CREATINE KINASE Flashcards
What is the reaction of CK?
Creatine + ATP <> Phosphocreatine + ADP
What is the major phosphorylated compound in muscle?
Phosphocreatine
When muscles contracts, what happen?
ATP is consumed to form ADP.
CK catalyzes the resphosphorylation of ADP to for ATP
In terms of tissue course of CK, enumerate where it it GREATEST and SMALLER QUANTITIES.
GREATEST:
Striated muscle and Heart tissue
SMALLER QUANTITIES:
Bladder, Placenta, GIT, Thyroid, Uterus, KIdney, Lung, Prostate, Spleen and Pancreas
How much protein CK activity is present is striated muscle and Heart tissue?
Striated muscle : 2,500
Heart tissue: 500
Which is devoid of CK activity?
Liver and RBC
What is the structure of CK?
A DIMER with 2 subunits
What is the MW of each subunit?
40, 000 Dalton’s
What are the 3 important Isoenzymes of the CK?
CK-BB (CK1)
CK-MB (CK2)
CK-MM (CK3)
The 3 important isoenzymes are mainly found in what part?
The cytosol
What are the forms of CK?
Type 1 and Oligomeric Mitochondrial CK.
What type of macromolecular form of CK has the Isoenzymes of CK forms complex with the Immunoglobulin?
Type 1
What type of Macromolecular form of CK is commonly found in adults with malignancy or liver conditions?
Oligomeric Mitochondrial conditions
CK1, CK2 and CK3 can be found in?
CK1
- Brain
- Prostate
- GUt
- Lung
- Bladder
- Uterus
- Placenta
- Thyroid
CK2
- Heart muscles
CK3
- Skeletal (predominates)
- Cardiac muscle
What do you call the 4th ISoenzyme?
CK-Mt (MItochodrial Isoenzyme)
To which does CK-Mt differ?
Immunologically and in electrophoretic mobility
CK-Mt constitutes up to ________ CK activity in the heart.
15%
This diagnostic significance of CK refers to a viral infection caused by entero virus and etc.
Viral myositis
This disease talks about an autoimmune disorder that happens in the muscle?
Polymyositis
Muscular dystrophy Duchenne type increases up to?
50x ULN
In this disease, the problem is the nerves.
Neurogenic muscle disease
What are the examples of Neurogenic Muscle Disease?
Myasthenia gravis
Multiple sclerosis
Poliomyelitis
Parkinsonism
Rhabdomyolisis
This NMD produce antibodies against nerves that control our muscles.
Myasthenia gravis
This disorder has the brain and the spinal cord conditions
Multiple sclerosis
This disease came from a fecal oral route and is contagious.
Poliomyelitis
This disease has symptoms like tremors and bradycardia
Parkinsonism
This results from a muscular trauma such as hazing in which breakdown of muscle tissue causing he release of muscle cell content into the bloodstream.
Rhabdomyolisis
TRUE OR FALSE:
The CK level is a sensitive indicator for AMI. Therefore, it is a serodiagnostic test for AMI.
TRUE
This is caused by a trauma in the heart muscle.
Coronary Artery Bypass Surgery
What are the diseases of the CNS that increases CK activity?
Cerebral Ischemia
Acute cerebrovascular disease
Head injury
Reye’s syndrome
This disease refers to the lack of blood supply to the brain
Cerebral Ischemia
This is a common condition among children and young adults wherein the brain is most likely to be affected.
Reye’s Syndrome
Why is there a little amount of CK-1 activity in the brain?
It is because of the Brain Blood Barrier whereas it not allow the passage of large molecules to the brain and CK1 that escapes our brain.
Where are the sites for CK-1 elevated activities?
GIT infarction
Adenocarcinoma
Tumors of the prostate, bladder, kidney, breast and ovary
What is the optimal pH in the CK forward reaction and reverse reaction?
FR: 9.0
RR: 6.8
What is the substrate of the FR acted by Creatine Kinase?
Creatine and ATP
What is the substrate of the FR acted by Pyruvate Kinase?
ADP and Phosphoenolpyruvate
What is the substrate of the FR acted by Lactate Dehydrogenase?
Pyruvate + NADH + H
What is the PRODUCT of the FR acted by Creatine Kinase?
Creatine Phosphate + ADP
What is the PRODUCT of the FR acted by Pyruvate Kinase?
Pyruvate + ATP
What is the PRODUCT of the FR acted by Lactate Dehydrogenase?
Lactate + NAD
What is the method of the Revers Reaction?
Method by Oliver - Rosalki
How many times is Oliver - Rosalki method faster?
6x
The rate of ____________ formation is a measure of the CK activity.
NADPH
What is the PRODUCT of the RR acted by Creatine Kinase?
CREATINE + ATP
What is the PRODUCT of the RR acted by Hexoinase?
ADP + Glucose 6-phosphate
What is the PRODUCT of the RR acted by Glucose 6-phosphate dehydrogenase?
6-Phosphogluconate + NADPH + H
What is the SUBSTRATE of the RR acted by Hexokinase?
ATP + Glucose
What is the SUBSTRATE of the RR acted by Creatine KInase ?
Creatine phosphate and ADP
What is the SUBSTRATE of the RR acted by G6PD?
Glucose 6-phosphate + NADP
What is the other method that is added
Modification of Szaz and his colleagues
What are the reagents that Szaz and colleagues add?
N-acetylcysteine
EDTA (Ethylenediaminetetraacetic acid)
Adenosine pentaphosphate
Transcribe IFCC
International Federation of Clinical Chemistry
What are the Sources of Error in CK?
Adenylate Kinase Effect
Hemolysis
What is the mechanism of AK effect?
The AK will react with the ADP to produce ATP causing falsely elevated CK activity.
What is the Reference range of CK?
F: 15-130 U/L
M: 15-160 U/L
CK-MB: <6% total CK
In electrophoresis, there is an alteration of biochemical environment of our ___________________.
Human serum albumin
What is the visualization of Electrophoresis?
There would be an incubation of the agarose gel (RR). Then, NADPH would be detected by observing a BLUISH WHITE FLUORESCENCE at 360nm.
This separation and quantitationn of Isoenzymes is more tedious and less common. Thus, potential for being more sensitive and precise than electrophoresis.
Ion-exchange chromatography
This measures the concentration of enzyme protein rather than enzyme activity And detects enzymatically inactive CK-2. In addition, infarction can be detected earlier.
Immunoassays
This contains anti A or ANti B. CK activity is measured before and after inhibition
Immunoinhibition
This allows the diff’n of MB activity due to AK and the atypical isoenzymes
Double-Ab Immunoinhibition
