Cardiac

Question 1

Specificity of troponin

Answer 1

cTnI > cTnT (TnC not useful as a cardiac marker)

Question 2

Diagnosis of MI

Answer 2

Biochemical evidence + 1 clinical evidence (symptoms / ECG change / Echocardiogram / intracoronary thrombus)

Question 3

Classification of MI

Answer 3

Type 1: ACS
Type 2: causes other than ACS
Type 3: SCD before biomarkers measured
Type 4,5: Procedure related

Question 4

Kinetics of hsTn

Answer 4

onset of elevation: 30~60 mins
Peak: 24~48h
Normalisation: 5~14d

Question 5

DDx of elevation of troponin

Answer 5

Cardiac: Iatrogenic / trauma, myocarditis / pericarditis, CHF
Non-cardiac: PE, renal failure, spesis

(cTnT: myositis)

Question 6

Marker to distinguish HF from other causes of dyspnea

Answer 6

BNP / NT-proBNP

Question 7

DDx of elevated BNP

Answer 7

cardiac: HF, LVH, ACS, AF
non-cardiac: pulmonary PT, renal failure, cirrhosis, hyperaldosteronism, Cushing, sepsis

Question 8

Cardiac application of hsCRP

Answer 8

marker of atherosclerotic process

Question 9

Secondary causes of hyperlipidaemia

Answer 9

DM, hypothyroidism
nephrotic syndrome, cholestasis, alcohol…

Question 10

Score for cardiovascular risk (what is it calculating for?)

Answer 10

Framingham risk score
(10-year risk of developing CHD)

Question 11

What sample tube should be used for lipid profile?

Answer 11

Li heparin tube

Question 12

RR for TC, TG, HDL-C, LDL-C

Answer 12

<5, <1.7, >1, <3

Question 13

Formula for indirect LDL-C (name)

Answer 13

Friedewald formula:
LDL-C = TC - HDL-C - TG/2.2

Question 14

MC primary hyperlipidaemia (What are the genes (3)?)

Answer 14

Familial hypercholesterolemia (AD)

LDLR, apoB, PCSK9

Question 15

Diagnostic criteria for familial hypercholesterolaemia

Answer 15

DLCN (Dutch Lipid Clinic Network criteria)

Question 16

Gene for sitosterolaemia

Answer 16

ABCG5/8

Question 17

What is CHADS-VASc score?

Answer 17

To determine thromboembolic risk in AF patient

CHF, HT, Age (>75), DM, Stroke,
Vascular diseases, Age (65-74), Sex

Question 18

Which secondary cause(s) of hyperlipidaemia give rise to elevated TG only?

Answer 18

alcoholism, CKD

Question 19

Which secondary cause(s) of hyperlipidaemia give rise to elevated TC only?

Answer 19

hypothyroidism, cholestasis, nephrotic syndrome

Question 20

Which secondary cause(s) of hyperlipidaemia give rise to elevated TC and TG?

Answer 20

DM, nephrotic syndrome

Question 21

Why does nephrotic syndrome lead to hyperlipidaemia?

Answer 21

hypoproteinaemia –> ↑ synthesis of lipoprotein in liver to compensate

Question 22

Gene for autosomal recessive familial hypercholesterolaemia

Answer 22

LDLRAP1