Name: Danushi De Silva

 

Theme: Enzymology

 

 

OPTION LIST

 

A	Alanine aminotransferase (ALT)	I	Glucagon
B	Alkaline Phosphatase	J	PSA
C	Creatinine kinase	K
D	Lactate dehydrogenase (LDH)	L
E	Gamma-glutamyl transferase	M
F	Amylase	N
G	Aspartate aminotransferase (AST)	O
H	Brain natriuretic peptide (BNP)	P

 

 

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

 

1. A 32-year-old man presents to his GP complaining that his urine has changed colour and is now brown. He has no other symptoms. On further questioning, he reveals that he recently recovered from “an awful ‘flu”. He adds that he still feels quite weak and “aches all over”. A urine dipstick is positive for blood. What enzyme would you expect to be raised in these circumstances?

 

 

2. This enzyme is raised in severe uraemia

 

 

3. A 57-year-old man complains of moderate-severe left hip pain, hearing loss, lethargy and pain on chewing. What enzyme would be raised under these conditions?

 

 

4. An 8-year-old boy presents with jaundice and severe lethargy following a mild infection. The blood film shows bite cells and Heinz bodies. What enzyme would be raised?

 

 

5. A 28-year-old man presents with generalised abdominal pain and mild jaundice. He has no other symptoms. An ERCP shows a classical “beaded” appearance of the biliary tree. Which is enzyme is raised?

 

 

 

ANSWERS

1. C

2. F

3. B

4. D

5. B