Clinical Chemistry

  1. Clinical Enzymology
    1. Basic Enzyme Principles
      1. Enzyme Structure and Function
        1. Active Site
          1. Cofactors and Coenzymes
            1. Allosteric Regulation
            2. Enzyme Kinetics
              1. Michaelis-Menten Equation
                1. Km and Vmax
                  1. Lineweaver-Burk Plot
                  2. Enzyme Inhibition
                    1. Competitive
                      1. Non-competitive
                        1. Uncompetitive
                      2. Factors Affecting Enzyme Activity
                        1. Temperature
                          1. Q10 Effect
                            1. Thermal Denaturation
                            2. pH
                              1. Optimal pH
                                1. pH Stability
                                2. Substrate Concentration
                                  1. Saturation Kinetics
                                  2. Inhibitors
                                    1. Reversible vs. Irreversible
                                  3. Measurement of Enzyme Activity
                                    1. Kinetic vs. Endpoint Methods
                                      1. Continuous Monitoring
                                        1. Units of Measurement
                                          1. International Unit (IU)
                                            1. Katal
                                            2. Reference Methods
                                          2. Diagnostic Enzymes
                                            1. Cardiac Markers
                                              1. Creatine Kinase (CK) and Isoenzymes
                                                1. CK-MM
                                                  1. CK-MB
                                                    1. CK-BB
                                                      1. Clinical Significance
                                                        1. Timing of Release
                                                        2. Troponin
                                                          1. Troponin I (cTnI)
                                                            1. Troponin T (cTnT)
                                                              1. Structure and Function
                                                                1. Clinical Significance
                                                                  1. High-Sensitivity Assays
                                                                  2. Myoglobin
                                                                    1. Clinical Significance
                                                                      1. Timing of Release
                                                                      2. Lactate Dehydrogenase (LD)
                                                                        1. Isoenzymes
                                                                          1. Clinical Significance
                                                                        2. Liver Enzymes
                                                                          1. Aspartate Aminotransferase (AST)
                                                                            1. Cellular Distribution
                                                                              1. Clinical Significance
                                                                                1. AST/ALT Ratio
                                                                                2. Alanine Aminotransferase (ALT)
                                                                                  1. Cellular Distribution
                                                                                    1. Clinical Significance
                                                                                      1. Liver Specificity
                                                                                      2. Alkaline Phosphatase (ALP)
                                                                                        1. Isoenzymes
                                                                                          1. Clinical Significance
                                                                                            1. Bone vs. Liver Origin
                                                                                            2. Gamma-Glutamyl Transferase (GGT)
                                                                                              1. Clinical Significance
                                                                                                1. Alcohol Consumption
                                                                                                2. Lactate Dehydrogenase (LD)
                                                                                                  1. Isoenzymes
                                                                                                    1. Clinical Significance
                                                                                                  2. Pancreatic Enzymes
                                                                                                    1. Amylase
                                                                                                      1. Pancreatic vs. Salivary
                                                                                                        1. Clinical Significance
                                                                                                          1. Macroamylase
                                                                                                          2. Lipase
                                                                                                            1. Clinical Significance
                                                                                                              1. Specificity for Pancreas
                                                                                                            2. Other Significant Enzymes
                                                                                                              1. Acid Phosphatase (ACP)
                                                                                                                1. Prostatic vs. Non-prostatic
                                                                                                                  1. Clinical Significance
                                                                                                                  2. Cholinesterase
                                                                                                                    1. Pseudocholinesterase
                                                                                                                      1. Clinical Significance
                                                                                                                        1. Organophosphate Poisoning
                                                                                                                        2. Aldolase
                                                                                                                          1. Clinical Significance
                                                                                                                          2. 5'-Nucleotidase
                                                                                                                            1. Clinical Significance
                                                                                                                        3. Enzyme Induction and Inhibition
                                                                                                                          1. Drug Effects
                                                                                                                            1. Disease Effects
                                                                                                                              1. Genetic Variations

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                                                                                                                            8. Non-Protein Nitrogen (NPN) Compounds

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                                                                                                                            10. Electrolytes and Acid-Base Balance