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PATH: Cardiac Marker
basics
| Question | Answer |
|---|---|
| why was LDH isoenzyme 1 used? | it was around at day 7 unlike CK and could be measured |
| how long do troponin I and T stick around | they stay around for just as long if not longer than LDH |
| creatine kinase is composed of? | M and B subunits |
| what CK is in the brain | CK-BB |
| CK in the Heart | CK-MB and CK-MM |
| CK in the skeletal muscle | CK-MM |
| CK in tumors | CK-BB |
| CK in smooth muscle | CK-BB |
| how can you tell if there is muscular dystrophy | CK-MB and MM elevated |
| Trauma would affect CK ? | MB (less than 1-2% total) and MM elevated |
| what effect on CK would hypothyroid have | increased MM |
| what affect on CK would stroke have | increased MM |
| What effect on CK would psychosis have | increased MM |
| how is cardiac muscle distributed with regards to CK | 80% MB 20% MM |
| when you have an MI what percent of total CK is CKMB | more than 3% |
| Labor in the uterus would produce what effect on CK | elevated BB |
| intestinal trauma would produce what CK | elevated BB |
| Shock would increase CK ? | elevated BB and MB |
| when would CK MB not be elevated | most cardiac conditions, pulmonary emboli, intramuscular injection |
| how long after an MI is CK-MB elevated | 2-8 hours after MI Peaks at 36 hours and is normal 2-3 days after that |
| what are troponins | 3 regulatory proteins bound to contractile apparatuses of striated muscle |
| what troponins are cardiac markers | TnI and TnT |
| what troponin is also made in the heart but is not specific | TnC |
| where else is TnC found | in skeletal muscle (slow twitch) |
| what other conditions could make CK-MB less specific | renal failure, skeletal trauma or disease |
| how does the timing of troponins compare with CK and LDH | same speed as CK and same durations as LDH-1 |
| how does troponin last so long | continuous release not delayed clearance |
| how high in magnitude does Troponin elevate compared to CK | same magnitude but much greater fold increase as troponin unlike CK does not have other factors elevating its baseline |
| how likely is somone with incresaed troponin but no increase in EKG or CKMB to have an immenint event | high liklihood |
| how specific are TnI and TnT for MI | not at all only specific for myocardial damage you need a history |
| what are the three kinds of natriuretic peptide | A, B, C |
| how do natriuretic peptides change with chronic heart failure | increase |
| where are natriuretic peptides synthesized | in the atria and ventricles |
| ANP is released from the ? | atria when there is distension |
| BNP is relesed from the? | brain and ventricles when there is ventricular overload |
| CNP is released from? | brain and CNS when there is endothelial stress |
| Which natriuretic peptide corresponds with other tests diagnosing the severity of a heart conditino | BNP |
| what is BNP used for | to monitor CHF therapy, diagnose heart failure, and determine prognosis with acute coronary symptoms |
Created by:
jmuame03
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