TEXTBOOK OF CLINICAL BIOCHEMISTRY at Meripustak

TEXTBOOK OF CLINICAL BIOCHEMISTRY

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  • General Information  
    Author(s)Ramnik Sood
    PublisherCBS Publishers & Distributors
    Edition1st Edition 2019
    ISBN9789387964266
    Pages840
    BindingSoftbound
    LanguageEnglish
    Publish YearNovember 2018

    Description

    CBS Publishers & Distributors TEXTBOOK OF CLINICAL BIOCHEMISTRY by Ramnik Sood

    This master-piece presents complete clinical biochemistry in an easily assimilable form. It will prove as a comprehensive textbook for both pathophysiology as well as an introduction to clinical biochemistry for medical students.

    Table of Contents:- 
    Biochemical Investigations in Clinical
    Medicine 1–21
    Introduction 1
    Diagnosis 1
    Prognosis 2
    Monitoring 2
    Screening 2
    Specimen Collection 2
    The Patient 2
    The Specimen 3
    Unacceptable Specimens 3
    Sample Analysis and Reporting of Results 5
    Point-of-care Testing Policy and Accountability 6
    Bibliography 19
    2. The Body Buffer Systems and Blood Gases 22–67
    Introduction 22
    Acid-base Homeostasis 23
    Chemical Buffer Systems 24
    Phosphate Buffers 26
    Role of Bone Buffering 27
    Respiratory Regulation 28
    Acid-base Disorders 29
    Respiratory Acidosis 30
    Metabolic Acidosis 34
    Lactic Acidosis 39
    Acidosis and Renal Failure 41
    Drugs and Toxins 42
    Renal Causes 44
    Gastrointestinal Tract Causes 46
    Other Causes 46
    Respiratory Alkalosis 52
    Metabolic Alkalosis 54
    Chloride Depletion 55
    Hydrochloric Acid Infusion 57
    Interpretation of Acid-base Data 59
    Understanding the Oxyhemoglobin
    Dissociation Curve 59
    Dissociation Curve’s Clinical Uses 61
    Bibliography 65
    Foreword by Dr Anurag Mehta vii
    Preface ix
    3. Water and Electrolytes 68–113
    Introduction 68
    Water Distribution 68
    Properties of Water 69
    Water Regulation 70
    Movement of Water Among Compartments 71
    Water and ECF Osmolality 71
    Antidiuretic Hormone 72
    Water Depletion 72
    Water Excess 73
    Electrolytes 73
    Sodium 74
    Sodium and Extracellular Fluid 76
    Atrial Natriuretic Peptide Hormones 76
    Classification of Hyponatremia 79
    Hyponatremia by Osmolality 80
    Pseudohyponatremia 81
    Patient History 81
    Symptoms and Signs 82
    Diagnosis
    xii Textbook of Clinical Biochemistry
    4. The Kidneys 114–148
    Introduction 114
    Measurement of Glomerular Filtration Rate 116
    Clearance 117
    Plasma Urea 120
    Assessment of Glomerular Integrity 121
    Tests of Renal Tubular Function 121
    Acute Kidney Injury 123
    Determination of Cause 125
    Chronic Kidney Disease 127
    Anemia and Coagulation Disorders 130
    Aluminum Toxicity 132
    Nephrotic Syndrome 133
    Laboratory Urine Testing 134
    Defects of Urinary Concentration 138
    Lysinuric Protein Intolerance 140
    Types of Stones 141
    Bibliography 143
    5. The Liver 149–188
    Introduction 149
    Liver Structure 149
    Liver Function 151
    Bilirubin Metabolism 152
    Nonalcoholic Steatohepatitis 157
    Alcoholic Liver Disease 158
    Jaundice 161
    Inborn Metabolic Disorders 164
    Identification of the Cause 168
    Acute Viral Hepatitis 170
    Chronic Hepatitis 175
    Liver Masses and Granulomas 178
    Hematologic Cancers and the Liver 181
    Liver Injury Caused by Drugs 182
    Other Tests of Liver Function 185
    Bibliography 186
    6. The Gastrointestinal Tract 189–231
    Introduction 189
    The Structure of GI 190
    Gastrointestinal Disorders 191
    Peptic Ulcer Disease 195
    Helicobacter Pylori Infection 196
    The Small Intestine Diseases 198
    Crohn’s Disease 200
    Fistulas 202
    Surgery 203
    Investigation of Intestinal Function 205
    Whipple Disease 207
    Pancreatic Disorders and their Investigation 207
    Laboratory Tests 209
    Pancreatic Cancer 212
    Cystic Fibrosis 213
    Intermediate Sweat Test Results 216
    Respiratory Assessment 216
    Newborn Screening 217
    Antibiotics 218
    Pancreatic Enzyme Replacement 219
    Recombinant Human Growth Hormone (RHGH) 219
    Bibliography 220
    7. The Hypothalamus and Pituitary Gland 232–246
    Introduction 232
    Anterior Pituitary Hormones 232
    Gonadotrophins 233
    Disorders of Anterior Pituitary Function 235
    Anorexia Nervosa 236
    Acromegaly 237
    Pituitary Gigantism 238
    Cushing’s Disease 239
    Measurement of Anterior Pituitary Hormones 240
    Insulin Hypoglycemia Test 241
    Disorders of Posterior Pituitary Gland 242
    Psychogenic Polydipsia 244
    Bibliography 244
    8. The Adrenal Glands 247–267
    Introduction 247
    Adrenal Steroid Hormone Biosynthesis 248
    Disorders of the Adrenal Cortex 250
    Adrenal Crisis 251
    Adrenal Hyperfunction 253
    Conn’s Syndrome 257
    Congenital Adrenal Hyperplasia 258
    Disorders of the Adrenal Medulla 261
    Pheochromocytoma 261
    Imaging Tests to Localize Tumors 262
    Bibliography 263
    9. The Thyroid Gland 268–288
    Introduction 268
    Synthesis of Thyroid Hormones 269
    Hyperthyroidism 271
    Thyroid Storm 273
    Hypothyroidism 275
    Subclinical Hy+pothyroidism 277
    Hashimoto Thyroiditis 277
    Euthyroid Sick Syndrome 278
    Silent Lymphocytic Thyroiditis 278
    Subacute Thyroiditis 279
    Simple Nontoxic Goiter (Euthyroid Goiter) 279
    Thyroid Cancers 280
    Radiation-induced Thyroid Cancer 281
    Screening for Thyroid Disease 284
    Bibliography 284
    xiii Contents
    10. The Gonads 289–325
    Androgens and Testicular Function 289
    Estrogens and Ovarian Function 291
    Progesterone 292
    Biosynthesis of Estrogens and Progesterone 292
    Transport of Hormones in the Blood 294
    Disorders of Male Gonadal Function 294
    Gynecomastia 296
    Disorders of Female Gonadal Function 298
    Anovulatory Amenorrhea 299
    Dysfunctional Uterine Bleeding 303
    Polycystic Ovary Syndrome 305
    Primary Ovarian Insufficiency 306
    Hirsutism and Virilism 308
    Gonadotropin and Inhibin Measurements 311
    Measurement of Unbound Testosterone Levels 312
    Ovulatory Dysfunction 314
    Tubal Dysfunction and Pelvic Lesions 315
    Assisted Pregnancy 316
    Specific Hormonal Changes 316
    Maternal Monitoring 319
    Metabolic Effects of Oral Contraceptives 320
    Bibliography 320
    11. Disorders of Carbohydrate Metabolism 326–355
    Introduction 326
    Insulin 326
    Proinsulin 328
    Insulin-like Growth Factors 331
    Disorders of Carbohydrate Metabolism 333
    Complications 335
    Gestational Diabetes 337
    Metabolic Complications of Diabetes 339
    Nonketotic Hyperglycemia 340
    Hypoglycemia in Diabetic Patients 342
    Postprandial Hypoglycemia 343
    Hepatic and Renal Disease 345
    Hypoglycemia in Childhood 345
    Measurement of Glucose Concentration 346
    Specimen Collection and Storage 346
    Glycosuria 347
    Specimen Collection and Storage 347
    Glycogen Storage Disorders 348
    Mucopolysaccharidoses 351
    Bibliography 352
    12. Disorders of Bone and Mineral Metabolism 356–388
    Introduction 356
    Cell Signaling in Bone 357
    Measurement of Calcium 360
    Specimen Requirements 360
    Measurement of Parathyroid Hormone 362
    Measurement of Vitamin D Metabolites 364
    Calcium and Phosphate Homeostasis 365
    Magnesium 368
    Paget Disease of Bone 371
    Osteomalacia and Rickets 372
    Renal Osteodystrophy 373
    Bibliography 382
    13. Plasma Proteins 389–429
    Introduction 389
    Physical Properties of Proteins 390
    Plasma Protein Concentrations 390
    Major Plasma Proteins 391
    Specific Plasma Proteins 393
    Increased Plasma Concentrations 393
    Clinical Significance of Albumin 395
    Laboratory Testing 396
    1 Acid Glycoprotein 397
    1 Antitrypsin 398
    2 Macroglobulin 400
    Ceruloplasmin 400
    Haptoglobin 402
    Transferrin 404
    2 Microglobulin 405
    C-Reactive Protein 405
    Complement Proteins 406
    Cytokines 410
    Immunoglobulins 410
    Free Immunoglobulin Light Chains 413
    Polyclonal Hyperimmunoglobulinemia 415
    Macroglobulinemia 419
    Heavy Chain Diseases 420
    Specimen Collection and Storage for
    Immunoassay 423
    Immunofixation Electrophoresis 424
    Mass Spectrometry 424
    Bibliography 425
    14. Serum Enzymes 430–454
    Introduction 430
    Diagnostic Enzymology 430
    Muscle Enzymes 432
    Creatine Kinase 432
    Methods for Determination of Creatine
    Kinase Activity 434
    Aldolase 435
    Methods for Measurement of Aldolase Activity 435
    Liver Enzymes 435
    Alkaline Phosphatase 435
    Methods for Determination of Alkaline
    Phosphatase Activity 436
    Aminotransferases 438
    Methods for Measurement of Transaminase
    Activity 440
    Glutamate Dehydrogenase 441
    Methods for Determination of Glutamate 441
    xiv Textbook of Clinical Biochemistry
    -Glutamyl Transferase 442
    5’-Nucleotidase 443
    Pancreatic Enzymes 444
    Amylase 444
    Lipase 446
    Methods for Measuring Lipase Activity 447
    Trypsin 448
    Methods for Determination of Trypsin 449
    Alkaline Phosphatase (Bone Isoform) 449
    Methods for Determination of Lactate 451
    Enzyme Activity 451
    Disadvantages of Enzyme Assays 451
    Bibliography 452
    15. Lipids, Lipoproteins and Apolipoproteins 455–486
    Introduction 455
    Cholesterol 455
    Cholesterol Synthesis 456
    Cholesterol Catabolism 458
    Fatty Acids 459
    Glycerol Esters (Acyl Glycerols) 461
    Lipoproteins 462
    Apolipoproteins 464
    Exogenous Pathway 466
    Endogenous Pathway 468
    Reverse Cholesterol Transfer Pathway 469
    Lipid Disorders 469
    Dyslipidemia (Hyperlipidemia) 469
    Primary Causes 470
    Secondary Causes 472
    Elevated LDL Cholesterol in Children 476
    Hypolipidemia 478
    Hypobetalipoproteinemia 479
    Elevated High-density Lipoprotein Low-density
    Lipoprotein Level 479
    Bibliography 482
    16. Therapeutic Drug Monitoring 487–528
    Introduction 487
    Routes of Drug Administration 487
    Drug Metabolism 488
    Drug Excretion 489
    Anti-epileptic Drugs 489
    Carbamazepine 491
    Ethosuximide 491
    Phenobarbital 492
    Primidone 492
    Phenytoin 493
    Valproic Acid 493
    Contemporary Anti-epileptics 494
    Epilepsy 497
    Generalized Seizures 498
    Physical Examination 501
    Antimicrobial Agents 502
    Aminoglycosides 503
    Glycopeptides 503
    Tuberculosis Therapy 503
    Other Antibiotics 504
    Protease Inhibitors 506
    Enzyme-multiplied Immunoassay 510
    Everolimus 514
    Ethanol and Alcohol Testing 519
    Metabolism and Excretion of Ethanol 519
    Automated Immunoassay Methods 521
    Chromatography Methods 522
    Heavy Metal Toxicity 522
    Mercury Exposure 523
    Bibliography 524
    17. Tumor Markers 529–550
    Introduction 529
    Enzymes 529
    Alkaline Phosphatase 530
    Neuron-specific Enolase 531
    Kallikreins 531
    Prostate-specific Antigen 532
    The Urokinase-plasminogen Activator System 534
    Hormones 534
    Oncofetal Antigens 537
    Carcinoembryonic Antigen 538
    Carbohydrate Markers 539
    Proteins 543
    Bladder Cancer Markers 543
    Receptors and Other Markers 544
    Bibliography 545
    18. Vitamins 551–580
    Introduction 551
    Fat-soluble Vitamins 553
    Vitamin A Deficiency 554
    Vitamin E 555
    Vitamin D 557
    Vitamin K 560
    Water Soluble Vitamins 562
    Riboflavin 563
    Riboflavin Deficiency 564
    Vitamin B6 564
    Niacin 565
    Folic Acid 567
    Vitamin B12 568
    Biotin 572
    Pantothenic Acid 572
    Ascorbic Acid 572
    Bibliography 574
    19. Trace and Toxic Elements 581–600
    Introduction 581
    Trace Elements Homeostasis 581
    Copper 582
    xv Contents
    Absorption, Transport, and Excretion 582
    Inherited Copper Deficiency 582
    Wilson Disease 583
    Selenium 586
    Chromium 587
    Manganese 587
    Iodine 588
    Molybdenum 589
    Fluoride 589
    Aluminum 590
    Arsenic 591
    Cadmium 592
    Lead 592
    Mercury 593
    Inductively Coupled Plasma Mass Spectrometry 596
    Interferences 597
    Elemental Speciation 598
    Bibliography 599
    20. Toxicology of Specific Agents 601–625
    Introduction 601
    Agents that Cause Cellular Hypoxia 602
    Carbon Monoxide 602
    Analytical Methods 602
    Cyanide 603
    Methemoglobin-forming Agents 604
    Alcohols of Toxicologic Interest 605
    Ethanol 605
    Methanol 606
    Isopropanol and Acetone 607
    Ethylene Glycol 607
    Estimation of Blood Alcohol 608
    Ethyl Glucuronide 609
    Analysis of Volatile Alcohols (Methanol,
    Isopropanol, and Acetone) 609
    Pharmacologic Response 611
    Morphine 614
    Codeine 615
    Semisynthetic Opiates 615
    Heroin 615
    Hydrocodone 615
    Hydromorphone 615
    Oxycodone 615
    Oxymorphone 616
    Fully Synthetic Opioids 616
    Fentanyl 616
    Meperidine 616
    Methadone 616
    Propoxyphene 616
    Tramadol 616
    Opioid Antagonists and Mixed Agonist/
    Antagonists 617
    Buprenorphine 617
    Naloxone 617
    Sample Preparation and Extraction 618
    Drugs of Abuse Related to the Sympathomimetic
    Syndrome 619
    Cocaine 619
    Pharmacologic Response 620
    Bibliography 622
    21. The Porphyrias and Other Disorders of
    Porphyrin Metabolism 626–649
    Introduction 626
    Chemistry of Porphyrins 626
    Porphyrin Synthesis 627
    Porphyria Disorders 627
    Acute Porphyrias 630
    Cutaneous Porphyrias 636
    Pseudoporphyria 637
    Erythropoietic Protoporphyria and X-linked
    Protoporphyria 639
    Laboratory Diagnosis of Porphyria 640
    Methods for Porphyrin Precursors 641
    Analysis of Porphyrins in Urine and Feces 642
    HPLC Fractionation of Porphyrins in
    Urine and Feces 643
    Methods for Blood Porphyrins 643
    Analysis of Plasma Porphyrins 644
    Bibliography 645
    22. Inherited Disorders of Metabolism and
    Newborn Screening 650–695
    Introduction 650
    Clinical Presentation 650
    History and Physical Examination 650
    Amino Acid and Organic Acid Metabolism
    Disorders 653
    Maple Syrup Urine Disease 658
    Propionic Acidemia 659
    Methylmalonic Acidemia 659
    Methionine Metabolism Disorders 659
    Classic Homocystinuria 660
    Other Forms of Homocystinuria 661
    Cystathioninuria 661
    Sulfite Oxidase Deficiency 661
    Phenylketonuria 661
    Transient Tyrosinemia of the Newborn 662
    Alkaptonuria 664
    Oculocutaneous Albinism 665
    Urea Cycle Disorders 665
    Carbohydrate Metabolism Disorders 672
    Galactosemia 672
    Glycogen Storage Diseases 673
    Pyruvate Metabolism Disorders 675
    Fatty Acid and Glycerol Metabolism Disorders 676
    Beta-oxidation Cycle Disorders 677
    Glutaric Acidemia Type II 680
    Glycerol Metabolism Disorders 680
    xvi Textbook of Clinical Biochemistry
    Lysosomal Storage Disorders 681
    Mucopolysaccharidosis 681
    Sphingolipidoses 683
    Cholesteryl Ester Storage Disease 686
    Fabry Disease 686
    Gaucher Disease 686
    Krabbe Disease 687
    Metachromatic Leukodystrophy 687
    Purine and Pyrimidine Metabolism Disorders 687
    Adenosine Deaminase Deficiency 689
    Purine Nucleoside Phosphorylase Deficiency 690
    Uridine Monophosphate Synthase Deficiency
    (Hereditary Orotic Aciduria) 691
    Plasma Acylcarnitine Profile 693
    Bibliography 693
    23. Analytic Techniques and Instrumentation 696–727
    Introduction 696
    Spectrophotometry 696
    Beer’s Law 697
    Spectrophotometric Instruments 698
    Components of a Spectrophotometer 699
    Photodetectors 700
    Atomic Absorption Spectrophotometer 701
    Flame Photometry 703
    Basic Instrumentation 703
    Advantages and Disadvantages of Fluorometry 704
    Chemiluminescence 705
    Turbidity and Nephelometry 705
    Galvanic and Electrolytic Cells 706
    Indicator Electrode 707
    Liquid Junctions 707
    Gas-sensing Electrodes 709
    Enzyme Electrodes 709
    Osmometry 713
    Automation of Specimen Preparation 713
    Mobile Robots 714
    Sample Introduction and Internal Transport 715
    Reagent Handling and Storage 716
    Barcoding 717
    Modes of Separation 718
    Steric Exclusion 718
    Chromatographic Procedures 719
    High-performance Liquid Chromatography 720
    Sample Injectors 721
    Gas Chromatography 722
    Electron Ionization 723
    Atmospheric Pressure Chemical Ionization 724
    Tandem Mass Spectrometry 725
    High-resolution Mass Spectroscopy 726
    Bibliography 727
    24. Point-of-Care Testing 728–742
    Introduction 728
    Laboratory Regulations 729
    Implementation 730
    Quality Management 732
    Informatics and POCT 734
    Equipment Procurement and Evaluation 736
    Training and Certification of Operators 736
    Maintenance and Inventory Control 737
    Documentation 738
    Bibliography 739
    25. Clinical Chemistry and the Geriatric Patient 743–772
    Introduction 743
    Aging 743
    General Physiologic Changes with Aging 744
    Evaluation of the Elderly Patient 745
    Polypharmacy 746
    Physical Examination 750
    Head and Neck 751
    Cranial Nerves 754
    Reflexes 755
    Comprehensive Geriatric Assessment 756
    Increased Hormone Level 757
    Decreased Hormone Level 758
    Establishing Reference Intervals for the Elderly 758
    Hepatic Metabolism 759
    Pharmacodynamics in the Elderly 761
    Drug-related Problems in the Elderly 762
    Reasons for Drug-related Problems 762
    Drug-disease Interactions 762
    Drug Categories of Concern in the Elderly 764
    Anticoagulants 767
    Anxiolytics and Hypnotics 769
    Bibliography 770
    26. Lean Six Sigma Methodology for Quality
    Improvement in the Clinical Chemistry
    Laboratory 773–782
    Introduction 773
    Lean Six Sigma 773
    Adoption and Implementation of Lean
    Six Sigma 773
    Senior Roles 774
    Process Improvement 775
    Measurements of Success Using Lean and
    Six Sigma 776
    Practical Application of Six Sigma Metrics 779
    Bibliography 780
    Appendix A to C 783–817
    Index 818–824