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FTM Exam 1 > Lecture 24 > Flashcards

Lecture 24 Flashcards

1
Q

Serum total protein

A

Careful

A fall in one protein my be masked by an increase in another

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2
Q

4 causes for elevated enzyme levels in serum

A

Increased cellular turnover
Cellular proliferation (neoplasia)
Increased enzyme synthesis (induction)
Obstruction to secretion (pancreatic duct)

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3
Q

Isoenzymes or isozymes

A

Catalyze the same reaction, but differ in their primary structure and/or subunit composition, or quaternary level

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4
Q

Infarction

A

Necrosis of tissue/organ due to disruption of its blood supply
Can be arterial or venous

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5
Q

Criteria for MI diagnosis (WHO)

A

Severe chest pain
ECG change
Increase or present of cardiac biomarkers

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6
Q

Enzymes for MI

A

CK (not in liver)
LDH
AST

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7
Q

Creatine kinase

3 isoforms

A

2 subunits, M for muscle, B for brain
CK-1 BB: brain and lungs, moves furtherest on electrophoresis
CK-2 MB: myocardium
CK-3 MM: myocardium and skeletal muscle

Negatively charged, move to anode

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8
Q

CK MB

A

Specific to heart muscle
Peak at 24h then rapidly fall, last 2-3 days
Detect reinfarction
Indicate whether MI occurred

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9
Q

Toal CK

A

Measure size and intensity of infarction

Peak at 18-30 h, duration 2-5 days

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10
Q

LDH isoforms and places

A

LDH-1: heart and serum
LDH-5: liver and muscle
Also LDH2-4

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11
Q

LDH 1 serum level increase producing?

A

1,2-Flip
But 1 2 isoforms also found in erythrocytes, not specific

LDH peaks 40-50 h post MI

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12
Q

The percent of CK MB to total CK

A

> 3 indicates MI

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13
Q

Non-enzymatic cardiac biomarkers for MI

A

Myoglobin: detected 1-3 h post MI, peak 4-12 h, highly sensitive for MI, but lack specificity

troponin isoforms: highly specific and sensitive

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14
Q

Troponins 3 regulatory proteins

A 
Troponin T (TnT):specific to heart
Troponin I (TnI): specific for myocardial tissues
Troponin C (TnC): nonspecific
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15
Q

TnI

A

Rise 3/5 h
Peak 14/18 h
Remain 5-7 days

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16
Q

TnT

A

Less specific than cardiac TnI
Rise 3/5 h
Remain 14-21 days
Angina attacks also cause its release

17
Q

Liver function tests = LFT includes

A 
Total bilirubin
Albumin
AST and ALT
ALP = alkaline phosphatase
Gamma GT = gamma-glutamyl transferase
18
Q

Hepatocyte function tests

A

Decrease in capacity to synthesize:
Serum albumin
Prothrombin
Fibrinogen

Measure serum ammonia, elevated ammonia indicates hepatic dysfunction

19
Q

hepatocyte integrity disease is implicated by elevated enzyme activity of :

A

AST: more sensitive, also for MI
ALT: more specific to liver
LDH-5

20
Q

Fatty liver disease = FLD

A

AST:ALT > 2

Caused by alcohol

21
Q

Hepatitis and NAFLD

A

High ALT:AST

22
Q

ALT

A

Cytosolic enzyme converts reversibly alanine to pyruvate

Amino group used to form glutamate (urea cycle)

Liver biomarker

23
Q

AST

A

Cytosolic and mitochondrial isoforms

Reversible conversion of aspartate to OAA

Liver and heart biomarkers

24
Q

Biliary excretion function diseases are implicated by elevated:

A

Serum and urine bilirubin, serum bile acid

Membrane bound enzymes (from damage to bile canaliculus): serum ALP, serum GGT, serum 5’nucleotidase

25
Q

ALP

A

High concentration in osteoblasts, liver, placenta, and intestinal epithelium, increase during pregnancy and childhood

Pathological increase due to liver disease and certain bone diseases

Decrease associates with hypothyroidism

26
Q

ALP isoforms

A

ALPI: intestinal
ALPL: tissue nonspecific: liver, bone, kidney
ALPP: placental

27
Q

Disease of ALP

A

Paget’s disease

Deformities of the skull

28
Q

Liver bile duct obstructions

A

Gallstones, tumors

Biomarkers: ALP-1, GGT, conjugated bilirubin

29
Q

GGT

A

Mainly in liver, less in pancreas and kidney

Cell surface glycoprotein that cleaves gamma-glutamyl amide bond

Biomarker for liver dysfunction and bile duct injury

30
Q

Acute pancreatitis

A

Gallstones

Excessive ethanol consumption

31
Q

Chronic pancreatitis

A

CF
Hypertriglyceridemia: too many TAG in blood
Long-term excessive ethanol consymption

32
Q

Biomarkers for pancreatitis

A

Elevated serum alpha-amylase

Serum lipase: amylase ratio >2: ethanol-induced pancreatitis

33
Q

Prostate specific antigen (PSA)

A

Glycoprotein produced by prostate cells

Elevated PSA indicate prostate cancer

Not specific

34
Q

Alpha-foetal protein (AFP)

A

Synthesized by foetal liver

Low in adults

High AFP indicates hepatocellular carcinoma

Lack specificity

Similar fcn to albumin, replace by albumin in 12 months

35
Q

Cancer of liver

A

Common site for secondary metastases

Jaundice may be first sign of cancer

Liver biopsy performed if w/o blood clotting factors deficiency

FTM Exam 1 (23 decks)

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