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CLINICAL ENZYMOLOGY (CC2) > MAJOR CLINICAL ENZYMES > Flashcards

MAJOR CLINICAL ENZYMES Flashcards

1
Q

A nonspecific phosphatase enzyme capable of reacting with many different substrates

A

Alkaline phosphatase

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2
Q

In healthy sera, ALP levels are derived from

A

Liver and Bone (osteoblasts)

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3
Q

Bone isoenzyme increases due to osteoblastic activity and normally elevated in

A

Children during periods of growth and geriatric adults

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4
Q

In normal pregnancy, increased ALP activity can be detected between

A

16-20 weeks of pregnancy

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5
Q

ALP is higher in individuals of what blood group?

A

Groups B and O

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6
Q

After consumption of a fatty meal intestinal ALP of B or O blood group what?

A

Increases

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7
Q

Placental ALP is lower in pregnant women of what blood group?

A

Groups A and AB

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8
Q

Major tissue sources of ALP

A

Liver, bone, placenta and intestinal

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9
Q

When total ALP levels are increased, it is the major liver fraction that is most frequently elevated, especially in what disease?

A

Obstructive Jaundice

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10
Q

For bone disorders, highest elevations of ALP occur in

A

Paget’s disease (osteitis deformans)

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11
Q

Cardioplacental ALP found in lung, breast, ovarian and gynecological cancers; Bone ALP co-migrator. Most heat stable ALP (65℃ for 30mins). Inhibited by phenylalanine reagent

A

Regan ALP

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12
Q

Found in adenocarcinoma of the pancreas and bile duct, pleural cancer; variant of Regan ALP; inhibited by L-leucine and phenylalanine

A

Nagao ALP

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13
Q

The most anodal ALP isoenzymes are

A

Liver and Bone ALPs

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14
Q

The least anodal ALP isoenzyme

A

Intestinal ALP

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15
Q

Improves separation of bone and liver ALPs in Electrophoresis

A

Use of neuraminidase and wheat germ lectin

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16
Q

Unheated serum

A

High ALP

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17
Q

Performed at 56℃ for 10 minutes

A

Heat Fractionation/Stability Test

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18
Q

Most heat stable ALP

A

Placental ALP

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19
Q

Most heat labile ALP

A

Bone ALP

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20
Q

Decreasing order of ALP heat stability

A

Placental, Intestinal, Liver and Bone

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21
Q

Inhibited by Phenylalanine reagent in Chemical Inhibition Test

A

Placental and Intestinal ALPs

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22
Q

Inhibited by 3M Urea

A

Bone ALP

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23
Q

Inhibited by Levamisole

A

Bone and Liver ALPs

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24
Q

Considered as the most specific method and IFCC recommended. A continuous monitoring technique which requires a pH environment of 10.15 and should be read at 450nm

A

Bowers and McComb (Szasz Modification)

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25
Q

Required pH environment for Bowers and McComb method

A

pH of 10.15

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26
Q

Bowers and McComb method should be read at

A

450nm

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27
Q

A component of ALP

A

Zinc

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28
Q

Enzyme activator for ALP

A

Magnesium

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29
Q

Sources of analytical errors; elevated serum ALP

A

Hemolysis and diet(fatty meals)

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30
Q

ALP is sensitive if stored at what temperature

A

Low temp (4℃)

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31
Q

If ALP is stored at 4℃ it would lead to

A

Increased serum level

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32
Q

ALP is inhibited by

A

Phosphorus

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33
Q

Decreased ALP is seen in

A

Zinc deficiency

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34
Q

Prolonged low levels of ALP occur in

A

Hypophosphatasia

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35
Q

Transient low serum ALP may occur after

A

Blood transfusion or cardiopulmonary bypass

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36
Q

A useful tumor marker in serum and CSF for most germ cell tumors

A

Placental ALP (PLAP)

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37
Q

Phosphatase enzyme active at pH 5.0

A

Acid Phosphatase

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38
Q

Indicates the presence of seminal fluid in the sample

A

ACP activity >50IU/L

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39
Q

Tissue sources of ACP

A

Prostate, RBCs, platelets, liver and bone (osteoclasts)

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40
Q

ACP is used for the detection of

A

Prostatic Adenocarcinoma/Metastatic Prostate Carcinoma

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41
Q

Useful in forensic clinical chemistry, in the investigation of rape cases

A

Acid Phosphatase

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42
Q

Seminal fluid-ACP activity examined in vaginal washings can persists for up to how many days

A

4 days

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43
Q

Serum ACP decreases within how many hours if left at room temperature?

A

1 to 2 hours

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44
Q

If not assayed immediately serum for ACP tests should be

A

Frozen or acidified to a pH lower than 6.5

45
Q

With acidification, ACP is stable for how many days at room temperature?

A

2 Days

46
Q

ACP inhibited by 20mM L-tartarate ions

A

Prostatic ACP

47
Q

ACP inhibited by 1mM cupric sulfate and 2% formaldehyde ions

A

Red Cell ACP

48
Q

Present in certain chronic leukemias and some lymphomas, most notably hairy cell leukemia

A

Tartarate-resistant acid phosphatase (TRAP)

49
Q

ACP in thrombocytopenia

A

Increased ACP

50
Q

Markers used to monitor recurrence of prostate cancer

A

Prostatic acid phosphatase (PAP) & Prostate specific antigen (PSA)

51
Q

Marker that is more sensitive in detecting stages A and B prostatic cancer

A

PSA - Prostate Specific Antigen

52
Q

Transferase/transminase enzyme involved in the transfer of an amino group between aspartate and alpha keto acids with the formation of oxaloacetate and glutamate

A

Asparate Aminotransferase (AST)

53
Q

Other name of AST

A

Serum glutamate-oxaloacetic transaminase (SGOT)

54
Q

In AMI, AST levels begin to rise

A

6-8 hours

55
Q

In AMI, AST levels peak at

A

24 hours

56
Q

In AMI, AST levels normalize within

A

5 days

57
Q

Method for AST that uses malate dehydrogenase (MD) and monitors the change in absorbance at 340nm

A

Karmen Method

58
Q

Highest concentration is in the liver, more liver-specific than AST

A

Alanine Aminotransferase (ALT)

59
Q

Other name of ALT

A

Serum glutamate-pyruvic transaminase (SGPT)

60
Q

Major tissue source of ALT

A

Liver

61
Q

Other tissue sources of ALT

A

Kidney, pancreas, RBC, heart, Skeletal muscles, lungs

62
Q

Significant in the evaluation of hepatic disorders and markedly increased concentration in acute inflammatory conditions than AST

A

ALT

63
Q

Normal in Myocardial Infarction

A

ALT

64
Q

Used to screen blood donors

A

ALT levels

65
Q

More sensitive and specific screening test for posttransfusion hepatitis or occupational toxic exposure

A

ALT

66
Q

Aminotransferases are present in

A

Human plasma, bile, CSF and saliva

67
Q

Error that should be avoided because it increases AST 10x

A

Hemolysis

68
Q

Anticoagulant that may inhibit the activity of AST (but not all methods)

A

Heparin

69
Q

The highest elevations of transferase is seen in what hepatitis?

A

Acute Hepatitis

70
Q

In acute hepatitis, the De Ritis Ratio (ALT:AST) is

A

> 1.0

71
Q

Transferase level in chronic hepa, hepatic cancer and IM is

A

Moderately elevated

72
Q

Transferase level in hepatic cirrhosis, alcoholic hepatitis and obstructive jaundice

A

Slightly increased

73
Q

ALT levels in Obstructive Jaundice

A

Slightly increased

74
Q

ALT levels in Necrotic Jaundice

A

Markedly increased

75
Q

With most forms of acute hepatocellular injury, such as hepatitis this transferase enzyme will be higher initially because of the higher activity in hepatocytes

A

AST

76
Q

Within 24-48 hours, particularly if ongoing damage occurs, this transferase enzyme will become higher based on its longer half-life

A

ALT

77
Q

The levels of both enzymes generally are not elevated and may be low as the result of massive tissue destruction

A

End-stage cirrhosis

78
Q

An enzyme that catalyzes the breakdown of starch and glycogen

A

Amylase

79
Q

An important enzyme in the physiologic digestion of starch

A

Amylase

80
Q

Earliest pancreatic marker

A

Amylase

81
Q

The most predominant pancreatic amylase isoenzyme in acute pancreatitis

A

P3

82
Q

Amylase isoenzyme predominantly in normal serum

A

S-type (ptyalin)

83
Q

Amylase isoenzyme predominantly in urine

A

P-type (amylopsin)

84
Q

Major tissue source of Amylase

A

Acinar cells of the pancreas and salivary glands

85
Q

In Acute Pancreatitis, AMS levels rise

A

2-12 hours after onset of attack

86
Q

In AP, AMS levels peak at

A

24 hours

87
Q

In AP, AMS levels normalize within

A

3-5 days

88
Q

Anticoagulant that may inhibit the activity of AMS using some but not all methods

A

Heparin

89
Q

Lipid classification that may inhibit serum AMS activity

A

Triglycerides

90
Q

Samples with high activity of AMS should be diluted with what to prevent inactivation

A

Sodium Chloride (NaCl)

91
Q

Administration of these drugs before blood sampling would lead to falsely elevated serum AMS levels

A

Morphine and other opiates

92
Q

Administration of morphine and other opiates for pain relief before blood sampling will lead to

A

Falsely elevated serum AMS levels

93
Q

Substrate for all methods of AMS

A

Starch

94
Q

Classic reference method expressed in Somogyi units

A

Saccharogenic

95
Q

Measures the amount of reducing sugars produced by the hydrolysis of starch by the usual glucose methods

A

Saccharogenic

96
Q

Measures amylase activity of following the decrease of starch

A

Amyloclastic

97
Q

Measures amylase activity by the increase in color intensity

A

Chromogenic

98
Q

Measures amylase activity by a continuous-monitoring technique

A

Coupled-enzyme

99
Q

The most specific pancreatic marker-secreted exclusively in the pancreas; not affected by renal disorders

A

Lipase

100
Q

Substrates for LPS assay

A

Olive oil and Triolein

101
Q

Reference method for LPS

A

Cherry Crandal

102
Q

Most commonly used method; does not use 50% olive oil

A

Peroxidase coupling

103
Q

Earliest Pancreatic Marker

A

Amylase

104
Q

Most specific pancreatic marker

A

Lipase

105
Q

In AP, LPS levels rise

A

6hrs after onset of attack

106
Q

In AP, LPS levels peak at

A

24hrs

107
Q

In AP, LPS levels remain elevated for

A

7 days

108
Q

In AP, LPS levels normalize in

A

8-14 days

CLINICAL ENZYMOLOGY (CC2) (2 decks)

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