CV labs

Question 1

LDH1

Answer 1

heart and RBC

Question 2

LDH5

Answer 2

mm and liver

Question 3

flipped LDH pattern

Answer 3

in MI LDH1 >LDH2

peaks about 48 hours post MI

Question 4

myoglobin

Answer 4

first to peak in MI, but transient

Question 5

CPK

Answer 5

transfers high energy phosphate btwn creatine ad ADP
MM- muscle
BB-brain
MB- heart
peaks about 24 hours post MI
reinfarction after 3 days could be diagnosed w/elevated CK-MB b/c usually declines rapidly

Question 6

troponin

Answer 6

cardiac m contains cTnL, CTnT isoforms
peak is plateau from 24-48 hours
changing troponin is more diagnostic then an elevated troponin

Question 7

diagnosing an MI

Answer 7

must have a changing troponin plus have either symptoms, ECG, or echo evidence

Question 8

hsCRP

Answer 8

released by hepatocytes due to IL6 and TNFalpha
may oxidize LDL
ideal <1mg/L
can be reduced w/statins and thiozolinediones

Question 9

hsCRP in stable CHD

Answer 9

a level >3mg/L = worse prognosis

Question 10

hsCRP in ACS

Answer 10

a level >10mg/L = worse prognosis

Question 11

myeloperoxidase

Answer 11

WBC enzyme that produces toxic O2 radicals (green color of pus)
marker for plaque vulnerability preceding ACS

Question 12

homocysteine

Answer 12

associated w/vascular injury, ASHD, coagulation, venous thromboembolism
less important than cholesterol, DM, smoking, HTN

Question 13

LDL-C =

Answer 13

total-C - (VLDL-C (1/5trig) + HDL-c)

only works for trig <400

Question 14

Non-HDL-c

Answer 14

better measurement of risk then LDL-C

Question 15

chlamydophylia pneumonia

Answer 15

does stimulate plaque formation

Question 16

fibrinogen

Answer 16

binds platelets and sticks RBCs together (sed rate)

Question 17

uric acid

Answer 17

part of metabolic syndrome

Question 18

PLAQ test

Answer 18

lipoprotein phospholipase A2
elevated levels lead to increased MI and stroke
cleaves oxidized FAs form LDL-C
levels decreased by statin

Question 19

best marker for severity of CHF

Answer 19

serum Na

Question 20

BNP

Answer 20

mainly from cardiac ventricles and activated GPCRs
same actions as ANP
useful in accessing severity of ACS, stable angina, mitrla regurg, aortic stenosis
low in obesity

Question 21

BNP and evaluation of dyspnea

Answer 21

less then 100 = no CHF, must be pulmonary

Question 22

N-terminal Pro-BNP

Answer 22

2000 suggests CHF

Question 23

CHF

Answer 23

hypotonic, hypervolemic, hyponatremic

Question 24

which marker is most useful in excluding CHF

Answer 24

NT-proBNP

Question 25

Hypercholesterolemia type IIa

Answer 25

familial and polygenic
high LDL-C w/ normal triglycerides
defective LDLR apoB100

Question 26

hypercholesterolemia type IIa presentation

Answer 26

high cholesterol, normal trig
cornela arcus
xanthelasma and tendionous xanthomas
premature CAD and aortic stenosis

Question 27

hypercholesterolemia type IIb

Answer 27

elevated cholesterol and trig
most common hyperlipidemia,
acquired in diabetics

Question 28

hypercholesterolemia type IIb

Answer 28

no skin findings, early CAD, PVD, stoke, HTN, obese

Question 29

type III

Answer 29

aka sysbetalipoproteinemia or broad beta disease
increased apo E2/E2
equal increase of chol and trig
can mimic hepatic lipase deficiency 
skin and urine abnormalities

Question 30

abdominal obesity

Answer 30

men >40”

women > 35”

Question 31

triglycerides

Answer 31

> 150mg/dL

Question 32

HDL

Answer 32

men <50mg/dL

Question 33

BP

Answer 33

> 130/85

Question 34

fasting glucose

Answer 34

> 100mg/dL