M.I Profile (Cardiac Enzyme)

Question 1

Type of transferase involved in the storage of high-energy creatine phosphate in muscle cells

Answer 1

Creatinine Kinase (CK)

Question 2

Not specific to the heart because it is widely distributed, with highest activities in skeletal muscle, heart, and brain

Answer 2

CK

Question 3

Give the structure of CK

Answer 3

Dimeric enzyme composed of 2 monomer subunits (either M or B)

Question 4

Also known as Forward Reaction method for CK

Answer 4

Tanzer-Gilvarg

Question 5

Optimum pH of forward reaction

Answer 5

9.0

Question 6

Also known as Reverse Reaction

Answer 6

Oliver Rosalki

Question 7

Optimum pH of reverse reaction

Answer 7

6-8

Question 8

Hemolysis can false __ CK activity

Answer 8

Increase

Question 9

RBC has __ which is the same with CK activity

Answer 9

Adenylate Kinase (AK)

Question 10

CK is inactivated by light and can cause false __

Answer 10

Decrease

Question 11

Physical activity and IM injection can __ CK

Answer 11

Increase

Question 12

Slowest mobility toward the anode

Answer 12

CK-3 / CK-MM / Muscle type

Question 13

Major isoenzyme in striated muscle and normal serum of healthy individuals

Answer 13

CK-3 / CK-MM / Muscle type

Question 14

2nd fastest to migrate toward the anode

Answer 14

CK-2 / CK-MB / Hybrid Type

Question 15

Significant quantities are found in heart tissues.

Answer 15

CK-2 / CK-MB / Hybrid Type

Question 16

Migrate fastest toward the anode

Answer 16

CK-1 / CK-BB / Brain Type

Question 17

Highest concentration in CNS, GI tract and uterus (pregnancy)

Answer 17

CK-1 / CK-BB / Brain Type

Question 18

How many percent of CK MB is found in the total CK?

Answer 18

> 6%

Question 19

After MI, CK-MB __ levels to begin to rise within __ hours, peak at __ hours, and returns to normal levels within 48-72 hours

Answer 19

> 6%
4-8
24

Question 20

The first enzyme to elevate in Myocardial Infarction

Answer 20

CK MB

Question 21

First protein/ marker or analyte to elevate during Myocardial infarction, faster than CK-MB

Answer 21

Myoglobin

Question 22

More helpful in diagnostic and improve the specificity of the test in terms of identifying the target organ or tisse

Answer 22

CK Isoenzyme

Question 23

CK BB low in blood but high in CSF indicates

Answer 23

CSF Leakage (BBB is damaged)

Question 24

CK Isoenzyme that is dominant in the blood

Answer 24

CK MM

Question 25

CK enzyme is combined/coupled with antibodies or lipoprotein

Answer 25

Macro-CK

Question 26

CK isoenzyme with antibodies (IgA or IgG)

Answer 26

CK BB

Question 27

CK isoenzyme with Lipoprotein

Answer 27

CK MM

Question 28

Seen or migrate between CKMM and CKBB

Answer 28

Macro-CK

Question 29

- Bound to mitochondrial membrane *severe damage to the cell - Migrates cathodal and farthest to anode

Answer 29

Mitochondrial CK (CK-MI)

Question 30

- Oxidoreductase that catalyzes the interconversion of lactic and pyruvic acids - Widely distributed, highest activities in heart, hepatic, skeletal muscle and RBC

Answer 30

Lactate Dehydrogenase (LD)

Question 31

Forward reaction in LD assay

Answer 31

Wacker Method

Question 32

Optimal pH for wacker method

Answer 32

8.3 to 8.9

Question 33

Reverse reaction of LD assay

Answer 33

Wrobleuski La Due

Question 34

Three times faster but more susceptible to substrate exhaustion (prolonged testing or substrate testing may have high probability of exhaustion

Answer 34

Wrobleuski La Due

Question 35

Optimal pH for Wrobleuski La Due

Answer 35

7.1 to 7.4

Question 36

Has greater affinity of H subunits (greater the subunit=greater affinity)

Answer 36

Alpha-hydroxybutyrate dehydrogenase (a-HBD)

Question 37

Represent LDH-1 (since it composed ONLY of numerous H subunit

Answer 37

Alpha-hydroxybutyrate dehydrogenase (a-HBD)

Question 38

After MI, LD begin to rise within __ hours, peak at 48-72 hours and remains elevated for __days

Answer 38

10-24 10

Question 39

Structure of LD

Answer 39

Tetramer and has 2 active subunits (M and H)

Question 40

Give the tissue and disorder: LDH 1 (HHHH)

Answer 40

Heart, RBC MI, Hemolytic anemia

Question 41

Give the tissue and disorder: LDH 2 (HHHM)

Answer 41

Heart, RBC RI (Renal infarction), Megaloblastic anemia

Question 42

Give the tissue and disorder: LDH 3 (HHMM)

Answer 42

Lung, Spleen, Pancreas Pulmonary embolism

Question 43

Give the tissue and disorder: LDH 4 (HMMM)

Answer 43

Liver Hepatic injury

Question 44

Give the tissue and disorder: LDH 5 (MMMM)

Answer 44

Skeletal Muscle Skeletal Muscle Injury

Question 45

T/F: LDH can also be a liver enzyme

Answer 45

TRUE

Question 46

LDH isoenzyme that is fastest and closest to the anode

Answer 46

LDH 1 (HHHH)

Question 47

The most predominant LD Isoenyzme in healthy individuals and greater with LDH 1

Answer 47

LDH 2 (HHHM)

Question 48

Shows in AMI and intravascular hemolysis (LDH 1 > LDH2)

Answer 48

Flipped Pattern