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100
What are the three layers of the heart wall?
pericardium, myocardium, endocardium 
100
What marker is a predictor of CVD (Cardiovascular disease)?
High sensitivity C-reactive protein (hsCRP) 
100
What cardiac marker rises first? Is it specific or non-specific?
Myoglobin, NON-SPECIFIC 
100
What marker can predict CHF (congestive heart failure)?
BNP (Brain Natriuretic Peptide) 
100
What two filaments make a contraction?
Myosin and actin
200
What is the calculation for the CK index? What ranges/% are significant?
CKMB/CK *100 

>4%: CK from heart (MI)

<4%: CK from skeletal muscle 

200
What are some symptoms of an MI?
Sweating or cold clammy skin, dizziness, women:SOB, Pain in the chest that radiates out to arm, back, neck, stomach, or jaw
200
What are some risk factors for atherosclerosis? 
Elderly, men, diabetics, previous history of MI 
200
Which cardiac marker stays elevated the longest? Specific or not?
LDH, non-specific it is elevated in many tissues such liver, kidneys, lungs, and muscles 
200
What are some symptoms of CHF (chronic Heart failure)?
EDEMA, SOB, fatigue, lower extremity edema 
300
What is a common ECG pattern when a heart attack is occurring? Months later?
Now: ST elevation showing myocardial necrosis due to ischemia 

Months: Deep Q wave shows previous myocardial necrosis  

300
What color tube with what additive is used for CK testing?
light green, lithium or sodium heparin 
300
What are the three isoforms of Creatinine Kinase (CK)? What tissues do they monitor?
CK-BB: brain and smooth muscle

*CK-MB: Cardiac with very little skeletal muscle 

CK-MM: Muscles skeletal and cardiac 

300
What are the four types of Cardiovascular Disease (CVD) aka Acute coronary syndromes (ACS)
Coronary Heart Disease (CHD)

Cerebrovascular disease

Peripheral artery disease

Aortic atherosclerotic disease 

300
Which cardiac marker is most cardiac sensitive?
Troponin I
400
What are the RRs of...

Total CK

CK-MB

CK index

cTnI

Total: 38-120 ng/mL

CK-MB: < or equal to 5 ng/mL

CK index: <4%

cTnI: < or equal to 0.05 ng/mL

400
Where is BNP released from in the body? What tube is it drawn on? What does it correlate with? What is the RR of BNP?
Cardiac ventricles, purple top (Plasma), Severity of CHF, < 100 pg/mL
400
How many sets of cardiac markers are drawn on a patient who is suspected to be having a heart attack? How often are they drawn?

What is the turn around time for results from the lab?

At least three draws (one at presentation to facility, and then two more after that)

Drawn every 6-9 hours

<60 minutes from time patient is drawn 

400
What does homocysteine correlate with? What tube is it drawn on? Is it time sensitive? 
Correlates with atherosclerosis, vascular disease, and premature vascular disease

Drawn on a green top

Very time sensitive 

400
What are the stages of ACS (acute coronary syndrome)?
Stable angina (Pre-ACS)

Unstable angina

MI (Myocardial infarction)

Possible CHF (Post ACS) 

500
What are some other diseases that total CK is elevated in?
Stroke, pulmonary disease, chronic alcoholism, Strenuous exercise, muscular dystrophy, and end-stage renal disease
500
What types of drugs are used to treat MIs? Give an example.
Thrombolytics 

Ex: Streptokinase, Tissue Plasminogen Activator (TPA) 

500
A pearly white area within the wall of an artery that causes the interior surface to bulge into the lumen
Atheroma 
500
What is the preferred cardiac marker for reinfarction?
CK-MB
500
Why is myoglobin drawn in a purple top, what type of specimen is it?
It is whole blood so it does not need a 30 minute clot time before you can spin and run the test
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