Author Information and Learning Objectives

 

All individuals involved in planning and developing the contents of this program were required to disclose whether or not they (or an immediate family member) have any financial relationships relevant to the contents of this educational activity. If any potential or real conflicts of interests were identified by the organizing committee, they were resolved prior to the program. The committee members’ disclosure information is provided below:

Planning Committee

Nader Rifai, PhD
Professor and Director of Clinical Chemistry
Boston Children's Hospital
Boston, MA

Christina Ellervik, MD, PhD
Associate Professor, Laboratory Medicine
Boston Children's Hospital
Boston, MA

Drs. Ellervik and Rifai both disclosed no relevant financial relationships

Authors, Disclosure Information, and Learning Objectives – by Module

Body Fluids

Author Information
Darci R. Block, PhD, DABCC
Consultant
Mayo Clinic
Rochester, MN
Dr. Block disclosed no relevant financial relationships.

Learning Objectives

  • Differentiate between standard and non-standard body fluids
  • Describe collection and handling of various body fluids
  • Describe anatomy, production, and composition of various body fluids in physiological and disease states
  • Describe clinical utility of various analytes in various body fluids
  • Interpret results from measurements of analytes in various body fluids
  • The fluids covered in the course are: serous, pleural, peritoneal, pericardial, synovial, amniotic, cerebrospinal

Clinical Toxicology: Drugs of Abuse

Author Information
Shannon Haymond, PhD
Director
Clinical and Mass Spectrometry Laboratories
Northwestern University
Chicago, IL
Dr. Haymond had no relevant financial relationships to disclose.

Learning Objectives

  • Differentiate between forensic and therapeutic screening
  • Recall general legal regulations of drug screening
  • Describe and compare specimen types
  • Describe general principles for analytical methods of drug screening
  • Describe and interpret analytical methods for the following drugs of abuse:
    • acetaminophen
    • benzodiazepine
    • PCP
    • Marijuana
    • Opiates
    • Cocaine
    • Barbiturates

Hemolytic Disease of the Fetus and Newborn

Author Information
Kerry O'Brien, MD
Assistant Professor
Harvard Medical School
Cambridge, MA
Dr. O'Brien disclosed no relevant financial relationships.

Learning Objectives

  • Discuss the pathophysiology of HDFN and which patients are most at risk for HDFN
  • Describe the critical titer of anti-D as it pertains to HDFN
  • Detail the history of Rh immune globulin, its clinical utility, its mechanism of action, how it is dose and when it should be given to women at risk of HDFN due to anti-D
  • Discuss the methodology and indications for the rosette test, the Kleihauer-Betke test and flow cytometry in assessing for fetomaternal hemorrhage
  • Discuss whether women with weak D and partial D mutations are candidates for Rh immune globulin
  • Explain why anti-K HDFN differs from all other types of HDFN and how one would monitor the at-risk patient
  • Discuss when and how an antibody titration procedure is performed in a pregnant woman
  • Describe the clinical presentation of HDFN
  • Detail the antenatal management of pregnancies at risk for HDFN including the use of middle cerebral artery Doppler ultrasonography, fetal blood sampling, and intrauterine transfusion
  • Describe the post-delivery management of neonates afflicted with HDFN including the use of neonatal intravenous immunoglobulin, phototherapy, and red cell exchange transfusion

Liver Disease

Author Information
Paul Johnson, PhD
Assistant Professor, Clinical Laboratory Science
Mayo Clinic of Medicine
Scottsdale, AZ
Dr. Johnson had no relevant financial relationships to disclose.

Learning Objectives

  • Describe micro- and macroscopic anatomical findings of the liver
  • Describe biochemical functions of the liver
  • Describe clinical features of various liver diseases
  • Describe pre-analytical and biological variation of liver biomarkers
  • Describe analytical principles for measurement of liver biomarkers
  • Describe inherited conditions of liver disease
  • Describe hepatobiliary disease
  • Describe hepatocellular disease
  • Describe hepatocellular carcinoma

Mass Spectrometry

Author Information
Erin Kaleta, PhD
Clinical Director
Sonora Quest Laboratories
Tempe, AZ
Dr. Kaleta had no relevant financial relationships to disclose.

Learning Objectives

  • Describe basic concepts of mass spectrometry
  • Differentiate between hard and soft ionization
  • Differentiate between electron impact, electrospray, chemical, and desorption ionization techniques
  • Contrast the configurations of quadrupole, ion trap, and time of flight mass analyzers
  • Describe the practical use of various types of mass analyzers
  • Diagram a tandem mass spectrometer
  • Describe the function of each component of a tandem mass spectrometer
  • Contrast fixed and scanning mode configurations for ion selection
  • Describe sample preparation and introduction methods for mass analysis

Metals: Trace and Toxic

Author Information
Paul J. Jannetto, PhD, DABCC, FACB, MT (ASCP)
Director, Metals Laboratory
Director, Clinical and Forensic Toxicology Laboratory
Director, Clinical Mass Spectrometry Laboratory
Mayo Clinic
Rochester, MN
Dr. Janetto had no relevant financial relationships to disclose.

Learning Objectives

  • Recognize the common clinical signs and symptoms of deficiency or toxicity to essential, non- essential, and heavy elements
  • Identify the appropriate laboratory test/specimen matrix which should be ordered/collected to assess for elemental exposure or toxicity
  • Correctly interpret the elemental laboratory test results and suggest appropriate follow-up testing or care
  • Identify common sources of exposure to various elements

Nucleic Acid Isolation

Author Information
Linnea Baudhuin, PhD
Associate professor
Laboratory Medicine and Pathology
Mayo Clinic College of Medicine
Rochester, MN
Dr. Baudhuin had no relevant financial relationships to disclose.

Learning Objectives

  • Recall the major steps involved in nucleic acid isolation
  • Discuss overcoming issues with difficult sample types during nucleic acid isolation
  • Detail different reagents and approaches involved with cell lysis and nucleic acid separation
  • Compare similarities and differences between DNA and RNA extraction
  • Describe different types of liquid phase nucleic acid extraction
  • Recall details about the different methods for solid phase nucleic acid extraction
  • Discuss measurement and optimization of nucleic acid quantity and quality

Pharmacogenetics

Author information
Hoi-Ying (Elsie) Yu, PhD, DABCC, FACB
System Director
Geisinger Health System
Chemistry, Toxicology and Point-of-Care Testing
Danville, PA
Dr. Yu had no relevant financial relationships to disclose.

Learning Objectives

  • Identify different types of pharmacogenetic targets and understand how medications can be affected by genes
  • Recall the specific role of pharmacogenetics in certain cancer treatments
  • Define the specific roles of pharmacogenetics in pain management
  • Recall details about cardiovascular-related pharmacogenetics
  • Describe examples for psychiatry-related pharmacogenetics
  • Describe HLA genes that impact drug hypersensitivity
  • Recall clinical benefits and limitations of pharmacogenetic testing

Protein Electrophoresis

Author Information
Danyel Tacker, PhD, DABCC, FACB
Associate Professor and Director of Clinical Chemistry
West Virginia University Health Science Center and Hospital
Morgantown, WV
Dr. Tacker had no relevant financial relationships to disclose.

Learning Objectives

  • Understand basic principles in electrophoretic separation
  • Discuss indicated uses for protein electrophoresis tests
  • Interpret protein electrophoretic patterns in health and disease states
  • Describing major pitfalls in electrophoretic separation

Serum Enzymes

Author Information
Christopher McCudden, PhD, DABCC, NRCC, FACB
Assistant Professor
Pathology and Laboratory Medicine
University of Ottawa
Ottawa, ON
Dr. McCudden had no relevant financial relationships to disclose.

Learning Objectives

  • Describe the basic structure and function of enzymes
  • Recognize different enzymes naming conventions and nomenclature
  • Discuss the methods to measure clinically relevant enzymes
  • Identify clinically relevant serum enzymes
  • Discuss how serum enzymes are used to diagnose and manage disease

The Exocrine Pancreas

Author Information
Mark Albert Marzinke, PhD, DABCC, FACB
Director, Pre-analytical Chemistry and General Chemistry
The Johns Hopkins Hospital
Associate Professor of Pathology
Baltimore, MD
Dr. Marzinke had no relevant financial relationships to disclose.

Learning Objectives

  • Describe the cytoarchitecture of the pancreas
  • Recall the digestive enzymes synthesized, stored, and secreted by the pancreas
  • Identify the components of pancreatic fluid, and its role in downstream digestion
  • Recognize the importance of pH in pancreatic enzyme activity
  • Describe how amylase and lipase are measured in the clinical laboratory setting
  • Stratify invasive and noninvasive tests to assess pancreatic function
  • Detail how laboratory tests can be used in the differential diagnosis of pancreatitis
  • Compare and contrast clinical presentation and laboratory findings associated with acute and chronic pancreatitis

Therapeutic Drug Mangagment I

Author Information
Christine Snozek, PhD, DABCC, FACB
Director
Clinical Chemistry and Core Laboratory
Mayo Clinic
Scottsdale, AZ
Dr. Snozek had no relevant financial relationships to disclose.

Learning Objectives

  • Understand the rational for therapeutic drug monitoring
  • Describe the principles of pharmacokinetics
  • Describe the preanalytical and analytical factors affecting drug measurement

Thyroid

Author Information
Robert Nerenz, PhD
Assistant Professor
Department of Pathology and Laboratory Medicine
Dartmouth Hitchcock Medical Center
Lebanon, NH
Dr. Nerenz had no relevant financial relationships to disclose.

Learning Objectives

  • Understand basic pathophysiology of the thyroid gland
  • Describe basic biochemistry of the thyroid
  • Describe major sources of preanalytical and analytical error in thyroid testing
  • Understand analytical principles used for thyroid function testing
  • Interpret thyroid function testing results

Vitamin D

Author Information
Nicole Tolan, PhD
Instructor in Pathology
Beth Israel Deaconess Medical Center
Boston, MA
Dr. Tolan disclosed grant/research funds and consultant fees from Sciex.

Learning Objectives

  • Describe the biochemistry of vitamin D
  • Describe major sources of preanalytical and analytical error in vitamin D testing
  • Understand methodologies used for vitamin D testing and their limitations
  • Interpret vitamin D results