32. Lactate dehydrogenase and creatine phosphokinase in serum

Question 1

What is the Purpose of Measuring LDH?

Answer 1

For Tissue Damage

Question 2

Where is LDH Located?

Answer 2

Heart

Liver

Kidney

Skeletal Muscles

Brain

Blood Cells

Lungs

Question 3

What is Lactate Dehydrogenase (LDH)?

Answer 3

Oxidoreductase

Catalyses the 2-Way Transition of AEROBIC to ANAEROBIC Glycolysis

(Lactate-Pyruvate)

Question 4

What are the 5 Isoenzymes of LDH?

Answer 4

1. LDH1 = HHHH
2. LDH 2 = HHH | M
3. LDH3 = HH | MM
4. LDH4 = H | MMM
5. LDH5 = MMMM

Question 5

What are the Analytical Methods for LDH?

Answer 5

Kinetic Method

DECREASED of Optic Density within UV Spectrum

At 240 nm / min

• Isoenzymes with HIGH H-Subunit are Measured with a-ketobutirate
• Determining Activity of Hydroxybutyrate Dehydrogenase

Question 6

Where is the Subunit, Heart Type H Found?

Answer 6

Tissues with AEROBIC Metabolism

• Myocardium
• Kidney
• Lung

Question 7

Where is the Subunit, Muscle Type M Found?

Answer 7

Tissues with ANAEROBIC Metabolism

• Skeletal Muscles
• Liver
• Erythrocytes

Question 8

What is the Error of LDH Investigation?

Answer 8

Positive (+ve) FALSE Reading

DUE to Haemolysis

Question 9

What are the Indications for LDH Investigation?

Answer 9

Existence + Severity of Acute / Chronic Tissue Damage

Monitor Cancer, Kidney + Liver Disease

Question 10

What Specimen is Required for LDH Investigation?

Answer 10

Serum WITHOUT HAEMOLYSIS

Question 11

What is the Reference Range of LDH?

Answer 11

230 - 460 U / L

Question 12

What is Associated by INCREASED LDH Levels by MORE THAN 10x?

Answer 12

Advanced Megaloblastic Anaemia

Question 13

What is Associated by INCREASED LDH Levels by 5 - 10x?

Answer 13

Myocardial Infarction

Muscle Injuries

Acute Pancreatitis

Question 14

What is Associated by INCREASED LDH Levels by UP-TO 5x?

Answer 14

Infectious Mononucleosis

Dyspeptic Syndrome

Question 15

What is Creatinine Phosphokinase (CK)?

Answer 15

Catalyses Conversion of Creatine

Consumes ATP

TO FORM Phosphocreatine _ ADP

Question 16

What are the 3 Isoenzyme Forms of Creatinine Phosphokinase?

Answer 16

1. CK-MM = Muscle
2. CK-BB = Brain
3. CK-MB = Heart

Question 17

What is the Analytical Method for CK Investigation?

Answer 17

1. 3-Stage Kinetic = Absorption at 340 nm / min

2. CK Isoenzymes Determined SEMI-QUANTITAVELY by Electrophoresis

Question 18

What are the Errors of CK Investigation?

Answer 18

Positive (+ve) False Reading

Negative (-ve) False Reading

Question 19

What is Associated with POSITIVE (+ve) FALSE Readings of CK?

Answer 19

Mild Muscle Traumas

Question 20

What is Associated with NEGATIVE (-ve) FALSE Readings of CK?

Answer 20

Haemolysis

Stale Serum

Using Statins

Question 21

What are the Indications for CK Investigation?

Answer 21

Acute MI

Rhythm Disorders

Bundle Branch Block

Chest Pain

Acute Renal Failure

Muscle Disorders

Question 22

What Specimen are Required for CK Investigation?

Answer 22

Serum WITHOUT HAEMOLYSIS

Question 23

What is the Reference Range of TOTAL CK in MALE?

Answer 23

25 – 200 U / L

Question 24

What is the Reference Range of TOTAL CK in FEMALE?

Answer 24

25 – 175 U / L

Question 25

What is the Reference Range of CK-MB (Heart)?

Answer 25

UP-TO 20 U / L

Question 26

What is Associated by INCREASED CK Levels by MORE THAN 10x?

Answer 26

Extensive Recent Myocardial Infraction / Re-infarction

Dermatomyositis

Question 27

What is Associated by INCREASED CK Levels by 5 - 10x?

Answer 27

After Surgical Operations

Injuries to Skeletal Muscles

Heavy Physical Activity

Question 28

What is Associated by INCREASED CK Levels UP-TO 5x?

Answer 28

Newborns

Hypothyroidism

Pericarditis