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CLIN CHEM > ASESSMENT OF LIVER FUNCTION & ENZYME INTRO > Flashcards

ASESSMENT OF LIVER FUNCTION & ENZYME INTRO Flashcards

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1
Q

High AST, ALT, LD, ALP, BILIRUBIN

A

Hepatitis

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2
Q

Coagulation test for monitoring of synthetic liver function

A

PT

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3
Q

Low total protein, albumin
High bilirubin, ammonia

A

Cirrhosis

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4
Q

Low TP and albumin, the rest is high - basta ABNORMAL LAHAT

A

Fulminant hepatic failure

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5
Q

High ALP and Bilirubin (B1)

A

Biliary obstruction

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6
Q

High LD and ALP

A

Space-occupying lesion

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7
Q

Normal total protein and albumin ; the rest is abnormal (Slightly high)

A

Passive congestion

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8
Q

Destruction of more than 80% of liver tissue with no regeneration

A

Panhepatic cirrhosis

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9
Q

Results from a VARIETY of causes e.g Reye syndrome, hepatitis, cirrhosis

A

Fulminant hepatic cirrhosis

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10
Q

Prehepatic / hemolytic
Unconjugated
Water-insoluble
Non-polar
Indirect reaction with diazo (requires accelerator)
Not excreted in urine
Has affinity for CNS

A

B1

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11
Q

Post hepatic / obstructive
Conjugated
Water-Soluble
Polar
Direct reaction with diazo
Excreted in urine
Has no affinity to CNS

A

B2

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12
Q

CONJUGATED bilirubin covalently bond to albumin ; long half life of 17 days ; seen in cases of bile duct obstruction ; direct reaction with diazo reagent ; separated from other fractions by HPLC

A

Delta bilirubin

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13
Q

High B1 due to increased production ; low delivery and uptake, or low conjugation

A

Unconjugated hyperbilirubinemia

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14
Q

High B2 due to intra or extra hepatic cholestasis

A

Conjugated hyperbilirubinemia

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15
Q

High B1 and B2 due to a combination of defects

A

Mixed hyperbilirubinemia

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16
Q

Serum bilirubin : high B1
Urine bilirubin : negative
Urine urobilinogen : 3+

A

Pre-hepatic/hemolytic jaundice

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17
Q

Serum bilirubin : high B1, high B2, or BOTH
Urine bilirubin : trace
Urine urobilinogen 2+

A

Hepatic jaundice

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18
Q

Serum bilirubin : high B2
Urine bilirubin : 3+
Urine urobilinogen : normal

A

Post-hepatic / obstructive

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19
Q

Conjugation of bilirubin happens in what organ

A

Liver

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20
Q

Form of bilirubin that undergoes recirculation to the liver via the portal system of enterohepatic circulation

A

Urobilinogen

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21
Q

Once urobilinogen is taken up by the liver after recirculation, it is now then reexcreted through the small intestine and becomes oxidized in the form of ____ giving feces its brown color

A

Urobilin

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22
Q

Type : unconjugated hyperbilirubinemia ; prehepatic
B1 : high
B2 : normal
Defect : increased rbc destruction = high bilirubin production

A

Hemolytic disease

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23
Q

Type : unconjugated hyperbilirubinemia, hepatic
B1 : high
B2 : normal
Defect : transport defect coupled with UDPGT deficiency

A

Gilbert Syndrome

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24
Q

Type : unconjugated hyperbilirubinemia, hepatic
B1 : high
B2 : normal
Defect : circulating inhibitor of bilirubin conjugation

A

Lucey-Driscoll syndrome

Ci(rculating) = (Lu)cey

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25
Type : unconjugated hyperbilirubinemia, hepatic B1 : high B2 : normal Defect : transient UDPGT deficiency ; no life
Physiologic jaundice of the newborn
26
Type : unconjugated hyperbilirubinemia, hepatic B1 : high B2 : normal Defect : total or partial UDPGT deficiency ; survival is possible
Criggler-Najjar syndrome
27
How to prevent kernicterus
Phototherapy
28
Type : mixed hyperbilirubinemia B1 : high B2 : high Defect : low conjugation ; bile flow interference ; intrahepatic cholestasis
Viral hepatitis or cirrhosis ; hepatic carcinoma
29
Type : conjugated/mixed hyperbilirubinemia ; hepatic B1 : normal/high B2 : high Defect : secretory defect
Dubin-Johnson syndrome ; Rotor syndrome
30
Type : conjugated hyperbilirubinemia ; hepatic B1 : normal B2 : high Defect : extra hepatic cholestasis , tumor, stricture
Biliary obstruction
31
Colorimetric and spectrophotometric measurement of bilirubin is based on the ____ reaction (diazotization with incorporated accelerator/solubilizer) ; 2 methods
Van Den Berg reaction ; Evelyn-Malloy and Jendrassik-Grof
32
Evelyn-Malloy : accelerator
Methanol
33
Evelyn-Malloy : pH
Acidic
34
Evelyn-Malloy : color reaction
Red purple
35
Evelyn-Malloy : maximum absorbance
560 nm
36
Jendrassik-Grof : accelerator
Caffeine sodium benzoate
37
Jendrassik-Grof : pH
Alkaline
38
Jendrassik-Grof : color reaction
Blue
39
Jendrassik-Grof : maximum absorbance
600 nm
40
Jendrassik-Grof : alkalizing agent
Fehlng’s reagent or Alkaline tartrate
41
Jendrassik-Grof : stopping reagent
Ascorbic acid
42
Bilirubin + diazo + accelerator —> Azodipyrroles (ALL FRACTIONS)
Total bilirubin
43
Bilirubin + diazo + accelerator —> Azodipyrroles (B2 and Delta bilirubin only)
Direct bilirubin
44
Calculated —> TB - DB
Indirect bilirubin
45
Over jaundice has a total bilirubin value of
3 mg/dL or above
46
Panic value for unconjugated hyperbilirubinemia
15 mg/dL or above
47
Based on the absorption of light by bilirubin at ___ nm ; correction for oxyhemoglobin is achieved by measuring absorbance at two wavelengths ; appropriate only for neonatal serum ; not done on serum due to the presence of carotenoid pigments
Direct spectrophotometry (Bilirubinometry)
48
Bilirubin reference value ; B1
0.2 - 0.8 mg/dL
49
Bilirubin reference value ; B2
0-0.2 mg/dL
50
Bilirubin reference value : total bilirubin
0.2 - 1.0 mg/dL
51
Biological catalysts that accelerate biochemical reactions without being consumed or changed in composition
Enzymology
52
Combines with only one substrate and catalyzes only the corresponding reaction
Absolute specificity
53
Combines with ALL substrates containing a particular chemical group
Group specificity
54
Breaks or forms a solitary type of covalent bond
Bond or reaction specificity
55
Combines with only one optical or geometric isomer of a compound
Stereoisomeric/geometric specificity
56
Oxidoreductases
LDH G6PD MDH GLDH
57
TRANSFERASES & KINASES
AST ALT GGT CK HK
58
HYDROLASE (Estrases)
ACP ALP CHS 5-NT LPS
59
HYDROLASE (PEPTIDASES)
TRYPSIN PEPSIN LAP (Leucine amino peptidase)
60
HYDROLASE (glycosidases)
AMS GALACTOSIDASE
61
LYASE
Aldolase Decarboxylase
62
EC code : 1
Oxidoreductases
63
EC code : 2
Transferases
64
EC code : 3
Hydrolases
65
EC code : 4
Lyases
66
EC code : 5
Isomerases
67
EC code : 7
Ligases
68
Enzymatic reaction/catalytic reaction
E + S <—> ES —> P + E
69
(E) > (S) - rate limiting component
First-order kinetics
70
(S) > (E)
Zero-order kinetics
71
Amount of enzyme that catalyzes the reaction of 1 UMOL of substrate per MINUTE
IU
72
Amount for enzyme that catalyzes the reaction of 1 MOL of substrates per SECOND
KATAL
73
1 IU = ___ukat
0.0167 ukat
74
0.0167 ukat = ____ nkat
16.7 nkat
75
1 kat = _____ IU
6X10^7 IU
76
End-point ; the reactions are combined, the reaction proceeds for a DESIGNATED TIME, the reaction is stopped followed by measurement of the amount of reaction that has occurred
Fixed-tome
77
Kinetic ; multiple measurements of absorbance change as a function of time, either at specific time intervals of continuously by a continuous recoding spectrophotometer
Continuous monitoring
78
Most enzymatic reactions occur at pH
pH 7-8 except ACP and ALP
79
Denaturation is usually significant at
Every 10C increase in temperature, the velocity (rate of reaction) doubles
80
Activators
Mg, Ca, Zn, and Cl
81
Coenzymes
NAD/NADH , NADP/NADPH
82
Prosthetic group
Pyridoxal phosphate (B6)
83
Inorganic ; may be essential for the reaction or may only enhance the reaction rate
Activators
84
Serve as second substrates for enzymatic reactions
Coenzymes
85
Bound tightly to enzyme
Prosthetic group
86
Competitive Binding site: Effect of adding substrate: Lineweaver-Burk plot:
Active site ; reverse the inhibition ; same vmax and increased km
87
Noncompetitive Binding site: Effect of adding substrate: Lineweaver-Burk plot:
Allosteric site ; no effect ; decreased vmax and same km
88
Uncompetitive Binding site: Effect of adding substrate: Lineweaver-Burk plot:
Enzyme-substrate complex ; increases the inhibition ; low vmax and low km
89
High molecular-mass forms of the serum enzymes that can be bound to either an immunoglobulin or a nonimmunoglobulin substance ; long half life ; high in plasma/serum
Macroenzymes
90
Macroenzymes bound to an immunoglobulin
Macroenzymes type 1
91
Macroenzymes bound to a non immunoglobulin substance
Macroenzyme type 2
92
Enzymes with macroforms
CK AMS LD AST ALT ALP ACP LPS GGT

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