MLT Enzymes and Bilirubin Testing
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| What is the largest gland and most versatile organ in the body, and how much does it weight? | show 🗑
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| show | It results in death from hypoglycemia within 24 hours
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| show | Hepatic Artery and Portal Vein; 15ml blood/min
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| show | Hepatic Artery
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| What drains the GI tract and transports most recently absorbed material from the intestines? | show 🗑
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| show | Hepatic Lobule
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| What is the Hepatic Lobule composed of? | show 🗑
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| What are Sinusoids? | show 🗑
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| What is the most important function of the hliver? | show 🗑
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| show | The main digestive chemical synthesized by the liver
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| How much bile is produced in one day? | show 🗑
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| What is formed in the liver from cholesterol? | show 🗑
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| What are bile acids conjugated with to form bile salts? | show 🗑
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| Where is Bile stored during fasting or between meals? | show 🗑
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| show | 2-5 times
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| show | Clotting factor 8
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| show | AST, ALT, SGOT, ALP, 5NT, and GGT
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| show | formation of glucose by the breakdown of glycogen
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| What is the breakdown of glycogen due to hydrolysis? | show 🗑
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| What is the formation of glucose from noncarbohydrate sources? | show 🗑
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| show | Liver
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| show | A, D, E, K
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| show | Group of peptides formed in the liver that mediates growth
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| show | What is the Microsomal Drug Metabolism System
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| show | Bilirubin
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| show | Both iron and protein are reused and porphyrin is broken down as waste
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| show | It is attached to albumin
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| What enzyme is used to catalyze the cinjugation of bilirubin? | show 🗑
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| ctWhat is another name for conjugated bilirubin? | show 🗑
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| show | It is oxidized to Urobilin (producing red-brown color), and excreted in teh stool
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| show | Urobilinogen
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| show | Yellowish pigment inteh sclera of the eyes, skin, and mucus membrane due to the rise of bilirubin concentration in the blood
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| show | Increased RBC destruction, larger load than liver can handle
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| show | Unconjugated Bilirubin
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| What conditions are associated with Prehepatic/Hemolytic Jaundice? | show 🗑
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| What are the causes of Hepatic Jaundice? | show 🗑
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| What disease is associated with Hepatic Jaundice? | show 🗑
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| What is the cause of Post Hepatic Jaundice? | show 🗑
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| What type of bilirubin is elevated when there is an obstruction of the common bile duct? | show 🗑
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| What are enzymes? | show 🗑
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| How do enzymes operate? | show 🗑
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| What are the structures of enzymes? | show 🗑
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| What does the lock and key model assume? | show 🗑
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| show | it recognizes that there is much flexibility in an enzyme's structure and that an enzyme is able to conform to a substrate
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| show | Reactants
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| show | Ph ( 7-8), Temp (optimal temp is 37 C), Substrate concentration , and enzyme concentration
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| What is first order Kinetics? | show 🗑
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| show | Reaction rate is directly proportional to enzyme concentration
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| show | Reaction rates are reduced
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| show | Denaturation of the enzyme
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| What are cofactors? | show 🗑
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| show | Protein portion of enzyme that's almost ready to work.; needs cofactor
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| what acts as a second substrate, is consumed during reaction and must be in excess quantity of the substrate? | show 🗑
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| show | Coenzyme
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| What is an inhibitor? | show 🗑
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| When does enzyme inhibition occur? | show 🗑
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| Which inhibitor physicall binds to the active site, and can be reversed by increased substrate concentration to saturated point? | show 🗑
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| show | Non-competitive Inhibitor
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| show | Uncompetitive inhibitor
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| What is the measurement of catalytic activity? | show 🗑
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| show | End-point (colorimetric or direct)
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| show | Multipoint (rate or kinetic)
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| show | IU/L (international units/Liter)
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| show | the amount of enzyme that will catalyze reaction of 1 micromole of substrate per minute, at optimal conditions
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| What is the function of Creatine kinase (CK)? | show 🗑
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| What are the tissue sources when testing for CK? | show 🗑
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| show | Disorders of muscle and cardiac tissue; bis e4-8 hrs, peaks 12-24 hrs, and normal in 48-72 hrs
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| show | An isoenzyme that migrates fastes in an electric field
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| show | An isoenzyme that migrates second furthest, and is elevated in AMI and serious muscle disorders
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| Which isoenzyme doesn't migrate and is elevated in AMI, muscle disorders and muscle trauma? | show 🗑
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| show | Catalyzes the conversion of lactic acid and pyruvic acid
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| What are the tissue sources for LD? | show 🗑
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| In cardiac disorders, when does LD levels Rise, peak and return to normal? | show 🗑
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| When LD rises for Hematologic/Neoplastic disorders, when are highest levels seen? | show 🗑
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| When are the isoenzyems for LD elevated? | show 🗑
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| show | Cardiac Tissue, Liver, and Skeletal Muscles
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| show | Hepatocellular disorders( acute disorders, Viral hepatitis and Cirrhosis) and Skeletal muscle involvement (Muscular dystrophies and inflammatory conditions)
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| Where are the highest concentrations of Alanine Aminotransferase (ALT) found , and where are higher elevations seen? | show 🗑
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| show | Intestine, liver, bone, spleen, placenta, and kidney
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| Elevations of ALP are significant in the evaluations of what disorders? | show 🗑
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| show | Due to the production of ALP in the placenta; can be detected between 16 and 20 weeks
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| show | prostate; aids is diagnosing prostatic carcinoma, and in the investigation of rape
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| Which enzymeis an excellent indicator fo chronic alcoholism and is useful in monitoring the effects of abstention from alcohol? | show 🗑
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| Which enzyme is used for the breakdown of starch and glycogen and is helpful in the diagnosis of acute pancreatitis? | show 🗑
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| show | Lipase
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| Which enzyme catalyzes the oxidation of glucose-6-Phosphate to 6-Phosphogluconate? | show 🗑
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| show | Erythrocytes, Spleen, Adrenal Cortex, Thymus, Lymph Nodes, and Lactating mammary glands
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| show | protects RBC's from oxidants and can lead to drug-induced hemolytic anemia (antimalarial drugs)
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| What catalyst is used in the Evelyn-Malloy's method of bilirubin testing? | show 🗑
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| What catalyst is used in Jendrassic-Grof's method of bilirubin testing? | show 🗑
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| show | Serum or plasma; sample must be protected from light
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| show | conjugated (direct) 0 - .2 mg/dl; Unconjugated (indirect) .2 - .8 mg/dl; Total bili .2 - 1.0 mg/dl
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| What is the total bilirubin referance ranges for premature infants? | show 🗑
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| What is the reference ranges for bilirubin in a full term infant? | show 🗑
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| show | Male 15 - 160 U/L; female 15 - 130 U/L
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| What is the reference range for CK-MB? | show 🗑
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| What is the refereence range for total LD? | show 🗑
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| What are the normal fractions for LD isoenzymes? | show 🗑
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| show | serum 5 - 30 U/L
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| show | serum 6 - 37 U/L
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| show | prostatic 0 - 3.5 ng/ml
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| What is the reference range for GGT? | show 🗑
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| What is the reference range for AMS? | show 🗑
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| What is the reference range for Lipase? | show 🗑
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| What is the reference range for G6PD? | show 🗑
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| show | To determine the level of specific enzymes in the blood
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| show | All are either Colorimetric (direct0 or Kinetic (indirect/rate)
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| show | Colorimetric; Use of a starch-iodine reaction, measured in Somogyi units
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| What are Somogyi Units? | show 🗑
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| What is the methodology used to test for lipase? | show 🗑
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| What are the specimen requirements for enzyme testing? | show 🗑
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| show | G6PD
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| show | ALP , Aminotransferases (AST & ALT), and 5NT (5 Nucleotidase)
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| What is the use of 5NT? | show 🗑
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| What is the first enzyme seen in the serum of heavy drinkers? | show 🗑
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| show | CK, AST, and LD
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| Which pattern is the most relaible diagnostic criteria for detecting AMI? | show 🗑
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| show | Pattern 2; CK >= 6% total CK-MB, LD2> LD1
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| Which pattern indicates no AMI occured, regardless of LD isoenzyme data? | show 🗑
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| Which pattern usually indicates noncardiac disorder such as, intravascular homolysis, renal cortex infarction, and megaloblastic anemia? | show 🗑
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| What are the most frequent enzymes used in evaluating Hepatocellular disorders? | show 🗑
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| show | ALP, GGT, 5NT, and LAP
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| What is the most sensitive enzyme for liver disorders? | show 🗑
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| show | CK, AST, LD, and Aldolase
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| What are some conditions where enzyme elevations are seen? | show 🗑
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| show | Multiple Sclerosis, Masthenia Gravis, and poliomyelitis
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| Where is the highest level of CK seen? | show 🗑
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| What is the major enzyme associated with bone disorders? | show 🗑
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| show | Increased fraction of ACP & ALP
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| Which enzyme is increased in liver metastases? | show 🗑
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| show | LD elevations can be seen in AML, ALL, and CLL; markedly evevated level of LD indicative of ALL
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| Which 2 enzymes are helpful in the diagnosis of acute pancretitis? | show 🗑
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