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CP2 Enzymes pt 1

Basic Enzymes questions

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