Liver Function Test (ALP | P)

Question 1

What is the meaning of ALP?

Answer 1

Alkaline Phosphatase

Question 2

ALP can be used for evaluation of what disorders?

Answer 2

1) Hepatobiliary disorders

2) Bone disorders

Question 3

ALP is seen predominantly in what conditions?

Answer 3

In obstructive conditions than in hepatocellular diseases

Question 4

If the pt has hepatobiliary disorders specifically characterized as having obstructive conditions, what is the result of the pt’s ALP?

Answer 4

3 - 10x the upper / border limit

Question 5

ALP is involved in what?

Answer 5

In osteoblasts

Question 6

Where are osteoblasts present?

Answer 6

In the bone

Question 7

What are the diff ALP isoenzymes?

Answer 7

1) Liver
2) Bone
3) Placenta
4) Intestine

Question 8

What are the conditions where ALP is increased due to the presence of liver ALP?

Answer 8

1) Hepatobiliary

2) Obstruction

Question 9

What is the condition that causes increased ALP in connection to bone ALP?

Answer 9

Due to osteoblastic act

Question 10

True or False

ALP is not normally elevated in children growth

Answer 10

False, because ALP is normally elevated in children growth

Question 11

In what condition is ALP increased due to the presence of placental ALP?

Answer 11

In pregnant women

Question 12

In what circumstances are ALP increased in connection to intestinal ALP?

Answer 12

1) It depends on the pt’s blood grp
2) It depends on the pt’s secretor status
3) In hemodialysis pts

Question 12

What are the abnormal isoenzymes (or abnormal fractions) of ALP isoenzymes?

Answer 12

1) Regan isoenzyme
2) Nagao isoenzyme
3) Carcinoplacental ALP

Question 13

What is the characteristic of carcinoplacental ALP?

Answer 13

It has similarities w/ placental isoenzyme

Question 14

What is the method used for ALP determination?

Answer 14

Bowers and McComb

Question 15

What is the principle of rxn of Bowers and McComb?

Answer 15

p-Npp + H2O (via the action of alk. phos.) -> p-Nitrophenol + H3PO4

Question 16

What should be done to acquire an ALP rgnt?

Answer 16

R1 + R2

Question 17

What are the components of the ALP working rgnt?

Answer 17

1) p-Nitrophenyl Phosphate
2) Magnesium ions
3) Buffer
4) Activator and binder

Question 18

What is the concentration of p-Nitrophenyl phosphate (as a component of the ALP working rgnt)?

Answer 18

17 mM

Question 19

What is the concentration of Mg ions (as a component of the ALP working rgnt)?

Answer 19

4 mM

Question 20

What should be the pH of the buffer (present as a component of the ALP working rgnt)?

Answer 20

pH 10.2 +&- 0.2

Question 21

What are the sx considerations for ALP determination?

Answer 21

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

Question 22

How many hrs should the pt fast for ALP determination?

Answer 22

8 - 10 hrs

Question 23

Why are oxalate, fluoride, and EDTA unsuitable anticoagulants for ALP determination?

Answer 23

Because they inhibit ALP

Question 24

Why should sxs be kept cold and assayed as soon as possible after blood collection?

Answer 24

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

Question 25

What is the process (or steps) of ALP determination?

Answer 25

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

Question 26

What is the normal reference range for ALP?

Answer 26

30 - 120 IU/L

Question 27

What are the causes of increased ALP?

Answer 27

1) Paget’s disease
2) Osteomalacia
3) Rickets
4) Hyperparathyroidism
5) Osteogenic sarcoma
6) Healing of bone structures
7) Physiologic bone growth
8) Pregnancy

Question 28

What is the cause of decreased ALP?

Answer 28

Hypophosphatasia