Enyzmes and Cardiac Markers

what are the isoenzymes of creatine kinase

CK-1 = CK-BB (brain)

CK-2 = CK-MB (heart)

CK-3 = CK-MM (muscle)

AST, ALT, CK, LD, ALP, lipase are affected by _______

hemolysis

what is in excess and what is limiting factor in zero order kinetics

substrate in excess, enzyme is limiting factor

what is in excess and what is limiting factor in first order kinetics

enzyme in excess, substrate is limiting factor

what order are lab assays typically in (what is limiting factor)

zero order, enzyme is limiting

what enzyme is used in diagnosing prostate cancer

acid phosphatase (ACP)

what enzyme is elevated in all hepatobiliary disorders and is the most sensitive enzyme for all liver disease

GGT

what enzyme catalyzes lactic acid to pyruvic acid using NAD+

lactate dehydrogenase (LD)

what enzyme is the most sensitive for skeletal muscle disease

creatine kinase (CK)

what enzymes are indicators for pancreatitis

amylase and lipase

what type of disorder is measured with AST, ALT, and LD

hepatocellular disorders

what type of disorder is measured with ALP, GGT

biliary tract obstruction

what type of disorder is measured with CK, AST, LD and aldolase

skeletal muscle disorders

what type of disorder is measured by ALP

bone disorders

out of Aspartate transaminase (AST) and Alanine transaminase (ALT) which is more liver specific

ALT

which enzyme is associated with increased alcohol intake

GGT

which enzyme is elevated in bone disorders with osteoblastic activity

ALP = alkaline phosphastase

of amylase and lipase which is more specific for acute pancreatitis

lipase

heme protein found in skeletal and cardia muscle

myoglobin

what enzyme is useful in detecting reinfarction

CK-MB

what is the most specific marker for myocardial damage and is not normally found in blood circulation

troponin

this hormone is a vasodilator (decreases blood pressure) that is only produced by the hear under abnormal conditions; acts as a sensitive/specific indicator of heart failure

BNP

what is tested to assess a patient’s risk for cardiovascular disease and what is the normal vs risk range

hs-CRP; normal <1, risk 1-3, high risk >3

how soon is myoglobin elevated after AMI and how long does it remain elevated

1-4 hours; 18-24 hours

how soon is CK-MB elevated after AMI and how long does it remain elevated

4-6 hours, 2-3 days

how soon is Troponin elevated after AMI and how long does it remain elevated

4-10 hours, 4-10 days

when is blood drawn on a patient suspected of AMI

upon admission, 6-9 hours and 12-24 hours

what enzymes will increase due to a delay in centrifugation

ALT, AST, LD

what are the sources of ALP (alkaline phosphatase)

liver, bone, intestine, placenta, and kidney

disorder: cardiac tissue death due to lack of oxygen caused by obstruction of circulation

Acute myocardial Infarction

disorder: chest pain caused by an inadequate supply of oxygen to heart myocardium

angina

disorder: inadequate blood supply that decreases the availability of ocygen

myocardial ischemia