Cardiovascular Lab Tests

Question 1

Enzymes with Suspected MI

Answer 1

• creatine phosphokinase
• lactate dehydrogenase
• aspartate aminotransferase

Question 2

Isoenzymes

Answer 2

• subtypes of broken down enxymes

- ex. CK-MB, LDH1

Question 3

5 LDH Isoenzymes

Answer 3

-LDH1-LDH5

Question 4

Cardiac Markers

Answer 4

• enzymes

- Mm proteins

Question 5

Enzymes

Answer 5

• 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

Question 6

Muscle Proteins

Answer 6

• Troponin

- Myoglobin

Question 7

3 CK Isoenzymes

Answer 7

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

Question 8

Hb Normal Values

Answer 8

• male: 14-18 g/dL

- female: 13-16 g/dL

Question 9

Ballpark CK Value Interpretation

Answer 9

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

Question 10

Myoglobin

Answer 10

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

Question 11

CK-MB Mass

Answer 11

• measures protein concentration of CK-MB

- Elevates sooner than CK or CK-MB

Question 12

Blood Analysis

Answer 12

• Hb
• Hct
• Leukocytes
• Platelets

Question 13

Hct

Answer 13

-% of volume of blood that consists of RBC

the rest is plasma

Question 14

Clotting Measurements

Answer 14

• PT
• PTT
• INR

Question 15

INR

Answer 15

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

-Increased #=slower to clot

Question 16

Significance of increased Hb

Answer 16

-increased blood viscosity

Question 17

<5,000 platelets

Answer 17

bed rest

Question 18

5,000-20,000 platelets

Answer 18

• AROM
• walk in room
• light activities/ADLs

Question 19

20,000-50,000 platelets

Answer 19

• light resistance
• walking as tolerated
• bike

Question 20

50,000-150,000 platelets

Answer 20

• moderate resistance training
• walking as tolerated
• stationary bike

Question 21

150,000-450,000 platelets

Answer 21

-normal activity

Question 22

Significance of decreased Hb levels

Answer 22

• 8-10g/dL=fatigue & tachycardia

- s contraindicated

Question 23

Platelet Normal Value

Answer 23

-150,000-450,000 cells/microliter

Question 24

Hct Normal Values

Answer 24

• male: 42-52%

- female: 37-48%

Question 25

Normal Leukocyte Levels

Answer 25

43,000-10,800 cells/microliter

Question 26

Increased Hb levels due to:

Answer 26

- polycythemia | - dehydration

Question 27

Decreased Hb levels due to:

Answer 27

- anemia - iron insufficiency - fluid overload (dilution)

Question 28

AST

Answer 28

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

Question 29

CK-MB

Answer 29

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

Question 30

CK

Answer 30

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

Question 31

Troponin

Answer 31

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

Question 32

LDH1

Answer 32

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

Question 33

LDH

Answer 33

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

Question 34

PTT

Answer 34

- assess intrinsic coagulation pathway - HEPARIN therapy monitored with PTT - normal: 30-40 sec -(on heparin=1.5-2.5x normal)

Question 35

PT

Answer 35

- measures extrinsic coaculation pathway - Warfarin (Coumadin) monitored with PT - Normal range: 11-12.5 sec -(on Wararin=1.5-2.5x normal)

Question 36

Decreased Leukocyte Levels

Answer 36

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

Question 37

decreased platelet levels

Answer 37

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

Question 38

increased platelets

Answer 38

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

Question 39

Increased Leukocyte levels

Answer 39

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