CHAPTER 3 PART 1 REVIEWER Flashcards
AST systematic name
E.C. 2.6.1.1
ALT systematic name
E.C. 2.6.1.2
CK systematic name
E.C. 2.7.3.2
LDH systematic name
E.C. 1.1.1.27
AST former name
Serum glutamic-oxalocacetic transaminase
ALT former name
Serum glutamic pyruvic transaminase
2 isoenzymes of AST
ytoplasmic
mitochondrial
Isoenzyme of severe tissue damage
mitochondrial
Cirrhosis ULN
4x
AST levels are NOT useful in the diagnosis
TRUE
Products of ALT in reverse reaction
Alanine
Alpha-ketoglutarate
Products of AST in forward reaction
Oxaloacetate
Glutamate
ALT is more liver specific
TRUE
AST:ALT ratio
De Ritis Ratio
Karmen Method wavelength
340 nm
AST indicator enzyme
Malate Dehydrogenase
ALT indicator enzyme
Lactate Dehydrogenase
AST activity in RBC
15x
major phosphorylated compound in muscle
Phosphocreatine
CK forward reaction optimal pH
9
Products of CK in reverse reaction
Creatine
Adenosine Triphosphate
LDH forward reaction pH
8.8-8.9
LDH hydrogen acceptor
NAD
Oliver-Rosalki reverse reaction enzymes
Creatine Kinase
Hexokinase
Glucose-6-Phosphate Dehydrogenase
Alcohol dehydrogenase
LDH6
S. muscle injury
LDH5
Hepatic injury
LDH4
P. embolism, lymphocytosis and acute pancreatitis
LDH3
Highest distribution of LDH subclass
LDH2
Myocardial infarct and hemolytic anemia
LDH1
Reference method for CK
Electrophoresis
Hypothyroidism
CK-MM
predominates in skeletal & cardiac muscle
CK-MM
Constitutes up to 15% CK activity in the heart
CK- Mr
can be a useful tumor marker
CK-BB
obligate activator in CK
Magnesium
obligate coenzyme of aminotransferase
Pyridoxal phosphate
Products of AST in reverse reaction
Aspartate
Alpha-ketoglutarate
Products of ALT in forward reaction
Pyruvate
Glutamate
Products of CK in forward reaction
Phosphocreatine
Adenosine Diphosphate
Products of LDH in forward reaction
Pyruvate
NADH
Products of LDH in reverse reaction
L-Lactate
NAD
Products of indicator reaction catalyzed by MDH
Malate
NAD
Substrates of indicator reaction catalyzed by MDH
Oxaloacetate
NADH
H+
Products of indicator reaction catalyzed by LDH
Lactate
NAD
Substrates of indicator reaction catalyzed by LDH
Pyruvate
NADH
H+
Oliver-Rosalki forward reaction enzymes
Creatine kinase
Pyruvate kinase
Lactate Dehydrogenase
Products of indicator reaction catalyzed by PK
Pyruvate
Adenosine Triphosphate
Substrates of indicator reaction catalyzed by PK
Adenosine Diphosphate
Phosphoenol pyruvate
Substrates of indicator reaction catalyzed by LDH
Pyruvate
NADH
H+
Products of indicator reaction catalyzed by PK
ADP
G6PD
Substrates of indicator reaction catalyzed by PK
ATP
Glucose
Products of indicator reaction catalyzed by G6PD
6-Phosphogluconate
NADPH
H
Substrates of indicator reaction catalyzed by G6PD
Glucose-6-Phosphate
NADP
Viral hepatitis ULN
100x
Skeletal muscle disorders: Muscular dystrophies & inflammatory conditions ULN
4-8x
AST activity in RBC
15x
muscular dystrophy ULN
50x
AST Karmen Method Optimal pH
7.3 – 7.8
CK reverse reaction optimal pH
6.8
LDH reverse reaction pH
7.4-7.8
Wacker Method (forward rxn)
pH8.8
Wrobleuski La Due (reverse rxn)
pH7.2
LDH activity in RBC
100 - 150x
AST Karmen Method Reference Range
5 – 30U/L(37°C)
ALT Reference Range
6 – 37U/L(37°C)
Reference range TOTAL CK in Male
15 – 160U/L(37°C)
Reference range TOTAL CK in Female
15 – 130U/L(37°C)
Reference range CKMB
< 6% Total CK
LDH Reference range
100 – 225U/L(37°C)
AST peak, rise, return to normal
6-8hrs, 24hrs, 5days
CKMB peak, rise, return to normal
4-8hrs, 12-24hrs, 48-72hrs
25 – 46% of CK activity
CKMB
major CK in serum of healthy people
CKMM
heart muscle activity
CKMM
CK level: sensitive indicator of AMI
Total CK & CK-2
Cardiac trauma ff. heart surgery (including transplantation)
Elevation of Total CK
cardiac conditions
CKMB
- head injury and acute cerebrovascular disease
CKBB
- Reye’s syndrome
CKBB
- rarely seen in the serum bec. Of its molecular size
CKBB
- Extensive damage to the brain may lead to the leakage of it in the serum
CKBB
