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CLINICAL CHEMISTRY 2 > CREATINE KINASE > Flashcards

CREATINE KINASE Flashcards

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1
Q

What is the reaction of CK?

A

Creatine + ATP <> Phosphocreatine + ADP

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2
Q

What is the major phosphorylated compound in muscle?

A

Phosphocreatine

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3
Q

When muscles contracts, what happen?

A

ATP is consumed to form ADP.
CK catalyzes the resphosphorylation of ADP to for ATP

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4
Q

In terms of tissue course of CK, enumerate where it it GREATEST and SMALLER QUANTITIES.

A

GREATEST:
Striated muscle and Heart tissue

SMALLER QUANTITIES:
Bladder, Placenta, GIT, Thyroid, Uterus, KIdney, Lung, Prostate, Spleen and Pancreas

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5
Q

How much protein CK activity is present is striated muscle and Heart tissue?

A

Striated muscle : 2,500
Heart tissue: 500

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6
Q

Which is devoid of CK activity?

A

Liver and RBC

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7
Q

What is the structure of CK?

A

A DIMER with 2 subunits

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8
Q

What is the MW of each subunit?

A

40, 000 Dalton’s

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9
Q

What are the 3 important Isoenzymes of the CK?

A

CK-BB (CK1)
CK-MB (CK2)
CK-MM (CK3)

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10
Q

The 3 important isoenzymes are mainly found in what part?

A

The cytosol

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11
Q

What are the forms of CK?

A

Type 1 and Oligomeric Mitochondrial CK.

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12
Q

What type of macromolecular form of CK has the Isoenzymes of CK forms complex with the Immunoglobulin?

A

Type 1

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13
Q

What type of Macromolecular form of CK is commonly found in adults with malignancy or liver conditions?

A

Oligomeric Mitochondrial conditions

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14
Q

CK1, CK2 and CK3 can be found in?

A

CK1
- Brain
- Prostate
- GUt
- Lung
- Bladder
- Uterus
- Placenta
- Thyroid

CK2
- Heart muscles

CK3
- Skeletal (predominates)
- Cardiac muscle

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15
Q

What do you call the 4th ISoenzyme?

A

CK-Mt (MItochodrial Isoenzyme)

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16
Q

To which does CK-Mt differ?

A

Immunologically and in electrophoretic mobility

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17
Q

CK-Mt constitutes up to ________ CK activity in the heart.

A

15%

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18
Q

This diagnostic significance of CK refers to a viral infection caused by entero virus and etc.

A

Viral myositis

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19
Q

This disease talks about an autoimmune disorder that happens in the muscle?

A

Polymyositis

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20
Q

Muscular dystrophy Duchenne type increases up to?

A

50x ULN

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21
Q

In this disease, the problem is the nerves.

A

Neurogenic muscle disease

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22
Q

What are the examples of Neurogenic Muscle Disease?

A

Myasthenia gravis
Multiple sclerosis
Poliomyelitis
Parkinsonism
Rhabdomyolisis

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23
Q

This NMD produce antibodies against nerves that control our muscles.

A

Myasthenia gravis

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24
Q

This disorder has the brain and the spinal cord conditions

A

Multiple sclerosis

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25
Q

This disease came from a fecal oral route and is contagious.

A

Poliomyelitis

26
Q

This disease has symptoms like tremors and bradycardia

A

Parkinsonism

27
Q

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.

A

Rhabdomyolisis

28
Q

TRUE OR FALSE:
The CK level is a sensitive indicator for AMI. Therefore, it is a serodiagnostic test for AMI.

A

TRUE

29
Q

This is caused by a trauma in the heart muscle.

A

Coronary Artery Bypass Surgery

30
Q

What are the diseases of the CNS that increases CK activity?

A

Cerebral Ischemia
Acute cerebrovascular disease
Head injury
Reye’s syndrome

31
Q

This disease refers to the lack of blood supply to the brain

A

Cerebral Ischemia

32
Q

This is a common condition among children and young adults wherein the brain is most likely to be affected.

A

Reye’s Syndrome

33
Q

Why is there a little amount of CK-1 activity in the brain?

A

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.

34
Q

Where are the sites for CK-1 elevated activities?

A

GIT infarction
Adenocarcinoma
Tumors of the prostate, bladder, kidney, breast and ovary

35
Q

What is the optimal pH in the CK forward reaction and reverse reaction?

A

FR: 9.0
RR: 6.8

36
Q

What is the substrate of the FR acted by Creatine Kinase?

A

Creatine and ATP

37
Q

What is the substrate of the FR acted by Pyruvate Kinase?

A

ADP and Phosphoenolpyruvate

38
Q

What is the substrate of the FR acted by Lactate Dehydrogenase?

A

Pyruvate + NADH + H

39
Q

What is the PRODUCT of the FR acted by Creatine Kinase?

A

Creatine Phosphate + ADP

40
Q

What is the PRODUCT of the FR acted by Pyruvate Kinase?

A

Pyruvate + ATP

41
Q

What is the PRODUCT of the FR acted by Lactate Dehydrogenase?

A

Lactate + NAD

42
Q

What is the method of the Revers Reaction?

A

Method by Oliver - Rosalki

43
Q

How many times is Oliver - Rosalki method faster?

A

6x

44
Q

The rate of ____________ formation is a measure of the CK activity.

A

NADPH

45
Q

What is the PRODUCT of the RR acted by Creatine Kinase?

A

CREATINE + ATP

46
Q

What is the PRODUCT of the RR acted by Hexoinase?

A

ADP + Glucose 6-phosphate

47
Q

What is the PRODUCT of the RR acted by Glucose 6-phosphate dehydrogenase?

A

6-Phosphogluconate + NADPH + H

48
Q

What is the SUBSTRATE of the RR acted by Hexokinase?

A

ATP + Glucose

49
Q

What is the SUBSTRATE of the RR acted by Creatine KInase ?

A

Creatine phosphate and ADP

50
Q

What is the SUBSTRATE of the RR acted by G6PD?

A

Glucose 6-phosphate + NADP

51
Q

What is the other method that is added

A

Modification of Szaz and his colleagues

52
Q

What are the reagents that Szaz and colleagues add?

A

N-acetylcysteine
EDTA (Ethylenediaminetetraacetic acid)
Adenosine pentaphosphate

53
Q

Transcribe IFCC

A

International Federation of Clinical Chemistry

54
Q

What are the Sources of Error in CK?

A

Adenylate Kinase Effect
Hemolysis

55
Q

What is the mechanism of AK effect?

A

The AK will react with the ADP to produce ATP causing falsely elevated CK activity.

56
Q

What is the Reference range of CK?

A

F: 15-130 U/L
M: 15-160 U/L
CK-MB: <6% total CK

57
Q

In electrophoresis, there is an alteration of biochemical environment of our ___________________.

A

Human serum albumin

58
Q

What is the visualization of Electrophoresis?

A

There would be an incubation of the agarose gel (RR). Then, NADPH would be detected by observing a BLUISH WHITE FLUORESCENCE at 360nm.

59
Q

This separation and quantitationn of Isoenzymes is more tedious and less common. Thus, potential for being more sensitive and precise than electrophoresis.

A

Ion-exchange chromatography

60
Q

This measures the concentration of enzyme protein rather than enzyme activity And detects enzymatically inactive CK-2. In addition, infarction can be detected earlier.

A

Immunoassays

61
Q

This contains anti A or ANti B. CK activity is measured before and after inhibition

A

Immunoinhibition

62
Q

This allows the diff’n of MB activity due to AK and the atypical isoenzymes

A

Double-Ab Immunoinhibition

CLINICAL CHEMISTRY 2 (14 decks)

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