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CLIN CHEM > ASESSMENT OF LIVER FUNCTION & ENZYME INTRO > Flashcards

ASESSMENT OF LIVER FUNCTION & ENZYME INTRO Flashcards

1
Q

High AST, ALT, LD, ALP, BILIRUBIN

A

Hepatitis

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2
Q

Coagulation test for monitoring of synthetic liver function

A

PT

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3
Q

Low total protein, albumin
High bilirubin, ammonia

A

Cirrhosis

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4
Q

Low TP and albumin, the rest is high - basta ABNORMAL LAHAT

A

Fulminant hepatic failure

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5
Q

High ALP and Bilirubin (B1)

A

Biliary obstruction

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6
Q

High LD and ALP

A

Space-occupying lesion

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7
Q

Normal total protein and albumin ; the rest is abnormal (Slightly high)

A

Passive congestion

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8
Q

Destruction of more than 80% of liver tissue with no regeneration

A

Panhepatic cirrhosis

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9
Q

Results from a VARIETY of causes e.g Reye syndrome, hepatitis, cirrhosis

A

Fulminant hepatic cirrhosis

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10
Q

Prehepatic / hemolytic
Unconjugated
Water-insoluble
Non-polar
Indirect reaction with diazo (requires accelerator)
Not excreted in urine
Has affinity for CNS

A

B1

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11
Q

Post hepatic / obstructive
Conjugated
Water-Soluble
Polar
Direct reaction with diazo
Excreted in urine
Has no affinity to CNS

A

B2

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12
Q

CONJUGATED bilirubin covalently bond to albumin ; long half life of 17 days ; seen in cases of bile duct obstruction ; direct reaction with diazo reagent ; separated from other fractions by HPLC

A

Delta bilirubin

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13
Q

High B1 due to increased production ; low delivery and uptake, or low conjugation

A

Unconjugated hyperbilirubinemia

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14
Q

High B2 due to intra or extra hepatic cholestasis

A

Conjugated hyperbilirubinemia

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15
Q

High B1 and B2 due to a combination of defects

A

Mixed hyperbilirubinemia

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16
Q

Serum bilirubin : high B1
Urine bilirubin : negative
Urine urobilinogen : 3+

A

Pre-hepatic/hemolytic jaundice

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17
Q

Serum bilirubin : high B1, high B2, or BOTH
Urine bilirubin : trace
Urine urobilinogen 2+

A

Hepatic jaundice

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18
Q

Serum bilirubin : high B2
Urine bilirubin : 3+
Urine urobilinogen : normal

A

Post-hepatic / obstructive

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19
Q

Conjugation of bilirubin happens in what organ

A

Liver

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20
Q

Form of bilirubin that undergoes recirculation to the liver via the portal system of enterohepatic circulation

A

Urobilinogen

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21
Q

Once urobilinogen is taken up by the liver after recirculation, it is now then reexcreted through the small intestine and becomes oxidized in the form of ____ giving feces its brown color

A

Urobilin

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22
Q

Type : unconjugated hyperbilirubinemia ; prehepatic
B1 : high
B2 : normal
Defect : increased rbc destruction = high bilirubin production

A

Hemolytic disease

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23
Q

Type : unconjugated hyperbilirubinemia, hepatic
B1 : high
B2 : normal
Defect : transport defect coupled with UDPGT deficiency

A

Gilbert Syndrome

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24
Q

Type : unconjugated hyperbilirubinemia, hepatic
B1 : high
B2 : normal
Defect : circulating inhibitor of bilirubin conjugation

A

Lucey-Driscoll syndrome

Ci(rculating) = (Lu)cey

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25
Q

Type : unconjugated hyperbilirubinemia, hepatic
B1 : high
B2 : normal
Defect : transient UDPGT deficiency ; no life

A

Physiologic jaundice of the newborn

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26
Q

Type : unconjugated hyperbilirubinemia, hepatic
B1 : high
B2 : normal
Defect : total or partial UDPGT deficiency ; survival is possible

A

Criggler-Najjar syndrome

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27
Q

How to prevent kernicterus

A

Phototherapy

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28
Q

Type : mixed hyperbilirubinemia
B1 : high
B2 : high
Defect : low conjugation ; bile flow interference ; intrahepatic cholestasis

A

Viral hepatitis or cirrhosis ; hepatic carcinoma

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29
Q

Type : conjugated/mixed hyperbilirubinemia ; hepatic
B1 : normal/high
B2 : high
Defect : secretory defect

A

Dubin-Johnson syndrome ; Rotor syndrome

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30
Q

Type : conjugated hyperbilirubinemia ; hepatic
B1 : normal
B2 : high
Defect : extra hepatic cholestasis , tumor, stricture

A

Biliary obstruction

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31
Q

Colorimetric and spectrophotometric measurement of bilirubin is based on the ____ reaction (diazotization with incorporated accelerator/solubilizer) ; 2 methods

A

Van Den Berg reaction ; Evelyn-Malloy and Jendrassik-Grof

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32
Q

Evelyn-Malloy : accelerator

A

Methanol

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33
Q

Evelyn-Malloy : pH

A

Acidic

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34
Q

Evelyn-Malloy : color reaction

A

Red purple

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35
Q

Evelyn-Malloy : maximum absorbance

A

560 nm

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36
Q

Jendrassik-Grof : accelerator

A

Caffeine sodium benzoate

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37
Q

Jendrassik-Grof : pH

38
Q

Jendrassik-Grof : color reaction

39
Q

Jendrassik-Grof : maximum absorbance

40
Q

Jendrassik-Grof : alkalizing agent

A

Fehlng’s reagent or Alkaline tartrate

41
Q

Jendrassik-Grof : stopping reagent

A

Ascorbic acid

42
Q

Bilirubin + diazo + accelerator —> Azodipyrroles (ALL FRACTIONS)

A

Total bilirubin

43
Q

Bilirubin + diazo + accelerator —> Azodipyrroles (B2 and Delta bilirubin only)

A

Direct bilirubin

44
Q

Calculated —> TB - DB

A

Indirect bilirubin

45
Q

Over jaundice has a total bilirubin value of

A

3 mg/dL or above

46
Q

Panic value for unconjugated hyperbilirubinemia

A

15 mg/dL or above

47
Q

Based on the absorption of light by bilirubin at ___ nm ; correction for oxyhemoglobin is achieved by measuring absorbance at two wavelengths ; appropriate only for neonatal serum ; not done on serum due to the presence of carotenoid pigments

A

Direct spectrophotometry (Bilirubinometry)

48
Q

Bilirubin reference value ; B1

A

0.2 - 0.8 mg/dL

49
Q

Bilirubin reference value ; B2

A

0-0.2 mg/dL

50
Q

Bilirubin reference value : total bilirubin

A

0.2 - 1.0 mg/dL

51
Q

Biological catalysts that accelerate biochemical reactions without being consumed or changed in composition

A

Enzymology

52
Q

Combines with only one substrate and catalyzes only the corresponding reaction

A

Absolute specificity

53
Q

Combines with ALL substrates containing a particular chemical group

A

Group specificity

54
Q

Breaks or forms a solitary type of covalent bond

A

Bond or reaction specificity

55
Q

Combines with only one optical or geometric isomer of a compound

A

Stereoisomeric/geometric specificity

56
Q

Oxidoreductases

A

LDH
G6PD
MDH
GLDH

57
Q

TRANSFERASES & KINASES

A

AST
ALT
GGT

CK
HK

58
Q

HYDROLASE (Estrases)

A

ACP
ALP
CHS
5-NT
LPS

59
Q

HYDROLASE (PEPTIDASES)

A

TRYPSIN
PEPSIN
LAP (Leucine amino peptidase)

60
Q

HYDROLASE (glycosidases)

A

AMS
GALACTOSIDASE

61
Q

LYASE

A

Aldolase
Decarboxylase

62
Q

EC code : 1

A

Oxidoreductases

63
Q

EC code : 2

A

Transferases

64
Q

EC code : 3

A

Hydrolases

65
Q

EC code : 4

66
Q

EC code : 5

A

Isomerases

67
Q

EC code : 7

68
Q

Enzymatic reaction/catalytic reaction

A

E + S <—> ES —> P + E

69
Q

(E) > (S) - rate limiting component

A

First-order kinetics

70
Q

(S) > (E)

A

Zero-order kinetics

71
Q

Amount of enzyme that catalyzes the reaction of 1 UMOL of substrate per MINUTE

72
Q

Amount for enzyme that catalyzes the reaction of 1 MOL of substrates per SECOND

73
Q

1 IU = ___ukat

A

0.0167 ukat

74
Q

0.0167 ukat = ____ nkat

75
Q

1 kat = _____ IU

76
Q

End-point ; the reactions are combined, the reaction proceeds for a DESIGNATED TIME, the reaction is stopped followed by measurement of the amount of reaction that has occurred

A

Fixed-tome

77
Q

Kinetic ; multiple measurements of absorbance change as a function of time, either at specific time intervals of continuously by a continuous recoding spectrophotometer

A

Continuous monitoring

78
Q

Most enzymatic reactions occur at pH

A

pH 7-8 except ACP and ALP

79
Q

Denaturation is usually significant at

A

Every 10C increase in temperature, the velocity (rate of reaction) doubles

80
Q

Activators

A

Mg, Ca, Zn, and Cl

81
Q

Coenzymes

A

NAD/NADH , NADP/NADPH

82
Q

Prosthetic group

A

Pyridoxal phosphate (B6)

83
Q

Inorganic ; may be essential for the reaction or may only enhance the reaction rate

A

Activators

84
Q

Serve as second substrates for enzymatic reactions

85
Q

Bound tightly to enzyme

A

Prosthetic group

86
Q

Competitive

Binding site:
Effect of adding substrate:
Lineweaver-Burk plot:

A

Active site ; reverse the inhibition ; same vmax and increased km

87
Q

Noncompetitive

Binding site:
Effect of adding substrate:
Lineweaver-Burk plot:

A

Allosteric site ; no effect ; decreased vmax and same km

88
Q

Uncompetitive

Binding site:
Effect of adding substrate:
Lineweaver-Burk plot:

A

Enzyme-substrate complex ; increases the inhibition ; low vmax and low km

89
Q

High molecular-mass forms of the serum enzymes that can be bound to either an immunoglobulin or a nonimmunoglobulin substance ; long half life ; high in plasma/serum

A

Macroenzymes

90
Q

Macroenzymes bound to an immunoglobulin

A

Macroenzymes type 1

91
Q

Macroenzymes bound to a non immunoglobulin substance

A

Macroenzyme type 2

92
Q

Enzymes with macroforms

A

CK
AMS
LD
AST
ALT
ALP
ACP
LPS
GGT

CLIN CHEM (10 decks)

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