[LEC] Muscle Enzymes Flashcards
ENZYME CLASSIFICATION OF CK
TRANSFERASE
EC CODE OF CK
2.7.3.2
RECOMMENDED NAME OF CK
CREATININE KINASE
SYSTEMATIC NAME OF CK
ATP: CREATINE N-PHOSPHOTRANSFERASE
ENZYME CLASSIFICATION OF LDH
OXIDOREDUCTASES
EC CODE OF LDH
1.1.1.27
SYSTEMATIC NAME OF LDH
L-LACTATE: NAD OXIDOREDUCTASE
RECOMMENDED NAME OF LDH
LACTATE DEHYDROGENASE
ENZYME CLASSIFICATION OF GP
TRANSFERASE
EC CODE OF GP
2.4.1.1
RECOMMENDED NAME OF GP
GLYCOGEN PHOSPHORYLASE
SYSTEMATIC NAME OF GP
1,4-a-D-GLUCAN: ORTHOPHOSPHATE GLUCOSYLTRANSFERASE
ENZYME CLASSIFICATION OF ALD
LYASES
EC CODE OF ALD
4.1.2.13
RECOMMENDED NAME OF ALD
ALDOLASE
SYSTEMATIC NAME OF ALD
D-D-FRUCTOSE-1, 6-BISDIPHOSPHATE D-GLYCERALDEHYDE-3-PHOSPHATE LYASE
WHAT ARE THE GP ISOENZYME FRACTIONS
GP LL — Liver and all other tissues except the heart, smooth muscles, and brain
GP MM — Adult skeletal muscle
GP BB — Brain
CLINICAL SIGNIFICANCES OF GP
EARLY DIAGNOSIS OF AMI
LIMITED SPECIFICITY (NOT ROUTINELY USED)
TISSUE SOURCES OF GP LL
LIVER AND ALLL OTHER TISSUES
EXCEPT
— HEART
— SKELETAL MUSCLE
— BRAIN
TISSUE SOURCES OF GP MM
ADULT SKELETAL MUSCLE
TISSUE SOURCES OF GP BB
BRAIN
ISOENZYME FRACTIONS OF ALD
ALD A — Skeletal muscle
ALD B — WBC, liver, kidney
ALD C — Brain tissue
IN WHAT CLINICAL CONDITIONS DOES ALD INCREASE IN
SKELETAL MUSCLE DISEASE
LEUKEMIA
HEMOLYTIC ANEMIA
HEPATIC CANCER
FUNCTION OF CK
CATALYZE THE PHOSPHORYLATION OF ADP BACK TO ATP
OPTIMUM PH OF CK’S FORWARD REACTION
pH 9
OPTIMUM PH OF CK’S REVERSE REACTION
pH 6.7
ACTIVATING ION OF CK
MAGNESIUM
WHAT DOES THE ACTIVATING ION OF CK COMPLEX WITH
MAGNESIUM COMPLEXES WITH PHOSPHOCREATINE
WHAT IS THE EFFECT OF TOO MUCH MAGNESIUM ON CK ACTIVITY
EXCESS MAGNESIUM BECOMES INHIBITORY
MAJOR TISSUE SOURCES OF CK
STRIATED MUSCLE
HEART MUSCLE
MINOR TISSUE SOURCES OF CK
BRAIN
GIT
URINARY BLADDER
TISSUES OR ORGANS THAT ARE DEVOID OF CK ACTIVITY
LIVER
RBCs
SUBUNITS OF CK
CK B
CK M
GENETIC LOCUS OF THE CK SUBUNITS
CK B — CHR 14
CK M — CHR 19
SIZE OF EACH CK SUBUNIT
40,000 DALTONS
3 PAIRS OF CK FRACTIONS
CK BB — Brain
CK MB — Hybrid
CK BB — Muscle
FASTEST CK ISOENZYME TO MOVE TOWARDS THE ANODE
CK BB
CK ISOENZYME THAT HAS THE INCREASES IN BRAIN DAMAGE
CK BB
DOES CK INCREASE IN LIVER DAMAGE
NO
THE LIVER IS DEVOID OF CK ACTIVITY
INHIBITORS OF CK ACTIVITY
MAGNESIUM (IN EXCESS)
ZINC
COPPER
IODOACETATE
MANGANESE
OTHER SULFHYDRYL BINDING REAGENT
EFFECT OF SULFHYDRYL BINDING REAGENTS ON CK
CK BECOMES UNSTABLE IN SERUM
CK LOSES ACTIVITY
INHIBITOR THAT IS USED TO PARTIALLY RESTORE THE ACTIVITY OF CK
SULFHYDRYL BINDING REAGENTS
N-ACETYL CYSTEINE
DIOTHRIETOL
GLUTATHIONE
TRUE OR FALSE
SULFHYDRYL BINDING REAGENTS ARE ABLE TO FULLY RESTORE CK ACTIVITY WHEN IT IS LOST
FALSE
PARTIALLY RESTORE
IN WHAT CLINICAL CONDITIONS DOES TOTAL CK INCREASE
INJURY
INFLAMMATION
NECROSIS OF THE SKELETAL OR HEART MUSCLE
OTHER NAME OF CK BB
CK 1
BRAIN TYPE
SIZE OF CK BB
80,000 DALTONS
CK ISOENZYME THAT IS NOT NORMALLY PRESENT IN A HEALTHY PATIENT’S SERA
CK BB
CK 1
BRAIN TYPE
CK ISOENZYME THAT IS A TUMOR-ASSOCIATED MARKER
CK BB
CK 1
BRAIN TYPE
CONDITIONS IN WHICH CK BB CAN BE USED AS A TUMOR ASSOCIATED MARKER
PROSTATIC CARCINOMA
ADENOCARCINOMA
CK ISOENZYME THAT HAS THE SHORTEST HALFLIFE
CK BB
2-3 HOURS IN SERUM
HALF LIFE OF CK BB
2-3 HOURS
IN SERUM
CK ISOENZYME HIGHLY LOCALIZED IN THE BRAIN TISSUE
CK BB
CK 1
BRAIN TYPE
CK ISOENZYME FOUND IN THE BLADDER, LUNGS, PROSTATE, UTERUS, COLON, STOMACH, THYROID
CK BB
CK 1
BRAIN TYPE
IN WHAT OTHER ORGANS CAN CK BB BE FOUND IN SMALLER CONCENTRATIONS
BLADDER
PROSTATE
UTERUS
LUNGS
THYROID
COLON
STOMACH
IN WHAT OTHER ORGANS CAN CK BB BE FOUND IN HIGHER CONCENTRATIONS
CNS
GIT
UTERUS (DURING PRENANCY)
OTHER NAMES FOR CK MB
CK 2
HYBRID
PREDOMINANT TISSUE SOURCE OF CK MB
MYOCARDIUM TISSUE
20% OF TOTAL CK ACTIVITY
WHAT CK ISOENZYME IS PREDOMINANTLY FOUND IN THE MYOCARDIUM TISSUE
CK MB
CK 2
HYBRID
IN THE ABSENCE OF CK IN AMI
WHAT PROTEIN CAN BE USED
TROPONIN
HALF LIFE OF CK MB
ABOUT 12 HOURS
FIRST CK ISOENZYME TO RISE AT THE ONSET OF CHEST PAIN
CK MB
VOLUME AT WHICH CK MB IS NORMALLY PRESENT IN SERUM
<5 ug/dL
OTHER NAMES FOR CK MM
CK 3
MUSCLE
MAJOR ISOENZYME IN THE SERA OF HEALTHY PEOPLE
CK MM
CK 3
MUSCLE
PERCENTAGE OF CK MM IN NORMAL SERUM
94-100%
CK ISOENZYME WITH THE LONGEST HALFLIFE
CK MM
15 HOURS
TRUE OR FALSE
CK MM HAS THE SHORTEST HALF LIFE
CK BB HAS THE LONGEST HALF LIFE
CK MM IS ABUNDANT IN WHAT TISSUES
HEART MUSCLE
SKELETAL MUSCLE
MILD PHYSICAL ACTIVITY CAUSES WHAT CK ISOENZYME TO INCREASE
CK MM
CK 3
MUSCLE
IN HEART AND SKELETAL MUSCLES, WHAT CK ISOENZYME IS ABUNDANTLY PRESENT
CK MM
CK 3
MUSCLE
ATYPICAL FORMS OF CK
CK MT OR CK MI
MACRO CK
OTHER NAMES FOR CK MT
CK MI
MITOCHONDRIAL
WHERE IS CK MI PRESENT
IN BETWEEN THE INNER AND OUTER MEMBRANES OF THE MITOCHONDRIA
ATYPICAL ISOENYZME THAT MAKES UP 15% OF TOTAL CK ACTIVITY
CK MI
GENETIC LOCUS OF CK MI
CHR 15
THE CK ISOENZYME WHOSE GENETIC LOCUS IS CHROMOSOME 15
CK MI
WHAT IS THE MIDDLE FORM OF CK MM AND CK MB
MACRO CK
TYPE 1 MACRO CK
BB + IgG
TYPE 2 MACRO CK
MM + LIPOPROTEIN
OTHER FORMS OF MACRO CK
TYPE 1 — BB +IgG
TYPE 2 — MM + LIPOPROTEIN
TYPE OF CK ISOENZYME COMPLEXED WITH AN IMMUNOGLOBULIN
MACRO CK TYPE 1
BB + IGG
TYPE OF CK ISOENZYME COMPLEXED WITH A LIPOPROTEIN
MACRO CK
TYPE 2
MM + LIPOPROTEIN
WHAT CK ISOENZYME CAUSES FALSE ELEVATION DUE TO ITS COMPLEX WITH OTHER MOLECULES
MACRO CK
CHEMICAL REACTION OF LDH
LACTATE + NAD <—LD—> PYRUVATE + NADH + H
MOLECULAR WEIGHT OF LD’S PEPTIDE CHAINS
134 KILODALTONS
ISOENZYMES OF LDH
LD M
LD H
GENETIC LOCI OF LD ISOENZYMES
LD M — CHR 11
LD H — CHR 12
5 ISOENZYME FRACTIONS
LD 1
LD 2
LD 3
LD 4
LD 5
LDH ISOENZYMES AND THEIR PERCENTAGES OF TOTAL LDH
LD 1 — 29-37%
DL 2 — 42-48%
LD 3 — 16-20%
LD 4 — 2-4%
LD 5 — 0.5-1.5%
6TH LD ISOENZYME
LD X
LD C
XXXX
CCCC
SUBUNITS OF LD X/C
XXXX
CCCC
LD ISOENZYME FRACTION THAT IS PRESENT DURING POST PUBERTAL HUMAN TESTES
LD X
LD C
MAJOR TISSUE SOURCE OF LD 1 AND 2
HEART
KIDNEYS
ERYTHROCYTES
WHAT LD ISOENZYMES ARE PREDOMINANTLY FOUND IN THE
HEART, KIDNEYS, AND ERYTHROCYTES
LD 1
LD2 2
MOST ABUNDANT AMONG ALL LD ISOENZYME FRACTIONS
LD 2
MOST HEAT STABLE LD ISOENZYME
LD 2
LD ISOENZYME WITH INTERMEDIATE MOTILITY
LD 3
MAJOR TISSUE SOURCES OF LD 3
LUNGS
SPLEEN
PANCREAS
LYMPHOCYTES
PLATELETS
LD ISOENZYME THAT IS PREDOMINANTLY PRESENT IN THE
SPLEEN, LUNGS, PANCREAS, LYMPHOCYTES, PLATELETS
LD 3
LD ISOENZYMES THAT ARE CATHODAL IN MOBILITY
LD 4
LD 5
MOST COLD LABILE LD ISOENZYMES
LD 5
AT WHAT TEMPERATURE DOES LD LOSE ACTIVITY AND WHICH ISOENZYME IS PRONE TO THIS
4-5C
LD 4
LD 5
SEVENTH LD ISOENZYME
LD 6
LD ISOENZYME PRESENT IN PATIENTS WITH ATHEROSCLEROTIC CARDIOVASCULAR FAILURE
LD 6
WHAT MIGRATES IN BETWEEN LD 4 AND LD 5
LD 6
ILLUSTRATE THE CATHODAL AND ANODAL MIGRATIONS OF THE LD ISOENZYMES
CATHODE — LD4 -LD6- LD5
2M — LD3
ANODE — LD2 LD1
ILLUSTRATE THE CATHODAL AND ANODAL MIGRATION THE CK ISOENZYMES
CATHODE — MI : MM - MACRO - MB - BB — ANODE
RECALL:
BB — FASTEST
MM — SLOWEST
MACRO — IN BETWEEN MM AND MB
MI — DOESN’T MOVE
CLINICAL CONDITIONS WHERE LDH IS INCREASED
MYOCARDIAL INFARCTION
HEPATITIS
HEMOLYSIS
LUNG AND MUSCLE DISORDERS
WHAT CLINICAL CONDITION OBSERVES THE HIGHEST INCREASE CONCENTRATION OF LD
HEMOLYTIC ANEMIA — MEGALOBLASTIC ANEMIA — PERNICIOUS ANEMIA
UP TO 50X ULN
CAUSE OF PERNICIOUS/MEGALOBLASTIC ANEMIA
DEFICIENCY OF FOLATE OR VITAMIN B12
IN WHAT CLINICAL CONDITION IS LDH USED TO MONITOR ITS DISEASE ACTIVITY
LEUKEMIA
ENZYME USED TO MONITOR THE DISEASE ACTIVITY OF LEUKEMIA AND NON HODGKINS LYMPHOMA
LD
HEMOLYTIC ANEMIA OBSERVES A CONCENTRATION OF UP TO 50X ULN OF THIS ENZYME
LDH
MARKED ELEVATION OF LDH IS OBSERVED IN THESE CLINICAL CONDITIONS
HEPATIC AND NON HEPATIC METASTASIS
INCREASE OF THIS LD ISOENZYME IN GERM CELL TUMOR
LD 1
ATYPICAL FORM OF LDH
MACRO LD
LDH +IgG and IgA
NORMAL ID FLIPPED PATTERN OF LD
LD1 > LD2
ABNORMAL RATIO OF LDH’S ID FLIPPED PATTER
LD1:LD2 > 1
SEEN IN AMI