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Cardio Pulmonary > Diagnostic Cardiac Blood Tests > Flashcards

Diagnostic Cardiac Blood Tests Flashcards

1
Q

list non-modifiable risk factors for CHD

A
  1. age
  2. family history of CVD
  3. gender (specifically male)
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2
Q

list modifiable risk factors for CHD

A
  1. HTN
  2. elevated total cholesterol
  3. uncontrolled DM
  4. smoking/components of cigarette smoke
  5. physical inactivity
  6. obesity (BMI > 25)
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3
Q

list other/additional risk factors for CHD

A
  1. postmenopausal
  2. high levels of C-reactive protein
  3. uncontrolled stress
  4. poor diet
  5. alcohol use
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4
Q

what values are included in blood lipid profiles

A
  1. total cholesterol
  2. high density lipoproteins
  3. low density lipoproteins
  4. very low-density lipoproteins
  5. triglycerides
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5
Q

what is cholesterol? What does it do in the body?

A
  • a form of fat that is essential to the body
    • components of cell walls/cell fluidity
    • precursor molecule for:
      • vitamin D
      • sex hormones
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6
Q

What is a desirable total cholesterol value?

A

<200 mg/dL

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7
Q

what is borderline high total cholesterol? What about high?

A

200-239 mg/dL is borderline

>240 mg/dL is high

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8
Q

what is considered the “good” cholesterol?

A

HDL

  1. transports cholesterol in the blood and scavenges fats/cholesterol from the blood and returns it to the liver for disposal
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9
Q

normal ranges of HDL

A
  • Men → 40-60
  • Women → 50-60
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10
Q

T/F: aerobic exercise has no impact on HDL

A

FALSE

it can increase HDL concentrations

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11
Q

what is the relationship between ACS and HDL?

A

the greater the HDL levels the less likely to have ACS (acute coronary syndrome)

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12
Q

what are LDLs?

A

low density liproteins

  1. can invade tunica interna of blood vessels and remain → forms atheroma
    • creates an inflammatory cascade resulting in the formation of an athersclerotic plaque
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13
Q

describe how LDLs can lead to the formation of an athersclerotic plaque

A
  1. LDL invades tunica interna of blood vessel and stays (atheroma)
  2. WBCs move into this area and establish a low-grade inflammatory situation
  3. smooth muscle cells proliferate and enter this area
  4. fibrous CT accumulates
  5. macrophages are attracted to this area
  6. forms a swelling in the artery wall (plaque)
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14
Q

T/F: plaque formation is self-propagating?

A

TRUE

increased LDL → increased plaque formation and increased risk for CV disease

(increasing circulating LDLs increases risk for atherosclerosis)

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15
Q

how is the amount of LDL in the body determiend?

A

derived/calculated

LDL = Total cholesterol - HDL - triglyceride/5

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16
Q

normal ranges for LDLs

A

aka fasting values

100 mg/dL or less

(less is better)

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17
Q

What are triglycerides and how are they assocaited with CVD?

A
  1. Glycerol + 3 fatty acids = triglyceride
  2. high levels of triglycerides in the blood have been linked to:
    • atherosclerosis and by extension the risk of heart disease and stroke
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18
Q

What are the 2 types of triglycerides?

A
  1. Saturated fats
  2. Unsaturated fats
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19
Q

what are saturated fats?

A
  1. Fat molecules that have no double bonds between carbon molecules b/c they are saturated with hydrogen molecules
    • solid at room temp
  2. high levels of saturated fat in blood = increased risk of heart disease and stroke
20
Q

what are unsaturated fats?

A
  1. fat molecules in which there are one or more double bonds in the fatty acid chain
    • mono-unsaturated
    • polyunsaturated
    • low melting point/fluid at room temp
  2. can be classified as cis- and trans- fatty acid
21
Q

describe trans fatty acids

A
  1. type of unsaturated fats
  2. uncommon in nature but are commonly produced industrially from vegetable fats
    • increased intake associated with increased risk for CVD
22
Q

describe cis fatty acids

A
  1. unsaturated
  2. generally good for health
  3. naturally occuring
  4. chains of carbon atoms are on the same side of the double bond, resulting in a kink
23
Q

List/describe the ranges for triglycerides

A
  • Normal → <150
  • Borderline High → 150-199
  • High → 200-499
  • Very high (highest risk) → >500
24
Q

describe cholesterol ratios

A

total cholesterol/HDL

  • the lower this ratio, the lower your risk of heart disease
  • recommendations are to keep this ratio to 5 or less
25
Q

when should screening/cholesterol testing be conducted?

A

screen all men >35 years old

screen all women >45 years old

26
Q

List drugs that help manage cholesterol

A
  1. stains
  2. niacin
  3. PCSK9 inhibitors
27
Q

List several serum enzymes/cardiac biomarkers

A
  1. CPK
  2. Troponin
  3. Myoglobin
  4. LDH
  5. AST
  6. SGOT
  7. ANP
  8. BNP
  9. Fibrinogen
  10. CRP
  11. Lipoprotein A
  12. Serum creatinine
28
Q

list the types of CPK

A
  1. CPK-MB → most specific type for myocardial injury
  2. CPK-MM → skeletal muscle damage
  3. CPK-BB → brain tissue damage
29
Q

describe serum CPK trends after injury

A
  1. rises → 4-6 hours
  2. peaks → 12-24 hours
  3. duration → 4-5 days
  4. normal range = 0-175 IU/L
30
Q

what is troponin? Describe the various subtypes

A
  1. group of proteins found in striated muscle cells and bound to the actin filament
    • TnC → binds calcium
    • TnI → inhibits interaction between actin and myosin
    • TnT → links troponin complex to tropomyosin
31
Q

describe serum troponin trends after injury

A
  1. rises for about 4-6 hours
  2. peak concentrations 18-24 hours after symptoms begin
  3. troponin collected on admission and then 6-9 hours later
  4. can remain elevated for 10 days after injury
32
Q

what is myoglobin and where is it located?

A
  1. heme protein found in all muscle tissue
    • specifically striated muscle tissue
    • facilitates the movement of O2 from environment into the muscle cell
33
Q

how does myoglobin relate to injury?

A
  • recent potential diagnostic tool for acute MI
  • can be detected as early as 2 hours after injury
  • peaks 3-15 hours after injury
  • normal = 25-72 ng/mL
34
Q

what is ANP?

A

Atrial Natriuretic Peptide

  1. peptide hormone of cardiac origin which is released in response to atrial distension
  2. serves to maintain sodium homeostasis and limits activation of the renin-angiotensin-aldosterone system
  3. results in vasodilation, diuresis → decreased preload and aferload = decreased workload on the heart
35
Q

how does ANP relate to heart failure?

A

increases with increasing severity of HF

inhibits cardiac hypertrophy and fibrosis

36
Q

what is the gold standard for the measurement of HF?

A

BNP (brain natriuretic peptide)

37
Q

where is BNP produced and what does it do?

A
  1. produced in the ventricles and released in response to excessive stretch on the heart muscle
    • causes
      • dilation of blood vessels
      • increases sodium excretion and diuresis in the kidney
      • reduced release of angiotensin and aldosterone
    • net effect → decrease blood volume and BP to promote urine production
38
Q

what is the funciton of BNP?

A

maintain stable BP and plasma volume and to prevent excess salt and water retention

39
Q

normal values for BNP

A

less than 100 pg/mL

40
Q

BNP values that indicate cardiac decompensation

A

>700 = acute cardiac decompensation

100-700 = chronic cardiac compensation

41
Q

what is the funciton of fibrinogen?

A

occlude blood vessels → stop bleeding

if increased there is an increased risk for clot formation and experiencing a hemorrhagic stroke

42
Q

what is CRP?

A

C Reactive Protein

  • produced in liver and is increased in inflammatory states
    • atherosclerosis, CHF, cancer, infections, or liver dysfunction
  • measures general levels of inflammation in the body
43
Q

CRP values and their significance

A
  • normal → <1.0 = low risk
  • 1.0-3.0 = high risk
  • >10 = evaluated to exclude non-cardiovascular diseases
44
Q

what is lipoprotein A?

A
  1. a lipoprotein subclass
  2. atherogenic and prothrombotic effect
  3. high levels strongly associated with atherosclerosis
  4. independent risk factor for CAD
  5. risk factor for CHD, stroke, thrombosis
45
Q

describe serum creatinine

A
  1. normal = <1.5
  2. fully filtered by the kidneys
  3. blood levels increase as kidney function declines
    • or with reduced renal perfusion
  4. creatinine accumualtes in blood
  5. HF → decreased CO → decreased renal perfusion
    • or elevated serum creatinine may by an independent predictor of cardiovascular mortality

Cardio Pulmonary (21 decks)

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