CK LDH GGT G6PD ACE 5N’T CHE AChE PChE ALD Flashcards
1
Q
E.C. 2.7.3.2
A
Creatine Kinase
2
Q
MW of CK
A
82,000 Da
3
Q
Associated with AT Pregeneration in contractile or
transport system (constant concentration of ATP in the muscle needed for any sudden burst of exercise)
A
Creatine Kinase
4
Q
CK
Isoenzymes, Tissue Sources, and Electrophoresis
A
CK-MM = Skeletal Muscle (CK-3)
CK-MB = Heart muscle (CK-2)
CK-BB = Brain tissues (CK-1)
5
Q
CK isoenzyme that migrate fastest toward anode
A
CK-BB
6
Q
CK isoenzyme that exhibit slowest mobilty
A
CK-MM
7
Q
Most significant CK
A
CK-MB
8
Q
CK-MB Myocardial Infarction: Rise
A
4-8 hours after the onset
9
Q
CK-MB Myocardial Infarction: Peak
A
12-24 hours
10
Q
CK-MB Myocardial Infarction: return to normal
A
Within 48-72 hours
11
Q
T or F
CK-MB is specific to MI
A
False; CK-MB is SENSITIVE but NOT specific to MI
12
Q
ATYPICAL ISOENZYMES
Bound to the exterior surface of inner mitochondrial membranes of muscle, brain, and liver.
A
CK-Mi (Mitochondrial Creatine Kinase)
13
Q
CK-Mi
For it to be detected in PLASMA, ? must occur, causing breakdown of the mitochondria and cell wall
A
Extensive tissue damage
14
Q
In most instances, the associated immunoglobin in Macro-CK
A
IgG
15
Q
Largely comprises CK-BB complexed with IgG
A
Macro-CK
16
Q
LDH EC
A
EC 1.1.1.27
17
Q
Systematic name of LDH
A
L-Lactate: NAD+ Oxidoreductase
18
Q
Catalyzes the interconversion of lactate to pyruvate;
Pyruvate to lactate in anaerobic glycolysis
A
LDH
19
Q
Reaction of LDH in anaerobin glycolysis
A
Pyruvate -> lactate
20
Q
LDH Higher Activities are found in
A
HELiSK
Heart
Erythrocytes
Liver
Skeletal muscle
Kidney
21
Q
LDH lesser amounts found in the
A
Lung
Smooth Muscle
Brain
22
Q
ISOENZYMES - TISSUE LOCALIZATION AND SOURCES OF ELEVATION
LDH-1 (HHHH)
A
Heart - Myocardial Infarction
Red Blood cell - Hemolytic anemia
23
Q
ISOENZYMES - TISSUE LOCALIZATION AND SOURCES OF ELEVATION
LDH-2 (HHHM)
A
Heart - Megaloblastic anemia
RBC - Acute Renal Infarction, Hemolyzed Specimen
24
Q
ISOENZYMES - TISSUE LOCALIZATION AND SOURCES OF ELEVATION
LDH-3 (HHMM)
A
Lung - Pulmonary Embolism
Lymphocytes - Extensive Pulmonary Pneumonia
Spleen - Pulmonary Pneumonia
Pancreas - Lymphocytosis, Acute Pancreatisis
25
ISOENZYMES - TISSUE LOCALIZATION AND SOURCES OF ELEVATION
LDH-4 (HMMM)
Liver - Hepatic injury or inflammation
26
ISOENZYMES - TISSUE LOCALIZATION AND SOURCES OF ELEVATION
LDH-5 (MMMM)
Skeletal muscle - Skeletal muscle injury
27
LDH Myocardial Infarction: Rise
12-24 hours after the onset
28
LDH Myocardial Infarction:Peak
48-72 hours
29
LDH Myocardial Infarction: Remain elevated
10 days
30
LD pattern suggestive of AMI
LD1>LD2>LD3>LD4>LD5
31
EC of Gamma-Glutamyl-Transferase
E.C. 2.3.2.2.
32
GGT Systemic name
(5-Glutamyl) Peptide: Amino Acid-5-Glutamyl-Transferase
33
GGT is Involved in the transfer of the gamma-glutamyl residue from gamma-glutamyl peptides to -, - and other small peptides
amino acid, H2O
34
Glutathione is a tripeptide composed of -, -, and -
Glutamate
Cysteine
Glycine
35
GGT physiology
- Involved in peptide and protein synthesis
- regulation of tissue glutathione levels
- transport of amino acids across cell membrane
36
GGT highest concentration tissue source
kidney
37
GGT other tissue sources
- brain
- prostate
- pancreas
- liver
38
clinical applications of GGT assay; primary sources of plasma GGT
evaluation liver and biliary system disorders
39
GGT is increased/elevated in
- elevated in all HEPATOBILLIARY DISODERS
- increased in patients receiving ENZYME-INDUCING DRUGS
- increased in CHRONIC ALCOHOLISM/Excessive alcohol consumption
40
enzyme-inducing drugs that will cause an elevated GGT
warfarin
phenobarbital
phenytoin
41
GGT
bone disease and biliary obstuction
Normal in BD
increased in BO
42
ALP
bone disease and biliary obstruction
all increase
43
Assay used in measuring Gamma-Glutamyl Transferase
Szasz assay
44
? And ? are located in the canalicular end, both of them are present in hepatobiliary conditions.
GGT and ALP
45
Substrate used for Szasz assay
Gamma-glutamyl-p-nitroanilide
46
szasz assay
? Is measured because its formation depends on the GGT
Para-Nitroaniline
47
yellow chromogenic product with a strong absorbance at 405 to 420 nm
Para-nitroaniline
48
EC for G6PD
1.1.1.49
49
G6PD systematic name
D-Glucose-6-Phosphate: NADP+ 1-Oxidoreductase
50
Catalyzes the oxidation of glucose-6-phosphate to 6-phosphogluconate or 6-phosphogluconolactone
Glucose-6-phosphate dehydrogenase (G6PD)
51
Lactate Dehydrogenase Coenzyme
Nicotinamide Adenine Dinucleotide NAD+
52
The conversion of glucose-6-phosphate to 6-phosphogluconate will also produce
NADPH
53
Diagnostic Significance of G6PD: RBC
- maintain NADPH in reduced form
- require reduced NADPH to reduce glutathione
- reduced glutathione protects hemoglobin (Hgb) from oxidation
54
Low G6PD may cause
Low NADPH = low reduced glutathione = hemolytic anemia
55
? must be present for anemia to occur in patients with G6PD
deficiency.
Oxidative stress
56
G6PD deficiency assay
Red cell hemolysate
57
G6PD
? Is used for evaluation of enzyme elevations
Serum
58
used as a confirmatory test for G6PD
Hemolysate
59
EC for ACE
3.4.15.1
60
ACE converts ? To ?
Angiotensin1 to Angiotensin 2
61
Other names for ACE
Kininase II and Peptidyl-Dipeptidase A
62
Hydrolysis of peptide bonds at a free C-terminus
releasing a dipeptide in the reaction
G6OD
63
ACE will Cleave ? In Angiotensin 1 to form Angiotensin 2
His-Leu sequence (Histidine-Leucine)
64
ACE contains ? In its active site
Zinc
65
Produces angiotensinogen
Liver
66
Produces renin
Kidney
67
Renin and angiotensinogen are activated by ?
Low blood pressure
68
Converts angiotensinogen to angiotensin 1
Renin
69
Cleaves the angiotensin seq to form angiotensin 2
ACE from the lungs
70
Effects of Angiotensin 2
Induce waterabsorption
Aldosterone = high blood pressure due to absorbed sodium
71
Endpoint of ACE
Higher blood pressure
72
Angiotensinogen converting enzyme inhibitors used for patients w high blood pressure
Captopril
73
ACE is predominantly found in ?
Endothelial cell membranes
74
Rich in ACE
Lungs
Testes
75
Substrate used to assess ACE levels
Hippurif acid
76
Hippuric acid is composed of
Hippuric acid
Histidine
Leucine
77
Abnormal collection of inflammatory cells called granulomas
may appear on the body (overreaction of the immune system)
Sarcoidosis
78
Sarcoidosis mainly affect the ?
Lungs
79
Most commonly affected areas of Sarcoidosis
Lungs
Skin
Eyes
Lymph nodes
80
ACE level: ?
Sarcoidosis progress to fibrosis
Decline
81
ACE is elevated w what illness
Sarcoidosis (Pulmonary involvement)
Granulomatous disease (10%)
82
EC OF 5’-Nucleotidase (5’NT)
EC 3.1.3.5
83
MW of 5’NT
70 kDa
84
It is a cytoplasmic membrane–bound phosphatase with a wide
specificity for 5′-ribonucleotides
5’-Nucleotidase
85
5’-Nucleotidase function in
Adenosine production
Nutrient absorption
Cell proliferation
86
5’-Nucleotidase acts only on - ?; substrate
Nucleotides (adenosine 5’-monophosphate and guanosine 5’-monophosphate)
87
Function of 5’NT
Nucleotide will be converted into RIBONUCLEOSIDE = release PHOSPHATE GROUP
88
5’NT systematic name
5’-Ribonucleotide Phosphohydrolase
89
5NT is widely distributed in ?
Tissues
90
5NT clnical uyilit is the diagnosis of ?
hepatobiliary disorders
91
5’NT serves as a marker to differentiate between ? and ?
Bone
Liver alkaline phosphatase
92
capable of cleaving the substrate used to measure the lower activity of 5′-NT present in the sample.
ALP
93
5’NT
High concentrations of nonspecific phosphatases may cause
Falsely increased results
94
inhibit 5’NT enzyme activity, likely due to the chelation of zinc
EDTA
95
Samples used for 5’NT
Serum
96
EC of Acetylcholinesterase
EC 3.1.1.7
97
EC of Pseudocholinesterase (PChE)
EC 3.1.1.8
98
True’ cholinesterase (choline esterase 1) or RBC cholinesterase
Acetylcholinesterase (AChE)
99
Butyrylcholinesterase (choline esterase 2)
Pseudocholinesterase (PChE)
100
AChE is found in the
Nervous system
Neuromuscular junctions
RBCs
101
primary neurotransmitter at various sites in the CNS
AChE
102
AChe rapidly hydrolyzes ?, producing rapid termination of neurotransmission
ACh (Acetycholine)
103
ACh is produced from
Choline
Acetyl CoA
104
serves as a neurotransmitter for signal transmission.
ACh
105
transported back into the axon terminal for ACh
synthesis.
Choline
106
ACh is broken down by acetycholinesterase into
Acetate and choline
107
Prolonged presence of ACh in the synaptic cleft can lead to
excessive signal transmission and paralysis
108
Main reason for measuring AChE
- to monitor EXPOSURE to
cholinesterase inhibitors
- for use as a LIVER FUNCTION TESTS
- for DIAGNOSIS of genetic variants
109
Useful in organophosphate exposure and poisoning
Ache
110
prevents the breakdown of acetylcholine (ACh)
organophosphates insectisides
111
have the capability to inhibit cholinesterase (ChE)
Snake toxins
112
reflects acute toxicity
PChe
113
reflects chronic exposure.
AChE
114
indicates toxic exposure
Low level of cholinesterase
115
may be useful in the diagnosis of neural tube defects
Qualitative analysis in amniotic fluid
116
PChe is produced by the
Liver
117
Function of PChe
Not known
118
Pche is also called
Acetylcholine acylhydrolase
119
neuromuscular blocking agent, and muscle relaxants used during surgery
Succinylcholine
Mivacurium
120
important in the cleavage of acetylcholine antagonists such as succinylcholine and mivacurium
PCHE
121
Irreversible inhibitors of both AChE and PChE; unable to break down ACh
Organophosphate Insecticides
122
Substrate used to react w ACHe and PCHe to produce thiocholine
Acylthiocholine ester
123
Reacts w Ellman’s reagent (dithiobisnitrobenzoicacid), releasing 5-mercapto-2-nitrobenzoic acid
Thiocholine
124
Thiocholine is then reacted with Ellman’s reagent
(dithiobisnitrobenzoicacid), releasing ?
5-mercapto-2- nitrobenzoic acid
125
Ellman’s reagent
Dithiobisnitrobenzoic acid
126
5-mercapto-2- nitrobenzoic acid, which is measured spectrophotometrically at
412 nm
127
Pseudocholinesterase activity is measured in ?
Serum
128
AChE activity is measured in
Hemolysate of washed RBCs
129
AChE may also be determined in AMNIOTIC FLUID by ?
Gel electrophoresis
130
AChe in amniotic fluid may be useful in the diagnosis of ?
Neural tube defects and other birth defects
131
a condition when a baby's SPINE and SPINAL CORD does not develop properly in the womb, causing a GAP in the spine.
Spina bifida
132
a serious birth defect in which a baby is born WITHOUT parts of the BRAIN and SKULL.
Anencephaly
133
a sac-like protrusion or projection of the brain and the membranes that cover it through an opening in the skull.
Encephalocele
134
EC of aldolase
EC 4.1.2.13
135
Aldolase systematic name
D-fructose- 1,6 - bisphosphate- D-Glyceraldehyde - 3 - phosphate - lyase
136
catalyzes the REVERSIBLE conversion of fructose-1,6-bisphosphate to glyceraldehyde 3-phosphate (G3P) and dihydroxyacetone phosphate (DHAP)
ALD
137
Aldolase A tissue source
Skeletal muscle
138
Aldolase B tissue source
WBC, Liver, Kidneys
139
Aldolase C tissue source
Brain tissue
