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Where does CK come from? and what do elevations in CK mean?
- Muscular tissue
- Elevations - IM/IV injections or muscular activity
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Normal CK
M/W
- Men - 60-400
- Women - 40-150
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List where CK 1,2,&3 are found.
- 1. BB Brain tissue and smooth muscle
- 2. MB Heart tissue
- 3.MM Muscle tissue
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How log does it take for enzymes to leave the bloodstream?
<24 hours
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Ratio of CK MB to total CK.
CK index
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When is the probability of an MI when looking at CK index?
CK-MB is > 5 and CK index is >4 = MI
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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.
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Normal CK - MB
Normal CK index
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Enzyme that helps remove a water molecule from lactic acid.
Found in large amounts in the heart, liver, muscles and erythrocytes
Lactic Dehydrogenase - LDH
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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
Troponins
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What Troponin level is most indicative of an MI?
T
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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
Myoglobin
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What is the earliest marker for an MI?
Myoglobin
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Normal Myoglobin
50-120 u/ml
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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
-
-
The ____________ BNP level the higher the chance of Heart Failure
Higher
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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
C-reactive protein
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The _____________ the C-reactive protein the higher the risk
higher (>3)
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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
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Serum Amylase norm
Normal Urinary amylase
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Serum amylase is combined with __________ and imaging (CT, or ultrasound) to diagnose
lipase
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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
Urinary Amylase
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Pancreatic enzyme that breaks down fat into glycerol and fatty acids
Elevated in acute pancreatitis but later than amylase
40-375 U/L
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