Chemistry 3 (Pancreatic and Cardiac)

Question 1

wheat germ lectin (triticum vulgaris) inhibits what type of amylase

Answer 1

salivary

Question 2

Fractional excretion equation

Answer 2

(UrineX x Pcreat)/(PlasmaX x Ucreat)

Question 3

cause of acute pancreatitis without increase amylase

Answer 3

hypertriglyceridemia

Question 4

non-pancreatic causes of hyperamylasemia

Answer 4

DKA
PUD
cholecystitis
ectobic preg/salpingitis
bowel ischemia/obstruction
renal insufficiency
macroamylasemia

Question 5

Ranson criteria at admission

Answer 5

Age>55
WBC>16
Glucose>198
AST>250
LDH>350

Question 6

Ranson criteria at 48hr

Answer 6

Urea>1.8, Ca4, fluid sequestration >6L, Hct drop >10

Question 7

what has specificity >95% for gallstone pancreatitis

Answer 7

ALT>150

Question 8

what is suggestive of EtOH pancreatitis

Answer 8

Lipase/Amylase >5

Question 9

causes of familial pancreatitis

Answer 9

Cationic trypsinogen (PRSS1)
Pancreatic secretory trypsin inhibitor (PST1)
CFTR

Question 10

D-xylose test measures

Answer 10

small bowel mucosal absorptive capacity

Question 11

Pancreatic lesions with increased amylase

Answer 11

Pseudocyst, IPMN

Question 12

Pancreatic lesions with increased CEA

Answer 12

MCN, IPMN

Question 13

CK enzyme types

Answer 13

BB (CK1), MB (CK2), MM (CK3)

Question 14

location of CK-BB

Answer 14

brain > stomach, bladder, prostate

also migrates the fastest

Question 15

most widely distributed CK

Answer 15

CK-BB

Question 16

slowest migrating CK

Answer 16

CK-MM

Question 17

Skeletal muscle is ___% CK-MM

Answer 17

99%

Question 18

Cardiac muscle is ___% CK-MM

Answer 18

70%

Question 19

What percent of cardiac muscle is CK-MB

Answer 19

30%

Question 20

Macro-CK is ____ and is found in ____

Answer 20

CK-Ig complexes

healthy elderly women

Question 21

type of CK assd with poor prognosis

Answer 21

Mitochondrial (seen in advanced malignancies)

Question 22

most sensitive marker of cardiac damage

Answer 22

myoglobin (also least specific)

Question 23

most specific myocardial marker

Answer 23

cTnI

Question 24

earliest cardiac marker

Answer 24

myoglobin

Question 25

ischemia-modified albumin returns to baseline in

Answer 25

6hr

Question 26

natriuretic peptide causes

Answer 26

vasodilation and natriuresis

Question 27

stable fragment of BNP that is measured

Answer 27

N-terminal pro-BNP

Question 28

cTnI remains elevated

Answer 28

2wks

Question 29

time course of CK-MB

Answer 29

detect at 3-6hr
peaks at 20-24 hr
baseline at 72 hr

Question 30

marker with highest NPV at 2hr following onset

Answer 30

myoglobin