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Table of Contents
0.1. Diagnostic Value of Various Enzymes
0.2. Acid phosphatase (ACP)
0.2.0.0.1. Sample for acid phosphatase
0.2.0.0.2. Definition of acid phosphatase enzyme
0.2.0.0.3. Biochemical features of acid phosphatase enzyme:
0.2.0.0.4. Clinical significance of Acid phosphatase:
0.2.0.0.5. Method 1:
0.2.0.0.6. Method 2:
0.2.0.1. Diagnosis of prostate carcinoma:
0.3. Alkaline phosphatase (ALP)
0.3.0.0.1. Sample for Alkaline phosphatase
0.3.0.0.2. Indications for Alkaline phosphatase
0.3.0.1. Pathophysiology of alkaline phosphatase
0.3.0.2. Alkaline phosphatase is raised in:
0.4. Amylase
0.4.0.0.1. Sample for amylase
0.4.0.0.2. Precautions for Amylase
0.4.0.0.3. Purpose of the test (Indications)
0.4.0.0.4. Definition of the amylase
0.4.0.1. Pathophysiology of amylase
0.4.1. Acute pancreatitis:
0.5. Angiotensin-converting enzyme (ACE)
0.5.0.0.1. Indications:
0.5.0.1. Pathophysiology of ACE:
0.5.0.1.1. The raised level ACE is seen in the following:
0.5.0.2. Questions and answers:
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Diagnostic Value of Various Enzymes: Acid phosphatase enzyme
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Acid phosphatase distribution
ACP is raised in:
Medicolegal importance:
1. There is a very high concentration of ACP in the semen, so used in case of a rape investigation.
Method 1:
1. Take a swab from the alleged case of a rape victim, and preserve it in 2.5 mL of broth.
1. Broth contains one liter of the solution:
1. Bovine albumin = 50 grams.
2. Sodium azide = 0.2 gram.
3. Phosphate buffer at pH 7.4 (phosphate buffer 10 mmol + 9 gram NaCl).
2. Store the sample in the broth at 4 °C or room temperature.
3. The specimen can retain ACP activity for up to one month.
2. Interpretation of vaginal sample:
1. Vaginal ACP in noncoital women is <10 U/L (broth sample).
2. Post-coital women ACP is >50 U/L.
3. Post-coital vaginal ACP takes 4 days to become a non-coital level. So the sample can be taken during this time.
Method 2:
1. Take a vaginal swab and keep in 1 mL of isotonic saline.
2. Freeze the swab.
3. Before the test, thaw the swab at 2 to 4 °C for 24 hours before the assay.
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Precaution for Alkaline phosphatase
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Alkaline phosphatase in tissue
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Alkaline phosphatase isoenzyme
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Alkaline phosphatase level in the biliary obstruction
Amylase
Sample For Amylase
1. This test is done in the serum of the patient.
2. The serum is stable at room temperature for 7 days and at 4 °C for one month.
1. Take 3 to 5 ml of blood in the disposable syringe. Keep the syringe for 15 to 30 minutes and then centrifuge for 2 to 4 minutes. In this way,
you can get a clear serum.
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Purpose Of The Test (Indications)
1. To diagnose acute pancreatitis and monitor the treatment.
2. To differentiate other abdominal pain, epigastric discomfort, nausea, and vomiting.
3. In the case of ascites, it may be done to rule out pancreatitis.
Pathophysiology of amylase
1. Amylase is present in many organs and tissue.
2. Amylase molecular weight is 55,000 to 60,000; this small molecule can pass the kidneys’ glomeruli and is normally found in the urine.
3. It is of two types:
1. α-amylase is present in human tissue.
2. β-amylase is present in plants and bacteria.
4. The greatest amylase concentration is in the pancreas.
1. This enzyme is synthesized by the acinar cells and then secreted via a pancreatic duct system into the intestinal tract.
2. In the duodenum, a slightly alkaline medium favors the effective action of pancreatic and intestinal amylase.
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Amylase metabolism
5. The salivary glands also produce amylase to initiate the hydrolysis of starch while the food is still in the oral cavity and esophagus.
6. The trypsin activity destroys the amylase activity.
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Amylase’s role in the digestion of starch
Acute pancreatitis:
1. The amylase enzyme is a good marker of acute pancreatitis.
1. The initial rise is seen in 2 to 12 hours
2. The peak level is 12 to 72 hours
3. The normal level is seen after 3 to 14 days.
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Amylase level in Acute pancreatitis
Indications:
1. This test is used to monitor the activity of the disease.
2. This enzyme is used to detect the clinical course of sarcoidosis.
3. It differentiates between active and dormant sarcoidosis.
4. It differentiates between sarcoidosis and other granulomatous diseases.
Pathophysiology of ACE:
1. This is found in the epithelial cells of the lungs.
2. It converts angiotensin-1 to angiotensin II, which is a potent vasoconstrictor.
3. It helps in controlling hypertension.
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Angiotensin-converting enzyme (ACE)
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