Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Chem path > chem 6 > Flashcards

chem 6 Flashcards

(46 cards)

Start Studying
1
Q

What are the leading causes of mortality in developed countries?

A

Cardiovascular diseases

Cardiovascular diseases account for approximately 50% of all deaths in modern western societies.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the incidence of cardiovascular diseases related to age?

A

Increases with advancing age (>60 years)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the criteria for the diagnosis of Acute Cardiac Ischaemia?

A
  • History of chest pain
  • ECG changes (typically ST segment elevation)
  • A rise in biochemical markers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which biochemical markers were established by the 1970s?

A
  • AST
  • CK and CK-MB
  • LD-1 (heart specific)
  • Myoglobin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the recent applications of biomarkers in cardiovascular disease?

A
  • Acute Coronary Syndrome (ACS)
  • Acute Heart Failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the definition of biomarkers?

A

Cellular, biochemical or molecular alterations evaluated as indicators of biological, pathological, or pharmacological processes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are cardiac biomarkers?

A

Protein molecules released into the bloodstream from damaged heart muscles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What characteristics define an ideal cardiac biomarker of myocardial infarction (MI)?

A
  • Abundant in myocytes and low in blood
  • Rapid release into blood at myocardial injury
  • Direct relationship with extent of myocardial injury
  • Persistent enough for diagnosis
  • Easy, inexpensive, and rapid measurement
  • Heart-specific and sensitive
  • Differentiate irreversible damage from reversible
  • Detect re-occlusion and reinfarction
  • Monitor reperfusion therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the functions of cardiac biomarkers?

A
  • Risk stratification
  • Detection of reinfarction
  • Diagnosis
  • Prognosis
  • Monitoring of response to therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is required for the diagnosis of myocardial infarction (MI)?

A

Combination of at least two of three characteristics: typical symptoms, rise in biochemical marker levels, typical ECG pattern.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the significance of serial sampling for cardiac markers?

A

Recommended upon presentation, at 6-9 hours, and again at 12-24 hours if earlier samples were negative.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When does Creatine Kinase (total) start to rise after an MI?

A

4-6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the duration of rise for Lactate Dehydrogenase (LDH) after an MI?

A

7-12 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the first cardiac marker identified?

A

Aspartate aminotransferase (AST)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the clinical utility of Lactate Dehydrogenase (LDH)?

A

Sensitive marker of myocardial infarction, remains elevated for up to two weeks post-MI.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When is myoglobin detectable in blood after the onset of symptoms?

A

1 to 2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the significance of Creatine Kinase (CK)/ CK-MB in MI diagnosis?

A

Should be used with more sensitive biomarkers like cardiac troponins for accurate diagnosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the subunits of Troponin?

A
  • TnC
  • TnT
  • TnI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How long can Troponin levels remain elevated after myocardial injury?

Study These Flashcards
A

Up to 10 days

20
Q

Which conditions are associated with cardiac troponin elevation?

Study These Flashcards
A
  • Arrhythmias
  • Congestive heart failure
  • Coronary vasospasm
  • Systemic and pulmonary hypertension
  • Myocarditis and Pericarditis
  • Pulmonary embolism
  • Renal failure
  • Sepsis/septic shock
  • Hypothyroidism
21
Q

What are the biomarkers of myocardial ischemia?

Study These Flashcards
A
  • Ischemia-modified albumin (IMA)
  • Glycogen phosphorylase enzyme BB (GPBB)
  • Free fatty acids
  • Fatty acid binding proteins
  • Phospholipase enzymes (A–D)
  • Lipoprotein associated phospholipase A2
22
Q

What is Ischemia Modified Albumin (IMA)?

Study These Flashcards
A

A novel marker produced when serum albumin contacts ischemic heart tissues.

23
Q

What are the natriuretic peptides (NP) responsible for?

Study These Flashcards
A

Salt and water homeostasis and blood pressure regulation.

24
Q

What is the primary function of ANP?

Study These Flashcards
A

Released in response to atrial wall stretching and intravascular volume expansion.

25
What is the source of the majority of circulating BNP?
Ventricles
26
What conditions can elevate natriuretic peptide levels?
* Heart failure * Acute coronary syndrome * Other cardiac and noncardiac conditions
27
What is aldosterone secretion associated with?
Renal-tubule sodium reabsorption and vascular-cell growth ## Footnote Aldosterone plays a critical role in regulating blood pressure and fluid balance
28
What are Brain Natriuretic Peptides (BNP) originally isolated from?
Porcine brain ## Footnote BNP is now also discovered in the human heart
29
In which conditions are circulating levels of BNP raised?
Cardiovascular or renal disease ## Footnote BNP is more important than ANP in heart failure
30
What is the primary source of circulating BNP?
The ventricles ## Footnote The ventricles are thought to contribute the greatest proportion of BNP
31
List some causes for elevated natriuretic peptide levels.
* Heart failure, including RV syndromes * Acute coronary syndrome * Heart muscle disease, including LVH * Valvular heart disease * Pericardial disease * Atrial fibrillation * Myocarditis * Cardiac surgery * Cardioversion * Restrictive cardiomyopathy * Advancing age * Anemia * Renal failure * Pulmonary causes: obstructive sleep apnea, severe pneumonia, pulmonary hypertension * Critical illness * Bacterial sepsis * Severe burns * Toxic-metabolic insults, including cancer chemotherapy and envenomation ## Footnote These conditions can lead to an increase in natriuretic peptide levels
32
What are some causes of low BNP even in heart failure?
* Obesity * Pulmonary edema * Mitral valve disease ## Footnote Low BNP levels can occur despite the presence of heart failure due to these factors
33
What is C-reactive protein (CRP)?
An acute-phase protein produced by the liver ## Footnote CRP is a marker of inflammation and cardiovascular risk
34
What is the structure of CRP?
Pentameric structure consisting of five 23-kDa identical subunits ## Footnote This structure is significant for its function as a biomarker
35
How is CRP implicated in atherogenesis?
* Activates the classical complement pathway * Stimulates phagocytosis * Binds to immunoglobulin receptors * Causes endothelial dysfunction via increased NO synthesis * Promotes LDL deposition in plaque by CRP-stimulated macrophages ## Footnote These mechanisms contribute to cardiovascular disease
36
What are the limitations of using CRP as a cardiovascular risk marker?
* Low specificity * No evidence that lowering CRP levels decreases cardiovascular risk ## Footnote These limitations affect the clinical utility of CRP levels
37
What is myeloperoxidase?
An enzyme that aids white blood cells in destroying bacteria and viral particles ## Footnote It plays a role in immune response and inflammation
38
What does myeloperoxidase lead to?
* Oxidized LDL cholesterol * Consumption of nitric oxide * Vasoconstriction * Endothelial dysfunction ## Footnote These effects are part of the inflammatory response
39
What is homocysteine?
An intermediary amino acid formed by the conversion of methionine to cysteine ## Footnote Elevated levels are associated with vascular disease
40
What are recognized causes of elevated homocysteine levels?
* Genetic defects * Drugs * Vitamin deficiencies ## Footnote These factors can contribute to increased homocysteine levels
41
What are some effects of homocysteine on vascular health?
* Intimal thickening * Disruption of elastic lamina * Smooth muscle hypertrophy * Platelet aggregation * Vascular injury induced by leukocyte recruitment and foam cell formation ## Footnote These effects highlight the risk homocysteine poses to vascular integrity
42
What is the normal level of homocysteine?
Less than 6 micro mol/l ## Footnote Levels above this threshold are considered elevated
43
What treatments are available for elevated homocysteine levels?
* Supplementation with folate * B6 * B12 ## Footnote These vitamins can help lower homocysteine levels
44
What are some future protein biomarkers?
* Serum Amyloid Protein A * sCD40 Ligand * Pregnancy-Associated plasma Protein A * Placenta Growth Factor * Monocyte Chemotactic Protein * Tissue Plasminogen Activator Antigen (t-PA) * Plasminogen Activator Inhibitor * Secreted Platelet Granular Substance * Isoprostanes * Urinary Thromboxane ## Footnote These biomarkers are being researched for their potential in diagnosis and prognosis
45
Is there a single ideal marker for acute coronary syndrome (ACS)?
No ## Footnote Complicated diseases like ACS require multiple markers for accurate diagnosis
46
What can multi-marker panels aid in?
Differential diagnosis ## Footnote Using multiple markers increases diagnostic accuracy

Chem path (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions