Cardiac Flashcards
Primary cause of death and disability in the US
- CHA (coronary heart disease)
1 out of every (?) deaths are caused by CHD
5
based on the slides what has is the most valuable modifiable risk factor
diet
Essential substance required for synthesis of:
Cell membranes
Steroid hormones
Multiple other compounds utilized in daily physiological processes
cholesterol
Transport cholesterol and triglycerides
Lipid proteins
Transport dietary exogenous triglycerides (TG) and cholesterol from the
intestines to the liver
Chylomicrons
Transport endogenous cholesterol from the tissues to the liver
HDL
Transport TG & cholesterol from liver into circulation
VLDL
Transport TG & cholesterol within circulation
LDL
total cholesterol
TC: HDL+LDL+VDL
Good cholesterol
HDL
TG are elevated when
non fasting state
when fasting what cant you have
coffee
cum
when fasting can you have water
yes
V-LDL carries what
primarily TG
what is the good Apolipoprotein
A-1
Responsible for reverse cholesterol transport
HDL
Fatty material and plaque are deposited in the wall of an artery
Atherogenesis
what is the initial stage of Atherogenesis
vesicle inflammation
most TG are found in what lipid protein
V-LDL
how to calculate V- LDL
TG/5
Friedewald equation
Total cholesterol= HDL+LDL+ VLDL
normal Total cholesterol
< 200 mg/dl
Normal HDL
> 40 mg/ dl
Normal V-LDL
<30 mg/ dl
Normal LDL
< 130 mg/dl
Normal TG levels
< 150 mg/dl
3 issues on EKG that would indicate an oh shit
- T wave inversion
- ST elevation
- Abnormal Q wave
T wave inversion indicates what
ischemia
ST elevation indicates
acute MI
Abnormal Q wave indicates what
tissue death
CK or CPK stands for what
Creatine Kinase
Creatine Kinase is located where
94% CK-MM: muscle
6% CK-MB: Heart
0% CK-BB: Brain
These percentages are what you should find in the brain
Creatine Kinase hour by hour
Rise 4-6 hours , peak 18-24 hours, normalizes 48-72 hours
How is the sensitivity of CKMB for acute MI
Dog shit sn: 52%
with cardiac biomarkes MB stands for what
myoglobin
MB hour by hour
Rise in 2-4, peak 6-12, normalize 24-36
SN and SP for MB
Sensitivity of 83% and specificity of 99%
most SN cardiobiomarcker for acute MI
troponin I (sn99%)
timeline hour by hour for troponin C
Increases within 2-6, peak 18-24 hours, hours and normalizes in 7-14 days
Cut off values for troponin I
.04 MI
Most specific test for MI
MB
Secreted primarily by the ventricular myocardium in response to wall stress
Ventricular volume expansion
Pressure overload
BNP
BNP value for CHF
> 400pg/ml
High Sensitivity C-Reactive Protein tests for what
inflammatory disorders
A prothrombin time tests what
clotting time
INR is associated with what
clotting time
Injury to a vein or artery activates the coagulation cascade, creating a blood clot.
D dimer (SP but not SN)
Biggest contribute to cardiovascular disease
coronary heart disease
Biggest modifiable risk factor to coronary heart disease
poor diet
what race has the highest cholesterol
mexican
Transport cholesterol and triglycerides
Lipid proteins
Cell membranes
Steroid hormones
Multiple other compounds utilized in daily physiological processes
cholesterol
Transport dietary exogenous triglycerides (TG) and cholesterol from the intestines to the liver
Chylomicrons
Chylomicrons and VLDL have greatest concentration of what
TG’s
How long do you have to fast for a TG test
8-10 hours
Pre-cursor of IDL and LDL
V-LDL
Contains Apolipoprotein B
VLDL
Densest and smallest of lipoproteins
Contains Apolipoprotein A-1
HDL
Atherosclerosis starts in what decade of life
1st
The Friedewald equation should not be used under the following circumstances:
When chylomicrons are present which means that the patient should be fasting for 8 to 10 hours
When plasma triglyceride concentration exceeds 400 mg/dL
C reative protein has to do with what
vascular injury
PT is a coagulation test that measures the time it takes to form a firm fibrin clot after thromboplastin (factor III) and calcium are added to the serum sample.
PT/ INR
prothrombin time
who clots faster children or adults
children
Injury to a vein or artery activates the coagulation cascade, creating a blood clot.
D dimer
D dimer is highly …
sensitive
How long do halter monitors record
1-2 days
How long do event reorders monitor
2-30 days
until what % do you do a cardiac stress test
85%
Dobutamine
Adenosine
chemical stress test
Detection and recording of timing and conduction of electrical impulses
Induce arrhythmias and see where they originate
EPS
what do you not want on a dopler vein
red- This means it;s moving fast
what test looks at the structure of teh heart
echo
Transesophageal Echocardiography
looks at posterior heart
what is the best test for vesicle
CT
best for valves and coronary arteries
cardiac catheterization
Measures pressure in the RA and RV pulmonary artery
Swan Ganz catheter