32. Lactate dehydrogenase and creatine phosphokinase in serum Flashcards
What is the Purpose of Measuring LDH?
For Tissue Damage
Where is LDH Located?
Heart
Liver
Kidney
Skeletal Muscles
Brain
Blood Cells
Lungs
What is Lactate Dehydrogenase (LDH)?
Oxidoreductase
Catalyses the 2-Way Transition of AEROBIC to ANAEROBIC Glycolysis
(Lactate-Pyruvate)
What are the 5 Isoenzymes of LDH?
- LDH1 = HHHH
- LDH 2 = HHH | M
- LDH3 = HH | MM
- LDH4 = H | MMM
- LDH5 = MMMM
What are the Analytical Methods for LDH?
Kinetic Method
DECREASED of Optic Density within UV Spectrum
At 240 nm / min
- Isoenzymes with HIGH H-Subunit are Measured with a-ketobutirate
- Determining Activity of Hydroxybutyrate Dehydrogenase
Where is the Subunit, Heart Type H Found?
Tissues with AEROBIC Metabolism
- Myocardium
- Kidney
- Lung
Where is the Subunit, Muscle Type M Found?
Tissues with ANAEROBIC Metabolism
- Skeletal Muscles
- Liver
- Erythrocytes
What is the Error of LDH Investigation?
Positive (+ve) FALSE Reading
DUE to Haemolysis
What are the Indications for LDH Investigation?
Existence + Severity of Acute / Chronic Tissue Damage
Monitor Cancer, Kidney + Liver Disease
What Specimen is Required for LDH Investigation?
Serum WITHOUT HAEMOLYSIS
What is the Reference Range of LDH?
230 - 460 U / L
What is Associated by INCREASED LDH Levels by MORE THAN 10x?
Advanced Megaloblastic Anaemia
What is Associated by INCREASED LDH Levels by 5 - 10x?
Myocardial Infarction
Muscle Injuries
Acute Pancreatitis
What is Associated by INCREASED LDH Levels by UP-TO 5x?
Infectious Mononucleosis
Dyspeptic Syndrome
What is Creatinine Phosphokinase (CK)?
Catalyses Conversion of Creatine
Consumes ATP
TO FORM Phosphocreatine _ ADP
What are the 3 Isoenzyme Forms of Creatinine Phosphokinase?
- CK-MM = Muscle
- CK-BB = Brain
- CK-MB = Heart
What is the Analytical Method for CK Investigation?
- 3-Stage Kinetic = Absorption at 340 nm / min
2. CK Isoenzymes Determined SEMI-QUANTITAVELY by Electrophoresis
What are the Errors of CK Investigation?
Positive (+ve) False Reading
Negative (-ve) False Reading
What is Associated with POSITIVE (+ve) FALSE Readings of CK?
Mild Muscle Traumas
What is Associated with NEGATIVE (-ve) FALSE Readings of CK?
Haemolysis
Stale Serum
Using Statins
What are the Indications for CK Investigation?
Acute MI
Rhythm Disorders
Bundle Branch Block
Chest Pain
Acute Renal Failure
Muscle Disorders
What Specimen are Required for CK Investigation?
Serum WITHOUT HAEMOLYSIS
What is the Reference Range of TOTAL CK in MALE?
25 – 200 U / L
What is the Reference Range of TOTAL CK in FEMALE?
25 – 175 U / L
What is the Reference Range of CK-MB (Heart)?
UP-TO 20 U / L
What is Associated by INCREASED CK Levels by MORE THAN 10x?
Extensive Recent Myocardial Infraction / Re-infarction
Dermatomyositis
What is Associated by INCREASED CK Levels by 5 - 10x?
After Surgical Operations
Injuries to Skeletal Muscles
Heavy Physical Activity
What is Associated by INCREASED CK Levels UP-TO 5x?
Newborns
Hypothyroidism
Pericarditis
