Where does CK come from? and what do elevations in CK mean?
Elevations - IM/IV injections or muscular activity
Men - 60-400
Women - 40-150
List where CK 1,2,&3 are found.
1. BB Brain tissue and smooth muscle
2. MB Heart tissue
3.MM Muscle tissue
How log does it take for enzymes to leave the bloodstream?
Ratio of CK MB to total CK.
When is the probability of an MI when looking at CK index?
CK-MB is > 5 and CK index is >4 = MI
What is the first enzyme to elevate after an MI?
CK - MB
Begins to rise in 3-6 hrs
peaks in the first 24 hrs.
Normal CK - MB
Normal CK index
Enzyme that helps remove a water molecule from lactic acid.
Found in large amounts in the heart, liver, muscles and erythrocytes
Lactic Dehydrogenase - LDH
A regulatory protein found in striated muscles
Released in bloodstream when an infarction causes damage to the myocardium
increases in 4-6 hrs
peaks in 14-18 hours
remains elevated for 5-7 days
What Troponin level is most indicative of an MI?
Ferrous globin complex in striated muscle
responsible for red color of the muscle and its ability to store oxygen.
Damage to striated muscle causes release
What is the earliest marker for an MI?
Found in the ventricles of the heart, Increases in serum when V filling pressures are high (CHF)
Serum levels increase BEFORE ct has symptoms
affected by kidney dzz, dialysis, diuretics and cardiac glycosides
BNP B-Natriuretic peptide
< 100 pg/ml
The ____________ BNP level the higher the chance of Heart Failure
Protein manufactured in the liver and smooth muscle cells with coronary arteries.
Research showing it is an independent predictor of MI, stroke, PAD, and sudden cardiac death
The _____________ the C-reactive protein the higher the risk
An enzyme that helps with the digestion of starch
found in salivary glands and pancreas
Run as STAT test with acute abd pain
measured in both serum and urine
Serum Amylase norm
Normal Urinary amylase
4 - 400 U/L
Serum amylase is combined with __________ and imaging (CT, or ultrasound) to diagnose
Remains elevated in urine for as long as 2 weeks after an episode.
usually collected over a 2 - hour period or sometimes a 24-hour urine
Pancreatic enzyme that breaks down fat into glycerol and fatty acids
Elevated in acute pancreatitis but later than amylase