Cardiac Markers

Question 1

Ideal _______________ involves intact muscle cells, and adequate blood and oxygen supply.

Answer 1

Homeostasis

Question 2

True or false: ischaemia is reversible.

Answer 2

True

Question 3

Infarction is ______ ________, after prolonged ischaemia.

Answer 3

Cell death

Question 4

__________ is the result of blockage of the blood vessels supplying oxygen to the myocardial cells.

Answer 4

Ischaemia

Question 5

CAD’s major cause is atherosclerosis, which causes _______ formation within large- and medium-sized arteries.

Answer 5

Plaque

Question 6

Plaque is a pearly white area within an artery, which internally is made of lipid, cell debris, smooth muscle cells, collagen, and calcium, covered with a __________ ____.

Answer 6

Fibrous cap

Question 7

Arterial blood flow is reduced across plaque, leading to narrow ________.

Answer 7

Lumen

Question 8

________ ______________ ____________ is associated with heart pain, and death of heart tissue.

Answer 8

Acute myocardial infarction

Question 9

______ ___________ of the myocardium, may result during AMI, as a result of interruption to the blood supply.

Answer 9

Gross necrosis

Question 10

List the three principal characteristics of AMI.

Answer 10

Crushing chest pain
ECG changes
Cardiac muscle enzyme/markers will be released

Question 11

What elements are used to diagnose AMI?

Answer 11

History, clinical and presentation, changes to ECG (although differences may not be immediately noticeable), and evaluation of cardiac markers

Question 12

__________ are regulatory proteins, found in contractile proteins of myofibrils.

Answer 12

Troponins

Question 13

Where is troponin C found?

Answer 13

Heart and skeletal muscle

Question 14

Why is troponin C not useful as a cardiac marker?

Answer 14

The heart isoform is identical to slow twitch muscle

Question 15

Why is troponin I useful as a cardiac marker?

Answer 15

Unique cardiac specificity, as it has only one isoform

Question 16

___________ __ has eleven unique amino acids, lending specific markedness to the protein.

Answer 16

Troponin T

Question 17

When is troponin T released into circulation?

Answer 17

After injury to the heart

Question 18

How many main isoforms of troponin T are known?

Answer 18

Two

Question 19

______________ is an oxygen-binding protein of cardiac and skeletal muscle.

Answer 19

Myoglobin

Question 20

True or false: myoglobin is found in the cytoplasm, and increases rapidly after a cardiac event.

Answer 20

True

Question 21

___________ ________ catalyses the formation phosphocreatine from creatine and ATP.

Answer 21

Creatinine kinase

Question 22

The ________ form of creatinine kinase is a dimer made of two subunits, M (muscle) and B (brain).

Answer 22

Cytosolic

Question 23

CKBB, CKMB, and CKMM forms of creatinine kinase exist, with the ____________ CK1, CK2, and CK3, respectively.

Answer 23

Isoenzymes

Question 24

_______________ creatinine kinase has two isoenzymes.

Answer 24

Mitochondrial

Question 25

_________ is prominent in both skeletal and cardiac muscle.

Answer 25

CKMM

Question 26

___________ ______________ is an isoenzyme that catalyses the reduction of pyruvate to (L)-lactate, using NADH as an electron donor.

Answer 26

Lactate dehydrogenase

Question 27

Highest activity of lactate dehydrogenase is observed in __________ ________, liver, heart, kidney, and RBC.

Answer 27

Skeletal muscle

Question 28

List the five isoenzymes of lactate dehydrogenase.

Answer 28

LD1 (H4) (heart, kidney, and RBC) LD2 (H3M) LD3 (H2M2) LD4 (HM3) LD5 (M4) (skeletal muscle and liver)

Question 29

Most methods of measuring troponin I employ __________ ___________.

Answer 29

Monoclonal antibodies

Question 30

Assay times for troponin I vary from ______ to thirty minutes.

Answer 30

Seven

Question 31

Quantitative assays for ___________ ___ include immunoassays for serum/plasma, with antibodies and reagents; there is no cross-reactivity with skeletal muscle isoforms.

Answer 31

Troponin T

Question 32

Use of monoclonal antibody tests for ___________ can be an early marker.

Answer 32

Myoglobin

Question 33

List two methods of measuring creatinine kinase.

Answer 33

Electrophoresis and immunoassays

Question 34

List three qualities of an ideal marker.

Answer 34

Facilitates early AMI diagnosis Assists in risk stratification Monitors treatment

Question 35

CK and CKMB elevate _________ after an event.

Answer 35

Swiftly

Question 36

__________ is both released and cleared quickly, and is not used in diagnosis, as it has <80% clinical specificity.

Answer 36

Myoglobin

Question 37

Troponins T and I stay elevated, and have cardiac ____________.

Answer 37

Specificity

Question 38

Why are troponins not useful in relapse detection?

Answer 38

Values stay elevated for days after the event

Question 39

List the criteria for AMI.

Answer 39

Evidence of ischaemia A rise, or a fall, of troponin At least one troponin reading that is greater than, or equal to, the 99th percentile

Question 40

True or false: stable angina is irreversible.

Answer 40

False

Question 41

__________ angina arises when the fibrous cap ruptures.

Answer 41

Unstable

Question 42

True or false: high cholesterol, hypertension, and a sedentary lifestyle increase the odds of a cardiac event.

Answer 42

True

Question 43

____________ levels of homocysteine indicate risk to future events.

Answer 43

Increased

Question 44

_____ indicates presence of inflammation, but also increased in people at risk for future cardiovascular events.

Answer 44

CRP

Question 45

What are natriuretic peptides?

Answer 45

Series of ring-shaped molecules that promote an increased loss of sodium and water

Question 46

___-________ natriuretic peptides are produced by both the atria and the ventricles .

Answer 46

B-type