Long discussion 1

Jef Marc Valencia · 73問 · 2年前

通報

問題一覧

AST Systematic name

E.C. 2.6.1.1

AST other name

SERUM GLUTAMIC OXALOACETIC TRANSAMINASE

Substrate of AST

ASPARTATE+A KETOGLUTARATE

Product of AST

OXALOACETATE+GLUTAMATE

Widely distributed in human tissue with the Highest concentration in cardiac tissue, liver, & skeletal muscle

AST

Evaluation of hepatocellular disorders & skeletal muscle involvement

AST

isoenzymes of AST in the

MITOCHONDRIA, CYTOPLASM

Mild degree of liver tissue injury: cytoplasmic isoenzyme is

PREDOMINANT

Severe tissue damage: release of

MITOCHONDRIAL ISOENZYME

most important cause of elevated transaminase activity in serum

LIVER DISEASE

AST Elevations

PULMONARY EMBOLISM, VIRAL HEPATITIS: UP TO 100x ULN, CIRRHOSIS: ~4x ULN, SKELETAL MUSCLE DISORDER: ~4-8x ULN, AMI

in AMI, AST Rise: Peak: Return:

6-8 HOUR, 24 HOUR, 5 DAY

ALT systematic name

E.C 2.6.1.2

ALT other name

SERUM GLUTAMIC PYRUVIC TRANSAMINASE

ALT Substrate

ALANINE+A KETOGLUTARATE

ALT Product

PYRUVATE+GLUTAMATE

Distributed in many tissues, High concentrations in the liver (more liver – specific enzyme among the transferases)

ALT

ALT has an isoenzyme

CYTOPLASMIC

Evaluation of hepatic disorders (hepatocellular).

ALT

In cases of progressive inflammatory liver diseases _is higher than_

ALT, AST

(AST:ALT ratio) is also known as

DE RITIS RATIO

(AST:ALT ratio) normally and also in viral hepatitis

<1.0

(AST:ALT ratio) associated with cirrhosis

>1.0 but <2.0

(AST:ALT ratio)associated with alcoholic hepatitis or hepatocellular carcinoma.

>2.0

Acute hepatocellular injury:

AST>ALT

longer half – life, so after 24hrs or second testing during monitoring, it becomes higher

AST

Method of measurment in Transaminase reactions coupled to specific DH (dehydrogenase reactions) reactions.

CONTINOUS MONITORING

Assay for AST activity which Coupled enzymatic reaction w/ MDH (indicator reaction). Monitor the conversion of NADH to NAD, which is directly proportional to the amount of AST in the body

KARMEN

Optimal pH for Karmen in AST

7.3-7.8

In karment method, it is Monitored at spectrophotometrically at

340 NM

Aspartate + a – ketoglutarate (AST) Oxaloacetate + Glutamate What reaction

ASSAY

Oxaloacetate + NADH + H (MDH) Malate + NAD What reaction

INDICATOR

Error in AST which Increase in serum AST – AST activity in RBC 15x higher in the serum.

HEMOLYSIS

AST activity is stable in serum for

3-4 DAY

Assay for ALT activity indicator

LDH

RR for AST

5-30 u/L

RR for ALT

6-37 u/L

Method which Coupling w/ 2,4 – DNPH (Reitman – Frankel).• Still feasible.• Phenylhydrazones of oxaloacetate & pyruvate are more chromogenic.

COLORIMETRIC

Simple; limited but acceptable accuracy. Mostly used in research laboratories

COLORIMETRIC

Product formed in colorimetric method_is measured at_

STRONG BLUE, 505 NM

Creatine Kinase systematic name

E.C. 2.7.3.2

major phosphorylated compound in muscle

PHOSPHOCREATINE

Forward reaction requires pH_in ck

reverse reaction requires optimum pH_in ck

6.7

Catalyzes reversible phosphorylation of creatine by ATP

CREATINE KINASE

CK is mostly found in

STRIATED MUSCLE, BRAIN TISSUE, HEART TISSUE

Each sub unit of Ck has a MW

40000

(brain type) CK1 (fastest in electrophoresis)

CK-BB

(hybrid type) CK2 (2nd fastest in electrophoresis)

CK-MB

(muscle type) CK3 (3rd fastest in electrophoresis)

CK-MM

All three isoenzymes of Ck are found in the

CELL CYTOSOL

4th isoenzyme • Located between the inner and outer membranes of the mitochondria • Differs immunologically & in electrophoretic mobility

CK-MT

the major serum in healthy individuals.

CK3

contains almost mostly of CKMM

SKELETAL MUSCLE

sensitive indicator of AMI

CREATINE KINASE

Disease in skeleteal muscle in CK

MYASTHENIA GRAVIS, MULTIPLE SCLEROSIS, POLIOMYELITIS, PARKISON'S DISEASE

isoenzyme will be elevated in conditions such as cerebral ischemia and cerebrovascular ischemia where blood flow to the brain is insufficient

CK-BB

the liver and the brain is swollen as a side effect of viralinfections

REYE'S SYNDROME

results in CK-MM elevations because of the involvement of muscle tissue (increased membrane permeability), the effect of thyroid hormone on enzyme activity, and, possibly, the slower clearance of CK as a result of slowermetabolism.

HYPOTHYROIDISM

rarely seen in the serum because Of its molecular size

CK-BB

associated also with patients with carcinoma of various organs such as adenocarcinoma, lung tumors, tumors of the prostate, kidney breasts and ovary the CKBB can be a useful tumor marker

CK-BB

the reduction of NADH to NAD ismonitored spectrophotometrically. The change in absorbance is proportional to the activity of CK.

FORWARD REACTION

preferred in the laboratory because it is about six times faster than the forward reaction.The rate of NADPH formation is a measure and directly proportional to the CK activity

OLIVER ROSALKI, REVERSE REACTION

Sources of error in Ck dtermination

ADENYLATE KINASE EFFECT, HEMOLYSIS, LIGHT

RR in male ck

15-160 u/L

RR in female Ck

15-130 u/L

reference and the most useful method in CK. Detection of atypical bands • Bands are visualized by incubating the support with a concentrated CK assay using the reverse reaction • in hemodialysis, albumin becomes endogenously fluorescent (stimulate the CK-1 band) • Allows visualization of AK

ELECTROPHORESIS

Potential for being more sensitive & precise than electrophoresis

ION EXCHANGE CHROMATOGRAPHY

Measure the concentration of enzyme proteins rather than the enzyme activity. • Detects enzymatically inactive CK – 2 • Infarction can be detected earlier than the other methods. • Example: emergency cases

IMMUNOASSAY

Anti – M or Anti – B antibodies • CK activity is measured before and after inhibition. • Residual activity - Anti – B inhibit or stop the activity of B subunit of CK-B. • Multiply by 2 for the activity of CKMM

IMMUNOINHIBITION

COMPH Lesson 5

COMPH Lesson 5

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Discussion 1

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Dis 1

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Researcj Design

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Dis 1 mid

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Discussion -2 Six Sigma

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Sigma Levels

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ELEC TROCH

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TRANSCRIPTION

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LIS

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Carbohydrates

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Copper Reductions

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Exp.8

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QUIZ 8/9

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Immunology

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Immunology part 2

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Immunology 3

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Lesson 4

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PROTEINS

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PROTEIN 2

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PROTEIN 3

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Serum Albumin Determination

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CC lec debris

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NPN

NPN

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NPN 2

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Materials management

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Liver

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LESSON 10

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hyperlipoproteinemia

hyperlipoproteinemia

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THE SPIROCHETES

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PYOGENIC GRAM POSTIVE

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Introduction

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Introduction Page 2

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Introduction pg 3

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Introduction table

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NK-Immunity

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meet 2

meet 2

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discussion 3

discussion 3

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dis 1

dis 1

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Immune 3

Immune 3

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dis 4

dis 4

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dis 5

dis 5

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FIXATIVES

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ALDEHYDE-FIXATIVES

ALDEHYDE-FIXATIVES

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lactate dehydrogenase

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FIXATIVES-CHROMATE

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Specialized Macrophages

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LYMPHOPOIESIS

LYMPHOPOIESIS

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PICRIC ACID-FIXATIVE

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immune 4

immune 4

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FIXATIVES-ALCOHOL

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Immunoglobulins

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ARTIFACTS

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FIXATIVES QUIZ COPY

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MAJOR HISTOCOMPATIBILITY

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Introduction

Introduction

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OTHERS-FIXATIVES

OTHERS-FIXATIVES

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MEGAKARYOPOLESIS

MEGAKARYOPOLESIS

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DECALCIFICATION

DECALCIFICATION

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DEHYDRATION

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Blood Specimen Collection

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CLEARING

CLEARING

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CEARING AGENT

CEARING AGENT

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INTRODUCTION

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Introduction

Introduction

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Methods of Determination

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ASPARTATE AMINOTRANSFERASE

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ALANINE AMINOTRANSFERASE

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Creatinine Kinase

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LACTATE DEHYDROGENASE

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ACID PHOSPHATASE

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