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52 Cards in this Set
- Front
- Back
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example of plasma specific enzymes?
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blood coag enzymes
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examples of secretion enzymes?
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amylase, lipase, acid/alkaline phosphatase
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examples of metabolism enzymes?
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CK, LD, ALT, AST
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2 tumor markers?
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PAP, CK
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when are extracellular enzymes of interest?
Where are they synthesized? |
when decreased.
At the liver. |
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What're the 2 types of extracellular enzymes?
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-Secreted
-Metabolic |
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When are secreted enzymes increased?
decreased? |
1. Excretion is blocked (up)
2. Overproduced (up) 3. Tissue damaged (low) |
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When are metabolic enzymes increased?
When are tumor markers increased? |
When cell damage happens.
During tumor cell growth. |
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What reaction type does LD do?
What can interfere? |
Oxidoreductase
-Gross hemolysis - SIGNIFICANT elevation in serum -Instability - should keep below 25'C. |
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Where is each LD type found?
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1 - heart/RBCs
2 - Renal 3 - lung/spleen/pancreas 4 - liver/skeletal muscle 5 - liver/skeletal muscle |
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When would LD1 be elevated?
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-in heart MI - 1,2 flip
-in hemolytic anemia, megaloblst |
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When would LD3 be elevated?
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-In Pulmonary disorders
-In malignancies |
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When would L4/5 be elevated?
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In liver disease
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From highest-low, what is the order of LD amounts?
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2, 1, 3, 4, 5
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What are possible ways for direct msmnt of LD? What's better?
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-Electrophoresis
-immunoinhibition - better |
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What are sensitivity/spcfty of LD-1? When?
What disadvantage does this create? |
-about 90%
-within 24 hours - takes a long time to diagnose. -may not diagnose slight infarcts. |
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What type of reaction does CK catalyse?
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Transferase
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How is CK directly measured?
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-Electrophoresis (but bad)
-Reaction inhibition |
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Explain reaction inhibition for LD-1 - sorry forgot earlier.
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Ab to M subunit - precipitate all but LD1
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Now explain reaction inhibition for CK.
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Automated; Ab to B subunit, enzymatic 2ndary Ab to M peptide.
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Does hemolysis affect CK assays?
What else interferes? |
Yes; not because RBCs have CK, but AK, and it participates, falsely elevating CK.
Daylight decreases CK activity. |
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When is CKMB elevated?
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in myocardial infarct.
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When is CKMM elevated?
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in muscle injury, iection, exercise.
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When is CKBB elevated?
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in brain damage and tumors
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What is the sensitivity/spcfty of CK-MB, and when?
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about 90%, within 7-18 hrs; peak at 24 hrs.
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How is CK gotten rid of?
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Small, kidney filters; disappears quickly - 2,3 days.
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What affects sensitivity/spcfty?
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High CK, low sens.
Low CK, poor specif. |
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What/Where is AST significant?
What are its two isoforms? What type of reaction? |
Aspartate aminotransfrase.
Heart and mostly in Liver. Cytoplasmis/mitochondrial. Transferase |
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What can interfere with AST levels?
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hemolysis
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What are AST and ALT used to assess?
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Their ratio is for liver damage.
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What/Where is ALT significant?
What type of reaction? what interferes with reaction? |
alanine aminotransferase, LIVER.
Transferase. Hemolysis |
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How is the AST/ALT ratio altered in liver damage?
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-ALT is higher, so the ratio is lower, usually.
-When AST is HIGHER than ALT, this indicates poooor prognosis. |
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If AST and ALT are decreasing in liver disease, what do you think?
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Slow decrease is recovery.
Fast decrease is failure to produce them b/c of liver necrosis. |
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What type of rxtn is ALP?
Special conditions? Where is it found? (isoenzymes) |
Hydrolase; pH = 9-10, need Mg2+
Liver ALP1 Bone ALP2 Placenta/intestine ALP3 |
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What diseases can ALP2 be associated with if increased?
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Rickets,
Pagets, Healing fractures, Pregnancy and Puberty. |
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What diseases is ALP1 associated with?
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Biliary tract obstruction
Hepatitis Cirrhosis |
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What interferes with ALP levels?
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Hemolysis = RBCs have 6x the ALP as in plasma
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What type of reaction does 5 nucleotidase do?
What does it help to diagnose? |
Hydrolase
Hepatobiliary disorders - liver. |
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What does GGT very sensitively indicate?
What type of rxtn does it do? Where is it significant? |
-Alcoholism
-Transferase Liver, brain, kidney, pancreas. |
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What is the use of GGT?
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Helps differentiate bone from liver disorders with ALP
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What reaction type is Amylase?
Where is it found? What is it mainly used for? |
Hydrolase
Pancreas, salivary glands. Diagnosing pancreatitis. |
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What specimens are used for amylase analysis?
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Serum + urine -> elevated levels will cause filtering by glomerulus, is a small molecule.
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What type of reaction is Lipase?
Where is it found? What is its main use? |
-Hydrolase
Pancreas, some stomach/WBCs/fat. Diagnosing pancreatitis, elevated longer than amylase. |
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How can the water-soluble lipase act on water-insoluble lipids?
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Cofactors serve as detergents.
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What specimens are used for lipase analysis?
What error to look out for with lipase? |
Only serum; lipase is filtered but reabsorbed.
-Hemolysis will inhibit lipase activity. |
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What reaction type is Acid phosphatase?
Where is it found? What error affects it? |
-Hydrolase
-Prostate, bone, liver, spleen, kidney, RBCs. -Hemolysis falsely elevates levels. -Instability in >R.Temps |
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What are 2 uses of the acid phosphatase enzyme assay?
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-Detect metastisized prostate cancer in bone; (PSA is better).
-Forensic; from seminal fluid in rapes, 4 days later. |
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What type of reaction is aldolase?
Where is it found? What error affects it? |
-Lyase
-Skeletal muscle, liver, kidney, brain. -Hemolysis |
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What was the Aldolase assay mainly used for?
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Pancreas disorders, but not much anymore.
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-What type of reaction is done w/ Cholinesterase?
-Where is it found? |
-Hydrolase reaction.
-In liver, pancreas, heart, serum. |
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What are 2 uses for cholinesterase?
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1. Measure poisoning extent due to insecticides
2. Measure poisoning extent due to anesthesia. |
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What error affects cholinesterase assays?
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Hemolysis - RBCs contain AChE, which this enzyme is a surrogate for.
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