Clinical Chemistry Exam 1 Lecture 8

Dyspnea
Difficulty Breathing
Cyanosis
Bluish coloration to skin as a result of dyspnea
Ischemia
Decreased blood flow to the heart, leads to myocardial infarction
Angina
Chest pain usually due to ischemia
Atherosclerosis
Hardening of artery caused by cholesterol plaques
5 General Classifications of Cardiac Disease
Congenital Heart Disease
Congestive Heart Failure
Acute Coronary Syndrome
Hypertensive Heart Disease
Infective Heart Disease
Diagnosing AMI
Symptoms
ECG
Cardiac Markers
What % is ECG diagnostic?
50
For proper diagnosing and monitoring, you should run at least how many markers as well as look for serial changes?
2
Myoglobin
Muscle protein that facilitates the entry of oxygen into muscle cells
Rapidly released from damaged muscles
Myoglobin begins to rise _____ hours post AMI
1-4
Myoglobin clears the glomerulus post AMI and returns to normal by _____ hours
24
Is Myoglobin a reliable indicator of AMI in patients with renal disease or skeletal muscle trauma?
No
What is Myoglobin a good indicator of?
Re-infarction
Troponin I
Muscle protein that regulates contractions
What Cardiac Marker is the Most specific and Sensitive for Myocradial injury?
Troponin I
Troponin I peaks at ___ hours; persists for ___ ____ post AMI
24
several days
Is Troponin I found in normal healthy serum?
No
Troponin T peaks at ____ hours and remains elevated for _____ _____
48
7+ days
What Cardiac Marker is useful for diagnosing patients who delayed seeking medical attention?
Troponin T
CKMB peaks at ___ hours and returns to normal within ___ hours
24
48
NR of CKMB is equal to
0-5 ng/mL
True or False:
Increased levels of CKMB are also seen in some muscle diseases
True
CKMB Relative Index
To differentiate cardiac vs non-cardiac CKMB
CKMB RI =
(CKMB Total / Total CK) x 100
CKMB Relative Index >3 is indicative or what?
AMI
True or False:
CKMB Relative Index is useful only when Both Total CK and CKMB are Elevated
True
hs-CRP
Sensitive marker for Chronic Inflammation
Mild baseline elevations of hs-CRP in “healthy” people is associated with high risk for what?
future cardiac events
Interleukin-6 (IL6)
Cytokine secreted by T cells and macrophages
Is Interleukin-6 a sign of inflammation?
Yes
What substances are needed to eliminate homocysteine?
B vitamins and folic acid
Deficiencies in Vitamins B and folic acid contribute to what?
Accumulation of homoecyteine
There is a link between high homocysteine levels and ____ __ __ ___, causing ____ and the formation of blood clots
damage to the arteries
atherosclerosis
List 2 new markers that are under development
Fibrinogen
D-dimer
Other new markers
B natriuretic peptide (BNP) & N-terminal pro b-type natriuretic peptide (NT-ProBNP)
Hormone secreted by cardiac ventricles to stimulate urinary excretion of sodium
BNP and NT-ProBNP are increased in diseases characterized by what?
Expanded fluid volume not associated with necrosis
What illness is an example of when BNP and NT-ProBNP are elevated?
Congestive Heart Failure
The higher the level of BNP and NT-ProBNP, the _____ the prognosis
Poorer
x

Hi!
I'm Larry

Hi there, would you like to get such a paper? How about receiving a customized one?

Check it out