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CLIN CHEM > CLINICAL ENZYMOLOGY > Flashcards

CLINICAL ENZYMOLOGY Flashcards

1
Q

Sources of creatine kinase

A

Brain, myocardium, skeletal muscle

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2
Q

CK pronounced elevation (5 or more times)

A

Duchenne’s muscular dystrophy
Polymyolitis
Dermatomyositis
Myocardial infarction

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3
Q

CK isoenzyme - elevated in CNS damage, tumors, presence of macro-CK

A

CK-BB (CK1)

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4
Q

CK Isoenzyme : present in significant amounts in the cardiac tissue ; <6% of total CK in serum

A

CK-MB (CK2)

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5
Q

CK Isoenzyme : major isoenzyme found in striated muscle and normal serum (94-100%)

A

CK-MM (CK3)

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6
Q

CK isoenzyme from anode to cathode

A

CK MM
CK MB
MACRO CK
CK-IM

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7
Q

CK-BB bound to IgG ; migrates between CK MB and CK MM

A

CK-IM

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8
Q

CK determination : forward reaction / direct method ; creatine —> creatine PO4

A

Tanzer-Gilvarg

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9
Q

CK determination : reverse reaction / indirect method ; creatine PO4 —> creatine

A

Oliver-Rosalki

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10
Q

Total CK reference value (MALE)

A

15-160 U/L

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11
Q

Total CK reference value (FEMALE)

A

15-130 U/L

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12
Q

LD1 & LD2 tissue sources

A

Heart, RBCs, renal cortex

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13
Q

LD Isoenzyme found in lungs, lymphocytes, spleen, and pancreases

A

LD 3

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14
Q

LD Isoenzyme found in liver, skeletal muscle

A

LD4 and LD5

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15
Q

LD ISOENZYME : HHHH

A

LD1

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16
Q

LD ISOENZYME : HHHM

A

LD2

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17
Q

LD ISOENZYME : HHMM

A

LD3

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18
Q

LD ISOENZYME : HMMM

A

LD4

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19
Q

LD ISOENZYME : MMMM

A

LD5

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20
Q

LD1 and LD2 ratio in normal serum

A

LD2 > LD1

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21
Q

Flipped ratio ; seen in MI, hemolytic disorder, megaloblastic anemia, renal infarction

A

LD1 > LD2

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22
Q

LD Isoenzyme associated with arteriosclerotic cardiovascular failure signifying grave prognosis and impending death

A

LD6

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23
Q

LDH Pronounced elevation (5 or more times)

A

Megaloblastic anemia
Renal infarction

Septic shock & hypoxia
Hepatitis, thrombotic thrombocytopenic purpura
Widespread carcinomas, especially hepatic metastases

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24
Q

LDH moderate elevation (3-5 or more times)

A

Myocardial infarction
Pulmonary infarction
Hemolytic conditions, leukemias

Infectious mononucleosis
Delirium tremendous
Muscular dystrophy

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25
Q

LDH determination : forward reaction / direct reaction ;

A

Wacker method (lactate —> pyruvate)

FL(i)P

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26
Q

LDH determination : reverse method / indirect reaction

A

Wrobleuski-Ladue (pyruvate —> lactate)

RPL

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27
Q

Onset of elevation of CK-MB

A

4-6 hours

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28
Q

LD reference value

A

100-225 U/L (37C)

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29
Q

LD Isoenzyme most abundant in serum

A

LD2

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30
Q

AST/SGOT tissue sources

A

Liver, heart, skeletal muscle

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31
Q

ALT/SGPT tissue source

A

Liver

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32
Q

AST Pronounced elevation (5 or more times)

A

Acute hepatocellular damage
Myocardial infarction
Acute pancreatitis

Circulatory collapse (shock)
Infectious mononucleosis

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33
Q

Liver-specific ; higher and more sustained elevation

A

ALT/SGPT

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34
Q

AST isoenzyme that is first released

A

Cytoplasmic AST

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35
Q

AST Isoenzyme that is increased in hepatocellular disorder

A

Mitochondrial AST

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36
Q

In most acute hepatocellular disorders, the De Ritis ratio is ___

A

<1

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37
Q

AST/ALT ratio

A

De Ritis ratio

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38
Q

Rietman & Frankel method (AST)

Substrate :
End product :

A

SS: Aspartate + alpha-keto glutarate

EP: Glutamate + oxaloacetate

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39
Q

Rietman & Frankel method (ALT)

Substrate :
End product :

A

SS: Alanine + alpha-keto glutarate

EP: Glutamate + Pyruvate

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40
Q

AST Method : coupled-enzymatic method that uses Malate dehydrogenase

A

Karmen method

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41
Q

AST reference values

A

5-35 U/L

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42
Q

ALT reference values

43
Q

ALP tissues sources

A

Liver, bone, placenta, intestine

44
Q

ALP pronounced elevation (5 or more times normal)

A

Bile duct obstruction (intrahepatic or extra hepatic)
Osteitis deformas (PAGET’S DISEASE)
Biliary cirrhosis
Osteogenic sarcoma (bone tumor)
Hyperparathyroidism

45
Q

ALP slight elevation (up to 3 times normal)

A

Pregnancy

Viral hepatitis
Cirrhosis
Healing fractures
Normal growth patterns in children

46
Q

Highest ALP elevation is in what condition

A

PAGET’S DISEASE

47
Q

ALP isoenzyme electrophoretic pattern:

A

(+) L > B > P > I (-)

48
Q

ALP isoenzyme heat stability:

A

P > I > L > B

“Promise ikaw lang baby” yiee sanaol mwehehehe

49
Q

Placental ALP resists heating at __C for __ mins

A

65C for 30mins

50
Q

Bone ALP <20% activity at __C for __ mins

A

56C for 10 mins

51
Q

Bone is inhibited by

52
Q

Liver and bone are inhibited by

A

Levamisole

53
Q

Placental, intestinal, carcinoplacental are inhibited by

A

Phenylalanine

54
Q

ALP Isoenzyme that is more likely to be found in B or O secretor individuals ; bound by group A erythrocytes; level increases after consumption of a fatty meal

A

Intestinal ALP

55
Q

Carcinoplacental Isoenzymes

A

Regan
Nagao
Kasahara

56
Q

Carcinoplacental Isoenzymes : detected in lung, breast, ovarian, and gynecologic cancers ; MOST HEAT STABLE ; inhibited by phenylalanine

57
Q

Carcinoplacental Isoenzymes : detected in carcinoma of pleural surfaces, pancreas, and bile duct ; inhibited by leucine

58
Q

Carcinoplacental Isoenzymes : associated with GI and hepatic tumors

59
Q

Reference method for ALP determination ; most specific

A

Bowers and McComb

60
Q

Bowers & McComb substrate

A

P-nitrophenylphosphate (PNPP)

61
Q

ALP reference value

62
Q

Small pancreatic enzyme ; easily to excrete ; found in pancreas and salivary glands

63
Q

Diagnostic significance of amylase

A

Acute pancreatitis (pancreas)
Mumps, parotitis, macroamylasemia (salivary glands)

64
Q

Large pancreatic enzyme ; late marker but pancreas-specific ; marker of acute pancreatitis ; produces higher and more sustained elevation

65
Q

Amylase onset of elevation

A

2-12 hours

66
Q

Amylase peak activity

67
Q

Amylase duration of elevation

68
Q

Lipase onset of elevation

69
Q

Lipase peak activity

70
Q

Lipase duration of elevation

71
Q

Amylase determination method : decrease in color of starch-iodine complex

A

Amyloclastic method

72
Q

Amylase determination method : increased reducing sugars as STARCH is hydrolyzed by amylase

A

Saccharogenic method

73
Q

Amylase determination method : increased COLOR intensity of soluble dye-substrate solution

A

Chromogenic method

74
Q

Amylase determination method : increased absorbance of NADH at 340 nm

A

Coupled-enzymatic / continuous-monitoring method

75
Q

Amylase reference values (SERUM)

A

25 - 130 U/L

76
Q

Amylase reference values (URINE)

77
Q

Reference method for amylase

A

Saccharogenic method

78
Q

Amylase Isoenzyme inhibited by wheat germ lectin

A

Salivary amylase

79
Q

Lipase determination method : uses olive oil (trioleine-new) as substrate ; REFERENCE METHOD

A

Cherry-Crandall method

80
Q

Lipase determination method : Measures the rate of CLEARING as fats are hydrolyzed by LPS

A

Turbidimetric method

81
Q

Lipase determination method : based on coupled reactions with glycerol kinase and Peroxidase

A

Colorimetric method

82
Q

Lipase reference value

83
Q

Miscellaneous enzymes : hepatobiliary disorders, alcoholic liver disease, microsomal induction by drugs and alcohol ; used to identify the source of increase ALP level

A

GGT (Gamma glutamyl transferase)

84
Q

Miscellaneous enzymes : intrahepatic cholestasis : used to identify the source of high ALP level

A

5’Nucleotidase

85
Q

HIGH ALP in conjunction with HIGH GGT and 5’Nucleotidase, the condition source must be from the ____

A

Liver (Hepatobiliary)

86
Q

HIGH ALP in conjunction with NORMAL GGT and 5’Nucleotidase, the condition source must be from the ____

A

Bone (bone lesion)

87
Q

Szasz substrate

A

Gamma-glutamyl-p-nitroanilide

88
Q

Szasz method end product : color

A

P-nitroaniline (yellow)

89
Q

Major sources of ACP

A

Prostate and RBCs

90
Q

ACP clinical significance

A

Prostatic carcinoma/hyperplasia, rape (vaginal washings)

91
Q

Roy and Hillman substrate

A

Thymolphthalein monophosphate (endpoint)

92
Q

RBC ACP is inhibited by

A

Copper and formaldehyde

93
Q

Prostatic ACP is inhibited by

94
Q

Prostatic ACP formula

A

Total ACP - ACP after tartrate inhibition

95
Q

Miscellaneous enzymes : skeletal muscle disorders

96
Q

Miscellaneous enzymes : hepatocellular disorder

A

Glutamate dehydrogenase and Glutathione-S-transferase

97
Q

Miscellaneous enzymes : blood pressure regulation

A

Angiotensin-converting enzyme (ACE)

98
Q

Miscellaneous enzymes : Acute myocardial infarction

A

Acute myocardial infarction

99
Q

Miscellaneous enzymes : pancreatic insufficiency

A

Trypsin
Chymotrypsin/elastase 1

100
Q

Miscellaneous enzymes : when low in RBC, its manifestation is drug-induced hemolytic anemia

101
Q

Miscellaneous enzymes : When low in RBC, its manifestation is hemolytic anemia secondary to membrane abnormality

A

Pyruvate kinase

102
Q

Miscellaneous enzymes : low in serum due PESTICIDE POISONING, liver disease, genetic variants (abnormal response to muscle relaxants)

A

Pseudocholinesterase

103
Q

Miscellaneous enzymes : low in serum due PESTICIDE POISONING, liver disease, genetic variants (abnormal response to muscle relaxants)

A

Pseudocholinesterase

CLIN CHEM (10 decks)

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