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ASCP Chemistry Exam Prep > (4) Enzymes > Flashcards

(4) Enzymes Flashcards

1
Q

Enzymes are protein catalysts involved in the regulation of…

A

biochemical reactions in metabolic pathways.

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2
Q

Enzymes increase…

A

the rate of reaction without being altered or consumed during a reaction.

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3
Q

Enzymes ___ the activation energy of a reaction.

A

Lower.

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4
Q

Role of oxidoreductases.

A

Catalyze oxidation-reduction reactions.

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5
Q

Role of transferases.

A

Catalyze group transfer of C, N, or P containing groups.

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6
Q

Role of hydrolases.

A

Catalyze cleavage bonds by the addition of water.

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7
Q

Role of lyases.

A

Catalyze cleavage of C-C, C-S, & certain C-N bonds, lysis generating a double bond.

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8
Q

Role of isomerases.

A

Catalyze optical or geometric isomers, rearrangements.

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9
Q

Role of ligases.

A

Catalyze the formation of bonds between C, O, S, N; coupled of hydrolysis of high energy phosphates (ATP required).

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10
Q

Reference range of AST.

A

5 - 30 U/L.

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11
Q

Reference range of ALT.

A

6 - 37 U/L.

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12
Q

Reference range of CPK.

A

15 - 160 U/L (slightly lower in females).

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13
Q

Reference range of GGT.

A

6 - 45 U/L (slightly lower for females).

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14
Q

Reference range of LDH.

A

Forward: 100-225 U/L.
Reverse: 80 - 290 U/L.

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15
Q

Reference range of ALP.

A

30 - 90 U/L.

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16
Q

Reference range of AMY.

A

95 - 290 U/L.

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17
Q

State the enzyme class for each of the following analytes:

AST, ALT, CK, GGT

A

Transferases.

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18
Q

State the enzyme class for each of the following analytes:

LDH, G-6-PD

A

Oxidoreductase.

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19
Q

State the enzyme class for each of the following analytes:

PChE, AMY, LIP, ALP, ACP

A

Hydrolases

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20
Q

State the enzyme class for each of the following analytes:

ALD

A

Lyase.

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21
Q

State the optimal pH for the following analyte:

Amylase

A

6.9 - 7.0

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22
Q

State the optimal pH for the following analyte:

ALP

A

10

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23
Q

State the optimal pH for the following analyte:

ACP

A

5.0

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24
Q

State the optimal pH for the following analyte:

Lipase

A

8.6 - 9.0

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25
Q

State the cofactors required for the following analyte:

CPK

A

Mg2+

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26
Q

State the cofactors required for the following analyte:

Lipase

A

Colipase

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27
Q

State the cofactors required for the following analyte:

Amylase

A

Calcium and Chloride

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28
Q

State the cofactors required for the following analyte:

ALP

A

Mg2+, CO2+, Mn2+

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29
Q

State the cofactors required for the following analyte:

LD

A

NAD+

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30
Q

Explain Kinetic measurement.

A

Measures the concentration continuously throughout the reaction.

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31
Q

Explain End point measurement.

A

Measures enzyme concentration by measuring a substance after the reaction is stopped (fixed time method).

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32
Q

Define the international unit and how it applies to enzymes.

A

Enzyme activity rather than concentration is measured in serum or plasma. A unit of activity is expressed as IU which is a standard unit established for all methods.

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33
Q

In enzyme testing, 1 IU is that quantity of enzyme that will…

A

catalyze the reaction of one micromole of substance per minute under optimum reaction conditions.

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34
Q

Explain zero order kinetics.

A

The reaction is independent of substrate concentration.

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35
Q

Explain first-order kinetics.

A

Reaction velocity is directly proportional to substrate concentration.

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36
Q

Explain competitive inhibition.

A

Inhibitor similar to the normal substrate molecule competes with the substrate for binding at the activation site.

KM increases, Vmax no change

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37
Q

Explain noncompetitive inhibition.

A

Inhibitor binds to enzyme at a site other than the active site.

KM no change, Vmax decreases

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38
Q

Explain uncompetitive inhibition.

A

Inhibitor binds to the ES complex and prevents product formation

KM decreases, Vmax decreases

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39
Q

List the main tissue source for the following enzyme:

AST

A

Liver, myocardial, skeletal muscle, kidney.

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40
Q

List the main tissue source for the following enzyme:

ALT

A

Liver, skeletal muscle, kidney, heart, pancreas, lungs, spleen erythrocytes.

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41
Q

List the main tissue source for the following enzyme:

CPK

A

Skeletal muscle, brain, stomach muscles.

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42
Q

List the main tissue source for the following enzyme:

GGT

A

Kidney, liver, pancreas, and intestine.

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43
Q

List the main tissue source for the following enzyme:

LDH

A

Brain, erythrocytes, WBC, kidneys, liver.

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44
Q

List the main tissue source for the following enzyme:

Lipase

A

Pancreas (only one of clinical significance), intestinal mucosa, leukocytes, and adipose tissue.

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45
Q

List the main tissue source for the following enzyme:

Amylase

A

Salivary glands and acinar cells of pancreas.

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46
Q

List the main tissue source for the following enzyme:

ACP

A

Greatest concentration in prostate, liver, kidneys, erythrocytes, platelets, bone.

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47
Q

List the main tissue source for the following enzyme:

ALP

A

Liver, bone, placenta, intestine, spleen, and kidneys.

48
Q

State the most prominent location(s) for the following LDH isoenzyme:

LD1 (HHHH)

A

Heart, RBCs.

49
Q

State the most prominent location(s) for the following LDH isoenzyme:

LD2 (HHHM)

A

Renal cortex.

50
Q

State the most prominent location(s) for the following LDH isoenzyme:

LD3 (HHMM)

A

Lung, spleen, pancreas, lymphocytes.

51
Q

State the most prominent location(s) for the following LDH isoenzyme:

LD4 (HMMM)

A

Liver, skeletal muscle.

52
Q

State the most prominent location(s) for the following LDH isoenzyme:

LD5 (MMMM)

A

Liver, skeletal muscle.

53
Q

What are the possible disease states for the following serum enzyme elevations:

CK

A
  • MI,
  • muscle disorders,
  • cerebrovascular accidents,
  • CO poisoning,
  • after shock or circulatory failure.
54
Q

What are the possible disease states for the following serum enzyme elevations:

LD

A
  • Pernicious anemia,
  • MI,
  • pulmonary disorders,
  • hepatitis,
  • skeletal disorders.
55
Q

What are the possible disease states for the following serum enzyme elevations:

AST

A
  • MI,
  • liver disease,
  • muscular dystrophy.
56
Q

What are the possible disease states for the following serum enzyme elevations:

ALT

A
  • Hepatic disorders,
  • Increased ALT specific for liver disease,
  • viral hepatitis.
57
Q

What are the possible disease states for the following serum enzyme elevations:

ALP

A
  • Hepatobiliary disorders (obstruction)
  • Bone diseases
  • Pregnancy
  • Carcinomas
58
Q

What are the possible disease states for the following serum enzyme elevations:

ACP

A
  • Prostate cancer
  • Bone disease
  • Thrombocytopenia
59
Q

What are the possible disease states for the following serum enzyme elevations:

GGT

A
  • Alcoholism
  • Hepatobiliary Disorders
60
Q

What are the possible disease states for the following serum enzyme elevations:

AMS

A
  • Acute pancreatitis
  • Mumps
  • Perforated ulcer
  • Acute appendicitis
  • Macroamylasemia
  • AIDS
61
Q

What are the possible disease states for the following serum enzyme elevations:

LPS

A
  • Pancreatitis
  • Ulcers
  • Intestinal obstruction
62
Q

What are the possible disease states for the following serum enzyme elevations:

5’-nucleatidase

A
  • Hepatobiliary
63
Q

Relate pathologic conditions with an enzyme increase and the degree of elevation:

Metastatic Carcinoma of Prostate

A

Increased: acid phosphatase

64
Q

Relate pathologic conditions with an enzyme increase and the degree of elevation:

Myocardial Infarction

A

Increased: CK, CK-MB, LD, AST

65
Q

Relate pathologic conditions with an enzyme increase and the degree of elevation:

Hepatocelular Disease

A

Increased: ALP, GGT, AST, ALT, 5’-nucleotidase

66
Q

Relate pathologic conditions with an enzyme increase and the degree of elevation:

Pancreatic Disease

A

Increased: lipase, amylase

67
Q

Relate pathologic conditions with an enzyme increase and the degree of elevation:

Bone Disease

A

Increased: ALP, ACP

68
Q

Relate pathologic conditions with an enzyme increase and the degree of elevation:

Muscle Disease

A

Increased: CK, aldolase, AST, LD

69
Q

Relate pathologic conditions with an enzyme increase and the degree of elevation:

Malignancy

A

Increased: LD (moderate leukemia, hemolysis), GGT

70
Q

Relate pathologic conditions with an enzyme increase and the degree of elevation:

Alcoholism

A

Increased: GGT (occult alcohol intake)

71
Q

Relate pathologic conditions with an enzyme increase and the degree of elevation:

Obstructive Jaundice

A

Increased: GGT, ALP

72
Q

Relate pathologic conditions with an enzyme increase and the degree of elevation:

Hepatitis, acute and chronic

A

Increased: AST and ALT, 100x higher elevations in acute vs. chronic

73
Q

Indicate the percentage of the distribution of CK isoenzyme in the following human tissues:

Normal Serum

A

CKMM: 100%

74
Q

Indicate the percentage of the distribution of CK isoenzyme in the following human tissues:

Skeletal Muscle

A

CKMM: 100%

75
Q

Indicate the percentage of the distribution of CK isoenzyme in the following human tissues:

Heart

A
  • *CKMB**: 40%
  • *CKMM**: 60%
76
Q

Indicate the percentage of the distribution of CK isoenzyme in the following human tissues:

Brain

A
  • *CKBB**: 90%
  • *CKMM**: 10%
77
Q

Indicate the percentage of the distribution of CK isoenzyme in the following human tissues:

Lung

A
  • *CKBB**: 90%
  • *CKMM**: 10%
78
Q

Indicate the percentage of the distribution of CK isoenzyme in the following human tissues:

Bladder

A
  • *CKBB**: 95%
  • *CKMM**: 5%
79
Q

Indicate the percentage of the distribution of CK isoenzyme in the following human tissues:

Bowel

A

CKBB: 100%

80
Q

During a myocardial injury determine the when elevation is apparent, when they peak, and how long it takes for these analytes to return to normal:

CK

A
  • *Time of Elevation**: 4 - 8 hours
  • *Peak**: 12 - 24 hours
  • *Return to Normal**: 3 - 4 days
81
Q

During a myocardial injury determine the when elevation is apparent, when they peak, and how long it takes for these analytes to return to normal:

LD

A
  • *Time of Elevation**: 12 - 24 hours
  • *Peak**: 48 - 72 hours
  • *Return to Normal**: 5 - 10 days
82
Q

During a myocardial injury determine the when elevation is apparent, when they peak, and how long it takes for these analytes to return to normal:

AST

A
  • *Time of Elevation**: 6 - 8hrs
  • *Peak** 24hrs
  • *Return to Normal**: 3 - 5 days
83
Q

During a myocardial injury determine the when elevation is apparent, when they peak, and how long it takes for these analytes to return to normal:

Troponin (I)

A
  • *Time of Elevation**: 2 - 6hrs
  • *Peak**: 13 - 30hrs
  • *Return to Normal**: 7 days
84
Q

During a myocardial injury determine the when elevation is apparent, when they peak, and how long it takes for these analytes to return to normal:

Myoglobin

A
  • *Time of Elevation**: 2 - 5hrs
  • *Peak**: 2hrs
  • *Return to Normal**: 24hrs
85
Q

Which cardiac marker is first to show elevation following a myocardial injury?

86
Q

What is the significance of the CK relative index (CKI)?

A

The CKI is an expression of the percentage of the total CK that is attributed to CKMB.

87
Q

Normal reference range of CKI.

88
Q

CKI values greater than 4% are indicative of…

A

CKMB increase due to cardiac muscle (i.e. myocardial infarction).

89
Q

Calculate the CK relative index when the total CK = 735 U/L and the CKMB = 23 ug/L.

A

CKI = (CKMB ug/L)/(Total CK) x100

=23/735 x100

= 3.1%

90
Q

(T/F) Increases in CK and CKMB probably not due to myocardial infarction.

91
Q

What is the clinical usefulness of Troponin?

A

Troponin is a complex protein of three subunits C, T, and I.

When heart damage occurs, they are released into circulation.

92
Q

What are the troponin assays?

A
  • Quantitative monoclonal immunoassay
    • Qualitative immunoassay
93
Q

What analyte is replacing troponin and why?

A

Due to their specificity and sensitivity, they are being replaced by the use of CK-MB.

94
Q

What are lipases?

A

Enzymes that hydrolyze the ester linkage of fats to produce alcohols & fatty acids.

95
Q

Why test for lipase levels?

A

Since acinar cells of the pancreas produce it predominantly, it is useful in diagnosing acute pancreatitis.

96
Q

How does EDTA affect lipase values?

A

Decreases activity of lipase, causing falsely decreased results.

97
Q

Relate lipase and amylase results in acute pancreatitis and acute appendicitis.

A

Acute Pancreatitis: increased lipase and amylase; hyperlipidemia may suppress lipase resulting in a false normal amount.

Opiates and morphine administered for pain before drawing sample will give a false elevation.

Acute Appendicitis: increased amylase, usually normal lipase.

98
Q

List the amylase isoenzymes.

A
  • *P-AMS (Pancreatic)**: P1, P2, and P3
  • *S-AMS (Salivary)**: S1, S2, S3
99
Q

What would an increased urine amylase suggest?

A

Acute pancreatitis, peptic ulcer, intestinal obstruction.

100
Q

What would be an increased serum amylase without an increase in urine indicate?

A

Benign Macroamylasemia

Enzyme bound to an immunoglobulin or other substance resulting in an unexplained persistent increase in serum.

101
Q

What might GGT increase in myocardial infarction?

A

Occurs when there is hypoxic liver damage from circulatory disturbances.

102
Q

When is elevated ALP seen under normal physiological conditions?

A

Pregnancy and bone growth due to normal growth or healing fractures.

103
Q

Explain elevated alkaline phosphatase in children and pregnancy.

A

ALP is increased in children due to the increased osteoblastic activity during bone growth. ALP increases between labor 16th and 20th weeks of pregnancy until labor. (Placental ALP).

104
Q

What fraction of the ALP enzyme is the most heat stable?

105
Q

Assess the effect of insecticide poisoning on cholinesterase level and the most common method for measurement.

A

Some organophosphorus compounds found in many insecticides decrease pseudocholinesterase (PChE) activity.

Inhibition of PChE is characterized by tremors and paralysis.

Acylthiocholine esters are used as substrates; activity of PChE is determined from the rate of hydrolysis of butyryl or propionyl thiocholine in the presence of a chromogenic disulfide agent.

106
Q

What enzymes will be affected by slight hemolysis?

107
Q

What enzymes will be affected by moderate hemolysis?

A

LD, ALP, amylase, ALT, AST, ACP.

108
Q

Does hemolysis interfere with ALT?

109
Q

Determine the products of the following reaction:

Creatinine + ATP

A

Creatinine Phosphate + ADP

110
Q

Determine the products of the following reaction:

Lactate + NAD+

A

Pyruvate + NADH + H

111
Q

Determine the products of the following reaction:

Aspartate + Alpha Ketoglutarate

A

Oxaloacetate + Glutamate

112
Q

Determine the products of the following reaction:

Alanine + Alpha Ketoglutarate

A

Pyruvate + Glutamate

113
Q

Determine the products of the following reaction:

Phosphomonoester + H2O

A

Alcohol + Phosphate ion

114
Q

Determine the products of the following reaction:

Glutathione + Amino Acid

A

Glutamyl-peptide + L-cysteinyl glycine

115
Q

Determine the products of the following reaction:

Triglyceride + 2 H2O

A

2-monoglyceride + 2 fatty acid

ASCP Chemistry Exam Prep (10 decks)

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