Nur 412 Exam 1 Practice Questions and
Answers
Cardiac biomarkers definition ✅When cells are injured they release their contents,
including enzymes and other proteins, into circulation. These are useful in the diagnosis
of ACS
Cardiac-specific troponin ✅heart muscle protein released into circulation after injury or
infarction
Two types of cardiac specific troponin ✅_troponin T (cTnT)
-Troponin I (cTnI)
When do cardiac specific troponin levels rise? ✅Myocardial infarction or injury
-Detectible within hours (avg of 4-6), peak within 10-24 and can be detectible for up to
14 days
Specific CK heart biomarker ✅CK-MB
When does CK-MB rise? ✅Specific for MI injury
-Levels begin to increase 3-6 hours after symptom onset, peak in 12-24, and are back
to baseline within 12-48 hours after MI
Myoglobin ✅lacks specificity for MI and usefulness in diagnosing MI is limited
When does myoglobin rise? ✅sensitive indicator of very early MI
What does C-reactive protein measure? ✅produced by the liver during periods of
acute inflammation
When does CRP rise? ✅increased levels have been linked with the presence of
atherosclerosis and the first occurrence of a cardiac event.
What is hemocyseine ✅AN amino acid that is produced during protein catabolism
Higher levels of hemocyseine have been linked to what? ✅Higher risks of CVAD,
peripheral vascular resistance, and stroke
-Test for this when family predisposition for early CVD or a history of CVD in absence of
other common risk factors
Cardiac Natriuretic Peptide Markers ✅-Atrial natriuretic peptide (from thr atrium)
, -B-type natriuretic peptide (From the ventricles) Heart failure
-C-type natriuretic peptide (from endothelial and renal epithelial cells)
What is the marker of choice for distinguishing a cardiac or respiratory cause of
dyspnea? ✅BNP
Normal BNP level ✅<100 pg/mL
low-density lipoprotein (LDL) ✅bad cholesterol
Normal LDL levels ✅<100 mg/dL
HDL (High Density Lipoprotein) ✅good cholesterol
Normal HDL levels ✅÷<40
When is statin therapy recommended ✅-Pts with known CVD
-LDL cholesterol >190
-Age 40-75 w/ diabetes and LDL 70-189
-Age 40-75 with LDL 70-189 and 10 year risk for CVD at least 7.5%
Category of drugs that restrict lipoprotein production ✅HMG-CoA reductase inhibitors:
Statins
What do statins do? ✅Inhibit cholesterol synthesis, decrease LDL, increase HDL, and
lower CRP
What is the most potent statin and what are the risks ✅Rosuvastatin (Crestor)
Serious adverse effects (rare): Liver damage (liver enzymes) and myalgia
Niacin ✅Used in care for CAD
-Reduces LDL and triglycerides by inhibiting synthesis
-Increases HDL
-Side effects: flushing, pruritis, GI symptoms, orthostatic hypotension
Gemfibrozil (Lopid) ✅Used in care of CAD
-Reduces triglycerides, increases HDL
-Increases bleeding with warfarin and effects of antihyperglycemic drugs (repaglinide)
Ezetimibe (Zetia) ✅Used in care of CAD
-Decreases absorption of dietary biliary cholesterol; COMBINE with statins
Clopidogrel (Plavix) ✅Used in care of CAD
-Antiplatelet therapy
Answers
Cardiac biomarkers definition ✅When cells are injured they release their contents,
including enzymes and other proteins, into circulation. These are useful in the diagnosis
of ACS
Cardiac-specific troponin ✅heart muscle protein released into circulation after injury or
infarction
Two types of cardiac specific troponin ✅_troponin T (cTnT)
-Troponin I (cTnI)
When do cardiac specific troponin levels rise? ✅Myocardial infarction or injury
-Detectible within hours (avg of 4-6), peak within 10-24 and can be detectible for up to
14 days
Specific CK heart biomarker ✅CK-MB
When does CK-MB rise? ✅Specific for MI injury
-Levels begin to increase 3-6 hours after symptom onset, peak in 12-24, and are back
to baseline within 12-48 hours after MI
Myoglobin ✅lacks specificity for MI and usefulness in diagnosing MI is limited
When does myoglobin rise? ✅sensitive indicator of very early MI
What does C-reactive protein measure? ✅produced by the liver during periods of
acute inflammation
When does CRP rise? ✅increased levels have been linked with the presence of
atherosclerosis and the first occurrence of a cardiac event.
What is hemocyseine ✅AN amino acid that is produced during protein catabolism
Higher levels of hemocyseine have been linked to what? ✅Higher risks of CVAD,
peripheral vascular resistance, and stroke
-Test for this when family predisposition for early CVD or a history of CVD in absence of
other common risk factors
Cardiac Natriuretic Peptide Markers ✅-Atrial natriuretic peptide (from thr atrium)
, -B-type natriuretic peptide (From the ventricles) Heart failure
-C-type natriuretic peptide (from endothelial and renal epithelial cells)
What is the marker of choice for distinguishing a cardiac or respiratory cause of
dyspnea? ✅BNP
Normal BNP level ✅<100 pg/mL
low-density lipoprotein (LDL) ✅bad cholesterol
Normal LDL levels ✅<100 mg/dL
HDL (High Density Lipoprotein) ✅good cholesterol
Normal HDL levels ✅÷<40
When is statin therapy recommended ✅-Pts with known CVD
-LDL cholesterol >190
-Age 40-75 w/ diabetes and LDL 70-189
-Age 40-75 with LDL 70-189 and 10 year risk for CVD at least 7.5%
Category of drugs that restrict lipoprotein production ✅HMG-CoA reductase inhibitors:
Statins
What do statins do? ✅Inhibit cholesterol synthesis, decrease LDL, increase HDL, and
lower CRP
What is the most potent statin and what are the risks ✅Rosuvastatin (Crestor)
Serious adverse effects (rare): Liver damage (liver enzymes) and myalgia
Niacin ✅Used in care for CAD
-Reduces LDL and triglycerides by inhibiting synthesis
-Increases HDL
-Side effects: flushing, pruritis, GI symptoms, orthostatic hypotension
Gemfibrozil (Lopid) ✅Used in care of CAD
-Reduces triglycerides, increases HDL
-Increases bleeding with warfarin and effects of antihyperglycemic drugs (repaglinide)
Ezetimibe (Zetia) ✅Used in care of CAD
-Decreases absorption of dietary biliary cholesterol; COMBINE with statins
Clopidogrel (Plavix) ✅Used in care of CAD
-Antiplatelet therapy
