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Contemporary Practice in Clinical Chemistry
4th Edition - June 8, 2020
Editors: William Clarke, Mark Marzinke
Paperback ISBN:
9 7 8 - 0 - 1 2 - 8 1 5 4 9 9 - 1
eBook ISBN:
9 7 8 - 0 - 1 2 - 8 1 5 8 3 3 - 3
Contemporary Practice in Clinical Chemistry, Fourth Edition, provides a clear and concise overview of important topics in the field. This new edition is useful for students,… Read more
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Contemporary Practice in Clinical Chemistry, Fourth Edition, provides a clear and concise overview of important topics in the field. This new edition is useful for students, residents and fellows in clinical chemistry and pathology, presenting an introduction and overview of the field to assist readers as they in review and prepare for board certification examinations. For new medical technologists, the book provides context for understanding the clinical utility of tests that they perform or use in other areas in the clinical laboratory. For experienced laboratorians, this revision continues to provide an opportunity for exposure to more recent trends and developments in clinical chemistry.
- Includes enhanced illustration and new and revised color figures
- Provides improved self-assessment questions and end-of-chapter assessment questions
Fellows and residents of pathology and clinical chemistry, as well as laboratory professionals
- Cover image
- Title page
- Table of Contents
- Copyright
- List of contributors
- Preface
- Chapter 1. Preanalytical variation
- Abstract
- Order entry
- Patient preparation
- Specimen collection
- Processing and transportation
- Detecting preanalytical errors
- Summary
- References
- Self-assessment questions
- Answers
- Chapter 2. Statistical methods in laboratory medicine
- Abstract
- Introduction
- Basic descriptive statistical analysis
- Is my data normally distributed?
- Detecting outliers
- Common inferential statistics
- Methods of regression
- Evaluation of diagnostic test performance
- Likelihood ratios
- Receiver operating characteristic curves
- Suggested additional topics for study
- References
- Self-assessment questions
- Answers
- Chapter 3. Reference intervals: theory and practice
- Abstract
- Introduction
- Methodological approaches to establishment of reference intervals
- Pediatric and geriatric reference intervals: challenges and recent advances
- Reference interval transference and verification
- Toward reference interval harmonization
- Limitations of population-based reference intervals
- Concluding remarks
- References
- Self-assessment questions
- Answers
- Chapter 4. Method validation
- Abstract
- Introduction
- Regulations
- Analytical goals and method selection
- Helpful tips and tools prior to performing validation
- Method validation basics
- Validation of laboratory developed tests
- The role of the medical laboratory director
- References
- Self-assessment questions
- Answers
- Chapter 5. Quality control
- Abstract
- Introduction
- Implementing statistical process control
- Development of a quality control plan based on risk management
- Reviewing the quality control plan
- Using patient data in quality control procedures
- Proficiency testing
- References
- Further reading
- Self-assessment questions
- Answers
- Chapter 6. Laboratory calculations
- Abstract
- Analytical calculations
- Clinical calculations
- Statistics
- Method evaluation
- Laboratory management
- References
- Chapter 7. Spectrophotometry
- Abstract
- Principles of light absorption and emission
- Principles of spectrophotometric measurement
- Critical operating parameters: accuracy
- Critical operating parameters: precision
- Interferences
- Other applications of spectrophotometric or light emission measurements
- References
- Suggested reading
- Self-assessment questions
- Answers
- Chapter 8. Chromatography and electrophoresis
- Abstract
- Introduction to chromatography
- Gas chromatography
- Liquid chromatography
- Introduction to electrophoresis
- Gel electrophoresis
- Capillary electrophoresis
- References
- Self-assessment questions
- Answers
- Chapter 9. Electrochemistry
- Abstract
- Introduction
- Potentiometric methods in clinical chemistry
- Amperometric methods in clinical chemistry
- Conductometric methods in clinical chemistry
- Coulometric methods in clinical chemistry
- Interferences for potentiometric and amperometric sensors
- Biosensors based on electrochemical methods
- References
- Self-assessment questions
- Answers
- Chapter 10. Mass spectrometry
- Abstract
- Basic mass spectrometry concepts
- Sample introduction
- Ion sources
- Mass analyzers
- Detectors and processors
- Clinical mass spectrometry applications
- Challenges and opportunities in the implementation of clinical mass spectrometry methods
- Acknowledgments
- References
- Further reading
- Self-assessment questions
- Answers
- Chapter 11. Nuclear magnetic resonance technology and clinical applications
- Abstract
- Introduction
- Theory of nuclear magnetic resonance
- Proton nuclear magnetic resonance spectroscopy
- Nuclear magnetic resonance analyzers in clinical analysis
- Conclusions
- Disclosure
- References
- Self-assessment questions
- Answers
- Chapter 12. Immunoassays
- Abstract
- Introduction
- Immunoassays
- HIV Ag/Ab combination assay
- Mass spectrometry measurement of thyroglobulin
- Multiplexed immunoassay testing
- References
- Self-assessment questions
- Answers
- Chapter 13. Nucleic acid analysis in the clinical laboratory
- Abstract
- Introduction
- The biochemistry of deoxyribonucleic acid
- The human genome
- Complementarity
- Southern blot
- Fluorescence in situ hybridization
- FISH probes
- The polymerase chain reaction
- The process of polymerase chain reaction amplification
- Reverse transcriptase polymerase chain reaction
- Analysis of polymerase chain reaction amplicons
- Multiplex polymerase chain reaction
- Real-time polymerase chain reaction
- Probes for real-time polymerase chain reaction
- Post real-time polymerase chain reaction analysis
- Multiplexing with real-time polymerase chain reaction
- Digital polymerase chain reaction
- Digital polymerase chain reaction and multiplexing
- Microarrays
- Sequencing
- Implementation of molecular assays in the clinical laboratory
- Conclusion
- References
- Self-assessment questions
- Answers
- Chapter 14. Laboratory automation
- Abstract
- Goals of automation
- Components of laboratory automation
- Expectations of automation
- Automation beyond the chemistry analyzer
- Measurements of success
- Oversight
- Limitations of automation
- Ongoing monitoring
- Future perspective
- Conclusion
- References
- Self-assessment questions
- Answers
- Chapter 15. Laboratory regulations and compliance
- Abstract
- Introduction
- Regulatory responsibility in the laboratory
- Federal regulations
- Patient privacy
- Biobanking and providing specimens for research
- Occupational Safety and Health Administration regulations
- Reimbursement regulations: fraud and abuse
- State regulations
- Negligence
- Acknowledgments
- References
- Self-assessment questions
- Answers
- Chapter 16. Evidence-based laboratory medicine
- Abstract
- Introduction
- Elements of evidence-based laboratory medicine
- Metrics for evaluating diagnostic laboratory tests
- Using clinical laboratory medicine data for decision-making
- Summary
- References
- Self-assessment questions
- Answers
- Chapter 17. Harmonization of results among laboratories
- Abstract
- Why harmonized results are important?
- Infrastructure to support harmonization
- How to achieve harmonized results
- Commutability
- How to verify traceability of a clinical laboratory measurement procedure
- References
- Self-assessment questions
- Answers
- Chapter 18. Laboratory information management
- Abstract
- Introduction
- Management of digital laboratory information
- Laboratory information systems: preanalytic phase
- Laboratory information systems: analytic phase
- Laboratory information systems: postanalytic phase
- Data exchange and standards
- Logical observation identifier names and codes
- Servers, directories, and security
- File types
- Secondary data use
- Data warehousing
- Data analysis
- Data privacy
- Opportunities
- Summary
- Acknowledgments
- Suggested reading
- Self-assessment questions
- Answers
- Chapter 19. Point-of-care testing
- Abstract
- Introduction
- Quality point-of-care testing
- Point-of-care testing regulations
- Point-of-care testing connectivity and interfacing
- Point-of-care testing quality assurance programs
- Interdisciplinary communication
- Self-management
- Analytical performance
- Method limitations
- Risk management
- Summary
- References
- Self-assessment questions
- Answers
- Chapter 20. Applications of molecular techniques in the clinical laboratory
- Abstract
- Molecular diagnostics
- Genetic variants in hemostasis
- Nucleic acid testing in pathogen detection and monitoring
- Assay approaches
- Regulatory considerations for molecular approaches
- Conclusions
- References
- Self-assessment questions
- Answers
- Chapter 21. Applications of mass spectrometry in the clinical laboratory
- Abstract
- Mass spectrometric applications for measuring small molecules
- Mass spectrometry applications for measuring proteins
- Techniques used in clinical proteomics
- Examples of clinical protein mass spectrometric assays
- Use of mass spectrometry in method standardization and harmonization
- Regulatory considerations for clinical mass spectrometry
- Challenges of implementing mass spectrometry in the clinical laboratory
- Future of clinical mass spectrometry
- Conclusion
- References
- Self-assessment questions
- Answers
- Chapter 22. Proteins: analysis and interpretation in serum, urine, and cerebrospinal fluid
- Abstract
- Introduction
- Prealbumin region
- Albumin region
- αl Region
- α2 Region
- β Region
- β1 Region
- β2 Region
- γ Region
- Standard analytical techniques
- Turbidimetry and nephelometry
- Radial immunodiffusion
- Calculated results
- Quantitative assessment of proteins
- Interferences
- Protein analysis and interpretation
- References
- Suggested readings
- Self-assessment questions
- Answers
- Chapter 23. The complement system
- Abstract
- Introduction
- Overview of the complement system
- Assays in the clinical laboratory
- Disorders associated with complement deficiency or dysregulation
- Complement therapeutics
- Future directions
- Acknowledgments
- References
- Self-Assessment Questions
- Answers
- Chapter 24. Hemoglobin variant detection
- Abstract
- Introduction
- Blood smears and cell counts
- Biochemical techniques
- Molecular techniques
- References
- Further reading
- Self-assessment questions
- Answers
- Chapter 25. The complete blood count and white blood cell differential
- Abstract
- The cellular components of the peripheral blood
- The complete blood count and white blood cell differential
- Interpretation of abnormal results for the complete blood count or white blood cell differential
- Interpretation of the peripheral blood smear
- References
- Self-assessment questions
- Answers
- Chapter 26. Hemostasis
- Abstract
- The physiology of hemostasis
- Laboratory testing
- Pathophysiology and advanced coagulation testing
- References
- Self-assessment questions
- Answers
- Chapter 27. Diagnostic body fluid testing
- Abstract
- Introduction
- Regulations
- Specific body fluids
- References
- Self-assessment questions
- Answers
- Chapter 28. Lipids and lipoproteins
- Abstract
- Background
- Clinically relevant lipids
- Lipoprotein metabolism
- Clinical laboratory lipid measurements
- Lipoprotein electrophoresis
- Nonfasting lipid assessment
- Lipoprotein subfraction methods
- Lipoprotein disorders
- Hyperlipoproteinemias
- Hypolipoproteinemias
- Lipids and cardiovascular disease
- Lipid lowering for treatment of cardiovascular disease
- Clinical practice lipid measurement guidelines
- References
- Self-assessment questions
- Answers
- Chapter 29. Pediatric laboratory medicine
- Abstract
- Blood volume and sample volume requirements
- Challenges associated with small blood volumes
- Specimen types and collection
- Reference intervals in pediatrics
- Newborn screening
- Lead
- Transient hyperphosphatasemia
- Potassium and hemolysis
- Hemolysis and plasma hemoglobin
- Lipids
- Bilirubin
- Implications for testing in the pediatric population
- Transitioning to adult care
- References
- Self-assessment questions
- Answers
- Chapter 30. Biomarkers for coronary artery disease and heart failure
- Abstract
- Introduction
- Pathophysiology of acute coronary syndrome and myocardial infarction classification
- Evolving definitions of myocardial infarction with an increasing focus on biomarkers
- Cardiac troponins T and I
- Other biomarkers of acute myocardial infarction
- High-sensitivity cardiac troponin assays
- Pathophysiology of heart failure
- B-type natriuretic peptide and N-terminal-proBNP
- Clinical utility of B-type natriuretic peptide and N-terminal-proBNP in acute coronary syndrome
- Clinical need for future biomarkers of acute cardiovascular diseases
- Laboratory analysis for cardiac biomarkers
- Conclusions
- References
- Self-assessment questions
- Answers
- Chapter 31. Laboratory diagnosis of liver disease
- Abstract
- Review of normal liver structure and function
- Tests of liver injury
- Assessment of liver disease
- Acute liver disease
- Chronic liver disease
- Hepatic tumors
- Suggested reading
- Self-assessment questions
- Answers
- Chapter 32. Clinical chemistry of the gastrointestinal disorders
- Abstract
- Anatomy/physiology
- Pathology
- Small intestine
- Colon
- References
- Further reading
- GI CHEMISTRY—Self-assessment questions
- Answers
- Chapter 33. Evaluation of exocrine pancreatic function
- Abstract
- Anatomy and physiology of the pancreas
- Laboratory measurement of pancreatic enzymes
- Disorders of the pancreas
- Conclusion
- References
- Self-assessment questions
- Answers
- Chapter 34. Carbohydrate disorders
- Abstract
- Introduction
- Glucose measurements
- Common specimen sources for glucose measurement
- Hypoglycemia
- Hypoglycemic conditions in children
- Hyperglycemia
- Galactose disorders
- References
- Self-assessment questions
- Answers
- Chapter 35. Laboratory evaluation of kidney function
- Abstract
- Physiology of kidney function
- Chronic kidney disease
- Measurement of glomerular filtration rate
- Estimating equations
- Kidney function assessment and drug dose adjustment
- Urine protein
- Other biomarkers of kidney damage
- References
- Self-assessment questions
- Answers
- Chapter 36. Contemporary practice in clinical chemistry: blood gas and critical care testing
- Abstract
- Introduction
- Explanations of blood gas, acid–base, and cooximetry terms
- Physiology of acids and bases
- Clinical abnormalities of acid–base balance
- Evaluating blood gas results
- Evaluating the acid–base status
- Step 1: evaluate the patient’s status and history to anticipate possible acid–base abnormalities
- Step 2: evaluate the pH
- Step 3: evaluate the ventilatory and metabolic statuses
- Steps 4a–4c: evaluate for a possible mixed disorder
- Evaluating oxygen status
- Disorders of oxygenation: hypoxemia and tissue hypoxia
- O2 delivery to tissues
- Evaluation of oxygenation status and arterial oxygenation
- Arterial O2 tension and sO2 of Hb
- paO2/FIO2 ratio
- Hb concentration
- Blood O2 content
- Alveolar–arterial oxygen difference or gradient (A–a)
- V/Q mismatch and intrapulmonary shunting
- Evaluating tissue oxygenation
- Collection and handling of samples for blood gas analysis
- Collection and handling of blood
- Cord blood gases
- Temperature correction of blood gas results
- Usefulness of other tests on modern blood gas analyzer menus
- Met-Hb
- References
- Self-assessment questions
- Answers
- Chapter 37. Water and electrolyte balance
- Abstract
- Normal physiology of water and electrolytes
- Laboratory tests used to evaluate fluid and electrolyte abnormalities
- Disorders of water and sodium
- Disorders of potassium
- Disorders of chloride
- Acknowledgments
- Suggested reading
- Self-assessment questions
- Answers
- Chapter 38. Urinalysis
- Abstract
- Introduction
- Specimen collection and handling
- Routine urinalysis
- Physical examination
- Chemical examination
- Microscopic examination
- Automated urinalysis platforms
- Suggested reading
- Self-assessment questions
- Answers
- Chapter 39. Disorders of the anterior and posterior pituitary
- Abstract
- Introduction
- Anatomy
- Physiology and regulation
- Anterior pituitary hormone pathophysiology and lab findings
- Adrenocorticotropic hormone
- Thyroid-stimulating hormone
- Growth hormone
- Follicle-stimulating hormone and luteinizing hormone
- Prolactin
- Posterior pituitary hormone pathophysiology and lab findings
- Oxytocin
- References
- Self-assessment questions
- Answers
- Chapter 40. Laboratory evaluation of thyroid function
- Abstract
- Thyroid: anatomy, physiology, and biochemistry
- Thyroid hormone regulation
- Thyroid hormone synthesis
- Thyroxine versus triiodothyronine
- Thyroid hormone transport, conversion, and mechanism of action
- Clinical assessment of thyroid function
- Hyperthyroidism (thyrotoxicosis)
- Hypothyroidism
- Nonthyroidal illness
- Thyroid function and pregnancy
- Thyroid cancer
- Laboratory measurements of thyroid function
- Thyroid-stimulating hormone (thyrotropin)
- Total thyroxine
- Free thyroxine
- Total triiodothyronine and free triiodothyronine
- Reverse triiodothyronine
- Thyroxine-binding globulin
- Thyroglobulin
- Thyroid autoantibodies
- References
- Self-assessment questions
- Answers
- Chapter 41. Disorders of the adrenal cortex and medulla
- Abstract
- Introduction
- Adrenal cortex
- The adrenal medulla
- References
- Further readings
- Self-assessment questions
- Answers
- Chapter 42. Laboratory testing in pregnancy
- Abstract
- Normal pregnancy
- Human chorionic gonadotropin
- Progesterone expression in pregnancy
- Abnormal pregnancy
- Laboratory testing for fetal anomalies
- Preterm birth
- References
- Further reading
- Self-assessment questions
- Answers
- Chapter 43. Laboratory testing in reproductive disorders
- Abstract
- Introduction
- Hypothalamic–pituitary–gonadal axis
- Male reproductive endocrinology
- Female reproductive endocrinology
- Suggested reading
- Self-assessment questions
- Answers
- Chapter 44. Tumor markers
- Abstract
- Introduction to cancer
- Introduction to tumor markers
- Specific tumor markers
- Guidelines for the use of tumor markers
- References
- Self-assessment questions
- Answers
- Chapter 45. Calcium biology and disorders
- Abstract
- Introduction
- Calcium
- Hypocalcemia
- Hypercalcemia
- Calcitonin
- Phosphate
- Magnesium
- Markers of bone turnover
- Summary
- References
- Self-assessment questions
- Answers
- Chapter 46. Vitamins: functions and assessment of status through laboratory testing
- Abstract
- Introduction
- Vitamins
- Fat-soluble vitamins
- Vitamin A
- Vitamin D
- Vitamin E
- Vitamin K
- Water-soluble vitamins
- The B vitamin complex
- Thiamine
- Riboflavin
- Niacin
- Pantothenic acid
- Vitamin B6 (pyridoxine, pyridoxamine, and pyridoxal)
- Biotin
- Folic acid
- Vitamin B12
- Choline
- Vitamin C
- References
- Self-assessment questions
- Answers
- Chapter 47. Trace elements: functions and assessment of status through laboratory testing
- Abstract
- Introduction
- Iron
- Iodine
- Zinc
- Selenium
- Copper
- Manganese
- Cobalt
- Molybdenum
- Boron
- Chromium
- Fluorine
- References
- Self-assessment questions
- Answers
- Chapter 48. Newborn screening and inborn errors of metabolism
- Abstract
- Introduction to inborn errors of metabolism
- Newborn screening
- Metabolic testing
- The disorders
- Conclusion
- Acknowledgment
- References
- Further readings
- Self-assessment questions
- Answers
- Chapter 49. The porphyrias: fundamentals and laboratory assessment
- Abstract
- Introduction
- Biochemistry: heme formation
- Genetic disorders: porphyrias
- Diagnosis: laboratory evaluation
- Secondary causes of increased porphyrin excretion
- Treatment and management of the porphyrias
- Summary
- References
- Self-assessment questions
- Answers
- Chapter 50. Basic pharmacokinetics
- Abstract
- Introduction
- Pharmacokinetics and influencing factors
- Pharmacokinetic calculations
- Population pharmacokinetics and modeling
- Special populations
- References
- Self-assessment questions
- Answers
- Chapter 51. Therapeutic drug monitoring
- Abstract
- Management of therapeutic drugs
- Principles of therapeutic drug monitoring
- Analytical and clinical laboratory considerations for therapeutic drug monitoring
- Clinical areas where therapeutic drug monitoring is routine practice
- References
- Self-assessment questions
- Answers
- Chapter 52. Toxicology and the clinical laboratory
- Abstract
- Background
- Laboratory methods
- Toxidromes
- Key laboratory formulas
- Pharmacology and analysis of specific drugs and toxic agents
- Alcohols
- Analgesics (nonprescription)
- Drugs of abuse
- Metals
- Tricyclic antidepressants
- Agents related to cholinergic syndrome
- References
- Self-assessment questions
- Answers
- Chapter 53. Pharmacogenomics
- Abstract
- Introduction
- Drug response
- Pharmacogenetic testing
- Pharmacogenetics implementation
- Limitations
- References
- Self-assessment questions (True/False)
- Answers
- Chapter 54. Infectious diseases
- Abstract
- Herpesviruses
- Hepatitis viruses
- Human immunodeficiency virus
- Conclusion
- References
- Self-assessment questions
- Answers
- Chapter 55. Clinical microbiology
- Abstract
- Specimen collection
- Laboratory automation in clinical microbiology
- Components of automation
- Commercially available systems
- Benefits of lab automation and future directions
- Methods for identification of microorganisms
- DNA sequencing
- Biochemical/phenotypical methods
- Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry
- Point-of-care microbiology
- Syndromic-based multiplex molecular testing
- Blood culture identification panels
- Meningitis and encephalitis panel
- Conclusion
- References
- Self-assessment questions
- Answers
- Index
- No. of pages: 1064
- Language: English
- Published: June 8, 2020
- Imprint: Academic Press
- Paperback ISBN: 9780128154991
- eBook ISBN: 9780128158333
WC
William Clarke
Dr. William Clarke is a Professor of Pathology at the Johns Hopkins University School of Medicine. His research focuses on the development of analytical methods for drug analysis, clinical mass spectrometry, and devices for point-of-care testing. He serves as the director of Clinical Toxicology for Johns Hopkins Hospital, as well as the Point-of-Care Testing Program for Johns Hopkins Medicine.
Affiliations and expertise
Professor, Department of Pathology, Johns Hopkins University School of Medicine
Baltimore, MD, USAMM
Mark Marzinke
Dr. Mark Marzinke is Associate Professor of Pathology and Medicine at the Johns Hopkins University School of Medicine.Dr. Marzinke serves as the Director of General Chemistry in the Johns Hopkins Hospital Core Laboratories, and is the Director of the Clinical Pharmacology Analytical Laboratory within the Division of Clinical Pharmacology. He is also Co-Director of the HIV Prevention Trials Network Laboratory Center.
Affiliations and expertise
Associate Professor, Departments of Pathology and Medicine, Johns Hopkins University School of Medicine
Baltimore, MD, USA