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Enzymes Flashcards

1
Q

Which of the following statements describes CK-MB?
* Major form in the sera of healthy people and in striated muscle. (Hypothyroidism, IM injections, mild to strenuous activities)
* Cardiac tissue contains significant amounts.
* Highest concentration in the CNS
* None of the choices

A

Cardiac tissue contains significant amounts.

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2
Q

Temperature stability of Serum lipase
* 3 degrees
* 4 degrees
* 5 degrees
* 6 degrees

A

4 degrees

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3
Q

The oxidoreductase that is increased significantly during megaloblastic anemia is.
* LD
* CK
* ALP
* ACP

A

LD

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4
Q

STATEMENT 1: CK-MB becomes abnormal 4 hours postinfarction, peaks in 16-20 hours, and usually returns to normal within 48 hours. STATEMENT 2: Persistent elevation of CK-MB and total CK is associated with muscular dystrophy.
* 1 is correct
* 2 is correct
* Both are correct
* Both are incorrect

A

Both are correct

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5
Q

Saccharogenic Method for Amylase
* Amyloclastic
* Nelson, Somogyi Method
* Klein, Forman, Searcy Method
* Peralta and Reinhart Method

A

Nelson, Somogyi Method

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6
Q

Hemolysis affects the following analytes except:
* CK-MB
* Lactate dehydrogenase
* Alanine aminotransferase
* GGT

A

Alanine aminotransferase

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7
Q

STATEMENT 1: In healthy persons, the principal form of amylase in the plasma is pancreatic amylase. STATEMENT 2: The recommended method for amylase testing makes use of p-nitrophenyl maltohepatiside.
* 1 is correct
* 2 is correct
* Both are correct
* Both are incorrect

A

2 is correct

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8
Q

Which of the following Acid Phosphatase isoenzymes is found in granulocytes?
* Band 1
* Band 2 and 4
* Band 3
* Band 5

A

Band 2 and 4

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9
Q

Cherry-Crandall Method is used for lipase determination. What is the substrate used for this technique?
* Thymolpthalein monophosphate
* Olive oil
* Triolein
* Pyruvate

A

Olive oil

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10
Q

In acute pancreatitis, the following results should be expected.
* LD isoenzymes 1 elevates higher than 2 within 72 hours.
* Lipase elevates within 4-8 hours of an attack, peaks at 24 hours and stay elevated 4 days.
* Amylase and lactate rise successively in the first 24 hours and stay elevated 4 days.
* Amylase and lipase elevated in few hours, but amylase normalize within 3 days.

A

Amylase and lipase elevated in few hours, but amylase normalize within 3 days.

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11
Q

STATEMENT 1: In hepatoma, there is a 50-70% increase of pseudocholinesterase. STATEMENT 2: In hepatitis, there is 30-50% increase of pseudocholinesterase.
* 1 is correct
* 2 is correct
* Both are correct
* Both are incorrect

A

Both are incorrect

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12
Q

In the laboratory measurement of ALP, a chromogenic assay forms the basis of almost all current methods used for ALP analysis. The substrate in the assay is.
* Acid phosphatase
* 4-nitrophenyl phosphate
* P-nitroaniline
* Succinyldithiocholine

A

4-nitrophenyl phosphate

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13
Q

This enzyme causes false elevation of CK activity.
* Adenosine deaminase
* Adenylate kinase.
* Lactate dehydrogenase
* Phosphofructokinase

A

Adenylate kinase.

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14
Q

Given the following results: ALP marked increased; AST slight increased; ALT slight increased; GGT marked increased. This is most consistent with
* Acute hepatitis
* Osteitis fibrosa
* Chronic hepatitis
* Obstructive jaundice

A

Obstructive jaundice

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15
Q

STATEMENT 1: Placental ALP is associated with lung cancer. STATEMENT 2: Heat inactivation is used to distinguish liver ALP and placental ALP.
* 1 is correct
* 2 is correct
* Both are correct
* Both are incorrect

A

1 is correct

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16
Q

A scanning CK isoenzyme fractionation revealed 2 peaks: a slow cathodic peak (CKMM) and an intermediate peak (CKMB). A possible interpretation for this pattern is.
* Brain tumor
* Muscular dystrophy
* Myocardial infarction
* Viral hepatitis

A

Myocardial infarction

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17
Q

STATEMENT 1: Serum LDH is highest in obstructive liver disease. STATEMENT 2: While it is slightly increased in pernicious anemia.
* 1 is correct
* 2 is correct
* Both are correct
* Both are incorrect

A

Both are incorrect

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18
Q

What is the most anodal isoenzyme of ALP based on electrophoretic fractionation?
* Hepatic ALP
* Bone ALP
* Placenta ALP
* Intestinal ALP

A

Hepatic ALP

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19
Q

The classification of enzyme catalyzes the bonding together of 2 molecules into 1 with the participation of ATP.
* Oxidoreductase
* Transferase
* Hydrolase
* Ligases

A

Ligases

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20
Q

What is the reference method for GGT determination?
* Walker et.al method
* Szasz method
* Karmen method
* Wacket et. al method

A

Szasz method

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21
Q

Which isoenzyme of ALP is most heat labile
* Bone
* Liver
* Intestinal
* Placental

A

Bone

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22
Q

STATEMENT 1: Total CK is sensitive and specific for AMI. STATEMENT 2: Exercise and IM injection can cause a slight elevation of total CK.
* 1 is correct
* 2 is correct
* Both are correct
* Both are incorrect

A

Both are incorrect

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23
Q

STATEMENT 1: When a competitive inhibitor is present in the sample, a dilution can be performed to increase the rate of reaction by reducing the concentration of the inhibitor. STATEMENT 2: Reaction rate will also increase if the low samples volume is used in the assay because less inhibitor will be present in the reaction mixture.
* 1 is correct
* 2 is correct
* Both are correct
* Both are incorrect

A

Both are correct

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24
Q

STATEMENT 1: CK and ALP requires Magnesium for full activity. STATEMENT 2: Amylase requires zinc for full activity.
* 1 is correct
* 2 is correct
* Both are correct
* Both are incorrect

A

1 is correct

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25
All the following serve as enzyme co-factor, except * Calcium * Zinc * Magnesium * Chloride
Calcium
26
Which of the following enzymes are used to diagnose acute pancreatitis? * AMS * AST * CK * LD
AMS
27
STATEMENT 1: CK-2 is more commonly measure by immunoassay using polyclonal anti-CK-2 antibodies. STATEMENT 2: CK-2 is greater than 6% of total CK. * 1 is correct * 2 is correct * Both are correct * Both are incorrect
28
STATEMENT 1: An enzyme will accelerate the reaction rate thus reducing the time required to reach equilibrium. STATEMENT 2: The concentration of the reactants and products at equilibrium will change with or without the enzyme. * 1 is correct * 2 is correct * Both are correct * Both are incorrect
1 is correct
29
STATEMENT 1: Amylase in humans is a ligase that splits the second alpha 1-4 glycosidic linkage of polyglucans forming maltose. STATEMENT 2: Isoenzymes of amylase may be separated by both electrophoresis and immunoassay. * 1 is correct * 2 is correct * Both are correct * Both are incorrect
2 is correct
30
Which of the following substrates is used for the detection of ACP using Bodansky Method? * Phenylphosphate * P-nitrophenylphosphate * Beta-glycerophosphate * Alpha-napthylphosphate
Beta-glycerophosphate
31
A lactate dehydrogenase flipped pattern suggest which of the following. * Pernicious anemia * Myocardial infarction * Meningitis * Muscle trauma
Myocardial infarction
32
All the following clinically important enzyme has moderate specificity EXCEPT * AST * ACP * CK * ALP
33
The serum enzyme that demonstrates an increase in activity 4 to 8 hours after an attack of acute pancreatitis peaks at 24 hours, and then returns to normal within a week is. * Amylase * Lipase * ALP * Serum Cholinesterase
Lipase
34
Measurement of decreased activity of which of the following enzymes is used to determine possible insecticide poisoning. * CK * ALP * ALT * CHE
CHE
35
STATEMENT 1: Chloride and Calcium are both required for amylase activity. STATEMENT 2: Samples with high amylase activity should be diluted with HCl to prevent inactivation. * 1 is correct * 2 is correct * Both are correct * Both are incorrect
Both are correct
36
The most specific enzyme test for acute pancreatitis is. * ACP * Trypsin * Amylase * Lipase
Lipase
37
Given the following results: ALP slight increased; AST slight increased; ALT slight increased; GGT slight increased. This is most consistent with * Acute hepatitis * Chronic hepatitis * Obstructive jaundice * Liver hemangioma
Chronic hepatitis
38
STATEMENT 1: In turbidimetric assays, the rate of clearing turbidity is related to the mount of lipase in the serum. STATEMENT 2: Cholesterol is the substrate used for lipase testing. * 1 is correct * 2 is correct * Both are correct * Both are incorrect
1 is correct
39
AST and ALT are both elevated in which of the following disease. * Muscular dystrophy * Viral hepatitis * Pulmonary emboli * Infectious mononucleosis
Viral hepatitis
40
Which of the following CK isoenzyme is the fastest to migrate during serum electrophoresis * CK BB * CK MB * CK MM * Both A and C
CK BB
41
Lactate Dehydrogenase enzyme is increased in all the following conditions EXCEPT * Myocardial infarction * Liver disease * Chronic alcoholism * Pernicious anemia
Chronic alcoholism
42
STATEMENT 1: A negative myoglobin rules out acute myocardial infarction. STATEMENT 2: Myoglobin is sensitive and specific marker for AMI. * 1 is correct * 2 is correct * Both are correct * Both are incorrect
1 is correct
43
Which of the following statements is INCORRECT about G-6-PD deficiency * Defective Hexose Monophosphate Shunt * It is a type of hemolytic anemia * Deficiency of galactose-6-phosphate epimerase * PBS shows denatured hemoglobin in form of Heinz bodies.
Deficiency of galactose-6-phosphate epimerase
44
Which of the following enzymes demonstrates an increase in activity with progressive Duchenne muscular dystrophy, followed by a decrease as muscle mass decreases? * ALP * ALT * CHE * CK
CK
45
STATEMENT 1: ALT prevails over AST in alcoholic liver disease. STATEMENT 2: AST is higher than ALT in liver cirrhosis. * 1 is correct * 2 is correct * Both are correct * Both are incorrect
Both are incorrect
46
A serum sample drawn in the emergency room for a 42-year-old man yielded the following laboratory results: CK 185 U/L; AST 123 U/L; CKMB 6 U/L. Which of the following conditions might account for these values? * Crush injury of the thigh * Cerebrovascular accident * Pulmonary infarction * Early acute hepatitis
Crush injury of the thigh
47
STATEMENT 1: lipase may be increased after opiate administration. STATEMENT 2: lipase is increased in acute pancreatitis. * 1 is correct * 2 is correct * Both are correct * Both are incorrect
Both are correct
48
What method is used for STAT analysis of Amylase * Amyloclastic * Nelson, Somogyi Method * Klein, Foreman, Searcy Method * Peralta and Reinhart Method
Peralta and Reinhart Method
49
STATEMENT 1: inherited G-6-PD deficiency can lead to hemolytic anemia following exposure to certain drug. STATEMENT 2: G-6-PD is within the RBC’s, so the specimen required for testing is serum. * 1 is correct * 2 is correct * Both are correct * Both are incorrect
1 is correct
50
Given the following results: ALP slight increased; AST marked increased; ALT marked increased; GGT slight increased. This is most consistent with: * Acute hepatitis * Chronic hepatitis * Obstructive jaundice * Liver hemangioma
Acute hepatitis
51
Reference method for ALP determination * Shinowara-Jones-Reinhart * King- Armstrong * Bessy-Lowry-Brock * Bowers-McComb
Bowers-McComb
52
STATEMENT 1: Amylase is increased in all persons with pancreatitis and can also be elevated in several nonpancreatic conditions. STATEMENT 2: Lipase adds both sensitivity and specificity to the diagnosis of acute pancreatitis. * 1 is correct * 2 is correct * Both are correct * Both are incorrect
2 is correct
53
STATEMENT 1: Lipase elevation has greater magnitude and duration than amylase in acute pancreatitis. STATEMENT 2: Lipase is also increased in peptic ulcers, renal insufficiency, and intestinal obstruction. * 1 is correct * 2 is correct * Both are correct * Both are incorrect
Both are correct
54
STATEMENT 1: LD is 50-80 times more concentrated in RBC’s. STATEMENT 2: Hemolysis will increase the total LD but may not result on a flipped pattern, only AMI is associated with LD flipped pattern. * 1 is correct * 2 is correct * Both are correct * Both are incorrect
55
STATEMENT 1: Elevated 5’Nucleotidase and ALP are associated with liver damage. STATEMENT 2: 5’Nucleotidase is increased primarily in obstructive liver disease and liver cancer. * 1 is correct * 2 is correct * Both are correct * Both are incorrect
2 is correct
56
STATEMENT 1: Oliver-rosalski method for CK is based upon the formation of ATP from glucose-6-phosphate. STATEMENT 2: Glucose-6-phosphate is produced from phosphorylation of glucose by ATP, catalyzed by hexokinase enzyme. * 1 is correct * 2 is correct * Both are correct * Both are incorrect
2 is correct
57
Which of the following enzymes catalyzes the conversion of starch to glucose and maltose? * AMS * AST * CK * LD
AMS
58
STATEMENT 1: The liver disease produces elevated LD-4 and LD-5. STATEMENT 2: Levels of LDH are low (lower) in viral hepatitis * 1 is correct * 2 is correct * Both are correct * Both are incorrect
59
Which of the following substrates is used in Wrobleuski and La Due Method for the detection of LDH. * P-nitrophenyl phosphate * Oxaloacetate produced by transaminase during the reaction. * Lactate * Pyruvate
60
The differential enzyme test for ruling out hepatobiliary disorders from osteogenic disorders. * ALP * 5’Nucleotidase * GGT * ACP
ALP
61
STATEMENT 1: G-6-PD deficiency is the most common RBC enzyme deficiency and is X-linked. STATEMENT 2: The enzyme is measured in the serum using glucose-6-phosphate as substrate. * 1 is correct * 2 is correct * Both are correct * Both are incorrect
1 is correct
62
Which of the following have conditions that have decreased G-6-PD level * Hereditary predisposition of hemolytic crisis * Ingestion of drug such as primaquine * Diabetic ketoacidosis * All of the choices
All of the choices
63
The isoenzyme of amylase that is synthesized by acinar cells of the pancreas and that remains elevated in most individuals for at least one week after the onset of pancreatitis is. * S-amylase * Macro-amylase * P-amylase * G-amylase
P-amylase
64
STATEMENT 1: Acid phosphatase can be used in the investigation of sexual assault. STATEMENT 2: ACP activity >50 IU/L establishes the presence of seminal fluid in the vaginal sample. * 1 is correct * 2 is correct * Both are correct * Both are incorrect
Both are correct
65
Which of the following describes the LDH Flipped Pattern * LD-1 > LD-3 * LD-1 > LD-2 * LD-3 < LD-4 * LD-2 < LD-4
LD-1 > LD-2
66
The most sensitive enzymatic indicator for liver damage from ethanol is * ALT * AST * GGT * ALP
GGT
67
Interpretation of and sources of interference in serum enzyme analysis should consider that a significant source of _________ is found in RBCs. * AST * ALT * GGT * CK
AST
68
STATEMENT 1: Hemolysis can cause interference to AST testing. STATEMENT 2: AST can be 5-10 times elevated after AMI, but elevation to this range is also seen in muscular dystrophy, crush injury, and pulmonary embolism. * 1 is correct * 2 is correct * Both are correct * Both are incorrect
Both are correct

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