Clinical Biochemistry and related diagnostic techniques

A.Y. 2021/2022
7
Max ECTS
70
Overall hours
SSD
BIO/12 MED/46
Language
Italian
Learning objectives
The course aims to provide the basic notions to:
1. use the biological sample correctly, treating it and keeping it in correct way so as to draw from it clinically useful indications
2. know the main clinical biochemistry analytes and the related methodological principles used for their measurement
3. know the related clinical biochemistry techniques.
Expected learning outcomes
The student will be in possession of the basic notions of clinical biochemistry and clinical molecular biology in order to be able to use, treat and conserve the biological sample properly as well as to know the main analytes used in clinical biochemistry.
The basic knowledge learned by clinical biochemistry will be used by the student to understand and apply the methodological principles underlying the main analytical techniques related to clinical biochemistry and clinical molecular biology.
Course syllabus and organization

Single session

Responsible
- The program of the course will not be modified
- Teaching resources will not be modified
- Teaching method: on-line teaching on Microsoft Teams platform
- Assessment method: written on-line exam
Prerequisites for admission
The student must have previously passed the exam of "Biological Chemistry and Molecular Biology" course, which is compulsory foundation course to the "Clinical Biochemistry and related diagnostic techniques" course.
Assessment methods and Criteria
The exam consists of a quiz written test with a single correct answer aimed to ascertain the student's knowledge on the theoretical/practical aspects of clinical biochemistry, clinical molecular biology and related techniques. Students are allowed, upon request, to discuss the outcome of the test.
Clinical biochemistry and molecular biology
Course syllabus
MODULE: CLINICAL BIOCHEMISTRY AND CLINICAL MOLECULAR BIOLOGY

GENERAL CONCEPTS
1) Preanalytical phase: patient preparation and methods for obtaining biological samples. Other preanalytical variables and interference factors.
2) Analytical phase: laboratory method validation
3) Analytical phase: standardization of measurements and metrological traceability
4) Analitycal phase: Internal quality control
5) Analitycal phase: External quality control
6) Biological variability and derived indices
7) Reference values and decision-making levels
8) Clinical laboratory automation
9) Point of care testing

CLINICAL BIOCHEMISTRY OF THE MAIN ANALYTES
10) Clinical biochemistry of major plasma proteins: prealbumin, albumin, 1-antitrypsin, β2-microglobulin, ceruloplasmin, C Reactive Protein, haptoglobin, transferrin, complement factors, immunoglobulins
11) Clinical Enzymology:
- Basic Knowledge (isoenzymes/isoforms, release kinetics, etc.)
- Muscle enzymes: creatine kinase
- Liver enzymes: aminotransferases, alkaline phosphatase (and isoenzymes), GT, 5'-nucleotidase
- Pancreatic enzymes: lipase, pancreatic amylase
- Other clinically relevant enzymes: lactate dehydrogenase (and isoenzymes), cholinesterase, bone acid phosphatase
12) Biochemical markers of neoplasia (tumor markers)
- Prostatic-specific antigen (PSA)
- -fetoprotein
- human chorionic gonadotropin (hcg)
- carcinoembryo antigen (CEA)
- Carbohydrate antigens: CA 125, CA 15.3, CA 19.9
- chromogranine A
- neuron-specific enolase (NSE)
- CYFRA 21.1
- human epididymis protein 4 (HE4)
13) Clinical biochemistry of renal function:
- Creatinine
- Cystatin C
- Urea
- Uric acid
- Urinary proteins (total protein, albuminuria, tubular absorption proteins)
14) Clinical biochemistry of carbohydrates and related laboratory tests:
- glucose
- Glycated proteins (haemoglobin, fructosamine, albumin)
- Ketonic bodies
- Lactate and pyruvate
- Insulin and C-peptide
15) Clinical biochemistry of lipoproteins and related laboratory tests:
- lipoprotein and apolipoprotein
- cholesterolemia (total, HDL, LDL)
- triglyceridemia
- apolipoprotein A-I and B
- lipoprotein (a)
16) Clinical biochemistry of myocardium: cardiac troponin (I and T) and B-type natriuretic peptide
17) Electrolytes and blood gas analysis:
- Sodium
- Potassium
- Chlorides
- Bicarbonates
- Osmolality
- blood gas and pH
18) Mineral metabolism and biochemical markers of bone remodeling:
- Calcium, phosphates, magnesium
- bone biomarkers (alkaline phosphatase, procollagen, osteocalcin)
- bone resorption biomarkers (deoxypyridinoline, CTx, NTx)

MOLECULAR DIAGNOSTICS
19) Principles of clinical molecular biology (human genome, mutations and DNA repair, molecular pathologies, cancer genetics)
20) Molecular techniques (AN preparation, amplification, detection)
Teaching methods
Frontal lessons assisted by visual tools.
Teaching Resources
TESTO CONSIGLIATO: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Fundamentals of Clinical Chemistry & Molecular Biology, VIII ed., Elsevier 2019.

Culture of Animal Cells: R.I. Freshney A Manual of Basic Technique and Specialized Applications, Seventh Edition, 2016, Wiley Blackwell
Medical and biotechnology laboratory techniques
Course syllabus
Absorption and emission spectrophotometric techniques
Enzymatic assay
∙ Chromatographic methods
∙ Centrifugal techniques
∙ Neonatal screening techniques for metabolic disorders. Maintenance Therapies and Therapeutic Perspectives
∙ Basic methods in hematology; Blood components identification, meaning and clinical application
∙ Blood typing techniques; Direct and indirect tests; Compatibility test
∙ Immunochemical assays I: mono- and polyclonal antibodies production; immunoprecipitation, immunofixation and agglutination techniques; nephelometry and turbidimetry
∙ Immunochemical assays II: labeled immunoassay, direct and indirect methods; competitive immunoassays and immunometric tests; ELISA, ELISPOT, homogeneous assays and fluorescent polarization immunoassay
∙ Cell culture techniques: cultured cells biology
∙ Aseptic techniques and biological containment in the cell culture laboratory
∙ Cultured cells characterization; authentication, cellular morphology analysis and differentiation markers
∙ Transformation and immortalization
∙ Cellular contamination analysis and cryopreservation
Teaching methods
Frontal lessons assisted by visual tools.
Teaching Resources
TESTO CONSIGLIATO: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Fundamentals of Clinical Chemistry & Molecular Biology, VIII ed., Elsevier 2019.

Culture of Animal Cells: R.I. Freshney A Manual of Basic Technique and Specialized Applications, Seventh Edition, 2016, Wiley Blackwell
Clinical biochemistry and molecular biology
BIO/12 - CLINICAL BIOCHEMISTRY AND MOLECULAR BIOLOGY - University credits: 4
Lessons: 40 hours
Medical and biotechnology laboratory techniques
MED/46 - BIOTECHNOLOGY AND METHODS IN LABORATORY MEDICINE - University credits: 3
Lessons: 30 hours