Laboratory (Blood Chemistry)

Laboratory (Blood Chemistry)

1. Serum Protein

   • Measures the total amount of protein in the blood.
     • measures the total amount of protein in theblood.
   • Two major groups of proteins
     • Blood serum contains two major protein groups: albumin and globulin. Both albumin and globulin carry substances through the bloodstream. 
     • Albumin
       •  mainly in the liver. It helps keep the blood from leaking out of blood vessels. High albumin: DehydrationLow albumin: Poor nutrition; inflammation; liver disease; kidney disease
       • High albumin: Dehydration Low albumin: Poor nutrition; inflammation; liver disease; kidney disease
     • Globulin
       • Some globulins are made by the liver, while others are made by the immune system. Certain globulins bind with hemoglobin. Other globulins transport metals, such as iron, in the blood and help fight infection.
       • Alpha
         • Alpha-1 globulin
           •  High-density lipoprotein (HDL), the "good" type of cholesterol, is included in this fraction. High alpha-1 globulin: Infection; inflammation Low alpha-1 globulin: Severe inflammation; liver disease
           • High alpha-1 globulin: Infection; inflammation Low alpha-1 globulin: Severe inflammation; liver disease
         • Alpha-2 globulin
           • protein called haptoglobin, which binds withhemoglobin, is included in the alpha-2 globulin fraction. High alpha-2 globulin: Inflammation; kidney disease Low alpha-2 globulin: Thyroid problems; liver disease
           • High alpha-2 globulin: Inflammation; kidney disease Low alpha-2 globulin: Thyroid problems; liver disease
       • Beta
         • Beta globulin proteins help carry substances, such as iron, through the bloodstream and help fight infection. High beta globulin: Very high cholesterol; low iron (iron-deficiencyanemia) Low beta globulin: Poor nutrition
         • High beta globulin: Very high cholesterol; low iron (iron-deficiencyanemia) Low beta globulin: Poor nutrition
       • Gamma
         • These proteins are also called antibodies. They help prevent and fight infection. Gamma globulins bind to foreign substances, such as bacteria or viruses, causing them to be destroyed by the immune system High gamma globulin: Inflammation; infection; liver disease; some forms of cancer  Low gamma globulin: Problems with the immune system
         • High gamma globulin: Inflammation; infection; liver disease; some forms of cancer Low gamma globulin: Problems with the immune system
   • Why it is Done
     • done to help diagnose and monitor a wide variety of conditions
     • Some forms of cancer.
     • Problems with the kidneys or liver.
     • Problems with the immune system.
     • Conditions that lead to poor nutrition.
   • How it is done:
     • Put a tourniquet around upper arm to stop flow of blood.
       • This makes the veins below the band larger so it is easier to put a needle into the vein.
       • Clean the needle site with alcohol
         • Put the needle into the vein.
           • More than one needle stick may be needed.
           • Attach a tube to the needle to fill it with blood
             • Remove the band from your arm when enough blood is collected
               • Apply a gauze pad or cotton ball over the needle site as the needle is removed.
                 • Apply pressure to the site and then a bandage

2. Serum Lipase

   • A lipase test measures the amount of this enzyme in a blood sample.
     • High amounts of lipase may be found in the blood when the pancreas is damaged or when the tube leading from the pancreas (pancreatic duct) to the beginning of the small intestine is blocked.
   • Why it is done
     • Check for pancreatitis and other diseases of the pancreas.
     • See if the treatment for pancreatitis is working.
     • Help check for cystic fibrosis or see if treatment for it is working.
   • Preparations
     • NPO
       • 8-12 hours before lipase test
   • Procedure:
     • Put a tourniquet around upper arm to stop flow of blood.
       • Clean the needle site with alcohol
         • Put the needle into the vein.
           • Attach a tube to the needle to fill it with blood
             • Remove the band from your arm when enough blood is collected
               • Apply a gauze pad or cotton ball over the needle site as the needle is removed.
                 • Apply pressure to the site and then a bandage
   • Results
     • Results are normally available within 12 hours.
     • A high lipase level may be caused by: Diseases of the pancreas, such as pancreatitis or cancer of the pancreas. Problems with the gallbladder, such as gallstones and inflammation (cholecystitis). Chronic kidney disease. Problems with the intestines, such as bowel blockage (obstruction) or tissue death (infarction). Infection, inflammation, or cancer of a salivary gland. Peptic ulcer disease. Primary biliary cirrhosis. Alcohol or drug abuse.
       • A high lipase level may be caused by:      Diseases of the pancreas, such        as pancreatitis or cancer of the pancreas.      Problems with the gallbladder, such as gallstones and inflammation (cholecystitis).      Chronic kidney disease.      Problems with the intestines, such as bowel blockage (obstruction) or tissue death (infarction).      Infection, inflammation, or cancer of a salivary gland.      Peptic ulcer disease.      Primary biliary cirrhosis.        Alcohol or drug abuse.

3. Serum Amylase

   • Normally, only low levels of amylase are found in the blood or urine.  But if the pancreas  or salivary glands  become damaged or blocked, more amylase is usually released into the blood and urine.  In the blood, amylase levels rise for only a short time.  In the urine, amylase may remain high for several days.
   • An amylase test measures the amount of this enzyme in a sample of blood taken from a vein or in a sample of urine.
   • Why it is done
     • Find pancreatitis and other pancreatic diseases.
     • See if the treatment for pancreatitis and other pancreatic diseases is working.
     • Check swelling and inflammation of the salivary glands.
   • Preparation
     • No Alcohol
       • Do not drink alcohol for 24 hours before the test
     • Do not eat or drink (except water)
       • 2 hours prior to test
     • For a 24-hour urine test for amylase, be sure to drink enough fluid
       • to prevent dehydration
   • Procedure
     • Blood Test
       • Same procedure as Serum Lipase and Serum Protein
     • Urine Test
       • Do not get toilet paper, pubic hair, stool (feces), menstrual blood, or other foreign matter in the urine sample.
       • A 24-hour urine sample is all of the urine you produce over a 24-hour period.
       • Start collection in the morning
         • When you first get up, empty your bladder but do not save this urine. Write down the time that you urinated to mark the beginning of your 24-hour collection period.
         • For the next 24 hours, collect all your urine
           • Your doctor or lab will usually provide you with a large container that holds about 1 gal (4 L). The container has a small amount of preservative in it. Urinate into a small, clean container and then pour the urine into the large container. Do not touch the inside of the container with your fingers.
           • Keep the large container in the refrigerator for the 24 hours.
             • Empty your bladder for the final time at or just before the end of the 24-hour period.
               • Add this urine to the large container and record the time.
       • 2-hour urine sample
         • A 2-hour urine sample is all of the urine you produce over a 2-hour period. Collect it in the same manner as the 24-hour urine sample, during the 2-hour period your health professional recommends.
   • Results
     • Reasons you may not be able to have the test or why the results may not be helpful include:    Medicines, including opiates such as codeine and morphine, birth control pills, diuretics, indomethacin, and blood-thinning medicines, such as warfarin and aspirin.    Drinking a large amount of alcohol before the test.    Saliva, which contains large amounts of amylase. Coughing, sneezing, or even talking over an uncovered urine or blood specimen can contaminate the specimen and artificially increase amylase values.    Being pregnant.    Having an endoscopic retrograde cholangiopancreatogram (ERCP)  test before the amylase test.

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