Liver Function Test (ALP | P) Flashcards
What is the meaning of ALP?
Alkaline Phosphatase
ALP can be used for evaluation of what disorders?
1) Hepatobiliary disorders
2) Bone disorders
ALP is seen predominantly in what conditions?
In obstructive conditions than in hepatocellular diseases
If the pt has hepatobiliary disorders specifically characterized as having obstructive conditions, what is the result of the pt’s ALP?
3 - 10x the upper / border limit
ALP is involved in what?
In osteoblasts
Where are osteoblasts present?
In the bone
What are the diff ALP isoenzymes?
1) Liver
2) Bone
3) Placenta
4) Intestine
What are the conditions where ALP is increased due to the presence of liver ALP?
1) Hepatobiliary
2) Obstruction
What is the condition that causes increased ALP in connection to bone ALP?
Due to osteoblastic act
True or False
ALP is not normally elevated in children growth
False, because ALP is normally elevated in children growth
In what condition is ALP increased due to the presence of placental ALP?
In pregnant women
In what circumstances are ALP increased in connection to intestinal ALP?
1) It depends on the pt’s blood grp
2) It depends on the pt’s secretor status
3) In hemodialysis pts
What are the abnormal isoenzymes (or abnormal fractions) of ALP isoenzymes?
1) Regan isoenzyme
2) Nagao isoenzyme
3) Carcinoplacental ALP
What is the characteristic of carcinoplacental ALP?
It has similarities w/ placental isoenzyme
What is the method used for ALP determination?
Bowers and McComb
What is the principle of rxn of Bowers and McComb?
p-Npp + H2O (via the action of alk. phos.) -> p-Nitrophenol + H3PO4
What should be done to acquire an ALP rgnt?
R1 + R2
What are the components of the ALP working rgnt?
1) p-Nitrophenyl Phosphate
2) Magnesium ions
3) Buffer
4) Activator and binder
What is the concentration of p-Nitrophenyl phosphate (as a component of the ALP working rgnt)?
17 mM
What is the concentration of Mg ions (as a component of the ALP working rgnt)?
4 mM
What should be the pH of the buffer (present as a component of the ALP working rgnt)?
pH 10.2 +&- 0.2
What are the sx considerations for ALP determination?
1) Fasting sx should be used
2) Oxalate, fluoride, and EDTA are unsuitable anticoagulants
3) Sxs should be kept cold and assayed as soon as possible after blood collection
How many hrs should the pt fast for ALP determination?
8 - 10 hrs
Why are oxalate, fluoride, and EDTA unsuitable anticoagulants for ALP determination?
Because they inhibit ALP
Why should sxs be kept cold and assayed as soon as possible after blood collection?
Because if sxs are not kept cold and assayed as soon as possible after blood collection, it can result to false elevation of ALP lvls
What is the process (or steps) of ALP determination?
1) Pre-warm rgnts
2) Label test tubes (blank, standard, and unknown)
3) Pipet 1,000 uL of ALP working rgnt to all tubes
4) Transfer 25 uL of sx
5) Mix well and stand for 1 min
6) Measure the A at 405 nm
What is the normal reference range for ALP?
30 - 120 IU/L
What are the causes of increased ALP?
1) Paget’s disease
2) Osteomalacia
3) Rickets
4) Hyperparathyroidism
5) Osteogenic sarcoma
6) Healing of bone structures
7) Physiologic bone growth
8) Pregnancy
What is the cause of decreased ALP?
Hypophosphatasia
