Which of the following statements is true? C.

Decreased perfusion of the tissue

A. Apoenzyme + prosthetic group = D. Increased production and secretion by
holoenzyme cells
B. A coenzyme is an inorganic molecule Which of the following enzymes is
required considered
for activity most tissue specific?
C. Cofactors are as tightly bound to the A. Creatine kinase (CK)
enzyme as
B. Amylase
prosthetic groups
C. Alkaline phosphatase (ALP)
D. All enzymes have optimal activity at pH
D. Alcohol dehydrogenase (ADH)
7.00
Which of the following enzymes is activated
Which of the following statements about
by
enzymatic reactions is true?
calcium ions?
A. NADH has absorbance maximas at 340
A. CK
and 366 nm
B. Amylase
B. Enzyme concentration must be in excess
C. ALP
to
D. LD
achieve zero-order kinetics
Which of the following enzymes is a
C. Rate is proportional to substrate
transferase?
concentration in
A. ALP
a zero-order reaction
B. CK
D. Accumulation of the product increases
the C. Amylase
reaction rate D. LD
The increase in the level of serum enzymes 2. Which statement about methods for
used to measuring
detect cholestatic liver disease is caused LD is true?
mainly by:
A. The formation of pyruvate from lactate
A. Enzyme release from dead cells (forward
B. Leakage from cells with altered reaction) generates NAD+
membrane
B. The pyruvate-to-lactate reaction proceeds
permeability at
about twice the rate as the forward reaction 16. In which type of liver disease would you
expect the
C. The lactate-to-pyruvate reaction is
optimized at greatest elevation of LD?
pH 7.4 A. Toxic hepatitis
D. The negative-rate reaction is preferred B. Alcoholic hepatitis
Chemistry/Apply principles of basic C. Cirrhosis
laboratory
D. Acute viral hepatitis
procedures/Lactate dehydrogenase/2
Lactate dehydrogenase/2
13. Which condition produces the highest
17. Which of the following conditions will
elevation
interfere
of serum lactate dehydrogenase?
with the measurement of LD?
A. Pernicious anemia
A. Slight hemolysis during sample
B. Myocardial infarction collection
C. Acute hepatitis B. Storage at 4°C for 3 days
D. Muscular dystrophy C. Storage at room temperature for 16 hours
14. In which condition is the LD most likely D. Use of plasma collected in heparin Which
to be of the following statements regarding total
within normal limits? CK is true?
A. Hepatic carcinoma A. Levels are unaffected by strenuous
exercise
B. Pulmonary infarction
B. Levels are unaffected by repeated
C. Acute appendicitis
intramuscular
D. Crush injury
injections
15. The LD pleural fluid:serum ratio for a
C. Highest levels are seen in Duchenne’s
transudative
muscular
fluid is usually:
dystrophy
A. 3:1 or higher
D. The enzyme is highly specific for heart
B. 2:1 injury Which of the following statements
regarding the
C. 1:1
clinical use of CK-MB (CK-2) is true?
D. 1:2 or less
A. CK-MB becomes elevated before
myoglobin
after an AMI A. Abnormal before 1 hour; peaks within 3
hours;
B. CK-MB levels are usually increased in
cases of Which of the following cardiac returns to normal in 8 hours
markers is
B. Abnormal within 3 hours; peaks within 6
consistently increased in persons who hours;
exhibit
returns to normal in 18 hours
unstable angina?
C. Abnormal within 2 hours; peaks within
A. Troponin C
12 hours; returns to normal in 36 hours
B. Troponin T
D. Abnormal within 6 hours; peaks within
C. CK-MB
24 hours; returns to normal in 72 hours
D. Myoglobin Which of the following statements about the
cardiac ischemia aminotransferases (AST and ALT) is true?
C. CK-MB is more specific than myoglobin A. Isoenzymes of AST and ALT are not
found in
D. An elevated CK-MB is always
accompanied by humans
an elevated total CK B. Both transfer an amino group to α–
ketoglutarate
In a nonmyocardial as opposed to a
myocardial C. Both require NADP+ as a coenzyme
cause of an increased serum or plasma CK- D. Both utilize four carbon amino acids as
MB, substrates Select the products formed from
the forward
which would be expected?
reaction of AST.
A. An increase in CK-MB that is persistent
A. Alanine and α–ketoglutarate
B. An increase in the percent CK-MB as
well as B. Oxaloacetate and glutamate
concentration C. Aspartate and glutamine
C. The presence of increased TnI D. Glutamate and NADH . Select the
products formed from the forward
D. A more modest increase in total CK than
reaction of ALT.
CK-MB
A. Aspartate and alanine
What is the typical time course for plasma
B. Alanine and α–ketoglutarate
myoglobin following an AMI?
C. Pyruvate and glutamate
D. Glutamine and NAD+ D. Hepatic carcinoma
Which statement accurately describes serum Which of the following statements regarding
transaminase levels in AMI? transaminases is true?
A. ALT is increased 5- to 10-fold after an A. ALT is often increased in muscular
AMI disease,
B. AST peaks 24–48 hours after an AMI and pancreatitis, and lymphoma
returns to normal within 4–6 days B. ALT is increased in infectious
mononucleosis,
C. AST levels are usually 20–50 times the
upper but AST is usually normal
limit of normal after an AMI C. ALT is far more specific for liver
diseases than
D. Isoenzymes of AST are of greater
diagnostic is AST
utility than the total enzyme level Which D. Substrate depletion seldom occurs in
condition gives rise to the highest serum assays of
level of transaminases? serum from hepatitis cases
A. Acute hepatitis 53. Select the most sensitive marker for
alcoholic liver
B. Alcoholic cirrhosis
disease.
C. Obstructive biliary disease
A. GLD
D. Diffuse intrahepatic cholestasis In which
liver disease is the DeRitis ratio B. ALT
(ALT:AST) usually greater than 1.0? C. AST
A. Acute hepatitis D. γ-Glutamyltransferase (GGT)
B. Chronic hepatitis Which enzyme is least useful in
differentiating
C. Hepatic cirrhosis
necrotic from obstructive jaundice?
D. Hepatic carcinoma In which liver disease
is the DeRitis ratio A. GGT
(ALT:AST) usually greater than 1.0? B. ALT
A. Acute hepatitis C. 5’ Nucleotidase
B. Chronic hepatitis D. LD
C. Hepatic cirrhosis Which of the following statements regarding
ALP
is true? immunochemically
A. In normal adults, the primary tissue B. Bone ALP is increased in bone resorption
source is
C. Bone ALP is used for the diagnosis of
fast-twitch skeletal muscle
osteoporosis
B. Geriatric patients have a lower serum
D. There are two distinct bone isoenzymes
ALP than
other adults
C. Serum ALP levels are lower in children
than in
adults
D. Pregnant women have a higher level of
serum
ALP than other adults
Which isoenzyme of ALP is most heat
stable?
A. Bone
B. Liver
C. Intestinal
D. Placenta
Which isoenzyme of ALP migrates farthest
toward
the anode when electrophoresed at pH 8.6?
A. Placental
B. Bone
C. Liver
D. Intestinal

Which statement regarding bone-specific

ALP
is true?
A. The bone isoenzyme can be measured