cardiac function

Question 1

CAD

Answer 1

coronary artery disease

Question 2

CHF

Answer 2

congestive heart failure

Question 3

CVD

Answer 3

cardiovascular disease

Question 4

ACS

Answer 4

acute coronary heart disease/ acute heart syndrome

Question 5

CHD

Answer 5

coronary heart disease
- angina pectoris
- myocardial infarction
- heart failure
-> largely due to atherosclerosis

Question 6

cerebrovascular disease

Answer 6

• blood supply cut off from brain
• stroke or transient ischemic attack

Question 7

peripheral arterial disease (PAD)

Answer 7

• blockage in arteries to extremities
• includes DVT (deep vein)

Question 8

atherosclerosis

Answer 8

chronic inflammatory disease from accumulation of lipid material in veins and arteries causing narrowing and hardening

Question 9

ischemia

Answer 9

lack of blood supply

Question 10

conclusion of atherosclerosis without treatment

Answer 10

vessel occlusion
thrombosis
plaque rupture or combo

Question 11

most common locations of atherosclerosis

Answer 11

• proximal left anterior descending
• proximal left main coronary
• entier right coronary arteries

Question 12

evaluation of chest pain

Answer 12

• physical - causes
• EKG - ST segment for MI (stemmy)
• chest Xray - non cardiac source

Question 13

principle behind serum biomarkers for cardiac damage

Answer 13

cell death releases intracellular proteins from myocardium into circulation

Question 14

describe CK

Answer 14

• creatine kinase: found in nearly all cells
• peak levels at 24 hours
• return to normal in 3 days
• plasma levels >2x normal = MI

Question 15

describe CKMB

Answer 15

heart specific
- ordered with total CK to compare levels

Question 16

list the 3 cardiac troponins

Answer 16

• troponin T - binds tropomyosin
• troponin I - inhibits binding of actin and myosin
• Troponin C - binds calcium

Question 17

which troponin(s) have specific isoforms for cardiac evaluation

Answer 17

cTnI and cTnT - fast and slow twitch

Question 18

how are cardiac troponins detected

Answer 18

monoclonal antibodies with specificity for cardiac isotopes

Question 19

describe changes in troponin levels

Answer 19

increase after 3-12 hours, peak in 24 and remain elevated for more than a week
- rise and fall indicate acute myocardial injury

Question 20

describe hs-cTn

Answer 20

low concentrations of troponin detected

Question 21

dialysis patient’s relation to TnT

Answer 21

elevated cTnT associated with increased mortality

Question 22

effects of Hemodialysis on troponin

Answer 22

dialysis alters concentrations of enzymes and will vary due to dialysis

Question 23

describe myoglobin indicator

Answer 23

• released in muscle damage
• short half life
• an additional marker for damage
• nonspecific

Question 24

describe differences in apoptosis and necrosis

Answer 24

apoptosis requires energy
necrosis occurs when energy supply fails

Question 25

list common insults that result in cardiac injury and elevated cardiac biomarkers

Answer 25

- trauma to heart - sepsis - myocarditis (virus) - heart failure - myocardial infarction (ischemia) - wall stress

Question 26

describe heart failure

Answer 26

heart fails to supply metabolic neds of the body -> decrease in pumping action

Question 27

biomarkers for heart failure

Answer 27

- BNP - NT-proBNP -> distinguish cardiac from non-cardiac

Question 28

when are BNP and NT-proBNP released

Answer 28

from heart in response to increased pressure and volume load - goal to reduce intravascular volume

Question 29

cardiac troponins use in heart failure cases

Answer 29

- diagnosis for mycoardial injury by ischemia not heart failure

Question 30

markers of inflammation in plaque risk

Answer 30

- myeloperoxidase (neutrophils in blood system): used in ACS and CAD - CRP inflamation and hs prognostic for atherosclerosis

Question 31

inflammatory marker of choice for cardiac heart disease risk

Answer 31

hs-CRP

Question 32

homocysteine

Answer 32

- 4 forms - linked to vascular disease

Question 33

embolus

Answer 33

circulating mass of solid, liquid, or gas

Question 34

pulmonary embolus

Answer 34

embolus lodged within pulmonar arteries

Question 35

D Dimer

Answer 35

- cross linked fibrin - indicates current or recent coagulation and fibrinolysis

Question 36

use of D dimer

Answer 36

levels abnormal in most pulmonary embolism (PE) - rule out measrument

Question 37

value of troponin assay in acute PE

Answer 37

prognostic value

Question 38

value of BNP assay in acute PE

Answer 38

elevated elvels associated with increase in short term mortality

Question 39

what biomarkers are used to diagnose ACS and acute MI

Answer 39

- Ck MB - myoglobin - TnI, TnT - hs-Tn

Question 40

what biomarkers are used to differentiate heart fialure from lung disease

Answer 40

- BNP - Nt-proBNP

Question 41

what biomarkers are used to diagnose PE / risk stratification

Answer 41

- TnI, TnT - BNP - NT-proBNP - D Dimer

Question 42

what biomarkers are used for cardiovascular risk stratification

Answer 42

- TnI, TnT - hs-CRP - homocysteine

Question 43

lipoprotein A

Answer 43

predicts premature cardiovascular disease