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From Flashcardlet > Pathology: Laboratory Markers of Tissue Injury and Inflammation > Flashcards

Pathology: Laboratory Markers of Tissue Injury and Inflammation Flashcards

1
Q

Principle means of determining enzyme levels in clinical labs is

A

To measure the activity of the enzyme in catalyzing the rate of a chemical reaction rather than a direct measurement of the quantity or mass of the enzyme present

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2
Q

Isoenzymes

A

enzymes that have similar catalytic activity, but are separable because of distinct physiochemical properties

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3
Q

Acute Pancreatitis- enzymes to look at (6)

A
  • Elevated hemoglobin and hematocrit
  • Hyperglycemia
  • Hypocalcemia
  • Hyperlipidemia
  • Methemalbumin
  • Amylase
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4
Q

Recognized cause of falsely negative serum amylase values

A

Hyperlipidemia

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5
Q

Cornerstone of lab diagnosis of acute pancreatitis

A

Serum and urine amylase measurements (mostly serum)

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6
Q

Pancreatitis: Amylase

A
  • High serum amylase
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7
Q

Serum amylase alone has a sensitivity of

A

80%

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8
Q

Measure serum amylase + ____ to increase sensitivity

A

serum lipase

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9
Q

What to use as an indicator of acute pancreatitis if urine amylase levels are normal, but serum amylase levels are elevated?

A

Macroamylasemia (amalyase bound to serum proteins)

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10
Q

Acute pancreatitis- urine amylase levels

A

Urine amylase rises out of proportion to elevation in serum

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11
Q

Pancreas is the only source of (2)

A
  • Trypsin

- Lipase

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12
Q

If amylase peak has been missed, use

A

Lipase

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13
Q

Acute myocardial infarction- definition

A

Irreversible cellular injury and necrosis of a portion of the myocardium resulting from prolonged ischemia

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14
Q

Best marker for MI

A
  • Cardiac troponins (cTn)
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15
Q

Types of troponins (3)

A

T, I, C

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16
Q

Which troponin is not useful in deriving cardiac selective information

A

TnC

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17
Q

Sensitivity of troponins for acute MI

A

100%

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18
Q

Cardiac troponin levels need to be measured ___ to attain sensitivity needed for satisfactory discovery or exclusion purposes

A

Serially

19
Q

General biomarkers of acute viral hepatitis (4)

A
  • Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST)
  • Alkaline phosphatase (ALP)
  • Bilirubin levels
20
Q

Alanine aminotransferase and aspartate aminotransferase levels in acute viral hepatitis

A
  • Elevated
21
Q

Alkaline phosphatase levels in acute viral hepatitis

A

Moderately elevated

22
Q

Bilirubin levels in acute viral hepatitis (2)

A
  • Variable

- Height correlates with severity of liver injury

23
Q

Biomarkers of hepatitis A (2)

A
  • Anti-HAV IgM

- Anti-HAV IgG

24
Q

What test confirms diagnosis of hepatitis A

A

Anti-HAV IgM

25
Q

Anti-HAV IgG test (3)

A

Test has little or no value for diagnosis of acute hepatitis A because

o Positive test = recent or remote HAV infection

o Negative test = does not exclude hepatitis A

26
Q

Biomarkers for Hepatitis B (4)

A
  • HBsAg
  • Anti-HBs
  • Anti-HBc
  • Anti-HBc IgM
27
Q

HBsAg (2)

A
  • Hepatitis B surface antigen

* Detectable in latter part of incubation period

28
Q

Anti-HBs

A

• Antibody to hepatitis B surface antigen

29
Q

Anti-HBc (2)

A
  • Antibody to HB core antigen

* Is positive lifelong

30
Q

Which hepatitis B biomarker does not establish diagnosis of acute hepatitis B infection

A

Anti-HBc

31
Q

Which hepatitis B biomarker is used during the window period

A

Anti-HBc IgM

32
Q

Cons of Anti-HBc IgM

A

Does not establish diagnosis of acute hepatitis B by itself

33
Q

Biomarker for hepatitis C

A
  • Anti-HCV
34
Q

Anti-HCV appearance does not indicate

A

immunity to infection

35
Q

Hepatitis D infection requires

A

prior/simultaneous infection with HBV

36
Q

Serodiagnosis of hepatitis D relies on (3)

A
  • Demonstration of antibodies to HDV
  • Anti-HDV IgM in acute phase
  • Anti-HDV IgG in chronic phase
37
Q

Which biomarker(s), if positive, indicates hepatitis A

A

Anti-HAV IgM

38
Q

What biomarker(s) need to be positive to confirm hepatitis B

A

HbsAg with postive anti-Hbc IgM

39
Q

What does a postive anti-HBc IgM value indicate

A
  • It favors acute hepatitis B, but may also be positive in chronic hepatitis B
40
Q

If anti-HAV IgM, HBsAg, and anti-HBc are all negative in a patient with the clinical picture consistent with acute viral hepatitis, what disease needs to be considered?

A

Hepatitis C

41
Q

When history suggests post-transfusion hepatitis, the initial serodiagnostic testing should include (4)

A
  • Anti-HCV
  • HBsAg
  • Anti-HBc IgM
  • NOT anti-HAV IgM
42
Q

Acute hepatitis D is diagnosed with the presence of

A

Anti-HDV IgM

43
Q

Chronic hepatitis D is diagnosed with the presence of

A

Positive anti-HDV IgG

44
Q

Longer persistence of ____ in serum after acute MI may be extremely helpful in diagnosing

A

Patients who have atypical chest pain

From Flashcardlet (110 decks)

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