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MLSCI 262 > 360 - Lipids & Cardiac Markers > Flashcards

360 - Lipids & Cardiac Markers Flashcards

1
Q

these transport lipids in the plasma

A

lipoproteins

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2
Q

typical lipoprotein structure

A

core of triglycerides and cholesteryl ester and a shell composed of apolipoprotein, unesterified cholesterol, and phospholipid

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3
Q

linear hydrocarbon chains that terminate in a carboxyl group

A

fatty acids

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4
Q

beta oxidation of free fatty acids

A

forms acetyl-CoA which enters the Kreb’s cycle to produce energy

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5
Q

triglycerides

A

many types
- composed of 3 fatty acid molecules and one molecule of glycerol; they are classified as neutral lipids

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6
Q

describe cholesterol

A
  • amphipathic molecule
  • esterified form of cholesterol = cholesteryl ester, is conjugated to fatty acids and is classed as a neutral lipid
  • used to synthesize many hormones, including mineral corticoids, and sex hormones
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7
Q

amphipathic molecules composed of two esterified fatty acids, glycerol, and a phospholipid group

A

phospholipids
- found in cell membranes

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8
Q

T or F. Apolipoproteins are amphipathic.

A

T!

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9
Q

how are lipoproteins classified

A
  • by their densities
  • 6 categories: chylomicrons, very low-density lipoproteins (VLDL), intermediate density lipoproteins (IDL), low-density lipoproteins (LDL), high-density lipoproteins (HDL) and lipoprotein (a)
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10
Q

T or F. As the density of lipoproteins increases the proportion of triglycerides decreases and the proportion of cholesteryl ester increases

A

T

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11
Q

how are lipoproteins measured?

A

immunoturbidimetry and immunonephelometry

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12
Q

these transport dietary lipid to the liver and peripheral cells

A

chylomicrons

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13
Q

the largest lipoprotein and the least dense

A

chylomicrons
- form the creamy layer that settles on serum; Apolipoprotein B-48 is only found in chylomicrons

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14
Q

where is VLDL primarily produced?

A

liver

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15
Q

this carries endogenous triglycerides from the liver to peripheral cells

A

VLDL

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16
Q

these are used for energy during fasting periods

A

triglycerides

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17
Q

the primary component of VLDL apolipoprotein

A

Apolipoprotein B-100

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18
Q

formed by the lipolysis of VLDL

A

LDL
- contains apolipoprotein B-100

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19
Q

T or F. LDL is readily taken up by the liver and peripheral cells

A

T
- LDL can move into the extracellular space of blood vessel walls
- LDL is oxidized and ingested by macrophages
- laden with lipid evolve into foam cells
- foam cells are components of fatty streaks, which can develop into atherosclerotic plaques

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20
Q

the densest lipoprotein

A

HDL

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21
Q

where is HDL synthesized?

A

in the liver and intestine

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22
Q

what does HDL do?

A

transports cholesterol away from the peripheral cells, back to the liver

23
Q

Its anti-atherogenic properties are attributed to its ability to remove cholesterol

A

HDL

24
Q

this component may be measured to determine anti-atherogenic status of HDL

A

apolipoprotein A-1

25
Q

Coronary heart disease is characterized by …

A

narrowing of the small vessels that carry oxygenated blood to the heart

26
Q

Atherosclerosis

A

a pathologic process characterized by cholesterol deposits on vessel walls, macrophage invasion, and plaque formation

27
Q

interferences in triglycerides enzymatic assay

A
  • Endogenous free glycerol can participate in the reaction, reagent blank may correct this interference
  • Bilirubin and vitamin C may interfere, but enzymes may be added to eliminate this interference
  • Hemolysis may cause positive interference
28
Q

specimen used for triglycerides enzymatic assay

A
  • 12hr fasting (triglyc incr after meals)
  • aviod alc for 24 hrs before test (transient increase in trigly)
  • smoking increases trigly
  • increase when go from lying down to standing
29
Q

total cholesterol enzymatic assay interferences

A
  • Bilirubin and vitamin C can cause false DECREASES because they react with H2O2
    - Hemolysis may cause positive interference
30
Q

total cholesterol enzymatic assay specimen collection

A
  • 12hr fasting specimen (IF part of lipid panel)
  • chol DECREASEs w exercise
  • smoking increases chol
  • prolonged toueniquet = increases chol
  • chol increases from lying to standing
31
Q

HDL methodology

A
  • direct HDL cholesterol = homogenous assay
  • does not require pretreatment/centrifugation
  • depends on a unique detergent which solubilizes only HDL lipoprotein particles & releases HDL cholesterol to react with chol esterase and chol oxidase in presence of chromogens
  • the detergent also inhibits the reaction of the cholesterol enzymes with LDL, VLDL, and chylomicron lipoproteins by adsorbing to their surfaces
32
Q

HDL methodology:
A ____________ contained in the reagent enhances the selectivity for HDL cholesterol assay by complexing ____, _____, and _____________ lipoproteins

A

polyanion; LDL, VLDL, chylomicrons

33
Q

T or F. In HDL direct method, the change in absorbance at 560 nm is directly proportional to the concentration of cholesterol in the sample

A

T, (Beckman Coulter LX 20 manual).

34
Q

Friedewald formula for calculating LDL cholesterol

A

Total cholesterol - [Triglyceride÷2.2] - [HDL cholesterol]

35
Q

the result of an obstruction in the circulatory pathway of the heart resulting in necrosis of the heart muscle

A

myocardial infarction

36
Q

cardiac markers of choice for MI

A

troponins

37
Q

this occurs when the heart is unable to pump blood to maintain oxygenation of the tissues

A

congestive heart failure

38
Q

congestive heart failure is characterized by …

A

edema, due to sodium and water retention, and breathlessness

39
Q

congestive heart failure cardiac markers of choice

A

B-type natriuretic peptide (BNP) and a catabolic product of pro-BNP: NT-pro-BNP

40
Q

a protein molecule composed of three subunits, TnC, TnT, and TnI and is a part of the actin-myosin contractile unit of muscle

A

troponin

41
Q

where are cardiac troponins found?

A

found only in the heart and are released into the blood during cell death

42
Q

Troponin I (cTnI) and Troponin T (cTnT) rise approximately _-_hours after the onset of symptoms.

A

2-6 hrs

43
Q

T or F. cTnI is more specific than cTnT for myocardial infarction

A

T!!

44
Q

Troponin remains elevated in the blood ______ to ____days after an MI.

A

four to ten days

45
Q

these may interfere with troponin I performance

A

heparin, heterophilic antibodies, autoantibodies, fibrin/hemolysis, and rheumatoid factors

NOTE: Barricor tubes may reduce interference

46
Q

AHS recommends the collection of a Troponin I sample at __ hours and again ___ hours later to rule out an MI

A

0; 6

47
Q

a hormone secreted by the ventricles of the heart

A

B-type natriuretic peptide (BNP)

48
Q

BNP synthesis

A
  • synthesized as a preprohormone (preproBNP)
  • preprohormone is cleaved into proBNP, which is further cleaved into two parts: the N-terminal portion (NT-proBNP) and the C terminal, the active portion (BNP)
  • NT-proBNP and BNP are found in the circulation
49
Q

an excellent measure of cardiac stretch

A

BNP

50
Q

used for identifying individuals with moderate to severe congestive heart failure and for risk assessment

A

BNP

51
Q

the only acceptable sample for BNP

A

EDTA in a PLASTIC tube

52
Q

NT-proBNP acceptable sample

A

Serum or heparin plasma in a glass or plastic tube

53
Q

high sensitivity C reactive protein

A

values above normal but below those seen in infection can be detected by the hsCRP assay and are indicative for atherosclerosis, a risk factor for heart disease

MLSCI 262 (21 decks)

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