MAJOR CLINICAL ENZYMES

Question 1

MAJOR ISOENZYMES OF ALP

Answer 1

. Liver ALP (from the liver)
2. Bone ALP (from the bone)
3. Placental ALP (from the placenta)
4. Intestinal ALP (from the intestines)

Question 2

Increased TOTAL ALP:

Answer 2

OBSTRUCTIVE JAUNDICE

Question 3

For bone disorders, ALP highest elevations
occur in:

Answer 3

PAGET’S DISEASE

Question 4

• Detected in serum of dialysis
  patients
• Used to study low bone mineral
  disease in patients with chronic
  kidney disease

Answer 4

Bone ALP isoform B1x

Question 5

Where does Regan ALP found?

Answer 5

Found in lung, breast, ovarian and
gynecological cancers

Question 6

MOST HEAT STABLE ALP

Answer 6

Regan ALP

Question 7

Regan ALP is Inhibited by

Answer 7

phenylalanine reagent

Question 8

Where does Nagao ALP can be found?

Answer 8

Found in adenocarcinoma of the
pancreas and bile duct, pleural
cancer

Question 9

Nagao ALP is inhibited by

Answer 9

L-leucine and
phenylalanine

Question 10

In terms Electrophoretic mobility liver ALP is the

Answer 10

fastest, followed by
bone, placental, and intestinal

Question 11

ALP increase 3-x

Answer 11

• Biliary Tract obstruction (induced
  by cholestasis)
• Hepatitis and cirrhosis -slight
  increase

Question 12

The presence of intestinal ALP in serum
depends on the____ and______

Answer 12

blood group and secretor
status

Question 13

In terms of Heat Stability PLACENTAL ALP is the

Answer 13

most heat stable,
followed by intestinal, liver and
bone

Question 14

Placental ALP can resists denaturation at?

Answer 14

65°C for 30 mins

Question 15

ASSAYS FOR ENZYME ACTIVITY FOR ALP

Answer 15

Bowers and McComb

Question 16

Substrate of Bowers and McComb

Answer 16

• p-nitrophenol
• p-Nitrophenylphosphate
  (colorless) is hydrolyzed to p-
  nitrophenol (yellow), and the
  increase in absorbance at 405 nm

Question 18

Aids in detection of prostatic carcinoma
particularly metastatic carcinoma

Answer 18

ACID PHOSPHATASE (ACP)

Question 19

more useful screening and diagnostic tool.

Answer 19

PSA (Prostate-specific antigen)

Question 20

Most specific substrate of Acid Phosphatase

Answer 20

Thymolphthalein monophosphate

Question 21

Most frequently used inhibitor Acid Phosphatase

Answer 21

TARTRATE

Question 22

Used in forensic clinical chemistry in investigation of rape

Answer 22

Acid Phosphatase

Question 23

Serum ACP is frequently elevated in

Answer 23

bonedisease
Gaucher’s disease
idiopathic thrombocytopenic purpura

Question 24

ACP assays are performed in

Answer 24

acid pH

Question 25

____should be avoided, and serum should be_____ as soon as blood has clotted to prevent leakage of ACP

Answer 25

Hemolysis separated

Question 26

two isoenzyme fractions of Aspartate Aminotransferase

Answer 26

Cytoplasm AST (predominant) Mitochondrial AST

Question 27

Aspartate Aminotransferase is Limited mainly to the evaluation of ______and_______

Answer 27

hepatocellular disorders skeletal muscle involvement

Question 28

In AMI, AST levels begin to rise with_____, peaks at_____, returns to normal within_____

Answer 28

6 to 8 hours 24 hours 5 days

Question 29

Elevations of AST are frequently seen in

Answer 29

pulmonary embolism May also increase after congestive heart failur

Question 31

Levels of AST are highest in

Answer 31

acute hepatocellular disorders

Question 32

viral hepatitis

Answer 32

100x AST increase

Question 33

cirrhosis

Answer 33

4x AST increase

Question 34

Muscle dystrophies

Answer 34

4-8x AST increase

Question 35

Assay used in AST

Answer 35

KARMEN METHOD

Question 36

incorporates a coupled enzymatic reaction using(______) as the indicator reaction and monitors the change in absorbance at____ continuously as_____ is oxidized to____

Answer 36

Malate dehydrogenase 340 nm NADH NAD+

Question 37

The optimal pH used in Karmen method is

Answer 37

7.3 to 7.8

Question 38

Considered as more liver-specific enzyme of the transferases

Answer 38

ALANINE AMINOTRANSFERASE (ALT)

Question 39

Higher elevations of ALT are found in

Answer 39

hepatocellular disorders

Question 40

In acute inflammatory conditions of the liver, ALT is higher than____ tends to remain elevated longer______

Answer 40

AST (16-24 hrs)

Question 41

Assay of ALT Absorbance? Optimal pH?

Answer 41

Consists of a coupled enzymatic reaction using LDH as the indicator enzyme, which catalyzes the reduction of pyruvate to lactate with the simultaneous oxidation of NADH. Absorbance at 340 nm Optimal pH: 7.3-7.8