Clinical Enzymology/fxn If Covered

Question 0

Creatine kinase

Answer 0

Ck-MB (ck2)- MI marker. Early, peaks 24 hrs, gone after 48 hrs

Ck-MM (ck3)-rhapdomyolysis (I.e: mcardle gsd 5 myophosphorylase)

Question 1

MI markers

Answer 1

Ck-MB and total CK (CK-MB >3-5% depending on other test). Early marker

cTnI and cTnT (not TnC) early marker. Lasts several days

LDH- late marker LDH1>LDH2 (switch)

Myoglobin (unspecific early marker)

Question 2

LDH

Answer 2

In MI LDH1>LDH2. Peaks @ 48, observable at 24 hrs. Half life 5 days.

Reversible: pyruvate to lactate, nad+ to nadh

Question 3

Alanine amino transferase

Answer 3

ALT, marker for liver damage

EtOH abuse->cirrhosis AST/ALT >2

Alanine and a-Kg to pyruvate and glutamate

Use ala as substrate for gluconeogenesis.

Question 4

Aspartate aminotransferase

Answer 4

Liver damage marker
AST
EtOH abuse->cirrhosis AST/ALT >2

Question 5

Liver damage

Answer 5

AST, alt, ammonium, bilirubin, albumin

EtOH abuse->cirrhosis AST/ALT >2

Question 6

Biliary system

Answer 6

Alkaline phosphotase (liver isozyme), GGT (gamma glutamyl transpeptidase)

Question 7

Alkaline phosphotase

Answer 7

Biliary obstruction w/ GGT (ALP-1)

Bone (alone) (ALP-2)

Question 8

Gamma-glutamyltranspeptidase (transferase)

Answer 8

Makes GSH

Biliary obstruction marker with ALP

Increased in response to EtOH or other medications

Question 9

EtOH abuse

Answer 9

AST/ALT >2

High GGT

Lipase/Amylase >2

Question 10

Pancreatitis

Answer 10

a-amylase, pancreatic lipase

Acute: gallstones, heavy ETOH intake (lipase/amylase>2)

Chronic: CF, hypertriglycerolemia, years of alcoholism.

Question 11

Bones

Answer 11

ALP-2 (made by osteoblasts)

Bone disease or tumors

High levels normal in growing children and pregnancy.

Question 12

Prostate cancer

Answer 12

PSA

Question 13

a-fetoprotein (AFP)

Answer 13

Hepatocellular, testicular, ovarian tumors