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[LAB] AST & ALT Flashcards

1
Q

EC CODE OF AST

A

2.6.1.1

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2
Q

EC CODE OF ALT

A

2.6.1.2

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3
Q

NORMAL VALUES OF AST

A

30C — Up to 28
37C — Up to 40

QUICK:
28–30
40–37

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4
Q

MULTIPLIER OF AST and ALT

A

x 1768

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5
Q

SI CONVERSION FACTOR OF AST AND ALT

A

x 16.67

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6
Q

CONC. OF 2-OXOGLUTARATE IN AST REAGENT

A

0.12 mM

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7
Q

CONC. OF 2-KETOGLUTARATE IN ALT REAGENT

A

0.13 mM

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8
Q

CONC. OF L-ASPARTATE IN AST REAGENT

A

200 mM

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9
Q

CONC. OF L-ALANINE IN ALT REAGENT

A

400 mM

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10
Q

CONC. OF LDH AND MDH IN AST REAGENT

A

LDH — 800 mM
MDH — 600 mM

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11
Q

DETECTION LIMIT/ LINEARITY OF AST AND ALT

A

Up to 500 IU/L

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12
Q

TROUBLESHOOTING SAMPLES WITH VALUES HIGHER THAN THE LINEARITY

A
  1. Dilute with 1:1 Saline Solution
  2. Re-assay
  3. Multiply results by 2
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13
Q

STORAGE CONDITION OF DRY REAGENTS OF AST AND ALT

A

Store at 2-8C

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14
Q

STABILITY OF RECONSTITUTED REAGENTS

A

Stable for 8 hours at RT (15-30C)
OR
21 days when refrigerated immediately

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15
Q

STABILITY OF SPECIMEN

A

Stable at 4C for a minimum of 7 days

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16
Q

ALT ACTIVITY IN HEMOLYZED SERUM

A

7x ALT ACTIVITY

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17
Q

AST ACTIVITY IN HEMOLYZED SERUM

A

15x AST ACTIVITY

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18
Q

NORMAL VALUES OF ALT

A

30C — Up to 26 IU/L
37C — Up to 38 IU/L

QUICK
26 — 30
38 — 37

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19
Q

RECONSTITUTE DRY REAGENT WITH __ mL of ___

A

12 mL of Distilled Water

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20
Q

WAVELENGTH OF AST AND ALT ASSAYS

A

340 nm

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21
Q

BLANK SOLUTION COMPOSITION

A

1.0 mL of Distilled Water

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22
Q

SAMPLE SOLUTION COMPOSITION

A

1.0 mL Reagent
0.1 mL Patient’s Sample

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23
Q

AST/ALT INCUBATION TEMPERATURE AND PERIOD

A

37C for 3 minutes

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24
Q

AST/ALT INCUBATION TEMPERATURE AND PERIOD IN BETWEEN READINGS

A

37C for 1 minute

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25
REACTION PRINCIPLE OF AST
L-aspartate + a-ketoglutarate —AST—> oxaloacetate + glutamate oxaloacetate + NADH + H —MDH—> malate + NAD
26
REACTION PRINCIPLE OF ALT
L-alanine + a-ketoglutarate —ALT—> oxaloacetate + pyruvate pyruvate + NADH + H —LDH—> lactate + NAD
27
FORMER NAME OF AST
SGOT Serum Glutamic Oxaloacetate Transferase
28
FORMER NAME OF ALT
SGPT Serum Glutamic Pyruvic Transferase
29
MAIN TISSUE SOURCE OF AST
HEART LIVER SKELETAL MUSCLES
30
MINOR SOURCES OF AST
KIDNEYS SPLEEN RBC PANCREAS LUNGS TIP: Where does blood go/flow?
31
MAJOR TISSUE SOURCE OF ALT
LIVER** KIDNEYS
32
MINOR TISSUE SOURCE OF ALT
HEART SKELETAL MUSCLES
33
CLINICAL CONDITION IF AST REMAINS NORMAL BUT ALT INCREASES
ALT ↔️ AST ⬆️ MYOCARDIAL INFARCTION
34
CLINICAL SIGNIFICANCE OF AST
- Verify course of hepatic diseases - Monitor patients with myocardial infarction, skeletal muscle disease
35
ABSORBANCE TREND OF AST/ALT
DECREASING
36
CLINICAL SIGNIFICANCE OF ALT
- Monitor or help diagnose hepatic diseases (ex.: hepatitis, hepatic obstructions) - Diagnose myocardial infarction (in conjunction with AST)
37
ULN REACHED TO STOP MEDICATIONS
3x ULN
38
AMOUNT OF ABSORBANCES RECORDED
4
39
FACTORS THAT CAUSE FALSE ELEVATIONS
1. Hemolyzed samples 2. Lipemic or icteric samples 3. Pyridoxal phosphate (Coenzyme of AST & ALT btw) 4. Pyruvate 5. Drugs
40
DRUGS THAT CAUSE FALSE ELEVATIONS
1. Anabolic steroids 2. Chloramphenicol 3. Antacids
41
ISOENZYMES OF AST
1. Cytoplasmic 2. Mitochondrial
42
ASSAY METHODS USED IN BOTH AST AND ALT
1. Reitman - Frankel 2. Babson 3. Chemiluminesence
43
HALF LIFE OF AST
24 hours
44
HALF LIFE OF ALT
16 Hours
45
AMOUNT OF Hb THAT CAUSES INTERFERENCE
Hb > 45 mg/dL
46
AMOUNT OF BILIRUBIN AND TRIGLYCERIDES THAT CAUSE INTERFERENCE
Bilirubin > 19 mg/dL Triglycerides > 650 mg/dL
47
DO ANTICOAGULANTS AFFECT AST/ALT ACTIVITY?
NO — Which is why plasma can be used.
48
WHY IS LDH INCLUDED IN AST REAGENTS?
To convert pyruvate to lactate. Pyruvate intensifies AST activity.
49
WHAT DOES PYRIDOXAL PHOSPHATE ACTIVATE
THE APOENZYME FORM OF TRANSAMINASE
50
SOURCE OF PYRIDOXAL PHOSPHATE IN ASSAYS
WATER CONTAMINATED WITH MICROBIAL GROWTH
51
AMOUNT OF PYRUVATE THAT CAUSES INTERFERENCES IN ALT ASSAYS
Pyruvate > 0.2 mmol/L
52
ELEVATION PERIODS OF AST IN ANGINA PECTORIS
Rise — 6-8 hrs Peak — 24 hrs Return — 3-5 days or Within 5 days
53
[Assay] OPTIMAL PH IS 7.3 TO 7.8
KARMEN METHOD REITMAN - FRANKEL
54
[Assay] ALT ASSAY METHOD RECOMMENDED BY THE IFCC
KARMEN METHOD
55
[Assay] REACTS WITH 2,4 DINITROPHENYLHYDRAZONE
REITMAN-FRANKEL
56
[Assay] COLORED COMPOUND OF REITMAN-FRANKEL
BLUE
57
[Assay] WAVELENGTH OF REITMAN-FRANKEL
550 nm
58
[Assay] DISADVANTAGE OF REITMAN-FRANKEL
NON-SPECIFIC Can react with any ketoacid
59
[Assay] USES DIAZONIUM SALT WITH OXALOACETIC ACID
BABSON REACTION WITH DIAZONIUM SALT
60
[Assay] ADVANTAGE OF BABSON
SPECIFIC AND SENSITIVE Lesser need for reagent blank
61
[Assay] COLORED COMPOUND OF BABSON
RED
62
[Assay] ADVANTAGE OF CHEMILUMINESENCE
SENSITIVE Low background signal level Wide angle of concentration
63
[Assay] DISADVANTAGE OF CHEMILUMINESENCE
INHIBITORS 1. Superoxide dismutase 2. N-nitro-Larginine-methyl ester hydrochloride
64
[Assay] SIDE REACTIONS MONITORED/ DIRECT DETECTIONS MADE BY CHROMATOGRAPHY
1. Xanthine 2. Glutamate
65
[Assay] CONCENTRATION OF AST AND GLUTAMATE IN CHROMATOGRAPHY
AST — 0.1 UI-L GLUTAMATE — 5 UI-L
66
[Assay] METHOD THAT CAN IDENTIFY ALL COMPONENTS IN THE REACTION
CHROMATOGRAPHY
67
[Assay] SEPARATION OF AST ISOENZYMES
ELECTROPHORESIS
68
[Assay] AST ISOENZYME CHARGES
Cytoplasmic — anionic Mitochondrial — cationic
69
[Assay] PRINCIPLE OF IMMUNOPRECIPITATION IN AST
Using antibodies against both mitochondrial and cytoplasmic fraction
70
[Assay] ALT ASSAY METHOD RECOMMENDED BY THE IFCC
WROBLEWSKI AND LA DUE
71
[Assay] OPTIMAL PH OF WROBLEWSKI AND LA DUE
pH 7.3 to 7.8
72
[Assay] WAVELENGTH OF WROBLEWSKI AND LA DUE
340 nm
73
[Assay] PRINCIPLE OF CHEMILUMINESENCE
2H202+ luminol + 20H -> 4H20 + N2+ 3-aminophthalate + hu BASTA — oxidation of luminol by hydrogen peroxide creates chemiluminesence

CLINICAL CHEMISTRY 2 (10 decks)

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