Practical Clinical chemistry I

AMSL3120
Name: 20171249/ ‫نور نائل ابو عبيده‬

Answer the following questions

• 1- Name the methods or reagents that are used for
detection each of the following
( AST , Protein , Albumin , Bilirubin )
* AST
. Reagent. 1 ( Buffer )
L-aspartate
Lactate dehydrogenase(LDH)
Malate dehydrogenase(MDH)
. Reagent. 2 (substance)
NADH
alpha-ketoglutarate
* protein
Biuret assay
* Albumin
Colorimetric test by the use of Bromocresol green.
* Bilirubin
. Urine bilirubin
- Use of dipstick impregnated with 2,6-dichlorobenzene-diazonium
tetrafluoroborate or 2,4-dichloroaniline diazonium.
. Serum total bilirubin ( Jendrassik method )
- Diazosulphanilic acid forms acolored compound (azobilirubin).
. Serum direct bilirubin (Jendrassik method)
- Diazotized sulfanilic acid .

• 2- Enumerate functions of protein and Albumin .

* Protein
. Maintain osmotic pressure
 . Coagulation
. Tissue growth and repair
. PH buffer
. Immunity
. Act as enzymes, hormones, transport component and
chromosome preservatives .
* Albumin
. Regulator of blood oncotic pressure
. Carrier for many cations and water insoluble substance
. As a pool of amino acid for coloric or synthetic purposes.

• 3- In Multiple Myeloma the ratio of protein increased but

the ratio of Albumin stay normal … Why ?
- Because the myloma cells are making M_protein ,the amount
of globulin in the blood rises(antibody increase) which results in
elevated total protein.

• 4- AST , ALP enzymes is not more specific enzyme for liver

disease ,,, Why ?
- Because it could be from other places,
. AST (heart, muscle, liver ).
. ALP (liver, bone, placenta, kidney).

• 5- If we found conc. Of LDH 1 higher than LDH 2 ,, this case

was named as ?
- Flipped pattern suggests myocardial infarction.

• 6- Sketch the Bilirubin metabolism .

1-senescent red cells are a major source of hemeproteins.
2-breakdown of heme to bilirubin occurs in macrophages of the
reticuloendothelial system (tissue macrophages ,spleen,and liver.
3- unconjugated bilirubin is transported through the blood
(complexed to albumin ) to the liver.
4-bilirubin is taken up via facilitated diffusion by the liver and
 conjugated with glucuronic.
5-conjugated bilirubin is actively secreted into bile and then the
intestine.
6-in the intestine,glucuronic acid is removed by bacteria, the
resulting bilirubin is converted urobilinogen.
7-some of the urobilinogen is reabsorbed from the gut and
enters the portal blood.
8-a portion of this urobilinogen participates in the enterohepatic
urobilinogen cycle.
9-the remainder of the urobilinogen is transported by the blood
to the kidney ,where it is converted to yellow urobilin and
excreted ,giving urine it's characteristic color.
10-urobilinogen is oxidized by intestinal bacteria to the brown
stercobilin.

• 7- Name the enzyme that are used to following AMI

disease
. Troponin
. CK.MD
. LDH
. Myoglobin

• 8- ALP conc. In young people is higher than adult people .

Why ?
- Because young people in a growing stage.

• 9- Write in briefly your knowledge about GGT enzyme .

Gamma-glutamyl transferase (GGT) is an enzyme that is found in
many organs throughout the body, with the highest concentrations
found in the liver. GGT is elevated in the blood in most diseases that
cause damage to the liver or bile ducts. Normally, GGT is present in
low levels, but when the liver is injured, the GGT level can rise. GGT is
usually the first liver enzyme to rise in the blood when any of the bile
ducts that carry bile from the liver to the intestines become
obstructed, for example, by tumors or stones. This makes it the most
sensitive liver enzyme test for detecting bile duct problems.
Done by God's goodness: