BIoChem Mini 3 Flashcards

Question

Troponin

Answer 1

Marker for MI * Not an enzyme * Troponin: C, I, T ( calcium binding protiens) present in the cytosol of the myoctye * Not present in blood under normal circumstances * Troponin I&T can present in cardiomyocytes; very important marker for MI. Release in blood within 2-4 hrs Peaks between 12-24 hrs Presists in blood for up to 7-days ***HIGH TROPONIN LEVEL ARE EVIDENT IN MI, PE, MYOCARDITIS.***

Answer 2

Occurs due to: Decreased albumin synthesis Increased catabolism of albumin ***Can occur due to liver issues such as cirrhosis, nephrotic sysndrome, burns , etc.*** **_Hypoalbuminemia leads to edema_**

Answer 3

**Does same thing as heptogloblin; except it binds Heme not Hb.** * synthesized in the liver. * Binds free Heme from intravascular hemolysis and *_take it to the liver to be converted to bilirubin._* * ***Low levels of hemoplexin during severe hemolytic anemia.***

Answer 4

Found in lots of places. Converts pyruvate to lactate when in hyoxic conditions - High Conc in cardiac and skeletal muscles - 4 polypetide chains that give rise to 5 isoenzymes * **_2 types:_ *H, M types*** WHEN YOU SE ELEVATED LDH THAT MEANS CELL DAMAGE HAS HAPPENED. When you see evelated LDH that means that you must order more specific markers to see what is going on.

Answer 5

* *Marker of Acute Pancreatitis (levels elevated 5-10 times)** - elevated plasma levels & low urine levels of alpha-amylase suggests severe glomerular issues. **_Exocrine: 3 important enzyme:_** Typsin ( protease), Pancreatic alpha-amylase ( breaks down simple carbs), Lipases ( helps break down comp fats into glycerol). ( THESE 3 DIGEST PROTEINS, LIPIDS AND CARDS IN DUODENUM & JEJUNUM) All 3 produced in inactive form until typsinogen is activated in intestines; Typsin becomes activated and then it activates Amylase and Lipase. **\* if typsin is activated in pancreas it will tell auto-digest pancreatic acinar cells cause inflammation known as Pancreatitis.**

Answer 6

Relative or Absolute increase in total protein conc in plasma/serum * Relative: [Protein] results from change in [water}. * Absolute: Occurs due to increased protein synthesis. May occur due to increased protein loss, blood loss, low protein intake, bad burns, edema(relative).

Answer 7

Serum Proteins that respond ( elevate/decline) to acute inflammatory conditions.

Answer 8

* Involved in enzymatic pathway of cholesterol oxidation which is production of bile. * Catalyzes Enzymatic pathway - * Leads to synthesis of bile -occurs in hepatocytes

Answer 9

* Catalyze the synthesis of FA Single multifocal polypeptide chain with 7 active sites * Contains 2 carrier proteins (shuttlers) * Acyl Carrier protein ( ACP) * beta-ketoacyl synthase (K-SH)

Answer 10

Metabolic bone disease due to excessive rate of bone remodeling. - Diagnostic markers are bone alkaline phosphatase (BAP) conc elevated

Answer 11

Affects kids, can be inability to stand with muscle weakness, in extremities. MM (CK3): found in skeletal and muscles. elevator plasma levels marker for muscular dystrophy MM will be greatly elevated.

Answer 12

Diagnostic marker for Prostate Cancer - Widely avaliable in bones, liver, spleen, kidney, RBCs - Higher levels in Males due to Prostate. **SIGNIFICANT ELEVATED:** MARKER FOR **_METASTATIC PROSTATE CANCER_** **_MODERATE ELEVATION:_** Bone disease, lysosomal disease, Sickle cell, etc.

Answer 13

**Abnormal proliferation of *_single clone*_ of _*plasma cells._* Prevalent neoplastic disease.** * Excessive amounts/production of immunogloblins molecules. * Hematological cancer * IgG myelona: 50% * IgA myeloma 25% * Monoclonal production of light chains: 20% * Affects **Afr Amers** more in US * Survivial is 3-10 years afer Dx **_Common syptoms:_** "**Bone pain"**, infections, hypercalemia, renal issues, fractures, neuropathies. 1. Lytic Bone Disease 2. Hematological issues: leukopenia, anemia, thrombocytopenia 3. Kidney: stones and **_high blood Ca level_** =kidney dysfuction **_Dx Features:_** * Abnormal increase in serum protein * Plasma serum electrophoresis ( **abnormal M-Spike of M-Protien)**

Answer 14

* enzymatic pathway catalyzed by cytochrome P450 enzymes * non-enzymatic pathway (auto oxidation)

Answer 15

**_3 Ways_** **-Direct:** Label Primary Antibody only; no secondary **-Indirect:** Label Secondary, which is attachedto unlabeled Primary -**Sandwiched:** same as indirect but thereis an unlabeled captured antibody.

Answer 16

CK-2 level very high in response to cardiomyopathy Take 3-6 hrs for CK-2 to be in blood Peaks in 12-24 hours Returns to pre-MI level within 12-24 hours Total CK &CK-2 important for Dx of MI

Answer 17

* **_High amt of gamma globlins. High amount of immunogloblins._** * Abnormal proliferation of plasma cells * Monoclonal gammopathy

Answer 18

1. Heptogloblin 2. Ceruloplasmin

Answer 19

**Diagnostic Marker for Liver** - Present only hepatocytes - Available in high concentrations then AST. (AST/ALT) Ratio slightly (AST/ALT) Ratio (AST/ALT)Ration\>1 ( alcohol induced liver issues)

Answer 20

**_Rare monogammopathy with High Levels Of IgM (pentamers) in blood._** * Clonal disease of B Lymphocyte * Called indolent Lymphoma b/c it spreads slowl * **_Common S&S:_** different from multiple myelnoma. ***_Nose&gum bleeding***_, _***Numbness/tingling***_ in _***extemities in cold_*** that return to normal in warm. ***_blurry vision/HA_*** * **_Clinical Features:_*** * *Hyperviscosity:**Excess IgM increases serum viscosity =circulatory impairment. * *Anemia: Excessive** B-Cells in bone marrow hinder RBC production. * *Cryoglobulinemia:** Single/mixed (IgM/IgG/IgA); undergoes REV **_precipitation at low temps._** causes hyperviscosity of plasma, cap spasms, pain, cyanosis, tingling of fingers in cold weather. (lytic bone& kidney dysfunc **_are not common in these Pts._**) DX: CBC, Serum Eletrophoresis ( for M-Spikes), Cryocrit ( looking for plasma cryogloblins), bone marrow biophy (abnormal # of malignant lyphocytes in bone marrow)

Answer 21

Vasoconstriction and formation of platelet plug

Answer 22

activation of coagulation cascade; stabilization of plug ( formation of fibrin network.

Answer 23

Dissolution of the fibrin meshwork 1. **_Clot Retraction:_** retraction of the edge of the wound; started by contractile proteins in platelets 2. **_Fibrinolysis:_** ***plasmin*** mediated breakdown of clot. * *tPA:** Dissolves clots used in tx strokes * *Streptokinase:** fibrinolytic Rx used to dissolve clots by activating plasminogen into plasmin. ***\*\*Urokinase & tPA play a big role in this process.***

Answer 24

Factor VIII + VWF COMBINED Prevents Factor VIII from binding. Release of Factor VIII initiated by Thrombin Factor VIII then used in Intrinsic Pathway.

Answer 25

Low platelet count (\<40,000/microL) **_may affect platelet plug formation_**

Answer 26

**Clinically heterogenous hereditary hemorrhagic disease classified into the following three types:** **_vWDI_**: Symptoms. Common. Caused by a quantitative deficiency of the vWF (20-50%) **_vWDII:_** ***Structural abnormalities*** of vWD protein ; ***_vWF & Factor VIII binding is slowed down_***. **_vWDIII:_** Rare vWF-mutation disease. **_TOTAL ABSENCE_** **_of vWF protien_**. Pts will blood badly/hemmorrhagic.

Answer 27

Activation of multiple coagulation factors (serine protease enzymes) starts generation of **_active factor Xa_** (central element of both cascades) **_Factors: 3, 7, 10_** **Xa=converts Prothrombin to Thrombin which converts fibrinogen into fibrin.**

Answer 28

Amplifies generation of **_Factor Xa._** * Activated by contact ( implants shoudnt be charged it will cause clots) * Activates Xa, makes large amts. * 1 molecule of Xa can make 1000 of thrombin. **_Factors:_ 5, 8, 9, 10, 11, 12** **Xa=converts Prothrombin to Thrombin which converts fibrinogen into fibrin.**

Answer 29

Intrinsic Pathway **Factos IXa, VIIIa bound to platelet membrane phospholipds (CA²⁺ dependent).** **Factor X** binds to tenase complex and **activates Xa** **Tenase along with prothrombin complex requires Ca+**

Answer 30

**_X-linked recessive disorder; occurs in males; females are commly asymptomatic genotyphic carriers._** **_Cause:_** deficiency of specific coag factors * *_2 Types:_** * *_Hemophilia A:_** Deficiency of ***Factor VIII*** * *_Hemophilia B:_** Deficiency of ***Factor IX*** (christmas disease) Combination of A&B leads to death in newborns. **_Symptoms:_** Abnormal bleeding. moderate= response to trauma/surgery; severe: spontaneous.

Answer 31

Thrombosis regulator. Trypsin like serine protease; major regulator of coagulation; made by liver

Answer 32

Thrombosis Regulator Cofactor of activated Protien C (PC)

Answer 33

**Thrombin** bounds to endothelial **thrombomodulin** and **activates PC to PCa** * **aPC & PS inactivate Va, VIIIa** * **Blocks formation of prothrombinase complexe** * **Blocks activation of factor X**

Answer 34

Activator of Antithrombin III; potentiates the activity of antithrombin III ## Footnote **_Mimics antithrombin III_ _slows down the coag_ cascade/ _short term anticoagulate._**

Answer 35

**Regulator of coagulation** Neutralizes thrombin; stops activitites of Factor IXa, Xa, XIa, XIIa, plasma and kallikren.

Answer 36

**Cofactor of the liver enzyme gamm glutamyl carboxylase (GGC)** **GGC catalyzes carboxylation of glutamic acid residues in factors II, VII, IX, X activating them ( Ca²⁺dependent).** Vitamin K is oxidized to **K-2,3 epoxide (inactive form)** **Vitamin K epoxide reductase (VKOR)** reduces Vit K epoxide back to vit K ( reused)

Answer 37

**Inhibits** the action of **_vitamin K epoxide reductase (VKOR)._** Affect sconversion of Vit K epoxide back to reusable Vit K. Thus leads to depletion. **Functional impairment of clotting factors** Inhibites hemostatic pathways. _***\*\*\*\*\*Tell pts to avoid vit K ( GREENY LEAFY VEGETABLES)***_

Answer 38

Chelates Calcium, lowers level of calcium in the blood. Activation of coagulation factors are blocked.

Answer 39

1. Dysregulated coagulation & fibrinolysis 2. Widespread formation of small clots 3. Clotting factors reduced in blood 4. Occurs 2nd to other disease.

Answer 40

**Measures efficiency of the _extrinsic pathway_/cascade** ## Footnote **Detects deficiences** in clotting **factors I, II, V, VII, X** **Normal value:** 11-15 sec **Prolonged PT:** indicative of liver disease, Vit K issues, vWD, hemophilia of admin of blood thinners

Answer 41

**Measures efficiency of *_intrinsic_* and common pathways of coagulation.** Detects deficiencies of f**actors XII, XI, IX, VIII, pre-kellikrein.** **Normal PTT values:** 25-37 sec **High PTT:** indicator of deficiencies of the mentioned clotting factors; **vWD, hemophilia, liver disease, Vit K def.**

Answer 42

Standard test used to access platelet function. Prick finger, watch time it takes to for bleeding to stop. Normal time: 2-5 mins (Duke's method); 3-9 min (Ivy method) \*\* Prolonged bleeding is sign of thrombocytopenia, platelet dysfucntion, blood vessel defect, platelet aggregation defect.