Chem Path - enzymology and cardiac markers

Question 1

Causes of a raised CK

10x CK whilst on statin

Answer 1

Statin Myopathy

Exact cause not known but can cause v bad symptoms such as rhabdomyolysis.

Risk factors:
Polypharmacy (on many drugs)
High dose of statin
Genetic predisposition
previous episode

Question 2

Causes of a raised CK

Child with difficulty walking

Answer 2

Duchenne/Becker’s Muscular Dystrophy

X-linked recessive disorder of gene that codes for dystrophin, which is a protein that maintains muscle fibre cell membranes. Duchenne is more severe and presents younger

Cause 10x CK-MM

Question 3

Causes of a raised CK

MI

Answer 3

10x CK-MB

Question 4

Causes of raised CK

Excercise

Answer 4

5x CK-MM

Question 5

Troponin and MI

Answer 5

Rises 4-6 hours post-MI

Peaks at 12-24 hours post-MI 

Remains elevated for 3-10 days

Question 6

Diagnostic Criteria for acute MI

Answer 6

Either raised Troponin or CK-MB with one of the following:

    Ischaemic symptoms 

    Pathologic Q waves on ECG 

    Ischaemic changes on ECG 

    Coronary artery intervention 

Pathologic findings of Acute MI