DLM

Question 1

Total Cholesterol

Answer 1

Normal: < 200mg/dL
High: >240 mg/dL
High increases risk of death due to CHD within 25 yrs, atherosclerotic lesions.

Question 2

Triglycerides

Answer 2

Normal: <150 mg/dL
High: 200-499 mg/dL
- CHD, pancreatitis

Question 3

LDL

Answer 3

Optimal: <100 mg/dL
High: 160-189
Bad cholesterol- associated with increased risk of CHD & atherosclerotic vascular disease

Question 4

HDL

Answer 4

Low: 40 mg/dL
High: >60 mg/dL
Good cholesterol. High = cardio protection, low = increased risk of CHD, MI

Question 5

Chylomicrons

Answer 5

• Release triglycerides to fat depots and muscle- no standard range
• Presence indicates potential for high triglycerides

Question 6

VLDL

Answer 6

• Normal: <30 mg/dL
• Triglycerides- become LDL particles
• Elevated lease to CHD

Question 7

Lipoprotein a Lpa

Answer 7

Variation of LDL cholesterol

- Risk factor in premature development of plaque, atherosclerosis

Question 8

Homocystine

Answer 8

Males: 4-12 mcmol/L
Females: 4-10 mcmol/ L
- amino acid in blood
- High = risk factor for atherosclerosis, CHD< thromboembolism

Question 9

Creatine phosphokinase (CPK or CK)

Answer 9

• AMI Dx =2 fold risk above normal
• Lacks specificity for cardiac damage
• Rise 4-8 H, peak 24-36 H
• Normal within 48 H

Question 10

CK-MB

Answer 10

• Subtype of Ck found in cardiac muscle
• Assess reperfusion after thrombolysis
• Sensitive & specific
• Rise 3-4H, Peak: 15-20 H, Normal 24-36 H
• Bad for low muscle mass pts
• May be abn in normal CPK- order separately

Question 11

Myoglobin

Answer 11

Earliest AMI marker
Rise: 1-4 H, Peak: 4-12, Normal 24 H
- Sensitive, not specific

Question 12

Troponin

Answer 12

Gold standard
- T, less available
- I commonly used
- Normal 0.0= 1.5ng.mL
Rise: 3-12 hrs, Peak 10-24 H, Normal 7 - 10 days
- Retrospective MI dx
- Low early specificity, increases with time.

Question 13

C-reactive protein

Answer 13

hs-CRP for cardiac risk

• 1.0-3.0 mg/L = average risk
• > 3.0 high risk
• also elevated in rheumatologic and cancer

Question 14

d-dimer

Answer 14

Fibrin degradation product- used to dx thrombotic disorders

- Potential marker for aortic dissection?

Question 15

BNP

Answer 15

• Neurohormone secreted in response to increased ventricular volume and pressure
• distinguish cause of dyspnea- BNP increases in proportion to heart failure
• elevated in other conditions- renal failure, age, endocrine
• Sensative, not specific

Question 16

CXR

Answer 16

Heart size, inter cardiac calcium deposits,

Question 17

Ambulatory EKG- Holter/ event monitoring

Answer 17

• Asses rate & rhythm over days to months

- evaluation of syncope, near-syncope, palpitations

Question 18

EKG

Answer 18

• Rate & rhythm
• Changes associates with MI, angina, syncope,
• Stress- evaluate ischemic heart disease with angina

Question 19

Cardiac catheterization

Answer 19

Inserted in brachial or femoral artery to assess intracardiac pressure, hemodynamic data, blood flow.
- Used in stent, balloon placement

Question 20

Cardiac angiography

Answer 20

• Contrast and imaging to asses atherosclerotic lesions

- Indications: angina, aortic valve disease, unidentified chest pain, emergency procedures