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Phosphatase Information and Courses from MediaLab, Inc.

These are the MediaLab courses that cover Phosphatase and links to relevant pages within the course.

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Laboratories Individuals

CLIA Chemistry / Urinalysis Review
Serum alkaline phosphatase activity is derived from all of the following organs except:View Page
Alkaline phosphatase activity is increased in all of the following conditions except:View Page
All of the following are sources of serum alkaline phosphatase except:View Page
Which of the following conditions would be suggested by a marked rise in alkaline phosphatase, jaundice, and a moderate rise in ALT:View Page

CLIA Hematology / Hemostasis Review
The procedure which may be used to assist in differentiating chronic myelocytic leukemia from leukemoid reaction is:View Page

Fundamentals of Molecular Diagnostics
Amplified Nucleic Acid Testing Principle

These methodologies use principles that amplify or multiply the target of interest, usually incorporating an enzyme to produce millions or billions of copies in a relatively short time.Some enzymes used in amplification include: DNA ligase DNA polymerase RNA polymerase Reverse transcriptase Alkaline phosphatase Cleavase Note: the steps in amplified testing will vary depending on the target amplified, requirement for thermal cycling and detection techniques.

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Amplified Nucleic Acid Tests

Amplification Method Amplifies Use of Thermal Cycling (Thermocycling) Polymerase Chain Reaction (PCR) Target amplification using DNA polymerase Yes Ligase Chain Reaction (LCR) Target amplification using DNA ligase Yes Transcription- based or Transcription-mediated amplification(TMA) Target amplification using reverse transcriptase and RNA polymerase No Strand Displacement (SDA) Target amplification using DNA polymerase that continuously displaces strands of DNA containing the target sequence No Branched DNA (bDNA) Signal amplification using alkaline phosphatase No Loop Mediated (LAMP) Target amplification of multiple DNA sequences in a loop pattern using DNA polymerase No Nucleic acid sequence based (NASBA) Target amplification using 3 enzymes No Q-beta Replicase Probe amplification- The concentration of an RNA probe increases if the target is present No

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Match the following tests to their appropriate principle:View Page

Pharmacology in the Clinical Lab: Therapeutic Drug Monitoring and Pharmacogenomics
Chemiluminescence

Chemiluminescent assays use antibodies that are conjugated to enzymes, such as peroxidase or alkaline phosphatase. These enzymes, mixed with chemiluminescent substrates, produce light in the visible spectrum. A direct relationship exists between the amount of drug that is present in the sample and the light units that are produced and measured by the luminometer in the instrument. Assays that use chemiluminescence are more sensitive than immunoassays that rely on the generation of a colored product.

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Phlebotomy
Hepatic function panel

Albumin (Alb) Bilirubin (Bili) Alkaline phosphatase (Alk Phos) Total protein (TP) Alanine aminotransferase (ALT) Aspartate aminotransferase (AST)

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Comprehensive metabolic panel (CMP)

Consists of a basic metabolic panel, plus:Albumin (Alb) and Bilirubin (Bili) Alkaline Phosphatase (Alk Phos) Total protein (TP) Alanine aminotransferase (ALT) Aspartate aminotransferase (AST)

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Semen Analysis
Composition of Semen

Semen is produced as a combination of secretions from the different regions of the male reproductive tract. Each fraction differs in chemical composition and function. The combination of these fractions during ejaculation results in the optimal environment for transporting sperm to the endocervical mucus in the female. Spermatozoa are produced in the testes. They mature in the epididymis. The testes also produce testosterone and inhibin.Fluid from the seminal vesicles accounts for approximately 70% of semen volume. The seminal vesicles are the source of fructose in semen. Fructose is used by the spermatozoa as an energy source.The prostate gland supplies about 20% of the volume of semen. Its fluids include acid phosphatase and proteolytic enzymes that lead to coagulation and subsequent liquefaction of semen. The prostate also contains most of the IgA found in semen.The bulbourethral gland produces mucoproteins that make up about 5% of the volume of semen.

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White Cell and Platelet Disorders: Peripheral Blood Clues to Nonneoplastic Conditions
Typical cells on a peripheral blood smear as photographed here were repeatedly encountered as the smear was reviewed. The peripheral white blood cell count was 51,000/ml with an orderly maturation sequence. The comment "leukemoid reaction" may properly be appended to the report.View Page
Leukemoid reaction revisited

The term leukemoid reaction is used to describe peripheral white blood cells that on the stained blood smear may have some resemblances to leukemia cells. Quantatively in a leukemoid reaction, the neutrophil count is >50,000 cumm with more immature cells, particularly myelocytes, than are usually present in toxic left shift syndromes. The presence of immature cells in a leukemoid reaction awakens thoughts of leukemia. Great care must be taken to make a distinct differentiation between aberrant white blood cell proliferations and a benign but exaggerated granulocytic proliferative response. Our material is from a 1-month-old girl with Down's syndrome. Her total white blood count was 37,000/mm3 interpreted as leukocytosis with left shift. Leukocytosis with a left shift, and leukemoid reactions with high alkaline phosphatase are conditions to be mindful of in patients with Down's syndrome. The alkaline phosphatase score is high in leukemoid reactions, low in granulocytic leukemia.

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Eosinophil description

The cytoplasm of eosinophils is evenly filled by numerous orange-red granules of uniform size. They do not overlie the nucleus. The eosinophil granules contain numerous enzymes including peroxidase, phospholipase D, catalase, acid phosphatase, and vitamin B12-binding proteins. Their ability to kill bacteria is less than that of neutrophils. Their main purpose is to counteract parasitic infections and to participate in immune allergic reactions. They may also be increased in a variety of nonimmunologic inflammatory responses from bacteria and fungi causing chronic infections. Malignancies, collagen vascular diseases, and myeloproliferative disorders may also may be settings for prominent eosinophils.

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A most useful follow-up test to consider when faced with hypersegmented neutrophils and oval macrocytes (see photograph) in a peripheral blood smear is:View Page
More about lymphocytes, their impostors and varied faces

In this photograph of blood cells from yet another submitted slide, we find cells resembling lymphoblasts with increased nuclear/cytoplasmic ratios and dense, finely meshed nuclear chromatin. In addition, note the extrusion of delicate strands of cytoplasm from the outer cell membranes (blue arrow). These are cells connoting hairy cell leukemia (HCL). Under scanning electron microscopy, the cytoplasmic extensions appear to be either slender microvilli or delicate pseudopods. The most helpful confirmatory finding is the detection of acid phosphatase isoenzymne 5 in the cytoplasm of suspected hairy cells by staining. The enzyme concentrates primarily in golgi bodies and in the nuclear membrane and its staining is not inhibited by the addition of tartrate. Stated in another way, hairy cells on the peripheral smears are detected by their staining positively for tartrate-resistant acid phosphatase. Be suspicious of HCL if marrow resists aspiration-a consequence of reticulin fibrosis of the marrow in HCL.

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