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FINALS CC 2 > M.I. PROFILE/ CARDIAC MARKERS/ CARDIAC ENZYMES > Flashcards

M.I. PROFILE/ CARDIAC MARKERS/ CARDIAC ENZYMES Flashcards

1
Q

Involved in the storage of high-energy creatine phosphate in muscle cells

A

: Creatine Kinase (CK)/ Creatine Phosphokinase

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2
Q

when creatine phosphate is consumed during muscle metabolism →

A

creatinine is generated

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3
Q

Creatinine is excreted at a _______ by the glomerular membrane

A

constant rate

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4
Q

CK is _______ . It is widely distributed, highest activities in _____, _____, _____, and _____

A

NOT HEART SPECIFIC
skeletal muscle, heart, and brain

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5
Q

Creatine kinase would transfer 1 phosphate group from ___ to creatine to form ______ and ___

A

ATP, Creatine phosphate and ADP

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6
Q

Creatine Kinase (CK)/ Creatine Phosphokinase substrates

A

Creatine & ADP

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7
Q

Creatine Kinase (CK)/ Creatine Phosphokinase
products

A

Creatine Phosphate & ADP

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8
Q

Creatine Kinase (CK)/ Creatine Phosphokinase structure

A

Dimeric enzyme; composed of 2 monomer subunits (M or B) M = Muscle and B = Brain

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9
Q

↓ in absorbance at 340 nm is determined; Oxidized NAD

A

Forward Reaction (Tanzer-Gilvarg)

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10
Q

Forward Reaction (Tanzer-Gilvarg) optimum pH

A

Optimum pH is 9.0 (alkaline)

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11
Q

Forward Reaction (Tanzer-Gilvarg) primary enzyme

A

Creatine Kinase

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12
Q

Forward Reaction (Tanzer-Gilvarg) secondary emzymes

A

Pyruvate Kinase, LDH

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13
Q

↑ in absorbance at 340 nm is determined; Reduced NADPH

A

Reverse Reaction (Oliver-Rosalki)

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14
Q

Reverse Reaction (Oliver-Rosalki) Optimum pH

A

Optimum pH: 6.8 (acidic)

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15
Q

Reverse Reaction (Oliver-Rosalki) primary enzyme

A

Creatine Kinase

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16
Q

Reverse Reaction (Oliver-Rosalki) secondary enzymes

A

Hexokinase and G-6-PD

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17
Q

Sources of Error

A
  1. Hemolysis cause false ↑ CK activity
  2. CK is inactivated by light (decreased ↓)
  3. Physical activity and IM injections cause ↑ CK
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18
Q

Creatine Kinase (CK)/ Creatine Phosphokinase Reference Range

A

Male (higher): 15-160 U/L Female: 15-130 U/L
CK-MB: <6% of total CK

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19
Q

CK-3/ CK-MM/
Muscle Type

A

Specific to Skeletal Muscle

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20
Q

CK that has lowest mobility toward the anode (least anodic)

A

CK-3/ CK-MM/ Muscle Type

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21
Q

CK that major isoenzyme in striated muscle and normal serum

A

CK-3/ CK-MM/ Muscle Type

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22
Q

CK-2/ CK-MB/ Hybrid Type

A

Specific to the Heart

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23
Q

CK that is 2nd fastest to migrate toward the anode

A

CK-2/ CK-MB/ Hybrid Type

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24
Q

CK that significant quantities are found in heart tissues

A

CK-2/ CK-MB/ Hybrid Type

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25
CK-1/ CK-BB Brain Type
Specific to the Brain
26
CK that migrate fastest toward the anode (most anodic)
CK-1/ CK-BB Brain Type
27
CK that has Highest conc. in CNS, GI tract, and uterus (pregnancy)
CK-1/ CK-BB Brain Type
28
In normal serum, CK-BB is ______; negligible
very low
29
CK-BB increases when there is damage in the ____ → ____
BBB, CSF leakage
30
The first cardiac enzyme to increase in cases of acute myocardial infarction of all MI markers.
CK-MB (hybrid subunit, specific to the HEART)
31
The first protein to increase in cases of MI is ______ (faster than CK-MB). The first enzyme however is _______
myoglobin, CK-MB
32
Has the highest normal value in healthy individuals
CK-MM
33
CK-MM is predominant in
BLOOD
34
____________ measurement is not diagnostic because CK is _______
Total CK enzyme, not specific
35
After MI, CK-MB (>6%) levels begin to rise within ______, peak at _______, and returns to normal levels within ______
4-8 hours, 12-24 hours, 48-72 hours
36
1st enzyme to increase is __ → ___→ ___
CK → AST → LDH
37
CK REFERENCE VALUES CK-MM: CK-MB: CK-BB:
CK-MM: 94-98%; CK-MB: 2-6%; CK-BB: very low
38
The CK isoenzyme is coupled/ complexed with antibodies or lipoproteins
Macro-CK
39
Farthest to ANODE
Mitochondrial CK (CK-Mi)
40
Migrates cathodal to CK-MM; before CK-3
CK-Mi
41
Catalyzes the interconversion of lactic and pyruvic acids
Lactate Dehydrogenase (LD)
42
Lactate Dehydrogenase (LD) IS widely distributed, highest activities in _____, _____, _____ and _____
highest activities in heart, hepatic, skeletal muscle and RBC
43
LD main source for monomers
Heart & Skeletal Muscle
44
LD structure
Tetramer with 2 active sub-units (H & M active units) H = HEART and M = MUSCLE
45
LD second substrate
NAD coenzyme
46
Forward Reaction (Lactate→Pyruvate)
WACKER METHOD
47
WACKER METHOD Increase in absorbance is monitored at
340 nm (oxidized → reduced NADH)
48
WACKER METHOD optimal pH
Optimal pH is 8.3 – 8.9 (basic/ alkaline)
49
Reverse Reaction (Pyruvate→Lactate)
WROBLEUSKI LA DUE
50
WROBLEUSKI LA DUE Decrease in absorbance at
Decrease in absorbance at 340 nm
51
3x faster but more susceptible to substrate exhaustion
WROBLEUSKI LA DUE
52
WROBLEUSKI LA DUE optimal pH
Optimal pH is 7.1–7.4
53
Has greater affinity to H subunits of LDH
α-hydroxybutyrate Dehydrogenase (α-HBD)
54
After MI, LD begin to: RISE within ________ PEAK at ________ REMAINS elevated for _______
RISE within 10-24 hours (slowest of all cardiac markers) PEAK at 48-72 hours or 2-3 days REMAINS elevated for 10 days (longest to remain elevated)
55
LD reference range
100-225 U/L
56
5 LACTATE DEHYDROGENASE (LDH) ISOENZYMES
LDH-1 (HHHH) LDH-2 (HHHM) LDH-3 (HHMM) LDH-4 (HMMM) LDH-5 (MMMM)
57
Fastest to migrate LDH isoenzyme, nearest to the anode
LDH-1 (HHHH)
58
MOST ABUNDANT LDH isoenzyme
LDH-2 (HHHM)
59
LDH-1 (HHHH) tissues
Heart, RBC (Heart Specific)
60
LDH-2 (HHHM) tissues
Heart, RBC
61
LDH-3 (HHMM) tissues
Lung, Spleen
62
LDH-4 (HMMM) tissues
Liver
63
LDH-5 (MMMM) tissue
Skeletal Muscle
64
LDH-1 (HHHH) disorder
MI, Hemolytic Anemia (more significant than LD2)
65
LDH-2 (HHHM) disorder
Renal Infarction, Megaloblastic Anemia
66
LDH-3 (HHMM) disorder
Pulmonary Embolism
67
LDH-4 (HMMM) disorder
Hepatic Injury
68
LDH-5 (MMMM) disorder
Skeletal Muscle Injury
69
LDH isoenzyme most abundant to least in serum
2>1>3>4>5 (most abundant to least)
70
LDH isoenzyme Flipped Pattern seen on AMI/ Intravascular Hemolysis
1>2>3>4>5
71
LDH isoenzyme Muscle & Liver Disorders:
5>4>3>2>1
72
LD isoenzyme Lung Disorders (LD3):
3>4>2>1>5
73
CK -MB Appearance Peak Stay Elevated
4-8 hours 12-24 hrs 3 days
74
AST Appearance Peak Stay Elevated
6-8 hrs 24 hrs 5 days
75
LDH Appearance Peak Stay Elevated
10-24 hrs 48-72 hrs 10 days

FINALS CC 2 (7 decks)

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