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16 Cards in this Set
- Front
- Back
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where is GGT found?
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present primarily in the liver, kidney, pancreas, and prostate
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what is GGT good for?
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GGT is much more sensitive and specific for hepatic disease and is elevated in all forms of liver disease (i.e. cholangitis, cholecystitis, especially obstruction of the common bile duct, and pancreatitis)
NOTE: Severe/ Morbid Obesity can be an isolated cause of elevated GGT(>than 150lbs) |
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causes of ↑ GGT?
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Acute/chronic hepatitis
Cirrhosis Liver metastasis Liver Carcinoma Alcoholism Infectious Mononucleosis Pancreatitis Carcinoma of the breast and lung CHF Hyperthyroidism(bc ur taxing the liver & its throwing it out hoping maybe it will help) Diabetes Mellitus Type II SLE (usu attacks kidney first) |
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causes of ↓GGT?
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Vitamin B6 deficiency
Magnesium insufficiency - (low GGT<10 suggests above) Protein deficiency Malabsorption Hypothyroidism bc not absorbing the nutrients needed to make GGT Kidney failure |
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what is LDH? where is it found?
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intracellular enzyme that is widely distributed in the tissues of the body, particularly:
Kidney Heart skeletal muscle Brain Liver RBCs Lungs |
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what does increase in total LDH suggest?
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Increases in the total LDH level indicate cellular death and leakage of the enzyme from the cell
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what is LDH isoenzymes involved in?
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General carbohydrate metabolism
The cellular transport of chloride with glucose The cellular transport of glucose with zinc and sodium |
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what are causes of ↓LDH?
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hypoglycemia
pancreatic fxn glucose metabolism |
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how many fractions does LDH have?
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5
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though ↑ levels of LDH are non-specific what is it good for?
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LDH level is useful in confirming MI when viewed in relation to other blood parameters.
For example, LDH remains elevated longer than CK (creatine phosphokinase) in an MI can help to dx megaloblastic anemia as it causes incrsd destruction of RBC cells which triggers inflamm |
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what is seen with MI pts & LDH levels?
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Total LDH levels are elevated within 26 to 55 hours post-MI in approximately 90-95% of all patients with acute MI
LDH levels remain elevated much longer than AST or CK. |
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how can you ddx btw megaloblastic & hemolytic anemia?
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An elevated LDH-2 usually occurs with hemolytic anemia contributing to an increase in total LDH
However, LDH-1 will also be mildly elevated BUT the LDH-2 elevation is much greater. Megaloblastic anemia will not have a greatly elevated LDH-2 just highly elevated LDH-1 |
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what are causes of ↑LDH?
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anemia (depending on isoenzyme)
Non-specific tissue destruction, will need to do isoenzymes Malignancy Hypothyroidism Viral infections Pulmonary infarct CHF Liver disease Skeletal muscle disease (MS, Polymyocytis, Dermatomyocytis) Sickle cell disease Acute/Chronic Pancreatitis |
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where is CPK/CK found?
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enzyme that is found in higher concentrations in the heart and skeletal muscles, and much smaller amounts are found in brain tissue
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what is CPK/CK good for?
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specific index of injury to myocardium and skeletal muscle esp MI dx, dx muscular dystrophy early before symptoms appear
mm(CK3)= skeletal m. bb (CK1)= brain mb(CK2)= cardiac m. (though can have MM) |
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but when can you have elevated LDH?
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CNS disorders ie. Reye's Syndrome
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