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BPM DLA1 > Lecture24 > Flashcards

Lecture24 Flashcards

1
Q

Use of serum proteins (3)

A
  1. Detecting disease
  2. monitor progress of disease
  3. Response to therapy
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2
Q

Difference between specificity and sensitivity

A

Specificity : higher specificity means less false result

Sensitivity : higher sensitivity means detection no matter how low or slight damage is with no false negative results

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3
Q

In terms of releasing enzymes what is difference between necrotic and inflamed tissue?

A

necrotic tissue release all its enzyme contents while inflamed tissue release soluble enzymes due to changes in membrane permeability

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4
Q

Possible causes for elevated enzyme levels in serum (4)

A

`1. Increased cellular turnover (normal or cell necrosis)

  1. Cellular proliferation (neoplasia)
  2. Increased enzyme synthesis (induction)
  3. Obstruction to secretion (pancreatic duct)
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5
Q

Gamma glutamyl transpeptidase (GGT) (for diagnosis)

A

Liver damage

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6
Q

Aspartate aminotransferase (AST) (for diagnosis)

A

Heart and liver damage

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7
Q

Alanine aminotransferase (ALT) (for diagnosis)

A

Liver damage

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8
Q

Alkaline phosphatase (ALP) (for diagnosis)

A

Obstructive liver disorder and bone disease

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9
Q

Acid phosphatase (for diagnosis)

A

Metastatic carcinoma of prostate gland

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10
Q

Alpha amylase (for diagnosis)

A

pancreatitis or obstruction of pancreatic duct

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11
Q

What is isoenzyme?

A

Catalyze same reaction, but differ in primary structure or subunit composition
(eg. glucokinase/hexokinase)

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12
Q

What is infarction?

A

necrosis of tissue / organ due to disruption of its blood supply

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13
Q

3 criteria for MI Diagnosis

A
  1. Severe chest pain
  2. ECG change
  3. Increased in activity of cardiac biomarkers
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14
Q

3 enzymes for myocardial infarction

A
  1. Creatine kinase (CK)
  2. LDH (also occur in liver)
  3. Aspartate aminotransferase (AST) (nonspecific since it is for both heart and liver)
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15
Q

3 Isoforms of CK

A
  1. CK1 = BB= Brain & lungs
  2. CK2 = MB = Myocardium
  3. CK3 = MM = Myocardium & skeletal muscle
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16
Q

CK1

A

BB = Brain & lung

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17
Q

CK2

A

MB = Myocardium

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18
Q

CK3

A

MM = Myocardium & skeletal muscle

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19
Q

Which isozyme of CK have most electrophoretic mobility?

A

CK1 BB > CK2 BM > CK3 MM(least negatively charged)

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20
Q

What is difference between use of total CKs and CKMB?

A

Total CKs are indicative of the size of infarction whereas the amount of serum CKMB indicates whether MI occurred or not.

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21
Q

What does increase in infarction size mean?

A

it means there is an increased development of cardiac arrhythmia which causes death

22
Q

Half life of CKMB

A

24hours

23
Q

Which LDH isoform indicate myocardial infarction?

A

LDH-1

24
Q

What happens to LDH level following myocardial infarction?

A

sharply increase causing 1,2-flip, but 1,2-flip also found in erythrocytes(anemia, renal damage, hymolysis)

25
Q

indicative level of CK-MB / total CK for myocardial infarction

A

> 3%

26
Q

Peak of LDH

A

40-50 Post Myocardial infarction

27
Q

Non enzymic cardiac biomarker for myocardial infarction

A
  1. Myoglobin 1-3hours post MI (but not specific to cardiac, its for all muscles)
  2. Troponin isoforms
28
Q

Advantage and disadvantage of using myoglobin as MI biomarker

A

ADV : Highly sensitive of MI, if levels do not increase within first 3/6h it indicates no MI
DISADV : Not specific, associated with other causes too

29
Q

3 isoforms of troponin

A

Tn T
Tn I
Tn c

30
Q

difference between troponin T and I

A

I is specific for myocardial tissue, indicative of MI

T is less specific and in can be caused by angina attack

31
Q

Earliest indicator of Acute MI (2)

A

Myoglobin and CK-2

32
Q

Long diagnostic tool for MI

A

Troponin I

33
Q

What diseases does liver function test (LFT) differentiate?

A

acute liver damage,
chronic liver damage,
cholestatic disease (reduced bile flow)

34
Q

Hepatocyte function test measure decrease in capacity to synthesize which substance? (3) and increase in which (1)

A
  1. serum albumin
  2. prothrombin
  3. fibrinogen
  4. serum ammonia (increased)
35
Q

Liver disease(hepatocyte integrity) is diagnosed by which enzymes elevated activities ? (3)

A

Serum aspartate aminotransferase (More sensitive)
Serum alanine aminotransferase (More specific)
Serum LDH-5

36
Q

Role of ALT biochemically (2)

A

converse rebersibly alanine to pyruvate

also used to form glutamate (urea cycle)

37
Q

Role of AST biochemically

A

Reversibl converrsion of aspartate to OAA

38
Q

Ratio of AST:ALT for fatty liver disease (Alcoholic)

A

AST:ALT >2

39
Q

Ratio of AST:ALT for hepatitis and NAFLD (nonalcoholic fatty liver disease)

A

High ALT:AST

40
Q

What indicates abnormality in biliary excretion function of liver? (3)

A
  1. elevated serum and urine bilirubin
  2. serum bile acid
  3. membrane bound enzymes such as serum ALP, GGT and serum 5’nucleotidase
41
Q

Isozymes of alkaline phosphatase (ALP)

A
  1. ALPI - Intestinal
  2. ALPL - liver/bone/kidney
  3. ALPP - Placental
42
Q

How is alkaline phosphatase related to obstructive disorder/

A

ALPL is specifically synthesized in cells lining hepatic biliary ducts, thus related with obstructive disorders.

43
Q

When are there increased alkaline phosphatase (ALP)? (4)

A

Bone disease
Liver (esp obstructive bile disorder)
pregnancy or childhood
Growth

44
Q

Paget’s disease

A

excessive and disorganised resoprtion and bone formation

High plasma ALP indicated

45
Q

Biomarkers for liver bile duct obstruction (3)

A

ALP-L, GGT, Conjugated bilirubin

46
Q

How can we differentiate bile disorder from other bone and liver disorders?

A

For bile, elevated serum level of both ALPL and GGT should be shown. ALPL alone is liver or bone disorder.

47
Q

Role of GGT biochemically

A

A cell surface glycoprotein that cleaves gamma glutamyl amide bond in the cells lining the bile ducts

48
Q

What is cholestasis

A

When substance normally secreted in bile are retained

Bile duct obstruction

49
Q

Biomarker for pancreatitis

A

Alpha amylase activity

50
Q

Serum lipase : amylase ratio to diagnose ethanol-induced pancreatitis

A

ratio >2

BPM DLA1 (47 decks)

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