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Clinical Chem 2 > cardiac function > Flashcards

cardiac function Flashcards

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1
Q

CAD

A

coronary artery disease

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2
Q

CHF

A

congestive heart failure

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3
Q

CVD

A

cardiovascular disease

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4
Q

ACS

A

acute coronary heart disease/ acute heart syndrome

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5
Q

CHD

A

coronary heart disease
- angina pectoris
- myocardial infarction
- heart failure
-> largely due to atherosclerosis

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6
Q

cerebrovascular disease

A
  • blood supply cut off from brain
  • stroke or transient ischemic attack
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7
Q

peripheral arterial disease (PAD)

A
  • blockage in arteries to extremities
  • includes DVT (deep vein)
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8
Q

atherosclerosis

A

chronic inflammatory disease from accumulation of lipid material in veins and arteries causing narrowing and hardening

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9
Q

ischemia

A

lack of blood supply

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10
Q

conclusion of atherosclerosis without treatment

A

vessel occlusion
thrombosis
plaque rupture or combo

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11
Q

most common locations of atherosclerosis

A
  • proximal left anterior descending
  • proximal left main coronary
  • entier right coronary arteries
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12
Q

evaluation of chest pain

A
  • physical - causes
  • EKG - ST segment for MI (stemmy)
  • chest Xray - non cardiac source
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13
Q

principle behind serum biomarkers for cardiac damage

A

cell death releases intracellular proteins from myocardium into circulation

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14
Q

describe CK

A
  • creatine kinase: found in nearly all cells
  • peak levels at 24 hours
  • return to normal in 3 days
  • plasma levels >2x normal = MI
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15
Q

describe CKMB

A

heart specific
- ordered with total CK to compare levels

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16
Q

list the 3 cardiac troponins

A
  • troponin T - binds tropomyosin
  • troponin I - inhibits binding of actin and myosin
  • Troponin C - binds calcium
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17
Q

which troponin(s) have specific isoforms for cardiac evaluation

A

cTnI and cTnT - fast and slow twitch

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18
Q

how are cardiac troponins detected

A

monoclonal antibodies with specificity for cardiac isotopes

19
Q

describe changes in troponin levels

A

increase after 3-12 hours, peak in 24 and remain elevated for more than a week
- rise and fall indicate acute myocardial injury

20
Q

describe hs-cTn

A

low concentrations of troponin detected

21
Q

dialysis patient’s relation to TnT

A

elevated cTnT associated with increased mortality

22
Q

effects of Hemodialysis on troponin

A

dialysis alters concentrations of enzymes and will vary due to dialysis

23
Q

describe myoglobin indicator

A
  • released in muscle damage
  • short half life
  • an additional marker for damage
  • nonspecific
24
Q

describe differences in apoptosis and necrosis

A

apoptosis requires energy
necrosis occurs when energy supply fails

25
Q

list common insults that result in cardiac injury and elevated cardiac biomarkers

A
  • trauma to heart
  • sepsis
  • myocarditis (virus)
  • heart failure
  • myocardial infarction (ischemia)
  • wall stress
26
Q

describe heart failure

A

heart fails to supply metabolic neds of the body -> decrease in pumping action

27
Q

biomarkers for heart failure

A
  • BNP
  • NT-proBNP
    -> distinguish cardiac from non-cardiac
28
Q

when are BNP and NT-proBNP released

A

from heart in response to increased pressure and volume load
- goal to reduce intravascular volume

29
Q

cardiac troponins use in heart failure cases

A
  • diagnosis for mycoardial injury by ischemia not heart failure
30
Q

markers of inflammation in plaque risk

A
  • myeloperoxidase (neutrophils in blood system): used in ACS and CAD
  • CRP inflamation and hs prognostic for atherosclerosis
31
Q

inflammatory marker of choice for cardiac heart disease risk

A

hs-CRP

32
Q

homocysteine

A
  • 4 forms
  • linked to vascular disease
33
Q

embolus

A

circulating mass of solid, liquid, or gas

34
Q

pulmonary embolus

A

embolus lodged within pulmonar arteries

35
Q

D Dimer

A
  • cross linked fibrin
  • indicates current or recent coagulation and fibrinolysis
36
Q

use of D dimer

A

levels abnormal in most pulmonary embolism (PE)
- rule out measrument

37
Q

value of troponin assay in acute PE

A

prognostic value

38
Q

value of BNP assay in acute PE

A

elevated elvels associated with increase in short term mortality

39
Q

what biomarkers are used to diagnose ACS and acute MI

A
  • Ck MB
  • myoglobin
  • TnI, TnT
  • hs-Tn
40
Q

what biomarkers are used to differentiate heart fialure from lung disease

A
  • BNP
  • Nt-proBNP
41
Q

what biomarkers are used to diagnose PE / risk stratification

A
  • TnI, TnT
  • BNP
  • NT-proBNP
  • D Dimer
42
Q

what biomarkers are used for cardiovascular risk stratification

A
  • TnI, TnT
  • hs-CRP
  • homocysteine
43
Q

lipoprotein A

A

predicts premature cardiovascular disease

Clinical Chem 2 (25 decks)

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