By William J. Marshall MA MSc PhD MBBS FRCP FRCPath FRCPEdin FIBiol, Stephen K Bangert, Márta Lapsley MB BCh BAO DipPath MRCPath MD FRCPath
Clinical Chemistry considers what occurs to the body's chemistry whilst plagued by affliction. every one bankruptcy covers the appropriate uncomplicated technology and successfully applies this to scientific perform. It comprises dialogue on diagnostic ideas and sufferer administration and makes general use of case histories to stress medical relevance, summarise bankruptcy key issues and to supply an invaluable start line for exam revision.
The transparent and interesting writing variety liked through generations of readers has been retained during this new 7th version, whereas the content material has been completely up to date all through. The process and scope of this relied on textual content makes it excellent for built-in clinical curricula for clinical education and for college students and practitioners of medical and biomedical technology. The complementary on-line model of the booklet, together with extra self-assessment fabric, completes this very good studying package.
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Additional info for Clinical Chemistry: With STUDENT CONSULT Access, 7e
It is clearly desirable that such instruments should be capable of providing results that are as robust with regard to accuracy and precision as those provided by the main laboratory. These instruments are designed to be very simple to operate but it is nevertheless essential that individuals using them, who will usually not be laboratory staff, are properly trained in their use. They should adhere to protocols designed to ensure the quality of results and to provide a robust audit trail so that, for example, should a manufacturer report a problem with a particular test, patients whose results may have been affected can be identified.
Other analytes may also be affected by haemolysis, depending on the analytical method used. The laboratory should always draw attention to potentially spurious results. It should be noted that leakage from cells in vitro can cause increases in plasma potassium and phosphate concentrations even in the absence of obvious haemolysis, particularly in patients with high white blood cell or platelet counts. 1): citrate and EDTA, which are used as anticoagulants in containers used for some haematological tests, combine with calcium and cause low measured concentrations in the plasma; so does oxalate (the anticoagulant in containers for blood glucose measurement, which also contain fluoride to inhibit glycolysis), and it is clearly inappropriate to collect blood for lithium measurement into a container with lithium heparin as an anticoagulant.
For example, in patients being treated with thyroxine for hypothyroidism, it can take several weeks for the plasma concentration of thyroid stimulating hormone (TSH) to stabilize at a new value after a change in the dose of thyroxine: repeating thyroid function tests in a patient whose dose of thyroxine has been changed at an interval of <1 month may therefore provide misleading information, and could prompt a doctor who is not cognizant with the rate of response to make a further change of dose prematurely.