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CLINICAL CHEMISTRY 2 > [LAB] AST & ALT > Flashcards

[LAB] AST & ALT Flashcards

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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
Q

REACTION PRINCIPLE OF AST

A

L-aspartate + a-ketoglutarate —AST—> oxaloacetate + glutamate
oxaloacetate + NADH + H —MDH—> malate + NAD

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26
Q

REACTION PRINCIPLE OF ALT

A

L-alanine + a-ketoglutarate —ALT—> oxaloacetate + pyruvate
pyruvate + NADH + H —LDH—> lactate + NAD

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27
Q

FORMER NAME OF AST

A

SGOT
Serum Glutamic Oxaloacetate Transferase

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28
Q

FORMER NAME OF ALT

A

SGPT
Serum Glutamic Pyruvic Transferase

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29
Q

MAIN TISSUE SOURCE OF AST

A

HEART
LIVER
SKELETAL MUSCLES

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30
Q

MINOR SOURCES OF AST

A

KIDNEYS
SPLEEN
RBC
PANCREAS
LUNGS

TIP: Where does blood go/flow?

31
Q

MAJOR TISSUE SOURCE OF ALT

A

LIVER**
KIDNEYS

32
Q

MINOR TISSUE SOURCE OF ALT

A

HEART
SKELETAL MUSCLES

33
Q

CLINICAL CONDITION IF AST REMAINS NORMAL BUT ALT INCREASES

A

ALT ↔️
AST ⬆️

MYOCARDIAL INFARCTION

34
Q

CLINICAL SIGNIFICANCE OF AST

A
  • Verify course of hepatic diseases
  • Monitor patients with myocardial infarction, skeletal muscle disease
35
Q

ABSORBANCE TREND OF AST/ALT

A

DECREASING

36
Q

CLINICAL SIGNIFICANCE OF ALT

A
  • Monitor or help diagnose hepatic diseases (ex.: hepatitis, hepatic obstructions)
  • Diagnose myocardial infarction (in conjunction with AST)
37
Q

ULN REACHED TO STOP MEDICATIONS

A

3x ULN

38
Q

AMOUNT OF ABSORBANCES RECORDED

A

4

39
Q

FACTORS THAT CAUSE FALSE ELEVATIONS

A
  1. Hemolyzed samples
  2. Lipemic or icteric samples
  3. Pyridoxal phosphate (Coenzyme of AST & ALT btw)
  4. Pyruvate
  5. Drugs
40
Q

DRUGS THAT CAUSE FALSE ELEVATIONS

A
  1. Anabolic steroids
  2. Chloramphenicol
  3. Antacids
41
Q

ISOENZYMES OF AST

A
  1. Cytoplasmic
  2. Mitochondrial
42
Q

ASSAY METHODS USED IN BOTH AST AND ALT

A
  1. Reitman - Frankel
  2. Babson
  3. Chemiluminesence
43
Q

HALF LIFE OF AST

A

24 hours

44
Q

HALF LIFE OF ALT

A

16 Hours

45
Q

AMOUNT OF Hb THAT CAUSES INTERFERENCE

A

Hb > 45 mg/dL

46
Q

AMOUNT OF BILIRUBIN AND TRIGLYCERIDES THAT CAUSE INTERFERENCE

A

Bilirubin > 19 mg/dL
Triglycerides > 650 mg/dL

47
Q

DO ANTICOAGULANTS AFFECT AST/ALT ACTIVITY?

A

NO — Which is why plasma can be used.

48
Q

WHY IS LDH INCLUDED IN AST REAGENTS?

A

To convert pyruvate to lactate.
Pyruvate intensifies AST activity.

49
Q

WHAT DOES PYRIDOXAL PHOSPHATE ACTIVATE

A

THE APOENZYME FORM OF TRANSAMINASE

50
Q

SOURCE OF PYRIDOXAL PHOSPHATE IN ASSAYS

A

WATER CONTAMINATED WITH MICROBIAL GROWTH

51
Q

AMOUNT OF PYRUVATE THAT CAUSES INTERFERENCES IN ALT ASSAYS

A

Pyruvate > 0.2 mmol/L

52
Q

ELEVATION PERIODS OF AST IN ANGINA PECTORIS

A

Rise — 6-8 hrs
Peak — 24 hrs
Return — 3-5 days or Within 5 days

53
Q

[Assay] OPTIMAL PH IS 7.3 TO 7.8

A

KARMEN METHOD
REITMAN - FRANKEL

54
Q

[Assay] ALT ASSAY METHOD RECOMMENDED BY THE IFCC

A

KARMEN METHOD

55
Q

[Assay] REACTS WITH 2,4 DINITROPHENYLHYDRAZONE

A

REITMAN-FRANKEL

56
Q

[Assay] COLORED COMPOUND OF REITMAN-FRANKEL

A

BLUE

57
Q

[Assay] WAVELENGTH OF REITMAN-FRANKEL

A

550 nm

58
Q

[Assay] DISADVANTAGE OF REITMAN-FRANKEL

A

NON-SPECIFIC
Can react with any ketoacid

59
Q

[Assay] USES DIAZONIUM SALT WITH OXALOACETIC ACID

A

BABSON
REACTION WITH DIAZONIUM SALT

60
Q

[Assay] ADVANTAGE OF BABSON

A

SPECIFIC AND SENSITIVE
Lesser need for reagent blank

61
Q

[Assay] COLORED COMPOUND OF BABSON

A

RED

62
Q

[Assay] ADVANTAGE OF CHEMILUMINESENCE

A

SENSITIVE
Low background signal level
Wide angle of concentration

63
Q

[Assay] DISADVANTAGE OF CHEMILUMINESENCE

A

INHIBITORS
1. Superoxide dismutase
2. N-nitro-Larginine-methyl ester hydrochloride

64
Q

[Assay] SIDE REACTIONS MONITORED/ DIRECT DETECTIONS MADE BY CHROMATOGRAPHY

A
  1. Xanthine
  2. Glutamate
65
Q

[Assay] CONCENTRATION OF AST AND GLUTAMATE IN CHROMATOGRAPHY

A

AST — 0.1 UI-L
GLUTAMATE — 5 UI-L

66
Q

[Assay] METHOD THAT CAN IDENTIFY ALL COMPONENTS IN THE REACTION

A

CHROMATOGRAPHY

67
Q

[Assay] SEPARATION OF AST ISOENZYMES

A

ELECTROPHORESIS

68
Q

[Assay] AST ISOENZYME CHARGES

A

Cytoplasmic — anionic
Mitochondrial — cationic

69
Q

[Assay] PRINCIPLE OF IMMUNOPRECIPITATION IN AST

A

Using antibodies against both mitochondrial and cytoplasmic fraction

70
Q

[Assay] ALT ASSAY METHOD RECOMMENDED BY THE IFCC

A

WROBLEWSKI AND LA DUE

71
Q

[Assay] OPTIMAL PH OF WROBLEWSKI AND LA DUE

A

pH 7.3 to 7.8

72
Q

[Assay] WAVELENGTH OF WROBLEWSKI AND LA DUE

A

340 nm

73
Q

[Assay] PRINCIPLE OF CHEMILUMINESENCE

A

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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