T2 Clinical Chemistry

1. List 3 creatine kinase isoenzymes: Skeletal muscle: CK - MM Brain: CK -BB Heart muscle: CK -MB

2. Which immunoglobulin is most abundant in the blood? IgA IgM IgG 🟩 IgD

3. Which of the following enzymes is classified as a membrane-bound enzyme? Lactate dehydrogenase Alanine aminotransferase Alkaline phosphatase 🟩 Creatine kinase

4. Black line represents healthy person serum protein electrophoresis (SPE) profile. Red line represents patient X's SPE profile. The patient most likely has which of the following disease? IgG multiple myeloma 🟩 Chronic autoimmunity Chronic hepatitis Agammaglobulinemia

5. Which method is commonly used to differentiate isoenzymes in laboratory settings? Mass spectrometry Spectrophotometry Immunoassay 🟩 Enzymatic assay

6. nephrotic syndrome, which plasma protein is markedly increased? Gamma-globulin Transferrin Alpha-2 macroglobulin 🟩 Albumin

7. What reagent is used in the Bradford method for total protein analysis? Silver nitrate Ponceau S Cupric sulfate Coomassie brilliant blue 🟩

8. What is the primary clinical significance of elevated CK- MB? Marker of muscle damage 🟩 Diagnostic of myocardial infarction Associated with brain injury Indicator of liver disease

9. Which enzyme is often associated with elevated levels due to liver cell damage or bile duct obstruction? Creatine kinase Lactate dehydrogenase Lipase Gamma-glutamyl transferase 🟩

10. Which of the following factors is essential for an enzyme to be suitable for diagnostic use in serum measurement? High tissue specificity 🟩 Reactivity with multiple substrates Rapid clearance rate Constant serum concentration

11. Serum protein electrophoresis separates proteins mainly based Charge 🟩 Shape Size Weight

12. Which of the following BEST explains why macroenzymes may cause persistently elevated serum enzyme activity? Macroenzymes have increased catalytic activity due to structural mutations. Macroenzymes form high-molecular-weight complexes with reduced clearance 🟩 Macroenzymes stimulate the continuous release of intracellular enzymes. Macroenzymes inhibit the degradation of intracellular enzymes.

12. Black line represents healthy person serum protein electrophoresis (SPE) profile. Red line represents patient Y's SPE profile. The patient most likely has which of the following disease? Agammaglobulinemia 🟩 Multiple Myeloma Waldenström's macroglobulinemia Autoimmune disease

13. The measurement of 1 katal is based on which amount of substrate conversion? 1 mole per hour 1 micromole per second 1 mole per second 🟩 1 micromole per minute

14. What condition is associated with a marked increase in IgM? Multiple myeloma Waldenström's macroglobulinemia 🟩 Wilson disease Iron-deficiency anemia

15. Which of the following assays measures the total concentration of enzyme, including both active and inactive forms? Activity assay Kinetic assay Mass assay 🟩 Bradford assay

16. Which protein contributes the most to maintaining oncotic pressure in plasma? Immunoglobulins Fibrinogen Transferrin Albumin 🟩

17. What is the main role of the reticuloendothelial system (RES) concerning circulating enzymes? To inhibit enzyme function To clear enzymes from serum 🟩 To induce enzyme release during hypoxia To increase enzyme synthesis

18. What is the most commonly used sample type for protein electrophoresis? Serum 🟩 Plasma Whole blood Urine

19. Which protein is negative acute phase reactant? Haptoglobin Transferrin 🟩 Ferritin Alpha-1-antitrypsin

20. DIFFERENTIATING ISOENZYMES IN LABORATORY SETTINGS Immunoassay: Differentiate isoenzymes based on their immunological properties • High-resolution electrophoresis: This method, exemplified by ALP (AIkaline Phosphatase), separates isoenzymes based on their migration rates in an electric field, which is influenced by their size and charge • Activity-measuring methods: These methods use enzyme-specific inhibitors, like pancreatic Amylase, to measure the activity of isoenzymes and distinguish between them

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