CLINICAL CHEMISTRY 2 LAB MARKERS OF CARDIAC DAMAGE AND FUNCTION

Question 1

What are the four types of cardiovascular disease

Answer 1

Coronary heart disease
Cerebrovascular disease
Peripheral arterial disease
Aortic atherosclerotic disease

Question 2

What are the manifestation of Coronary heart disease?

Answer 2

Myocardial Infarction (heart attack)
Angina Pectoris (chest pain)
Heart failure
Sudden cardiac death

Question 3

What are the manifestation of Cerebrovascular disease

Answer 3

Stroke or Transient Ischemic attack (short reversible stroke)

Question 4

What are the manifestation of Peripheral Arterial Disease

Answer 4

Intermittent claudication (acute localized pain in arms and legs)

Question 5

What are the manifestationn of Aortic Atherosclerosis

Answer 5

Aneurysm (abnormal widening of an artery)
Dissection (tears in thoracic or abdominal aorta)

Question 6

What is the classic manifestation of Cardiac Ischemia?

Answer 6

Angina (heavy chest pressure, burning feeling and difficulty breathing)

Question 7

What are the category of patients from the guidelines of AHA and ACC

Answer 7

Class I- patients suspected with ACS and has chest pain, snycope/presyncope, or palpitations (for immediate medical service)
Class IIb- patients with lss severe symptoms (for medical refferal)

Question 8

Screening for what type of recreational drug is done with younger patients suspected with Acute Coronary Syndrome

Answer 8

Cocaine

Question 9

These are the 2 lipoproteins that causes Atherosclerotic plaques in the arteries

Answer 9

Low density lipoprotein (LDL)
Very low density lipoprotein (VLDL)

Question 10

Leukocytes that plays a critical role in atherogenesis by maintaining proinflammatory state around the lesion

Answer 10

Neutrophils
Monocytes

Question 11

Foam cells (cholesterol filled cells) function

Answer 11

Production of inflammatory signals
Counter lesion progression by secreting HDL
Activation of inflammasomes and NF-kB pathway

Question 12

These cytokines activates the T and B lymphocytes and macrophages

Answer 12

Interleukin-1
Tumor necrosis factor-A

Question 13

These growth factors stimulates smooth muscle cell migration and activtation when released by lymphocytes and endothelial cells

Answer 13

Platelet derived growth factor
Fibroblast growth factor
Tissue growth factor-A

Question 14

What does smooth muscle secretes to form a fibrous backbone that fix the plaque firmly in the vessel wall

Answer 14

Collagen
Elastin
Proteoglycans

Question 15

What are he cardiac markers used extensively in clinical practice

Answer 15

Glutamic oxaloacetic transaminase/Aspartate transaminase (AST)-first marker choice
Lactic dehydrogenase/Lactate dehydrogenase- more sensitive marker for MI, elevated up to 2 weeks post MI
Malic dehydrogenase

Question 16

CK is readily detected in conditions such as:

Answer 16

Stroke
Pulmonary disease
Chronic alcoholism
Strenous exercise

Question 17

What 3 enzymes are tested for Myocardial Infarction

Answer 17

AST- intermediate presentation
LD- late presentation
CK- early presentation

Question 18

Regulatory proteins of muscle cells

Answer 18

Troponin
Tropomyosin