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PREANALYTICAL VARIABLESPREANALYTICAL VARIABLES
Tapeshwar Yadav
(Lecturer)BMLT, DNHE, M.Sc. Medical Biochemistry
Defined as errors which occur when non analytical factors change the conc. of analytes,so the result do not reflect real the condition of the patient.
PREANALYTICAL VARIABLES CONTROLLABLE UNCONTROLLABLE TEST & SAMPLE COLLECTION AGE PHYSIOLOGICAL SEX DIET RACE LIFE STYLE ENVIRONMENT STIMULANTS SEASON DRUGS OBESITY HERBAL PREGNANCY RECREATIONAL SUBSTANCE STRESS FEVER
CONTROLABLE VARIABLES
TEST & SAMPLE COLLECTION Test conducted Patient identification Turn around time Laboratory logs Transcription errors Patient preparation Specimen collection Separation ,aliquoting
PHYSIOLOGICAL
POSTURE
BLOOD VOLUME HEART RATE & BLOOD PRESSURE GFR ORTHOSTATIC PROTEINURIA
PROLONGED BED REST
FLUID RETENTION CK & K+
EXERCISE
BLOOD GLUCOSE LACTATE URATE PLASMA LIPIDS HORMONES FFA CREATININE BUN.
PHYSICAL TRAINING
SERUM ENZYMES OF MUSCULAR ORIGIN NPN
T4
LIPID
CIRCADION VARIATION
CORTISOL RENIN& ALDOSTERONE TSH GROWTH HORMONE
TRAVEL GLUCOSE TGL.
DIET HIGH PROTEIN FAT SUCROSE & CARBOHYDRATE
FOOD INGESTION
FASTING & POST PRANDIAL ALKALINE TIDE AFTER MEAL GTT SPECIFIC FOOD
CAFFEINE
VEGETARIANISM LIPID URINARY pH VIT B₁₂.
MALNUTRITION
PROTEIN (S) LIPID T4 TSH.
FASTING & STARVATION
BLOOD GLUCOSE INSULIN GLUCAGON LYPOLYSIS KETOGENESIS BR. CHAIN AMINO ACIDS PROTEIN (S) URINARY EXCRETION OF NH₃ & CREATININE.
LIFE STYLE
SMOKING NICOTINE PLASMA EPINEPHRINE, GLUCOSE & INSULIN LACTATE LIPIDS CORTISOL CARBOXYHEMOGLOBIN GASTRIC JUICE IMMUNOGLOBULINS VIT B12
ALCOHOL
GLUCOSE INHIBITION OF GLUCONEOGENESIS LACTATE & URATE TGL & HDL CORTISOL GGT.
DRUGS
SIDE EFFECTS
THIAZIDES- HYPERGLYCEMIA, PHENYTOIN- BILIRUBIN
CONJUGATING ENZYMES.
RECREATIONAL SUBSTANCES AMPHETAMINES -FFA
MORPHINE -AMYLASE&LIPASE
HEROIN – CHOLESTEROL,THYROXIN
NONCONTROLABLE VARIABLES
BIOLOGICAL INFLUENCES
BETTER AGREEMENT BETWEEN SERUM CONC OR
ACTIVITIES OF CONSTITUENTS IN MONOZYGOTIC THAN IN DIZYGOTIC TWINS.
IN WOMEN & BLOOD GR ‘O’- Hb CONC < OTHER BOOD GR.
AGE
NEW BORN- -CHANGES RELATED TO INFANTS
ADAPTATION TO INDEPENDENT EXISTENCE -R.B.C COUNT & Hb CONC. Hb F,
PHYSIOLOGICAL JAUNDICE, BLOOD GLUCOSE, PLASMA AMINO ACID CONC.
CHILDHOOD TO PUBERTY- -PLASMA PROTEIN , ADULT- ELDERLY- -CREATINE CLEARANCE, T3, INSULIN.
SEX
CH. CHANGES AFTER PUBERTY- -ENZYMES -LIPID -NPN
RACE
TOTAL PROTEIN ALBUMIN GLUCOSE TOLERANCE Hb
ENVIRONMENTAL
ALTITUDE AMBIENT TEMPERATURE RESIDENCE SEASONAL
MEDICAL CONDITIONS
OBESITY PREGNANCY STRESS FEVER