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Flashcards in Cardiovascular Lab Tests Deck (39):
1

Enzymes with Suspected MI

-creatine phosphokinase
-lactate dehydrogenase
-aspartate aminotransferase

2

Isoenzymes

-subtypes of broken down enxymes
-ex. CK-MB, LDH1

3

5 LDH Isoenzymes

-LDH1-LDH5

4

Cardiac Markers

-enzymes
-Mm proteins

5

Enzymes

-some are organ specific & get released with organ is damaged
-blood serum analyzed to detect presence of increased enzyme levels

-determine amount & time of damage

6

Muscle Proteins

-Troponin
-Myoglobin

7

3 CK Isoenzymes

-CK-MB (heart)
-CK-MM (muscle)
-CK-BB (brain)

8

Hb Normal Values

-male: 14-18 g/dL
-female: 13-16 g/dL

9

Ballpark CK Value Interpretation

5-75 Normal
200-400 Small MI
400-800 Med MI
>800 Large MI
>2000 very large MI

10

Myoglobin

-O2 binding heme protein
-found in cytosol of striated Mm
-Upper limit of reference interval: 70 microgram/L

11

CK-MB Mass

-measures protein concentration of CK-MB
-Elevates sooner than CK or CK-MB

12

Blood Analysis

-Hb
-Hct
-Leukocytes
-Platelets

13

Hct

-% of volume of blood that consists of RBC
(the rest is plasma)

14

Clotting Measurements

-PT
-PTT
-INR

15

INR

-method to standardize between labs
-normal: 0.9-1.1
-therapeutic: 1.5-2.5

-Increased #=slower to clot

16

Significance of increased Hb

-increased blood viscosity

17

<5,000 platelets

bed rest

18

5,000-20,000 platelets

-AROM
-walk in room
-light activities/ADLs

19

20,000-50,000 platelets

-light resistance
-walking as tolerated
-bike

20

50,000-150,000 platelets

-moderate resistance training
-walking as tolerated
-stationary bike

21

150,000-450,000 platelets

-normal activity

22

Significance of decreased Hb levels

-8-10g/dL=fatigue & tachycardia
-s contraindicated

23

Platelet Normal Value

-150,000-450,000 cells/microliter

24

Hct Normal Values

-male: 42-52%
-female: 37-48%

25

Normal Leukocyte Levels

43,000-10,800 cells/microliter

26

Increased Hb levels due to:

-polycythemia
-dehydration

27

Decreased Hb levels due to:

-anemia
-iron insufficiency
-fluid overload (dilution)

28

AST

-(SGOT)
-increase 12 hours after MI
-peak at 24 hours
-return to normal in 4 days

29

CK-MB

-isoenzyme of heart
-4-8 hours after MI
-peak: 12-24 hours
-return to normal 2-3 days

30

CK

-rises 1st, rapidly after MI
-rises: 3-4 hours
-peak: 33 hours
-return: 3 days

31

Troponin

-normal values are low
-rise: 4-6 hours
-peak: 10-24 hours
-return: 1 week

32

LDH1

-prominent in heart
-rise: 8-24 hours
-peak: 72-144 hours
-return: 14 days

33

LDH

-rise: 12-24 hours
-peak: 72 hours
-return: 5-14 days

34

PTT

-assess intrinsic coagulation pathway
-HEPARIN therapy monitored with PTT
-normal: 30-40 sec

-(on heparin=1.5-2.5x normal)

35

PT

-measures extrinsic coaculation pathway
-Warfarin (Coumadin) monitored with PT
-Normal range: 11-12.5 sec

-(on Wararin=1.5-2.5x normal)

36

Decreased Leukocyte Levels

-due to: viral infections, immunocompromised status
-result in pt being isolated
-ex's not contraindicated, but follow guidelines

37

decreased platelet levels

-due to: leukemia, lymphomas, aplastic anemia, etc
-results in spontaneous bleeding

38

increased platelets

-due to: leukemia, cancer, primary thrombocytosis, post splenectomy
-ex's not contraindicated unless blood flow to organs compromised

39

Increased Leukocyte levels

-due to: bacterial/parasitic infections allergic reactions, leukemia