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33 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Source of CK |
Cytoplasmic enzymes Mitochondrial enzymes |
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Liver
What proteins do liver synthesize? |
Nearly all
Exceptions? |
Ig Hemoglobins |
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Liver synthesizes nearly all proteins, except ___________ |
Ig Hemoglobins |
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Liver function tests that truly assess liver function |
Albumin Bilirubin PT/INR
How they are changed? |
Albumin: decreased Bilirubin: increased PT/INR: prolonged |
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Liver function tests that truly assess liver function
PT/INR |
prolonged
Bilirubin Albumin |
Increased Decreased |
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Enzymes Indicators of liver damage
How many? |
5 |
AST ALT GGT ALP LDH |
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5 enzymatic indicators of liver damage |
AST ALT GGT ALP LDH |
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5 enzymatic indicators of liver damage
____ ALT GGT ALP LDH |
AST
What does it do? |
Transamination
gluconeogenesis |
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AST
transamination
Description |
Interconversion of amino acids and alpha-ketoacids
by transfer of amino acids
Importance |
Important in synthesis and degradation of aa during intermediary metabolism |
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AST
Gluconeogenesis
Description |
Oxaloacetate to asparate
Significance |
asparate can pass through the mitochondrial membrane |
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AST
Clinical significance |
Cardiac: ____
Liver diseases: _____
Muscle diseases: _____ |
Cardiac: MI
Liver: hepatitis
Muscle diseases: dystrophy, muscle injury |
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AST
Methodologies
Describe this method |
Modification of the Karmen method
What is added? |
coenzyme P-5-P |
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AST
Why P-5-P is added? |
Ensure full activity |
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AST methodologies
Step 1 |
L-asparate+2-oxoglutarate (alpha-ketoglutarate) converted to Oxaloacetate+L-glutamate
by |
AST P-5-P |
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AST methodologies
Step 2 |
Oxaloacetate + NADH + H+ is coverted to malate + NAD+
by? |
malate dehydrogenase |
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AST methodologies
Step 3 |
Step 2 is indicator rxn
Measure the decrease in absorbance at 340 nm
Why? |
NADH is oxidized to NAD+ |
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5 enzymatic indicators of liver diseases
AST _____ GGT ALP LDH |
ALT
Clinical significance |
hepatocellular disorder |
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ALT vs. AST |
ALT is more specific than AST in hepatocellular disorders
ALT is more concentrated in the liver |
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ALT
Highest elevation
Clinical significance
How many? |
2
List |
Acute viral hepatitis
Toxic hepatitis |
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ALT
Moderate elevations
Clinical significance
How many? |
3
List |
Obstructive liver disease
Hepatic cancer
Cirrhosis |
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ALT
Rxn |
Alanine + alpha ketoglutarate, aka? to Pyruvate + glutamate
by? |
ALT
alpha ketoglutarate: oxoglutarate |
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ALT
What is measured? |
Decrease in NADH at 340 n |
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DeRitis Ratio |
AST/ALT |
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AST/ALT
Name? |
DeRitis ratio
Indications |
Over 2.0: Alcoholic liver disease
Less than 1: NASH Viral H Obstructive liver disease Acute inflammatory disease |
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ALT
Reference range |
Male
female |
male: less than 41 u/L female: less than 31 u/L |
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ALP
Rxn |
Phosphomonoester + H2O to Alcohol + HPO4-
By? |
ALP Zn and Mg 2+ |
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ALP
Rxn Phosphomonoester+H2O to Alcohol+HPO4-
Significance |
Frees inorganic phosphate from organic monoester
What is produced? At what environment? |
Alcohol
Optimal pH: 10 |
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Measurement of enzyme activity
Common types of measurement |
Increase in product conc decrease in substrate conc Increase/decrease in coenzyme conc. (NAD+/NADH) |
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Measurement of enzyme activity
Enzyme concs always performed in |
zero-order kinetics
Substrates and any coenzymes must be added in? |
excess |
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what must be added in excess? |
coenzymes substrates |
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Measurement of enzyme activity
What must be absent? |
inhibitors
What must be carefully controlled? |
variables |
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Types of measurement of enzymatic rxn? |
Fixed-time Continuous monitoring |
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Types of measurement of enzymatic rxn
Fixed-time _________________ |
continuous monitoring
aka |
kinetic assay |
