Protein and Myocardial Infarction Flashcards
what is the majority of protein in blood
albumin 60%
globulin 40%
what is albumin made up of
prealbumin and albumin
where is albumin made
liver
how is albumin a measure of liver function
diseased liver cells lose ability to create albumin so its decreased in liver damage
what is the main purpose of albumin
maintain osmotic pressure and transport substances - drugs, hormones, enzymes
does albumin increase or decrease the solubility of materials in blood
increases
where are globulins made
most are made in the reticular endothelial system
RE system and liver
what are globulins divided into
alpha globulins
beta globulins
gammaglobulins
what are the majority of alpha globulins
what type of protein are they
when are they elevated
alpha 1 anti-trypsin 90%
acute phase protein
inflammation, malignancy, infection
an absence of alpha globulins indicates what
absence of alpha 1 antitrypsin causes emphysema
what are the alpha globulin proteins
besides alpha 1 antitrypsin, the rest of the alpha globulins are thyroid or cortisol binding proteins
haptoglobulin
prothrmobin
ceruloplasmin
cholinesterase
what are the beta 1 globulins
what are the beta 2 globulins
beta 1 - lipoproteins, transferrin, plasminogen, compliment
beta 2 - fibrinogen
what are the gamma globulins
immune globulins
antibodies
what is serum protein electrophoresis
separates the components of the serum
electric current passed through sample and the charged proteins migrate into a pattern descriptive of certain diseases
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
immunoglobin
classify it as monoclonal or polyclonal
monoclonal - multiple myeloma and waldenstroms macroglobulinemia
polyclonal - cirrhosis, nephrotic syndrome, chronic or acute inflammation
__% of MIs shows unequivocal evidence on ECG
__% of MIs show non specific changes
50%
30%
what is the usual presentation of MI
symptoms and evidence of tissue damage
patients with MI may exhibit a ___ within __ hrs of chest pain and may last a week or two
__ elevates and stays elevated for __
WBC increase
Mostly PMN
12-24 hrs
ESR –> 3-4 weeks
when does AST elevate in MI
elevates first 12 hrs
peaks at 24 hrs
normal in a week
when does LDH elevate in MI
elevates in 24-48 hrs
peaks at 48-72 hrs
normal in 5-10 days
where is CK found
cardiac muscle
skeletal muscle
brain
why is CK iso enzyme used
used to DDx cardiac from other sources of AST or LDH
CKBB or CK1 is found where
brain and lung
CKMB or CK2 is found where
cardiac muscle
when does CKMB elevate in MI
elevates 3-6 hrs
peaking 24 hrs
normal 48 hrs
CKMM or CK3 is found where
skeletal muscle mostly
little in cardiac muscle
Troponin T elevates when
how does it compare to CKMB
elevates 4-6 hrs
stays longer than CKMB
Troponin I elevates when
may elevate sooner than Troponin T
stays for 3-4 days
what is brain natiuretic peptide produced
when does it increase
produced by the heart
increased cardiac workload and causes kidney to secrete Na
