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Adv. Clinical Chem.

Exam 1 - Cardiac Enzymes

QuestionAnswer
What kind of specimen is required for cardiac enzyme analysis? Serum or heparinized plasma lacking hemolysis
If testing cannot be performed immediately how must the specimen be stored? At 4 deg C in the dark (for up to 7 days)
What are the major sources of CK in the body? Skeletal muscle, myocardium, brain.
What do increased levels of CK indicate? Tissue damage such as AMI, autoimmune muscle disease, or that an athletic workout has occurred.
If the total CK is greater than _____ U/L an isoenzyme assay is indicated. Greater than 215 U/L.
If the total CK is greater than _____ U/L a dilution will be required. Greater than 400 U/L.
CK1 (CKBB) is associated with which tissue/ organ? Brain
CK2 (CKMB) is associated with which tissue/ organ? Myocardium
CK3 (CKMM) is associated with which tissue/ organ? Muscle
The forward reaction of the CK enzyme assay is done at which pH? pH 6.8
The reverse reaction of the CK enzyme assay is done at which pH? pH 9.0
Normal serum contains what percentage of CKMB? 3-6%
CKMM will be elevated after: Muscle trauma, muscular dystrophy, Reye's syndroms, hypothyroidism.
CKBB can be elevated after: Normal child birth, tumors, shock syndrome.
CKMB is elevated after: Myocardial injury, brain injury, carbon monoxide poisoning
Which cardiac protein/ enzyme is first to rise after AMI? Myoglobin
What is the purpose of the CKMB relative index (RI)? It relates CKMB mass to CK activity.
Is a CKMB mass of less than 10ng/ mL useful in the determination of CKMB RI? NO, CKMB hass to be greater than 10 ng/mL.
Is a normal (within reference range) total CK useful in the determination of CKMB RI? NO
List some factors that can affect interpretation of CK isoenzyme results. Exercise, age, gender, supplement use.
What are the major sources of LD in the body? Kidney, liver, heart
List some conditions that will have elevated levels of LD. AMI, hemolysis, cirrhosis, hepatits, muscular dystrophy, pernicious anemia, malignancy.
What level does total LD have to be at to indicate isoenzyme evaluation? Greater than 180 U/L
Is CK a tetramer or a dimer? Dimer
Is LD a tetramer or a dimer? Tetramer
In the heart, LD1 is greater than/ less than LD2? (Select one) GREATER THAN
In the skeletal muscle, LD1 is greater than/ less than LD2? LESS THAN
Serum levels of LD1 > LD2 indicate what? What is this called? Myocardial injury LD1/LD2 Flip
CKMb rises how many hours after AMI? 6-8 hrs
LD1 rises how many hours following chest pains? Peaks? Returns back to baseline? 8-12 hrs Peak: 24- 48 hrs Returns: 7- 12 days
How many hours after AMI will AST rise? 6- 8 hrs
What is AST formerly known as? SGOT
List the major sources of AST in the body. ALL body tissues, especially heart, liver skeletal muscle
True or false: AST levels can be used alone to diagnose AMI? FALSE
List some conditions that will elevate AST levels. AMI, kidney damage, jaundice, metastasis, peripheral muscle disease, crush injury, muscular dystrophy, ingestion of aspirin, codeine, cortisone, shock, circulatory collapse, liver damage.
For the first 48 hours of hospital stay for AMI, cardiac enzymes should be drawn how often. Every 8- 12 hrs.
True or false: If a sample was collected within 48 hours of chest pain and CKMB is ABSENT, the person is definitely not having an AMI. TRUE
True or false: If a sample was collected within 48 hours of chest pain and CKMB is present with LD1/ LD2 levels normal, it most definitely is not an AMI. FALSE. Seen in both AMI and non- AMI.
True or false: If a sample was collected within 48 hours of chest pain and the LD1/ LD2 flip is present, it is not a heart attack. FALSE.
How soon following AMI will myoglobin be released? When is the peak? When will it return baseline? 2- 4 hrs. Peak: 8- 12 hrs Back to baseline: 18- 24 hrs
What is the half life of myoglobin? 10 min.
List some causes of myoglobinemia. Angina without infarction, muscle trauma, renal failure, open heart surgery, myopathies, IM injection, electric shock, vigorous exercise.
Which component of the troponin complex is more specific than CKMB for AMI? Troponin I
Troponin I rises within how many hours of chest pain? Peaks? Rises within 4-8 hours. Peaks: 12- 16 hours
True or false: The magnitude of troponin I indicates the size of the infarction. TRUE
What protein/ enzyme can be used for a marker of artherosclerosis? CRP
What level of CRP indicated a low risk of artherosclerosis? < 1 mg/ L
What level of CRP indicates an intermediate risk for artherosclerosis? 1- 3 mg/L
What level of CRP indicates a high risk for arthersclerosis? Greater than 3 mg/ L
What is the main source of brain natriuretic peptide (BNP) in the body? Heart ventricles
Elevated BNP indicates what conditions? Congestive heart failure or hypertension
What are some risk factors for coronary heart disease? cigarettes, increased blood pressure, diabetes, dyslipidemia, initiating factor of injury or inflammation
List 2 disease conditions that can affect serum cholesterol. Hypothyroidism Nephrotic syndrome
Created by: UTHSCSA-CLS