Clinical Biochemistry Lecture Notes presents the fundamental science behind common biochemical investigations used in clinical practice. Taking a system-based approach, it explores the underlying physiological rationale for tests, with each test explained within the context of disruption by disease. It also explores the value and limitations of biochemical investigations, while helping readers to quickly develop the knowledge and skills required to select the appropriate investigations for diagnosis and management, and to correctly interpret test results. Case studies throughout chapters place the information within a clinical context to further assist readers in the development of test-selection and interpretation skills.

Key features include:

• A comprehensive, yet concise overview of the science behind common biochemical investigations


• Helps readers rapidly acquire a fully integrated, practical understanding of biochemical diagnostics


• Full-colour flowcharts and algorithms detailing the rationale for tests, the biochemical processes involved, and test procedures, for quick comprehension and reference


• More clinical cases demonstrating application to practice

Now in its tenth edition, this classic introductory, reference, and revision text is indispensable to medical students, and all those who want to quickly acquire a practical understanding of the scientific principles underpinning biochemical tests and a working knowledge of test selection, test procedures, and the interpretation of results within a clinical context.

Peter Rae is Consultant Clinical Biochemist at the Royal Infirmary of Edinburgh, and Honorary Senior Lecturer, University of Edinburgh, UK.

Mike Crane is Consultant Clinical Scientist at the Royal Infirmary of Edinburgh and Royal Hospital for Sick Children, and Honorary Lecturer, University of Edinburgh, UK.

Rebecca Pattenden is Consultant Clinical Scientist at Western General Hospital, Edinburgh, UK.

Preface vi

List of abbreviations vii

About the companion website x

1 Requesting and interpreting tests 1

2 Disturbances of water, sodium and potassium balance 12

3 Acid-base balance and oxygen transport 30

4 Renal disease 43

5 Disorders of calcium, phosphate and magnesium metabolism 60

6 Diabetes mellitus and hypoglycaemia 77

7 Disorders of the hypothalamus and pituitary 91

8 Abnormalities of thyroid function 105

9 Disorders of the adrenal cortex and medulla 121

10 Investigation of gonadal function infertility, menstrual irregularities and hirsutism 139

11 Pregnancy and antenatal screening 158

12 Cardiovascular disorders 167

13 Liver disease 183

14 Gastrointestinal tract disease 198

15 Nutrition 208

16 Inflammation, immunity and paraproteinaemia 224

17 Malignancy and tumour markers 234

18 Disorders of iron and porphyrin metabolism 241

19 Uric acid, gout and purine metabolism 252

20 Central nervous system and cerebrospinal fluid 259

21 Therapeutic drug monitoring and chemical toxicology 263

22 Clinical biochemistry in paediatrics and the elderly 276

Index 295