Biochem Clinical
Terms
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- Cardiac Troponins
- Regulatory proteins found in skeletal and cardiac muscle, 3 subunits, Skeletal and cardiac forms distinct - makes it the "gold standard" among cardiac markers, last longer in bloodstream
- Creatinine
- Derived from metabolism of creatine in skeletal muscle and released into the circulation at a fairly constant rate, freely filtered, secreted in the proximal tubule*, clinically most often used measurement of GFR/renal function****, S. Creat and GFR vary inversely
- Myoglobin
- Only heme protein in cardiac myocytes, low molecular weight for early release in serum, non-specific for myocardial damage, rises 1-3 hours after infarction, rise over 1-2 hours strong suggestion of acute MI
- CK-MB
- highest in cardiac muscle, low in other muscles, if relative index is greater than 5%, highly suggestive of MI
- Infarction
- ST elevation, tested with myoglobin and troponin
- Renal Function Tests
- The measurement of renal function is important in the diagnosis and treatment of kidney disease, index of functioning renal mass and barometer/measurement of renal function
- Lipoprotein A
- Has been called the most important genetic factor associated with early atherosclerosis and coronary artery disease
- Pre Renal ARF
- Decreased circulating arterial volumes, Azotemia, States of relative hypo-perfusion and decreased effective circulating arterial volumes, volume depletion
- Intrinsic ARF
- Renal parenchymal (vascular, glomerular, and tubular)
- Ischemia
- ST depression, creates chest pain due to hypoxia, modified albumin (IMA) used to test for it
- Post Renal ARF
- Obstruction - tubules to urthera, solitary kidney function
- BUN
- Blood urea nitrogen, freely filtered, reabsorbed in proximal tubule*, not always good reflection of renal function/GFR
- CD40 ligand
- Transmembrane protein of the tumor necrosis factor family. Important contributor to inflammatory processes that lead to atherosclerosis and thrombosis. Elevation in healthy women has been shown to be associated with increased risk of cardiovascular events
- Creatine Kinase
- Not specific for MI: skeletal trauma, myositis, dystrophy, electrical-cardioversion, cardiac catheterization, hypothyroidism, convulsions
- Metabolic Syndrome
- Characterized by a group of metabolic risk factors in 1 person: abdominal obesity, atherogenic dyslipidemia, elevated BP, insulin resistance or glucose intolerance, prothrombotic state, proinflammatory state
- Lactate Dehydrogenase
- LDH - five isozymes, usually ratio of LD1 to LD2 is <0.7, flipped by cardiac dysfunction or MI
- BNP/proBNP
- Cardiac ventricles are major source of plasma brain natriuretic peptide. Synthesized as prohormone and cleaved into 2 fragments - a biologically active fragment and an inactive fragment
- Homocysteine
- AA produced by breakdown of dietary protein in the liver. High levels can lead to increased thickness of carotid artery wall and plaque formation. Reduced by increasing folic acid and vitamin B6
- GFR
- Glomerular filtration rate - allows measurement of renal functions, equal to sum of all filtration rates of the nephrons
- D-Dimer
- Final product of cross-linked fibrin degradation. Reliable marker of pathologic coagulation. Elevated levels in blood indicates increased risk of MI