Enzymes and Bilirubin

  1. What is the largest gland and most versatile organ in the body?
  2. What is the weight of the adult liver?
    1400-1600 grams
  3. The liver is devided into how many major lobes?
  4. This is a branch of the aorta that supplies 20% overall blood and the majority of O2 needed.
    hepatic artery
  5. This drains the GI tract and transports the most recently absorbed material from intestines.
    portal vein
  6. what is the main digestive chemical synthesized by the liver?
  7. excretion of _____ is one of the most important liver functions.
  8. What is the total daily bile production?
    • about 3 liter a day
    • one liter is excreted
  9. during a meal what is bile secreted by?
    liver cells
  10. where is bile stored between meals?
    gall bladder
  11. plasma protein and all blood clotting factors are produced in the liver except which one?
    factor V111
  12. what is metabolized to form bile acids?
  13. What is stored in the liver?
    • Fat soluble vitamins (A,D,E,K)
    • water soluble vitamins such as B12
    • Carotene into vitamin A
  14. What is the group of peptides formed in the liver that mediates growth hormone.
  15. What is the most important mechanism in detoxification and drug metabolism in the liver?
    Microsomal Drug Metabolism System
  16. This is a waste product of RBC breakdown
  17. When the heme ring from RBC destruction splits what is formed?
  18. When biliverdin is reduced in the RE system what is formed?
  19. Which type of blirubin is insoluble?
    unconjugated bilirubin
  20. When mesobilirubin is oxidized what is formed?
  21. What are the three ways that urobilinogen is removed from the body?
    • urine
    • feces
    • recycled
  22. This is a yellowish pigmentation in the sclera of the eyes, skin, and mucus membrane.
  23. This type of Jaundice is caused by increased RBC destruction or a larger load than the liver can handle.
    prehepatic/hemolytic jaundice
  24. What are the three conditions associated with hemolytic (prehepatic) jaundice?
    • autohemolytic anemia
    • HDN
    • incompatible transfusion
  25. What are the laboratory findings of hemolytic (prehepatic) jaundice.
    • increased unconjugated bilirubin
    • increased urobilinogen
  26. This type of jaundice is caused by a conjugation failure, bilirubin transport disruption, or general hepatic damage.
    hepatic jaundice
  27. What are the laboratory findings associated with hepatic jaundice?
    • increased conjugated/unconjugated bilirubin
    • increased or normal urobilinogen
  28. This type of jaundice is caused by obstruction of common bile duct.
    post hepatic (obstructive) jaundice
  29. what are the laboratory findings of Post hepatic (obstructive) jaundice.
    • increased conjugated bilirubin
    • urobilinogen in urine will be decreased or 0.
  30. These are typically very large proteins that react with one or only a few types of molecules.
  31. This enzyme structure shows the specific amino acid sequence.
    primary structure
  32. This enzyme structure shows the stearic arrangement of chains.
    secondary structure
  33. This enzyme structure shows the 3-D configuration.
    tertiary structure
  34. This enzyme structure contains >1 polypeptide chain
  35. What is the naming of enzymes based on?
    • what it reacts with
    • how it reacts
    • add -ase ending
  36. This organization created a standardized classification of naming enzymes in 1961.
    international union of biochemistry (IUB)
  37. This model, created by Emil Fisher, assumes that an enzyme active site will only accept a specific substrate.
    Lock and key model
  38. This model recognizes that there is much flexibility in an enzyme's structure. according to the model, an enzyme is able to conform to a substrate.
    induced fit model
  39. This is the site where the reaction actually occurs.
    catalytic site
  40. This is the area that holds substrate in proper place.
    binding site
  41. these are molecules that react with specific enzymes
  42. When substrate concentration is lower than the enzyme, substrate readily binds to the enzyme, binding increases as more substrate is added. This is called what?
    first-order kinetics
  43. Once substrate concentration reaches a point of maximum enzyme activity (saturation), the rate of reaction becomes dependent upon enzyme concentration.
    zero-order kinetics
  44. How does changes in pH and temp affect enzyme reactions?
    it causes denaturation
  45. most enzymatic reactions occur at a pH of what?
  46. what is the optimum temp for most enzymatic reactions?
  47. Enzyme concentrations are usually expressed in what?
    units per liter (IU/L)
  48. The standardized reporting unit in which the amount of enzyme that will catalyze a reaction of one micromole of substrate per minute is known as what?
    international unit
  49. This enzyme is found in skeletal muscles, heart, and brain, increased levels are often used to detect disorders of muscle and cardiac tissues, sucha as AMI.
    creatine kinase (CK)
  50. This is the brain type of CK that migrates fastest in an electric field.
  51. This hybrid type of CK migrates second furthest and is elevated in AMI and serious muscle disorders.
  52. This is the muscle type of CK that doesnt migrate but is elevated in AMI and muscle disorders.
  53. This enzyme is found in the heart, liver, skeletal muscles, kidneys, and erythrocytes, increased levels indicate cardiac disorders, but the highest levels are seen in pernicious anemia.
    Lactate Dehydrogenase (LD)
  54. Elevataions of this enzyme are limited mainly to hepatocellular disorders and muscular dystrophies. It is not useful in the diagnosis of AMI.
    Aspartate aminotransferase (AST)
  55. Highest concentrations of this enzyme are found in the liver and is elevated in hepatic disorders.
  56. activity of this enzyme in bones is confined to osteoblasts
  57. clinical significance of this enzyme is predominant in obstructive conditons, and durring pregnacy especially in preeclampsia, eclampsia, and threatened abortion.
  58. This enzyme has the same function as ALP but at an acidic pH, it's richest source is the prostate.
    acid phosphatase (ACP)
  59. This enzyme is used in the diagnosis of prostatic carcinomas.
  60. This enzyme is an excellent indicator for chronic alcoholism, and is useful in monitoring the effects fo abstention from alcohol.
  61. This enzyme catalyzes the breakdown of starch and glycogen and is found in the pancreas and salivary gland.
    Amylase (AMS)
  62. This enzyme is used to diagnose acute pancreatitis but is also elevated in mumps.
    amylase (AMS)
  63. This enzyme is used in the breakdown of fats, is found in the pancreas, and elevated in the diagnosis of acute pancreatitis
  64. deficiency of this enzyme leads to drug-induced hemolytic anemias
  65. These are the two methods of spectrophotometry bilirubin testing.
    • evelyn-malloy
    • jendrassik-grof
  66. This method of bilirubin testing uses caffine.
  67. Bilirubin tests should be protected from _________.
  68. what is the normal ranges for adult bilirubin.
    conjugated (direct):
    Unconjugated (indirect):
    total bili:
    • conjugated: 0.0-0.2 mg/dL
    • unconjugated: 0.2-0.8 mg/dL
    • Total: 0.2-1.0 mg/dL
  69. what is the reference ranges for premature total bilirubin
    24hr: 1-6mg/dL
    48hr: 6-8mg/dL
    3-5 days:10-12 mg/dL
  70. what is the reference range for full term total bilirubin.
    24 hr:
    48 hr:
    3-5 days:
    • 24 hr: 2-6mg/dL
    • 48 hr: 6-7 mg/dL
    • 3-5 days: 4-6 mg/dL
  71. what is the reference range for total CK
    • male: 15-160 U/L (37oC)
    • Female: 15-130 U/L (37oC)
  72. what are the normal ranges for CK-MB
    <6% of total CK
  73. What is the reference range of total serum LD
    100-225 u/L (37oC)
  74. what is then normal range for serum AST
    5-30 U/L
  75. what is the reference range for serum ALT
  76. what is the reference range for prostatic ACP.
    0-3.5 ng/ml
  77. what is the reference range for GGT.
    • Males: 6-45 U/L
    • Females: 5-30 U/L
  78. what is the reference range for AMS
    • Serum: 25-130 U/L
    • Urine: 1-15 units/hr
  79. what is the reference range for serum LPS.
    0-1.0 U/mL
  80. What is the enzyme testing method that uses first or zero order kinetics.
  81. what is the enzymatic testing method that measures reactions at specific times in intervals.
  82. ______ affects most enzyme testings
  83. measurements of ______ LD is usually not diagnostically helpful.
  84. what are the most frequently used enzyme for diagnosing/monitoring AMI.
    • CK
    • AST
    • LD
Card Set
Enzymes and Bilirubin
Enzymes and bilirubin