CMT Clinical Chemistry 2

Question 1

An LD isoenzyme 'flipped pattern' (LD1 greater than LD2) is most characteristic of which condition?

Accepted Answer

Myocardial infarction

Answer

Cardiac muscle and red cells are rich in LD1, so myocardial injury raises LD1 above LD2.

Question 2

Which alkaline phosphatase isoenzyme is the most heat-stable when serum is heated at 56°C?

Accepted Answer

Placental

Answer

Placental ALP resists heat inactivation at 56°C, while bone ALP is the most heat-labile.

Question 3

A serum protein electrophoresis shows beta-gamma bridging. This pattern is most suggestive of:

Accepted Answer

Hepatic cirrhosis

Answer

Polyclonal IgA rises in cirrhosis and fills in the zone between the beta and gamma bands.

Question 4

Decreased albumin with a markedly increased alpha-2 globulin band on SPE is typical of:

Accepted Answer

Nephrotic syndrome

Answer

Small proteins like albumin are lost in urine, while large alpha-2 macroglobulin is kept and rises.

Question 5

A patient has elevated alkaline phosphatase and a normal GGT. The most likely source of the ALP is:

Accepted Answer

Bone

Answer

GGT rises with hepatobiliary ALP but not with bone ALP, so a normal GGT points to bone.

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