Lipid and Cardiac Function Tests

Question 1

4 major lipoproteins

Answer 1

1. chylomicrons
2. VLDL
3. LDL
4. HDL

Question 2

chylomicrons

Answer 2

synthesized in the wall of small intestine and liver

formed in epithelial cells and enter circulation

transfer TGs to adipose and skeletal muscle cells

synthesizes VLDL or used in bile excretion

Question 3

cholesterol and triglyceride are insoluble in plasma so….

Answer 3

must be broken down for absorption

must be encapsulated by lipoproteins for transport

Question 4

VLDL

Answer 4

made be taking remains TGs, FFAs, and cholesterol in liver

primary pathway for transport of TGs made in liver

either recycled or converted to LDL

Question 5

LDL

Answer 5

main carrier of cholesterol

clearance dependent on LDL receptors in adrenal cortex and gonads

40% used to make cell membranes and steroid hormones

60% used to make bile acids and other free cholesterol or reabsorbed into circulation -

Question 6

LDL and scavenger receptors

Answer 6

Macrophages pick up picked up excess LDL causing foam cell formation

foam cells cause atherosclerosis

Question 7

HDL

Answer 7

primarily produced and released by liver

reverses transport of cholesterol back into the liver

inverse relationship between HDL and atherosclerosis

Question 8

total cholesterol numbers

normal, borderline, high

Answer 8

in serum:

desirable <200
boderline 200-239
high >240

Question 9

only non fasting lipid profile

Answer 9

total cholesterol

Question 10

total triglyceride serum levels

normal, borderline, high

Answer 10

normal <150
borderline high 150-199
high 200-499
very high 500

Question 11

elevated triglycerides are considered an independent risk factor for

Answer 11

coronary artery Dz

also a major risk factor for pancreatitis

Question 12

VLDL normal ranges

Answer 12

5-40

Question 13

HDL

Answer 13

less than 40 is bad - risk of heart disease

> 60 is protective

Question 14

LDL ranges

Answer 14

optimal is less than 100

high is 160+

Question 15

myoglobin

Answer 15

released with muscle injury

non specific for skeletal or cardiac

Question 16

Creatine Kinase

Answer 16

intracellular enzyme that splits to create phosphate in presence of ADP, yields creatine and ATP

found in cardiac, skeletall, brain

Question 17

isoenzyme used for MI

Answer 17

Ck-MB

Question 18

CK-MB post MI serum levels

Answer 18

appears 4 hrs after infarction

peaks at 12-24 hrs post MI

eclipse over 48-72 hrs

Question 19

troponin

Answer 19

more sensitive and more specific for cardiac damage

not found on any skeletal muscle

Marker of choice

Question 20

troponin I levels

Answer 20

become detectable 4-6 hrs post MI

peaks then falls and is elevated at low levels for 7-10 days

Question 21

lactate dehydrogenase

Answer 21

catalyzes oxidation of late to pyruvate

found in all tissues so just suggests injury to muscles, liver, hemolysis, or rapid cell division

not often used bc so nonspecific

Question 22

what marker is used to asses vascular inflammation and CV risk stratification

Answer 22

CRP

Question 23

CRP

Answer 23

increases when inflammation occurs

very sensitive but non specific marker of inflammation

Question 24

Patients with high hsCRP are more likely to develop

Answer 24

stroke, MI, severe peripheral vascular disease so it is used to stratify risk

Question 25

BNP elevation

Answer 25

found in hypervolemic states such as congestive HF

used in serial monitoring of CHF

Question 26

BNP clinical application

Answer 26

used in CHF to:

determine cause of symptoms
estimate degree of severity
estimate risk of progression