Clinical Enzymology Pancreatic mark Flashcards
Classification of pancreatic enzymes
Hydrolase
Smallest pancreatic enzyme
Amylase
Function of amylase
Breaks down carbohydrates: starch & glycogen
Coenzymes for amylase
Calcium and Chloride
Diagnostic significance of amylase
Acute pancreatitis, mumps, parotitis, macroamylasemia
Time profile of amylase in acute pancreatitis
Increases in 5-8 hours, peaks at 24 hours, normalizes in 3-5 days
Isoenzymes of amylase
Ptyalin and Amylopsin
Source and characteristics of Ptyalin
Salivary amylase (1,2,3); present in fallopian tubes and lungs; predominant in serum; faster migration in electrophoresis
Source and characteristics of Amylopsin
Pancreatic amylase (1,2,3); predominant in urine
Predominant amylopsin isoenzyme in acute pancreatitis
P3
Chemical inhibitor of salivary amylase
Wheat germ
Specificity of lipase
High specificity, sustained elevation due to increased half-life
Coenzymes for lipase
Bile salts and Colipase
Time profile of lipase in acute pancreatitis
Increases in 4-8 hours, peaks at 24 hours, normalizes in 7-14 days
Primary source of lipase
Pancreas
Specimen considerations for amylase determination
Avoid intake of pain relievers and use of lipemic serum
Spectrophotometric method: Measures disappearance of starch substrate; decrease in color of starch-iodine complex
Amyloclastic
Spectrophotometric method: Measures appearance of product; increases reducing sugars as starch is hydrolyzed by AMS; classic reference method
Saccharogenic
Spectrophotometric method: Measures increasing color from production of product coupled with a chromogenic dye
Chromogenic
UV method: Coupled-enzymatic- coupling of several enzyme systems; monitors amylase activity by measuring increased Abs of NADH at
340 nm
Reference values for serum amylase
25–130 U/L
Reference values for urine amylase
1–15 U/h
Specimen considerations for lipase determination
Avoid hemolysis
Cherry-Crandall method for lipase substrate
olive oil
Product of Cherry-Crandall method”.”glycerol + 3 fatty acids
Method that measures rate of clearing as fats are hydrolyzed by LPS
Turbidimetric
Reference range for lipase
<38 U/L
Rise time of amylase
5-8 hours
Rise time of lipase
4-8 hours
Peak time of amylase and lipase
24 hours
Decline time of amylase
3-5 days
Decline time of lipase
8-14 days