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Cardiovascular Diagnostic Tests & Procedures
Chapter 8 Exam 1
96
Medical
Graduate
02/13/2012

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Term
Proportion of those individuals with the dz who have a true positive test
Definition
Sensitivity
Term
Proportion of those indiviudals without the dz qith a true negative test
Definition
Specificity
Term
Proportion of individuals who had a positive test and actually have the dz
Definition
Positive predictive value
Term
Proportion of individuals who had a negative test and truly do not have the dz
Definition
Negative predictive value
Term
Looked at in patients who are suspected to have MI or some type of heart problem
Definition
Serum Enzymes and Cardiac Biomarkers
Term
Serum enzymes and cardiac biomarkers contribute to a definitive diagnosis of what?
Definition
Myocardial necrosis
Term
Name 7 serum enzymes and cardiac biomarkers
Definition
Creatine Phosphokinase
Troponin
Myoglobin
Carbonic Anhydrase III
Cardiac Myosin Light Chains
Lactic Dehydrogenase
Aspartate Aminotransferase
Term
What is CPK-MB
Definition
Myocardial
Term
What is CPK-MM
Definition
Skeletal muscle
Term
What is CPK-BB
Definition
Brain Tissue
Term
__ assessment is considered the gold standard for cardiac injury
Definition
Troponin
Term
Name 4 facts about blood lipids
Definition
1. Hyperlipidemia - a major risk factor
2. Serum cholesterol & Triglycerides
3. Associated with ingestion of excess amounts of saturated fat and cholesterol
4. Breakdown consists of total cholesterol, HDL, LDL, and ratio of total to HDL
Term
What is the worst case scenariod
Definition
High LDL and/or high triglycerides
Term
A type of amino acid found in blood; when elevated it is linked to cardiovascular dz. Elevated level is >13
Definition
Homocysteine
Term
Are low levels of folate and vitamin B good or bad?
Definition
Bad. They are risk factors for CAD
Term
Name 5 potential clinical lab risk factors for CAD
Definition
1. Elevated Homocysteine
2. Low Folate and Vitamin B
3. Fibrinogen and elevated WBC
4. Highly sensitive C-reactive protein
5. BNP
Term
What is normal, average, and high risk levels of C-reactive protein?
Definition
Normal = <1.0
Average = 1.0-3.0
High = >3.0
Term
A protein produced by the ventricles of the heart, important in the diagnosis of heart failure.
Definition
BNP (B-type natriuretic peptide)
Term
What 3 things should be evaluated in a complete blood cell count
Definition
Hemoglobin
Hematocrit
WBC
Term
What value of hemoglobin is a red flag for out of bed activities
Definition
<8g/100ml
Term
This is monitored for body's response to infectious dz
Definition
WBC
Term
What is the term for elevated WBC
Definition
Leukocytosis
Term
What is the term for decreased WBC
Definition
Leukopenia
Term
What 2 things measure the coagulation of blood
Definition
Prothrombin Time
Partial Thromboplastin Time
Term
Why do you care to watch PT and PTT levels in pt after heart surgery?
Definition
Be careful no to get too thin due to easy bruising or have bleeding with mild cut. Don't want it to get too high because they can get a DVT while bedridden
Term
Target of 3 (post MI) and 2.5-3.0 (other clotting problems)
Definition
International Normalized Ratio (INR)
Term
An increase in this is most commonly related to increased numbers of neutrophils, lymphocytes, eosinophils, or monocytes.
Definition
WBC
Term
A decrease in this is usually due to viral infections, bone marrow suppression, and chemotherapy
Definition
WBC
Term
An increase in this value may be due to acute infections or tissue breakdown
Definition
Neutrophils
Term
An increase in this may be due to a chronic bacterial infection, viral infection, or lymphocytic leukemias
Definition
Lymphocytes
Term
A decrease in this may be due to stress situations, corticosteroid use, or chemotherapy
Definition
Lymphocytes
Term
An increase in this value can be due to TB, viral infections, or chronic inflammatory disorders
Definition
Monocytes
Term
What is the job of a monocyte?
Definition
to gobble up stuff in the tissues
Term
Why might monocyte levels be decreased?
Definition
Aplastic anemia, lymphocytic leukemias
Term
Why might eosinophil levels be increased?
Definition
Alergic reactions, eczema, parasitic infections, leukemia, or autoimmune diseases
Term
Why might eosinophil levels be decreased?
Definition
Stress situations, acute infections, or sepsis
Term
Why might basophil levels be increased?
Definition
Leukemia or inflammatory processes
Term
Long term corticosteroid use may do what?
Definition
Decrease bone density and immunity
Term
Decreased basophil levels may be due to what?
Definition
Stress reactions, hypersensitivity reactions, or corticosteroids
Term
High does high altitude levels increase RBC?
Definition
Because you need to produce more RBC to accommodate
Term
Occurs when blood cells get thick and there is an increased risk for clots. Pt may need to get blood taken from them regularly
Definition
Polycythemia Vera
Term
What might cause RBC to be elevated?
Definition
Dehydration, high altitude, polycythemia vera, or cardiovascular dz
Term
What might cause RBC to be decreased?
Definition
Anemias, hemorrhage, or marrow failure
Term
Why might there be an increase in platelets?
Definition
Malignancy, collagen disorders, or acute infections
Term
What is thrombocytopenia a sign of?
Definition
Decreased platelets
Term
What might be the cause of prolonged PT?
Definition
Anticoagulation therapy, liver dz, or decreased Vitamin K
Term
What might cause decreased PT?
Definition
Vitamin K supplementation
Term
What might cause prolonged PTT?
Definition
Anticoagulation therapy, liver dz, decreased vitamin K
Term
When might a person have a decreased PTT?
Definition
Immediately after acute hemorrhage
Term
Name 3 electrolytes
Definition
Potassium
Sodium
Carbon Dioxide
Term
Dehydration means decreased what?
Definition
Electrolytes
Term
Why do we need electrolyte levels testes?
Definition
To check hydration state, medications, and dz
Term
What are normal BUN levels?
Definition
8-23 mg/dl
Term
What 2 things might BUN indicate?
Definition
Heart or renal failure
Term
Why is BUN unsuitable as a single measure for renal disease?
Definition
It could be elevated due to heart failure
Term
What value tells mainly about renal failure?
Definition
Creatinine
Term
What are normal creatinine levels?
Definition
<1.5 mg/dl
Term
What causes elevated Bilirubin?
Definition
Hepatic cellular damage, biliary obstruction, and prolonged fasting
Term
What causes decreased bilirubin?
Definition
Drugs (barbituates)
Term
What causes increased BUN?
Definition
Renal failure, GI bleed, acute MI, stress
Term
What can cause a decrease in BUN?
Definition
Diuresis, low protein/high carb diet, or impaired absorption
Term
What may cause elevated BNP?
Definition
CHF, LV dysfunction, or cardiomyopathy
Term
What is BNP values correlated to?
Definition
Level of CHF
Term
What can cause elevated Glycosylated Hemoglobin?
Definition
DM with poor blood sugar control
Term
Name the causes for elevated calcium.
Definition
Hyperparathyroidism, Vitamin D intoxication, acute osteoporosis
Term
What might cause decreased calcium levels?
Definition
Hypoparathyroidism, malabsorption of calcium and vitamin D
Term
What might cause increased chloride levels?
Definition
Metabolic acidosis due to prolonged diarrhea or renal dz
Term
What might cause decreased chloride levels?
Definition
Prolonged vomiting or NG suction, salt losing renal dz, or water intoxication
Term
What may cause increased PotassiuM?
Definition
Impaired excretion or decreased blood volume
Term
What can cause decreased potassium?
Definition
Diuretics, GI loss, severe eating disorders
Term
Normal amount of WBC
Definition
4,000-11,000
Term
What % of neutrophils make up WBC
Definition
50-70%
Term
What % of lymphocytes make up WBC?
Definition
20-10%
Term
What % of monocytes make up WBC?
Definition
1-6%
Term
What % of eosinophils make up WBC?
Definition
less tahn 3%
Term
What % of basophils make up WBC?
Definition
<1%
Term
What would a persons WBC count be if they had leukopenia?
Definition
<4000
Term
There are risks of bleeding complications in ___ patients that can include intracranial bleeding, intra-articular bleeding, hematomas, and others. This pt would be recommended to do less vigorous activity with levels of 50,000-100,000 and no therapy or exercise with levels below 20,000.
Definition
Thrombocytopenic
Term
What is the platelet count for thrombocytopenia?
Definition
100,000 - 150,000
Term
What would a pts RBC count be if they had polycythemia?
Definition
>5.1-5.5
Term
What does pancytopenia mean?
Definition
Abnormally low counts of RBCs, all WBC types, and platelets
Term
A continuous 24 hour electrocardiographic monitoring of a patient's heart rhythm. Essential to the diagnosis and management of episodes of cardiac arrhythmias and symptoms. Patient's demonstrating life-threatening arrhythmias while on this monitor may be referred to electrophysiological ventricular tachycardia (EPS)
Definition
Holter Monitoring
Term
This diagnostic test uses pulse reflected ultrasound to evaluate the functioning of the heart. It provides real time images of the beating heart.
Definition
Echocardiography
Term
What information can be derived from an echocardiography?
Definition
Size of ventricular cavity, thickness and integrity of interatrial and intraventricular septa, functioning of valves, motions of individual segments of ventricular wall
Term
This diagnostic test quantifies volumes of left ventricle, estimates SV and EF
Definition
Echocardiography
Term
This may be done on large patients to improve the view of the heart and mediastinum. It also may help in the diagnosis of mitral valve prolapse.
Definition
Transesophageal echocardiography (TEE)
Term
This diagnostic test uses an intravenous contrast agent with echocardiogram. It assesses myocardial perfusion and ventricular chambers. It may be used with TEE or epicardial echocardiography to assess distribution of cardioplegia and degree of valvular regurgitation
Definition
Contrast Echocardiography
Term
A nuclear technique that provides visualization and direct measurement of metabolic functioning. It is the gold standard for blood flow measurement. It is costly, used a lot to diagnose cancer, and can detect jeopardized but viable myocardium without exercise.
Definition
PET Scan (Positron Emission Tomography)
Term
This diagnostic test is used to identify masses in cardiovascular system or to detect aortic aneurysms or pericardial thickening.
Definition
CT Scan (Computed Tomography)
Term
This diagnostic test is used to detect and quantify myocardial perfusion defects and contractility defects. It is used in conjunction with radioactive isotopes that may be injected or taken orally.
Definition
Single-Photon Emission CT
Term
This diagnostic test is used to detect calcium in coronary arteries and quantify coronary atherosclerosis. Patients with coronary calcifications may identify those high risk for future MI and CAD. This test may be performed if the pt is symptomatic or has angina.
Definition
Electron Beam CT
Term
This diagnostic test calculates left ventricular ejection fraction. It is non-invasive and can be used on critically ill cardiac pts
Definition
Multigated Acquisition Imaging
Term
This diagnostic test is used to evaluate morphology, cardiac blood flow, and myocardial contractility. It has similar accuracy to the PET scan but is more available and less expensive.
Definition
MRI (magnetic resonance imaging)
Term
This diagnostic test uses magnetic and radio wave energy to take pictures of blood vessels.
Definition
MRA (magnetic resonance angiogram)
Term
What does decreased EF mean?
Definition
Not getting enough blood flow to the rest of the body
Term
The middle ground between a person with CHF and waiting to get a transplant
Definition
LVAD (Left Ventricular Assistive Device)
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