enzymology obj
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where do extracel enzymes act?
When do we study them? -
Plasma
When decreased - What are a couple extracell enzymes?
- blood coag enzymes
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Where do intracel enzymes act?
When do we study them? - in tissues/organs; when tissues are damaged
- what are 2 intracell enzyme types?
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secreted
metabolic - what will happen to secreted levels if tissues are damaged?
- Decrease - tissues cant make them
- what will happen to metabolic enzymes if tissues are damaged?
- increase - spill out of tissues
- what are some secreted enzymes?
- AML, LIP, ALP/ACP
- what are some metabolic enzymes?
- CK, LD, ALT/AST
- 5 physical properties that allow seperation of isoenzymes:
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1. affinity to subst/cofactor
2. inhibition by specf agents
3. Heat stability/charge
4. biochemical composition
5. structure/subunits - 2 causes of MI
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-Plaque blockage of coronary artery
-Plaque rupture, clot formed - 3 criteria for WHO MI diagnosis
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1. Chest pain
2. ECG abnormal
3. Serial enzymes - Which criteria is most spcf/sensitive for labs?
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1. Serial markers
2. ECG
3. Pain - on the ECG which wave is altered in MI?
- ST wave elevation
- What are cardiac markers?
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PAST: CK, LD, AST
Current: Myoglobin, CKMB, Trp -
When does CK peak after MI?
What is used in conjuncion? - Peak CK at 24 hrs; elevates faster than LD, but LD stays high until 48 hrs.
- What is the earliest current cardiac marker that elevates?
- Myoglobin (6 hrs peak)
- What is used with Myoglobin to evaluate MI?
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CK-MB; peak at 24 hrs
TnI or TnT; peak at 24, but remain elevated past 48 hrs. - What type of troponin is a cardiac marker?
- cTnI or cTnT - cardiac specific forms.
- what is homocystein, and what do high levels mean?
- protein metabolism product; indicates CVD risk independent of smoking or high cholesterol levels.
- What is hs-CRP?
- hi-sensitivity C-reactive protein
- How does hs-CRP affect CVD diagnosis?
- detects levels within the normal range, as opposed to highly elevated. Allows prediction of future CV event.