Chemical Pathology 15 - Enzymes and cardiac markers Flashcards Preview

Year 5 - Pathology > Chemical Pathology 15 - Enzymes and cardiac markers > Flashcards

Flashcards in Chemical Pathology 15 - Enzymes and cardiac markers Deck (16)
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1
Q

What is the Km?

A

Michaelis Mentin constant

= concentration of substrate at which the reaction velocity is 50% of maximum

2
Q

What tumour marker can be used for germ cell, ovarian and testicular malignancies?

A

ALP

3
Q

When is ALP elevated physiologically?

A

In pregnancy and childhood

4
Q

Recall 4 pathologies that can cause a raised ALP

A
  1. Bile duct pathology (eg cholestatic liver disease)
  2. Bone pathology (fracture/ metabolic bone disease)
  3. Germ cell tumours
  4. Intestinal pathology (but not routinely used for investigation of bowel disorders)
5
Q

Which LFT enzyme is most specific to liver pathology?

A

ALT

6
Q

How can hepatic and biliary disease be best distinguished on the LFTs?

A

ALT:ALP ratio

If ALT much higher than ALP = hepatic

7
Q

How many isoenzymes of LDH exist?

A

5

8
Q

Recall 3 things that a raised LDH may indicate

A
  1. Haemolytic anaemia
  2. Tumour marker (lymphoma, germ cell testicular Ca)
  3. Myositis (rheum)
9
Q

Which enzyme is markedly raised in acute pancreatitis?

A

Serum amylase

10
Q

What is the most likely cause of a raised CK-MB1?

A

Rhabdomyolysis (history of long lie/ big fall?)

11
Q

Where is CK-MB1 vs CK-MB2 produced?

A

CK-MB1 - skeletal muscle

CK-MB2 - cardiac muscle

12
Q

In which population is CK physiologically slightly raised?

A

Afrocaribbean

13
Q

Which prescription drug may be the cause of a raised CK-MB1?

A

Statins (as they can cause myopathy)

14
Q

When does troponin I peak following chest pain?

A

2-4 hours

15
Q

Within what time period does troponin I return to normal following a cardiac event?

A

5-10 days

16
Q

What change in troponin levels is indicative of cardiac myocyte injury?

A

A 50% increase or decrease between 2 measurements

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