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MLT 203 > Cardiac Markers > Flashcards

Cardiac Markers Flashcards

1
Q

average weight of the heart

A

men: 325 grams
women: 275 grams

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2
Q

outermost layer of the heart

A

epicardium

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3
Q

middle layer of the heart

A

myocardium

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4
Q

inner layer of the heart

A

endocardium

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5
Q

layer most susceptible to ischemia

A

endocardium

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6
Q

where heart tissue is slowly or suddenly starved of oxygen and other nutrients

A

ischemia

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7
Q

double-layered membrane that encloses the heart

A

pericardium

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8
Q

R/L valves contract closing mitral valve, aortic valve opens

A

systole

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9
Q

relaxation phase, tricuspid/mitral valves open moving blood from atria to ventricles

A

diastole

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10
Q

function of heart

A

pumps blood to organs, delivers oxygen and nutrients where needed, removes waste products

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11
Q

reduced contraction and relaxation, decreased pumping ability. (ex. Congenital, Hypertension, damage from MI)
(heart disease category)

A

mechanical defects

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12
Q

electrical defects

A

irregularities in heartbeat (arrhythmias)

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13
Q

plumbing defects

A

atherosclerosis, increased cholesterol buildup, decreased blood flow, ischemia

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14
Q

congenital conditions

A

abnormalities arising from abnormal formation pf heart/blood vessels present at birth

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15
Q

signs of congenital heart condition

A

cyanosis, pulmonary hypertension, clubbing of fingers, embolism, reduced growth, syncope

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16
Q

causes of congenital heart conditions

A

maternal rubella infection, maternal alcohol abuse, drug treatment, genetics

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17
Q

rheumatic heart disease

A

complication of rheumatic fever from group A streptococcus

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18
Q

infective endocarditis

A

infection of endocardial surface of the heart by bacteria

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19
Q

pericarditis

A

inflammation of the pericardium

bacteria, fungi, viral, autoimmune

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20
Q

myocardial infarction, angina, heart failure

A

coronary heart disease

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21
Q

stroke

A

cerebrovascular disease

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22
Q

acute pain, arms and legs

A

peripheral arterial disease

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23
Q

aneurysm

A

aortic atherosclerotic disease

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24
Q

4 categories of cardiovascular disease

A

coronary heart disease
cerebrovascular disease
peripheral arterial disease
aortic atherosclerotic disease

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25
Q

Criteria for Acute Myocardial Infarction (AMI)

A
  • major rise in troponin (99th)
  • ischemia
  • ECG changes
  • new loss of myocardium
  • thrombi
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26
Q

plaques of cholesterol deposit in artery walls, leads to ischemia

A

atherosclerosis

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27
Q

symptoms of artherosclerosis

A

chest pain, nausea, vimiting, dyspnea, diaphoresis, light headedness

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28
Q

heart attack is more professional known as

A

myocardial infarction

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29
Q

first stage of artherosclerosis

A

vascular injury caused by hypertension, hyperlipidemia, hyperhomocysteinemia

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30
Q

second stage of artherosclerosis

A

increased permeability to lipids (LDL, VLDL) –> inflammation

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31
Q

3rd stage of artherosclerosis

A

monocytes and leukocytes arrive to help

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32
Q

fourth stage of artherosclerosis

A

macrophages scavenge LDL/cholesterol-rich-lipoproteins become foam cells

33
Q

fifth stage of artherosclerosis

A

foam cells promote lesion progression

34
Q

sixth stage of artherosclerosis

A

T and B lymphocytes are recruited by plaque

35
Q

seventh stage of artherosclerosis

A

interactions between t and b lymphs and foam cells recruits smooth muscle cells into lumen

36
Q

final stage of artherosclerosis

A

smooth muscle cells secrete collagen, elastin, and other proteins to fix plaque to the vessel wall (atheroma)

37
Q

cardiac markers

A

CK-MB, Troponin, myoglobin, myeloperoxidase, BNP, NT-ProBNP

38
Q

BNP, NT-ProBNP

A

congestive heart failure markers

39
Q

historical cardiac enzymes

A

CK, AST, LD, LD isoenzymes, CK-MB activitiy

40
Q

how coronary artery disease progresses

A

lipids, hs-CRP, cardiac markers

41
Q

characteristics of ideal cardiac markers

A
  • smaller = faster
  • specificity
  • release from myocardium complete following injury
  • remain elevated
  • cleared rapidly (allow diagnosis of recurrent injury)
  • quick/easy assays
42
Q

MICAL

A

Mical had (MI). His (CK) rose first, followed by (A)ST, and lastly, (LD)

43
Q

Balloon angioplasty and stents

A
  • guide wired inserted
  • inflate balloon
  • take out balloon, stent is left behind
44
Q

CK-MB limitations

A
  • 2 assays
  • slower, may require dilution
  • not always diagnostic
  • no increase in activity is found in heart failure
45
Q

relative index ref range

A 
<3% = normal
>6% = cardiac source
46
Q

consists of three proteins that bind to thin filaments (actin) of cardiac and skeletal muscle

A

troponin

47
Q

troponin isomers used in cardiac assay

A

troponin T, troponin I, troponin C

48
Q

troponin specimen

A

plasma (not found in serum of healthy people)

49
Q

TnI reference range

A

<0.04 ng/mL

50
Q

advantages of troponin

A
  • specific
  • high diagnostic specificity/sensitivity
  • early detection following Myocardial Infarction (MI)
  • undetected in healthy people
  • remain elevated
  • few interfering substances
51
Q

how to determine re-injury using cardiac markers

A

cardiac makers remain elevated for a specific period of time, after a few days if levels spike, then it will suggest increase from re-injury

52
Q

heme protein found in skeletal/cardiac muscle. transports oxygen from muscle cell membrane to mitochondria

A

myoglobin

53
Q

clinical use of myoglobin

A
  • early release from damaged muscle

- not specific

54
Q

myoglobin specimen

A

serum

55
Q

myoglobin ref range

A

<90 ng/mL

56
Q

POC/ER testing

A

whole blood analyzer
myoglobin, ck-mb, TnI
12 min

57
Q

i-STAT

A

tests for troponin I, followed up on chemistry analyzer upon admission

58
Q

High Sensitivity C-reactive protein (hsCRP)

A

acute phase reactant
produced in liver in response to injurt
increase in CRP correlate with CAD and CVD

59
Q

homocysteine

A

connection between increased levels and artherosclerosis and formation of blood clots

60
Q

any structural or functional cardiac disorder that impairs ability of the ventricle to fill with or eject blood

A

heart failure or congestive heart failure

61
Q

excessive fluid accumulated in lungs producing edema, reduced output of blood to systemic circulation, retention of fluid by the kidneys

A

heart failure/congestive heart failure

62
Q

natriuretic peptide

A
  • hormones that include ANP, BNP
  • assist in regulation of cardiovascular homeostasis
  • marker of congestive heart failure
63
Q
  • increased renal excretion of sodium
  • released on ventricular stretch or stress to myocytes in absence of necrosis
  • increased indicated expanded fluid volume (renal failure, CHF)
A

BNP

64
Q

BNP specimen

A
  • available on iSTAT

- plasma, EDTA

65
Q

BNP ref range

A

<100 pg/mL

66
Q

rule out infection or anemia

A

CBC is ordered

67
Q

fluid imbalance or retention

A

electrolyte panel

68
Q

kidney function and damage

A

BUN/Creatinine

69
Q

Liver damage

A

LFT

70
Q

detect arrhythmias

A

electrocardiogram

71
Q

protein in urine, and increased risk of heart failure

A

urinalysis

72
Q

high lipids associated with heart disease

A

lipid panel

73
Q

hypothyroidism associated with high lipid levels

A

TSH

74
Q

embolus lodged in pulmonary arteries, impairing blood flow

A

pulmonary embolism

75
Q

markers of pulmonary embolism

A

chest pain, dizziness, coughing, irregular heartbeat, low PO2, DVT, swelling/leg pain, discoloration, D-DIMER

76
Q

D-dimer

A

marker for assessing clot formation/pulmonary embolism

77
Q

protein produced from breakdown of fibrin clots

A

d-dimer

78
Q

a normal D-Dimer rules out

A

Pulmonary Embolism, deep vein thrombosis

79
Q

D-dimer specimen

A

plasma/whole blood

MLT 203 (10 decks)

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