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Clinical Chemistry Exam 1 Lecture 7
Enzymes of Clinical Significance
103
Chemistry
Undergraduate 3
01/31/2015

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Term
Given the abbreviation give the enzyme:
ACP
Definition
Acid Phosphatase
Term
Given the abbreviation give the enzyme:
ALT
Definition
Alanine Aminotransferase
Term
Given the abbreviation give the enzyme:
ALP
Definition
Alkaline Phosphatase
Term
Given the abbreviation give the enzyme:
AMS
Definition
Amylase
Term
Given the abbreviation give the enzyme:
AST
Definition
Aspartate Aminotransferase
Term
Given the abbreviation give the enzyme:
CK
Definition
Creatine Kinase
Term
Given the abbreviation give the enzyme:
GGT
Definition
Gamma-glutamyltransferase
Term
Given the abbreviation give the enzyme:
G6PD
Definition
Glucose-6-Phosphate Dehydrogenase
Term
Given the abbreviation give the enzyme:
LD
Definition
Lactate Dehydrogenase
Term
Given the abbreviation give the enzyme:
LPS
Definition
Lipase
Term
Given the abbreviation give the enzyme:
SChE
Definition
Pseudocholinesterase
Term
Given the enzyme give the Disease/Organs:
Pseudocholinesterase
Definition
Organophosphate Poisoning
Term
Given the enzyme give the Disease/Organs:
Lipase
Definition
Pancreatitis
Term
Given the enzyme give the Disease/Organs:
Lactate Dehydrogenase
Definition
Heart, Liver, Lungs
Term
Given the enzyme give the Disease/Organs:
Glucose-6-Phosphate Dehydrogenase
Definition
Hemolytic Anemia
Term
Given the enzyme give the Disease/Organs:
Gamma-glutamyltransferase
Definition
Bile Duct, Liver
Term
Given the enzyme give the Disease/Organs:
Creatine Kinase
Definition
Heart, Muscle
Term
Given the enzyme give the Disease/Organs:
Aspartate Aminotransferase
Definition
Heart, Muscle, Liver
Term
Given the enzyme give the Disease/Organs:
Amylase
Definition
Pancreatitis
Pancreas and Salivary Glands
Term
Given the enzyme give the Disease/Organs:
Alkaline Phosphatase
Definition
Bone, Liver, and Placenta
Term
Given the enzyme give the Disease/Organs:
Alanine Aminotransferase
Definition
Liver
Term
Given the enzyme give the Disease/Organs:
Acid Phosphatase
Definition
Prostate Cancer
Term
Given the organ what are the enzymes associated with it:
Liver
Definition
AST
ALT
LD
GGT
ALP
Term
Given the organ what are the enzymes associated with it:
Biliary Obstruction
Definition
GGT
ALP
Term
Given the organ what are the enzymes associated with it:
Heart Attack
Definition
CK
CKMB
AST
Term
Given the organ what are the enzymes associated with it:
Skeletal Muscle
Definition
CK
AST
LD
Term
Given the organ what are the enzymes associated with it:
Bone
Definition
ALP
Term
Given the organ what are the enzymes associated with it:
Pancreas
Definition
AMS
LPS
Term
Given the organ what are the enzymes associated with it:
Prostate
Definition
ACP
Term
Given the organ what other tests should be performed:
Liver
Definition
Albumin
Bilirubin
PT
Term
Given the organ what other tests should be performed:
Heart Attack
Definition
Myoglobin
Troponin
Term
Given the organ what other tests should be performed:
Bone
Definition
Ostase
Calcium
PTH
Term
Given the organ what other tests should be performed:
Prostate
Definition
PSA
Term
Highest levels of Lactate Dehydrogenase are seen in what?
Definition
Pernicious anemia and hemolytic anemias, AMI and Hemolysis
Term
Other than Heart, Liver, and Skeletal Muscle what else is Lactate Dehydrogenase associated with?
Definition
RBCs
Term
Sources of error with Lactate Dehydrogenase
Definition
Avoid any traces of hemolysis
Avoid refrigerating or freezing
Term
At what temperature should you store Lactate Dehydrogenase?
Definition
Room Temperature
Term
Acid Phosphatase
Definition
Highest in Prostate Cancer
Presumptive evidence of semen
Term
True or False:
ACP is rarely performed
Definition
True
Term
What has ACP been replaced by?
Definition
PSA (Tumor Markers)
Term
What are Bone Illnesses associated with ALP?
Definition
Paget's Disease
Osteomalacia and rickets
Bone fractures
Osteoporosis
Childhood/adolescence
Term
What test can you perform for Osteoporosis?
Definition
Ostase - test to monitor response to therapy
Term
What is associated with the Liver and ALP?
Definition
Biliary tract obstruction
Term
To differentiate Bone from Liver in ALP results, what should you do?
Definition
Heat serum to 56 degrees C for 10 minutes
Term
When differentiating Bone from Liver in ALP which serum lives and which dies?
Definition
Liver lives
Bone dies
Term
Which trimesters are associated with the placenta and ALP?
Definition
2nd and 3rd
Term
Sources of error with ALP:
Definition
Hemolysis
Run ASAP to prevent serum increases
Term
What does ALP require?
Definition
Magnesium
Term
AST Liver - Up to 100x ULN in
Definition
Viral Hepatitis
Term
AST Liver - Up to 4x ULN in
Definition
Cirrhosis
Term
AST Heart - Levels begin to rise within ____ hours of AMI
Definition
6
Term
Is AST useful for assessing AMI?
Definition
No, it is too non-specific
Term
AST Skeletal Muscle is often associated with what?
Definition
Muscular dystrophy
Crush injuries
Term
Sources of error with AST?
Definition
Hemolysis
Term
Is ALT more specific for the liver than AST?
Definition
Yes
Term
ALT Liver - Levels higher and persist longer than AST in ____ _____
Definition
Viral Hepatitis
Term
True or False:
ALT may increase prior to symptoms of liver cell damage
Definition
True
Term
Though AST is high in all of the following, which 1 will ALT be high in?
Heart, Liver, or Skeletal Muscle
Definition
Liver
Term
Sources of error for ALT
Definition
No significant interferences
Term
Amylase
Definition
Catalyzes breakdown of starches
Normally filtered by glomerulus and detectable in urine
Term
2 Illnesses associated with Amylase
Definition
Acute Pancreatitis
Macroamylasemia
Term
Acute Pancreatitis - AMS levels rise in _______ hours after onset of an attack and return to normal in a _____
Definition
2-12
week
Term
____ levels of AMS in Urine of Acute Pancreatitis patients
Definition
High
Term
What are the most common causes of Acute Pancreatitis?
Definition
Gall Stones
Alcoholism
Term
Can Acute Pancreatitis lead to tissue necrosis and death?
Definition
Yes
Term
Macroamylasemia
Definition
Benign condition affecting 1-2% of population.
Amylase binds to immunoglobulins
This bound pair can't filter through glomerulus, thus serum levels rise
Term
Though Serum amylase rises in both Acute Pancreatitis and Macroamylasemia, is Urine Amylase elevated or decreased in Acute Pancreatitis?
Definition
Elevated
Term
Though Serum amylase rises in both Acute Pancreatitis and Macroamylasemia, is Urine Amylase elevated or decreased in Macroamylasemia?
Definition
Decreased
Term
Sources of error of AMS
Definition
Calcium and Chloride are Activators
Term
Do you use EDTA tubes for Amylase samples?
Definition
NO
Term
Lipase (LPS)
Definition
Breaks down dietary triglycerides into fatty acids and glycerol
Term
LPS is highest in what?
Definition
Acute Pancreatitis
Term
Is LPS elevated in Salivary disorders?
Definition
No
Term
Sources of error for Lipase
Definition
Hemolysis inhibits lipase activity to cause a falsely low value
Term
Delta-Glutamyltransferase
Definition
Sensitive indicator of alcohol ingestion
Term
What is GGT used to monitor?
Definition
Abstention from alcohol because levels rapidly rise if drinking is resumed
Term
Are there any sources of error for GGT?
Definition
No, it is Relatively Stable
Term
Does Hemolysis interfere with GGT?
Definition
No
Term
G-6-PD - Most in ___ ___ to maintain NADPH which protects hemoglobin from oxidative damage
Definition
red cells
Term
Is G6PD Sex linked?
Definition
Yes
Term
Where is there a high incidence of G6PD?
Definition
Africa
Middle East
Far East
Term
G6PD - Exposure to oxidant drugs can cause what?
Definition
Drug-Induced Hemolytic Episode
Term
A Deficiency in G6PD can provide what?
Definition
Some protection against Plasmodium falciparum
Term
Sources of error for G6PD?
Definition
None
Term
What is used to test for deficiency of G6PD?
Definition
A RBC hemolysate
Term
Pseudocholinesterase & Acetylcholinesterase are needed for what?
Definition
Nerve conduction and muscle contraction/impulse termination
Term
What does an Inherited Deficiency in Pseudocholinesterase & Acetylcholinesterase cause?
Definition
Muscle contraction and respiratory distress when given anesthesia
Term
What does an Acquired Deficiency in Pseudocholinesterase & Acetylcholinesterase cause?
Definition
Salivation, vomiting, twitching, slurred speech, behavioral changes, and respiratory failure
Term
Where does an Acquired Deficiency in Pseudocholinesterase & Acetylcholinesterase come from?
Definition
Organophosphate pesticide poisoning
Term
Creatine Kinase - 3 isoforms are also called
Definition
Isoenzymes
Term
CK - All three forms contibute to the ____ ___ activity in serum
Definition
Total CK
Term
CKMM is associated with which organs?
Definition
Skeletal muscle
Heart (95% of total CK)
Term
*CKMB is associated with which organs?
Definition
Heart
Skeletal Muscle
Term
CKBB is associated with which organs?
Definition
Brain
Bladder
Lungs
Other
Term
What illnesses are often associated with CKMM?
Definition
Muscular trauma and crush (rhabdomyolysis), Muscular Dystrophy, Strenuous exercise, AMI
Term
What illnesses are often associated with *CKMB?
Definition
Acute Myocardial Infarction (AMI) & Angina
Term
What illnesses are often associated with CKBB?
Definition
Cerebrovascular accidents & Seizures
Term
Name the CK isoenzyme isolated from the heart?
Definition
CKMB
Term
What test is used to assess treatment of post-menopausal osteoporosis
Definition
Ostase
Term
List two "normal" conditions that can cause an elevation of ALP
Definition
Childhood
Pregnancy
Term
Which enzyme(s) require Calcium as an activator?
Definition
Amylase
Term
List another enzyme other than amylase that can be used to assess pancreatitis
Definition
LPS
Term
Which enzyme is Most susceptible to the effects of Hemolysis AND Freezing temperatures
Definition
LD
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