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CCHM 2 > LEC2 - Enzymes of Clinical Significance > Flashcards

LEC2 - Enzymes of Clinical Significance Flashcards

1
Q

Characterized by its ability to hydrolyze a large variety of organic phosphate esters with the formation of an alcohol and a phosphate
ion

A

Phosphatases

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2
Q

alkaline phosphatase whole name

A

Alkaline Orthophosphoric Monoester
Phosphohydrolase

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3
Q

2 clinically significant enzyme under phosphatases

A

alp and acp

alkaline phosphatase
and acid phosphatase

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4
Q

Alkaline Phosphatase reference value

A

Reference Value: 30-90 ul

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5
Q

Alkaline Phosphatase optimal pH

A

8.6-10 pH

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6
Q

acid phosphatase optimal pH

A

3-5 pH

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7
Q

class of phosphatases

A

class 3

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8
Q

is an enzyme involved in the cleavage of phosphate-containing compounds in alkaline pH.

A

Alkaline Phosphatase (EC 3.1.3.1) or ALP

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9
Q

It facilitates movement of substances
across cell membranes

A

Alkaline Phosphatase (EC 3.1.3.1) or ALP

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10
Q

in healthy serum, ALP mendles and usually derived from which organs

A

liver and bone

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11
Q

Alkaline Phosphatase (EC 3.1.3.1) or ALP

Several isoenzymes exist which include

A
  • Placental isoenzyme
  • Intestinal isoenzyme
  • Liver isoenzyme
  • Bone isoenzymes.
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12
Q

Placental isoenzyme is peak at what week of pregnancy

A

16th to 20th week of normal pregnancy

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13
Q

Alkaline Phosphatase isoenzyme which can be used to determine any abnormalities in the placenta

A

Placental isoenzyme

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14
Q

Placental isoenzyme are can be seen as well in people with what blood group

A

blood A or AB in low levels only

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15
Q

Intestinal isoenzyme

it increases after consuming fatty meal within ___

A

2-3 hrs

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16
Q

Intestinal isoenzyme

it increases after consuming fatty meal within 2-3 hrs, specially for what group

A

type B or O blood group

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17
Q

isoenzyme that is very helpful in detection of post hepatic and liver disease

A

Liver isoenzyme

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18
Q

ALP isoenzyme that increases in osteoblastic activities

A

Bone isoenzymes

in children, elevated as they are still growing
in older peeps, elevated as the bones are damaged causing the leaked in the blood

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19
Q

how to differentiate the alp isoenzymes from each other

A

electrophoresis
heat fractionation

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20
Q

in heat fractionation, isoenzymes are can be denatured above what temp

A

60*C

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21
Q

Liver ALP is inhibited by

A

Levamisole

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22
Q

is the iso enzyme of alp that is the most heat labile

A

Bone ALP

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23
Q

chemical inhibition test that inhibits the bone amp

A

Urea
Levamisole

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24
Q

is the iso enzyme of alp that is the most heat stable

A

Placental ALP

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25
Q

chemical inhibition test that inhibits the placental alp

A

Phenylalanine Rgt

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26
Q

Phenylalanine reagent will inhibit what enzymes

A

placental ALP
Intestinal ALP

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27
Q

Urea will inhibit which isoenzyme

A

bone

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28
Q

Levamisole will inhibit which ALPisoenzyme

A

liver and bone isoenzyme

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29
Q

why do Carcinoplacental ALP is called as Carcinoplacental ALP

A

present only in the presence of cancer or carcinoma, placental alp because it has the same chemical composition with placental alp but they are not the same

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30
Q

Carcinoplacental ALP types

A

Regan ALP
Nagao ALP
Kasahara ALP

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31
Q

Regan ALP is a carcinoplacental ALP that is found in

A

lung, breast, ovarian and gynecological cancers;

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32
Q

bone ALP co-migrator

A

regan - carcinoplacental ALP

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33
Q

the most heat stable carcinoplacental ALP

A

Regan ALP

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34
Q

Regan ALP (carcinoplacental ALP) is inhibited by

A

phenylalanine
reagent

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35
Q

Nagao ALP (carcinoplacental ALP ) is found in

A

adenocarcinoma of the pancreas and bile duct,

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36
Q

a carcinoplacental ALP that is can be seen in pleural cancer

A

Nagao ALP

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37
Q

variant of Regan ALP

A

Nagao ALP

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38
Q

Nagao ALP
(carcinoplacental alp) is inhibited by

A

L-leucine and phenylalanine

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39
Q

Kasahara ALP (carcioplancental ALP) is predominant in what condition

A

hepatoma/hepatocellular carcinoma

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40
Q

2 isoenzymes of liver sample

A

kasahara ALP as a tumor marker
liver isoenzyme for detection of post hepatic biliary disease

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41
Q

Methods of Determination of ALP

A

Bowers and Mc Comb(continuous-monitoring technique)

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42
Q

what is the constant level of pH of Bowers and Mc Comb for determining ALP

A

– pH 10.15 or alkaline

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43
Q

aside from the constant pH for determining ALP, what is the wavelength we can use to depending on the method used

A

405 nm

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44
Q

substrate of Bowers and Mc comb (continuous-monitoring technique)

A

p-nitrophenylphosphate

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45
Q

Bowers and Mc Comb

ALP will act on the substrate
p-nitrophenylphosphate resulting to products which are

A

p-nitrophenol + phosphate ion
(alcohol and inorganic phosphate)

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46
Q

the substrate recommended for ALP

A

p-nitrophenyl phosphate

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47
Q

methods that are using Beta-glycerophosphate as their substrate

A

bodansky
shinowara
jones
reinhart

48
Q

methods that are using Phenylphosphate as their substrate

A

King and Armstrong

49
Q

methods that are using Phenolphthalein
diphosphate as their substrate

A

huggins and talalay

50
Q

methods that are using Alpha-naphthol
phosphate as their substrate

A

moss

51
Q

methods that are using Buffered phenolphthalein
phosphate as their substrate

A

Klein, Babson and
Reid

52
Q

a method King and Armstrong and a substrate of Phenylphosphate has a product of

A

phenol

53
Q

Activators for ALP are ____

A

zinc, magnesium.
and other cations,

54
Q

In ALP determination, Chelators(such as _____) can falsely lower activity

A

EDTA, citrate, oxalate as they have the mechanism of binding

55
Q

Activity of enzyme ____ slightly on storage due
to loss of inhibitors.

A

increases

56
Q

ALP is relatively stable at____ for up to one week.

A

4 * C

57
Q

optimum pH of ALP

A

Optimum pH: 8.6-10

58
Q

Increased ALP is seen on the ff. conditions

A
  • Osteitis deformans/Paget’s disease
  • Osteomalacia
  • Rickets
  • Osteoblastic bone tumors
  • Bone Cancer
  • Sprue
  • Hyperparathyroidism
  • Obstructive jaundice
  • Hepatitis and cirrhosis
59
Q

most important activator for ALP is

A

magnesium

60
Q

most common causes of ALP elevations

A

liver and bone diseases

61
Q

Decreased ALP are seen in what cirmcumstances and conditions

A

After blood transfusions or cardiopulmonary bypass (transiently decrease)
Malnutrition
Hypophosphatemia (prolonged, severely low levels)
Zinc deficiency (prolonged, severely low levels.

62
Q

Acid Phosphatase is active at what pH

A

pH 5.0

63
Q

Diagnostic significance of acid phosphatase

A

detection of prostatic carcinoma

64
Q

Acid Phosphatase

major tissue sources

A

prostate

65
Q

other tissue source of acid phosphatase aside from prostate

A

rbc, platelet, and bone

66
Q

Reference values for ACP

A

2.5-11.7 (total ACP male)
0-3.5 ng/mL (prostatic ACP)

67
Q

is a hydrolytic enzyme secreted by a number of cells

A

Acid Phosphatase (EC 3.1.2.3) or ACP

68
Q

There are several isoenzymes of ACP, each with
tissue specificity. Isoenzymes may be fractionated
into how many bands

A

five bands

69
Q

the band 1 of ACP, its major source is the

A

prostate gland

70
Q

ACP Isoenzymes
* Band 1, is inhibited by

A

tartrate

71
Q

ACP isoenzymes

Band 2 and 4 isoenzymes are from ____.

A

granulocytes

72
Q

ACP isoenzymes

Band 3 is the major form present in ___.

A

plasma

73
Q

This isoenzyme (band 3) is derived from ____.

A

platelets, erythrocytes, and monocytes

74
Q

Band 5 of ACP soenzyme is found mainly in ___.

A

osteoclasts

75
Q

the only resistant in tartrate inhibition among the 5 bands of ACP isoenzyme

A

band 5

76
Q

the method with highest specificity among the method of determination of ACP is the

A

Roy and Hillman

77
Q

Tartrate-inhibited ACP (Prostatic Isoenzyme)

disease associated

A
  • Prostatic Cancer
  • Benign prostatic hyperplasia
  • Prostatic infarction
  • Urinary tract obstruction, carcinoid tumors of the rectum, and prostatic massage
78
Q

___also has implications in suspected rape

A

ACP

79
Q

Positive ACP is
evident in vaginal swab if semen is present for the first ___ hrs to ___ days from
the incident

A

12 hours up to four days

80
Q

Tartrate-resistant ACP (Bone Isoenzyme)

disease correlation

A
  • Active osteoclast-mediated bone resorption
  • Gaucher’s cells
  • Hairy cell leukemia
81
Q

how to differentiate the prostatic and non prostatic acp

A

through Chemical Inhibition
Technique

82
Q

in Chemical Inhibition
Technique

prostatic acp is resistant in ___

A

copper

83
Q

in Chemical Inhibition
Technique

rbc acp is resistant in ___

A

tartrate

84
Q

Moderate elevation of Total ACP are seen in what conditions

A
  • Female Breast CA
  • Paget’s disease
  • Hyperparathyrodism
85
Q

Non-prostatic ACP elevations

A
  • Neimann-Pick disease
  • Gaucher’s disease
  • Myelocytic leukemia
86
Q

Catalyzes the transfer of an amino group of one amino acid to a
hydrocarbon to form a different amino acid

A

Aminotransferases

87
Q

Aminotransferases are of two

A
  • Aspartate Aminotransferase (EC 2.6.1.1) or AST
  • Alanine Aminotransferase (EC 2.6.1.2) or ALT
88
Q

Cofactor of aminotrasnferase

A

vitamin b6 or pyridoxal-S’-phosphate or P-5’-P

89
Q

SGPT means

A

Serum Glutamate Pyruvate Transaminase i

90
Q

SGOT means

A

serum glutamic-oxaloacetic transaminase

91
Q
A
92
Q

The half-life of AST is __

A

17+- 5 hrs

93
Q

ALT has a half-life of

A

47 +- 10 hours

94
Q

AST is stable in serum at refrigerator
temperature for up to ____,

A

three weeks

95
Q

ALT has the same
stability but markedly decreases with ___.

A

freezing

96
Q

Specimens for AST and ALT are stable in whole
blood for up to 12 to 24 hours, but increase
with time due to release from red blood cells

tue or fa;se

A

true

97
Q

optimum ph of ast and alt

A

Optimum pH: 7.4

98
Q
  • Involved in the transfer of an amino group
    between aspartate and α-ketoacids with the
    formation of oxaloacetate and glutamate
A

AST (Aspartate
Aminotransferase)

99
Q

AST (Aspartate
Aminotransferase)

Has 2 isoenzymes fractions:

A

cytoplasm and
mitochondrial

100
Q

AST (Aspartate
Aminotransferase)

Major tissue source:

A

cardiac tissue, liver and skeletal muscles

101
Q

AST other sources

A

Other sources: kidney, pancreas and RBC

102
Q

ast ref values

A

Reference values: (5-37 U/L)

103
Q

method of determiation for AST

A
  • Karmen Method – pH 7.5; 340 nm
104
Q

Method of determination of AST

karmen method

Uses ___ and monitors the change in absorbance

A

malate dehydrogenase

105
Q

significance of (Increased
AST activity

In the evaluation of

A

myocardial infarction,
hepatocellular disorders and skeletal muscle
involvement

106
Q

MI AST level is usually ___ times the upper
limit of normal

A

4-10

107
Q

Clinical
Significance
(Decreased AST
activity)

  • Decreased level is seen during
    ___
A

pregnancy

108
Q

ALT (Alanine
aminotransferase)

highest concentration is in

A

liver

109
Q

Other sources of ALT

A

kidney, pancreas,
RBC, heart, skeletal muscles,
lungs

110
Q

ALT (Alanine
aminotransferase ref range

A

Reference Values: 6-37 U/L

111
Q

Method of determination of ALT

A

Coupled Enzymatic reaction: pH 7.5; 340 nm
Reitman-Frankel Method

112
Q

Aminotransferase activity measurement
is done by coupled enzymatic reactions,
using ___ as the final reaction product

A

NADH

113
Q

Reagents with NH4 will give falsely
__ ALT and AST owing to the
conversion of NADH to NAD by the
ammonium ion

A

increased

114
Q

+++recommended that
methods should include P-5’-P in the
reagent

A

International Federation of Clinical
Chemistry (IFCC)

115
Q

Diagnosis of acute or chronic viral
hepatitis  ALT increases to a
greater degree than AST

tru or false

A

true

116
Q

Aminotransferase levels
are altered in

A
  • Hepatocyte injury (increase in AST, and ALT but to a lesser degree)
  • Muscle injury (increase in both enzymes)
  • Kidney infarcts (increase in both enzymes)
  • Renal failure (falsely lowered)

CCHM 2 (7 decks)

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