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Medical Biochemistry > Ch. 7: Clinical Enzymology & Biomarkers of Tissue Injury > Flashcards

Ch. 7: Clinical Enzymology & Biomarkers of Tissue Injury Flashcards

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USMLE® Step 1 flashcards
1
Q

3 main ways enzymes are used clinically?

A

1) Diagnosis & prognosis of diseases
2) Analytical reagents: Measure activity of other enzymes/nonenzyme substances in body fluids
3) Therapeutic agents

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2
Q

Difference between serum vs plasma?

A

Plasma: liquid in which blood cells suspended

Serum = plasma - clotting factors

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3
Q

What processes are plasma specific enzymes involved in?

A 
Blood clotting
fibrinolysis
complement activation
cholinesterase
ceruloplasmin
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4
Q

What are non-plasma specific enzymes?

When are they seen? What causes this?

A

Intracellular enzymes

High turnover, cellular damage, impairment of cells

⬇️O2 supply, infection, toxic chemicals

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5
Q

Acid phosphatase: main tissue source?

A

Prostate

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6
Q

Alanine aminotransferase: main tissue source?

A

Liver

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7
Q

Alcohol dehydrogenase: main tissue source?

A

Liver

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8
Q

Alkaline phosphatase: main tissue sources?

A 
Bone
intestinal mucosa
hepatobiliary system
placenta
kidney
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9
Q

Amylase: main tissue sources?

A

Pancreas

Salivary glands

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10
Q

Arginase: main tissue source?

A

Liver

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11
Q

Aspartate aminotransferase: main tissue sources?

A

Heart & skeletal muscle
Liver
Kidney
Brain

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12
Q

Ceruloplasmin: main tissue source?

A

Liver

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13
Q

Cholinesterase: main tissue source?

A

Liver

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14
Q

Chymotrypsinogen: main tissue source?

A

Pancreas

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15
Q

Creatine kinase: main tissue sources?

A

Skeletal & heart muscle

Brain

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16
Q

Fructose-bisphosphate aldolase: main tissue sources?

A

Skeletal & heart muscle

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17
Q

Gamma-glutamyl transferase: main tissue sources?

A

Kidney
Hepatobiliary system
Prostate
Pancreas

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18
Q

Glutamate dehydrogenase: main tissue source?

A

Liver

19
Q

Isocitrate dehydrogenase: main tissue source?

A

Liver

20
Q

Lactate dehydrogenase: main tissue sources?

A 
Skeletal & heart muscle
Liver
Kidney
RBCs
Pancreas
Lungs
21
Q

Leucine aminopeptidase: main tissue sources?

A

Hepatobiliary system
Intestine
Pancreas
Kidney

22
Q

Ornithine carbamoyl-transferase: main tissue source?

A

Liver

23
Q

Pepsinogen: main tissue source?

A

Gastric mucosa

24
Q

Prostatic specific antigen (serine protease): main tissue source?

A

Prostate

25
Q

Sorbitol dehydrogenase: main tissue source?

A

Liver

26
Q

Triacylglycerol lipase: main tissue source?

A

Pancreas

27
Q

Trypsinogen: main tissue source?

A

Pancreas

28
Q

What enzymes indicate heart disease? (Old and new)

A

Old: creatine kinase (CK): CK-MB (CK2)

New: cardiac troponin I

29
Q

What isoenzyme pattern is found in skeletal muscle?

A

Creatine kinase (CK): CK-MM (CK3)

30
Q

How is the rate of an enzyme-catalyze reaction measured?

A

Measure product formation (via photometric procedures, e.g. spectrophotometer ➡️ NAD+, product of indicator reaction, absorbs light)

31
Q

Serum markers of acute pancreatitis?

A

Amylase
Lipase
Trypsinogen

32
Q

Serum markers of hepatocellular necrosis?

A

AST

ALT

33
Q

Serum markers of cholestasis?

A

Alkaline phosphatase
5’-nucleotidase
Gamma-glutamyl transferase

34
Q

Where can gallstones occur?

A

Ampulla of Vater

35
Q

What is the advantage of using enzymes as analytical reagents?

A

Specificity & direct measurement of substrate in complex mixture

36
Q

What monitoring assay procedures are used when enzymes are used as analytical reagents?

A

ELISA

37
Q

Describe steps of using enzymes as analytical reagents via specific antibodies absorbed to beads?

A

1) antibody + bead bind to antigen in test specimen
2) antibody + bead + antigen bind to antibody + enzyme
3) incubate w/substrate & quantitate products ([products directly proportional to [antigen])

38
Q

Enzyme as reagent: what is the negative reaction for incubating enzyme + hapten w/specimen (w/out hapten)?

A

Antibody for hapten added ➡️ competes to bind to enzyme + hapten ➡️ inactive enzyme (when substrate added ➡️ no products)

39
Q

Enzyme as reagent: what is the positive reaction for incubating enzyme + hapten w/specimen (w/hapten)?

A

Antibody for hapten added ➡️ competes to bind to free hapten ➡️ active enzyme (when substrate added ➡️ products correlated to [free hapten])

40
Q

Enzyme as reagent: Antibody bind to solid phase + antigen in sample + antigen w/chemiluminescent compound (cc)

If less antigen in sample ➡️ ?
If more antigen in sample ➡️ ?

A

Less antigen ➡️ more antigen-cc binds to antibody ➡️ more light

More antigen ➡️ less antigen-cc binds antibody ➡️ less light

41
Q

Enzymes as therapeutic agents: how it is used with bleeding disorders?

A

Transfusion of fresh blood or its active components

42
Q

Enzymes as therapeutic agents: oral admin of digestive enzymes in digestive diseases ➡️ example?

A

Cystic fibrosis

43
Q

Enzymes as therapeutic agents: admin of fibrinolytic enzyme to recanalize blood vessels occluded by thrombi

What enzyme? Examples of diseases?

A

Streptokinase

Pulmonary embolism
AMI (acute MI)

44
Q

Enzymes as therapeutic agents: treating disorders of inborn metabolism & cancer therapy ➡️ examples of each?

A

Gaucher’s disease: can’t properly bind sugars to phospholipids

L-asparaginase in acute lymphocytic leukemia

Medical Biochemistry (23 decks)

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