ACP, ALP, LDH Flashcards
Systemic Name for Lactate Dehydrogenase?
E.C.1.1.1.27
Lactate Dehydrogenase catalyzes the interconversion of which two compounds?
Lactic acid and Pyruvic acid
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
B) Pernicious anemia and hemolytic anemia
Which LDH isoenzymes are most commonly associated with cancer markers?
LD 2
LD 3
LD 4
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
B) High LDH
Which additional substrate can LDH use in its catalytic activity besides lactate?
A) β-hydroxybutyrate
B) α-hydroxybutyrate
C) Acetoacetate
D) Pyruvate
B) α-hydroxybutyrate
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) 4°C
Which condition signifies a grave prognosis with elevated LDH-6 levels?
A) Myocardial Infarction
B) Arteriosclerotic Cardiovascular Failure
C) Hemolytic Anemia
D) Extensive Pneumonia
B) Arteriosclerotic Cardiovascular Failure
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
D. LDH-6 (Alcohol Dehydrogenase)
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.
B) LDH-1 is not specific to cardiac tissue and is not the preferred marker for AMI.
Which method is most commonly used to determine LDH-1 activity?
A) Wroblewski La Due Method
B) Electrophoresis
C) Wacker Method
D) Reverse Reaction
C) Wacker Method
Which reaction is preferred for LDH-5 determination?
A) Forward Reaction
B) Reverse Reaction
C) Electrophoresis
D) Colorimetric Assay
B) Reverse Reaction
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
C) More susceptible to substrate exhaustion and loss of linearity
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
LDH-1
Which substrate does LDH-1 prefer in the forward reaction?
A) Pyruvate
B) L-Lactate
C) a-hydroxybutyrate
D) NADH
B) L-Lactate
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
C) 15.6 U/L
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
C) p-Nitrophenolphosphate to p-Nitrophenol + Phosphate ion
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
C) E.C. 3.1.3.2
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)
C) Alkaline Phosphatase (ALP)
Which of the following tissues has the highest Acid Phosphatase (ACP) activity?
A) Liver
B) Bone
C) Prostate
D) Spleen
C) Prostate
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
B) Prostatic carcinoma
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
B) ACP is less sensitive and only useful when cancer has metastasized
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
B) Paget’s disease
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
B) Phenylphosphate
C) Inorganic Phosphate
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
B) Shinowara
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
C. Babson, Read and Philips
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
C) Alpha-naphthol
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
Answer: D) Roy and Hillman
The substrate used in the Roy and Hillman method is:
A) Alpha-naphthyl PO4
B) Phenylphosphate
C) Thymolphthalein monophosphate
D) PNPP
C) Thymolphthalein monophosphate
The substrate of choice for quantitative endpoint reactions
Thymolphthalein monophosphate
Which of the following is required as an activator for ALP?
A) Zinc
B) Calcium
C) Magnesium
D) Sodium
C) Magnesium
The major liver fraction of ALP is increased in which condition?
A) Diabetes mellitus
B) Hepatobiliary conditions
C) Osteomalacia
D) Rickets
B) Hepatobiliary conditions
hich ALP isoenzyme is increased in metastatic carcinoma of the liver?
A) Placental
B) Intestinal
C) Fast liver (a-1)
D) Bone
C) Fast liver (a-1)
Which of the following is a component of ALP?
A) Copper
B) Zinc
C) Iron
D) Manganese
B) zinc
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
C) 1 ½ ULN
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
B) Serum and CSF
ALP isoenzyme associated with liver is located primarily in which membranes?
A) Mitochondrial
B) Plasma
C) Sinusoidal and bile canalicular
D) Nuclear
C) Sinusoidal and bile canalicular
The Nagao isoenzyme is inhibited by which of the following?
A) Phenylalanine and L-leucine
B) Magnesium
C) Zinc
D) Calcium
A) Phenylalanine and L-leucine
Which isoenzyme is typically associated with adenocarcinoma of the pancreas and bile duct?
A) Kasahara
B) Regan
C) Nagao
D) Placental
C) Nagao
The most heat-stable ALP isoenzyme is:
A) Nagao
B) Kasahara
C) Regan
D) Placental
Answer:
C) Regan
Hypophosphatasia is related to which of the following?
A) Increased in Pregnancy Complications
B) Decreased ALP
B) Decreased ALP
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
C) Resist denaturation at 65°C for 30 minutes
Which condition is linked to an increased risk of hypertension during pregnancy?
A) Increased in Pregnancy Complications
B) Decreased ALP
Answer:
A) Increased in Pregnancy Complications
Preeclampsia is associated with which of the following conditions?
A) Increased in Pregnancy Complications
B) Decreased ALP
A) Increased in Pregnancy Complications
Which of the following conditions is associated with a pronounced elevation in ALP?
A) Pronounced Elevation
B) Moderate Elevation
C) Slight Elevation
A) Pronounced Elevation
Infectious mononucleosis would most likely cause which level of ALP elevation?
A) Pronounced Elevation
B) Moderate Elevation
C) Slight Elevation
B) Moderate Elevation
Cirrhosis is most likely to cause which level of ALP elevation?
A) Pronounced Elevation
B) Moderate Elevation
C) Slight Elevation
C) Slight Elevation
Metastatic tumor in bones typically leads to what level of ALP elevation?
A) Pronounced Elevation
B) Moderate Elevation
C) Slight Elevation
B) Moderate Elevation
Osteitis deformans (Paget’s disease) is most likely to result in which ALP elevation?
A) Pronounced Elevation
B) Moderate Elevation
C) Slight Elevation
A) Pronounced Elevation
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) Bowers and McComb Method (Szasz modification)
What is the color of the compound p-nitrophenol, which is produced during the Bowers and McComb method?
A) Colorless
B) Yellow
C) Blue
B) yellow
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
B. increase in ALP activity
Which of the following factors can falsely lower ALP activity in the Bowers and McComb method?
A) High temperature
B) Chelators
C) Low pH
B. Chelators
Which isoenzyme is inhibited by Phenylalanine in the selective chemical inhibition method?
A) Bone ALP
B) Intestinal ALP
C) Liver ALP
B) Intestinal ALP
Which isoenzyme is inhibited by Levamisole?
A) Placental ALP
B) Intestinal ALP
C) Bone & Liver ALP
C) Bone ALP & Liver ALP
Which of the following inhibits Bone ALP in the selective chemical inhibition method?
A) Levamisole
B) 3M Urea
C) Phenylalanine
Answer: B) 3M Urea
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) Agarose gel, polyacrylamide gel, and cellulose acetate
Which direction does the liver ALP isoenzyme migrate in electrophoresis?
A) Anodal (+)
B) Cathodal (-)
C) Neutral
A) Anodal (+)
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
B) To further separate the similar bone and liver ALP forms
