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Questions and Answers
What does a low leucocyte ALP (LAP) score generally indicate?
What does a low leucocyte ALP (LAP) score generally indicate?
- Presence of immature WBCs (correct)
- Presence of mature WBCs
- Normal white blood cell count
- Increased white blood cell count due to infection
Which condition is characterized by an increased white blood cell count greater than 50,000 cells/μL?
Which condition is characterized by an increased white blood cell count greater than 50,000 cells/μL?
- Acute myeloid leukemia (AML)
- Chronic myeloid leukemia (CML)
- Aplastic anemia
- Leukemoid reaction (correct)
Which type of leukemia is associated with the presence of very immature cells or blasts?
Which type of leukemia is associated with the presence of very immature cells or blasts?
- Chronic myeloid leukemia (CML)
- Leukemoid reaction
- Aplastic anemia
- Acute myeloid leukemia (AML) (correct)
In the context of leucocyte ALP, what is the significance of a high LAP score?
In the context of leucocyte ALP, what is the significance of a high LAP score?
What does the term 'left shifting' typically refer to in a hematological context?
What does the term 'left shifting' typically refer to in a hematological context?
What is the primary function of alkaline phosphatase?
What is the primary function of alkaline phosphatase?
In which environment does alkaline phosphatase operate most effectively?
In which environment does alkaline phosphatase operate most effectively?
Which tissue is NOT typically associated with high levels of alkaline phosphatase?
Which tissue is NOT typically associated with high levels of alkaline phosphatase?
What condition is indicated by high levels of alkaline phosphatase?
What condition is indicated by high levels of alkaline phosphatase?
Which type of leukemia is acid phosphatase positive?
Which type of leukemia is acid phosphatase positive?
What happens to the alkaline phosphatase levels in pregnancy?
What happens to the alkaline phosphatase levels in pregnancy?
Which of the following is NOT a common cause of low alkaline phosphatase levels?
Which of the following is NOT a common cause of low alkaline phosphatase levels?
Which enzyme is NOT commonly associated with the liver and biliary system?
Which enzyme is NOT commonly associated with the liver and biliary system?
Flashcards
Alkaline Phosphatase (ALP)
Alkaline Phosphatase (ALP)
An enzyme that works best in an alkaline environment and removes phosphate groups from molecules.
Acid Phosphatase
Acid Phosphatase
An enzyme that works in an acidic environment, used to monitor prostate cancer treatment and differentiate certain leukemias.
ALP Locations
ALP Locations
Present in various tissues, especially bone, liver, mature WBCs, kidneys and placenta.
High ALP Levels
High ALP Levels
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Low ALP Levels
Low ALP Levels
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Leucocyte Alkaline Phosphatase (LAP)
Leucocyte Alkaline Phosphatase (LAP)
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ALP in Biliary Disease
ALP in Biliary Disease
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ALP in Liver Disease
ALP in Liver Disease
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Low LAP score
Low LAP score
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High LAP score
High LAP score
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Leukemia
Leukemia
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Leukemoid reaction
Leukemoid reaction
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Aplastic anemia
Aplastic anemia
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Study Notes
Alkaline Phosphatase
- Alkaline phosphatase (ALP) is an enzyme
- It's stable and functions best in an alkaline environment
- It removes phosphate groups from molecules
- It dephosphorylates compounds to enable free cellular diffusion
- ALP is found in various tissues, including bone, liver (especially hepatobiliary system), kidneys, mature white blood cells (WBCs), and placenta
ALP Test
- ALP tests are used to evaluate various health issues
High ALP Levels
- Associated with biliary diseases (gallstones, cholecystitis)
- May indicate liver diseases (hepatitis, cirrhosis)
- Linked to bone diseases with excessive bone formation (Paget's disease)
- Often seen in increased bone formation in children and adolescents
- Can be a signal of kidney tumors
- Present during pregnancy
- Associated with hyperthyroidism and hyperparathyroidism
- May occur in leukomoid reactions
Low ALP Levels
- Found in Wilson disease
- Observed in postmenopause
- Possible sign of hypothyroidism
- Might be associated with chronic myeloid leukemia (CML)
Acid Phosphatase
- Acid phosphatase works in an acidic environment
- Used to monitor the response to treatment in prostate cancer
- Helps differentiate between different types of acute lymphoblastic leukemia (ALL):
- B-type ALL: Acid phosphatase is absent (-ve)
- T-type ALL: Acid phosphatase is present (+ve)
Liver, Pancreas, and Biliary System
- Liver tests include Alanine aminotransferase (ALT, SGPT) and Aspartate aminotransferase (AST, SGOT).
- Pancreas tests include amylase and lipase
- Biliary system test is alkaline phosphatase (ALP)
Leucocyte ALP (LAP)
- Found in mature white blood cells (WBCs)
- Immature WBCs don't uptake the stain for LAP
- A low LAP score indicates immature WBCs (possible cancer cells)
- A high LAP score indicates mature WBCs (healthy cells)
Leukemoid Reaction (Not Cancer)
- Characterized by an increase in white blood cell count (> 50,000 cells/µL).
- It's a physiological response to stress or infection
Leukemia (Cancer)
- Caused by bone marrow malignancy
- Characterized by an increased white blood cell count (10,000-100,000 cells/µL)
- Involves the presence of immature blood cells (blasts)
- In cancer (leukemia) there is a left shift
Aplastic Anemia
- A condition where the body fails to produce sufficient blood cells.
- Stem cells in the bone marrow are responsible for producing blood cells.
- Causes a deficiency in all blood cell types: red blood cells, white blood cells, and platelets
- Associated with a low LAP score
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