Protein and Myocardial Infarction

Question 1

what is the majority of protein in blood

Answer 1

albumin 60%

globulin 40%

Question 2

what is albumin made up of

Answer 2

prealbumin and albumin

Question 3

where is albumin made

Answer 3

liver

Question 4

how is albumin a measure of liver function

Answer 4

diseased liver cells lose ability to create albumin so its decreased in liver damage

Question 5

what is the main purpose of albumin

Answer 5

maintain osmotic pressure and transport substances - drugs, hormones, enzymes

Question 6

does albumin increase or decrease the solubility of materials in blood

Answer 6

increases

Question 7

where are globulins made

Answer 7

most are made in the reticular endothelial system

RE system and liver

Question 8

what are globulins divided into

Answer 8

alpha globulins
beta globulins
gammaglobulins

Question 9

what are the majority of alpha globulins

what type of protein are they

when are they elevated

Answer 9

alpha 1 anti-trypsin 90%

acute phase protein

inflammation, malignancy, infection

Question 10

an absence of alpha globulins indicates what

Answer 10

absence of alpha 1 antitrypsin causes emphysema

Question 11

what are the alpha globulin proteins

Answer 11

besides alpha 1 antitrypsin, the rest of the alpha globulins are thyroid or cortisol binding proteins

haptoglobulin
prothrmobin
ceruloplasmin
cholinesterase

Question 12

what are the beta 1 globulins

what are the beta 2 globulins

Answer 12

beta 1 - lipoproteins, transferrin, plasminogen, compliment

beta 2 - fibrinogen

Question 13

what are the gamma globulins

Answer 13

immune globulins

antibodies

Question 14

what is serum protein electrophoresis

Answer 14

separates the components of the serum

electric current passed through sample and the charged proteins migrate into a pattern descriptive of certain diseases

Question 15

what can be divided and fractioned out by electrophoresis if they is a spike

what does the pathologist due if they read a spike

what do these spikes mean

Answer 15

immunoglobin

classify it as monoclonal or polyclonal

monoclonal - multiple myeloma and waldenstroms macroglobulinemia

polyclonal - cirrhosis, nephrotic syndrome, chronic or acute inflammation

Question 16

__% of MIs shows unequivocal evidence on ECG

__% of MIs show non specific changes

Answer 16

50%

30%

Question 17

what is the usual presentation of MI

Answer 17

symptoms and evidence of tissue damage

Question 18

patients with MI may exhibit a ___ within __ hrs of chest pain and may last a week or two

__ elevates and stays elevated for __

Answer 18

WBC increase
Mostly PMN
12-24 hrs

ESR –> 3-4 weeks

Question 19

when does AST elevate in MI

Answer 19

elevates first 12 hrs
peaks at 24 hrs
normal in a week

Question 20

when does LDH elevate in MI

Answer 20

elevates in 24-48 hrs
peaks at 48-72 hrs
normal in 5-10 days

Question 21

where is CK found

Answer 21

cardiac muscle
skeletal muscle
brain

Question 22

why is CK iso enzyme used

Answer 22

used to DDx cardiac from other sources of AST or LDH

Question 23

CKBB or CK1 is found where

Answer 23

brain and lung

Question 24

CKMB or CK2 is found where

Answer 24

cardiac muscle

Question 25

when does CKMB elevate in MI

Answer 25

elevates 3-6 hrs
peaking 24 hrs
normal 48 hrs

Question 26

CKMM or CK3 is found where

Answer 26

skeletal muscle mostly

little in cardiac muscle

Question 27

Troponin T elevates when

how does it compare to CKMB

Answer 27

elevates 4-6 hrs

stays longer than CKMB

Question 28

Troponin I elevates when

Answer 28

may elevate sooner than Troponin T

stays for 3-4 days

Question 29

what is brain natiuretic peptide produced

when does it increase

Answer 29

produced by the heart

increased cardiac workload and causes kidney to secrete Na