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CC2 > ACP, ALP, LDH > Flashcards

ACP, ALP, LDH Flashcards

1
Q

Systemic Name for Lactate Dehydrogenase?

A

E.C.1.1.1.27

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2
Q

Lactate Dehydrogenase catalyzes the interconversion of which two compounds?

A

Lactic acid and Pyruvic acid

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3
Q

Which conditions are associated with the highest levels of LDH?

A) Myocardial infarction and stroke
B) Pernicious anemia and hemolytic anemia
C) Liver disease and kidney disease
D) Osteoporosis and arthritis

A

B) Pernicious anemia and hemolytic anemia

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4
Q

Which LDH isoenzymes are most commonly associated with cancer markers?

A

LD 2
LD 3
LD 4

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5
Q

In pleural fluid analysis, what LDH levels would indicate an exudate?
A) Low LDH
B) High LDH
C) No LDH detected
D) Moderate LDH levels

A

B) High LDH

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6
Q

Which additional substrate can LDH use in its catalytic activity besides lactate?
A) β-hydroxybutyrate
B) α-hydroxybutyrate
C) Acetoacetate
D) Pyruvate

A

B) α-hydroxybutyrate

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7
Q

LDH5 is the most labile isoenzyme. At what temperature does its activity most rapidly decline?

A) 4°C
B) 25°C
C) 37°C
D) 100°C

A

A) 4°C

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8
Q

Which condition signifies a grave prognosis with elevated LDH-6 levels?

A) Myocardial Infarction
B) Arteriosclerotic Cardiovascular Failure
C) Hemolytic Anemia
D) Extensive Pneumonia

A

B) Arteriosclerotic Cardiovascular Failure

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9
Q

Which Isoenzyme is responsible for the metabolic conversion of methanol and ethylene Glycol to toxic compounds?

A) LDH-1
B) LDH-3
C) LDH-4
D) LDH-6

A

D. LDH-6 (Alcohol Dehydrogenase)

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10
Q

Which statement is true about LDH-1 concerning cardiac tissue?

A) LDH-1 is highly specific to cardiac tissue and is the preferred marker for AMI.
B) LDH-1 is not specific to cardiac tissue and is not the preferred marker for AMI.
C) LDH-1 is only found in skeletal muscle tissue.
D) LDH-1 is highly specific to skeletal muscle tissue and is the preferred marker for AMI.

A

B) LDH-1 is not specific to cardiac tissue and is not the preferred marker for AMI.

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11
Q

Which method is most commonly used to determine LDH-1 activity?

A) Wroblewski La Due Method
B) Electrophoresis
C) Wacker Method
D) Reverse Reaction

A

C) Wacker Method

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12
Q

Which reaction is preferred for LDH-5 determination?

A) Forward Reaction
B) Reverse Reaction
C) Electrophoresis
D) Colorimetric Assay

A

B) Reverse Reaction

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13
Q

What is the primary disadvantage of the reverse reaction method for determining LDH-5 activity?

A) Requires a larger specimen volume
B) Lower specificity compared to the forward reaction
C) More susceptible to substrate exhaustion and loss of linearity
D) Produces NADH, which is unstable

A

C) More susceptible to substrate exhaustion and loss of linearity

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14
Q

Which isoenzyme is most likely to be detected using fluorometric or colorimetric methods?

A) LDH-2
B) LDH-4
C) LDH-1
D) LDH-5

A

LDH-1

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15
Q

Which substrate does LDH-1 prefer in the forward reaction?
A) Pyruvate
B) L-Lactate
C) a-hydroxybutyrate
D) NADH

A

B) L-Lactate

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16
Q

What is the standard concentration of p-Nitrophenol used in the ACP assay?
A) 10.0 U/L
B) 12.5 U/L
C) 15.6 U/L
D) 20.0 U/L

A

C) 15.6 U/L

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17
Q

Which reaction is catalyzed by Acid Phosphatase (ACP)?
A) Lactic acid to Pyruvate
B) Pyruvate to Lactate
C) p-Nitrophenolphosphate to p-Nitrophenol + Phosphate ion
D) Glucose to Glucose-6-phosphate

A

C) p-Nitrophenolphosphate to p-Nitrophenol + Phosphate ion

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18
Q

What is the enzyme classification (E.C.) number for Acid Phosphatase (ACP)?

A) E.C. 1.1.1.27
B) E.C. 2.3.4.5
C) E.C. 3.1.3.2
D) E.C. 4.2.1.11

A

C) E.C. 3.1.3.2

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19
Q

Acid Phosphatase (ACP) belongs to the same group of enzymes as which of the following?

A) Lipase
B) Amylase
C) Alkaline Phosphatase (ALP)
D) Lactate Dehydrogenase (LDH)

A

C) Alkaline Phosphatase (ALP)

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20
Q

Which of the following tissues has the highest Acid Phosphatase (ACP) activity?
A) Liver
B) Bone
C) Prostate
D) Spleen

A

C) Prostate

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21
Q

Which of the following conditions is associated with elevated levels of the prostatic isoenzyme of Acid Phosphatase (ACP)?

A) Osteoporosis
B) Prostatic carcinoma
C) Liver cirrhosis
D) Renal failure

A

B) Prostatic carcinoma

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22
Q

Why is ACP considered an inferior marker compared to Prostate-Specific Antigen (PSA) for prostatic cancer?

A) ACP is more specific than PSA
B) ACP is less sensitive and only useful when cancer has metastasized
C) ACP has a longer half-life than PSA
D) ACP levels remain elevated for weeks after treatment

A

B) ACP is less sensitive and only useful when cancer has metastasized

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23
Q

Which bone-related condition is associated with elevated Bone Isoenzyme levels of Acid Phosphatase (ACP)?

A) Osteoarthritis
B) Paget’s disease
C) Rheumatoid arthritis
D) Osteomalacia

A

B) Paget’s disease

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24
Q

Which substrate and end product is used in the Gutman and Gutman method for ACP determination? (2 answer)

A) Thymolphthalein monophosphate
B) Phenylphosphate
C) Inorganic Phosphate
D) Alpha-naphthol

A

B) Phenylphosphate
C) Inorganic Phosphate

25
Q

Which method uses PNPP as a substrate for ACP determination?

A) Gutman and Gutman
B) Shinowara
C) Babson, Read and Philips
D) Roy and Hillman

A

B) Shinowara

26
Q

The preferred method for kinetic analysis of ACP uses which substrate?

a. Gutman and Gutman
b. Shinowara
c. Babson, Read and Philips
d. Roy and Hillman

A

C. Babson, Read and Philips

27
Q

What is the end-product in the Babson, Read and Philips method for ACP determination?

A) Inorganic phosphate (PO4)
B) p-nitrophenol
C) Alpha-naphthol
D) Free thymolphthalein

A

C) Alpha-naphthol

28
Q

Which method for ACP determination is known for its use in quantitative endpoint reactions?

A) Gutman and Gutman
B) Shinowara
C) Babson, Read and Philips
D) Roy and Hillman

A

Answer: D) Roy and Hillman

29
Q

The substrate used in the Roy and Hillman method is:

A) Alpha-naphthyl PO4
B) Phenylphosphate
C) Thymolphthalein monophosphate
D) PNPP

A

C) Thymolphthalein monophosphate

30
Q

The substrate of choice for quantitative endpoint reactions

A

Thymolphthalein monophosphate

31
Q

Which of the following is required as an activator for ALP?

A) Zinc
B) Calcium
C) Magnesium
D) Sodium

A

C) Magnesium

32
Q

The major liver fraction of ALP is increased in which condition?

A) Diabetes mellitus
B) Hepatobiliary conditions
C) Osteomalacia
D) Rickets

A

B) Hepatobiliary conditions

33
Q

hich ALP isoenzyme is increased in metastatic carcinoma of the liver?

A) Placental
B) Intestinal
C) Fast liver (a-1)
D) Bone

A

C) Fast liver (a-1)

34
Q

Which of the following is a component of ALP?

A) Copper
B) Zinc
C) Iron
D) Manganese

A

B) zinc

35
Q

ALP in pregnant women is typically how much above the upper limit of normal (ULN)?

A) 1/2 ULN
B) 1 ULN
C) 1 ½ ULN
D) 2 ULN

A

C) 1 ½ ULN

36
Q

The placental isoenzyme of ALP is a useful tumor marker in which bodily fluids?

A) Serum and Urine
B) Serum and CSF
C) CSF and Urine
D) Blood and Urine

A

B) Serum and CSF

37
Q

ALP isoenzyme associated with liver is located primarily in which membranes?

A) Mitochondrial
B) Plasma
C) Sinusoidal and bile canalicular
D) Nuclear

A

C) Sinusoidal and bile canalicular

38
Q

The Nagao isoenzyme is inhibited by which of the following?

A) Phenylalanine and L-leucine
B) Magnesium
C) Zinc
D) Calcium

A

A) Phenylalanine and L-leucine

39
Q

Which isoenzyme is typically associated with adenocarcinoma of the pancreas and bile duct?

A) Kasahara
B) Regan
C) Nagao
D) Placental

A

C) Nagao

40
Q

The most heat-stable ALP isoenzyme is:

A) Nagao
B) Kasahara
C) Regan
D) Placental

Answer:

A

C) Regan

41
Q

Hypophosphatasia is related to which of the following?

A) Increased in Pregnancy Complications
B) Decreased ALP

A

B) Decreased ALP

42
Q

Which characteristic is true for the Regan isoenzyme?

A) Inhibited by L-leucine
B) Migrates to the same position as the liver fraction
C) Resist denaturation at 65°C for 30 minutes
D) Least heat stable in all ALP isoenzymes

A

C) Resist denaturation at 65°C for 30 minutes

43
Q

Which condition is linked to an increased risk of hypertension during pregnancy?

A) Increased in Pregnancy Complications
B) Decreased ALP
Answer:

A

A) Increased in Pregnancy Complications

44
Q

Preeclampsia is associated with which of the following conditions?
A) Increased in Pregnancy Complications
B) Decreased ALP

A

A) Increased in Pregnancy Complications

45
Q

Which of the following conditions is associated with a pronounced elevation in ALP?

A) Pronounced Elevation
B) Moderate Elevation
C) Slight Elevation

A

A) Pronounced Elevation

46
Q

Infectious mononucleosis would most likely cause which level of ALP elevation?

A) Pronounced Elevation
B) Moderate Elevation
C) Slight Elevation

A

B) Moderate Elevation

47
Q

Cirrhosis is most likely to cause which level of ALP elevation?

A) Pronounced Elevation
B) Moderate Elevation
C) Slight Elevation

A

C) Slight Elevation

48
Q

Metastatic tumor in bones typically leads to what level of ALP elevation?

A) Pronounced Elevation
B) Moderate Elevation
C) Slight Elevation

A

B) Moderate Elevation

49
Q

Osteitis deformans (Paget’s disease) is most likely to result in which ALP elevation?

A) Pronounced Elevation
B) Moderate Elevation
C) Slight Elevation

A

A) Pronounced Elevation

50
Q

Which method is considered the most specific and is recommended by the IFCC for ALP determination?

A) Bowers and McComb Method
B) Gutman and Gutman Method
C) Babson, Read, and Philips Method

A

A) Bowers and McComb Method (Szasz modification)

51
Q

What is the color of the compound p-nitrophenol, which is produced during the Bowers and McComb method?

A) Colorless
B) Yellow
C) Blue

A

B) yellow

52
Q

In the Bowers and McComb method, what does an increase in absorbance indicate?

A) Decrease in ALP activity
B) Increase in ALP activity
C) No change in ALP activity

A

B. increase in ALP activity

53
Q

Which of the following factors can falsely lower ALP activity in the Bowers and McComb method?
A) High temperature
B) Chelators
C) Low pH

A

B. Chelators

54
Q

Which isoenzyme is inhibited by Phenylalanine in the selective chemical inhibition method?

A) Bone ALP
B) Intestinal ALP
C) Liver ALP

A

B) Intestinal ALP

55
Q

Which isoenzyme is inhibited by Levamisole?

A) Placental ALP
B) Intestinal ALP
C) Bone & Liver ALP

A

C) Bone ALP & Liver ALP

56
Q

Which of the following inhibits Bone ALP in the selective chemical inhibition method?

A) Levamisole
B) 3M Urea
C) Phenylalanine

A

Answer: B) 3M Urea

57
Q

Which materials are commonly used in ALP isoenzyme separation?

A) Agarose gel, polyacrylamide gel, and cellulose acetate
B) Agarose gel, SDS-PAGE, and cellulose acetate
C) Polyacrylamide gel, starch gel, and agarose gel

A

A) Agarose gel, polyacrylamide gel, and cellulose acetate

58
Q

Which direction does the liver ALP isoenzyme migrate in electrophoresis?

A) Anodal (+)
B) Cathodal (-)
C) Neutral

A

A) Anodal (+)

59
Q

Why are enzymes or lectins used in the separation of ALP isoenzymes?

A) To enhance the stability of the isoenzymes
B) To further separate the similar bone and liver ALP forms
C) To inhibit the activity of all ALP isoenzymes

A

B) To further separate the similar bone and liver ALP forms

CC2 (4 decks)

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