AST ALT ALP ACP Flashcards
Coenzyme of AST, ALT
Pyridoxal phosphate
AST tissue sources
Cardiac tissue
Liver tissue
Skeletal muscle
Small amounts in:
Kidney
pancreas
erythrocytes
ALT tissue sources
Liver
Small amounts in
Pancreas
Heart
Erythrocytes
Kidney
Skeletal muscle
Significantly increased in disorders producing cellular necrosis
Mitochondrial isoenzyme
More present in plasma during hepatocellular injury since it is the one being released
Cytoplasmic isoenzyme
With membrane injury as in viral or chemically induced hepatitis, these enzymes are released and enter the sinusoids, raising plasma AST and ALT activities
Cytoplasmic AST and ALT
Mitochondrial AST is released when ?
Mitochondrial injury, caused by ethanol in alcoholic hepatitis
Increased in hepatobiliary disease
Alkaline phosphatase
AST is limited limited mainly to the evaluation of ? and ?
hepatocellular disorders
skeletal muscle involvement
ALT is confined mainly to the evaluation of ?
confined mainly to the evaluation of hepatic disorders (hepatocellular disorders):
4-8 times ULN
Muscular dystrophy
Inflammatory conditions
disproportionate elevation of AST over ALT, yielding an AST/ALT quotient, also called the ?
DeRitis Ratio, 3-4 : 1 (AST:ALT)
ALP tissue source
Liver
Bone: osteoblasts
Spleen
Placenya
Intestine
Kidney
ACP tissue source
Prostate
Bone: osteoclast
Liver
Spleen
Kidney
RBC
Platelets
useful tumor marker in serum and cerebrospinal fluid (CSF) for most germ cell tumor
Placental ALP
Increases in ? may occur in patients with intestinal infarction, inflammation, and ulceration and patients undergoing chronic
hemodialysis.
Intestinal ALP
Electrophoresis: usually in the early stages of hepatobiliary conditions
Major liver fraction
Electrophoresis: found in metastatic carcinoma of the liver and hepatobiliary diseases
Fast liver fraction
valuable indicator obstructive liver disease
Fast liver fraction
To remove sialic acid
Neuraminidase
To bind to other isoenzymes
What germ lectin
capable of resolving multiple bands of ALP.
High resolution electrophoresis
cannot completely resolve bone and liver isoenzymes, making them unsuitable for other than qualitative studies.
Standard cellulose acetate and agarose gel electrophoresis
ALP activity is measured before and after heating serum at ?
56C for 10 min
If the residual activity after heating is LESS than 20% of the total activity before heating
BONE ALP
If the residual activity after heating is GREATER than 20% of the total activity before heating
LIVER ALP
True or false
We USE ALP for Intestinal and Placental disorders
False
Inhibits INTESTINAL ALP and PLACENTAL ALP to a much greater extent than liver and bone ALP
Phenylalanine
Inhibits BONE ALP and LIVER ALP
Levamisole
Inhibits bone ALP
3M urea
3 abnormal isoenzymes can only found in cancer patients
Kasahara Isoenzyme
Regan Isoenzyme
Nagao Isoenzyme
Increased in ovarian (highest incidence) and gynecologic cancers
Regan Isoenzyme
Regan isoenzyme resists denaturation at ?
65C for 30 min
Inhibited by phenylalanine and migrates like bone ALP
Regan isoenzyme
Nagao isoenzyme is inhibited by
Phenylalanine and L-Leucine
Detected in METASTATIC carcinoma of pleural surfaces and ADENOCARCINOMA of the pancreas and bile duct
Nagao isoenzyme
Cholestasis in pregnancy may lead to
Cholangitis (inflammation of the bile duct)
Hallmarks for cholestasis in pregnant women
Charcot’s triad/Reynold’s pentad
Extra hepatic cholestatis in gallstones
Cholelithiasis
Choledolithiasis
A chronic condition that causes abnormal bone remodeling. Gain in bone mass
Paget’s Disease (Osteitis deformans)
characterized by the SOFTENING of bones due to inadequatemineralization
Osteomalacia (adults)
Rickets (children)
Main cause of osteomalacia and rickets
Vitamin D deficiency
In normal pregnancy, increased ALP is mainly because of the ?
Placental isoenzyme
Placental isoenzyme may be elevated in ?
(THEP)
Threatened abortion
Hypertension
Eclampsia
Preeclampsia
Increased ALL in normal pregnancy can be detected between -
16 and 20 weeks
Low ALP may occur transiently after ?
Blood transfuison
Cardiopulmonary bypass
rare inherited disorder of bone metabolism as the result of missense mutations of tissue-nonspecific ALP = low ALP
Hypophosphatasia
Zinc deficiency cause
Decreased ALP
5 important types of ACP found in humans
Prostatic
Lysosomal
Osteoclastic
Erythrocyte
Macrophage
2 isoenzymes used for DIAGNOSIS of ACP
Prostatic ACP
Erythrocyte ACP
Prostatic ACP is inhibited by
Tartrate
Erythrocyte ACP is inhibited bt
2% formaldehype
1 mmol cupric sulfate
present in certain chronic leukemias and some
lymphomas, most notably in hairy cell leukemia
TRAP
Tartrate Resistant Acid Phosphatase
produced by osteoclasts in the bone marrow and is used as a marker for bone remodeling/ resorption
TRAP-5b
expression of this enzyme in malignant GASTRIC
CARCINOMA cells is associated with an increased
probability of peritoneal involvement; its expression in specific subclasses of macrophages in patients w COLON CANCER
TRAP-5b
ACP activity peak during -, and remain elevated for up to -
First 12 hours; 4 days
Presumptive evidence of rape: ? = POSITIVE
ACP activity >50 U/L
Gaucher disease is caused by deficiency of what enzyme
Glucocerebrosidase
Enzyme that breakdown glycolipids present in cell to prevent buildup so fats will accumulate
Glucocerebrosidase
Glucocerebrosidase deficiency causing buildup of fatty substances in certain organs
Gaucher disease
Resulting from exercise platelet destruction from
idiopathic thrombocytopenic purpura(ITP)
Thrombocytopenia