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CLINICAL CHEMISTRY 2 > [LAB] TOTAL CK, CK-MB > Flashcards

[LAB] TOTAL CK, CK-MB Flashcards

1
Q

REFERENCE METHOD OF TOTAL CK ASSAYS

A

KINETIC METHOD BY OLIVER-ROSALKI
MODIFIED BY SZASZ

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2
Q

FUNCTION OF CK

A

CATALYZING THE REVERSIBLE REACTION BETWEEN CREATININE AND ATP TO FORM CREATININE PHOSPHATE AND ADP

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3
Q

CK ACTIVITY IN ORGANSE
HIGHEST TO LOWEST ACTIVITY

A

SKELETAL MUSCLE, HEART, BRAIN

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4
Q

CLINICAL CONDITIONS CK IS USED TO AID IN DIAGNOSING

A

MUSCULAR DYSTROPHY
MYOCARDIAL INFARCTION
HYPOTHYROIDISM
RENAL DISEASES

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5
Q

BASIS OF THE EARLY PROCEDURE OF DETERMINING CK

A

RATE OF ATO FORMATION

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6
Q

SUBSTANCE ADDED BY NIELSON TO MODIFY THE EARLY CK DETERMINATION METHOD

A

ADDITION OF SULFHYDRYL COMPOUNDS AND AMP

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7
Q

EFFECT OF SULFHYDRYL COMPOUNDS AND AMP ON CK ACTIVITY IN ASSAY

A

ASSURE MAXIMUM CK ACTIVITY
DELAY ADENYLATE KINASE ACTIVITY

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8
Q

WHO PUBLISHED THE OPTIMIZED CONDITIONS FOR MEASURING CK

A

SZASZ IN 1976
SCANDINAVIAN COMMITTEE ON ENZYME

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9
Q

DIRECTION OF REACTION USED IN STANDARDIZED METHODS FOR CK DETERMINATION

A

REVERSE REACTION
ACTIVATION BY NAC

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10
Q

IFCC EXTENDED THE STANDARDIZED METHOD’S TEMPERATURE TO WHAT

A

37C

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11
Q

FORWARD REACTION OF CK

A

CREATINE PHOSPHATE + ADP —CK—> CREATINE + ATP

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12
Q

REVERSE REACTION OF CK

A

CREATINE + ATP —CK—> CREATINE PHOSPHATE + ADP

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13
Q

PH OF THE FORWARD REACTION OF CK

A

PH 9.0

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14
Q

PH OF THE REVERSE REACTION OF CK

A

PH 6.7

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15
Q

ACTIVATOR OF CK

A

MAGNESIUM

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16
Q

DIRECTION OF REACTION IN THE TANZER-GILBARG METHOD

A

DIRECT OR FORWARD

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17
Q

RELATIONSHIP BETWEEN THE RATE OF OXIDATION OF NADH AND CK ACTIVITY

A

DIRECTLY PROPORTIONAL

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18
Q

SPEED DIFFERENCES OF THE CK REACTION IN THE TANZER-GILBARG METHOD

A

REVERSE IS 5X FASTER THAN THE FORWARD REACTION

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19
Q

METHODS FOR THE SEPARATION AND QUANTITATION OF CK ISOENZYMES

A

ELECTROPHORESIS
IMMUNOASSAYS
COLUMN CHROMATOGRAPHY

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20
Q

ELECTROPHORETIC MIGRATION OF CK ISOENZYMES

A

CATHODE — MI : MM - MACRO - MB - BB — ANODE

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21
Q

IMMUNOASSAYS USED TO MEASURE CK-MB PROTEIN MASS

A

RADIO-IMMUNOASSAY
MONOCLONAL AB SPECIFIC FOR CK-MB

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22
Q

ASSOCIATIONS THAT CAN BE MADE WITH THE MEASUREMENT OF PROTEIN MASS

A

TYPE OF MYOCARDIAL INFARCTION
DEGREE OF DAMAGE

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23
Q

[DEGREE OF DAMAGE TO LEFT VENTRICLE]
[PROTEIN MASS VALUE]
SMALL MI

A

<10% DAMAGE
10-60 UG/L

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24
Q

[DEGREE OF DAMAGE TO LEFT VENTRICLE]
[PROTEIN MASS VALUE]
MEDIUM MI

A

10-30% DAMAGE
60-225 UG/L

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25
Q

[DEGREE OF DAMAGE TO LEFT VENTRICLE]
[PROTEIN MASS VALUE]
LARGE MI

A

> 30% DAMAGE
225 UG/L

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26
Q

REFERENCE VALUE OF CK IN IMMUNOASSAYS

A

UP TO 5 UG/L

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27
Q

[PRINCIPLE]
COLUMN CHROMATOGRAPHY

A

SEPARATION OF SUBSTANCES IN A COLUMN PACKED WITH AN ADSORBENT

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28
Q

FACTOR THAT AFFECTS THE MIGRATION OF SUBSTANCES IN COLUMN CHROMATOGRAPHY

A

AFFINITY OF EACH SUBSTANCE FOR THE ADSORBENT

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29
Q

SOLUTION INCORPORATED INTO THE COLUMN IN COLUMN CHROMATOGRAPHY

A

DIETHYL AMINO ETHYL EXCHANGE RESIN

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30
Q

PH USED IN COLUMN CHROMATOGRAPHY

A

PH 8.0

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31
Q

WHAT CHARGE BINDS THE GREATEST TO THE COLUMN

A

ISOENZYMES OF CK WITH A NET NEGATIVE CHARGE

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32
Q

SOLUTION USED TO ELITE OR REMOVE THE ISOENZYMES IN THE COLUM CHROMATOGRAPHY METHOD

A

SODIUM CHLORIDE

33
Q

ISOENZYMES SEPARATED IN THE COLUMN CHROMATOGRAPHY CAN BE ASSAYED WITH WHAT METHOD

A

ROSALKI METHOD

34
Q

DIRECTION OF REACTION IN THE FLUORESCENCE AND BIOLUMINESCENCE METHOD

35
Q

CREATINE FORMED IN THE F&B METHOD IS ESTIMATED FLUOROMETRICALLY AFTER THE ADDITION OF WHAT SOLUTION

36
Q

SOLUTION USED TO FOLLOW THE RATE OF ATO FORMATION AND UTILIZATION IN THE F&B METHOD

A

LUCIFERIN
LUCIFERASE

37
Q

IONS THAT INHIBIT CK ACTIVITY

A

EXCESS Mg, Cl, SULFATES

38
Q

EFFECT OF EXCESS MG, CL, CA, AND SULFATES ON CK ACTIVITY

A

FLASE DECREASE
These inhibit CK activity

39
Q

OTHER SUBSTANCES THAT INHIBIT CK ACTIVITY

A

IODOACETATE
ADP
CITRATE
FLUORIDE
L-THYROXINE

40
Q

STABILITY OF CK ACTIVITY IN SERUM SAMPLES

A

2 HOURS, RT
8-12 HOURS, 4C
2-3 DAYS, FROZEN

41
Q

EFFECT OF HEMOLYZED SAMPLES ON CK ACTIVITY

A

FALSE INCREASE
Side reactions due to AK, ATP, and G6PD

42
Q

MAIN SOURCE OF AK

A

ERYTHROCYTES
PLATELETS

SKELETAL MUSCLE
BRAIN
LIVER
HEART
KIDNEY
SMALL INTESTINES

43
Q

HOW DOES AK INTERFERE WITH CK ACTIVITY

A

AK CATALYZES THE DIRECT CONVERSION OF ADP TO ATP AND AMP

MORE ATP GENERATED INCREASES CK ACTIVITY

44
Q

IN WHAT SAMPLES ARE LOWER CK VALUES OBSERVED

A

SAMPLES WITH HIGH ALP ACTIVITY

45
Q

EFFECT OF LIGHT ON CK ACTIVITY

A

FALSE DECREASE
Light inactivates CK

46
Q

EFFECT OF LIPEMIC SAMPLES ON CK ACTIVITY

A

FALSE INCREASE
High Abs readings

47
Q

EFFECT OF INTRAMUSCULAR INJECTIONS ON CK ACTIVITY

A

FALSE INCREASE
Sedatives and analgesics are examples

48
Q

[CK ACTIVITY DIFFERENCE]
MEN VS. WOMEN

A

MEN HAVE HIGHER VALUES
Due to muscle mass

49
Q

[CK ACTIVITY DIFFERENCE]
NEWBORNS VS. ADULTS

A

NEWBORNS HAVE HIGHER VALUES
Due to skeletal muscle trauma during birth

50
Q

EFFECT OF RECENT EXERCISE ON SERUM CK

A

FALSE INCREASE
Due to muscle activity
CK-MB may be increased when skeletal activity is sustained

51
Q

FUNCTION OF MAGNESIUM

A

COFACTOR FOR THE MAXIMUM CATALYTIC ACTIVOTY OF THE ENZYME

52
Q

FUNCTION OF ADENOSINE 5 MONOPHOSPHATE

A

INHIBITS ADENYLATE KINASE ACTIVITY

53
Q

FUNCTION OF N-ACETYLCYSTEINE

A

PREVENTS OXIDATION OF SULFHYDRYL GROUP OF CK

54
Q

WHAT MUST CK HAVE TO BE ACTIVE

A

A REDUCED SULFHYDRYL GROUP
When it is oxidized, no enzyme activity may be observed

55
Q

FUNCTION OF EDTA

A

CHELATES CALCIUM
Ca inhibits CK activity

56
Q

EFFECT OF TEMPERATURE ON CK ACTIVITY

A

CK ACTIVITY INCREASES

57
Q

TEMPERATURES AT WHICH CK ACTIVITY ALTERS

A

Up to 45C — CK activity increases
> 45C — CK activity rapidly decreases
55C and above — CK activity is no longer detectable

58
Q

REFERENCE METHOD FOR CK-MB ASSAYS

A

IMMUNO-INHIBITION METHOD BY WURZBURG

59
Q

WHAT CK SUBUNIT INCREASES WHILE TOTAL CK REMAINS NORMAL

IN WHAT CLINICAL CONDITION DOES THIS OCCUR

A

CK-MB
MYOCARDIAL INFARCTION

60
Q

[PRINCIPLE]
IMMUNO-INHIBITION METHOD BY WURZBURG

A

MEASURMENT OF CK ACTIVITY IN THE PRESENCE OF AN AB TO CK-M MONOMER

61
Q

WHAT DOES THE AB TO CK-M MONOMER INHIBIT

A

INHIBITS CK-MB AND 1/2 OF CK-BB

62
Q

METHOD USED TO QUANITATIVELY DETERMINE CK-B ACTIVITY

A

CK METHOD BY ROSALKI

63
Q

RELATIONSHIP OF THE RATE OF NADH FORMATION AND CK-B ACTIVITY

A

DIRECTLY PROPORTIONAL

64
Q

HOW TO COMPUTE FOR CK-MB

A

MULTIPLY CK-B ACTIVITY BY 2

65
Q

[PRINCIPLE]
IMMUNOPRECIPITATION

A

ANTISERA AGAINST PURE CK-MM AND CK-BB IS USED TO QUANTITATE THE THREE CK ISOENZYMES

66
Q

RESULT OF CK-MM AND BB ISOENZYMES IN IMMUNOPRECIPITATION

A

COMPLETELY PRECIPITATED

67
Q

SUBSTANCE USED TO PRECIPITATE CK-MM AND BB

A

HOMOLOGOUS RABIT ANTISERA

68
Q

RESULT OF CK-MB ISOENZYMES IN IMMUNOPRECIPITATION

A

PARTIAL PRECIPITATION

69
Q

WHAT CK ISOENZYMES ARE NORMALLY PRESENT IN SERA OF HEALTHY PATIENTS

A

CK-MM
CK-MB

70
Q

EFFECT OF CK-BB ACTIVITY ON CK-MB VALUES

A

INCREASED
Overestimation of CK-MB values

71
Q

EFFECT OF MACRO-BB ACTIVITY ON CK-MB VALUES

A

INCREASE
Macro BB will be measured as B-subunit

72
Q

VALUE OF CK-B IF MACRO BB IS SUSPECTED

A

MORE THAN 20% OF TOTAL CK ACTIVITY

73
Q

TYPE OF CK-M ANTIBODY USED IN THE ASSAY

A

ANTI-HUMAN CK-M AB
GOAT

74
Q

AMOUNT OF CK-MM INHIBITED BY GOAT SERUM

A

UP TO 1500 IU/L OF CK-MM
37C

75
Q

AMOUNT OF CK-MM INHIBITED BY ANTI CK-MM AB OF JOCKERS WRETOU

A

100 % CK-MM
80% CK-MB

76
Q

SIMILAR PROPERTIES OF INHIBITION BY THE ANTI CK-MM AB OF JOCKERS-WRETOU WERE FOUND IN WHAT OTHER ANTISERUM

A

RABBIT SERUM BY MORIN

77
Q

[DISADVANTAGE]
USE OF MORIN’S RABBIT ANTISERA

A

RESIDUAL ACTIVITY IN THE SAMPLE AFTER ADDITION OF THE ANTISERUM IS TOO LOW

78
Q

[ADVANTAGE]
USENOF ANTI HUMAN CK-M AB
GOAT ANTISERA

A

INHIBITS CK-MM TO 100% AND CK-MB TO 50+/55%

CLINICAL CHEMISTRY 2 (10 decks)

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