Hi

This is Lovely Rose and you're now viewing my blog..This is our Clinical Chemistry Blog Notes... In this blog you will learn more about the subject that may help you in your future career as a medical professional.. And once you have started exploring this blog, I can assure you that even a few seconds of your time spent on this blog will not be wasted, for you'll be learning a lot of things..

So enjoy and be one of us guys!

My First Week of Internship

My first week of duty was very exciting, because we will be dealing with other people and we will meet the laboratory’s staffs. It was very exciting and at the same time I felt so nervous. There is what they call the terror staffs. But if you look in general all staffs are kind and courteous. Maybe sometimes they are kind of snobbish but for me that is the way they do to teach us discipline and now to be responsible in every actions that we are doing. My first section is hematology for 21 days, we have a quota for 25 Sysmex Ca 50 and 25 for CBC and 1 for retic count. I enjoyed everyday because I’ve learned so many things from my staffs and from my co-interns. They taught me on how to do the test and how to operate the machine. What I really like the most was that my staffs and octoberian interns do, Lovely can do also. Why? Because everytime there is a specimen I am confident to get the specimen and start to process it and it feels do good when I have the results that I have processed and it is correctly done. It completes my day of duty, because of that I am very excited to come on duty and I am always early 30 minutes before my time. All I can say that my duties are very exciting and I will never loose this excitement to become a good and a fruitful intern of AUFMC.

Do You Agree That Drug Testing Should Be Done As A Requirement For Admission To Schools?

Do we really have to ask our selves this question? Well for me I 100% totally agree that drug testing should be done as a requirement for admissions to schools. I mean I don’t see any thing wrong with it and I can’t even think of disadvantages of having drug testing as a requirement for school admission. But this will be a very big problem for those who use illegal drugs and that’s their problem they shouldn’t even have been using illegal drugs from the start. To think of it I got a question of my own why even use drugs, what do they get from using drugs? As far as I know this can even endanger their life.

Drugs have been a major problem in our country but not only in our country but in the whole world. That’s why I agree with this statement. If this would be done I would say that this will reduce the number of students who use drugs knowing that it will affect their future in a big way that they won’t be able to enroll in a school because of the drug screening. This will be a big boost for our society having to decrease the number of cases of drug users. This will also be an advantage for the school and the students. Drugs can make a person change and really mess their mind up which can cause trouble in campus. So having a free from drugs school the school campus is safer. This is my point of view for this statement. I STRONGLY AGREE THAT DRUG TESTING SHOULD BE DONE AS A REQUIREMENT FOR ADMISSION TO SCHOOLS ….

Below I have added some information about drug testing..

A Drug Testing is a commonly technical examination to determine the specified drugs that are presence or absence or their metabolized traces of the patient. It is done to those people who are suspected on taking prohibited drugs, abusing of drugs that can affects the healthy body.

There are common types of specimen that can be used in drug testing:

1. urine

2. hair

3. blood

4. sweat

5. or other body fluids

Urine is the most common specimen for screening test for drug testing, some reasons why it is the chosen common specimen, its because urine can be collected anytime and is easily done rather than the other specimens. While the blood specimen is the confirmatory testing for drug testing if the result in the urine test is positive for taking prohibited drugs.

Types of Testing:

Pre-employment drug testing

it is the least effective drug testing, it is considered the " Intelligence test"
Random drug testing

Random drug testing

it is the most effective format in drug testing

Post-incident drug testing

is not very commonly administered test compared to two

Diagnostic screening

"Toxicology test or Tox screen" to denote the broader area of possible substances than sel-administered drugs.

Answers to Quiz time!

1. kidney stones

2. true

3. diabetic ketoacidosis

4. light yellow to amber

5. faintly aromatic

6. cloudy appearance

7. UTI

8. true

9. casts

10. true

Case Analysis:

diabetic ketoacidosis

Quiz Time!

Objectives:

1. The presence of a few crystals in urine is possible to healthy people. What is the condition if large amount of crystals are present in the urine?
2. True or False: Pregnancy is one predisposing factor for protein to be positive in the urine.
3. It is a serious condition of the patient if large amounts of ketones are present in his/her urine.
4. What is the normal color of the freshly voided urine in a healthy person?
5. What is the normal odor of your answer to # 4?
6. What will be the appearance of the urine if blood, sperm, bacteria, mucus are present in the urine?
7. The breakdown of nitrates to nitrites will show what type of infection?
8. True or False: Normally, a very little amount or no glucose at all present in the urine. But large amounts of glucose will indicate diabetes.
9. This are plugs of materials formed in tiny tubes of the kidney and get flushed out in the urine and this plugs can help to show what type of kidney disease is existing in the patient?.
10. True or False: A urine test can help find the cause of symptoms.

Case Analysis:

A 20 years old female is experiencing a frequent vomiting and starvation. She went in the hospital and the doctor asked her to have a urine test.

The results showed large amounts of ketones are present in her urine. What is a serious condition that may be present in the patient based on the results of urine test?

Urine Testing

Urinalysis is a diagnostic physical, chemical, and microscopic examination of a urine sample or specimen. Urine test checks the different components of the urine. The waste product secreted by the kidneys. . The kidneys take out waste material, minerals, fluids, and other substances from the blood to be passed in the urine. A urinalysis may include these different tests:

For the color, there are many factors that affect the color of the urine, including fluid balance, diet, medicines, and diseases. The dark or light the color tells you how much water is present and also vitamin B supplements may turn urine bright yellow. Clarity, normally urine is clear. Due to bacteria, blood, sperm, crystals, or mucus it may make urine look cloudy. Also in the odor, some diseases cause a change in the odor of urine. An example of this is an infection with E. coli bacteria which may cause a bad odor, while diabetes or starvation can cause a sweet odor. Protein normally is not found in the urine. Fever, hard exercise, pregnancy, and some diseases, especially kidney disease, are some factors for protein to be present in urine. Nitrates may be found in the urine. Bacteria that cause a urinary tract infection (UTI) make an enzyme that changes urinary nitrates to nitrites. Nitrites in urine show that UTI is present. Leukocyte esterase shows leukocytes in the urine. WBCs in the urine may mean a UTI is present. Ketones, This is when fat is broken down for energy where in these substances made by the body is called ketones and passed in the urine. Present of large amounts of ketones in urine may mean a very serious condition such as diabetic ketoacidosis may be present. A diet low in sugars and starches, starvation, or severe vomiting may also be a factor to cause ketones to be in the urine. Red blood cells and white blood cells normally are not found in the urine. Inflammation, disease, or injury to the kidneys, ureters, bladder, or urethra can cause blood in urine. Strenuous exercise may also cause blood in the urine. White blood cells may be a sign of infection or kidney disease. Some types of kidney disease can cause plugs of material (called casts) to form in tiny tubes in the kidneys. The casts then get flushed out in the urine. Casts can be made of red or white blood cells, waxy or fatty substances, or protein. The type of cast in the urine can help show what type of kidney disease may be present. Healthy people may have a few crystals in their urine but a large number of crystals present, or certain types of crystals, may mean kidney stones are present or there is a problem with how the body is using food or the metabolism. There are no bacteria, yeast cells, or parasites in urine normally. But if present this may indicate that there is an infection. Glucose is the type of sugar found in blood. Normally there is very little or no glucose in urine. When the blood sugar level is very high the sugar spills over into the urine. Glucose can also be found in urine when the kidneys are damaged or diseased. If you have glucose in your urine, you are likely to have diabetes. Thus, if your urine contains any glucose you should have a blood test to measure the blood level of glucose to confirm whether diabetes is present.

Top 10 Emerging Influential Blogs of 2009

I am very fond of their blogs..Upon reading their blogs it just makes me wonder where they get all their ideas and become so creative..Its seems that they have so many inspirations in their life.. For me after reading their blogs it will serve to me as an inspiration to exert more effort to become more creative with my blog and probably one day serve as an inspiration to other people..From these blogs you will be able to realize more about life and the reality here in our world..Reading these inspirational blogs just touches me..So are my nominees for Top 10 Emerging Influential Blogs of 2009:

1. Roy The Struggling Blogger

2. Doctor Z of Zorlone

3. Jan Geronimo of WritingToExhale

4. Angel Cuala of Father Blogger dot com

5. Irene of LifeLots

6. Luke of A Walk In The Dark

7. Holly Jahangiri of It’s all a matter of Perspective: Mine

8. Bingkee of I Love/Hate America

9. Kelvin Servigon of Kelvinonian Ideas 2.0

10. Dee of Tales From The Mom Side


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How Can I?

How can I treat a patient with Diabetes Mellitus?
If I don’t know the glucagon’s purpose.
How will I inject the arm or thigh of the patient?
If my knowledge about glucagon is insufficient.
How can I be sure of the effectiveness of this hormone?
If I, (without the help of an expert) try to do it on my own.
How will I be able to know about its importance?
If I don’t care or not aware of its existence.
Isn’t too hard to encounter the problem of these questions
For in this blog, it will provide us with the best solutions.

A Video About Glucagon

Source of video: http://www.youtube.com/watch?v=kU3NqNKc0Ss

Answers

1. Glucagon is a important hormone which is involved in the metabolism of:

CARBOHYDRATES

2. Often described as having the opposite effect of insulin, which instructs the cells of the body to take in glucose from the blood:

GLUCAGON

3. It is where the hormone is synthesized and secreted, which are located in the endocrine portion of the pancreas:

ALPHA CELLS

4. Give the main function of glucagon.

GLUCAGON HELPS MAINTAIN THE LEVEL OF GLUCOSE IN THE BLOOD

5. Pathway by which non-hexose substrates such as amino acids are converted to glucose.

GLUCONEOGENESIS

6-8. Give three conditions associated with decrease secretion of glucagon.

-SOMATOSTATIN
-INSULIN
-INCREASED FREE FATTY ACIDS AND KETOACIDS INTO THE BLOOD

9. A heterotrimeric protein with α, β, and γ subunits.

G PROTEINS

10. Define glycogenolysis.

Is the catabolism of glycogen by removal of a glucose monomer through cleavage with inorganic phosphate to produce glucose-1-phosphate.

11- 15.
A 34 year old women came to the hospital today with her chief complains of frequent headaches, increase hunger and heavy thirst. She also complained about her vision sometimes blurs. She also said that she easily gets tired. So the doctor asked her to under go some laboratory test to know her exact condition about the symptoms she is experiencing.

TYPE 2 DIABETES MELLITUS

16- 20.
A 30 year old male appears to have red-brown skin rashes. He complains about having a smooth texture of his tongue, and also he is experiencing lip inflammation. In his last laboratory findings his red blood cells are below normal range while his white blood cells are above the normal range, which may indicate a condition of anemia. To further explore his condition he was advised by the doctor to have another laboratory test.

GLUCAGONOMA SYNDROME

Quiz

ATTENTION MT-IV!!!

1. Glucagon is a important hormone which is involved in the metabolism of:
2. Often described as having the opposite effect of insulin, which instructs the cells of the body to take in glucose from the blood:
3. It is where the hormone is synthesized and secreted, which are located in the endocrine portion of the pancreas:
4. Give the main function of glucagon.
5. Pathway by which non-hexose substrates such as amino acids are converted to glucose.
6-8. Give three conditions associated with decrease secretion of glucagon.
9. A heterotrimeric protein with α, β, and γ subunits.
10. Define glycogenolysis.

11- 15.
A 34 year old women came to the hospital today with her chief complains of frequent headaches, increase hunger and heavy thirst. She also complained about her vision sometimes blurs. She also said that she easily gets tired. So the doctor asked her to under go some laboratory test to know her exact condition about the symptoms she is experiencing.

16- 20.
A 30 year old male appears to have red-brown skin rashes. He complains about having a smooth texture of his tongue, and also he is experiencing lip inflammation. In his last laboratory findings his red blood cells are below normal range while his white blood cells are above the normal range, which may indicate a condition of anemia. To further explore his condition he was advised by the doctor to have another laboratory test.

Glucagon

Glucagon

Glucagon is an important hormone that is involved in the metabolism of carbohydrates. It is produced by the pancreas, which is released when the level of glucose in the blood is low. This will cause the liver to convert the stored glycogen into glucose and released into the bloodstream. Glucagon is often described as having the opposite effect of insulin, which instructs the cells of the body to take in glucose from the blood. Glucagon also stimulates the release of insulin, so that newly available glucose in the bloodstream can be taken up and used by insulin-depende.

Production of Glucagon

The hormone is synthesized and secreted from alpha cells of the islets of Langerhans, which are located in the endocrine portion of the pancreas. In rodents, the alpha cells are located in the outer rim of the islet. Human islet structure is much less segregated, and alpha cells are distributed throughout the islet.

Functions

Glucagon helps maintain the level of glucose in the blood by binding to glucagon receptors on hepatocytes, causing the liver to release glucose stored in the form of glycogen through a process known as glycogenolysis. Glucagon stimulates breakdown of glycogen stored in the liver. blood glucose levels are high, large amounts of glucose are taken up by the liver. Under the influence of insulin, much of this glucose is stored in the form of glycogen. Later, when blood glucose levels begin to fall, glucagon is secreted and acts on hepatocytes to activate the enzymes that depolymerize glycogen and release glucose. As these stores become depleted, glucagon then encourages the liver to synthesize additional glucose by gluconeogenesis. Glucagon activates hepatic gluconeogenesis. Gluconeogenesis is the pathway by which non-hexose substrates such as amino acids are converted to glucose. As such, it provides another source of glucose for blood. This is especially important in animals like cats and sheep that don't absorb much if any glucose from the intestine - in these species, activation of gluconeogenic enzymes is the chief mechanism by which glucagon does its job. This glucose is released into the bloodstream. Both of these mechanisms lead to glucose release by the liver, preventing the development of hypoglycemia. Glucagon also appears to have a minor effect of enhancing lipolysis of triglyceride in adipose tissue, which could be viewed as an addition means of conserving blood glucose by providing fatty acid fuel to most cells.

Regulatory Mechanism

Increase secretion of glucagon is caused by the following:

· Decreased plasma glucose

· Increased catecholamines- norepinephrine and epinephrine

· Increased plasma amino acids (to protect from hypoglycemia if an all protein meal is consumed)

· Sympathetic nervous system

· Acetylcholine· Cholecystokinin


Decreased secretion of glucagon is caused by the following:

· Somatostatin

· Insulin

· Increased free fatty acids and ketoacids into the blood

Mechanism of Action

Glucagon binds to the glucagon receptor, a G protein-coupled receptor located in the plasma membrane. The conformation change in the receptor activates G proteins, a heterotrimeric protein with α, β, and γ subunits. When the G protein interacts with the receptor, it undergoes a conformational change that results in the GDP molecule, that was bound to the α subunit, to be replaced with a GTP molecule. This substitution results in the α subunit releasing from the β and γ subunit. The alpha subunit specifically activates the next enzyme in the cascade, adenylate cyclase.

Adenylate cyclase manufacture cAMP (cyclical AMP) which activates protein kinase A (cAMP-dependent protein kinase). This enzyme in turn activates phosphorylase kinase, which in turn, phosphorylates glycogen phosphorylase, converting into the active form called phosphorylase A. Phosphorylase A is the enzyme responsible for the release of glucose-1-phosphate from glycogen polymers.

Normal Value: The normal range is 50 to 100 pg/ml.

References:

http://en.wikipedia.org/wiki/Glucagon

http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/pancreas/glucagon.html