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Medicine > Lipoproteins and Cardiac Enzymes > Flashcards

Lipoproteins and Cardiac Enzymes Flashcards

1
Q

where is cholesterol metabolized?

A

liver

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2
Q

what transports cholesterol in the blood?

A

lipoproteins

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3
Q

why can cholesterol be a problem?

A

associated with atherosclerotic disease

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4
Q

what is the main function of cholesterol?

A

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

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5
Q

what can also cause low levels of cholesterol?

A

liver disease and malnutrition

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6
Q

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

A

Framingham study

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7
Q

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

A 
chylomicrons
VLDL
IDL
LDL
HDL
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8
Q

what do chylomicrons do?

A

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

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9
Q

what do VLDLs do?

A 
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)
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10
Q

what do IDLs do?

A

carries cholesterol esters and triglycerides

-usually not detectable

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11
Q

what do LDLs do?

A

carries cholesterol esters from liver to cells of the body

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12
Q

what do HDLs do?

A

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

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13
Q

what is reverse transport?

A

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

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14
Q

how can we increase HDL?

A

excersize

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15
Q

what do triglycerides do?

A

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

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16
Q

how are triglycerides transported?

A

VLDL and LDL

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17
Q

what purposed does the lipid profile serve?

A

assess CAD risk

assess vascular dz risk

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18
Q

what is on a lipid profile?

A 
total cholesterol
triglycerides
HDL
LDL
VLDL
HDL/LDL ratio
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19
Q

what are the normal adult TCC values?

A

<200mg/dl

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20
Q

what is the critical value of TG?

A

> 400mg/dl

21
Q

what are the normal HDL values?

A

m >45mg/dl

f >55mg/dl

22
Q

what are the normal LDL values?

A

adult <110mg/dl

23
Q

what TG value would cause an inaccurate LDL?

A

> 400mg/dl

24
Q

what is the normal range of VLDL?

A

7-32mg

25
Q

how do you calculate LDL?

A

TCC-(TG/5-HDL)

26
Q

what instructions are important for lipoprotein study?

A

12-14 hr fast

low fat meal prior to fast

27
Q

what can interfere with cholesterol levels?

A

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

28
Q

what can impact HDL levels?

A

age/sex

post MI decreases
smoking decreases
liver dz and malnutrition decreases
hyperthyroid decreases

hypothyroid increase
binge eating

29
Q

main drugs that alter lipoprotien

A 
beta blockers
alpha blockers
dilantin
steroids
estrogens
30
Q

what are the normal values of CK?

A

m 55-170 u/L

f 30-135 u/L

31
Q

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

A

CK-MM (skeletal muscle)

32
Q

when would CK-MB be greater than 0?

A

pt is having a cardiac event

33
Q

when would CK-BB be greater than 0?

A

pt is having something going on

brain assoc. CK problem

34
Q

why use CK?

A

support dx of MI

can also indicate neurological and skeletal muscle dz

35
Q

when can total CK rise?

A

within 6 hrs of damage

36
Q

when will total CK return to normal?

A

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

37
Q

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

A

marathons, triathalons

severe crush injury

38
Q

what else can indicate myocardial injury?

A

LD within 24-48 hours

39
Q

why do they no longer use LD?

A

it takes too long to see an elevation in the levels

40
Q

what will cause a false high LD level?

A

hemolysis

strenuous exercise

41
Q

what is the normal troponin T

A

<0.2 ng/ml

42
Q

what is the normal troponin I

A

<0.3ng/ml

43
Q

what are troponin levels used for?

A

determine if CP is caused by cardiac ischemia

early risk stratification for pts with unstable angina

44
Q

what does troponin test mean?

A

biochemical markers for cardiac dz

45
Q

why use troponin instead of CK?

A 
elevates sooner (3hrs) and remains elevated longer
more sens and specific (CK can't differentiate ischemia)
46
Q

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

A

know when to perform serial values

47
Q

when are troponin T levels falsely elevated?

A

pts with renal heart failure

48
Q

what marker increases in response to ventricular wall stress?

A

Btype natriuretic peptide (BNP)

useful prognostic indicator change over time

49
Q

what is the use of CRP?

A

evaluate cardiac risk profile

considered to be related to cardiac atherogenesis

Medicine (146 decks)

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