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Clinical Chemistry > Clinical Enzymology Liver Transfera > Flashcards

Clinical Enzymology Liver Transfera Flashcards

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1
Q

Liver transferases enzyme

A

AST, ALT, ALP, GGT

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2
Q

Alternative name for AST

A

Serum glutamic oxaloacetic transaminase (SGOT)

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3
Q

Substrate for AST

A

Aspartate

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4
Q

Reaction of AST

A

Exchange of amino group for oxaloacetate

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5
Q

Distribution of AST

A

Liver, Heart, Skeletal Muscle

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6
Q

Diagnostic use of AST

A

Increased in acute hepatocellular disorders, circulatory collapse, myocardial infarction

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7
Q

Moderate increase in AST

A

Muscular dystrophy, hepatic tumor, biliary obstruction, CHF, cardiac arrhythmia

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8
Q

Slight increase in AST

A

Cirrhosis, pericarditis, pulmonary infarction, cerebrovascular accident

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9
Q

Reference value for AST

A

5-35 IU/L or <36 IU/L

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10
Q

Isoenzymes of AST

A

Mitochondrial and cytoplasmic

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11
Q

Increase in cytoplasmic AST

A

Acute hepatocellular disorders (AHCDs)

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12
Q

Increase in mitochondrial AST

A

Hepatic failure, alcoholic liver disease (fulminant Hf)

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13
Q

Alternative name for ALT

A

Serum glutamic pyruvic transaminase (SGPT)

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14
Q

Reaction for ALT

A

Alanine is converted to pyruvate

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15
Q

Main purpose of ALT conversion

A

Amino acid metabolism and degradation (gluconeogenesis)

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16
Q

Diagnostic value of ALT in acute hepatocellular disorders

A

De Ritis ratio <1

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17
Q

Significance of De Ritis ratio in ALT

A

More specific, higher and sustained elevation (AST/ALT) - decreased <1

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18
Q

Comparison of half-life for AST and ALT

A

ALT has a longer half-life than AST

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19
Q

Distribution of ALT

A

Liver (more liver-specific)

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20
Q

Reference value for ALT

A

7-45 IU/L

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21
Q

Specimen consideration for AST and ALT

A

Avoid prolonged storage and hemolysis

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22
Q

Methods for AST and ALT

A

Reitman-Frankel and Karmen method

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23
Q

Reitman-Frankel method chemicals

A

2,4-dinitrophenylhydrazine and 0.4 N NaOH

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24
Q

Reitman-Frankel coenzyme/cofactor

A

Vitamin B6 (pyridoxine/pyridoxal phosphate)

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25
Q

Reitman-Frankel color product

A

Reddish brown at 505 nm

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26
Q

Reitman-Frankel color developer

A

2,4-DNPH

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27
Q

Method used for continuous monitoring of AST and ALT

A

Karmen method

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28
Q

pH buffer range for AST and ALT continues monitoring

A

7.3 to 7.8

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29
Q

Enzyme used for aspartate in AST method

A

Malate dehydrogenase

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30
Q

Enzyme used for alanine in ALT method

A

Lactate dehydrogenase

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31
Q

Product for AST in Karmen method

A

Malate and NAD (measured at decreased absorbance; 340 nm)

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32
Q

Product for ALT in Karmen method

A

Lactate and NAD (measured at decreased absorbance; 340 nm)

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33
Q

Activator for ALP

A

Magnesium (electrolyte)

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34
Q

Main isoenzymes of ALP

A

Intestine, Liver, Bone, Placenta

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35
Q

Small amounts of ALP found in

A

Kidney and Spleen

36
Q

Liver isoenzyme of ALP

A

Hepatobiliary

37
Q

Bone isoenzyme of ALP

A

Osteoblast

38
Q

Diagnostic significance of pronounced ALP elevation

A

Bile duct obstruction, biliary cirrhosis, Paget’s disease, osteogenic sarcoma, hyperparathyroidism

39
Q

Diagnostic significance of moderate ALP elevation

A

Granulomatous liver diseases, IM, metastatic bone tumors, rickets, osteomalacia

40
Q

Diagnostic significance of slight ALP elevation

A

Viral hepatitis, cirrhosis, healing bone fractures, growing children, pregnancy

41
Q

Reference range for ALP (Male)

A

53-128 IU/L

42
Q

Reference range for ALP (Female)

A

49-98 IU/L

43
Q

Reference range for ALP (Children)

A

54-369 IU

44
Q

Methods to avoid in ALP determination

A

CK, LD, LP

45
Q

Reference method for ALP determination

A

Bowers-McComb

46
Q

Bowers-McComb substrate for ALP

A

p-nitrophenylphosphate

47
Q

Product of Bowers-McComb method for ALP

A

p-nitrophenol (yellow)

48
Q

Substrate in Bessy, Lowey, and Brock/Bowers-McComb method

A

p-nitrophenylphosphate

49
Q

Measurable end product of Bessy, Lowey, and Brock/Bowers-McComb method

A

p-nitrophenol

50
Q

Substrate in Bodansky, Sinowara, Jones, Reinhart method

A

B-glycerophosphate

51
Q

Measurable endpoint in Shinowara method

A

Glycerol

52
Q

Substrate in King Armstrong method

A

Phenylphosphate

53
Q

Measurable end product in King Armstrong method

A

Phenol

54
Q

Substrate in Huggins and Talalay method

A

Phenolphthalein diphosphate

55
Q

Measurable end product in Huggins and Talalay method

A

Red phenolphthalein

56
Q

Substrate in Moss method

A

Alpha-napthylphosphate

57
Q

Measurable end product in Moss method

A

Alpha napthol

58
Q

Substrate in Klein Babson and Reed method

A

Buffered phenolphthalein phosphate

59
Q

Measurable end product in Klein Babson and Reed method

A

Phenolphthalein

60
Q

Electrophoresis migration pattern of ALP isoenzymes

A

I, P, B, L (Intestine, Placenta, Bone, Liver)

61
Q

Heat stability test for ALP isoenzymes

A

56°C for 10 minutes

62
Q

Heat stability pattern of ALP isoenzymes

A

P, I, L, B (Placenta most heat stable)

63
Q

Heat stability of Placental ALP

A

Resists heating at 65°C

64
Q

Heat stability of Bone ALP

A

<20% activity at 30 minutes

65
Q

Chemical inhibition by Phenylalanine

A

P, I (Placenta, Intestine, carcinoplacental)

66
Q

Chemical inhibition by Levamisole

A

B, L (Bone, Liver)

67
Q

Chemical inhibition by 3 molar urea

A

Bone

68
Q

Intestinal ALP characteristic

A

Increased after fatty meal, found in B or O secretor individuals

69
Q

Carcinoplacental abnormal isoenzyme

A

Regan

70
Q

Where Regan isoenzyme is detected

A

Lung, breast, ovarian, colon, and gynecologic cancers

71
Q

Carcinoplacental abnormal isoenzyme (Nagao)

A

Detected in carcinoma of pleural surfaces, pancreas, and bile duct

72
Q

Carcinoplacental abnormal isoenzyme (Kasahara)

A

Associated with GI and hepatic tumors

73
Q

Reference range for carcinoplacental isoenzymes

A

30-90 U/L

74
Q

Function of GGT

A

Transfer gamma-glutamyl amino acid residues (glutathione)

75
Q

Diagnostic use of GGT

A

Marker for hepatobiliary disorders, alcoholic liver disease, and microsomal induction by drugs and alcohol

76
Q

Use of GGT in hepatobiliary obstructions

A

Identifies source of increased ALP

77
Q

Popular use of GGT

A

Marker of chronic alcoholism

78
Q

Reference range for GGT (Male)

A

6-55 IU/L

79
Q

Reference range for GGT (Female)

A

5-38 IU/L

80
Q

Pre-analytical consideration for GGT

A

Always use a sample blank

81
Q

Effect of alcohol and drug abuse on GGT results

A

Increases GGT results

82
Q

Stability of GGT in serum

A

Stable up to 1 week if refrigerated

83
Q

Drugs that increase GGT

A

Warfarin, phenobarbital, phenytoin

84
Q

Szasz method substrate for GGT

A

Gamma-glutamyl-p-nitroanilide + glycylglycine

85
Q

Product of Szasz method for GGT

A

Gamma-glutamylglycylglycine + p-nitroanilide (yellow color)

86
Q

Measuring wavelength for Szasz method

A

420 nm

Clinical Chemistry (35 decks)

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