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Question 1

name some causes of a change in plasma enzyme activity?

Answer 1

normally present in blood due to high turnover
necrosis or severe damage
neoplasia
increased synthesis of enzymes within cells
duct obstruction .

Question 2

Name 5 important enzymes

Answer 2

Plasma cholinesterase
Lactate Dehydrogenase
Alanine transaminase
Aspartate transaminase
Creatine Kinase

Question 3

Name the different combinations that isoenzymes contain for lactate dehydrogenase

Answer 3

M-Skeletal muscle cells

H-Cardiac muscle

Question 4

What type of enzyme is creatine kinase

Answer 4

muscle enzymes helps maintain atp levels

Question 5

where does CK predominate

Answer 5

Skeletal and cardiac muscle

Question 6

What do dimeric B do and what does M do

Answer 6

B brain and M muscle

Question 7

Name the three types of dimers and where do tey predominate

Answer 7

MM MB BB
MM skeletal muscle
mm (75%) MB(25%) cardiac muscle
BB Brain mainly

Question 8

Name 2 diseases that CK is a marker on?

Answer 8

heart disease (MI) and muscle (muscular dystrophy )

Question 9

Name the enzyme type from CK used to diagnose MI?

Answer 9

CK-MB

Question 10

Where is AST predominant

Answer 10

all tissues but in heart liver and skeletal muscle

Question 11

What can ALT be used to measure

Answer 11

primarly liver ,kidney, skeletal

Question 12

Where is alkaline phosphatase

Answer 12

liver, bone and placenta significant

Question 13

what is gamma glutamyl tranferase

Answer 13

Mainly in kidney, liver, biliary tract, pancreas
important in diagnosis of liver disease
induced by alcohol and other drugs

Question 14

Amylase sign

Answer 14

-Amylase
present in pancreas and salivary glands (different isoenzymes)
used mainly to diagnose acute intra-abdominal conditions eg acute pancreatitis

Question 15

Cholinesterase

Answer 15

Cholinesterase
liver form found in plasma
acetylcholinesterase found in cholinergic nerve endings, not plasma
Low plasma ChE used for diagnosis of scoline apnoea and organophosphorus poisoning

Question 16

what is myocardial infarction

Answer 16

Myocardial infarction resulting from coronary thrombosis
Area of heart becomes severely ischaemic; since heart is a totally oxidative tissue
Resulting lack of oxygen leads to severe tissue damage in ischaemic area

Question 17

Name some enzyme and protein markers for MI

Answer 17

CK inc. CK-MB
CK-MB more sensitive & specific for MI than total
CK-MB mass now most common (ie immunoassay)
AST
LD (esp H4)
other proteins:
myoglobin - rapid release, but not cardiac specific
cTroponin I - highly cardiac specific
cTroponin T - very cardiac specific

Question 18

What is the initial lag phase

Answer 18

initial lag-phase 3 h; enzymes/proteins rise to peak in 18-36h -

Question 19

when do enzyme peak when thrombolytic

Answer 19

enzymes peak @ 10-18h

Question 20

name enzyme markers for liver disease

Answer 20

Liver disease: ALT & AST raised in heptatocellular damage; GGT and ALP in cholestatic disease