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35 Cards in this Set
- Front
- Back
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What is the reaction for AST?
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Aspartate + alpha-ketoglutarate --> oxaloacetate + glutamate |
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How is AST measured in an assay?
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Excess NADH (unutilized by AST) and malate dehydrogenase are added and then the disappearance of NADH at 340 nm is observed. COUPLED ENZYME ASSAY |
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How is alkaline phosphate measured?
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p-nitrophenol is detected at 405 nm |
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Where is AST in the body?
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CARDIAC MUSCLE Liver Skeletal muscle kidney brain lung pancreas |
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Where is ALT in the body? |
Kidney |
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Where is AST found in the cell? |
Mitochondria (80%) |
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Where is ALT found in the cell? |
Cytoplasm |
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What is elevated in heparin therapy? |
Both AST and ALT (~3x upper limit) |
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What is decreased in renal failure? |
AST and ALT |
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Which isoenzymes of LDH are fast moving? and where are they found in greatest abundance? |
Heart, RBCs, Kidney LDH-1 > LDH-2 in these tissues |
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Which isoenzymes of LDH are slow moving? Where are they found?
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Liver and Skeletal Muscle |
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Where is LD-3 found? |
Lung, Spleen, Lymphocytes, and Pancreas |
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What is the serum concentration of the LDH serotypes from highest to lowest?
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2 > 1 > 3 > 4 > 5
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What conditions are in the differential when the serum concentrations have LDH-1 > LDH-2?
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Hemolysis Renal Infarction |
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What does elevated LDH-4/5 suggest?
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Liver damage or skeletal muscle damage |
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What is elevated LDH-1 and LDH-5 explained by? |
OR Chronic alcoholic with liver damage and megaloblastic anemia |
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Where are acid phosphatases found?
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What distinguishes red cell acid phosphatase from other acid phosphatases?
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Susceptible to 2% formaldehyde inhibition Resistant to tartrate inhibition SAME THING AS tartrate-resistant acid phosphatase in Hairy Cell Leukemia |
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What produces the highest concentration of alkaline phosphatases?
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When do you see decreased alkaline phosphatase?
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Hypophosphatemia (inborn deficiency) and malnutirtion |
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Which alkaline phosphatase isoenzyme is inactivated by urea or heating?
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Bone (90%), Bilirary (50%) |
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Where is alkaline phosphatase produced in bone?
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Osteoblasts --> marker of bone formation --> Alk phos super high in Paget's Disease |
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If you have an elevated alk phos but a normal GGT and 5' nucleotidase, what is suspected? |
Bone origin |
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What is the best test to confirm an elevated Alk Phos is biliary in origin?
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GGT (gamma-glutamyl transferase) |
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Where is GGT produced in the biliary tree?
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Biliary epithelial cells |
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What can be used as a marker for alcohol use? |
2-3x elevated in Alcoholics Returns to normal after 3 weeks of abstinence |
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What is the Regan isozyme of alkaline phosphatase?
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Elevated in malignant conditions, equivalent to placental alk phos
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What non-pathologic conditions elevate alkaline phosphatase? |
Normal growth (childhood) Pregnancy After eating (intestinal alk phos) |
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What are the main sources of ammonia in the body? |
Skeletal Muscle (urea cycle) Gut (enteric bacteria) |
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What are special requirements for blood testing of ammonia? |
Needs to be transported on ice and tested immediately (ammonia levels increase over time) Smoking falsely elevates so patients need to abstain for several hours |
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What wavelength is bilirubin measured at? |
455 nm (peak at 575 nm must be subtracted because hemoglobin absorbs at both) |
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Gilbert Syndrome |
Autosomal Dominant Unconjugated hyperbilirubinemia |
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Crigler-Najjar Syndrome |
Autosomal Recessive Unconjugated hyperbilirubinemia Type 1: Severe, complete absence of UDP-glucuronidase Type 2: Diminished UDP-glucuronidase |
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Rotor Syndrome |
Autosomal recessive Conjugated hyperbilirubinemia Benign |
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Dubin-Johnson Syndrome |
Autosomal recessive Conjugated hyperbilirubinemia Hyperpigmented liver Benign |
