Clinical Chemistry Exam 1 Lecture 7 – Flashcards
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            | Given the abbreviation give the enzyme: ACP | 
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        | Acid Phosphatase | 
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            | Given the abbreviation give the enzyme: ALT | 
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        | Alanine Aminotransferase | 
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            | Given the abbreviation give the enzyme: ALP | 
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        | Alkaline Phosphatase | 
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            | Given the abbreviation give the enzyme: AMS | 
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        | Amylase | 
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            | Given the abbreviation give the enzyme: AST | 
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        | Aspartate Aminotransferase | 
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            | Given the abbreviation give the enzyme: CK | 
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        | Creatine Kinase | 
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            | Given the abbreviation give the enzyme: GGT | 
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        | Gamma-glutamyltransferase | 
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            | Given the abbreviation give the enzyme: G6PD | 
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        | Glucose-6-Phosphate Dehydrogenase | 
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            | Given the abbreviation give the enzyme: LD | 
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        | Lactate Dehydrogenase | 
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            | Given the abbreviation give the enzyme: LPS | 
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        | Lipase | 
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            | Given the abbreviation give the enzyme: SChE | 
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        | Pseudocholinesterase | 
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            | Given the enzyme give the Disease/Organs: Pseudocholinesterase | 
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        | Organophosphate Poisoning | 
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            | Given the enzyme give the Disease/Organs: Lipase | 
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        | Pancreatitis | 
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            | Given the enzyme give the Disease/Organs: Lactate Dehydrogenase | 
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        | Heart, Liver, Lungs | 
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            | Given the enzyme give the Disease/Organs: Glucose-6-Phosphate Dehydrogenase | 
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        | Hemolytic Anemia | 
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            | Given the enzyme give the Disease/Organs: Gamma-glutamyltransferase | 
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        | Bile Duct, Liver | 
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            | Given the enzyme give the Disease/Organs: Creatine Kinase | 
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        | Heart, Muscle | 
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            | Given the enzyme give the Disease/Organs: Aspartate Aminotransferase | 
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        | Heart, Muscle, Liver | 
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            | Given the enzyme give the Disease/Organs: Amylase | 
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        | Pancreatitis Pancreas and Salivary Glands | 
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            | Given the enzyme give the Disease/Organs: Alkaline Phosphatase | 
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        | Bone, Liver, and Placenta | 
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            | Given the enzyme give the Disease/Organs: Alanine Aminotransferase | 
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        | Liver | 
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            | Given the enzyme give the Disease/Organs: Acid Phosphatase | 
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        | Prostate Cancer | 
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            | Given the organ what are the enzymes associated with it: Liver | 
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        | AST ALT LD GGT ALP | 
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            | Given the organ what are the enzymes associated with it: Biliary Obstruction | 
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        | GGT ALP | 
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            | Given the organ what are the enzymes associated with it: Heart Attack | 
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        | CK CKMB AST | 
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            | Given the organ what are the enzymes associated with it: Skeletal Muscle | 
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        | CK AST LD | 
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            | Given the organ what are the enzymes associated with it: Bone | 
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        | ALP | 
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            | Given the organ what are the enzymes associated with it: Pancreas | 
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        | AMS LPS | 
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            | Given the organ what are the enzymes associated with it: Prostate | 
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        | ACP | 
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            | Given the organ what other tests should be performed: Liver | 
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        | Albumin Bilirubin PT | 
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            | Given the organ what other tests should be performed: Heart Attack | 
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        | Myoglobin Troponin | 
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            | Given the organ what other tests should be performed: Bone | 
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        | Ostase Calcium PTH | 
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            | Given the organ what other tests should be performed: Prostate | 
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        | PSA | 
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            | Highest levels of Lactate Dehydrogenase are seen in what? | 
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        | Pernicious anemia and hemolytic anemias, AMI and Hemolysis | 
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            | Other than Heart, Liver, and Skeletal Muscle what else is Lactate Dehydrogenase associated with? | 
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        | RBCs | 
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            | Sources of error with Lactate Dehydrogenase | 
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        | Avoid any traces of hemolysis Avoid refrigerating or freezing | 
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            | At what temperature should you store Lactate Dehydrogenase? | 
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        | Room Temperature | 
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            | Acid Phosphatase | 
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        | Highest in Prostate Cancer Presumptive evidence of semen | 
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            | True or False: ACP is rarely performed | 
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        | True | 
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            | What has ACP been replaced by? | 
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        | PSA (Tumor Markers) | 
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            | What are Bone Illnesses associated with ALP? | 
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        | Paget's Disease Osteomalacia and rickets Bone fractures Osteoporosis Childhood/adolescence | 
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            | What test can you perform for Osteoporosis? | 
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        | Ostase - test to monitor response to therapy | 
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            | What is associated with the Liver and ALP? | 
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        | Biliary tract obstruction | 
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            | To differentiate Bone from Liver in ALP results, what should you do? | 
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        | Heat serum to 56 degrees C for 10 minutes | 
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            | When differentiating Bone from Liver in ALP which serum lives and which dies? | 
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        | Liver lives Bone dies | 
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            | Which trimesters are associated with the placenta and ALP? | 
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        | 2nd and 3rd | 
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            | Sources of error with ALP: | 
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        | Hemolysis Run ASAP to prevent serum increases | 
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            | What does ALP require? | 
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        | Magnesium | 
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            | AST Liver - Up to 100x ULN in | 
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        | Viral Hepatitis | 
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            | AST Liver - Up to 4x ULN in | 
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        | Cirrhosis | 
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            | AST Heart - Levels begin to rise within ____ hours of AMI | 
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        | 6 | 
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            | Is AST useful for assessing AMI? | 
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        | No, it is too non-specific | 
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            | AST Skeletal Muscle is often associated with what? | 
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        | Muscular dystrophy Crush injuries | 
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            | Sources of error with AST? | 
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        | Hemolysis | 
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            | Is ALT more specific for the liver than AST? | 
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        | Yes | 
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            | ALT Liver - Levels higher and persist longer than AST in ____ _____ | 
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        | Viral Hepatitis | 
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            | True or False: ALT may increase prior to symptoms of liver cell damage | 
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        | True | 
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            | Though AST is high in all of the following, which 1 will ALT be high in? Heart, Liver, or Skeletal Muscle | 
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        | Liver | 
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            | Sources of error for ALT | 
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        | No significant interferences | 
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            | Amylase | 
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        | Catalyzes breakdown of starches Normally filtered by glomerulus and detectable in urine | 
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            | 2 Illnesses associated with Amylase | 
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        | Acute Pancreatitis Macroamylasemia | 
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            | Acute Pancreatitis - AMS levels rise in _______ hours after onset of an attack and return to normal in a _____ | 
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        | 2-12 week | 
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            | ____ levels of AMS in Urine of Acute Pancreatitis patients | 
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        | High | 
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            | What are the most common causes of Acute Pancreatitis? | 
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        | Gall Stones Alcoholism | 
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            | Can Acute Pancreatitis lead to tissue necrosis and death? | 
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        | Yes | 
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            | Macroamylasemia | 
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        | Benign condition affecting 1-2% of population. Amylase binds to immunoglobulins This bound pair can't filter through glomerulus, thus serum levels rise | 
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            | Though Serum amylase rises in both Acute Pancreatitis and Macroamylasemia, is Urine Amylase elevated or decreased in Acute Pancreatitis? | 
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        | Elevated | 
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            | Though Serum amylase rises in both Acute Pancreatitis and Macroamylasemia, is Urine Amylase elevated or decreased in Macroamylasemia? | 
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        | Decreased | 
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            | Sources of error of AMS | 
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        | Calcium and Chloride are Activators | 
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            | Do you use EDTA tubes for Amylase samples? | 
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        | NO | 
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            | Lipase (LPS) | 
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        | Breaks down dietary triglycerides into fatty acids and glycerol | 
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            | LPS is highest in what? | 
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        | Acute Pancreatitis | 
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            | Is LPS elevated in Salivary disorders? | 
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        | No | 
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            | Sources of error for Lipase | 
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        | Hemolysis inhibits lipase activity to cause a falsely low value | 
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            | Delta-Glutamyltransferase | 
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        | Sensitive indicator of alcohol ingestion | 
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            | What is GGT used to monitor? | 
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        | Abstention from alcohol because levels rapidly rise if drinking is resumed | 
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            | Are there any sources of error for GGT? | 
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        | No, it is Relatively Stable | 
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            | Does Hemolysis interfere with GGT? | 
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        | No | 
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            | G-6-PD - Most in ___ ___ to maintain NADPH which protects hemoglobin from oxidative damage | 
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        | red cells | 
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            | Is G6PD Sex linked? | 
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        | Yes | 
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            | Where is there a high incidence of G6PD? | 
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        | Africa Middle East Far East | 
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            | G6PD - Exposure to oxidant drugs can cause what? | 
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        | Drug-Induced Hemolytic Episode | 
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            | A Deficiency in G6PD can provide what? | 
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        | Some protection against Plasmodium falciparum | 
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            | Sources of error for G6PD? | 
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        | None | 
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            | What is used to test for deficiency of G6PD? | 
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        | A RBC hemolysate | 
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            | Pseudocholinesterase & Acetylcholinesterase are needed for what? | 
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        | Nerve conduction and muscle contraction/impulse termination | 
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            | What does an Inherited Deficiency in Pseudocholinesterase & Acetylcholinesterase cause? | 
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        | Muscle contraction and respiratory distress when given anesthesia | 
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            | What does an Acquired Deficiency in Pseudocholinesterase & Acetylcholinesterase cause? | 
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        | Salivation, vomiting, twitching, slurred speech, behavioral changes, and respiratory failure | 
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            | Where does an Acquired Deficiency in Pseudocholinesterase & Acetylcholinesterase come from? | 
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        | Organophosphate pesticide poisoning | 
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            | Creatine Kinase - 3 isoforms are also called | 
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        | Isoenzymes | 
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            | CK - All three forms contibute to the ____ ___ activity in serum | 
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        | Total CK | 
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            | CKMM is associated with which organs? | 
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        | Skeletal muscle Heart (95% of total CK) | 
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            | *CKMB is associated with which organs? | 
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        | Heart Skeletal Muscle | 
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            | CKBB is associated with which organs? | 
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        | Brain Bladder Lungs Other | 
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            | What illnesses are often associated with CKMM? | 
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        | Muscular trauma and crush (rhabdomyolysis), Muscular Dystrophy, Strenuous exercise, AMI | 
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            | What illnesses are often associated with *CKMB? | 
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        | Acute Myocardial Infarction (AMI) & Angina | 
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            | What illnesses are often associated with CKBB? | 
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        | Cerebrovascular accidents & Seizures | 
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            | Name the CK isoenzyme isolated from the heart? | 
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        | CKMB | 
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            | What test is used to assess treatment of post-menopausal osteoporosis | 
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        | Ostase | 
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            | List two "normal" conditions that can cause an elevation of ALP | 
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        | Childhood Pregnancy | 
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            | Which enzyme(s) require Calcium as an activator? | 
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        | Amylase | 
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            | List another enzyme other than amylase that can be used to assess pancreatitis | 
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        | LPS | 
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            | Which enzyme is Most susceptible to the effects of Hemolysis AND Freezing temperatures | 
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        | LD | 
