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Liz's Clinical Chemistry Module 2 > Cardiac Function > Flashcards

Cardiac Function Flashcards

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1
Q

Structure contains oxygenated and deoxygenated blood?

- Aorta

A

Oxygenated

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2
Q

Structure contains oxygenated and deoxygenated blood?

- Inferior vena cava

A

Deoxygenated

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3
Q

Structure contains oxygenated and deoxygenated blood?

- Left atrium

A

Oxygenated

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4
Q

Structure contains oxygenated and deoxygenated blood?

- Left ventricle

A

Oxygenated

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5
Q

Structure contains oxygenated and deoxygenated blood?

- Mitral valve

A

Oxygenated

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6
Q

Structure contains oxygenated and deoxygenated blood?

- Pulmonary artery

A

Deoxygenated

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7
Q

Structure contains oxygenated and deoxygenated blood?

- Pulmonary vein

A

Oxygenated

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8
Q

Structure contains oxygenated and deoxygenated blood?

- Right atrium

A

Deoxygenated

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9
Q

Structure contains oxygenated and deoxygenated blood?

- Right ventricle

A

Deoxygenated

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10
Q

Structure contains oxygenated and deoxygenated blood?

- Superior vena cava

A

Deoxygenated

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11
Q

Structure contains oxygenated and deoxygenated blood?

- Tricuspid valve

A

Deoxygenated

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12
Q

Changes configuration; grabs actin to pull across fiber

A

Myosin

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13
Q

Regulatory proteins for actin filaments

A

Troponin complex

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14
Q

Helps contract muscle

A

Calcium ions

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15
Q

Interaction during cardiac muscle contraction

A

Troponin is regulatory for actin in the heart; energy in the form of ATP is required

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16
Q

(At least) five modifiable risk factors for cardiovascular disease

A
  1. Smoking
  2. High cholesterol
  3. High TGL
  4. High LDL
  5. Decreased HDL
  6. High blood pressure
  7. Physical inactivity
  8. Obesity
  9. Type 2 diabetes mellitus
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17
Q

(At least) two non-modifiable risk factors for cardiovascular disease

A
  1. Age
  2. Gender
  3. Family history
  4. Race
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18
Q

Medicare Defined Panel criteria for total cholesterol

A

< 200 mg/dL

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19
Q

Medicare Defined Panel criteria for HDL cholesterol

A

> 40 mg/dL

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20
Q

Medicare Defined Panel criteria for LDL cholesterol

A

< 100 mg/dL

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21
Q

Defined Panel criteria for TGL

A

< 150 mg/dL

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22
Q

Describe the sequence of events in the progression of atheroscloerosis, relating these changes to the development of biomarkers for the disease

A
  1. Traditional markers identify the patient’s response to the inflammatory process involved
  2. Developing biomarkers identifying the patien’ts response to damage to the endothelial cell lining initiation a hemosatic response w/ thrombosis and subsequent fibrinolysis
23
Q

Five tests that may be used to assess risk for atherosclerosis development and subsequent cardiovascular disease

A
  1. High sensitivity CRP (HsCRP)
  2. Myeloperoxidase (MPO)
  3. Oxidized LDL
  4. Lipoprotein-associated phospholipase A2 (LpPLA2)
  5. Homocysteine
24
Q

Five tests that are being developed to assess where a hemostatic response to endothelial cell injury has occurred

A
  1. Homocysteine
  2. tPA/PAI-1
  3. TAFI
  4. Fibrinogen
  5. D-dimer
25
Q

Define unstable angina

A

Thoracic pain that may mark the onset of acute MI. It typically occurs at rest and has a sudden onset, sudden worsening, and stuttering recurrence over days and weeks. It carries a more severe short-term prognosis than stable chronic angina

26
Q

Define stable angina

A

Thoracic pain that occurs w/ activity or stress

27
Q

Briefly describe the sequence of changes in myocardial cells during an evolving acute myocardial infarction

A
  • Complete or partial occlusion of coronary arteries
  • Blood clot is a trigger for MI
  • May result in: ischemia, infarction, anoxia
  • Irreversible structural injury begins in less than 30 minutes after clot formation
28
Q

What is occurring during the EKG?

- P wave

A

Activation of the atria

29
Q

What is occurring during the EKG?

- QRS complex

A

Activation of the ventricles

30
Q

What is occurring during the EKG?

- T wave

A

Recovery wave

31
Q

Abnormal finding in the ST segment and T wave hours after MI

A
  • Hours after infarction, ST segment becomes elevated

- Hours to days later, T wave inverts and Q wave becomes larger

32
Q

2012 criteria for diagnosis of acute, evolving, or recent myocardial infarction

A

Detection of rise and fall of cardiac biomarker values and with at least one:

  • symptoms of ischemia
  • development of pathologic Q waves in ECG
  • New ST-segment-Twave changes or new left bundle branch block
  • identification of an intracoronary thrombus by angiography or autopsy
  • Imaging evidence of new loos of viable myocardium or new regional wall motion abnormality
33
Q

Appearance, peak, return to normal values in cardiac enzyme markers
- Total CK (CKMM, CKMB, CKBB)

A

Appearance: 3-8 hours
Peaks: 10-36 hours
Normal: 3-4 days

34
Q

Appearance, peak, return to normal values in cardiac enzyme markers
- AST

A

Appearance: w/in 12 hours
Peaks: 18-24 hours
Normal: 4-5 days

35
Q

Appearance, peak, return to normal values in cardiac enzyme markers
- LD

A

Appearance: 8-18 hours
Peaks: 48-72 hours
Normal: 6-10 days

36
Q

Four current lab markers for acute MI

A

Myoglobin, CKMB, Troponin I, Troponin T

37
Q

Principle O2 carrier protein in the cytoplasm of both skeletal and cardiac muscle cells

A

Myoglobin

38
Q

Appearance, peak, return to normal values for…

- Myoglobin

A

Appearance: 0.5-2 hours
Peaks: 5-12 hours
Normal: 18-30 hours

39
Q

Not often used due to non-specificity of the elevation to diagnose an AMI, clearance from the blood dependent on renal function so increases may not only be due to cardiac cell death

A

Myoglobin

40
Q

Appearance, peak, and return to normal values for…

- CKMB

A

Appears: 1-4 hours
Peaks: 4-8 hours
Normal: 24-48 hours

41
Q

B/c CKMB may be of myocardial or skeletal muscle origin, physicians prefer ____ ____

A

CK index = CKMB/Total CK

42
Q

Regulates cardiac contraction via the ACTIN filaments

A

Troponin C, I, T

43
Q

Ca-binding component

A

Troponin C

44
Q

Inhibitory component; binds to actin to inhibit activity of actinomyosin APTase (breaks down ATP)

A

Troponin I

45
Q

Tropomyosin-binding component

A

Troponin T

46
Q

Appearance, peak, return to normal values for…

- Troponin I

A

Appears: 4-6 hours
Peaks: 24 hours
Normal: 5-15 days

47
Q

Two physical changes to the heart in congestive heart failure

A
  1. Chambers enlarge to handle increased fluid

2. Walls may thicken to handle the increased strain

48
Q

Four symptoms of congestive heart failure

A
  1. Dyspnea
  2. Orthopnea
  3. Paroxysmal nocturnal dyspnea
  4. Exercise intolerance
  5. Fatigue
  6. Fluid retention
49
Q

Contained in pressure-sensing cells in the left ventricle

A

BNP

50
Q

Stimulus for BNP release

A

When pressure in the ventricle increases, BNP is released into the blood

51
Q

Effect of BNP on ADH secretion from the hypothalamus

A

Decreased Na+ inhibits production of ADH by the pituitary gland; increased diuresis results in decreased blood volume, thereby trying to solve the problem

52
Q

Effect of BNP on sodium excretion

A

In kidney, BNP stimulates natriuresis (Na+ excretion) by inhibiting Na+ reabsorption

53
Q

Why BNP may be used in the diagnosis of congestive heart failure

A

Focuses on several goals:

  • Determines the cause of diagnostic symptoms
  • Estimate the degree of severity of CHF
  • Estimate the risk of disease progression and risk
  • Screen for a less symptomatic disease

Liz's Clinical Chemistry Module 2 (9 decks)

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