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CC FINALS MTAP 2 > (18) ALP - LIVER ENZYMES > Flashcards

(18) ALP - LIVER ENZYMES Flashcards

1
Q

ALP aka

A

Alkaline Orthophosphoric monoester phosphohydrolase

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2
Q
  • Catalyze the hydrolysis of various phosphomonoesters at an alkaline pH
  • Liberate inorganic phosphate from an organic phosphate ester with production of alcohol
A

ALP (Alkaline phosphatase)

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3
Q

ALP activator

A

Mg2+

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4
Q

Most of ALP in healthy human sera are derived from

A

liver & bones (specifically osteoblast)

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5
Q

ALP Major tissue sources:

A

o Liver, Bones, Placenta, Intestine, Kidneys

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5
Q

ALP Major tissue sources:

A

o Liver, Bones, Placenta, Intestine, Kidneys

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6
Q

NOTE:

ALP Diagnostic significance:

A

o For evaluation of hepatobiliary & bone disorders.

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7
Q
  • Assay for Enzyme Activity for ALPs
  • Based on molar absorptivity of p-Nitrophenol
  • Absorbance is measured @ 405nm
A

Bowers & McComb

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8
Q

Bessy, Lowry & Brock
Bowers & McComb

A

ALP SUBSTRATE: p-nitrophenyl phosphate
ALP END PRODUCT: p-nitrophenol (yellow)

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9
Q

ALP SUBSTRATE: B-glycero-phosphate
ALP END PRODUCT: Inorganic PO4
Glycerol

A

Bodansky method
Shinowara method
Jones method
Reinhart method

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10
Q

King & Armstrong

A

ALP SUBSTRATE: Phenyl Phosphate
ALP END PRODUCT: Phenol

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11
Q

ALP isoenzymes are differentiated thru

A

Electrophoresis

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12
Q
  • fastest isoenzyme to migrate; most anodic
  • ↑in hepatobiliary disorder / liver dsz
A

Liver ALP

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13
Q

contributes to the abundance of ALP among healthy individual.

A

Major liver band

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14
Q

responsible for the fast migration

A

Fast liver (a1) band

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15
Q
  • 2nd fastest to migrate
  • Heat labile fraction
    o ↑temp = ↓ bone ALP activity
    o Significant ↓ @56°C
A

Bone ALP

16
Q
  • ↑ in bone dsz (pathologic cause), healing of bone & fractures physiologic bone growth
    o ↑↑ in Paget’s dsz (osteitis deformans)
A

Bone ALP

17
Q
  • Most heat-stable fraction
  • ↑in pregnancy on 16th-20th wk of gestation
  • Associated w/ malignancy → Carcinoplacental ALP
A

Placental ALP

17
Q
  • Most heat-stable fraction
  • ↑in pregnancy on 16th-20th wk of gestation
  • Associated w/ malignancy → Carcinoplacental ALP
A

Placental ALP

18
Q
  • slowest isoenzyme to migrate; least anodic
  • ↑ on certain blood groups
    o Type B or O secretors: ↑ALP secretions (physiologic cause)
  • ↑ in fatty meal consumption
  • ↑intestinal ALP: pathologic conditions in the GIT
A

Intestinal ALP

19
Q

Chemical inhibitor of Placental & intestinal ALP

A

Phenylalanine

20
Q

Chemical inhibitor for bone ALP

A

3M Urea reagent

21
Q

Chemical inhibitor for bone & liver ALP

A

Levamisole

22
Q

Inhibits activity of certain enzymes so that specific isoenzyme is measured.

A

Chemical inhibitors

23
Q

Total ALP elevations by liver or Bone ALP is differentiated by heating of serum at

A

56°C for 10mins

24
Q

differentiates bone ALP as cause of elevation of ALP in serum

A

Heat stability test

25
Q

Most heat-stable to least isoenzyme:

A

P> I > L > B

26
Q

most heat-stable

A

Placenta

27
Q

most heat-labile

A

Bone

28
Q

After heating ALP isoenzymes are surely ↓ but:

A
  • Liver ALP
    o ALP residual activity is ↓to >20% activity
  • Bone ALP
    o ALP residual activity is ↓ to <20% activity
29
Q

NOTE: ALP

A

Probable ALP present in 1 & 4 is probably LIVER (bcos >20%)

30
Q

▪ Lung, Breast, & gynecological CA, bone ALP co-migrator
▪ Most heat stable ALP
* Can remain stable even though u heat it at 65°C for 30mins

A

Regan ALP

31
Q

▪ Adenocarcinoma of the Pancreas & Bile duct, Pleural CA

A

Nagao ALP

32
Q

Carcinoplacental ALP Inhibitors:

A

Phenylalanine : Can inhibit Nagao and Regan

L-leucine : Can inhibit Nagao

33
Q

stage where there’s growth hormone surge

A

Puberty

34
Q

most active in bone growth which also increases ALP levels.

A

Osteoblast

35
Q

Reference range ng ALP

A

refer to handout (page 13)

CC FINALS MTAP 2 (29 decks)

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