Lipoproteins and Cardiac Enzymes

Question 1

where is cholesterol metabolized?

Answer 1

liver

Question 2

what transports cholesterol in the blood?

Answer 2

lipoproteins

Question 3

why can cholesterol be a problem?

Answer 3

associated with atherosclerotic disease

Question 4

what is the main function of cholesterol?

Answer 4

production of steroids, sex hormones, bile acids and cell membrane

Question 5

what can also cause low levels of cholesterol?

Answer 5

liver disease and malnutrition

Question 6

what coronary predictor is used to identify CAD risk from cholesterol?

Answer 6

Framingham study

Question 7

what are the 5 major lipoproteins? present on the standard lipid panal

Answer 7

chylomicrons
VLDL
IDL
LDL
HDL

Question 8

what do chylomicrons do?

Answer 8

carry fat from the GI tract to liver, skeletal muscle and adipose tissue
-they are very large particles

Question 9

what do VLDLs do?

Answer 9

carries endogenous (self-made) triglycerides from liver to adipose tissue
carries cholesterol
(when it is high it means that there is a lot of endogenous cholesterol)

Question 10

what do IDLs do?

Answer 10

carries cholesterol esters and triglycerides

-usually not detectable

Question 11

what do LDLs do?

Answer 11

carries cholesterol esters from liver to cells of the body

Question 12

what do HDLs do?

Answer 12

collects cholesterol from tissues and vacular endothelium and returns it to the liver
-has a protective effect against heart disease

Question 13

what is reverse transport?

Answer 13

when HDL takes cholesterol in the vasculature and returns it to the liver

Question 14

how can we increase HDL?

Answer 14

excersize

Question 15

what do triglycerides do?

Answer 15

acts as a storage source for energy, when they are high they are deposited in fatty tissues

Question 16

how are triglycerides transported?

Answer 16

VLDL and LDL

Question 17

what purposed does the lipid profile serve?

Answer 17

assess CAD risk

assess vascular dz risk

Question 18

what is on a lipid profile?

Answer 18

total cholesterol
triglycerides
HDL
LDL
VLDL
HDL/LDL ratio

Question 19

what are the normal adult TCC values?

Answer 19

<200mg/dl

Question 20

what is the critical value of TG?

Answer 20

> 400mg/dl

Question 21

what are the normal HDL values?

Answer 21

m >45mg/dl

f >55mg/dl

Question 22

what are the normal LDL values?

Answer 22

adult <110mg/dl

Question 23

what TG value would cause an inaccurate LDL?

Answer 23

> 400mg/dl

Question 24

what is the normal range of VLDL?

Answer 24

7-32mg

Question 25

how do you calculate LDL?

Answer 25

TCC-(TG/5-HDL)

Question 26

what instructions are important for lipoprotein study?

Answer 26

12-14 hr fast | low fat meal prior to fast

Question 27

what can interfere with cholesterol levels?

Answer 27

pregnancy increases levels recumbent positions decrease levels postmenopausal states cause increased levels

Question 28

what can impact HDL levels?

Answer 28

age/sex post MI decreases smoking decreases liver dz and malnutrition decreases hyperthyroid decreases hypothyroid increase binge eating

Question 29

main drugs that alter lipoprotien

Answer 29

``` beta blockers alpha blockers dilantin steroids estrogens ```

Question 30

what are the normal values of CK?

Answer 30

m 55-170 u/L | f 30-135 u/L

Question 31

If the pt is not having a coronary event, what will the total CK reflect?

Answer 31

CK-MM (skeletal muscle)

Question 32

when would CK-MB be greater than 0?

Answer 32

pt is having a cardiac event

Question 33

when would CK-BB be greater than 0?

Answer 33

pt is having something going on | brain assoc. CK problem

Question 34

why use CK?

Answer 34

support dx of MI | can also indicate neurological and skeletal muscle dz

Question 35

when can total CK rise?

Answer 35

within 6 hrs of damage

Question 36

when will total CK return to normal?

Answer 36

peaks at 12-24 hours and returns to normal 2-3 days after infarction

Question 37

when would CK-MB be slightly elevated and this would be normal?

Answer 37

marathons, triathalons | severe crush injury

Question 38

what else can indicate myocardial injury?

Answer 38

LD within 24-48 hours

Question 39

why do they no longer use LD?

Answer 39

it takes too long to see an elevation in the levels

Question 40

what will cause a false high LD level?

Answer 40

hemolysis | strenuous exercise

Question 41

what is the normal troponin T

Answer 41

<0.2 ng/ml

Question 42

what is the normal troponin I

Answer 42

<0.3ng/ml

Question 43

what are troponin levels used for?

Answer 43

determine if CP is caused by cardiac ischemia | early risk stratification for pts with unstable angina

Question 44

what does troponin test mean?

Answer 44

biochemical markers for cardiac dz

Question 45

why use troponin instead of CK?

Answer 45

``` elevates sooner (3hrs) and remains elevated longer more sens and specific (CK can't differentiate ischemia) ```

Question 46

why do you put date and time on test tube for cardiac enzyme tests?

Answer 46

know when to perform serial values

Question 47

when are troponin T levels falsely elevated?

Answer 47

pts with renal heart failure

Question 48

what marker increases in response to ventricular wall stress?

Answer 48

Btype natriuretic peptide (BNP) | useful prognostic indicator change over time

Question 49

what is the use of CRP?

Answer 49

evaluate cardiac risk profile | considered to be related to cardiac atherogenesis