Chemical Pathology

Chemical Pathology is another discipline in the field of Pathology which deals with the entire range of disease. It encompasses detecting changes in a wide range of substances in blood and body fluids (electrolytes, enzymes and proteins) in association with many diseases. In addition, it involves detecting and measuring tumour (cancer) markers, hormones, poisons and both therapeutic and illicit drugs. For example Chemical Pathologists are involved in assessing levels of iron in the blood, measuring the levels of enzymes that are released into the blood after a heart attack to help in the diagnosis, and in the measurement of certain proteins produced by cancers to monitor the response to their treatment.

As with the other clinical pathology specialities, the largest part of a Chemical Pathologist’s day is typically spent in clinical liaison. This involves advising clinicians about the appropriate tests for the investigation of a particular clinical problem, the interpretation of results and follow-up, and the effect of interferences eg by therapeutic drugs on test results. The working day also has a large component devoted to the validation and interpretation of test results, particularly for unusually abnormal results or more uncommon and highly specialised tests.

Evaluation of new technology and the development of new tests is an ongoing process in Chemical Pathology. This applies particularly to areas that are now opening up, such as the use of molecular biology techniques in diagnostic tests. Specialist areas of interest include such topics as inherited metabolic diseases, trace metals and environmental monitoring, drugs of abuse, and nutrition.

Alcohol / Ammonia

Aqueous BSA – 3mL vials to assess alcohol ammonia measurements

Frequency / Number of samples

12 surveys per year / 2 samples per survey

Tests

Ethanol, Ammonia

Bile Acids

Lyophilised Serum – 2mL vials to assess bile acids measurements

Frequency / Number of samples

12 surveys per year / 2 samples per survey

Tests

Total Bile Acids

Biogenic Amines

Lyophilised Urine – 10mL vials to assess biogenic amine measurements including metanephrines. Note: Urinary Free Metanephrine, Free Normetanephrine and Free 3-Methoxytyramine are included in the General Urine Chemistry material.

Frequency / Number of samples

12 surveys per year / 3 samples per survey

Tests

Noradrenaline, 5HIAA, Adrenaline, Dopamine, HMMA, HVA, 3-Methoxytyramine, Metanephrine, Normetanephrine, Serotonin, Clinical Evaluation Component

Blood Gases

Aqueous Bovine Albumin Buffered Matrix – 2.5mL ampoules to assess related methods available on blood gas analysers, not suited to I-Stat type devices

Frequency / Number of samples

12 surveys per year / 2 samples per survey

Tests

pH, Potassium, Ionised Calcium, pCO2, Chloride, Urea, pO2, Glucose, Creatinine, Sodium, Lactate

BNP

Lyophilised Serum – 0.5mL vials to assess B-type Natriuretic Peptide assays, may not be suitable for some POC analysers (e.g. h232)

Frequency / Number of samples

12 surveys per year / 2 samples per survey

Tests

B-type Natriuretic Peptide (BNP), N-terminal Prohormone B-type Natriuretic Peptide (NT-pro BNP)

C-Reactive Protein

Serum – 500 μL vials to assess CRP from low to high levels

Frequency / Number of samples

12 surveys / 2 samples per survey

Tests

C-reactive Protein, High-sensitivity C-reactive protein

Co-Oximetry

Lyophilised Bovine Haemoglobin – 0.5mL vials to assess performance for CO-Oximetry assay

Frequency / Number of samples

12 surveys per year / 2 samples per survey

Tests

Haemoglobin, Oxyhaemoglobin, Carboxyhaemoglobin, Methaemoglobin

Condensed Serum Chemistry (not for AUS or NZ)

Lyophilised Serum & Matching Diluent – 5mL vials to assess performance across a range of routine chemical pathology assays including therapeutic drugs and endocrine.

Frequency / Number of samples

12 surveys per year / 2 samples per survey

Tests

Albumin, Bicarbonate, Bilirubin-Total, Bilirubin-Conjugated, Calcium, Chloride, Creatinine, Fructosamine, Glucose, Lactate, Lithium, Magnesium, Osmolality, Phosphate (Inorganic), Potassium, Protein (Total), Sodium, Urate, Urea, Troponin I (quantitative), Troponin T (quantitative), Troponin T (semi-qualitative) Roche Cardiac Reader only, Troponin T (qualitative), ALT, Alkaline Phosphatase, Amylase, AST, Cholinesterase, Creatine Kinase, CK-MB, GGT, Lactate Dehydrogenase, Lipase, Iron, TIBC, Transferrin, Ferritin, Cholesterol, HDL Cholesterol, Triglyceride, Cortisol, Thyroxine, Free T4, TSH, Total T3, Free T3, hCG (quantitative), hCG (qualitative), Carbamazepine, Digoxin, Paracetamol, Phenobarbitone, Phenytoin, Salicylate, Theophylline, Valproate, Gentamicin, Vancomycin

CSF Chemistry

Lyophilised CSF – 2mL vials to assess common chemistry assays in a related CSF matrix

Frequency / Number of samples

12 surveys per year / 2 samples per survey

Tests

Total Protein, Immunoglobulin G, Glucose, Lactate, Albumin, Xanthochromia Screen – Haemoglobin (absorbance & qualitative), Xanthochromia Screen – Bilirubin (absorbance, concentration & qualitative)

CSF Oligoclonal Bands

Lyophilised CSF Lyophilised Matching Serum – 0.5mL vials to assess and interpret oligoclonal bands and Beta-2 Transferrin in CSF

Frequency / Number of samples

12 surveys per year / 2 samples per survey

Tests

Oligoclonal Banding (CSF), Oligoclonal Banding (serum), Beta-Trace Protein, Beta-2 Transferrin, Interpretive Comment

Endocrine

Lyophilised Serum – 5mL vials to assess performance for a range of endocrine assays

Frequency / Number of samples

12 surveys per year / 2 samples per survey

Tests

α Fetoprotein, CA-125, CEA, Ferritin, Folate, FSH, Growth Hormone, Homocysteine, hCG (Total), Insulin, LH, Prolactin, PTH, SHBG, TSH, Free T3, Free T4, Vitamin B12

Endocrine ACE

Lyophilised Serum – 0.25mL vials to assess Angiotensin Converting Enzyme assay performance

Frequency / Number of samples

12 surveys per year / 2 samples per survey

Tests

Angiotensin Converting Enzyme (ACE)