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General Information

Course ID (CB01A and CB01B)
HTEC D085C
Course Title (CB02)
Clinical Chemistry I Lecture
Course Credit Status
Credit - Degree Applicable
Effective Term
Fall 2023
Course Description
Fundamental principles of clinical chemistry will be presented. Topics include laboratory math, testing variables, analytical techniques, quality assurance/quality control, and Point of Care Testing. A detailed theory of enzymes, electrolytes, acid-base, trace metals, carbohydrates, cardiac, amino acids, proteins, porphyrins and hemoglobin, nutritional assessment, and vitamins. will be included. Correlating test results with disease states will be accomplished. Successful completion of this course and Clinical Chemistry I Laboratory are required to enroll in the Clinical Chemistry II Lecture and Clinical Chemistry II Laboratory. Currently, this course is accepted by Laboratory Field Services as meeting CLS pre-requisite requirements for Clinical Chemistry when applying for a CLS Training License.
Faculty Requirements
Course Family
Not Applicable

Course Justification

This course is CSU transferable and part of a CTE program. This is a course that was developed based on the National Accrediting Agency of Clinical Laboratory Sciences and California State Department of Public Health accreditation standards required for Medical Laboratory Technicians' training programs. This course belongs on the Certification of Proficiency-Advanced. This course introduces students to basic clinical chemistry theory used in the chemistry department of the clinical laboratory.

Foothill Equivalency

Does the course have a Foothill equivalent?
No
Foothill Course ID

Course Philosophy

Formerly Statement

Course Development Options

Basic Skill Status (CB08)
Course is not a basic skills course.
Grade Options
  • Letter Grade
  • Pass/No Pass
Repeat Limit
0

Transferability & Gen. Ed. Options

Transferability
Transferable to CSU only

Units and Hours

Summary

Minimum Credit Units
4.5
Maximum Credit Units
4.5

Weekly Student Hours

TypeIn ClassOut of Class
Lecture Hours4.59.0
Laboratory Hours0.00.0

Course Student Hours

Course Duration (Weeks)
12.0
Hours per unit divisor
36.0
Course In-Class (Contact) Hours
Lecture
54.0
Laboratory
0.0
Total
54.0
Course Out-of-Class Hours
Lecture
108.0
Laboratory
0.0
NA
0.0
Total
108.0

Prerequisite(s)

Corequisite(s)

HTEC D085A

Advisory(ies)

Limitation(s) on Enrollment

Entrance Skill(s)

General Course Statement(s)

Methods of Instruction

Lecture and visual aids

Discussion of assigned reading

Discussion and problem solving performed in class

Quiz and examination review performed in class

Homework and extended projects

Assignments

  1. Readings from the required texts.
  2. Collaborative learning exercises such as analysis of case studies, completion of investigative activities and other exercises designed to reinforce course content and allow for the application of subject matter.

Methods of Evaluation

  1. Class activity - Discussions and oral question and answer sessions that test comprehension and require synthesis and application of course material.
  2. Critical thinking assignments - analysis of case studies and completion of investigative questions designed to reinforce course content and allow for the application of subject matter.
  3. Problem solving - Case studies evaluate the students ability to apply critical thinking skills to a clinical situation.
  4. Objective tests - written test examination requiring students to apply theoretical concepts presented in this class to given situations and scenarios.
  5. Quizzes - Quizzes designed to cover each laboratory session requiring the student to apply recently presented course material to given situations and scenarios on a routine basis and help identify any areas that may need extra attention.
  6. Comprehensive final exam - written test requiring the student to demonstrate their ability to summarize, integrate and critically analyze concepts examined throughout the course.

Essential Student Materials/Essential College Facilities

Essential Student Materials
  • ±·´Ç˛Ô±đ.Ěý
Essential College Facilities
  • None.

Examples of Primary Texts and References

AuthorTitlePublisherDate/EditionISBN
Bishop, Michael L., Fody, Edward P., Van Siclen, Carleen, Mistler, James March, Moy, MichelleClinical Chemistry Principles, Techniques, and CorrelationsJones & Bartlett Learning2023/9th Edition13 978-1496335586
Doucette, Lorrain J.Mathematics for the Clinical LaboratoryElsevier2021/4th Edition978-0323-55482-4

Examples of Supporting Texts and References

None.

Learning Outcomes and Objectives

Course Objectives

  • Demonstrate an understanding of fundamental mathematical concepts critical to any analytical procedure.
  • Summarize quality control and quality assurance as it applies to the chemistry department of the clinical laboratory.
  • Select the proper sample to be used in clinical chemistry testing.
  • Explain the role of the laboratory in the management of a Point of Care Testing program.
  • Summarize the four basic laboratory methods including the mechanism of measurement and analytical limitations associated with the method.
  • Compare and contrast the three basic approaches with automation.
  • Classify an immunoassay, given its format, as homogenous or heterogeneous, competitive or noncompetitive and by its label.
  • Discuss the basic chemistry of nucleic acids, DNA, RNA, chromosomes , transcription and the chemistry of life.
  • Examine the biochemical theory and physiology of carbohydrates.
  • Discuss the biochemical structure of amino acids and proteins and physiology of aminoacidopathies including metabolic pathways.
  • Evaluate general properties and principles of enzymes, relating to the clinical diagnostic significance of specific physiologic enzymes, and assay methods for those enzymes.
  • Evaluate the critical role of laboratory testing in diagnosing coronary heart disease.
  • Compare and contrast electrolyte metabolic physiology and regulation and relate these factors to the clinical significance of electrolyte measurements.
  • Examine acid-base balance and the regulatory mechanisms within the body to include the analyte, physiology involved and clinical significance.
  • Recognize the porphyrin ring as it relates to porphyrins, hemoglobin and myoglobin.
  • Examine trace elements and the regulatory mechanisms within the body to include the analyte, physiology involved and clinical significance.
  • Investigate the four components of the nutrition care process as it relates to vitamins.
  • Discuss the challenges and adjustments that are needed to accommodate laboratory testing in geriatric and pediatric patients.

CSLOs

  • Identify sources of error in clinical laboratory testing and classify them as pre-analytical, analytical and post-analytical.

Outline

  1. Demonstrate an understanding of fundamental mathematical concepts critical to any analytical procedure.
    1. Review basic laboratory math formulas.
    2. Solve mathematical related problems presented using basic laboratory math skills.
      1. Perform calculations related to basic arithmetic, rounding numbers, and significant figures.
      2. Perform calculations related to scientific notation and logarithms.
      3. Perform calculations related to systems of measurement to include length, weight , mass and temperature.
      4. Perform calculations related to dilutions and titers.
      5. Perform calculations associated with solutions to include: molarity, normality and percent solutions.
      6. Perform calculations associated with spectrophotometry and Beer's law.
  2. Summarize quality control and quality assurance as it applies to the chemistry department of the clinical laboratory.
    1. Calculate mean, median, mode and confidence intervals.
    2. Use statistical tools to evaluate quality control testing results using Westgard multi-rules.
    3. Determine if patient results can be verified after evaluating quality control results.
    4. Differentiate between quality control and a quality assurance program.
  3. Select the proper sample to be used in clinical chemistry testing.
    1. Recognize pre-analytical, analytical and post-analytical errors and the consequences of those errors on patient care.
    2. Discuss the general steps for processing blood samples used in clinical chemistry testing.
  4. Explain the role of the laboratory in the management of a Point of Care Testing program.
    1. Define point-of-care testing
    2. State the basic principles behind common Point of Care applications
  5. Summarize the four basic laboratory methods including the mechanism of measurement and analytical limitations associated with the method.
    1. Use Beer's law to calculate the concentration of unknown samples.
    2. Differentiate between electrochemistry measurements of potentiometry, amperometry and coulometry.
    3. Identify the five components of electrophoresis.
    4. Refer to the basic components of chromatography and the function of each.
  6. Compare and contrast the three basic approaches with automation.
    1. Outline the basic steps in automated analysis.
    2. Diagram competitive immunoassays and sandwich immunoassays.
  7. Classify an immunoassay, given its format, as homogenous or heterogeneous, competitive or noncompetitive and by its label.
    1. Explain how the concentration of an analyte in the test sample is related to the amount of bound label antigen for competitive and noncompetitive assays.
    2. Describe the three methods used to separate unbound labeled reagent from bound labeled reagent.
  8. Discuss the basic chemistry of nucleic acids, DNA, RNA, chromosomes , transcription and the chemistry of life.
    1. Describe the molecular techniques used in the clinical laboratory.
    2. Review the concepts of binding, nature of reagents used, basic assay design and importance of single nucleotide polymorphism and DNA sequence.
  9. Examine the biochemical theory and physiology of carbohydrates.
    1. Describe simple and complex carbohydrates.
    2. Site specimen considerations, interferences and reference ranges for glucose and ketones.
    3. Diagram the principle metabolic pathways of glucose.
    4. Identify inborn errors of carbohydrate metabolism and which tests are used to detect these diseases.
    5. Correlate glucose levels, glucose tolerance tests and glycohemoglobin results with diabetes mellitus and hypoglycemia.
    6. Evaluate glucose disorders given patient laboratory results.
  10. Discuss the biochemical structure of amino acids and proteins and physiology of aminoacidopathies including metabolic pathways.
    1. Describe the basic structure and general properties of amino acids and proteins, including conjugated and simple proteins.
    2. Distinguish between essential and nonessential amino acids.
    3. Correlate general characteristics of nine common aminoacidopathies to its metabolic defect and laboratory findings.
    4. Outline basic protein synthesis and catabolism.
  11. Evaluate general properties and principles of enzymes, relating to the clinical diagnostic significance of specific physiologic enzymes, and assay methods for those enzymes.
    1. Analyze the chemical composition and properties, and the biological functions of enzymes.
    2. Compare the interactions of enzyme, substrate and product.
    3. Categorize enzymes by functional groups according to the reaction they catalyze.
    4. Choose proper specimen, proper collection technique and handling for samples to be assayed for enzyme measurements, including interference and reference ranges.
    5. Evaluate the common methods for assaying enzymes of clinical significance.
    6. Classify which enzymes are useful in the diagnosis of various disorders, including cardiac, hepatic, bone, and muscle, malignancies and acute pancreatitis.
    7. Evaluate patient serum enzyme levels in relation to disease states.
  12. Evaluate the critical role of laboratory testing in diagnosing coronary heart disease.
    1. Identify the principle organ/tissue source for each cardiac enzyme and state their relationship to myocardio infarction.
    2. Summarize the nine risk factors for coronary heart disease..
    3. Compare and contrast the etiology and physiologic effects of the cardiac conditions such as: congenital heart disease, hypertensive heart disease, infectious heart disease, coronary heart disease, and congestive heart failure.
    4. Compare and contrast the specificity, sensitivity, and the clinical utility of the most commonly used cardiac markers to assess myocardial infarction.
    5. Assess the usefulness of point-of-care cardiac markers and the role of the clinical laboratory in the use of these methods.
    6. Evaluate laboratory results presented through correlation of data with cardiac disorders.
  13. Compare and contrast electrolyte metabolic physiology and regulation and relate these factors to the clinical significance of electrolyte measurements.
    1. Summarize the electrolyte composition of body compartments relative to water content.
    2. Discuss the physiology and the clinical significance of each of the electrolytes discussed.
    3. Compare and contrast the analytical techniques used for testing sodium, potassium, chloride, and bicarbonate concentrations including specimen collection, interferences, reference ranges and clinical significance.
    4. Calculate osmolality, osmolal gap and an anion gap and discuss the clinical usefulness of each.
    5. Estimate osmolality using the formula presented.
    6. Evaluate given patient data and correlate the information with a possible disease state.
    7. Evaluate the role of the kidney in electrolyte excretion and conservation in a healthy individual.
    8. Examine the usefulness of urine electrolyte results: sodium, potassium, calcium and osmolality.
  14. Examine acid-base balance and the regulatory mechanisms within the body to include the analyte, physiology involved and clinical significance.
    1. Assess acid-base homeostasis by differentiating the analytes measured and noting the difference in reference ranges for venous versus arterial samples.
    2. Evaluate the buffering action of the major blood buffer systems and the importance of each toward acid-base control.
    3. Diagram cellular respiration of oxygen and carbon dioxide from the lungs to the cells and back.
    4. Analyze acid base regulation by the lungs and kidneys.
    5. Summarize the dissociation of oxygen from hemoglobin in RBC and parameters that affect it.
    6. Compare and contrast the interrelationship of O2 saturation, PO2 and P50.
    7. Compare the principal methods for determining pH, PCO2, PO2, bicarbonate, plus various calculated parameters.
    8. Choose specimens that have been correctly collected, know interferences and reference ranges.
    9. Calculate buffer solutions and acid-base calculations
    10. Interpret a patient's acid-base status given laboratory data.
  15. Recognize the porphyrin ring as it relates to porphyrins, hemoglobin and myoglobin.
    1. Relate the role of porphyrins in the body,
    2. Compare and contrast porphyrias with regard to enzyme deficiency, clinical symptoms, and clinical laboratory data.
    3. Explain the principles of the basic qualitative and quantitative porphyrin tests.
    4. Discuss the clinical significance and laboratory data associated with the hemoglobinopathies and thalassemias.
    5. Identify the tests used in the diagnosis of hemoglobinopathies and thalassemias.
    6. Discuss the clinical significance of myoglobin and its association with acute myocardial infarction.
  16. Examine trace elements and the regulatory mechanisms within the body to include the analyte, physiology involved and clinical significance.
    1. Define metalloenzyme and metalloprotein as they relate to the biochemical importance of trace metals.
    2. Identify the common testing methodologies used in the clinical laboratory to analyze trace metals.
    3. Analyze the clinical significance of trace elements in reference to their absorption, transport, distribution, metabolism and elimination.
    4. Assess specimen collection considerations and laboratory determinations.​​​​​​​
  17. Investigate the four components of the nutrition care process as it relates to vitamins.
    1. List biochemical parameters used to monitor nutritional status.
    2. ​​​​​​​Examine the metabolism and action of vitamins presented.
    3. Recognize the clinical expression of vitamin abnormalities.
    4. Categorize the properties of vitamins that enable them to be classified as fat-soluble or water soluble.
    5. Discuss the principles of laboratory procedures used in the assessment of vitamin status.
    6. ​​​​​Correlate alterations in vitamin status with circumstances of increased metabolic requirements, age-related physiologic changes or pathologic conditions.
  18. Discuss the challenges and adjustments that are needed to accommodate laboratory testing in geriatric and pediatric patients.
    1. Identify age-related changes in clinical chemistry analytes.
    2. Explain the problems associated with establishing reference intervals for pediatric and geriatric patients.
    3. Correlate age-related physiologic changes and laboratory results with pathologic conditions.
    4. Evaluate laboratory results on pediatric and geriatric patients presented through case studies.
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