Clin Path exam 4

enzyme

term for protein that catalyzes chemical reactions in cells or other systems

cell membrane, cytoplasm, organelles

enzymes are found attached to what of cell, dissolved in what in cell, and present in cell what

damaged, production, removal, ingestion, absorption

major mechanisms for serum enzyme elevation include release from what cells, increased what, decreased what, and what 2 things (I, A)

leakage

what kind of enzymes are released from damaged cells

marked

does mild, moderate, or marked increase of leakage enzymes come from necrosis of cell

moderate

does mild, moderate, or marked increase of leakage enzymes come from membrane blebbing and irreversible damage

mild

does mild, moderate, or marked increase of leakage enzymes come from membrane blebbing, reversible damage, and enzymes released to sinusoidal blood and lymph

damage, concentration, intracellular, half-life

degree of serum increase of enzymes is related to severity of what, what of enzymes within cells, what distribution, and enzyme what

injured

release from what cells is mechanism for serum enzyme elevation that is related to concentration of enzyme within cell and intracellular distribution, enzyme half-life, number of cells damaged, and severity

production

increased what is mechanism for serum enzyme elevation that is related to inducers, neoplasia, and hyperplasia

inducer, neoplasia, hyperplasia

increased production is a mechanism for serum enzyme elevation that is related to I, N, and H

removal

decreased what is a mechanism for serum enzyme elevation where enzymes that are excreted by kidneys will see increased levels with renal disease

ingestion, absorption

what 2 things (I, A) are mechanisms for serum enzyme elevation with the example being GGT rich colostrum for calf

inducers

what method of increased enzyme production stimulates ALP synthesis in hepatocytes

neoplasia

what method of increased enzyme production may increase production of ALP with osteosarcoma of bone

hyperplasia

what method of increased enzyme production increases production of ALP and GGT in biliary epithelium

no

do enzymes detect atrophy

no

is low enzyme activity diagnostically significant

degradation, reference range, interference

possible causes for low enzyme concentrations include enzyme what, inappropriate what, and what from another substance

trypsin

low what enzyme suggests inadequate exocrine pancreas function

exocrine pancreas

low trypsin suggests inadequate what function

color, light

enzymes are measured when enzyme creates a product and consumes a substrate to produce a what change that is detected by what absorption

enzye activity

with spectrophotometry, rate of color change is proportional to what

isoenzyme

term for enzymes with different molecular structure that catalyze the same reaction

L-ALP, B-ALP

example of 2 isoenzymes

immunoassay

what can you use to measure specific relevant isoform of isoenzymes, using antibodies to detect and analyte

CK, AST, ALT

3 enzymes leaked from damaged muscle

muscle

CK, AST, and ALT are enzymes leaked from damaged what

CK

what is the gold standard enzyme for detection of muscle damage

muscle

CK increases due to what injury

yes

is CK sensitive to minor muscle damage

skeletal muscle

CK source

short

does CK have a long or short half life

no

is AST specific

muscle, liver, erythrocyte

3 sources of AST

AST

what enzyme comes from muscle, liver, and erythrocytes

yes

does AST have good sensitivity

muscle, liver, hemolysis

AST is sensitive to what 2 damages and what process

AST

does CK or AST increase faster after damage

AST

does CK or AST have a longer half life

liver

ALT is primarily a what enzyme

ALT

what is primarily a liver enzyme

skeletal muscle

ALT has low levels in what

muscle

if ALT, CK, and AST are greatly elevated, you should consider what injury as a cause for increase in ALT

CK, AST, ALT

list these 3 enzymes in order from most likely to be elevated with muscle damage to least likely to be elevated: ALT, AST, CK

CK, AST, ALT

list these 3 enzymes in order from first to last to have serum enzyme activity after a single episode of muscle damage : ALT, AST, CK

no

is myoglobin an enzyme

myoglobin

term for iron containing protein in muscle

muscle

significant increase in myoglobin is typically associated with acute, severe what injury

myoglobin

significant increase in what is typically associated with acute, severe muscle injury

glomeruli, kidney, urine

when myoglobin is released it goes through what of what organ and is excreted in what

myoglobin

when urine is red-brown to brown what is causing the pigment

yes

is myoglobinuria usually detected with urine dipstick

hemoglobin, myoglobin, RBC

3 rule outs for positive heme urine dipstick results are H, M, and intact what

PCV, CK, bleeding

3 rule outs for positive heme urine dipstick results are hemoglobin (look for decreased what), myoglobin (look for increased what), and intact RBCs (look for sources of what)

leakage, inducible

2 major groups of hepatic enzymes

ALT, AST, SDH, GLDH

4 hepatic leakage enzymes

ALP, GGT

2 hepatic inducible enzymes

leakage

term for cytosolic enzymes in serum due to hepatocellular damage and death

damage

leakage enzyme activity increase is evidence of hepatocellular what

ALT

what enzyme is a hepatocyte cytosolic enzyme useful in dogs and cats, highly specific for liver, mild muscle activity

dog, cat

ALT is useful in what 2 animals

SDH

what enzyme is highly specific for liver used in horses and cattle, also may be used in cat/dog, relatively unstable

horse, cow

SDH is used in what 2 animals

GLDH

what enzyme is a hepatocyte mitochondrial enzyme, highly specific for liver, used mostly in large animals, limited availability in US

proteins

increased production of membrane bound what leads to increased serum enzyme activity

bile

ALP and GGT induction is caused by impaired what flow

cholestasis

term for impaired bile flow

ALP

what enzyme has several relevant isoforms

L-ALP

enzyme from hepatocytes and biliary epithelium cell membrane, major source of serum activity, cholestasis, induced by some drugs

phenobarbital

what drug induces L-ALP

B-ALP

what enzyme is minor source of serum activity, mild increase from bone remodeling, young/growing, fracture, osteosarcoma

C-ALP

what enzyme is from hepatocytes in response to corticosteroids, dogs only

hepatocyte, biliary, cholestasis, drugs

L-ALP is from what cells and what epithelium cell membrane, what causes it to increase, and it is induced by some what

bone, young/grow, fracture, osteosarcoma

B-ALP mildly increases from what remodel, including Y/G, F, O

corticosteroid, dog

C-ALP is from hepatocytes in response to what, in what animal only

GGT

what enzyme is induced from biliary epithelial cells and hepatocytes, cholestasis, some drugs, also present in colostrum in most species, commonly elevated in neonates

biliary, hepatocytes, cholestasis, drugs, colostrum, neonates

GGT is induced from what epithelial cells and what cells, C, some D, also present in what in most species, commonly elevated in what animals

GGT

which enzyme is most specific for cholestasis in the adult dog

direct, hepatocyte

hepatocellular damage is caused by direct or indirect damage to what cells

infection, inflammation, necrosis, toxin, neoplasia, hypoxia, congestion

etiology of hepatocellular damage includes I, I, N, T, N, H, C

intrahepatic

cholestasis type that is the closure of bile canaliculi between hepatocytes, hepatocyte swelling, and inflammation of bile duct epithelium

lipid, glycogen, injury

intrahepatic cholestasis via hepatocyte swelling is caused by accumulation of what 2 things, and response to what

cholangitis

term for inflammation of bile duct epithelium that causes intrahepatic cholestasis

extrahepatic

cholestasis type caused by blockage of biliary tract outside liver

cholelithiasis

term for bile stone that causes extrahepatic cholestasis

mucocele

term for biliary mucus plug that causes extrahepatic cholestasis

pancreas, duodenum

swelling of what 2 things causes extrahepatic cholestasis

common bile duct

mass lesion impinging what bile duct causes extrahepatic cholestasis

both

for cholestatic enzyme elevation, should you consider intra or extrahepatic process or both

yes

are secondary processes common with cholestasis

cholestasis

hepatocytes swell in response to injury and impinge bile canaliculi, which is called what

hepatocellular

bile accumulation in hepatocytes from cholestasis causes what damage

hepatocellular

is cholestatic or hepatocellular pattern when leakage enzymes elevation magnitude is greater than induced enzymes

cholestatic

is cholestatic or hepatocellular pattern when leakage enzymes elevation magnitude is less than induced enzymes

leakage

are leakage or induced enzyme elevation magnitude greater with hepatocellular pattern

induced

are leakage or induced enzyme elevation magnitude greater with cholestatic pattern

liver

what is the major synthesizer of albumin

glucose

liver makes and buffers serum what

cholesterol

liver makes what for lipid processing and trafficking