Clinical Biochemistry
ΒΒ0404 | ECTS: 5
Theory: 3 hours/week
Learning Outcomes
The main aim of the course is to introduce students to the ways in which the body’s biochemical processes undergo pathological changes, and to support their understanding of the fundamental mechanisms underlying metabolic disorders, as well as the biochemical markers used for their diagnosis. A substantial part of the course is also devoted to the organisation and operation of the clinical biochemistry (diagnostic) laboratory, quality control programmes, the establishment of reference intervals for individual analytes, and the diagnostic performance of laboratory tests.
Upon successful completion of the course, students will be able to:
- describe key pre-analytical considerations in specimen collection (sampling) and the establishment and interpretation of reference intervals,
- evaluate diagnostic test performance, including clinical sensitivity and specificity, ROC curve analysis,
- explain the pathobiochemistry of the major physiological systems;
- identify and interpret biochemical markers used in the laboratory assessment of the most important organ-related disorders;
- apply biochemical markers appropriately in differential diagnosis.
Analytical Description of the Course
- Introduction – Biochemical tests and specimen analysis; specimen collection (sampling)
- Reliability of analytical methods – Types and sources of error
- Reference intervals – Clinical decision Limits
- Selection and development of an analytical method
- Internal and External Quality control programmes
- Automated analysers
- Hydrogen ion homeostasis and blood gases (acid–base balance)
- Water and electrolyte balance
- Renal function
- The liver and the gastrointestinal tract
- Endocrine gland function
- Disorders of carbohydrate metabolism
- Lipids and lipoproteins
- Metabolic Syndrome
- Haemoproteins, porphyrins and iron
Laboratory Exercises
- Determination of serum lipids and lipoproteins; evaluation of method error.
- Determination of calcium and phosphate in serum samples; calculation of a reference interval.
- Blood glucose determination – oral glucose tolerance test (OGTT).
- Routine urinalysis.
- Quantitative determination of human chorionic gonadotropin (hCG) in serum by ELISA.
- Determination of serum urea and serum and urine creatinine; estimation of glomerular filtration rate (GFR).
- Determination of liver function test (LFT) markers: ALT, AST, γ-GT, alkaline phosphatase.
Student Performance Evaluation
Student assessment focuses on: (i) evaluation of the theoretical knowledge acquired through lectures, (ii) assessment of laboratory skills, and (iii) the ability to appraise and synthesise the scientific literature through the preparation of a review assignment.
At the beginning of the semester, recent review articles from the international literature on topics in Clinical Biochemistry are distributed. Students work in groups to investigate an assigned topic area.
Overall performance is assessed as follows:
- 10% of the final grade is based on the group’s oral presentation of the assigned topic;
- 10% of the final grade is based on the performance in the laboratory practical sessions, including execution of the exercises and the presentation/interpretation of results in the laboratory notebook;
- 80% of the final grade is based on the written examination during the official examination period.
The written examination includes:
- extended written-answer questions (50–60 marks);
- true/false statements and/or multiple-choice questions (20–30 marks);
- clinical case-based questions, where students use laboratory results to support a likely differential diagnosis (20–30 marks).
Successful completion of the laboratory practical sessions is a mandatory prerequisite for the validation of the written examination grade.
Suggested Bibliography
- Clinical Biochemistry, W. Marshall, Ed. Litsas, 2000.
- Clinical Biochemistry, G. Beckett, S. Walker, P. Rae& P. Ashby, Ed. Parisianou S.A, 2008.
- Clinical Biochemistry, Νesser Αhmed, Ed. Parisianou S.A, 2020
- Clinical Chemistry, Theory, Analysis, Correlation, L.A. Kaplan, A.J. Pesce, S.C. Kazmierrczak, 4th edition, Mosby Editions, 2003.
- Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics, Carl A. Burtis, and David E. Bruns, 7th Edition, Saunders, 2015
Teaching Material / E-class
Lecturers
Maria Kontou (Course Coordinator)
Vasiliki Skamnaki
