Ch. 7: Clinical Enzymology & Biomarkers of Tissue Injury Flashcards Preview

Medical Biochemistry > Ch. 7: Clinical Enzymology & Biomarkers of Tissue Injury > Flashcards

Flashcards in Ch. 7: Clinical Enzymology & Biomarkers of Tissue Injury Deck (44):
1

3 main ways enzymes are used clinically?

1) Diagnosis & prognosis of diseases
2) Analytical reagents: Measure activity of other enzymes/nonenzyme substances in body fluids
3) Therapeutic agents

2

Difference between serum vs plasma?

Plasma: liquid in which blood cells suspended

Serum = plasma - clotting factors

3

What processes are plasma specific enzymes involved in?

Blood clotting
fibrinolysis
complement activation
cholinesterase
ceruloplasmin

4

What are non-plasma specific enzymes?

When are they seen? What causes this?

Intracellular enzymes

High turnover, cellular damage, impairment of cells

⬇️O2 supply, infection, toxic chemicals

5

Acid phosphatase: main tissue source?

Prostate

6

Alanine aminotransferase: main tissue source?

Liver

7

Alcohol dehydrogenase: main tissue source?

Liver

8

Alkaline phosphatase: main tissue sources?

Bone
intestinal mucosa
hepatobiliary system
placenta
kidney

9

Amylase: main tissue sources?

Pancreas
Salivary glands

10

Arginase: main tissue source?

Liver

11

Aspartate aminotransferase: main tissue sources?

Heart & skeletal muscle
Liver
Kidney
Brain

12

Ceruloplasmin: main tissue source?

Liver

13

Cholinesterase: main tissue source?

Liver

14

Chymotrypsinogen: main tissue source?

Pancreas

15

Creatine kinase: main tissue sources?

Skeletal & heart muscle
Brain

16

Fructose-bisphosphate aldolase: main tissue sources?

Skeletal & heart muscle

17

Gamma-glutamyl transferase: main tissue sources?

Kidney
Hepatobiliary system
Prostate
Pancreas

18

Glutamate dehydrogenase: main tissue source?

Liver

19

Isocitrate dehydrogenase: main tissue source?

Liver

20

Lactate dehydrogenase: main tissue sources?

Skeletal & heart muscle
Liver
Kidney
RBCs
Pancreas
Lungs

21

Leucine aminopeptidase: main tissue sources?

Hepatobiliary system
Intestine
Pancreas
Kidney

22

Ornithine carbamoyl-transferase: main tissue source?

Liver

23

Pepsinogen: main tissue source?

Gastric mucosa

24

Prostatic specific antigen (serine protease): main tissue source?

Prostate

25

Sorbitol dehydrogenase: main tissue source?

Liver

26

Triacylglycerol lipase: main tissue source?

Pancreas

27

Trypsinogen: main tissue source?

Pancreas

28

What enzymes indicate heart disease? (Old and new)

Old: creatine kinase (CK): CK-MB (CK2)

New: cardiac troponin I

29

What isoenzyme pattern is found in skeletal muscle?

Creatine kinase (CK): CK-MM (CK3)

30

How is the rate of an enzyme-catalyze reaction measured?

Measure product formation (via photometric procedures, e.g. spectrophotometer ➡️ NAD+, product of indicator reaction, absorbs light)

31

Serum markers of acute pancreatitis?

Amylase
Lipase
Trypsinogen

32

Serum markers of hepatocellular necrosis?

AST
ALT

33

Serum markers of cholestasis?

Alkaline phosphatase
5'-nucleotidase
Gamma-glutamyl transferase

34

Where can gallstones occur?

Ampulla of Vater

35

What is the advantage of using enzymes as analytical reagents?

Specificity & direct measurement of substrate in complex mixture

36

What monitoring assay procedures are used when enzymes are used as analytical reagents?

ELISA

37

Describe steps of using enzymes as analytical reagents via specific antibodies absorbed to beads?

1) antibody + bead bind to antigen in test specimen
2) antibody + bead + antigen bind to antibody + enzyme
3) incubate w/substrate & quantitate products ([products directly proportional to [antigen])

38

Enzyme as reagent: what is the negative reaction for incubating enzyme + hapten w/specimen (w/out hapten)?

Antibody for hapten added ➡️ competes to bind to enzyme + hapten ➡️ inactive enzyme (when substrate added ➡️ no products)

39

Enzyme as reagent: what is the positive reaction for incubating enzyme + hapten w/specimen (w/hapten)?

Antibody for hapten added ➡️ competes to bind to free hapten ➡️ active enzyme (when substrate added ➡️ products correlated to [free hapten])

40

Enzyme as reagent: Antibody bind to solid phase + antigen in sample + antigen w/chemiluminescent compound (cc)

If less antigen in sample ➡️ ?
If more antigen in sample ➡️ ?

Less antigen ➡️ more antigen-cc binds to antibody ➡️ more light

More antigen ➡️ less antigen-cc binds antibody ➡️ less light

41

Enzymes as therapeutic agents: how it is used with bleeding disorders?

Transfusion of fresh blood or its active components

42

Enzymes as therapeutic agents: oral admin of digestive enzymes in digestive diseases ➡️ example?

Cystic fibrosis

43

Enzymes as therapeutic agents: admin of fibrinolytic enzyme to recanalize blood vessels occluded by thrombi

What enzyme? Examples of diseases?

Streptokinase

Pulmonary embolism
AMI (acute MI)

44

Enzymes as therapeutic agents: treating disorders of inborn metabolism & cancer therapy ➡️ examples of each?

Gaucher's disease: can't properly bind sugars to phospholipids

L-asparaginase in acute lymphocytic leukemia