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The use of enzymes in clinical diagnosis.
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Factors affecting enzyme levels in plasma or serum.
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Selection of enzyme tests. Techniques of enzyme assay. Measurement of isoenzymes and isoforms.
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PLASMA ENZYMES AS DIAGNOSTIC TOOLS:
Determination of the level of these enzymes is used for diagnosis of heart, liver, skeletal muscle, etc. The level of these enzymes in plasma correlates with the extent of tissue damage.
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Intracellular Distribution of Diagnostic Enzymes: Liver: LD5, ALT, AST. Heart: LD1, AST,CK. Pancreas: LPS, AMS.
Salivary glands: AMS. Bone: ALP. Muscle: CK. Biliary tract: ALP, GGT. Prostate: ACP.
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EXAM
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DISORDERS DIAGNOSED BY ENZYMES:
Cardiac Disorders: ALT, LD1, CK
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Hepatic Disorders: a) Hepatocellular disorders ALT, AST, LD5, b) Biliary tract disorders: ALP, GGT
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Skeletal Muscle Disorders: Muscle dystrophy, Muscle trauma, Muscle hypoxia, Frequent I.M Injections: CK, AST
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Bone Disorders: Paget’s Bone Disease, Rickets, Osteomalacia: ALP
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Pancreatic Disorders: Acute Pancreatitis: Lipase, AMS
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Salivary gland diseae (Mumps): Salivary gland inflammation, In mumps: a-Amylase (AMS)
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Malignancies:
a) Prostatic carcinoma, bone metastatic carcinoma: Plasma (Acid phosphatase) ACP levels
b) Pancreatic carcinoma, Bile duct carcinoma, Liver metastasis: Alkaline phosphatase (ALP) levels
c) Leukemia, Lymphomas, Liver metastasis: Total Lactate dehydrogenase (LDH) levels
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Clinical utility of cardiac markers in detection of acute myocardial infarction, minor myocardial injury, and in monitoring reperfusion following thrombolytic therapy
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FINAL EXAMINATION
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