LEC3 - ENZYME 3 Flashcards
it catalyzes the breakdown of starch and glycogen
amylase
important enzyme in the physiologic digestion of starch
amylase
calcium-containing enzyme
amylase
smallest enzyme in size and can be filtered by the renal glomeruli and normally appears in the urine
amylase
earliest pancreatic marker
amylase
are the major enzyme of amylase present in normal and healthy individuals?
yes
what are the major isoenzymes of amylase
(salivary) S-type (ptyalin)
(prancreas) P type (amylopsin)
major sources of amylase
acinar cells of the pranceas and salivary glands
other sources of amylase aside from the acinar cells of salivary gland and pancreas
fallopian tubes, small intestine, skeletal muscles, and adipose tissue
in acute pancreatitis, amylase levels can rise ___ after onset, peak at ___ hrs and normalize within ___ days
rise 2-12 hrs
peak at 24 hrs
normalize 5 days
increased plasma AMS/amylase is accompanied by increased ____
urinary excretion
amylase in urine remains elevated for up to __ days
7 days
Elevated renal clearance can be used as marker for __
acute and relapsing pancreatitis
it is characterize by elevated macroamylase in serum
macroamylasemia
is a combination of an amylase attached to a protein (either IgG or IgA)
macroamylase
samples with high activity of AMS should be diluted with ___ to prevent inactivation
NaCl
what will be the effect of morphine and other opiates for pain relief before blood sampling to AMS level
falsely increased
Ag prohibited for Amylase
citrate, oxalate, heparin
amylase serum and urine is stable for how many days at room temp
7 days
result of contamination of saliva in amylase
false increase
substrate of amylase
starch
the classic reference method expressed in Somogyi unit
saccharogenic
it measures amylase activity by following the decreases in substrate concentration (degradation of starch )
amyloclastic
it determines amylase activity by the increase in color intensity of the soluble dye-substrate solution produced in the reaction
chromogenic
it quantifies amylase activity by a continuous-monitoring technique
coupled-enzyme
it measures the amount of reducing sugars produced by the hydrolysis of starch by the usual glucose methods
saccharogenic
many endogenous inhibitors of amylase such as ____ are present in serum
wheat germ lectin
if there’s 3fold amylase increase with normal 24hr urine amylase is observed, what should we do
repeat serum amylase after polyethylene glycol precipitation
what pancreas amylase isoform is seen in renal failure
p3
normal amylase/creatinine ratio
1% to 4%
increased serum amylase is found in
acute pancreatitis
ectopic pregnancy
peptic ulcers
alcoholism
mumps
an enzyme that hydrolyzes the ester linkages of fats to produce alcohol and fatty acid
lipase
it catalyze partial hydrolysis of dietary TAG in the intestine ti the 2 monoglyceride intermediate with the production of long chain fatty acids
lipase
lipase is also called as
triacylglycerol acylhydrolase
the most specific pancreatic marker
lipase/ triacylglycerol acylhydrolase
isoenzymes of lipase
pancreatic LPS (predominant in serum)
intestinal LPS
lipoprotein LPS
gastric LPS
in acute pancreatitis, LPS will rise, peak and normalized in
rise 4-8 hrs
peak at 24 hrs remain elevated for 7 days
normalize in 8-14 days
persistent and prolonged elevations of serum lipase more than 2 weeks may indicate the presence of
pancreatic cysts
in chronic pancreatitis, acinar cell degradation occurs, resulting in
loss of amylase and lipase production
in traditional method for lipase determination, what is used as a substrate
olive oil - as esterases can hydrolyze TAG and synthetic Diglycerides
addition of ____, a protein secreted by the pancreas, and ____ will make assay more sensitive and specific for the detection of acute pancreatitis
colipase and bile salts
important activator for lipase
calcium
enzymatic reaction for lipase determination must have what pH
8.8
reference method for lipase determination
cherry-crandall method
this method involves hydrolysis of olive oil after incubation for 24 hrs at 37*C and titration of fatty acids using NaOH
cherry-crandall method for lipase
substrate used for cherry crandall method
50% olive oil
end product of cherry crandall method
fatty acids
in tietz and fiereck method for lipase, what is the substrate used
olive oil (TAG)
3 hrs incubation
pH 8.0 buffer
the currently used method for lipase determination
peroxidase coupling
substrate of peroxidase coupling
triolein (pure form of TAG )
it catalyzes the interconversion of lactic acid and pyruvic acid
lactate dehydrogenase
it is a zinc-containing enzyme that is part of the glycolytic pathway and kreb’s cycle
LDH
it is a hydrogen-transfer enzyme that uses the coenzyme nicotinamide dinucleotide (NAD)
LDH
which LD is the major isoenzyme in the sera of healthy person
LD 2
the most abundant LD isoenzyme in the skeletal muscle
LD 4 -
highest LD serum levels are seen in __ disorders
pernicious anemia and hemolytic disorders
in MI, LDH rise in, peak at, and remains elevated for
rise in 12-24 hrs
peak at 48-72 hrs
remains elevated for 10-14 days
flipped pattern is seen in what conditions
MI and hemolytic anemia
describe the LDH in exudates and transudates
high LDH in exudates
low LDH in transudates
LDH 6 represents
alcohol dehydrogenase
currently most widely used method for LDH
direct immunoassay
it is preferred over the reverse method because it produces a positive rate (NADH) and it is not affected by product inhibition
wacker method (forward/direct reaction)
it is about 2x faster as the forward reaction
wroblewski-ladue
this method for ldh determination is used in dry slide technology
wroblewski-ladue
a substrate of LDH that is more specific than pyruvate
lactate
aside from lactate and pyruvate, ldh can utilize other substrate such as
a hdyroxybutyrate
increased LD are seen in
anemia (pernicious, hemolytic, and megaloblastic)
MI
leukemia
renal infarction
hepatitis and hepatic cancer
muscular dystrophy
delirium tremens
malignancy
pneumocystis jerovecii pneumonia
is an enzyme is involved in storage of high energy creatine phosphate in muscles
creatine kinase
it catalyzes the transfer of a phosphate group between creatine phosphate and adenosine diphosphate
creatine kinase
CK’s cofactor
magnesium
creatine phosphate+ ADP rsults from
creatinine aand ATP using ck as enzyme
During periods of rest, ATP is converted to _____ by CK to serve as energy reservoir.
creatine phosphate
phosphorylation reservoir of creatine kinase
ADP
products in active muscle
creatine and ATP
3 major isoenzyme for ck
brain type of CK
isoenzyme found n brain and smoothmscle
ck1 or ckbb
ck2 are focus in
cardiac muscle
ck2 is also known as
ckmb
ck3 is found in
skeletal muscle
ck2 is aslo known as
ckmb
most rapidly moving isoenzyme of CK
CK BB
Among the 3 which ck isoenzyme is the slowest
ck MM
which chromosome is a prduct of ck bb
loci 14
loci of ck mb
chromosome 19
loci of ck t
chromosome15
majority of creatinine kinase we are getting are from
mb and mm
first enzyme after the onset of signs and symptoms of MI
creatinine kinase
gold standard for MI
troponin I and T
causes highest elevation of total ck
duchenne’s muscular dystrophy
method of chice for ck but not routinely used
electrophoresis
assay that uses antibodies against ck m subnit
immunoinhibition assay
antibody used to detect the presence of ck
anti-ck-m
most commonly used assay for ck which inhibits ck M
mass immunoassay
(Forward Direct method of ck)
Tanzer-Gilvarg Assay
(Reverse/indirect method of ck )
Oliver-Rosalki method
which one is faster,reverse or direct for cl
reverse - Oliver-Rosalki method6x faster
is ck light sensitive
yes
anticoagulants that inhibits ck action
oxalates and fluoride
compounds inhibiting ck activity
mn, ca, zinc, copper
can urate and citrate inhibts tthe sample CK
yes
CK levels are increased in:
Progressive muscular dystrophy
necrosis, muscle
Acute psychosis
Alcoholic myopathy
Delirium tremens
Hypothyroidism
Malignant hyperthermia
Acute cerebrovascular disease
Trichinosis and dermatomyositis
highest elevation of total CK is seen in
duchenne’s muscular dystrophy
ck bb is the dominant isoenzyme of CK found in
brain, intestine, and smooth muscle
cardiac tissues contain significant amount of what CK isoenzyme
CK MB
CK MM is both abundant in
cardiac and skeletal muscles
in the sera of healthy persons, what CK is the major isoenzyme
CK MM kasi skeletal muscle eh
2 atypical isoforms of CL
intramitochondrial CK
sarcomeric muscle CK
known as the MtCk or nonmuscle/ ubiquitious MtCk
intramitochondrial CK
elevated serum intramitochondrial CK or MtCK is seen in
cirrhosis or hepatitis
this atypical isoform of CL is a reliable independent predictor of development of hepatocellular carcinoma
MtCK - intramitochondrial CK
this atypical isoform of CK supports the myofibrillar structure and contractility
sarcomeric muscle CK
CK BB is increased in what condition
cerebrovascular injury
CK MB levels will rise, peak and normalize in ___ following MI
rise in 4-8 hrs
peak at 12-24 hrs
normalize within 48-72 hrs
CK is a diagnostic test for ___ syndrome
neuroleptic malignant syndrome
the forward/direct method for CK determination
tanzer-gilvarg assay
the reverse/indirect method for CK determination
oliver-rosalki method
it is the commonly used method due to faster reaction at pH 6.8 and wavelength of 340 nm for CK determination
oliver-rosalki method
it is an expression of the percentage of the total CK that is attributed to CK-MB
CK relative index (CKI )
this is computed to know the possible release of CK MB from non cardiac tissues when total CK is very high
CK Relative Index
serves as the buffer for CK
imidazole
crystals that are potent CK inhibitors
urate and cystine
purpose of EDTA in CK reagent which recommended by the Scandinavian committee
increase reagent stability from 24 hrs to 5 days
increased total CK is found in what diseases `
duchenne’s muscular dystrophy
MI
hypothyroidism
Pulmonary infarction
Reye’s syndrome
rhabdomyolysis
carbon monoxide poisonig
rocky mountain spotted fever
cerebral vascular accident
is a glycolytic enzyme that splits fructose-1,6-diphosphate into two triose phosphate molecules in the metabolism of glucose
aldolase
is ALDOLASE, a lyases, that splits fructose 1,6- diphosphate, included in the panel of markers for skeletal muscle injury
YES
increased ALDOLASE is seen in what conditions
skeletal muscle disease
leukemia
hemolytic anemia
hepatic cancer
major isoenzyme of ALDOLASE and their corresponding tissue sources
aldolase A: skeletal muscle
aldolase B: liver, kidney, and WBC
aldolase C: brain tissue
it catalyzes the transfer of the glutamyl groups between peptides or amino acids through linkage at a gamma-carboxyl group
gamma-glutamyl transferase (GGT)
gamma-glutamyl transferase is located in ___
the canaliculi of the hepatic cells and particularly in the epithelial cells lining the biliary duct
kidney
prostate
pancreas
in the canalicular system, what is the location of GGT and ALP in the liver
GGT is in the hepatic surface
ALP is on the calicular surface
GGT is elevated among individuals undergoing what therapies
warfarin, phenobarbital, and phenytoin therapies
patients with DM has high GGT, explain why
because of impaired pancreas
GGT is an enzyme involved in amino acid transport and glutathione metabolism. It is mainly found in the liver, pancreas, and biliary system.
increased GGT is seen in what conditions
obstructive jaundice, alcoholism, and DM
this enzyme is useful in differentiating the source of an increased ALP level
GGT
what is the difference of GGT level to ALP level during cholestasis in pregnancy
GGT remains normal
GGT is elevated in all ___ disorders
hepatobilliary disorders such as billiary tract obstruction
the most sensitive marker of acute alcoholic hepatitis
GGT
most sensitive indicator of alcoholism (occult alcoholism)
GGT
this enzyme is elevated in alcoholics even without liver disease
GGT
useful in monitoring the effects of abstention from alcohol
GGT
GGT is found to be elevated in individuals taking high dosage of what drugs
anti inflammatory and anti seizure drugs such as acetaminophen, carbamazepine, and phenytoin
aside from alcoholism and liver disease, since GGT is found in kidney, pancreas and prostate, it can be seen as well in pancreatitis and prostatic disorders
true or false
true
is a phosphoric monoester hydrolase that is predominantly secreted from the liver
5’ nucleotidase
a differentital test for serum ALP, to detect the source of the elevated ALP, if LIVER OR BONE
5’ nucleotidase
a marker for hepatobilliary disease and infiltrative lesions of the liver
5’ nucleotidase
also known as the butyrylcholinesterase
pseudocholinesteriase
a secondary liver function test
pseudocholinesterase
it is secreted by the liver, hence, the measurement of this enzyme reflects synthetic function rather than hepatocyte injury
pseudocholinesterase
a marker of insecticide/pesticide poisoning (organophosphate poisoning )
pseudocholinesterase
it also determines high exposure to nerve poisons such as sarin
pseudocholinesterase
this enzyme functions as a metabolism of drugs
pseudocholinesterase (BuChe)
this enzyme functions to terminate neuronal transmission and signaling between synapses to prevent AChE dispersal and activation of nearby receptors
acetylcholinesterase
what part of the brain is the source of acetylcholinesterase
gray matter
what part of the brain is the source of butyrylcholinesterase
white matter
sample for pseudocholinesterase
serum
sample for acetylcholinesterase
EDTA whole blood
angiotensin-converting enzyme is also calle as
peptidyl-dipeptidase A or kininase II
it is an aspartic acid protease
ACE
ACE
it is a hydrolase enzyme that requires ____ for activation
ZINC
angiotensin converting enzyme is found primarily in
vascular endothelium of the lungs and kidneys
ACE converts angiotensin I to II within what organ
lungs
ACE
a diagnostic test for ___
sarcoidosis
a possible indicator of neuronal dysfunction such as Alzheimer’s disease
ACE
a critical target for inhibitory drugs designed to lower blood pressure
ACE
the enzyme that is the cellular receptor of SARS and SARS-COV2
QACE2
it functions to maintain NADPH in the reduced form in the erythrocytes
glucose 6 phosphate dehydrogenase
deficiency of this enzyme can lead to drug induced hemolytic anemia after taking primaquine, an antimalarial drug
glucose 6 phosphate dehydrogenase
explain the relationship of G6PD to NADPH, glutathione, and rbc
G6PD is an enzyme that will produce NADPH
NADPH will reduce oxidative glutathione and convert back to reduced glutathione
glutathione is an antioxidant, kapag nakaencounter siya ng ROS or reactive oxygen species, nagiging oxidative gluta siya. Then papasok na diyan si NADPH and icoconvert niya pabalik to reduced gluta
kapag di naconvert, paktay, si oxidative glut is magca-cause ng hemolysis and destruction sa RBC since fragile sila from oxidative stress
is a copper carrying protein with an enzymatic activity
ceruloplasmin
a marker of wilson disease (hepatolenticular disease)
ceruloplasmin
serum level of ceruloplasmin in wilson’s disease, explain why
decreased -
Since ceruloplasmin needs copper for stability, when copper incorporation fails in Wilson’s disease, ceruloplasmin is degraded faster
ornithine carbamoyltransferase is a marker of
hepatobiliary disease
its serum concentration may provide a useful marker of disease severity, and thus, could be a useful marker for a high risk of hepatitis C occurence
ornithine carbamoyltransferase
it is produced in secretory granules of the pancreatic acinar cell
trypsin
a major enzyme that serves as an “activator” of digestive proenzymes
trypsin
it contributes to chronic pancreatitis when serine protease inhibitor KAZAL type 1 is altered
trypsin
it is only secreted in the pancreas, hence, a more specific marker of acute pancreatitis compared to the routine amylase test
not referring to the most specific
trypsin
