[LAB] TOTAL CK, CK-MB Flashcards by YANIZA GLORYCE JOCZEF BELMES

REFERENCE METHOD OF TOTAL CK ASSAYS

KINETIC METHOD BY OLIVER-ROSALKI
MODIFIED BY SZASZ

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FUNCTION OF CK

CATALYZING THE REVERSIBLE REACTION BETWEEN CREATININE AND ATP TO FORM CREATININE PHOSPHATE AND ADP

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CK ACTIVITY IN ORGANSE
HIGHEST TO LOWEST ACTIVITY

SKELETAL MUSCLE, HEART, BRAIN

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CLINICAL CONDITIONS CK IS USED TO AID IN DIAGNOSING

MUSCULAR DYSTROPHY
MYOCARDIAL INFARCTION
HYPOTHYROIDISM
RENAL DISEASES

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BASIS OF THE EARLY PROCEDURE OF DETERMINING CK

RATE OF ATO FORMATION

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SUBSTANCE ADDED BY NIELSON TO MODIFY THE EARLY CK DETERMINATION METHOD

ADDITION OF SULFHYDRYL COMPOUNDS AND AMP

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EFFECT OF SULFHYDRYL COMPOUNDS AND AMP ON CK ACTIVITY IN ASSAY

ASSURE MAXIMUM CK ACTIVITY
DELAY ADENYLATE KINASE ACTIVITY

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WHO PUBLISHED THE OPTIMIZED CONDITIONS FOR MEASURING CK

SZASZ IN 1976
SCANDINAVIAN COMMITTEE ON ENZYME

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DIRECTION OF REACTION USED IN STANDARDIZED METHODS FOR CK DETERMINATION

REVERSE REACTION
ACTIVATION BY NAC

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IFCC EXTENDED THE STANDARDIZED METHOD’S TEMPERATURE TO WHAT

37C

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FORWARD REACTION OF CK

CREATINE PHOSPHATE + ADP —CK—> CREATINE + ATP

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REVERSE REACTION OF CK

CREATINE + ATP —CK—> CREATINE PHOSPHATE + ADP

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PH OF THE FORWARD REACTION OF CK

PH 9.0

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PH OF THE REVERSE REACTION OF CK

PH 6.7

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ACTIVATOR OF CK

MAGNESIUM

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DIRECTION OF REACTION IN THE TANZER-GILBARG METHOD

DIRECT OR FORWARD

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RELATIONSHIP BETWEEN THE RATE OF OXIDATION OF NADH AND CK ACTIVITY

DIRECTLY PROPORTIONAL

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SPEED DIFFERENCES OF THE CK REACTION IN THE TANZER-GILBARG METHOD

REVERSE IS 5X FASTER THAN THE FORWARD REACTION

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METHODS FOR THE SEPARATION AND QUANTITATION OF CK ISOENZYMES

ELECTROPHORESIS
IMMUNOASSAYS
COLUMN CHROMATOGRAPHY

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ELECTROPHORETIC MIGRATION OF CK ISOENZYMES

CATHODE — MI : MM - MACRO - MB - BB — ANODE

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IMMUNOASSAYS USED TO MEASURE CK-MB PROTEIN MASS

RADIO-IMMUNOASSAY
MONOCLONAL AB SPECIFIC FOR CK-MB

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ASSOCIATIONS THAT CAN BE MADE WITH THE MEASUREMENT OF PROTEIN MASS

TYPE OF MYOCARDIAL INFARCTION
DEGREE OF DAMAGE

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[DEGREE OF DAMAGE TO LEFT VENTRICLE]
[PROTEIN MASS VALUE]
SMALL MI

<10% DAMAGE
10-60 UG/L

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[DEGREE OF DAMAGE TO LEFT VENTRICLE]
[PROTEIN MASS VALUE]
MEDIUM MI

10-30% DAMAGE
60-225 UG/L

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[DEGREE OF DAMAGE TO LEFT VENTRICLE] [PROTEIN MASS VALUE] LARGE MI

>30% DAMAGE >225 UG/L

REFERENCE VALUE OF CK IN IMMUNOASSAYS

UP TO 5 UG/L

[PRINCIPLE] COLUMN CHROMATOGRAPHY

SEPARATION OF SUBSTANCES IN A COLUMN PACKED WITH AN ADSORBENT

FACTOR THAT AFFECTS THE MIGRATION OF SUBSTANCES IN COLUMN CHROMATOGRAPHY

AFFINITY OF EACH SUBSTANCE FOR THE ADSORBENT

SOLUTION INCORPORATED INTO THE COLUMN IN COLUMN CHROMATOGRAPHY

DIETHYL AMINO ETHYL EXCHANGE RESIN

PH USED IN COLUMN CHROMATOGRAPHY

PH 8.0

WHAT CHARGE BINDS THE GREATEST TO THE COLUMN

ISOENZYMES OF CK WITH A NET NEGATIVE CHARGE

SOLUTION USED TO ELITE OR REMOVE THE ISOENZYMES IN THE COLUM CHROMATOGRAPHY METHOD

SODIUM CHLORIDE

ISOENZYMES SEPARATED IN THE COLUMN CHROMATOGRAPHY CAN BE ASSAYED WITH WHAT METHOD

ROSALKI METHOD

DIRECTION OF REACTION IN THE FLUORESCENCE AND BIOLUMINESCENCE METHOD

REVERSE

CREATINE FORMED IN THE F&B METHOD IS ESTIMATED FLUOROMETRICALLY AFTER THE ADDITION OF WHAT SOLUTION

NINHYDRIN

SOLUTION USED TO FOLLOW THE RATE OF ATO FORMATION AND UTILIZATION IN THE F&B METHOD

LUCIFERIN LUCIFERASE

IONS THAT INHIBIT CK ACTIVITY

EXCESS Mg, Cl, SULFATES

EFFECT OF EXCESS MG, CL, CA, AND SULFATES ON CK ACTIVITY

FLASE DECREASE These inhibit CK activity

OTHER SUBSTANCES THAT INHIBIT CK ACTIVITY

IODOACETATE ADP CITRATE FLUORIDE L-THYROXINE

STABILITY OF CK ACTIVITY IN SERUM SAMPLES

2 HOURS, RT 8-12 HOURS, 4C 2-3 DAYS, FROZEN

EFFECT OF HEMOLYZED SAMPLES ON CK ACTIVITY

FALSE INCREASE Side reactions due to AK, ATP, and G6PD

MAIN SOURCE OF AK

ERYTHROCYTES PLATELETS SKELETAL MUSCLE BRAIN LIVER HEART KIDNEY SMALL INTESTINES

HOW DOES AK INTERFERE WITH CK ACTIVITY

AK CATALYZES THE DIRECT CONVERSION OF ADP TO ATP AND AMP MORE ATP GENERATED INCREASES CK ACTIVITY

IN WHAT SAMPLES ARE LOWER CK VALUES OBSERVED

SAMPLES WITH HIGH ALP ACTIVITY

EFFECT OF LIGHT ON CK ACTIVITY

FALSE DECREASE Light inactivates CK

EFFECT OF LIPEMIC SAMPLES ON CK ACTIVITY

FALSE INCREASE High Abs readings

EFFECT OF INTRAMUSCULAR INJECTIONS ON CK ACTIVITY

FALSE INCREASE Sedatives and analgesics are examples

[CK ACTIVITY DIFFERENCE] MEN VS. WOMEN

MEN HAVE HIGHER VALUES Due to muscle mass

[CK ACTIVITY DIFFERENCE] NEWBORNS VS. ADULTS

NEWBORNS HAVE HIGHER VALUES Due to skeletal muscle trauma during birth

EFFECT OF RECENT EXERCISE ON SERUM CK

FALSE INCREASE Due to muscle activity CK-MB may be increased when skeletal activity is sustained

FUNCTION OF MAGNESIUM

COFACTOR FOR THE MAXIMUM CATALYTIC ACTIVOTY OF THE ENZYME

FUNCTION OF ADENOSINE 5 MONOPHOSPHATE

INHIBITS ADENYLATE KINASE ACTIVITY

FUNCTION OF N-ACETYLCYSTEINE

PREVENTS OXIDATION OF SULFHYDRYL GROUP OF CK

WHAT MUST CK HAVE TO BE ACTIVE

A REDUCED SULFHYDRYL GROUP When it is oxidized, no enzyme activity may be observed

FUNCTION OF EDTA

CHELATES CALCIUM Ca inhibits CK activity

EFFECT OF TEMPERATURE ON CK ACTIVITY

CK ACTIVITY INCREASES

TEMPERATURES AT WHICH CK ACTIVITY ALTERS

Up to 45C — CK activity increases > 45C — CK activity rapidly decreases 55C and above — CK activity is no longer detectable

REFERENCE METHOD FOR CK-MB ASSAYS

IMMUNO-INHIBITION METHOD BY WURZBURG

WHAT CK SUBUNIT INCREASES WHILE TOTAL CK REMAINS NORMAL IN WHAT CLINICAL CONDITION DOES THIS OCCUR

CK-MB MYOCARDIAL INFARCTION

[PRINCIPLE] IMMUNO-INHIBITION METHOD BY WURZBURG

MEASURMENT OF CK ACTIVITY IN THE PRESENCE OF AN AB TO CK-M MONOMER

WHAT DOES THE AB TO CK-M MONOMER INHIBIT

INHIBITS CK-MB AND 1/2 OF CK-BB

METHOD USED TO QUANITATIVELY DETERMINE CK-B ACTIVITY

CK METHOD BY ROSALKI

RELATIONSHIP OF THE RATE OF NADH FORMATION AND CK-B ACTIVITY

DIRECTLY PROPORTIONAL

HOW TO COMPUTE FOR CK-MB

MULTIPLY CK-B ACTIVITY BY 2

[PRINCIPLE] IMMUNOPRECIPITATION

ANTISERA AGAINST PURE CK-MM AND CK-BB IS USED TO QUANTITATE THE THREE CK ISOENZYMES

RESULT OF CK-MM AND BB ISOENZYMES IN IMMUNOPRECIPITATION

COMPLETELY PRECIPITATED

SUBSTANCE USED TO PRECIPITATE CK-MM AND BB

HOMOLOGOUS RABIT ANTISERA

RESULT OF CK-MB ISOENZYMES IN IMMUNOPRECIPITATION

PARTIAL PRECIPITATION

WHAT CK ISOENZYMES ARE NORMALLY PRESENT IN SERA OF HEALTHY PATIENTS

CK-MM CK-MB

EFFECT OF CK-BB ACTIVITY ON CK-MB VALUES

INCREASED Overestimation of CK-MB values

EFFECT OF MACRO-BB ACTIVITY ON CK-MB VALUES

INCREASE Macro BB will be measured as B-subunit

VALUE OF CK-B IF MACRO BB IS SUSPECTED

MORE THAN 20% OF TOTAL CK ACTIVITY

TYPE OF CK-M ANTIBODY USED IN THE ASSAY

ANTI-HUMAN CK-M AB GOAT

AMOUNT OF CK-MM INHIBITED BY GOAT SERUM

UP TO 1500 IU/L OF CK-MM 37C

AMOUNT OF CK-MM INHIBITED BY ANTI CK-MM AB OF JOCKERS WRETOU

100 % CK-MM 80% CK-MB

SIMILAR PROPERTIES OF INHIBITION BY THE ANTI CK-MM AB OF JOCKERS-WRETOU WERE FOUND IN WHAT OTHER ANTISERUM

RABBIT SERUM BY MORIN

[DISADVANTAGE] USE OF MORIN’S RABBIT ANTISERA

RESIDUAL ACTIVITY IN THE SAMPLE AFTER ADDITION OF THE ANTISERUM IS TOO LOW

[ADVANTAGE] USENOF ANTI HUMAN CK-M AB GOAT ANTISERA

INHIBITS CK-MM TO 100% AND CK-MB TO 50+/55%

[LAB] TOTAL CK, CK-MB Flashcards

(78 cards)