Clinical Chemistry 2 Lecture

Part I-Multiple Choice

Instructions: Choose the letter of the correct answer. (You may underline or highlight
your answer.)

1. An international unit (IU) of enzyme activity is the quantity of enzyme that:

A.Converts 1 µmol of substrate to product per liter

B.Forms 1 mg of product per deciliter

C.Converts 1 µmol of substrate to product per minute

D.Forms 1 µmol of product per deciliter

2.Which of the following statements regarding enzymatic reactions is true?

A.The enzyme shifts the equilibrium of the reaction to the right

B.The enzyme alters the equilibrium constant of the reaction

C.The enzyme increases the rate of the reaction

D. The enzyme alters the energy difference between reactants and products

3.Which statement about enzymes is true?

A.An enzyme alters the Gibbs free energy of the reaction

B.Enzymes cause a reaction with a positive free energy to occur spontaneously

C.An enzyme’s natural substrate has the highest Km

D.A competitive inhibitor will alter the apparent Km of the reaction

4. Which of the following statements is true?

A.Apoenzyme + prosthetic group = holoenzyme

B.A coenzyme is an inorganic molecule required for activity

C.Cofactors are as tightly bound to the enzyme as prosthetic groups

D.All enzymes have optimal activity at pH 7.00

5.The increase in the level of serum enzymes used to detect cholestatic liver disease is caused
mainly by:

A.Enzyme release from dead cells

Clinical Chemistry 2 Lecture

B.Leakage from cells with altered membrane permeability

C.Decreased perfusion of the tissue

D.Increased production and secretion by cells

6.Which of the following enzymes is considered most tissue specific?

A.CK

B.Amylase

C. ALP

C.ADH

7.Which of the following enzymes is activated by calcium ions?

A.CK

B.Amylase

C.ALP

D.LD

8.Which of the following enzymes is a transferase?

A.ALP

B.CK

C.Amylase

D.LD

9.Which statement about methods for measuring LD is true?

A.The formation of pyruvate from lactate (forward reaction) generates NAD+

B.The pyruvate-to-lactate reaction proceeds at about twice the rate as the forward reaction

C.The lactate-to-pyruvate reaction is optimized at pH 7.4

D.The negative-rate reaction is preferred

10.Which condition produces the highest elevation of serum lactate dehydrogenase (LD)?

A.Pernicious anemia
Clinical Chemistry 2 Lecture

B.Myocardial infarction

C.Acute hepatitis

D.Muscular dystrophy

Part II.

Instructions: Complete the table by filling in what is asked in each column.

Enzymes Class Substrate (for forward

reaction only)

Creatine kinase Transferase Creatine

Lactate dehydrogenase Oxidoreductase Lactate

AST Transferase Aspartate

ALT Transferase Alanine

ALP Hydrolase Various

phosphomonoesters at an
alkaline pH

GGT Transferase Glutathione

Amylase Hydrolase Starch

Lipase Hydrolase Lipid

G6PD Oxidoreductase Glucose-6-phosphate

Cholinesterase Hydrolase Acetylcholine