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CP2 Enzymes pt 1
Basic Enzymes questions
| Question | Answer |
|---|---|
| what is the definition of an enzyme? | a substance that increases the rate of a reaction without itself being consumed in the process |
| changes in enzyme concentration in tissue cells should reflect states of ______ and _______. | health and disease |
| what are the 4 main ways in which levels of enzymes can be increased? | cell leakage, increased synthesis, duct obstruction, and multiplication of cells which produce the enzyme |
| plasma half lives of enzymes are generally how long? | 10 hours to more than 5 days |
| what enzyme test is older and not found to be on a comprehensive metabolic panel anymore? | ACP |
| what are the main sources of ACP enzymes? | prostate, liver, spleen, milk, rbs, platelet, and bone marrow |
| the determination of ACP levels is primarily used to diagnose and stage ___________ and ____________ of treatment | prostatic carcinoma and monitor the efficacy |
| what needs to be avoided with a blood sample with intention of testing for ACP? | hemolysis |
| what physical exam procedures may cause a falsely high reading of ACP? | rectal exams or instrumentation of the prostate |
| what drug groups may cause decreased levels of ACP? | fluorides, phosphates, oxalates, and alcohol |
| what diseases can cause an increase in ACP? | prostatic carcinoma, multiple myeloma, pagets, sickle cell crisis, gaucher's disease, renal impairment, cancer of the breast and bone, cirrhosis, hyperparathyroidism, thrombocytosis, cancer metastisis to bone |
| what assay is quickly replacing ACP to screen for prostate cancer? what other test is done in conjunction with this test? | PSA and digital rectal exam |
| in what situation of prostate cancer are ACP levels normal or slightly raised? | when the carcinoma remains localized in the prostate gland |
| what percent of prostate cancer with metastisis causes an increase in ACP | 80% |
| what percent of local prostate cancer cases causes an increase in ACP? | 20% |
| what are the two sites to be concerned with an increase in ALP? | Liver and bone |
| at what pH is ALP maximally active? | 10 |
| what are 3 secondary areas that are found to contain ALP? | intestine, placenta, and the biliary tract |
| what cells of the liver is ALP found in? | Kupffer's cells |
| new _____ growth is associated with elevated ALP levels. | bone |
| in reference to the isoenzymes ALP1 and ALP2: which is/isnt heat stable, and where do each originate? | ALP1: liver origin and heat stable ALP2: bone origin and inactivated by heat |
| what other isoenzyme (ALP related, NOT ALP1 or 2) is shown to have heat stability? | Regan isoenzyme |
| what percent of people with disease output fetal ALP? | 5-15% |
| ingestion of what type of meal can increase ALP levels? | fatty |
| what drugs can cause increased ALP levels? | placental albumin, allopurinol, antibiotics, azathioprine, colchicine, fluorides, indomethacin, isoniazid, methotrexate, methyldopa, nicotinic acid, oral contraceptives, phenothiazine, probenecid, tetracycline, phenytoin, and verapamil |
| what drugs can cause decreased ALP levels? | arsenicals, cyanides, fluorides, nitrofurantoin, oxalates, and zinc salts |
| what diseases can cause increased levels of ALP? | cirrhosis, pagets, RA, biliary obstruction, primary or metastatic liver tumors, intestinal ischemia or infarction, mets to bone, and hyperparathyroidism |
| what normal occurrences can cause increased levels of ALP? | pregnancy, bones of growing children, and healing fractures |
| what diseases can cause decreased levels of ALP? | hypoparathyroidism, malnutrition, milk-alkali syndrome, pernicious anemia, hypophosphatemia, scurvy, and celiac disease |
| what are the three liver conditions that are most frequently associated with increased ALP levels? | extrahepatic biliary obstruction, intrahepatic biliary tract obstruction due to acute liver cell injury, and liver space occupying lesion |
| the three liver conditions that most frequently cause increased ALP can cause ________ times the upper reference limit. | 3 |
| what condition produce the highest known levels of ALP? | Pagets disease |
| what are the two main causes of moderate increases in ALP that are not disease related? | non-fasting patient sample and a third trimester pregnancy |
| what causes creatine phosphate and ADP to split into creatine and ATP? | CPK |
| where is CPK primarily found? | heart muscle, skeletal muscle, and the brain |
| what is a major cause of increased CPK levels? how quickly can CPK levels increase once this happens? how long until the levels return to normal? | damage to muscle cells. happens within 6 hours, return to normal in 2-3 days |
| where is isoenzyme CK1 primarily found? what is its alternate name? | nervous tissue, CPK-BB |
| where is isoenzyme CK2 primarily found? what is its alternate name? | heart muscle, CPK-MB |
| where is isoenzyme CK3 primarily found? what is its alternate name? | skeletal muscle, CPK-MM |
| which isoenzyme of CPK holds the largest fraction and what percent does it hold? | CK3 90% |
| what is the main cause of an increase in each of the isoenzymes of CPK? | stroke, acute MI, and skeletal muscle trauma |
| what is the main event that would cause a medical professional to measure a CPK? | a suspected myocardial injury |
| what is the progression of serum CPK levels after a MI? | levels rise 3-6 hours after, assuming no further damage happens levels peak at 12-24 hours, and return to normal 12-48 hours after the initial event |
| CPK-2 levels usually ____________ with chest pain caused by angina, pulmonary embolism, or congestive heart failure. | do not rise |
| what are a few sources of falsely high CPK levels? | IM injections, strenuous exercise, recent surgery, and early pregnancy |
| what are causes of increased total CPK levels? | acute MI, acute cerebrovascular disease, electric shock, convulsions, muscular dystrophy, delirium treatments, chronic alcoholism, polymyositis, hypokalemia, CNS trauma, pulmonary infarction, dermatomyositis |
| what are causes of increased CPK-1 levels? | pulmonary infarction, electroconvulsive therapy, brain injury, cerebrovascular accident, shock, adenocarcinoma, intestinal ischemia, pulmonary embolism, subarachnoid hemorrhage, seizures, and brain cancer |
| what are causes of increased CPK-2 levels? | acute MI, cardiac aneurysm surgery, cardiac defib, malignant hyperthermia, reyes syndrome, muscular dystrophy, cardiac ischemia, myocarditis, rhabdomyolysis |
| what are causes of increased CPK-3 levels? | muscular dystrophy, myositis, delirium treatments, recent convulsions, electroconvulsive therapy, recent surgery, electromyography, hypokalemia, hypothyroidism, IM injections, crush injuries, hemophilia |
| asymptomatic female carriers of Duchenne MD show how high of an increase of CPK? | 3-6 times |
| measurement of what enzyme has been suggested to distinguish seizures from syncope in patients complaining of loss of consciousness? | CPK |
| what is the main purpose of GGT? | to transfer amino acids and peptides across cellular membranes and possibly glutathione metabolism. |
| what is the main purpose of the testing of GGT? | to detect liver cell damage. |
| what other enzyme does GGT typically parallel? which is more sensitive? | ALP. GGT is more sensitive |
| can GGT detect alcohol ingestion? | yes, can be detected if ingested within 60 hours prior to the test |
| what can cause increased levels of GGT? | liver disease, hepatitis, cirrhosis, hepatic necrosis, hepatic ischemia, hepatic tumor, hepatotoxic drugs, cholestasis, jaundice, pancreatitis |
| what can cause decreased levels of GGT? | hypothyroidism |
| what conditions outside of the liver can cause increased GGT levels? | phenytoin, brain tumors, hyperthyroidism, DM, acute pancreatitis, acute cholecystitis, and acute MI |
| where are the greatest concentrations of Amylase | pancreas and salivary glands |
| what is a serum amylase test most specific for? | pancreatitis |
Created by:
okeywan
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