-: General Informtion for chemistry

pH is defined as a negative logarithm of the hydrogen ion activity in a solution . PH = - log { H } .pH indicator:- change of the solution color depend on PH indicators Acidic Basic Litmu Red Blue Phenolphthalein Colorless Pink to red -Plasma osmolality is a measure of the concentration of substances such as sodium, chloride, potassium, urea, glucose, and other ions in blood. -The bicarbonate buffering system (HCO3) is an important buffer system in the blood *Cholsetrol :Some types of cholesterol :1- Low-density lipoprotein (LDL) :- It is harmful . it cause atherosclerosis . 2- High-density lipoprotein (HDL) :- it is useful . 3- Very-low-density lipoprotein (VLDL) :- It is transports endogenous products 4- Chylomicrons :- transport exogenous - GGT is elevated by large quantities of alcohol (( alcoholism )) -The dose of glucose in GTT in adult is 75 Gram . and 30 Gram in children -For GTT collect 5 sample of blood + 5 sample of urine . *Copper reducation test :- detect glucose * Copper reducation test :- not detect sucrose . *atomic mass = the number of Protons + the Number of Neutrons *Atomic number = the number of Protons Proton is positive charge . Neutron is neutral charge ( ) Electron is negative charge . *Spectrophotometer :- used to measure the light transmitted by solution in order to determine the concentration . Spectrophotometer components :1- light source . 2- monochrmators . 3- cuvettes 4- phtodetector 5- read out device. *Flamofhotometer :- determine concentration of alkali metals like sodium , potassium , lithium , in body fluid . Flamofhotometer components :1-flame . 2- atomizers. 3- monochromators . 4- detector . 5- read out device Visible wave length = 400 700 nm Ultraviolet wave length = 10 400 nm

- : carbohydrate * -: Classification OF Carbohydrate . monosaccharide . . polysaccharide-3

2- oligosaccharide -1

-: monosaccharide : it contain two group -1 (aldose : which contain aldehyde group . eg : glucose (aldohexosis (ketose : which contain ketone group . eg : fructose ( ketohexosis . oligosaccharide : which contain 2-10 unit of monosaccharide -2 : example of oligosaccharide . sucrose . 2- maltose -1 . lactose . 4- cellobiose -3 . Sucrose (table sugar ) : consist of glucose +fructose * . Maltose : it is alpha glucose* . Lactose ( milk sugar ) : consist of glucose + galactose * . Cellobiose : consist of beta glucose * (polysaccharide : there are polymer of monosaccharide (more than 10 -3 . example : 1- starch . 2- glycogen . 3- cellulose * ( starch : consist polymers of glucose (formed in plant * . glycogen : it is called animal starch *| : Digestive of carbohydrate* digestion of carbohydrate start in mouth by alpha amylase secreted by salivary -1 . gland the digestion of carbohydrate contentious in small intestine by pancreatic alpha -2 . amylase , which convert starch to maltose & maltase convert maltose to glucose . glucose convert in liver -3 --------------------------------------------------------------------------------------

- : LIPID *
. insoluble in water * -: classification of lipid * . simple lipid . 2- complex lipid . 3- derived lipid -1

. Simple lipid : it is formed from alcohol +fatty acid only * complex lipid : formed from alcohol + fatty acid +another material like phosphate* . group or protein or carbohydrate . example of complex lipid : phospholipid - glycolipid : derived lipid : derived from simple and complex lipid , they consist of * . a- fatty acid . b- alcohol. C- hydrocarbon . example of derived lipid : steroid cholesterol--------------------------------------------------------------

. protein : unit of amino acid * : digestion of protein* . start in stomach -1 the digestive enzyme in the stomach is pepsin and rennin -2 . pepsin : is initiate protein digestion* . rennin : cause coagulation milk , found in infant only * . digestion of protein continuous in intestine -3 . pancreatic secretion consist :trypsin chemotropsin &elastase * . homeostasis : keep internal environment constant* . water content in the body : 40-75% of total body weight* -: water balance* 2500ml/day where loss from the body : regulation of body water * : normal water balance maintained by 2 important factor rennin angiotensin aldosteron system -1 (anti diuretic hormone (ADH -2 : MINERAL METABOLISM * (+SODIUM (NA* (is the most abundant cation (positive ion ) in the extra cellular fluid (ECF ( it is found associated with minerals mainly with NACL (common salt . RDA (recommended daily allowance ) 10-15 g nacl /daynormal range of NACL : 135- 145 mmol/l : Hyponatremia * . +decrease level of NA: causes * decrease intake of NACL ( addism"s disease ( deficiency of mineralocorticoid : hypernatremia * increase plasma level of NA : causes* . ( cushings syndrome ( excess glucocorticoid: estimation OF SODIUM* ( iron selective electrode (ISF: (POTTASIUM (K* . the most abundant cation (positive ion ) in the intra-cellular fluid (ICF ) of the body . RDA :at least 1,3 g/day* . normal range : 3.5-5 mmole/l-

: hypokalemia* decrease plasma level of K : causes. ( cushings syndrome (excess glucocorticoids -1 . insuline overdose -2 . alkalosis -3 : hyperkalemia* increase plasma level of K : causes( adisson disease (deficiency of mineralcorticoid -1 . acidosis -2 : estimation of K(iron selective electrode (ICF -1 (+CALCIUM (CA2* . it is most abundant mineral in the body 70kg contain one kg calcium. RDA : 4-6 g/day . normal range : 9-11 mg /dl. the free calcium (ionized ) is active calcium: function of ionized calcium * . participates in blood coagulation -1 . important for contraction of all heart -2 : regulation of calcium metabolism* : calcium and phosphorus is controlled by parathyroid hormone (PTH) secret from parathyroid gland -1 active vit D3 -2 ( calcitonin ( secreted from the thyroid gland -3 : function of parathyroid hormone * : a- on bone . it promote mobilization of calcium and phosphorous from bone to blood : b- on kidney . it promote re-absorption of calcium and excretion of phosphorous by kidneys , there for , PTH is ahypercalcemic hormone* : function of active vit D3* : a- on intestine . it promote absorption of calcium and phosphorus in the intestine : b- on bone , promote formation of bone vitamin D deficiency has been associated with Rickets : function of calcitonin* : Antagonized the action of PTH : a-on bone promote mobilization of calcium and phosphorous from blood to bone , it promote . bone formation : b- on kidney . promote excretion of calcium and re-absorption of phosphorous by kidneys . therefore , calcitonin is hypocalcemic hormone

: HYPOCALCEMIA * . low plasma calcium level: causesacute pancreatitis -1 . renal disease -2 : HYPER CALCEMIA* . high plasma calcium level : causes . malignancy -1 . hyperparathyroidism -2 . hypercalcemia cause renal stone* ; Estimation of calciumAnticoagulant such as oxalate or EDTA , bind calcium interfere with calcium . estimation , they should be avoided (Iron selective electrode (ISE . ANTICOAGULANT example : heparin citrate oxalate EDTA * * : (-CHLORIDE (Cl .major anion of ECF. normal plasma level : 300-365 mg/dl. normal CSF Cl level : 350 440 mg/dl: HYPOCHLOREMIA* . low plasma chloride level(+MAGNESIUM (Mg2* it is the fourth most abundant cation in the body (after calcium phosphorous ( sodium . RDA : 350 mg/ day: TRACE ELEMENTS* . they are needed in the body in minute (trace) amount:a- essential trace elements they have known physiological function in the body e.g. :iron copper zinc . manganese iodine fluorine :b- non essential trace elements they have no known physiological function in the body , their administration may harm . the body e.g. : aluminum cadmium arsenic lead mercury gold (IRON (FE* . RDA : 10-20mg /day. pregnant or pre-menopausal women and children have greater iron requirements( distribution of iron in the body : 5 g ( 60% in hemoglobin-

: form of iron in the body* iron is present the divalent (ferrous fe2+) state in hemoglobin mycoglobin -1 . catalase and peroxidase iron is present in the trivalent (ferric state fe3+ )in the transferrin ferritin 2 . hemosiderin : function of iron* . hemoglobin transports O2 from lungs to tissues and CO2 in the reverse direction : metabolism of iron* . dietary iron is mainly in the ferric (Fe3+) form: in the stomach . Ferric (Fe3+) is converted to ferrous (Fe2+) by vit C and gastric HCL : in the small intestine Absorption of Fe2+ mainly occur in small intestine : in the plasmaFe2+ is oxidized to Fe3+ by ferroxidase and bound to transferrin which transport Fe3+ . and release it in the bone marrow : in bone marrow . Iron incorporated in the hemoglobin of RBC : clinical disorders of iron* . iron deficiency anemia -1 . iron overload -2 : iron deficiency anemia * : parameters of iron deficiency anemia, decrease serum iron -1 ,increase plasma transferrin -2 (increase total iron binding capacity (TIBC -3 decreased serum ferritin -4 : Iron overload* : parameters of iron overload . increased serum iron -1 .decreased plasma transferrin -2 (decrease total iron binding capacity (TIBC -3 . increase serum ferritin -4 :(COPPER (CU* . copper essential for normal pigmentation. copper excess cause Wilson disease(+ZINC (ZN2 * . RDA : 15mg/day -

(IODINE (I * . plasma level : 5-10 mg/dl(iodine enter in the formation of thyroid hormone (T3 T4 ; deficiency of iodine(Causes enlargement of thyroid gland (goiter . function of iodine is prevent dental caries-

-: Organ Function
-: Heart* -: Plasma enzymes used in diagnosis of myocardial infraction ( Creatin kinase ( CK -1 ( Aspartate transaminase ( AST -2 ( Lactate dehydrogenase ( LDH -3 ( These are used in diagnosis in heart attack ( Myocardial infraction -: ( Creatin kinase ( CK ) or creatine phosphokinase ( CPK . CK in brain and heart and skeletal muscles . CK 1 ( BB ) mainly in the brain -1 CK 2 ( MB ) mainly in heart -2 . CK 3 ( MM ) mainly in skeletal muscle -3 . CKMB :increased 4- 8 hours following acute myocardial infraction * . LDH :- increased 24 hours following the acute myocardial infraction * -: Liver * -: liver function tests 1- Alanine transaminase (ALT)(SGPT):- diagnosis for abnormality liver function . 2- Aspartate transaminase (AST)(SGOT) :- diagnosis for abnormality liver and heart function . 3- Alkaline phosphatase (ALP) :- diagnosis for abnormality liver and Bone function . it is better to diagnosis of chronic bile duct . Bile is :- secreted from the liver . -: Carbohydrate metabolism in liver . ( Glycolysis :- oxidation of glucose ( in cytoplasm or cystol -1 . Gluconeogenesis :- synthesis of glucose from non carbohydrate compounds -2 . Glycogenesis :- synthesis of glycogen from glucose -3 . Glycogenolysis :- Breakdown of glycogen to glucose -4 -: Proteins metabolism in liver. Protein convert to -----} amino acid -1 . Ammonia convert to ----} urea-2 . synthesis of Albumin -3

. Liver store Vitamin B12 which is necessary for synthesis of RBCs. Kupffer cells are found in liver Jaundice :- it is yellowish discoloration of the skin , mucus , membrane , and sclera * ( of eye due to increases serum bilirubin ( more then 2 mg/dl Normal indirect bilirubin = 0.1 0.8 mg/dlNormal direct bilirubin = 0.1 0.4 mg/dlNormal total bilirubin = 0.2 1.2 mg/dl - . Bilirubin should be kept away from light -: Types and causes of JaundicePre-hepatic ( Hemolytic ) jaundice :- the pathology is occurring prior ( before ) the -1 . liver . Hepatic jaundice :- the pathology is located within the liver -2 Post-hepatic ( Obstructive ) jaundice :- the pathology is located after the -3 .conjugation of bilirubin in the liver

-: Kidney* -: Non Protein Nitrogenous ( NPN ) compounds urea 2- creatinine 3- uric acid 4- ammonia

5- amino acid -1

Urea :- it is the final product of breackdown ( catabolism ) of protein ( amino acid )( -it is present more then 75% of NPN (Non Protein Nitrogenous . Ammonia converted in the liver to urea Normal blood urea is 15-45 mg/dl( Urea in the blood measure as the blood urea nitrogen ( BUN Noraml BUN is 7-22 mg/dl creatinine :- Normal plasma creatinine is 0.7 1.4 mg/dlNormal creatinine clearance is 97 137 ml/min

Uric acid :- it is the waste product of the Purine metabolismNormal plasma uric acid is 3 7 mg / dl increased in uric acid cause :- Gout disease -: Renal ( kidney ) function test. blood urea or blood urea nitrogen -1 . serum creatinine -2 . creatinine clearance -3 . serum Uric acid -4 -: Body fluid * : Semen :- is secreation from these glands testes -1 seminal vesicles -2 prostate -3 bulbourethal gland -4 -: composition of the semen Color : white , opalescent Volume : 2-5 ml/ejaculation PH : 7.35 7.50 -: ComponentsThe important component is Fructose ( which is the sugar in the semen that give energy ( to the sperms -: Microscopic examination of semen* -: sperm count -1 Normal 60-150 millions/ml Oligospermia : less than 20millions/ ml . Azospemia : no sperm at all . motility : normally less than 80% motile after 1 hour -2 . morphology : normally less than 80% of sperm are normal -3 .(WBCs : there are very little number of WBCs .(less than 1 -4 : biochemical tests of semen * . fructose test : fructose is secreted from seminal vesicle for nutrition of sperms: fructose absent in cases of. a- absence of seminal vesicle . b- obstruction of ejaculatory ducts fructose test used as fertility test . . cerebrospinal fluid (CSF) : it is found in the subarachonoid space * : normal composition of CSF. volume : 135-150ml -1 . color : colorless -2 . appearance : clear with no clot -3 . PH : 7.3 -4 glucose : 45-100 mg/ dl -5

-: Urine * -: normal compositions . sodium , potassium , chloride , urea , uric acid , creatinine -1 : abnormal biochemical constituents of urineprotein glucose lactose ketone bodies bile pigments bile salt urobilinogen -1 . hemoglobin : volume of urine* . normal volume of urine : 600-2500 ml/24hrs(polyuria : abnormal increase of urine volume (more than 2500 ml/24hrs( oliguria : abnormal decrease of urine volume (les than 500 ml/24hrs. anuruea :complete suppression of urine formation e.g. acute renal failure : color of urine* . normal color : light amber color( Greenish yellow due to bilirubin (jaundice ( Red due to blood (hematouria ( Black (alkaptonuria : odor of urine* . normal odor : pungent smell due to presence of aromatic acids. Ammonia smell : prolonged standing . Fecal smell : urinary infection . Fruit smell : ketosis : aspect of urine * . normal urine is clear: abnormal urine is turbid due to presence of . a- bacteria . b- suspended crystals . c- mucus . d- blood : Reaction (PH) and specific gravity of urine * ( normal PH : 4.7- 7.5 (acidic : Biochemical examination of urine * . protien . 2-sugar e.g. glucose-1 ( ketone bodies . 4- bile salts (jaundice -3 . bile pigment (jaundice) 6- blood -5 :( protien in urine (proteinuria: TYPE* . albuminuria : detect by heat coagulation test -1 bence jones proteins : abnormal globulin appear in urine in the condition -2 . a- multiple myeloma . b- leukemia : ( Glucose in urine (glucosuria * : Causes . diabetes mellitus -1 . glucosuria detect by fehling test : ( Ketone bodies in urine (ketouria * . detect by urine by rothera test : Bile salt and Bile pigment in urine * . a- bile salts : they are present in urine in case of obstructive jaundice . bile salt detect in urine by hays. b- bile pigments : they are present in urine in all type of jaundice . bile pigment detect in urine by alcoholic iodine ring -

:( blood in urine (hematouria * : causes . bilhaziasis . 2-blood disease -1 . renal stones. 4- renal tumors -3 -: Microscopic examination of urine* -: Include the presence of( cells ( RBC WBC PUS cell -1 ( Crystals :- ( oxalate urate , phosphate , uric acid crystal -2 casts -3 ( Ova :- ( Belharzia ova -4 ( Parasites ( Leshmania larva trichomnous -5 -: Urinary Cells * Pus cells .

2- Red Cells .

3- Epithelial cells -1

Pus cell :- normal urine contain 2- 4 pus cells/HPF * Red Cells :- normal urine contain 0-2 Red cell/HPF* . The presence of excess of RBC is pathological and called Hematuria . Epithelial cells :- normal urine contain Few Epithelial cells* -: Urine Crystals* . a- crystal in acidic urine :- 1- calcium oxalate . 2- uric acid . 3-amorphous urate . b- crystal in alkaline urine :- 1- Tripple phosphate . 2- Amorphous phosphate . All these crystal are not present in normal urine . Urinary casts :- Normal urine does not contain casts* -: Urinary microorganisims* . Bacteria . 2- yeasts . 3- Protozoa . 4- Parasites -1 -: Some Normal Range * AST : 5-35 U/L -1 ALT : 7-56 U/L -2 ALP : 38-126 U/L -3 Albumin : 3.5-4.8 U/L -4 Amylase : 30-110 U/L -5 direct bilirubin : less than 0.3 mg/dl-6 total bilirubin : 0.2-1.3 mg/dl -7 calcium : 8.9-10.4 mg/dl-8 cholestrol : 120-200 mg/dl-9 creatinine : 0.5-1.4 mg/dl-10 Glucose : 70-120 mg/dl -11 Potassium : 3.6-5 mEq/l -12 sodium : 135-145 mEq/l-13 triglyceride : 50-250 mg/dl-14 uric acid : 3.5-8.5 mg/dl-15 urea nitrogen 7-21 mg/dl-16 total protein : 6.3-8.2 gm/dl-17

Diabetes mellitus : - it is metabolic disorders of carbohydrates metabolism * . producing hyperglycemia and glucosuria -: Types of Diabetes mellitus . type 1 diabetes -1 . type 2 diabetes -2 . Type 1 Diabetes mellitus ( 10% ) :- appear at young age before 30 years * . And it dependent of external insulin -: Symptoms ( Polyuria ( passing urine increase -1 ( polydipsia ( feeling of thirst increase -2 ( polyphagia ( feeling of hunger increase -3 . weight loss -4 . weakness -5 . ketoacidosis -6 . type 2 Diabetes mellitus (90%) : appear after 40 years of age* ( And not depended on external insulin (insulin may be normal or high : symptoms( Polyuria ( passing urine increase -1 ( polydipsia ( feeling of thirst increase -2 ( polyphagia ( feeling of hunger increase -3 without ketosis -4 .obesity is common -5 . Normal Random blood sugar : 80- 120 mg/dl * . Normal fasting blood sugar (FBS) : 70-110 mg /dl *