M.I Profile (Cardiac Enzyme) Flashcards
Type of transferase involved in the storage of high-energy creatine phosphate in muscle cells
Creatinine Kinase (CK)
Not specific to the heart because it is widely distributed, with highest activities in skeletal muscle, heart, and brain
CK
Give the structure of CK
Dimeric enzyme composed of 2 monomer subunits (either M or B)
Also known as Forward Reaction method for CK
Tanzer-Gilvarg
Optimum pH of forward reaction
9.0
Also known as Reverse Reaction
Oliver Rosalki
Optimum pH of reverse reaction
6-8
Hemolysis can false __ CK activity
Increase
RBC has __ which is the same with CK activity
Adenylate Kinase (AK)
CK is inactivated by light and can cause false __
Decrease
Physical activity and IM injection can __ CK
Increase
Slowest mobility toward the anode
CK-3 / CK-MM / Muscle type
Major isoenzyme in striated muscle and normal serum of healthy individuals
CK-3 / CK-MM / Muscle type
2nd fastest to migrate toward the anode
CK-2 / CK-MB / Hybrid Type
Significant quantities are found in heart tissues.
CK-2 / CK-MB / Hybrid Type
Migrate fastest toward the anode
CK-1 / CK-BB / Brain Type
Highest concentration in CNS, GI tract and uterus (pregnancy)
CK-1 / CK-BB / Brain Type
How many percent of CK MB is found in the total CK?
> 6%
After MI, CK-MB __ levels to begin to rise within __ hours, peak at __ hours, and returns to normal levels within 48-72 hours
> 6%
4-8
24
The first enzyme to elevate in Myocardial Infarction
CK MB
First protein/ marker or analyte to elevate during Myocardial infarction, faster than CK-MB
Myoglobin
More helpful in diagnostic and improve the specificity of the test in terms of identifying the target organ or tisse
CK Isoenzyme
CK BB low in blood but high in CSF indicates
CSF Leakage (BBB is damaged)
CK Isoenzyme that is dominant in the blood
CK MM
CK enzyme is combined/coupled with antibodies or lipoprotein
Macro-CK
CK isoenzyme with antibodies (IgA or IgG)
CK BB
CK isoenzyme with Lipoprotein
CK MM
Seen or migrate between CKMM and CKBB
Macro-CK
- Bound to mitochondrial membrane *severe damage to the cell
- Migrates cathodal and farthest to anode
Mitochondrial CK (CK-MI)
- Oxidoreductase that catalyzes the interconversion of lactic and pyruvic acids
- Widely distributed, highest activities in heart, hepatic, skeletal muscle and RBC
Lactate Dehydrogenase (LD)
Forward reaction in LD assay
Wacker Method
Optimal pH for wacker method
8.3 to 8.9
Reverse reaction of LD assay
Wrobleuski La Due
Three times faster but more susceptible to substrate exhaustion (prolonged testing or substrate testing may have high probability of exhaustion
Wrobleuski La Due
Optimal pH for Wrobleuski La Due
7.1 to 7.4
Has greater affinity of H subunits (greater the subunit=greater affinity)
Alpha-hydroxybutyrate dehydrogenase (a-HBD)
Represent LDH-1 (since it composed ONLY of numerous H subunit
Alpha-hydroxybutyrate dehydrogenase (a-HBD)
After MI, LD begin to rise within __ hours, peak at 48-72 hours and remains elevated for __days
10-24
10
Structure of LD
Tetramer and has 2 active subunits (M and H)
Give the tissue and disorder: LDH 1 (HHHH)
Heart, RBC
MI, Hemolytic anemia
Give the tissue and disorder: LDH 2 (HHHM)
Heart, RBC
RI (Renal infarction), Megaloblastic anemia
Give the tissue and disorder: LDH 3 (HHMM)
Lung, Spleen, Pancreas
Pulmonary embolism
Give the tissue and disorder: LDH 4 (HMMM)
Liver
Hepatic injury
Give the tissue and disorder: LDH 5 (MMMM)
Skeletal Muscle
Skeletal Muscle Injury
T/F: LDH can also be a liver enzyme
TRUE
LDH isoenzyme that is fastest and closest to the anode
LDH 1 (HHHH)
The most predominant LD Isoenyzme in healthy individuals and greater with LDH 1
LDH 2 (HHHM)
Shows in AMI and intravascular hemolysis (LDH 1 > LDH2)
Flipped Pattern
