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Clinical Science > Lecture 11: "I've got a polish sausage stuck in my coronary artery" > Flashcards

Lecture 11: "I've got a polish sausage stuck in my coronary artery" Flashcards

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Biology 101 flashcards
1
Q

What is the function of natriuretic peptides?

A

function to inhibit the reabsorption of sodium in the renal tubule so that sodium excretion in urine is increased

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2
Q

What is the function of natriuretic peptides?

A

function to inhibit the reabsorption of sodium in the renal tubule so that sodium excretion in urine is increased

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3
Q

What are the three major natriuretic peptides?

A

ANP, BNP, and C-type (CNP)

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4
Q

What are some causes of CHF?

A

hypertension, coronary artery or valvular hear disease, diabetes mellitus, or congenital heart disease

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5
Q

What is the role of BNP in the heart?

A

along with ANP it is released when the atria and ventricles stretch -> they cause vasorelaxation and increase the amount of sodium and water excreted

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6
Q

What is the role of creatine kinase?

A

this enzyme metabolizes creatine found in the mitochondria and cytoplasm of skeletal muscles to phosphocreatine; ATP is generated from this process

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7
Q

What is the normal level for creatine kinase?

A

50-200 U/L

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8
Q

What does elevation of total CK typically represent?

A

injury to the skeletal muscle

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9
Q

What are the three isoenzymes of Creatine Kinase?

A

CK-MM, CK-BB, CK-MB

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10
Q

Why is a CK-MB test not preferred to diagnose MI?

A

lack of specificity, lack of sensitivity, late increase in disease process, high levels can indicate that extensive myocardial damage has already occurred

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11
Q

Which troponin subtypes are used to diagnose an MI?

A

Troponin I and Troponin T

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12
Q

What is the interaction between troponin and calcium skeletal and cardiac muscle?

A

when troponin is bound by calcium it allows for exposure of the myosin binding sites on actin; troponins interact with calcium ions and tropomyosin during muscle contraction

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13
Q

What is the normal value for cardiac troponin I?

A
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14
Q

Why is cardiac troponin I used more commonly than troponin T?

A

renal failure more frequently increases cardiac troponin T

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15
Q

What is the function of myoglobin?

A

occurs only in the skeletal or cardiac muscle tissue; serves as a short-term oxygen storage in muscle tissue

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16
Q

When is myoglobin known to increase?

A

3 hours after cardiac injury- is an early maker; only released into serum when there is a skeletal or cardiac muscle injury

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17
Q

What is the normal value for cardiac troponin T?

A
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18
Q

What is the preferred test to diagnose a patient with acute coronary syndrome or myocardial injury?

A

troponin

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19
Q

What is lactate dehydrogenase?

A

enzyme that catalyzes the conversion of lactate to pyruvate

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20
Q

What is lactate dehydrogenase involved in?

A

energy production of the cells

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21
Q

Where is lactate dehydrogenase found?

A

tissues of heart, liver, RBCs, kidneys, skeletal muscle, brain, and lungs; not very specific

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22
Q

When is LDH released?

A

released into the blood when injury occurs but it is not very specific for one disease

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23
Q

What isoenzymes of LDH is usually most abundant?

A

LDH-2

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24
Q

When is LDH-2 not the most abundant?

A

during a myocardial infarction and LDH-1 becomes most abundant; this is called a flipped LDH

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25
Q

What is the normal value of D-Dimer?

A
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26
Q

What is D-Dimer typically used to diagnose?

A

a patient with a deep vein thrombosis (DVT) or pulmonary embolism (PE)

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27
Q

What is the normal value for a C-Reactive Protein- High Sensitivity (CRP-HS) test?

A
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28
Q

What is C-Reactive Protein

A

an acute phase reactant and an inflammatory mediator; produced in the liver in response to inflammation and infection

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29
Q

When is CRP-HS screening useful?

A

in assessing likelihood of future cardiac events

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30
Q

What does low-density lipoprotein carry?

A

75% of cholesterol

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31
Q

What does high-density lipoprotein carry?

A

25% of cholesterol; much more protein dense and therefore carries less cholesterol

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32
Q

What does a lipid panel generally include?

A

total cholesterol, triglyceride, HDL, and LDL

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33
Q

How often should diabetics have a lipid panel?

A

annually

34
Q

If initial lipid panel test is normal how often should you test a patient?

A

test can be performed every 5 years

35
Q

What should be your total cholesterol normal value?

A
36
Q

What factors increase triglyceride levels?

A

familial hypertriglyceridemia, hyperlipidemia, hypothyroidism, high carb diet, poorly controlled diabetes, chronic renal failure

37
Q

What factors decrease triglycerides?

A

malabsorption and malnutrition, hyperthyroidism

38
Q

What factors increase HDL:?

A

exercise, moderate alcohol use, healthier eating choices, estrogen administration, familial HDL lipoproteinemia

39
Q

What factors decrease HDL?

A

tobacco use, metabolic syndrome, genetically low HDL, hepatic disease

40
Q

What are lab values for LDL that are ideal for those at risk of heart disease?

A

70-100 mg/dL

41
Q

What is a high LDL lab value?

A

> 160 mg/ dL

42
Q

How does LDL particle sixe affect risk of CAD?

A

there is an increased risk of CAD with small, dense LDL particles; these small dense particles are more dangerous and promotes atherosclerosis and thrombosis

43
Q

What are the three major natriuretic peptides?

A

ANP, BNP, and C-type (CNP)

44
Q

What are some causes of CHF?

A

hypertension, coronary artery or valvular hear disease, diabetes mellitus, or congenital heart disease

45
Q

What is the role of BNP in the heart?

A

along with ANP it is released when the atria and ventricles stretch -> they cause vasorelaxation and increase the amount of sodium and water excreted

46
Q

What is the role of creatine kinase?

A

this enzyme metabolizes creatine found in the mitochondria and cytoplasm of skeletal muscles to phosphocreatine; ATP is generated from this process

47
Q

What is the normal level for creatine kinase?

A

50-200 U/L

48
Q

What does elevation of total CK typically represent?

A

injury to the skeletal muscle

49
Q

What are the three isoenzymes of Creatine Kinase?

A

CK-MM, CK-BB, CK-MB

50
Q

Why is a CK-MB test not preferred to diagnose MI?

A

lack of specificity, lack of sensitivity, late increase in disease process, high levels can indicate that extensive myocardial damage has already occurred

51
Q

Which troponin subtypes are used to diagnose an MI?

A

Troponin I and Troponin T

52
Q

What is the interaction between troponin and calcium skeletal and cardiac muscle?

A

when troponin is bound by calcium it allows for exposure of the myosin binding sites on actin; troponins interact with calcium ions and tropomyosin during muscle contraction

53
Q

What is the normal value for cardiac troponin I?

A
54
Q

Why is cardiac troponin I used more commonly than troponin T?

A

renal failure more frequently increases cardiac troponin T

55
Q

What is the function of myoglobin?

A

occurs only in the skeletal or cardiac muscle tissue; serves as a short-term oxygen storage in muscle tissue

56
Q

When is myoglobin known to increase?

A

3 hours after cardiac injury- is an early maker; only released into serum when there is a skeletal or cardiac muscle injury

57
Q

What is the normal value for cardiac troponin T?

A
58
Q

What is the preferred test to diagnose a patient with acute coronary syndrome or myocardial injury?

A

troponin

59
Q

What is lactate dehydrogenase?

A

enzyme that catalyzes the conversion of lactate to pyruvate

60
Q

What is lactate dehydrogenase involved in?

A

energy production of the cells

61
Q

Where is lactate dehydrogenase found?

A

tissues of heart, liver, RBCs, kidneys, skeletal muscle, brain, and lungs; not very specific

62
Q

When is LDH released?

A

released into the blood when injury occurs but it is not very specific for one disease

63
Q

What isoenzymes of LDH is usually most abundant?

A

LDH-2

64
Q

When is LDH-2 not the most abundant?

A

during a myocardial infarction and LDH-1 becomes most abundant; this is called a flipped LDH

65
Q

What is the normal value of D-Dimer?

A
66
Q

What is D-Dimer typically used to diagnose?

A

a patient with a deep vein thrombosis (DVT) or pulmonary embolism (PE)

67
Q

What is the normal value for a C-Reactive Protein- High Sensitivity (CRP-HS) test?

A
68
Q

What is C-Reactive Protein

A

an acute phase reactant and an inflammatory mediator; produced in the liver in response to inflammation and infection

69
Q

When is CRP-HS screening useful?

A

in assessing likelihood of future cardiac events

70
Q

What does low-density lipoprotein carry?

A

75% of cholesterol

71
Q

What does high-density lipoprotein carry?

A

25% of cholesterol; much more protein dense and therefore carries less cholesterol

72
Q

What does a lipid panel generally include?

A

total cholesterol, triglyceride, HDL, and LDL

73
Q

How often should diabetics have a lipid panel?

A

annually

74
Q

If initial lipid panel test is normal how often should you test a patient?

A

test can be performed every 5 years

75
Q

What should be your total cholesterol normal value?

A
76
Q

What factors increase triglyceride levels?

A

familial hypertriglyceridemia, hyperlipidemia, hypothyroidism, high carb diet, poorly controlled diabetes, chronic renal failure

77
Q

What factors decrease triglycerides?

A

malabsorption and malnutrition, hyperthyroidism

78
Q

What factors increase HDL:?

A

exercise, moderate alcohol use, healthier eating choices, estrogen administration, familial HDL lipoproteinemia

79
Q

What factors decrease HDL?

A

tobacco use, metabolic syndrome, genetically low HDL, hepatic disease

80
Q

What are lab values for LDL that are ideal for those at risk of heart disease?

A

70-100 mg/dL

81
Q

What is a high LDL lab value?

A

> 160 mg/ dL

82
Q

How does LDL particle sixe affect risk of CAD?

A

there is an increased risk of CAD with small, dense LDL particles; these small dense particles are more dangerous and promotes atherosclerosis and thrombosis

Clinical Science (15 decks)

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