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CC LEC 2 > P4: AST, ALT, ALP, ACP > Flashcards

P4: AST, ALT, ALP, ACP Flashcards

1
Q

Product of AST

A

○ oxaloacetate and glutamate

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2
Q

AST

● Former Name: _________________

A

○ Serum glutamic-oxaloacetic transaminase (SGOT or
GOT)

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3
Q

AST

Cofactor: ______________

A

○ Pyridoxal phosphate (Vitamin B6)

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4
Q

_________________will serve as the amino group donor and the amino
group of aspartate will be given to Oxoglutarate

A

aspartate

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5
Q

_________________will become Glutamate upon acquiring the amino
group from aspartate

A

Oxoglutarate

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6
Q

● Aspartate becomes Oxaloacetate after giving up the ______________

A

amino group.

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7
Q

ALT

Product: _____________

A

○ glutamate and pyruvate

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8
Q

ALT

● Former Name: ______________

A

○ Serum glutamic-pyruvic transaminase (SGPT or
GPT)

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9
Q

ALT

● Cofactor: ______________

A

○ Pyridoxal phosphate (Vitamin B6)

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10
Q

_______________ is the amino group donor. The amino group will be given
to Oxoglutarate

A

Alanine

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11
Q

● Oxoglutatrate upon acquiring NH2 becomes__________________

A

Glutamate.

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12
Q

● Functions in the synthesis and degradation of Amino acids

A

Aspartate aminotransferase

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13
Q

Glutamate will be
synthesized with the breakdown of aspartate

A

Forward reaction

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14
Q

Glutamate will be
degraded to form aspartate

A

Reverse reaction

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15
Q

_______________regulates the number of amino acids in
our system

A

Transaminase

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16
Q

___________________are ultimately oxidized by the tricarboxylic acid
cycle to provide a source of energy

A

Ketoacids formed

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17
Q

The highest in AST

A

Cardiac tissue

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18
Q

highest in ALT

A

Liver

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19
Q

AST

Intracellular level: ___________times than
plasma

A

7000

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20
Q

ALT

Intracellular level: 3000 times than
plasma

A

3000

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21
Q

__________is not used in the diagnosis of heart disorders because of its
non-specificity. It’s highest in the heart but it is not solely produced
by the heart

A

AST

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22
Q

Inside our hepatocytes, both ________ and _______ are in high levels
therefore their presence in the blood is ____________

A

ALT and AST
very low.

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23
Q

● AST occurs in 2 forms:
1.
2.

A

○ Cytoplasmic AST
○ Mitochondrial AST

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24
Q

Predominant form in serum

A

● Cell cytoplasm

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25
Q

Increased in disorders producing CELLULAR
NECROSIS

A

Mitochondria

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26
Q

○ Diseases that damage the hepatocyte directly.

A

● Hepatocellular (ALT & AST)

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27
Q

● Hepatobiliary (ALP)

○ Common example: _________________ or __________________

A

gallstone or obstruction of the bile duct

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28
Q

AST

○ Rise: ___________
○ Peak: __________
○ Normalizes within __________

A

○ Rise: 6-8 hours
○ Peak: 24 hours
○ Normalizes within 5 DAYS

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29
Q

○ Viral hepatitis: _________ upper limit of Normal (ULN)
○ Liver Cirrhosis: ________ ULN
● Muscular Dystrophies: _________ULN

A

100 times
4 times
4-8 times

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30
Q

ALT elevation is frequently higher than (cytoplasmic)
AST due to its ______________

A

longer half-life in blood

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31
Q

■ ALT: ________
■ Cytoplasmic AST: _________
■ mitochondrial AST: half-life of ___________;

A

■ ALT: 47 hours
■ Cytoplasmic AST: 17 hours
■ mitochondrial AST: half-life of 87 hours;

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32
Q

_________ - How long it would take for enzyme
decrease to 50% of concentration

A

Half life

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33
Q

■ De Ritis ratio (ratio of AST:ALT): _________

A

3-4:1

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34
Q

Catalyze the hydrolysis of various phosphomonoesters at a
certain pH

A

Phosphatases

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35
Q

○ need water to break down substrate

A

hydrolases

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36
Q

ALP

Systemic Name: _____________

A

Orthophosphoric Monoester Phosphohydrolase
(Alkaline Optimum)

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37
Q

ALP

Product: _____________

A

○ alcohol and phosphate ion

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38
Q

ALP

● Optimum pH: _____________

A

○ pH 9.0 - 10.0

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39
Q

ALP

● Cofactor: _______________

A

○ Magnesium and Zinc

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40
Q

ACP

● Systemic Name:

A

Orthophosphoric Monoester Phosphohydrolase
(Acid Optimum)

41
Q

ACP

Product: ________________

A

○ alcohol and phosphate ion

42
Q

ACP

● Optimum pH: _____________

A

○ pH 5.0

43
Q

ACP

● Cofactor:__________________

A

○ Magnesium and Zinc

44
Q

richest source in ACP

A

Prostate

45
Q

ALP

Diagnostic Use: ____________

A

Liver and bone

46
Q

ACP

Diagnostic Use: ______________

A

Prostate and bone

47
Q

Four major isoenzymes of alkaline phosphatase

A

placental alp
liver alp
bone alp
intestinal alp

48
Q

migrates the fastest and most anodal in alp

A

liver alp

49
Q

osteoblast activity

A

bone alp

50
Q

_______________is measured before and after heating the serum at 56 degrees Celsius for 10 minutes (to check for denaturation)

A

ALP activity

51
Q

Most heat stable in alp

A

placental

52
Q

Heat sensitive in alp

A

bone

53
Q

______________ If the residual activity after heating is less than 20% of the total activity before heating

A

bone alp

54
Q

Greater than 20% in alp

A

liver alp

55
Q

placental alp - resist heat denaturation at ________
degrees Celsius for __________

A

65 degrees celsius
30 minutes

56
Q

ALP

Alternative: use of _____________and _____________

A

neuraminidase and wheat germ lectin

57
Q

○ Inhibits Intestinal ALP and Placental ALP to a much
greater extent than liver and bone ALP

A

● Phenylalanine

58
Q

○ Inhibits Bone ALP and Liver ALP (Henry)

A

● Levamisole

59
Q

○ Inhibits Bone ALP

A

● 3M urea

60
Q

_______, _______, ___________ are termed as Carcinoplacental ALP because they are found in cancer patients only. Why? Because these isoenzymes are produced by the _____________

A

Regan, Nagao, and Kasahara
cancer cells.

61
Q

ALP isoenzymes that have abnormal fractions are:
1. ____________
2. ___________
3. ___________

A

Regan, Nagao, and Kasahara

62
Q

Intestinal alp- common in pxs with Blood Type ______ or ______ and are secretors

A

type B or O

63
Q

people whose blood type can be
determined in body fluids such as saliva or semen

A

secretors

64
Q

● Similarities to the placental isoenzymes

A

Carcinoplacental Alkaline Phosphatases

65
Q

CAP

● _________ in cancer patients

A

3% to 15%

66
Q

These isoenzymes should not be used as a ____________, because they are only found in 3% - 15% in cancer patients (Big chance for ___________________)

A

tumor markers
FALSE NEGATIVE RESULT

67
Q

● Detected in various carcinomas

A

regan isoenzymes

68
Q

Increase in ovarian (highest incidence) and
gynecologic cancers

A

regan isoenzymes

69
Q

Inhibited by phenylalanine and migrates like bone ALP (in
electrophoresis

A

regan isoenzymes

70
Q

● Identical to the Regan fraction (considered as a variant of Regan)

A

nagao isoenzymes

71
Q

● Inhibited by both phenylalanine and L-leucine

A

nagao isoenzymes

72
Q

Detected in metastatic carcinoma of pleural surfaces and
adenocarcinoma of the pancreas and bile duct

A

nagao isoenzymes

73
Q

○ Pleural surfaces - _______
○ Adenocarcinoma - ___________

A

○ Pleural surfaces - lungs
○ Adenocarcinoma - epithelial tissue

74
Q

Diagnostic significance in ALP

hepatobiliary disorders - _________
hepatocellular disorder - ___________

A

3-10 ULN
3 ULN

75
Q

● problem outside the liver

A

Extrahepatic

76
Q

Extrahepatic include:
1. _____________
2. ____________
3.______________

A

GCP

● Gallstones (cholelithiasis and
choledocholithiasis)
○ Most common cause
● Cysts and carcinoma
● Parasitic infection

77
Q

● Problem in transport

A

intrahepatic

78
Q

Intrahepatic include:
1. _____________
2. ____________

A

VC

● Viral hepatitis
● Cholestasis in pregnancy (due to
estrogen)

79
Q

o cholangitis hallmark:
_________________________

A

Hallmarks: Charcot’s triad/Reynold’s pentad
(Tokyo Guidelines are also used)

80
Q

inflammation of the bile duct

A

cholangitis

81
Q

● Charcot’s triad include:
1. ___________
2._____________
3._____________

A

○ Fever
○ Right Upper Quadrant
Pain (RUQ)
○ Jaundice

82
Q

____________: gain in bone mass

A

○ Paget Disease

83
Q

■ __________- for infants
■ ___________- for adults

A

Rickets - infant
Osteomalacia -adult

84
Q

○ Increased ALP

A

normal pregnancy

85
Q

○ observed in hypophosphatasia (an inborn error of
metabolism)

A

hypophosphatasia

86
Q

isoenzymes in ACP
1.___________
2.____________
3._____________

A
  1. Prostatic ACP
  2. Red Cell / Erythrocytes
  3. TRAP (Tartrate Resistant Acid Phosphatase)
87
Q

Inhibited by tartrate (Total ACP - ACP after tartrate
inhibition

A

● Prostatic ACP

88
Q

Inhibited by 2% formaldehyde and 1 mmol cupric
sulfate

A

● Red cell / Erythrocyte ACP

89
Q

marker for hairy cell leukemia

A

Tartrate-resistant Acid Phosphatase

90
Q

produced by osteoclasts in the bone marrow
and is used as a marker for bone remodeling/resorption

A

TRAP-5b

91
Q

■ Only found in prostate gland

A

○ Prostate-Specific Antigen

92
Q

■ More specific than ACP, useful in therapy
monitoring
■ May elevate in ____________
and ___________

A

○ Prostate-Specific Antigen
benign prostatic hypertrophy prostatitis

93
Q

Useful in investigation of rape

A

○ Prostate-Specific Antigen

94
Q

Presumptive evidence of rape: ACP activity

A

> 50 U/L = positive
= Decrease

95
Q

● ALP and ACP increase

A

■ Paget disease

96
Q

■ Caused by a deficiency of the enzyme
glucocerebrosidase to the buildup of fatty
substances in certain organs

A

○ Gaucher disease

97
Q

■ Resulting from excessive platelet destruction
from idiopathic Thrombocytopenia
Purpura (ITP

A

○ Thrombocytopenia

98
Q

■ __________ is found in platelets

A

ACP

99
Q
A

CC LEC 2 (15 decks)

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