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25 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Which enzyme is most useful in the diagnosis of acute pancreatitis? |
Pancreatic lipase
Location |
Digestive juice |
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Levels of serum pancreatic lipase during Acute pancreatitis |
Elevated
Besides acute pncreatitis, what condition can also elevate pancreatic lipase? |
Obstruction of pancreatic duct |
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The half life of pancreatic amylase vs. pancreatic lipase |
pancreatic amylase is Shorter |
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The half life of pancreatic lipase vs. pancreatic amylase |
Longer
Expected value for pancreatic lipase? |
0-65 U/L |
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Pancreatic lipase vs. amylase
Sensitivity |
Lipase is less sensitive for acute pancreatitis
Why?
What is sensitivity? |
Lipase is less affected by intra-abdominal conditions
TP |
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Pancreatic lipase vs. amylase
Specificity |
Lipase is more specific for acute pancreatitis
Why?
Review: specificity |
Lipase is less affected by intra-abdominal conditions.
TN |
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Enzymes that are associated with cardiac disorders |
CK-MB
aka?
Associated with what cardiac disorder? |
CK-2
MI |
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CK-MB is associated with what cardiac disorder? |
MI
Aka of CK-MB
Additional tests/methods? |
CK-2
Relative index |
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Relative index
function |
Diff between false-positive elevations of CK-MB from skeletal muscle
Indicative of a cardiac source? |
5% |
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Enzymes that are associated with muscle disorders? |
CK-3
aka |
CK-MM |
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CK-MM is associated with what disorder? |
Muscle disorders
Examples |
Duchenne's muscular dystrophy |
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CK-MM is associated with muscle disorder
Example |
Duchenne's muscular dystrophy
CK-3/CK-MM levels Total CK levels |
Both are elevated |
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Elevated levels of CK-3/MM and Total CK levels
Disease |
Duchenne's muscular dystrophy
Total CK reference range |
Male: 46-300 Females: 15-180 U/L |
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Total CK reference range |
males Females |
Males: 46-300 Females: 15-180 U/L |
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Clinical significance of detecting Macro CK |
Atypical Macro CK may falsely elevate CK-MB
What are macroenzymes? |
larger MW species formed as CK-IgG or IgA |
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Clinical significance of Macro CK |
Not well understood
Macro CK can falsely elevate? |
CK-MB |
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CK isoenzyme methodologies
How many? |
2 Creatine kinase isoenzyme methodologies
List |
Mass Assay Electrophoresis |
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2 Creatine kinase isoenzyme methodologies
List |
____________+ used on what CK? electrophoresis |
Mass assay
CK-MB |
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CK-MB Mass assay
Steps |
1. Anti M and B Ab + Pt. Serum 2. 2nd Ab bind to different epitope of CK-MB 3. Enzyme labels on the 2nd Ab cause color change that is proportional to CK-MB |
Notes 1. First two Abs bind only CK-Mb in pt. serum
2. Second Ab (detection) binds to a different epitope of CK-Mb bound to capture Ab
3. An enzyme labels on the 2nd Ab will cause a color change that is proportional to amount of CK-MB |
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CK-MB mass assay
UH reference range
Male |
Less than 6.7 ng/ml
Female? |
Less than 3.8 ng/mL |
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CK-MB mass assay
UH reference range
Female? |
Less than 3.8 ng/ml
Male? |
Less than 6.7 ng/mL |
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2 Creatine kinase isoenzyme methodologies
Mass assay ___________ |
Electrophoresis
Different bands |
Cathode (-)
MI
Origin
CK-MM (3) CK-Macro CK-MB (2) CK-BB
Anode (+) |
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2 Creatine kinase isoenzyme methodologies
Electrophoresis
Bands |
Cathode (-)
MI
Origin
CK-MM (3) CK-Macro CK-MB (2) _______________+clinical significance
Anode (+) |
CK-BB (1)
Most anodal +
CNS |
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Cathode (-)
MI
Origin
CK-MM (3) CK-Macro ___________+ clinical significance CK-BB (1)
Anode (+) |
CK-BB (2)
Heart: MI
Minor degree in: ______ |
Skeletal |
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Cathode (-)
MI
Origin
_____________ CK-Macro CK-MB (2) CK-BB (1)
Anode (+) |
CK-MM (3)
Clinical significance |
Skeletal: Duchenne's muscualr dystrophy
Cardiac |
