Alkaline Phosphatase Quiz

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Questions and Answers

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?

  • 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?

  • 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?

<p>It indicates the presence of normal mature WBCs. (C)</p> Signup and view all the answers

What does the term 'left shifting' typically refer to in a hematological context?

<p>Presence of more immature cells in the blood (D)</p> Signup and view all the answers

What is the primary function of alkaline phosphatase?

<p>To dephosphorylate molecules (C)</p> Signup and view all the answers

In which environment does alkaline phosphatase operate most effectively?

<p>Alkaline environment (C)</p> Signup and view all the answers

Which tissue is NOT typically associated with high levels of alkaline phosphatase?

<p>Brain (B)</p> Signup and view all the answers

What condition is indicated by high levels of alkaline phosphatase?

<p>Cholecystitis (B)</p> Signup and view all the answers

Which type of leukemia is acid phosphatase positive?

<p>T-type acute lymphoblastic leukemia (T-ALL) (C)</p> Signup and view all the answers

What happens to the alkaline phosphatase levels in pregnancy?

<p>They increase (C)</p> Signup and view all the answers

Which of the following is NOT a common cause of low alkaline phosphatase levels?

<p>Biliary disease (B)</p> Signup and view all the answers

Which enzyme is NOT commonly associated with the liver and biliary system?

<p>Lipase (C)</p> Signup and view all the answers

Flashcards

Alkaline Phosphatase (ALP)

An enzyme that works best in an alkaline environment and removes phosphate groups from molecules.

Acid Phosphatase

An enzyme that works in an acidic environment, used to monitor prostate cancer treatment and differentiate certain leukemias.

ALP Locations

Present in various tissues, especially bone, liver, mature WBCs, kidneys and placenta.

High ALP Levels

Associated with conditions like biliary disease, liver disease, bone diseases with excess formation, pregnancy, and hyperthyroidism.

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Low ALP Levels

Linked to conditions like Wilson's disease, postmenopause, and some leukemias (chronic myeloid).

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Leucocyte Alkaline Phosphatase (LAP)

A form of ALP found in mature white blood cells; LAP score indicates if WBCs are healthy or immature.

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ALP in Biliary Disease

Elevated ALP levels often indicate problems with the biliary system (gallstones, cholecystitis).

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ALP in Liver Disease

Elevated ALP levels can signal issues like hepatitis or cirrhosis.

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Low LAP score

Indicates immature white blood cells, suggesting a possible condition like leukemia or aplastic anemia.

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High LAP score

Indicates mature white blood cells, possibly a sign of a leukemoid reaction (not cancer).

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Leukemia

A cancer of the bone marrow. Characterized by immature blood cells (blasts) and an elevated white blood cell count.

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Leukemoid reaction

A physiological response to stress or infection, resulting in an increased white blood cell count (above 50,000 cells/μL), but not a cancer.

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Aplastic anemia

A disease where the bone marrow doesn't produce enough blood cells, leading to low blood cell counts.

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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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