Cardiac Biomarkers

Question 1

What is the earliest marker for MI?

Answer 1

Myoglobin

Question 2

Myoglobin: Rise / Peak / Return to Normal?

Answer 2

1-4 hours / 4-12 hours / 24 hours

Question 3

Early sensitivity of Myoglobin? / Specificity?

Answer 3

99% / NOT specific to myocardial muscle (does not distinguish from muscle injury elsewhere)

Question 4

What is the Gold Standard for determining whether or not someone had an MI? / Version of this test that is used less frequently

Answer 4

Troponin I / Troponin T

Question 5

For Troponin: Rise / Peak / Return to Normal?

Answer 5

3-12 hours / 10-24 hours / 7-10 DAYS

Question 6

Early sensitivity for Troponin? / Sensitivity at 10-190 hours?

Answer 6

Low (57%) / high (96-98%)

Question 7

About ______% of patients with CKD and other critical illnesses have increased Troponin

Answer 7

40%

Question 8

CK MM / CK BB / CK MB

Answer 8

Skeletal Muscle / Brain Tissue / Heart Muscle

Question 9

For CK MB, Rise / Peak / Return to Normal?

Answer 9

3-4 hrs / 15-20 hrs / 24-36 hrs

Question 10

CK MB sensitivity and specificity / what makes it particularly useful?

Answer 10

94-100% / 93-100% / Rise corresponds to size of infarct & you can use it to test for re-infarct

Question 11

What is D-Dimer / What is it left behind by / What is it used to rule in or out?

Answer 11

Fibrin degradation product / blood clot / thrombotic disorder (DVT, PE, DIC)

Question 12

What is BNP / what is it secreted in response to / what does it do a good job detecting

Answer 12

Cardiac neurohormone / increased ventricular volume and pressure / CHF (even when minimally symptomatic)

Question 13

What is BNP good for distinguishing?

Answer 13

causes of dyspnea

Question 14

Serial monitoring should be taken:

Answer 14

Every 4, 8, 12 / 3, 6, 9 hrs or Q6-8hrs x 24

Question 15

CK MB is useful for:

Answer 15

determining timing of events, correlating with size of infarct, looking for REINFARCTION