Name: Catherine O’Sullivan

Theme: Enzymes

OPTION LIST

A	Cardiac Troponin	I	Bone Alkaline Phosphatase
B	Gamma Glutanyl Transferase	J	Amylase
C	AST	K	Uroporphyrinogen decarboxylase
D	Creatine Kinase	L	ALT
E	Acid Phosphatase	M
F	Liver Alkaline Phosphatase	N
G	Alpha-1 Antitryspin	O
H	Lactase Dehydrogenase	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 55 year old man presents to A & E with a crushing central chest pain which radiates down his left arm. 3 hours later his blood tests show a large increase in a cardiac enzyme. This increase is still present when he is discharged 3 days later. Which enzyme is most likely to be raised?

2. A 53 year old woman presents to her GP because she has become increasingly tired recently. She also complains of itching which keeps her awake at night. On examination both scratch marks and signs of jaundice are found. Abnormalities in her blood tests include anti-mitochondrial antibodies. Which enzyme is most likely to be raised?

3. A 45 year old woman with known gallstones presents to A & E with abdominal pain which radiates to her back. The pain is relieved by sitting forward. The pain has been constant for several hours and she has also vomited twice. Which enzyme is most likely to be raised?

4. A 34 year old woman previously diagnosed with Hashimoto’s thyroiditis presents to her GP complaining of anorexia, amenorrhea and increasing fatigue. On examination she is found to have palmar erythema. Her blood tests show anti-smooth muscle and anti-nuclear antibodies. Which enzyme is most likely to be raised?

5. A 60 year old presents to his GP because of the onset of deafness in his right ear. He also mentions suffering from recurrent back pain. The gentleman has a bowed tibia.

ANSWERS

1. A

2. F

3. J

4. C

5. I