Exam 2, week 5: Cardiac Biomarker Lab Values Flashcards
CK and CKMB are cardiac enzymes. They are ENZYMES!!! Specifically, Creatine Kinase.
-Ck is found in what 3 places?
-CKMB is what specific?
Ck is found in the heart, brain, and skeletal muscles.
CKMB is heart specific.
If you wanted to assess the risk for an MI, which Enzyme lab value would you assess?
-CK
-CKMB
CKMB, because it is heart specific.
When looking at CKMB lab values to see if a patient has had an MI, the CKMB values rise and fall over a period of how many days?
When do the CKMB values for MI’s peak during this period?
CKMB values rise and fall over a 3-day period if a patient has had an MI.
CKMB levels peak at about 24 hours during the 3-day period.
CKMB levels USED to be the gold standard for checking to see if a patient had an MI, but it is no longer the standard because you had to basically wait for a patient to have an MI. Now, the gold standard Lab value for assessing an MI is the protein known as what?
Troponin
Why are Troponin levels used to assess for an MI?
Troponin is not found in healthy people.
Troponin is not found in healthy people. What does the presence of troponin represent in a patient’s heart condition?
Troponin represents heart necrosis.
Necrosis of the heart is recognized by the presence of what enzyme in the body?
Trick question.
Troponin presence indicates heart necrosis, but Troponin is a protein, not an enzyme.
Which Troponin levels indicate Heart Necrosis in a patient?
a.) 0.1ng/mL
b.) 0.4ng/mL
c.) 1.3ng/mL
d.) None of the above
e.) All of the above
e.) All of the above
Any presence of Troponin indicates Heart Necrosis
An amount at or over 0.4ng/mL is considered a Cardiac Event
Myoglobin comes from what 2 places in the body?
The heart and bones
Myoglobin levels can rise “X”-“Y” minutes after an MI, and then decline after “Z” hours.
Myoglobin levels can rise 30-60 minutes after an MI, and then decline after 7 hours.
Serum lipids are found in “X” proteins and in the “Y”, where it is made.
Serum lipids are found in animal proteins, and in the Liver, where it is made.
What should these Serum Lipid levels be at?
-Total Cholesterol
-Triglycerides
-HDL
-LDL
Total Cholesterol: Less than 200mg/dL
Triglycerides: Less than 150mg/dL
HDL: Greater than 40mg/dL
LDL: Less than 70mg/dL
BNP is a neurohormone that regulates Blood Pressure and fluid volume. BNP Helps diagnose heart failure, and MI’s, and Emboli.
What BNP lab value suggests the possibility of heart failure?
Any number GREATER than 100
BNP is a neurohormone that regulates what 2 things?
Blood pressure and fluid volume.
A BNP number greater than 100 suggests what?
Heart Failure
What symptoms would suggest to a nurse that a patients BNP levels should be checked?
-Swollen ankles
-Lung crackles in the bases
-Jugular distention
-Abdominal pulse/Distention
C-Reactive proteins are produced in the “X” and shows what?
C-reactive proteins are produced in the Liver and show inflammation.
C-Reactive protein is made in the liver and shows what?
Inflammation
CVD is shown in a patient if their C-Reactive proteins are above what number?
a.) 3
b.) 1.2
c.) 2
d.) 0.4
a.) If a patients C-Reactive protein is above 3, it is a risk for CVD.
As a side note, since C-reactive proteins show inflammation, an elevated lab value could also be present in which type of patient:
a.) Alcoholics
b.) Diabetics
c.) Smokers
d.) Obese
c.) Smokers also have higher levels of C-reactive proteins
Homocysteine is an amino acid that is linked to what artery disease?
Arteriosclerosis
Homocysteine levels are used to assess for possible coronary artery diseases. You have a high risk for CAD if your Homocysteine levels are greater than what?
Homocysteine levels greater than 15
If your blood levels have higher than normal coagulation, it means that your blood is taking too long to what?
Higher than normal coagulations means that your blood is taking too long to clot.
If your blood coagulation is lower than normal, it means that your blood is what?
Lower than normal coagulation means that your blood is not clotting enough.
True or False:
Having higher than normal blood coagulation means that your blood is clotting too easily.
True:
Having HIGHER than normal blood coagulation means that your blood is clotting too easily.
LOWER than normal blood coagulation means that your blood is taking too long to clot.
What can be the end result of having your blood coagulation levels too high?
-MI
-Stroke
Pt stands for Prothrombin Time. Prothrombin Time is a study done for patients taking what drug?
Coumadin
What does the drug Coumadin do to the blood?
Thins the blood.
Coumadin is a blood thinner.
A patient with Atrial Fibrillation would want to avoid clotting of their blood. What drug would be given to counteract clotting?
Coumadin
or
Warfarin
Partial Thromboplastin Time is if the patient is taking what drug?
Heparin
Which drug is for PT and which drug is for PTT?
-Coumadin
-Heparin
Coumadin is for PT
Heparin is for PPT
PT and PTT both test for the bloods ability to do what?
PT and PTT both test for how well blood clots.
What tests would you use to assess for a patient bleeding disorder?
-PT/INR
-PTT
PT/INR tests gauge how fast “Prothrombin” turns into what?
-Thrombin
What is the main difference between a PT/INR test and a PTT test?
PT/INR, and PTT are tests used to assess the bloods coagulation levels, aka: Its ability to form clots. The differences between the two tests come down to testing how the blood will clot when hit with an External injury, or an Internal injury.
PT/INR tests are used to assess for clotting of “X” injuries because they affect pathways called “X” clotting pathways.
PTT tests are used to assess for clotting of “Y” injuries, because they affect pathways called “Y” pathways.
PT/INR tests are used to assess for clotting of External Injuries because they affect pathways called External clotting pathways.
PTT tests are used to assess for clotting of Internal injuries because they affect pathways called Internal clotting pathways.
What is the difference in time between normal PT/INR test values, and normal PTT tests values?
PT/INR is 10-12 seconds
PTT is 30-40 seconds
BUN/Creatinine/Na+ levels would be elevated with decreased cardiac output.
What would be normal vs elevated levels in BUN/Creatinine/Na+?
BUN-
Normal: 6-20mg/dL
Elevated: >20mg/dL
Creatinine-
Normal: 0.7-1.3(M), 0.6-1.1(F)
Elevated: >1.3(M), >1.1(F)
Na+-
Normal: 135-145mEq
Elevated: >145mEq
While BUN/Creatinine/Na+ levels coincide with decreased cardiac output, which electrolytes coincide with cardiac instability?
K+, Mg++, and Ca+
If a patient is presenting with an MI, will Leukocyte levels be decreased or elevated?
What are normal Leukocyte levels?
Leukocyte levels will be elevated in an MI.
Normal WBC counts are 4,500 to 11,000.
