Clinical Chemistry Exam 1 Lecture 7 – Flashcards
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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 |
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