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Clinical Chemistry I > Cardiac Markers > Flashcards

Cardiac Markers Flashcards

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1
Q

Ideal _______________ involves intact muscle cells, and adequate blood and oxygen supply.

A

Homeostasis

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2
Q

True or false: ischaemia is reversible.

A

True

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3
Q

Infarction is ______ ________, after prolonged ischaemia.

A

Cell death

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4
Q

__________ is the result of blockage of the blood vessels supplying oxygen to the myocardial cells.

A

Ischaemia

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5
Q

CAD’s major cause is atherosclerosis, which causes _______ formation within large- and medium-sized arteries.

A

Plaque

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6
Q

Plaque is a pearly white area within an artery, which internally is made of lipid, cell debris, smooth muscle cells, collagen, and calcium, covered with a __________ ____.

A

Fibrous cap

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7
Q

Arterial blood flow is reduced across plaque, leading to narrow ________.

A

Lumen

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8
Q

________ ______________ ____________ is associated with heart pain, and death of heart tissue.

A

Acute myocardial infarction

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9
Q

______ ___________ of the myocardium, may result during AMI, as a result of interruption to the blood supply.

A

Gross necrosis

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10
Q

List the three principal characteristics of AMI.

A

Crushing chest pain
ECG changes
Cardiac muscle enzyme/markers will be released

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11
Q

What elements are used to diagnose AMI?

A

History, clinical and presentation, changes to ECG (although differences may not be immediately noticeable), and evaluation of cardiac markers

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12
Q

__________ are regulatory proteins, found in contractile proteins of myofibrils.

A

Troponins

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13
Q

Where is troponin C found?

A

Heart and skeletal muscle

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14
Q

Why is troponin C not useful as a cardiac marker?

A

The heart isoform is identical to slow twitch muscle

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15
Q

Why is troponin I useful as a cardiac marker?

A

Unique cardiac specificity, as it has only one isoform

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16
Q

___________ __ has eleven unique amino acids, lending specific markedness to the protein.

A

Troponin T

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17
Q

When is troponin T released into circulation?

A

After injury to the heart

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18
Q

How many main isoforms of troponin T are known?

A

Two

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19
Q

______________ is an oxygen-binding protein of cardiac and skeletal muscle.

A

Myoglobin

20
Q

True or false: myoglobin is found in the cytoplasm, and increases rapidly after a cardiac event.

A

True

21
Q

___________ ________ catalyses the formation phosphocreatine from creatine and ATP.

A

Creatinine kinase

22
Q

The ________ form of creatinine kinase is a dimer made of two subunits, M (muscle) and B (brain).

A

Cytosolic

23
Q

CKBB, CKMB, and CKMM forms of creatinine kinase exist, with the ____________ CK1, CK2, and CK3, respectively.

A

Isoenzymes

24
Q

_______________ creatinine kinase has two isoenzymes.

A

Mitochondrial

25
Q

_________ is prominent in both skeletal and cardiac muscle.

A

CKMM

26
Q

___________ ______________ is an isoenzyme that catalyses the reduction of pyruvate to (L)-lactate, using NADH as an electron donor.

A

Lactate dehydrogenase

27
Q

Highest activity of lactate dehydrogenase is observed in __________ ________, liver, heart, kidney, and RBC.

A

Skeletal muscle

28
Q

List the five isoenzymes of lactate dehydrogenase.

A

LD1 (H4) (heart, kidney, and RBC)
LD2 (H3M)
LD3 (H2M2)
LD4 (HM3)
LD5 (M4) (skeletal muscle and liver)

29
Q

Most methods of measuring troponin I employ __________ ___________.

A

Monoclonal antibodies

30
Q

Assay times for troponin I vary from ______ to thirty minutes.

A

Seven

31
Q

Quantitative assays for ___________ ___ include immunoassays for serum/plasma, with antibodies and reagents; there is no cross-reactivity with skeletal muscle isoforms.

A

Troponin T

32
Q

Use of monoclonal antibody tests for ___________ can be an early marker.

A

Myoglobin

33
Q

List two methods of measuring creatinine kinase.

A

Electrophoresis and immunoassays

34
Q

List three qualities of an ideal marker.

A

Facilitates early AMI diagnosis
Assists in risk stratification
Monitors treatment

35
Q

CK and CKMB elevate _________ after an event.

A

Swiftly

36
Q

__________ is both released and cleared quickly, and is not used in diagnosis, as it has <80% clinical specificity.

A

Myoglobin

37
Q

Troponins T and I stay elevated, and have cardiac ____________.

A

Specificity

38
Q

Why are troponins not useful in relapse detection?

A

Values stay elevated for days after the event

39
Q

List the criteria for AMI.

A

Evidence of ischaemia
A rise, or a fall, of troponin
At least one troponin reading that is greater than, or equal to, the 99th percentile

40
Q

True or false: stable angina is irreversible.

A

False

41
Q

__________ angina arises when the fibrous cap ruptures.

A

Unstable

42
Q

True or false: high cholesterol, hypertension, and a sedentary lifestyle increase the odds of a cardiac event.

A

True

43
Q

____________ levels of homocysteine indicate risk to future events.

A

Increased

44
Q

_____ indicates presence of inflammation, but also increased in people at risk for future cardiovascular events.

A

CRP

45
Q

What are natriuretic peptides?

A

Series of ring-shaped molecules that promote an increased loss of sodium and water

46
Q

___-________ natriuretic peptides are produced by both the atria and the ventricles .

A

B-type

Clinical Chemistry I (12 decks)

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