If baby is normal, sample will fluoresce)
-Microsomal Ab
test: performed on microtitre plate
ok so heres a recap!
chemistry testing---- modP or Cobas
immunology testing-- modEAO or Eles2010
diabetes------------- OGTT or HbAIC in D10
urine(microalbumin)- Clinitex
G6PD---------------- Manual testing on test strip
Microsomal Ab------- Manual testing on microtitre plate
Additional info~
Test tubes:
Yellow- plain tube with gel
Red --- plain without gel
Blue--- sodium citrate (D-dimer)
Purple- EDTA
Grey--- fluoride (glucose)
Green-- lithium haprine
Posted by=)
Kum Hui Min
0605989C
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24 comments:
hihi, hope you have fun during the 1st week of your attachment and learnt new things =)
i am very interested about the tests that you performed, there are some queries that i wanted to ask you about.
1, there are so many types of tests right, what types of results it will show? as in for eg. it only show present or absent of the chemical substances or the result will give you a value?
2,what are the principle of the machine ? how the machine works to dected all those chemical substances ?
thanks =)
ting jie
tg01
Hi Min! Is everything going well?
I noticed that quite a number of the chemistry tests carried out in your lab are similar to mine! Even though the names of machines you mentioned are rather unfamiliar.
Just to ask (as we all have to)
1. Does the machines send off an alarm when panic values (extremely abnormal results) are detected? If so, what are the procedures that should be taken?
In our lab here, we usually have to rerun the test and if the results values still reflect 'dangerous values', we are to inform the ward immediately.
Are the procedures similar over your laboratory?
TQ~
Tan Zhao Rong
Tg01
hey tingjie!
Thanks for reading! hope you are enjoying your sip too:)
And for the answers to your questions...
1) It depends on what type of tests it is...
For microalbumin(urine) test, it will show either normal or abonormal...
For HbAIC, glucose level is normal if the results does not show:
-unknown
-*
-no peak
For modP, modEAO, Cobas and Eles
and answer to qn2... i have not learnt yet due to time constraint:p
Actually next week i will be posted to another lab... If im posted back again then i will ask and answer u again ok:)
cheers,
hui min
tg01 grp4
hey zhao!
Yupyup everything is going fine:)
how about you?
Anyway for my lab is not very big... so i think our machines are different as i think your lab machines are bigger:)
haha my machines here they don't send off an alarm for abnormal results... it will only be reflected at the computer.
However there will be alarm if the samples are not loaded properly(eg. barcode error) or there is other type of errors...
As for abnormal results we also do rerun! But we need not inform the wards:)
cheers,
hui min
tg01
Hello
May I know what samples are usually required in chemistry and immunology testings?
You mentioned Clinitex under Microalbumin. What actually is Clinitex? Both the Clinitex and urine strips need to be used together in order to detect microalbumin in urine?
Thanks!
LeeJin
TG02
Hey there! Hope you are doing well.
I'm just wondering what's a Clinitex? You mentioned it at the Micoalbumin section.
Hardina
Tg01
Hi. Hope everything goes smooth in your first week of attachment.
I am just wondering, you mention that those type of tests that are higlighted in purple cannot be tested by ModP and so your lab detect them using Cobas501, then why is this so?
Is that because the concentration are too low that the machine is not senstive enough to detect them or is it that the machine does not detect them at all?
Thanks.
Xin Yi
TG02
hey min! how's it going? hope you're having lotsa fun there..
i'm currently attached to a Serology department and i do some of the tests that you do too, for example, free Beta-HCG, anti-EBV and anti-ds DNA. mine's automated, but the machine found in my department is called EVOLIS or EVOLIS Twin Plus. they both run using the ELISA method which causes fluorescences of the substrate.
so i'm wondering what is the principle of the machine your department uses. usually they will use a test kit right? what is the test kit used in your department and what does it say about the principle of the test? thanks C:
nur azeimah
TG02 grp 8
Hi Min!
How's everything? Ya. Think we only came across EDTA and Sodium Citrate tubes so far. What's the rest for? The red, grey, yellow and soon. What's so special about the gel in the tube?
See ya soon!
Ting Ying Chee
0606530D
hey LeeJin and Hardina!
The samples we use are mainly blood plasma... but if requested we will test the urine and glucose too:)
And for Clinitex its a machine that measure the urine strip, which test for the macroalbumin level in urine to determine if the urine is normal or abnormal.
The procedures are quite simple actually:)
1) Enter sample no. into Clinitex
2) Dip the urine strip into urine
3) Insert urine strip into Clinitex
4) Wait for results which will be printed out or shown on the CLinitex screen
Hope i answer your questions:)
cheers,
huimin
tg01
hey xinyi!
Thanks everything is going well! Hope you are enjoying your SIP too:)
ModP is unable to test for those samples highlighted in purple because it doesn't have those functions at all. This is because ModP is quite an old machine...
On the other hand Cobas501 is quite a new machine.. If i didn't remeber wrongly I think our lab just got it a few months ago!
Yupyup so Cobas501 can say its a newer vision of ModP... it have more functions:)
cheers,
huimin
tg01
hey azei!
haha i'm good.. the staff there are quite friendly! how about you?
For beta-HCG mine is automated too! We run on machine called Eles2010.. This is the only test i know so far that need to rerun regardless the result is normal or not.
For anti-EBV, anti-dsDNA, antiHCV and rubella i'm not very sure... I have yet to learn the procedures as they say its quite complicated:p
But that time i saw them doing it in very long test-tube rack.. and they go into another room to do the testing... I think the machine is in that room but i have not got the chance to peep at it yet:p
haha and for these tests they are only done on tuesday and friday.. and usually done by the same collegue:)
if i get posted back to the lab then i go check it out and let you know again:)
cheers,
huimin
tg01
hey ying!
The Yellow and Red tubes are plain tubes, which mean the blood will be in the 'original state' as it is not mixed with any substances at all.
What so special about the gel in the yellow tube is that it clearly seperate the serum and plasma. After centrifuging it, the serum will be be at e bottom of the tube, followed by the gel and the plasma will be at the top of the tube...
This is my favourite tube as this is the only tube that you can 'swing' around, without worrying about mixing the serum and plasma again:)
For the grey tube it contains fluriode and it is used to contain glucose. Floride prevents glucose from glycolysis:)
Lithium haprine is an anti-coagulant. So whenever we see a green-capped tube, we are suppose to use the fastest time to seperate the plasma and serum:)
Acutally so far i have only come across the yellow, grey and green tubes.
The red, blue and purple tubes are under the hematology section! I will be posted to there for next week... i update you again ok:)
cheers,
huimin :)
Hi huimin,
Regarding OGTT and HbAIC, may i know in what way is HbAIC more specific than OGTT? For HbAIC, is there any preservatives to preserve glucose in EDTA tubes? If not, how does EDTA tubes preserve glucose like fluoride tubes do?
Thanks!
Malerie
TG02
hihi can i ask what are the full names of all these tests? because you wrote in short form thus i only understand some:)thanks a lot:)--> Tchol, HDL, Tg, TP, glob, ratio(A/G), T-Bil, CPR Quant/latex, HS CRP, UA, APO-A, APO-B, D-Bil, D-Dimer,
Rachael
Tg1
hey Malerie!
For OGTT we uses fasting glucose.. it is not that accurate as a patient can fake his/her results by not eating for a few days before the test to reduce the glucose level!
On the other hand, the results of HbAIC cannot be 'faked' as HbAIC is a product of glucose regulation. Hence it is more accurate as it measures for the true value of blood glucose concentration.
Oh may be i didn't state clearly.. although HbAIC measures for glucose level but it uses blood as specimen. Hence it uses EDTA tube to prevent blood from clotting...
So in summary,
OGTT
--- specimen used: glucose
--- tube: fluoride
HbAIC
-- specimen used: blood
-- tube: EDTA
hope i clear ur enquires! :p
cheers,
huimin
tg01
hey Rachael!
They are:
Tchol: Total cholestrol
HDL: High density lipoprotein
Tg: triglyceride
TP: Total protein
Glob: Globulin
ratio(A/G): ratio of albumin over globulin
T-Bil: Total Bilirubin
CPR Quant/latex: Not sure about the full name but it indicates the need for urine test
HS CRP: high sensitive C-reactive protein
UA: Uric Acid
APO-A: Apoprotein A
APO-B: Apoprotein B
D-Bil: Direct Bilirubin
D-Dimer: i think D-dimer is the original name
Actually there are so many of them so i'm not 100% confident i got all of them right:p So sorry.. if anyone of them is wrong i let you know again :)
cheers,
huimin
tg01
Hello
Thanks for the reply! But so sorry.. A few more questions for you.. In the blog, you mentioned Clinitex measures microalbumin (Quanti). But you mentioned macroalbumin in your reply. So Clinitex can measure both the micro and macroalbumin? What exactly is microalbumin and macroalbumin? Is it the same as the Albumin that we usually come across?
Thank You
LeeJin
TG02
hey LeeJin!
So sorry i think I typed wrongly! I'm refering to microalbumin.. not macroalbumin:p
Haha sorry... So far my lab only come across microalbumin.. have not come across macroalbumin yet..
cheers,
huimin =)
tg01
Hello Hui Min,
I'd like to ask, I know OGTT is to test for diabetes but what is the principle of taking the 1st hr and 2nd hr blood of the patient? THANKS! (:
Leslie
hey Leslie!
1st hr: 1hr after consuming gluocse solution
2nd hr: 2 hrs after consuming glucose solution
In OGTT a healthy person blood glucose levels peak within an hour and then begin to drop after consuming glucose solution.
Hence if a patient 2nd hr glucose level is higher than 1st hr glucose, we can diagnose that the person is suffering from diabetes.
Am i clear enough? :P
cheers,
huimin
tg01
:)
yoz, Ivan here. according from what my lab collegue taught me, HbA1c is a test to monitor the diabetic patients condition and to determine the appropriate dosage quantity of anti-diabetic drugs do administer to patients(refer to my post for more info). It is not for diabetic detection. So my question here is how you learnt that HbA1c is a more specific test for diabetes? or what do u mean by specific test for diabetes? izit for diagnosis whether a patient is suffering from diabetes?
Please refer to Ivan comment. He has raised a very important point. Is HbA1c a screening test for DM? ALl of you need to be clear of the difference between screening test, confirmatory test and tests that assist doctors to manage disease in patients.
hey ivan!
So sorry for this very late reply... my lab been very busy this few weeks so didn't get the chance to clarify from my collegue as i've been attached to another section:p
Anw got to ask her during lunch break yesterday... She say each lab has different purpose of using HbA1c!
For our lab we uses HbA1c as a screening method to detect DM and also monitor the patient condition after injecting insulin... To confirm we use OGTT(the old traditional method) instead...
As for the determining the dosage or to diagnosis whether its DM or not, it's up to the doc as lab doesn't handle this part.
But my collegue also mention in actual fact, HbA1c can be use for confirmatory too as it provide enough details to diagnose DM.
haha i asked why we only use HbA1c as screening not confirmatory... she told me something but i don't think i can blog it here.. Will tell you in person during campus discussion yeah:)
see you on fri!
cheers,
huimin =)
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