Clinical Enzymology Part 2 Flashcards
What are the 2 pancreatic enzymes
Amylase
Lipase
Amylase is also known as?
a-1,4-glucan-4-glucohydrolase
It is the smallest enzyme which can be freely filtered by the glomerulus
amylase
T/F
Amylase is NOT normally present in urine
F; it is normally present in urine
The earliest pancreatic marker
Amylase
Amylase
Rise:
Peak:
Normalize:
Rise: 5-8 hrs,
Peak: 24 hrs
Normalize: 3-5 days
The rise, peak and normalization of amylase should be accompanied by (increase, decrease) urine amylase, which usually elevated within ______ upon onset of _________
increase
7 days
acute pancreatitis
Catalyzes the hydrolysis of 1,4-glycosidic bonds in polysaccharides
Amylase
Amylase catalyzes the hydrolysis of what bond in polysaccharides?
1,4-glycosidic bonds
Example of polysaccharides
starch, glycogen
Refers to long chains of glucose molecules
polysaccharides
Once starch and glycogen are hydrolyzed, the product is________
glucose
2 activators of Amylase
Calcium, Chloride
Major Tissue Sources of amylase
-Pancreas (Acinar Cells) and Salivary Glands
Other tissue sources of amylase
-Adipose Tissues, Fallopian Tubes, Small Intestines, Skeletal Muscles
Reference range of amylase
Serum: ______
Urine: _______
Serum: 28-100 U/L
Urine: 1-15 U/h
TYPES OF GLYCOSIDIC BONDS
α-glycosidic bond
β-glycosidic bond
T/F:
α-glycosidic bond is oriented down
T
T/F
β-glycosidic bond is oriented up
T
has branches (α-1,6-glycosidic bond)
Amylose
2 types of Isoenzymes
S-type isoamylase
P-type isoamylase
S-type isoamylase is aka
Ptyalin or Salivary Amylase
Initiate hydrolysis of polysaccharides in the mouth
S-type isoamylase
Example/group of S-type isoamylase
S1, S2, S3
The most anodal AMY isoenzyme
S-type isoamylase
P-type isoamylase is aka
aka Pancreatic Amylase and Amylopsin
Increased isoenzymes in acute pancreatitis
P-type isoamylase
Example/group of P-type isoamylase
P1, P2, P3
the most predominant pancreatic amylase isoenzyme in acute pancreatitis.
P3
Increased amylase is aka
Hyperamylasemia
What are the 8 diseases/condition associated with increased amylase (Hyperamylasemia)
Acute Pancreatitis
Parotitis
Perforated Peptic Ulcer
Intestinal Obstruction
Cholecystitis
Ruptured Ectopic Pregnancy
Mesenteric Infarction
Acute Appendicitis
The specimen used in Amylase
Serum, Heparinized Plasma
The substrate used in AMY
Starch
In all methods of analysis for Amylase, we measure the ____
Total Amylase
T/F
In all methods of analysis for Amylase, we measure the Total Amylase. Hence, we S-type and P-type should be classified
F; we don’t classify S-type and P-type.
What are the 4 methods of analysis in amylase
Saccharogenic
Amyloclastic
Chromogenic
Couple-Enzyme
Classical method (AMY)
Saccharogenic
It measures the amount of reducing sugars produced by the hydrolysis of starch by the usual glucose method
Saccharogenic
Saccharogenic measures the amount of _________ produced by the ________ of starch by the usual glucose method
reducing sugars
hydrolysis
It measures decrease in starch substrate
Amyloclastic
Substrate in Amyloclastic are coupled with ______ and will yield what color
iodine
Starch + Iodine = Bluish Black Color
Decrease in color is proportional to AMS activity
Amyloclastic
In amyloclastic, the ______ (less, more) color of the substrate, the ____ (less, more) enzyme activity in the solution
less
more
Measures the formation of Soluble Starch Fragments coupled with chromogenic dyes.
Chromogenic
Color intensity is proportional to AMS activity
Chromogenic
Measured amylase activity by a continuous-monitoring/kinetic technique.
Couple-Enzyme
The substrate used in couple-enzyme (Method of Analysis in Amylase)
Starch
The wavelength used in couple-enzyme (Method of Analysis in Amylase)
340 nm
pH level in couple-enzyme (Method of Analysis in Amylase)
6.9
Storage condition in couple-enzyme (Method of Analysis in Amylase)
Room temp (1 week), 4°C (2 months)
can be used to measure S-type and P-type isoenzyme.
Wheat Germ Lectin
Wheat Germ Lectin inhibits ____
Salivary Amylase
Steps in measuring S-type and P-type isoenzyme
- Measure Total Amylase
- Add Wheat Germ Lectin
- Measure Amylase (P-Type)
SA = Total Amylase – Pancreatic Amylase
false decrease variables in AMY
-Ca2+ Chelating Anticoagulant (EDTA)
-Triglycerides
Why is Ca2+ Chelating Anticoagulant (EDTA) false decrease in AMY
Bec. Calcium is used as an activator for Amylase
false increase variables in AMY
Morphine, other opiates
Acute Pancreatitis + Hyperlipidemia = _____ (high, normal, low) Levels in Amylase
Normal
Amylase bound to immunoglobulin
Macroamylasemia
it is a type of Amylasemia that is Asymptomatic and it is not filtered by the glomerulus.
Macroamylasemia
_____ and ______ are measured to differentiate Macroamylasemia from Hyperamylasemia,
Serum and Urine amylase
Macroamylasemia = (increased, decreased) urine amylase
decreased
Hyperamylasemia = (inc., dec.,) serum and urine amylase
increased
Amylase/Creatinine Ratio:
Normal: ________
Acute Pancreatitis: ______
Normal: 1-4% (0.01-0.04)
Acute Pancreatitis: >4%-15%
What is the E.C. numerical code of Lipase
E.C. 3.1.1.3
Lipase is aka
Triacylglycerol Acylhydrolase
AKA Triacylglycerol Acylhydrolase
Lipase
Catalyzes hydrolysis of glycerol esters of complex lipids to produce alcohol and fatty acid.
Lipase
Catalyzes partial hydrolysis of dietary TAG to 2-monoglyceride intermediate, with production of long-chain fatty acids.
Lipase
Cofactors of lipase
Colipase (coenzyme), Bile salts
Major Tissue Source of lipase
Pancreas
Other Tissue Source of lipase
Stomach, Small Intestines
Reference Range of lipase
<38 U/L
The MOST specific pancreatic marker
lipase
In chronic pancreatitis: (lipase)
- ______ are destroyed
- Loss of ____ and _____
Acinar cells
AMS, LPS
RISE:
AMS: ____
LPS: _____
5-8 hrs
4-8 hrs
PEAK:
AMS: ___
LPS: ____
both: 24 hrs
NORMALIZE:
AMS: ____
LPS: ____
3-5 days
8-14days
the specimen used in the methods of analysis of lipase
Serum
the storage condition used in the methods of analysis of lipase
room temp (1 week), 4°C (3 weeks)
interferences in the methods of analysis of lipase
hemolysis
hemolysis causes false ____ (inc., dec.,) n Lipase activity because hemoglobin interferes with lipase
decrease
3 methods used in the analysis of lipase
Cherry-Crandall Method
Tietz and Fierech
Peroxidase Coupling
Reference method in LPS
Cherry-Crandall Method
The substrate in Cherry-Crandall Method of LPS
50% Olive Oil
The end product in Cherry-Crandall Method of LPS
Fatty Acids (titrated and measured)
What method of LPS has this principle: Hydrolysis of olive oil for 24 hours producing fatty acids which are titrated
Cherry-Crandall Method
Most commonly used method in LPS
Peroxidase Coupling
Does NOT use 50% olive oil
Peroxidase Coupling
What are the 2 cardiac enzymes
Creatine kinase
Lactate dehydrogenase
Creatinine kinase is aka
ATP Creatine-N-Phosphotransferase
Catalyzes phosphorylation of creatine to form creatine phosphate.
CREATINE KINASE
Involved in storage of high-energy creatine phosphate in the muscles.
Creatine kinase
T/F:
Creatine kinase is a dimeric molecule
T
What are the dimeric molecules in creatine kinase
M subunit
B subunit
M subunit refers to
muscle
B subunit refers to
brain
Major Tissue Source of creatine kinase
brain, muscles (smooth, skeletal, cardiac)
Reference ranges (Creatine kinase)
Male: _____
Female: _____
CK-MB: ___
Male: 46-171 U/L
Female: 35-145 U/L
CK-MB: <5% of total CK
T/F:
Male has higher muscle mass than females
T
What are the normal isoenzymes
CK-BB
CK-MB
CK-MM
What isoenzyme is CK-1
CK-BB
What isoenzyme is CK-2
CK-MB
What isoenzyme is CK-3
CK-MM
Most anodal CK
CK-BB
2nd most anodal CK
CK-MB
3rd most anodal CK
CK-MM
Brain type isoenzyme
CK-BB
Hybrid type isoenzyme
CK-MB
Muscle type isoenzyme
CK-MM
Dominant in brain, intestines, and smooth muscles
CK-BB
Present in significant concentration in the cardiac muscles
CK-MB
Abundantly present in striated muscles
CK-MM
CK-BB is Rarely found in ____
serum (it cannot pass through the blood-brain barrier))
Serodiagnostic tool for AMI (Acute Myocardial Infarction)
CK-MB
Major Isoenzyme in normal individual (94-100%)
CK-MM
Useful Non-Specific Tumor Marker
CK-BB
Reference value OF CK-MB
<5% of Total CK
Myocardial Damage/AMI of CK-MB
-____ (elevated, decreased) CK-MB
- ____ of Total CK
Elevated
≥ 6
2 abnormal isoenzymes
- MACRO-CK
- Mitochondrial CK
In MACRO-CK:
CK-BB + ______
CK-MM + ________
Immunoglobulin
Lipoproteins
T/F
MACRO-CK is associated with any disease
F; not associated
It requires intensive tissue damage for it to be present
Mitochondrial CK
T/F:
in serum, mitochondrial CK is NOT associated with any disease or disorder but it may be used as an indicator/marker of severe illness.
T
Conditions with an increased CK
Acute Myocardial Infarction
Duchenne-type Muscular Dystrophy
Rhabdomyolysis
Cerebrovascular Accident
Seizures
Nerve Degeneration
CNS Shock
Hypothyroidism
Malignant Hyperpyrexia
Reye’s Syndrome
CK-MB during Acute Myocardial Infarction
RISE: _____
PEAK: ____
NORMALIZE: ____
Rise: 4-8 hrs.
Peak: 12-24 hrs.
Normalize: 48-72 hours
it shows the highest elevation of total creatine kinase
Duchenne-type Muscular Dystrophy
T/F:
Stress in muscle tissues results to increase CK
T
Conditions/activity that causes stress in muscle tissues resulting to increase CK
Crush syndrome, tetany, surgical incisions
Strenuous exercise, contact sports
IM Injection
Early diagnostic tool for Vibrio vulnificus infection
Creatine Kinase
flesh-eating bacterium
Vibrio vulnificus
causes Necrotizing fasciitis
Vibrio vulnificus
measures the creatinine kinase progesterone ratio
ectopic pregnancies
2 methods of analysis in CK
-Tanzer-Gilbard Assay
-Oliver-Rosalki Method
Forward/Direct Method
Tanzer-Gilbard Assay
Tanzer-Gilbard Assay:
coupled with: _____, _____, _____
Pyruvate Kinase, Lactate Dehydrogenase, and ADH System
Optimal pH in Tanzer-Gilbard Assay
9.0 (alkaline/basic)
Wavelength in Tanzer-Gilbard Assay
340 nm
Reverse/Indirect Method
Oliver-Rosalki Method
Most commonly performed method
Oliver-Rosalki Method
Why is Oliver-Rosalki Method
most commonly performed method
bec. it is 2-6x faster the Tanzer-Gilbard Assay
Oliver-Rosalki Method:
coupled with: ___
Hexokinase-Glucose-6-Phosphate -Dehydrogenase-NADP System
Optimal ph in Oliver-Rosalki Method
6.8 (Slightly Acidic)
wavelength in Oliver-Rosalki Method
340 nm
specimen used in Oliver-Rosalki Method
Serum, Heparinized Plasma
inhibitor of sulfhydryl group oxidation.
N-acetylcysteine, mercaptoethanol, thioglycerol, dithiothreitol
3 variables in Oliver-Rosalki method
-hemolysis
-light
-non-heparinized anticoagulant
Variables (Oliver-Rusalki method)
Hemolysis ( ____HGB)
> 320 mg/L
T/F:
Oliver-Rosalki Method:
In the presence of hemolysis, CK is falsely elevated even CK is not found in RBC
T
causes false elevation of CK activity
Adenylate Kinase
Added to inhibit/inactivate Adenylate Kinase
Adenosine Monophosphate
Added to inhibit/inactivate Adenylate Kinase
Adenosine Monophosphate
T/F:
CK is inactivated by light
T
What are the 4 methods of isoenzyme analysis
-Electrophoresis
-Ion-Exchange Chromatography
-Antibody-Inhibition
-Immunoassays
Reference method of isoenzyme analysis (CK)
Electrophoresis
In electrophoresis, Macro CK migrates between _____ and _____
CK-MM and CK-MB
It is potentially MORE sensitive and precise than electrophoresis
Ion-Exchange Chromatography
Errors in Ion-Exchange Chromatography
-CK-MM merge with CK-MB
-CK-BB eluted with CK-MB
-Macro-CK eluted with CK-MB
Used Anti-M antibodies
Antibody-Inhibition
Antibody-inhibition can detect ____ activity if present resulting to falsely ______ CK-MB activity
CKBB
elevated
a more specific method for CK-MB
Double-Antibody Immunoinhibition
It measures the enzyme protein rather than the activity of the enzyme. We can measure even the inactivated enzyme because we measure the CONCENTRATION.
Immunoassays
Catalyzes the oxidation of lactic acid to pyruvic acid with mediation of NAD+ as the hydrogen acceptor.
Lactate dehydrogenase
T/F:
The catalytic activity of LACTATE DEHYDROGENASE is IRREVERSIBLE.
F; reversible
It is present virtually in all cells of the body.
LACTATE DEHYDROGENASE
Coenzyme of LD
Oxidized NAD+
Inhibitor of LD
EDTA
contain H or M Unit/Peptide
Tetrametic Molecule
Tissue sources of Lactate Dehydrogenase
heart, RBCs, kidneys, lungs, pancreas, spleen, skeletal muscles, liver, intestines
Reference value of LD
125-220 U/L
What are the Lactate dehydrogenase isoenzymes
LD1
LD2
LD3
LD4
LD5
LD6
LD1 subunits
HHHH
LD1 Tissue source
Heart, RBC
LD1 % based on total LDH
14-26
Most predominant isoenzyme in LD
LD2
LD2 subunits
HHHM
LD2 tissue source
Heart, RBC
LD2 % based on total LDH
29-39%
increased in pulmonary involvement and various carcinomas
LD3
LD3 subunits
HHMM
LD 3 tissue source
Liver, Spleen, Lymphocytes, Pancreas
LD 3 based on total LDH
20-26%
LD 4 subunits
HMMM
LD 4 tissue source
Liver
LD 4 % based on Total LDH
8-16%
LD 5 is seen in ___
muscular injuries
LD 5 subunits
MMMM
LD 5 tissue source
Skeletal muscle
LD6 is aka
alcohol dehydrogenase
LD 6 is present in _____
Arteriosclerotic cardiovascular failure
Most predominant to leasT predominant LD (normal path)
LD 2>1>3>4>5
used as tumor markers for Acute Leukemia, Germ Cell Tumor, Breast Cancer, and Lung Cancer.
LD 2, 3 & 4
T/F:
Increase in Total LDH is SIGNIFICANT.
F; INSIGNIFICANT
Increased LDH is seen in:
-Acute Myocardial Infarction
-Hemolytic anemia
-Pernicious anemia
-Pulmonary infarction
-Muscle dystrophy
-Hepatic carcinoma, toxic hepatitis, cirrhosis, viral hepatitis
-Blood transfusion
-Pneumocystis jirovecii infection
Increased LDH:
Acute Myocardial Infarction
Rise: ___
Peak: ___
Normalize: ___
Exhibits LDH Flipped Pattern: ____
Rise: 12-24 hrs
Peak: 48-72 hrs.
Normalize: After 10-14 days
Exhibits LDH Flipped Pattern: LD1 > 2 > 3 > 4 > 5
Increased LDH:
Hemolytic anemia
Exhibits LDH Flipped Pattern: ___
LD1 > 2 > 3 > 4 > 5
Increased LDH:
Pernicious anemia
Exhibits LDH Flipped Pattern: ___
LD1 > 2 > 3 > 4 > 5
Increased LDH:
Pulmonary infarction
Pattern: ___
LD 3 > 4 > 2 > 1 > 5
Increased LDH:
Muscle dystrophy
Pattern: ___
LD 5 > 4 > 3 > 2 > 1
May cause an increase in Lactate Dehydrogenase but it will NORMALIZE within 24 hrs. after the blood transfusion.
Blood transfusion
Specimen in LDH
Serum
Substrate used in LDH
Lactate (Most commonly used),
Pyruvate of α-hydroxybutyrate (Specific to LD1)
Most common substrate used in LDH
Lactate
Storage (LDH)
Total LD: _____
LD Isoenzymes: _____
25°C (48 hours)
25°C (24 hours)
Variables in LDH method of analysis
-plasma specimen
-hemolysis
-cold storage
In LDH, plasma specimen causes _______ because of presence of platelets in plasma
false increase
The presence of hemolysis in LDH can cause ____ of LD because RBC has ____ more Lactate dehydrogenase than serum (specifically____ and _____)
false elevation
100-150x
LD1 & LD2
Cold storage in LDH:
old, and labile causes a false ____ (specifically ___ and ___)
decrease
LD4 & LD5
2 methods in Lactate dehydrogenase
Wacker Method
Wrobleuski La Due
Forward/Direct Method in LDH
Wacker Method
Most commonly used method in LDH
Wacker Method
Wacker Method:
pH: ___
Wavelength: ___
pH: 8.3-8.9
Wavelength: 340 nm
Reverse/Indirect Method of LDH
Wrobleuski La Due
T/F
Wrobleuski La Due is thrice the rate of forward method
T
Wrobleuski La Due is the preferred method for
Dry-Slide Technology
Example of Dry-Slide Technology
Vitros
Uses less costly cofactor and it has a smaller specimen volume requirement
Wrobleuski La Due
pH of Wrobleuski La Due
7.1-7.4
2 NON ENZYMATIC CARDIAC MARKERS
Myoglobin
Cardiac troponins
The primary oxygen-carrying protein found in striated skeletal and cardiac muscle.
Myoglobin
Screening test for myocardial infarction
Myoglobin
The earliest marker for MI
myoglobin
MYOGLOBIN:
Rise: ___
Peak: ___
Normalize: ____
Rise: 1-3 hrs
Peak: 5-12 hrs
Normalize: 18-30 hrs (ave. 24 hrs.)
Gold standard in diagnosis of AMI
. Cardiac Troponins
A complex protein that resides in the filaments of cardiac (____) and skeletal muscle (___)
Cardiac Troponins
94-97%
3-6%
Regulators of actin and myosin
Cardiac Troponins
responsible for muscle contraction
actin and myosin
3 subunits of cardiac troponins
Troponin T
Troponin I
Troponin C
Tropomyosin-binding subunit
Troponin T
Sensitive marker for diagnosis of unstable angina
Troponin T
In troponin T, a value of _____ is suggestive of AMI
≥ 1.5 ng/mL
Absent from normal serum
Troponin T
2 subunits of cardiac troponins that are NOT cardiac specific
Troponins T & C
Inhibitory subunit
Troponin I
Cardiac-specific and sensitive
Troponin I
Troponin I is only found in ___
Myocardium
Absent from normal serum
Troponin I
Calcium-binding subunit
Troponin C
Regulates muscle contraction
Troponin C
Troponin T
Rise: ___
Peak: ____
Normalize: ___
3-4 hrs
10-24 hrs
7 days
Troponin I:
Rise: ___
Peak: ____
Normalize: ___
3-6 hrs
12-18 hrs
5-10 days
Acute Myocardial Infarction: (T/F)
Aspartate aminotransferase is NOT liver-specific
T
Aspartate aminotransferase:
Rise: __
Peak: ___
Normalize: ___
6-8 hrs
24 hrs
Within 5 days
T/F:
Creatine Kinase-MB is cardiac specific
T
Creatine Kinase-MB:
Rise: __
Peak: ___
Normalize: ___
4-8 hrs
12-24 hrs
48-72 hrs
Lactate Dehydrogenase:
Rise: __
Peak: ___
Normalize: ___
12-24 hrs
48-72 hrs
After 10-14 days
Myoglobin:
Rise: __
Peak: ___
Normalize: ___
1-3 hrs
5-12 hrs
18-30 hrs (ave. 24)
Troponin T:
Rise: __
Peak: ___
Normalize: ___
3-4 hrs
10-24 hrs
7 days
Troponin I:
Rise: __
Peak: ___
Normalize: ___
3-6 hrs
12-18 hrs
5-10 days
OTHER CLINICALLY SIGNIFICANT ENZYMES
Acid phosphatase
Aldolase
Cholinesterase
Angiotensin-Converting Enzyme
Glucose-6-Phosphate Dehydrogenase
Ceruloplasmin
ACID PHOSPHATASE is aka
Acid orthophosphoric monoester phosphohydrolase
aka. Acid orthophosphoric monoester phosphohydrolase
ACID PHOSPHATASE
Catalyzes the same reaction as ALP but at pH 5.0 (Optimum pH)
ACID PHOSPHATASE
Major Tissue Source of Acid Phosphatase
Prostate
Other Sources of acid phosphatase
Erythrocytes, platelets, liver, bone, spleen, kidneys.
Reference ranges for total ACP:
Male: ___
Female: ___
2-5-11.7 U/L
0.3-9.2 U/L
Reference ranges for Prostatic ACP:
Male: ___
Female: ___
0.2-5.0 U/L
0.0-0.8 U/L
For detection of prostatic carcinoma (metastatic carcinoma)
ACID PHOSPHATASE
found in hairy cell leukemia
Tartrate-Resistant ACP (TRAP)
Tartrate-Resistant ACP (TRAP) is aka
Erythrocyte Acid Phosphatase
Tartrate-Resistant ACP (TRAP) is a marker for:
______ & ____
Marker for Bone remodeling
Marker for Metastatic Cancer in Bone Marrow
t/f:
Post-Prostatectomy is under the diagnostic significance of ACP
T
T/F: (ACP)
Thrombocytopenia - Increased ACP because of increased platelet destruction
T
T/F: (ACP)
Thrombocytopenia - Increased ACP because of increased platelet destruction
T
T/F: (ACP)
Thrombocytopenia - Increased ACP because of increased platelet destruction
T
Increased ACP (assoc. with bone disease):
Paget’s disease
Breast Cancer (with bone metastases)
Gaucher’s Disease (with bone marrow infiltration)
Detection of Seminal Fluid-ACP activity
Rape cases
Specimen used in rape cases (ACP)
Vaginal Washings (ACP in vaginal washing is stable for 4 days)
Detectability of ACP in rape cases
4 days
ACP Activity in rape cases
> 50 IU/L
Specimen in ACP
serum
Substrate in ACP
-Thymolphthalein monophosphate
-α-naphthyl phosphate
end-point methods/fixed point method.
Thymolphthalein monophosphate
specific substrate for prostatic ACP
Thymolphthalein monophosphate
Continuous monitoring methods
α-naphthyl phosphate
Inhibitors IN ACP
L-Tartrate
2% formaldehyde, cupric sulfate solution
inhibits prostatic ACP and lysosomal ACP
L-Tartrate
Not specific for prostatic ACP
L-Tartrate
inhibits RBC/Erythrocyte ACP, aka TRAP
2% formaldehyde, cupric sulfate solution
Storage in ACP
Frozen
Acidified
Acified at a pH of____
ACP is stable for ____ at room temp.
<6.5
2 days
Variables in ACP
-Room temp
-bilirubin
-hemolysis
-heparin, oxalate, fluoride
T/F:
at room temp., ACP activity is decreased within 1-2 hours because CO2 from blood sample is released which increases pH of the sample
T
T/F:
CO2 is not a principal acid component of the blood.
F; CO2 is one of the principal acid components of the blood.
Bilirubin in ACP is falsely ____ (TRAP)
decreased
Hemolysis in ACP is false ____ due to Erythrocyte ACP/TRAP
increased
Heparin, Oxalate, Fluorides causes a false ___ in ACP
decreased
To measure prostatic ACP, use inhibitors like ____
L-tartrate
Measuring Prostatic ACP steps
- Measure Total ACP
- Use inhibitor (L-tartrate)
- Measure ACP – TRAP
Prostatic ACP = Total ACP – TRAP
ACP methods:
substrate in Gutman and Gutan:
Phenyl phosphate
ACP methods:
end product in Gutman and Gutan:
Inorganic phosphate
ACP methods:
substrate in Shinowara:
P-nitrophenylphosphate
ACP methods:
end product in Shinowara:
p-nitrophenol
ACP methods:
substrate in Babson, Read & Philips:
α-naphthylphosphate
ACP methods:
end product in Babson, Read & Philips:
α-naphthol
ACP methods:
substrate in Roy and Hillman:
Thymolphthalein monophosphate
ACP methods:
endproduct in Roy and Hillman:
Free thymolphthalein
With a numeral code of E.C. 4.1.2.13
ALDOLASE
Aldolase is aka
Fructose-1,6-Diphosphate Aldolase
Catalyzes the reversible reaction that splits fructose-1,6-diphosphate into two triose phosphate molecules
Aldolase
Isoenzymes in Aldolase
Aldolase A
Aldolase B
Aldolase C
FOR Skeletal muscles (Skeletal muscle marker)
Aldolase A
For WBC, liver, kidney
Aldolase B
For Brain tissues
Aldolase C:
Increased Aldolase is seen in
Skeletal muscle disease, leukemia, hemolytic anemia, and hepatic cancers
2 types of CHOLINESTERASE
Acetylcholinesterase
Pseudocholinesterase
They are Anti-xenobiotic enzymes
CHOLINESTERASE
CHOLINESTERASE is secreted by ___
liver (synthetic function)
Catalyze the hydrolysis of the esters of choline
CHOLINESTERASE
Catalyzes the removal of Benzyl Group of cocaine
CHOLINESTERASE
Marker for Insecticide/Pesticide Poisoning (Organophosphate poisoning)
CHOLINESTERASE
Used to monitor effects of muscle relaxants after surgery such as Succinylcholine
CHOLINESTERASE
Involved in metabolism of anticholinergic drugs
CHOLINESTERASE
They are INVERSE MARKERS for Acetylcholinerase
CHOLINESTERASE
Methods for CHOLINESTERASE
Ellman technique and Potentiometry
Variables in CHOLINESTERASE
Hemolysis
Other names of Acetylcholinesterase
True Cholinesterase
Choline esterase I
EC Numerical Codes of Acetylcholinesterase
E.C. 3.1.1.7
Tissue source of Acetylcholinesterase
RBC, Lung, Spleen, Nerve endings
Decreased in chronic exposure to organophosphates
Acetylcholinesterase
Other names of Pseudocholinesterase
Choline Esterase II
Acylcholine acylhydrolase
Serum cholinesterase
Butyrylcholinesterase
EC Numerical Codes of Pseudocholinesterase
E.C. 3.1.1.8
Tissue source of Pseudocholinesterase
Liver, pancreas, heart, serum
Decreased in acute toxicity with organophosphates
Pseudocholinesterase
Decreased in hepatocellular diseases
Pseudocholinesterase
RV of Pseudocholinesterase
Male:
Female:
Male: 4-78 u/L
Female: 33-76 U/L
With an E.C numeral code of E.C. 3.4.15.1
ANGIOTENSIN-CONVERTING ENZYME (ACE)
Kininase II, Peptidyl-Dipeptide A
ANGIOTENSIN-CONVERTING ENZYME (ACE)
ANGIOTENSIN-CONVERTING ENZYME (ACE)is aka
Kininase II, Peptidyl-Dipeptide A
T//F
ANGIOTENSIN-CONVERTING ENZYME (ACE) is a hydrolytic enzyme
T
Converts angiotensin I to angiotensin II within the lungs (RAAS System)
ANGIOTENSIN-CONVERTING ENZYME (ACE)
promotes sodium reabsorption
Aldosterone
it will constrict the blood vessels, therefore, increasing the blood pressure of the patient.
Vasoconstriction
It responds to hypertension
ANGIOTENSIN-CONVERTING ENZYME (ACE)
T/F:
Angiotensin II Functions in decreasing Blood Pressure:
F; INCREASING
ANGIOTENSIN-CONVERTING ENZYME (ACE)
Possible indicator of ____
Neuronal Dysfunction
Target of blood pressure-lowering drugs (ACE inhibitors and Angiotensin II inhibitors)
ANGIOTENSIN-CONVERTING ENZYME (ACE)
Tissue sources of ANGIOTENSIN-CONVERTING ENZYME (ACE)
lungs, testes, macrophage, epithelioid cells
ANGIOTENSIN-CONVERTING ENZYME (ACE) is crucial for the diagnosis and monitoring of _____
sarcoidosis
Increased ACE is seen in
Sarcoidosis, Multiple Sclerosis, Addison’s Disease
Acute/Chronic Bronchitis
HIV and Leprosy
It maintains the NADPH in a reduced form to protect hemoglobin from oxidation and hemolysis.
GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G6PD)
Catalyzes the oxidation of glucose-6-phosphate to 6-phosphogluconate
GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G6PD)
GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G6PD)
is involved in what pathway
Hexose Monophosphate Shunt
Tissue sources of GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G6PD)
Adrenal cortex, spleen, thymus, lymph nodes, lactating mammary gland, and erythrocytes.
inherited X-linked trait common among African Americans
G-6-PD Deficiency
G-6-PD Deficiency can lead to _______ after in-take of ______ which is an anti-malarial drug, and also after intake of _____
Drug-Induced Hemolytic Anemia
Primaquine
Favadins.
It is detected in Newborn Screening
G-6-PD Deficiency
RBC inclusion in G-6-PD Deficiency
Heinz bodies
G-6-PD is increased during
Myocardial infarction, megaloblastic anemia
RV for G-6-PD
7.9-16.3 U/g HGB
Specimen (G6PD)
Red Cell Hemolysate - deficient
Serum - evaluate enzyme elevation
A glycoprotein and a copper-binding enzyme
CERULOPLASMIN
Imparts blue color to protein
CERULOPLASMIN
Ceruloplasmin is a marker for
Wilson’s Disease
Wilson’s Disease decreased Ceruloplasmin by ___
0.1 g/L
Characterized by copper deposition in skin, liver, brain and cornea
CERULOPLASMIN
Bluish-blue ring
Kayser-Fleisher Ring
RV for ceruloplasmin
18-45 mg/dL
RV for ceruloplasmin
18-45 mg/dL
type of isoamylase that is excreted by salivary gland
S-type isoamylase
type of isoamylase that is excreted by the pancreas
P-type isoamylase
triacyglycerol is the other term for
triglycerides
E.C numeral code for amylase
E.C. 3.2.1.1
E.C. Numeral code for creatine kinase
E.C. 2.7.3.2
E.C. Numeral code for lactate dehydrogenase
E.C. 1.1.1.27
E.C. Numeral code for Acid phosphatase
E.C. 3.1.3.2
LD 5 % based on Total LDH
6-16%
