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Clin Path Quiz 10/11
Lecture 11: Muscle DIsease/Injury
Question | Answer |
---|---|
skeletal muscle | voluntary, striated muscle that moves the bones of the skeleton |
cardiac muscle | involuntary, striated muscle |
smooth muscle | involuntary, nonstriated muscle, found in the GI tract |
types of diseases detected | trauma, exertion, degenerative myopathies, inflammation, nutritional myopathies, ischemic myopathies, metabolic myopathies |
myopathies | diseases of the muscle; white muscle disease, saddle thrombus, exertional rhabdomyolysis |
muscle disease/damage | monitor leakage of enzymes that originate from increased activity in the muscle, increase of enzymes is related to the number of myocytes injured, NOT the severity of the injury |
creatine kinase (CK) | cellular enzyme in muscle cells, drives the reaction that leads to energy storage in muscle, can be used to check for brain damage; major enzyme that indicates muscle damage when found in blood |
increases in CK | very SPECIFIC and SENSITIVE for skeletal and muscle damage, dramatic increases >20x reference interval |
creatine kinase sample | serum is preferred for some reference labs; false elevation could be due to hemolysis, needs to be evaluated quickly b/c it is not very stable |
causes of CK increase | muscle cell damage via IM injections, extreme exercise, persistent recumbency, myopathies, electric shock, hypothermia |
aspartate aminotransferase (AST) | found in most tissues, especially hepatocytes, skeletal muscle and cardiac muscle, erythrocytes |
increase in AST AND CK | most consistent wtih myopathy |
AST increase WITHOUT CK | more suspicious activity |
lactate dehydrogenase (LDH) | found in many tissues (skeletal and cardiac muscles, liver, kidney, erythrocytes); little clinical use for total LDH (not very specific) |
LDH increase | does NOT rule in any one disorder or organ that is damaged |