Interpreting Clinical Results

ALK/ALP is most abundant in

Liver and bone

GGT is most abundant in

Liver and pancreas

ALT is most abundant in

Liver

AST is most abundant in

Liver and muscle

LDH is most abundant in

Liver, muscle, RBC, and brain

CK is most abundant in

Muscle and brain

Which enzyme is the most specific test

ALT

Which enzyme is the least specific test

LDH

What are the components of a BMP

Electrolytes (Na, K, Cl, and Ca), CO2, BUN, creatinine, and glucose

What is BMP used to assess?

Glucose level, electrolyte and fluid balance, and kidney function

What are the components of CMP?

BMP panel plus liver function test -> albumin, ALK/ALP, AST, ALT, bilirubin, protein

What is CMP used to assess?

BMP in addition to liver function

What are the components of a renal profile?

BUN, Creatinine, BUN/creatinine ratio, and uric acid

What are the components of a liver profile?

ALK/ALP, ALT, AST, LDH, GGT, 5'NT, bilirubin (total, direct, and indirect)

What is BUN? What do elevated levels indicate?

Waste product of protein digestion. Elevated levels mean kidney dysfunction

What is creatinine? What do elevated levels indicate?

Waste product of muscle contraction cleared by the kidneys. Increased levels indicate kidney dysfunction.

What does ALT and AST help to determined in a liver profile?

Hepatocellular damage

What does the ALK/ALP ratio determine in a liver profile?

assess biliary tract damage, cholestasis

What can albumin help to determine in a liver profile?

Acute versus chronic liver damage

What does bilirubin determine in a liver profile?

Heme degradation and hemolytic anemias

What does an increased CK indicate in a heart/muscle profile?

Heart attack, strenuous exercise, or muscle injury

Enzyme activity assays

Estimates how much enzyme is present in a patient's blood by measuring how fast it makes product, using the Vmax

Immunological assays

Measures how much enzyme protein is present by using specific antibodies

Electrophoretic assay

Measures which isoenzymes are present by using electrophoresis, separating based off of charge and size

What is the difference between LDH-1 and LDH-2 isoenzymes?

LDH-1 indicates heart damage and LDH-2 indicates liver damage

What does CK-BB, CK-MB, and CK-MM indicate?

CK-BB is CNS damage

CK-MB is acute myocardial infarction

CK-MM is skeletal muscle damage

What markers are used for acute myocardial infarction?

CK-MB, LDH-1, myoglobin, and troponin

What markers will remain elevated the longest after an AMI?

LDH-1

What markers remain elevated the shortest after an AMI?

CK-MB