Topic 4- enzymes Diagnostic and prgnosis

Question 1

How do we treat paracetamol poising

Answer 1

N-acetylcysteine

Question 2

How do we figure out precise dose for paracetamol poisoning?

Answer 2

React paracetamol with bacterial enzyme Acetate p-aminophenol> react with two compounds> coloured substance

Question 3

What happens if we have too much paracetamol

Answer 3

> Cytochrome 50 oxidses
very reactive
modigy liver enzymes

Question 4

What is it called when glucose levels in a diabetic are low

Answer 4

Hyperglycaemia

Question 5

How do we monitor glucose levels in blood

Answer 5

Coupled reactions
>colour intensity
Assay of NADH
>NADH + Fluorescent

Question 6

What are the 2 coupled reaction

Answer 6

Glucose + O2+ H20—-> Gluconic Acid + H202
(Glucose oxidase)
H202 + Chromagen—–> Oxidised Chromagen (blue) +H20
(Peroxidase)

Question 7

What is the Assay of NADH

Answer 7

Glucose+ NAD+ ——>Gluconic Acid + NADH + H+

Glucose Dehydrogenase

Question 8

Uses isoenzymes

Answer 8

Used to locate dameag

Question 9

What are the isoenzymes of Creatine Kinase?
Where are they found?
What do they increase with?

Answer 9

MM> Muscle (Inc. AMI + skeletal injury)
MB> Myocardium (Inc. AMI)
BB> Brain (Inc. neurological disorder)

Question 10

Function of Creatine Kinase

Answer 10

Creatine + ATP —–> Creatine-phosphate + ADP
Phosphate storgae in muscle
reverse> energy

Question 11

How does muscle damage cause renal failure?

Answer 11

Myoglobin released> breaks down> toxic substances> Occlude kidney structure > renal failure> myogloburina> dark reddish brown urine

Question 12

How many sub units does Lactate dehydrogenase have LDH?

Answer 12

4

Question 13

What are the isoenzymes to LDH?

Where are they found?

Answer 13

H4> heart
M4> liver, skeletal muscle
H3M> monocytes/ macrophages

Question 14

Describe how LDH isoforms are used to diagnose a AMI

Answer 14

> Separate LDH isoforms> Electrophoresis
Colorimetric reaction
LDH1: LDH2 high in AMI

Question 15

Describe Lysis of blood clots with plasmin

Answer 15

TPA——> Serine protease cleaves Plasminogen——-> activates plasmin——->dissovles fibrin clots——>peptides

Question 16

What is TPA? What does it do?

Answer 16

Tissue- type plasminogen activator
>Adheres to clot + bind to plasminogen
>targets activity to right place

Question 17

What are clot- busters/ thrombolytics?

Answer 17

> Recombinant TPA >tTPA/ Alterplase

>Treats coronary thrombosis

Question 18

How do we use enzymes as drugs?

Answer 18

> Inject> replace defected

>thrombosis + CALL

Question 19

What enzymes measure cardiac injuries?

Answer 19

> Creatine Kinase
Myoglobin
Cardiac Trophonin -1
Lactate dehydrogenase `

Question 20

What enzymes are measured in liver function test

Answer 20

>Albumin
>GOT
>GPT
>Alkaline phosphate
>Bilirubin
>Prothrombin
>Gamma Glutaryl

Question 21

Albumin LFT

Answer 21

3.5-5.3
Inc> secretory function loss
>kidney disease

Question 22

GOT LFT

Answer 22

6-48

Muscle and liver specific

Question 23

GPT LFT

Answer 23

7-55

Liver specific

Question 24

Total Transaminase LFT

Answer 24

GOT+GPT

>High ratio> liver disease

Question 25

Alkaline Phosphate LFT

Answer 25

45-120

>Inc. bile obstruction

Question 26

Direct bilirubin + total bilirubin LFT

Answer 26

0.4 + 1.2
>Combing norm
>failure to excrete> bile duct obstruction (total)
liver duct obstruction (direct)

Question 27

Prothrombin time LFT

Answer 27

> clot time

> liver not producing clot enzymes

Question 28

Gamma Glutaryl Transpeptidase LFT

Answer 28

9-48

>liver specific