Clinical Chemistry Answers – Flashcards
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Unlock answers| What is the Ref Range for CK-Creatine Kinase? |
Males: 46-180mg/dl Females: 15-171 mg/dL |
| What is the clinical signifance of CK |
| Increases in brain, cardiac, muscle destruction |
| What are some examples of increases in CK? |
Heart attack Chronic heart failure Muscular dystrophy Epilepsey Stroke Tumors |
| What are the isoenzymes of CK |
| 2 Dimers: M,B=MM, MB, BB |
| iSoenzyme MM |
Skeletal/cardiac muscle major in serum |
| MB |
found in Heart muscle and skeletal muscles help diagnoise MI |
| BB |
travels farthest Brain CNS-stroke |
| WHat is the clinical signifiance of LD-Lactate dehydrogenase? |
Increases in heart, blood diseases liver disease (hepatitis) muscular dystrophy
|
| 5 Isoenzyme for LD |
Tetramer 2H 2M HHHH HHHM HHMM HMMM MMMM
|
| HHHH |
Heart RBC Kidney |
| HHHM |
Heart RBC Kidney |
| HHMM |
Spleen Lungs Many tissues
|
| HMMM, MMMM |
Liver Skeletal Muscle |
| What are the ezymes in cardiac diseases? |
CK CK-MB |
| Increase in CK is due to? |
MI peaks @ 24hr returns to normal in 2-4 days |
| Negative CK-MB indicates? |
| 6-8hrs 95% nedgative predicative vaule indicates no MI |
| Main location of AST-Aspartate aminotransferase |
| Liver |
| What are the clinical signifiance of AST? |
Increases: Liver Heart Muscles diseases
|
| Main location of ALT-Alanine aminotransferase |
| Liver |
Highest elevation in ALT more specific than AST |
1. Acute viral hepatitis 2. Toxic hepatitis
|
| ALT decreases with patients with |
| cirrohsis |
| Location of ALP- Alkaline Phosphastase |
| Liver |
| Clinical Signifance of ALP |
Help Diagnoise Liver and Bone disorders Increased ALP in hepatobillary disease/ obstructions and bone diseases |
| Location of GGT-Gamma Glutamyl Tranferase |
Serum present in all cells except muscle, biliray and liver |
| Clinical signifance of GGT |
Increases in hepatobiliary disease Helps differeniate between liver and bone diseases
|
Location of 5'-NT, 5'-nucleotidase?
|
| VAriety fo tissues, specifically liver |
| Clinical Signifance of 5'-NT |
Elevated in biliary tract diseases 5'-NT with GGT and ALP determinei if ALP elvation is from bone of liver disease ALP, GGT elevated = bone source of ALP |
| Location of AMY-amylase |
Digestive Salivary glands acinar cells of pancreas |
| Clinical Significance of AMY |
increses in acute pancreatitis, obstructive liver disease and acute acholism Associated with mumps, parotitis and lesions |
| Location of LPS-Lipase |
Digestive acinar cells of pancreas |
| Clinical Signifance of Lipase |
| Acute Pancreatitis |
| Clinical Signifance of TRY-Trypsin |
| Screening for cystic fibrosis, chronic pancreatitis |
| Clinical Signifance of CHY-Chymotrypsin |
| Investiagete chronic pancreatitis |
| Location of Acid Phospahte-ACP |
| Prostate |
| Clinical Signficance of ALP |
| Screening for prosate cancer --> PSA |
| Clinical SIgnifance of ALD-Aldolase |
Helpful in diagnosing/montoring sketelal muscle diseases Increases in ALD with CK:AST ratio help to differentaite neuro musclaular disease |
| What are the 2 groups of CHE- Cholinesterase |
ACHE pseudocholinesterrase |
| location of ACHE |
red cells lungs spleen CNS-gray matter nerver endings |
| function of ACHE |
| transmission of nerve impulses |
| Location of pseudocholinesterase? |
serum liver white matter of brain |
| CS of pseudocholinesterase |
test liver fxn dectect pesticide poisoning detection of abnormal genetic variants |
| Hepatitis |
Increase in all ezymes EXCEPT for ALD, and 5'-NT ; |
| Biliray obstruction |
| Increaese in all except for AST and ALP |
| Oxidoreductases |
Catalyze oxidation reduction rxn LD |
| transferases |
Catalyze transfer a group other than Hydrogen AST |
| Hydrolases |
Catalyze hydrolytic (cleavage of compounds) Amylase |
| Lyases |
| Catalyze removal of groups from substances with out hydrolysis |
| Isomerases |
| Catalayze Interconversion of Isomer |
| Ligases |
| 2 joining molecules |
| Inhibitors |
| Decrease rate of rxn |
| Competitive inhibition |
| Similar to normal substrate competes for active site |
| What are the 5 factors infulencing Enzyme Action |
1. Enzyme COncentration 2. Temperature 3. pH 4. Cofactors 5. Inhibitors |
| First Order |
| Velocity is directly proportional to subrate concentration |
| Zero Order |
| Rxn rate us independent of substrate concentration |
| Three properties of enzyme |
1. Ezymes are not altered or consumer in the rxn 2. Only a small amount of ezymes are used in the rxn 3. Ezymes acclerrate the speed of the rxn |
| Apoezymes |
| Heat-liable protein |
| Prosthetic group |
| Bound to co enzymes |
| Apoenzyme + cofactor |
| Holoenzyme |
| Organic/inorganix compounds need in enzyme fxns |
| Cofactors |
| Activators |
| Inorganic cofactors |
| Highest elevation of GGT |
Biliary obstruction Acute pancreatitis Help differntiate b/w liver and bone disease |
| catalyzes the hydrolysis of complex carbohydrates including starch, amylopectin, glycogen |
| fxn of AMY |
| Enzymes where acute pancreatitis is the issue |
| Amylase, Lipase, GGT |
| Pre-analytical errors |
timing of draw type of anticoagulant lipemia or icterus for some specimens serum vs. plasma serum vs. plasma vs. whole blood |
