ebook img

Clinical Chemistry: Techniques, Principles, Correlations, 6th Edition PDF

788 Pages·2009·42.19 MB·English
Save to my drive
Quick download
Download
Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.

Preview Clinical Chemistry: Techniques, Principles, Correlations, 6th Edition

LWBK942-FM.qxd 6/25/11 8:45 AM Page x Clinical Chemistry TECHNIQUES, PRINCIPLES, CORRELATIONS SIXTH EDITION Michael L. Bishop, MS, CLS, MT(ASCP) Director of Educational Services Global Med Technologies El Dorado Hills, California Edward P. Fody, MD Medical Director Department of Pathology Holland Hospital Holland, Michigan Larry E. Schoeff, MS, MT(ASCP) Professor and Director, Medical Laboratory Science Program University of Utah School of Medicine Education Consultant, ARUP Laboratories Salt Lake City, Utah Acquisitions Editor: John Goucher Managing Editor: Meredith Brittain Marketing Manager: Allison Noplock Project Manager: Rosanne Hallowell Designer: Stephen Druding Compositor: ASI Maryland Composition Sixth Edition Copyright © 2010, 2005, 2000, 1996, 1992, 1985 by Lippincott Williams & Wilkins, a Wolters Kluwer business. 351 West Camden Street 530 Walnut Street Baltimore, MD 21201 Philadelphia, PA 19106 Printed in China All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials ap- pearing in this book prepared by individuals as part of their official duties as U.S. government em- ployees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at 530 Walnut Street, Philadelphia, PA 19106, via email at permis- [email protected], or via website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Library of Congress Cataloging-in-Publication Data Clinical chemistry : techniques, principles, correlations / [edited by] Michael L. Bishop, Edward P. Fody, Larry E. Schoeff. -- 6th ed. p. ; cm. Includes bibliographical references and index. ISBN 978-0-7817-9045-1 (alk. paper) 1. Clinical chemistry. I. Bishop, Michael L. II. Fody, Edward P. III. Schoeff, Larry E. [DNLM: 1. Chemistry, Clinical--methods. 2. Clinical Chemistry Tests. QY 90 C6414 2010] RB40.C576 2010 616.07'56--dc22 2008052929 DISCLAIMER Care has been taken to confirm the accuracy of the information present and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omis- sions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this information in a particular situation remains the professional respon- sibility of the practitioner; the clinical treatments described and recommended may not be considered absolute and universal recommendations. The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with the current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the con- stant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and pre- cautions. This is particularly important when the recommended agent is a new or infrequently em- ployed drug. Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice. To purchase additional copies of this book, call our customer service department at (800) 638- 3030or fax orders to (301) 223-2320. International customers should call (301) 223-2300. Visit Lippincott Williams & Wilkins on the Internet: http://www.lww.com. Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 6:00 pm, EST. To Sheila, Chris, and Carson for their support and patience. MLB To Nancy, my wife, for her continuing support and dedication. EPF To my wife, Anita, for her continuing support. LES Foreword Health care delivery and the practice of medicine and viduals accessing the health care system, but also the clinical laboratory science have undergone exponential workforce that is delivering the care. There is a growing change in the last decade. There have been, and continue shortage of educated and trained clinical laboratory pro- to be, many factors contributing to that change. Rising fessionals. This is a result of many factors, including the costs and concern regarding unequal access to health aging workforce, reduction in educational programs, and care and the growing number of uninsured have made competing career opportunities. health care one of the top issues for this country. As a result of all of these issues, the role of clinical lab- Politicians and regulators are faced with the need to pro- oratory practitioners is changing. We can no longer afford vide accessible health care while trying to control costs. to be simply analysts that perform, report, and assure the Policy makers and payers have increased influence over quality of laboratory test results. Clinicians recognize and medical and diagnostic decisions through managed care. acknowledge the need for help in test selection and result Consumers and payers alike expect easy access and the interpretation. It is essential that laboratory professionals highest quality of care with the most economic prices. work with physicians in helping them understand testing Reports on medical errors have raised the visibility for options and optimize clinical outcomes. In order to do the need for enhanced patient safety and quality initia- this, clinical laboratory practitioners must be educated tives. Emphasis has shifted from simply diagnosing and and trained not only in test performance and utilization treating disease to identifying and controlling disease but also in pathophysiology, differential diagnosis, and risk factors and maintaining health. There is increased how diagnostic information contributes to patient care concern about public health issues and bioterrorism as and outcomes. well as environmental effects on health. As a result of The sixth edition of Clinical Chemistry: Techniques, these and other factors, laboratory testing is expanding Principles, Correlations was written with these changing and playing an increasingly valuable and prominent role needs in mind. The text provides a comprehensive view in health care delivery. of pathophysiology as it relates to clinical chemistry di- Technological advances have dramatically changed the agnostic testing. It emphasizes the preanalytical, analyti- way we practice clinical laboratory science. Molecular di- cal, and post-analytical aspects of diagnostic testing. This agnostic testing is allowing earlier detection of disease. text not only provides comprehensive information but Advances in biotechnology including the “omics”—ge- also includes case studies and other strategies that will nomics, proteomics, and pharmocogenomics—have enhance critical thinking and problem-solving skills. given rise to the advent of personalized medicine. We can Furthermore, Web-based support is provided with the now determine inherited predisposition to disease, iden- text. Utilization of the text and supportive materials will tify protein profiles associated with disease status, and tai- enhance theoretical, technical, and consultative skill de- lor treatment options based on genetic make-up. Testing velopment. This text is not only an excellent resource for techniques have shifted from test tubes, beakers, and clinical laboratory and medical students, but also for large, automated analyzers to microanalytic systems (“lab clinical laboratory practitioners, clinicians, and other on a chip”) that allow reduced sample size, fewer health care providers. reagents, and smaller instruments. The walls of the labo- ratory are disappearing, with increasing numbers of tests Paula Garrott, Ed.M. CLS(NCA) that can be performed at the “point of care.” Director, Natural Science Division The demographics of health care are also changing. As College of Liberal Arts and Sciences a result of the aging population and longer life ex- Chair and Associate Professor Emeritus pectancy, we are seeing an increase in chronic disease, Clinical Laboratory Science Department which is impacting the health care system. These demo- University of Illinois at Springfield graphics not only affect the number and types of indi- Springfield, Illinois iv Preface Clinical chemistry continues to be one of the most rap- sionals who practice clinical chemistry and laboratory idly advancing areas of laboratory medicine. Since the medicine on a daily basis. The basic principles of the publication of the first edition of this textbook in 1985, analytic procedures discussed in the chapters reflect the many changes have taken place. New technologies and most recent or commonly performed techniques in the analytical techniques have been introduced, with a dra- clinical chemistry laboratory. Detailed procedures have matic impact on the practice of clinical chemistry and been omitted because of the variety of equipment and laboratory medicine. In addition, the health care system commercial kits used in today’s clinical laboratories. is constantly changing. There is increased emphasis on Instrument manuals and kit package inserts are the improving quality of patient care, individual patient out- most reliable reference for detailed instructions on cur- comes, financial responsibility, and total quality manage- rent analytic procedures. All chapter material has been ment. For this reason, the editors have replaced updated, improved, and rearranged for better continu- “Procedures” with “Techniques” in the title in order to ity and readability. As a new offering, a Web site with reflect the continued evolution of the laboratorian’s role additional case studies, review questions, teaching re- in healthcare. Point-of-care testing (POCT) is also at the sources, teaching tips, additional references, and teach- forefront of health care practice and has brought both ing aids for instructors and students is available from challenges and opportunities to clinical laboratorians. the publisher to assist in the use of this textbook (see Now, more than ever, clinical laboratorians need to be section that follows). concerned with disease correlations, interpretations, problem-solving, quality assurance, and cost effective- ADDITIONAL RESOURCES ness; they need to know not only the how of tests but Clinical Chemistry: Techniques, Principles, Correlations, more importantly the what,why, and when. Sixth Edition, includes additional resources for both in- WHAT’S NEW IN THIS EDITION structors and students that are available on the book’s companion Web site at thePoint.lww.com/Bishop6e. The editors of Clinical Chemistry: Techniques, Principles, Correlations have designed the sixth edition to be Instructors an even more valuable resource to both students and practitioners. Approved adopting instructors will be given access to the Like the previous five editions, the sixth edition of following additional resources: Clinical Chemistry: Techniques, Principles, Correlations is ■ Brownstone Test Generator comprehensive, up-to-date, and easy to understand for ■ Answers To Case Studies students at all levels. It is also intended to be a practically ■ Answers To Review Questions organized resource for both instructors and practition- ■ Image Bank ers. The editors have tried to maintain the book’s read- ■ PowerPoint slides ability and further improve its content. Because clinical ■ Web links and Teaching Tips laboratorians use their interpretative and analytic skills in the daily practice of clinical chemistry, an effort has Students been made to maintain an appropriate balance between analytic principles, techniques, and the correlation of re- Students who have purchased Clinical Chemistry: sults with disease states. Techniques, Principles, Correlationshave access to the fol- In this sixth edition, the editors have made several lowing additional resources: significant changes in response to requests from our ■ Chapter Objectives readers, students, instructors, and practitioners. ■ Flash Cards Ancillary materials have been updated and expanded ■ Quiz Bank (see “Additional Resources,” below). Chapters now in- clude current, more frequently encountered case stud- In addition, purchasers of the text can access the ies and practice questions or exercises. To provide a searchable Full Text Online by going to the Clinical thorough, up-to-date study of clinical chemistry, all Chemistry: Techniques, Principles, Correlations Web site chapters have been updated and reviewed by profes- at thePoint.lww.com/Bishop6e. See the inside front cover v vi PREFACE of this text for more details, including the pass code you We extend appreciation to our students, colleagues, will need to gain access to the Web site. teachers, and mentors in the profession who have helped shape our ideas about clinical chemistry practice and ed- ucation. Also, we want to thank the many companies and ACKNOWLEDGMENTS professional organizations that provided product infor- A project as large as this requires the assistance and sup- mation and photographs or granted permission to repro- port of many individuals. The editors wish to express duce diagrams and tables from their publications. Many their appreciation to the contributors of this sixth edi- Clinical and Laboratory Standards Institute (CLSI) docu- tion of Clinical Chemistry: Techniques, Principles, ments have been important sources of information also. Correlations—the dedicated laboratory professionals These documents are directly referenced in the appropri- and educators whom the editors have had the privilege ate chapters. of knowing and exchanging ideas with over the years. The editors would like to acknowledge the contribu- These individuals were selected because of their expert- tion and effort of all individuals to previous editions. ise in particular areas and their commitment to the edu- Their efforts provided the framework for many of the cation of clinical laboratorians. Many have spent their current chapters. Finally, we gratefully acknowledge the professional careers in the clinical laboratory, at the cooperation and assistance of the staff at Lippincott bench, teaching students, or consulting with clinicians. Williams & Wilkins for their advice and support. In these frontline positions, they have developed a per- The editors are continually striving to improve future spective of what is important for the next generation of editions of this book. We again request and welcome our clinical laboratorians. readers’ comments, criticisms, and ideas for improvement. Contributors John J. Ancy, MA, RRT Julia C. Drees, PhD Senior Clinical Consultant Clinical Chemistry Fellow Instrumentation Laboratory San Francisco General Hospital Director, Respiratory Services University of California St. Elizabeth’s Hospital San Francisco, California Belleville, Illinois Sharon S. Ehrmeyer, MD Michael J. Bennett, PhD, FRCPath, FACB Professor, Pathology and Laboratory Medicine Professor Director, Medical Technology / Clinical Laboratory Department of Pathology and Laboratory Medicine Sciences University of Pennsylvania Department of Pathology and Laboratory Medicine and University of Wisconsin Director, Metabolic Disease Laboratory Madison, Wisconsin Children’s Hospital of Philadelphia Philadelphia, Pennsylvania Jordan Erickson, BS Quality Analyst – Six Sigma Black Belt Maria G. Boosalis, PhD, MPH, RD, LD Department of Pediatrics Director, Division of Clinical Nutrition University of North Carolina Healthcare College of Health Sciences Chapel Hill, North Carolina University of Kentucky Lexington, Kentucky Edward P. Fody, MD Medical Director Larry Broussard, PhD, DABCC, FACB Department of Pathology Professor Holland Hospital Clinical Laboratory Sciences Holland, Michigan Louisiana State University Health Sciences Center New Orleans, Louisiana Elizabeth L. Frank, PhD, DBACC Assistant Professor – Clinical Dean C. Carlow, MD, PhD Department of Pathology Assistant Professor University of Utah Health Sciences Center Department of Pathology and Laboratory Medicine Salt Lake City, Utah University of Pennsylvania School of Medicine and Vicki S. Freeman, PhD Medical Director, Clinical Chemistry Department Chair and Professor Department of Pathology and Clinical Chemistry Clinical Laboratory Sciences The Children’s Hospital of Philadelphia University of Texas Medical Branch Philadelphia, Pennsylvania Galveston, Texas Eileen Carreiro-Lewandowski, MS, CLS Linda S. Gorman, PhD Professor CRS Division Director Medical Laboratory Science University of Kentucky University of Massachusetts-Dartmouth Lexington, Kentucky N. Dartmouth, Massachusetts Marissa Grotzke, MD Janelle M. Chiasera, PhD, MT (ASCP) Fellow Associate Professor and Director Internal Medicine School of Health Professions Division of Endocrinology, Metabolism, and Diabetes University of Alabama at Birmingham University of Utah Medical Center Birmingham, Alabama Salt Lake City, Utah vii viii CONTRIBUTORS Ryan Hungerford, MD Christopher R. McCudden, PhD Fellow Assistant Professor Endocrinology Associate Director Core Laboratory University of Utah Director of Blood Gas and Special Chemistry Salt Lake City, Utah Department of Pathology & Laboratory Medicine University of North Carolina-Chapel Hill School of Medicine Kamisha Johnson-Davis, PhD Chapel Hill, North Carolina Clinical Chemistry Fellow Department of Pathology Gwendolyn Appell McMillan, PhD University of Utah Assistant Professor (Clinical) Salt Lake City, Utah Department of Pathology University of Utah Robert Jones, MD Salt Lake City, Utah Endocrinology Division and Utah Diabetes Center Medical Director Salt Lake City, Utah Toxicology, Trace Elements, Pharmacogenetics ARUP Laboratories Salt Lake City, Utah Thomas P. Knecht, MD, PhD Medical Director A. Wayne Meikle, MD Abbott Diabetes Care Professor Alameda, California Department of Internal Medicine University of Utah School of Medicine and Ronald H. Laessig, PhD Staff Physician Director, Wisconsin State Laboratory of Hygiene University of Utah Hospital Professor, Population Health Sciences Salt Lake City, Utah Professor, Pathology and Laboratory Medicine School of Medicine and Public Health Susan Orton, PhD (ABMLI) University of Wisconsin Assistant Professor Madison, Wisconsin Division of Clinical Laboratory Science The University of North Carolina Louanne W. Lawrence, DrPH, CLS (NCA) Chapel Hill, North Carolina Professor and Department Head Clinical Laboratory Sciences Joan E. Polancic, MSEd, CLS (NCA) Louisiana State University Health Sciences Center Director of Education and Project Planning New Orleans, Louisiana American Society for Clinical Laboratory Science (ASCLS) Bethesda, Maryland Kara L. Lynch, PhD Clinical Chemistry Fellow Elizabeth Porter, BS, MT (ASCP) Department of Laboratory Medicine Technical Specialist University of California – San Francisco Point of Care Testing San Francisco General Hospital Quest Diagnostics San Francisco, California Cincinnati, Ohio Ruth McCall, BS, MT (ASCP) Alan Remaley, MD, PhD Former Director, Phlebotomy and Clinical Laboratory Senior Staff Assistant Programs Laboratory Medicine Central New Mexico Community College National Institutes of Health Albuquerque, New Mexico Bethesda, Maryland

See more

The list of books you might like

Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.