cardiovasc syst, tumor markers, drugs, electrophoresis

CK-MB, TnI, TnT, hsTn

markers to diagnose ACS/AMI

BNP, NT-proBNP

markers to differentiate heart failure from lung disease

TnI, TnT, BNP, NT-proBNP, D-dimer

markers to diagnose PM or risk

TnI, TnT, hs CRP, homocystine

markers for cardiovascular injury risk

LD, myoglobin

markers no longer used or are experimental

exogenous TG (85)

major component of chylomicrons

B48

chylomicron Apo marker

chylomicrons

-Apo B48

-85% exogenous TGs

-intestine

-dietary lipids to cells

VLDL

-Apo B100 (E, C)

-50% endogenous TGs

-liver

-TGs to tissues

-sample turbidity

endogenous TG (50)

major composition VLDL

B100 (E, C)

VLDL Apo marker

LDL (50-130)

-Apo B100

-62% cholesterol

-VLDL lipolysis product

-extravascular

-foam cells, fatty streaks, plaques

cholesterol (62)

major component LDL

B100

LDL Apo marker

HDL (40-75)

-Apo A1, A11, C

-50% prot

-removes cholesterol from peripheral cells

A1, A11, C

HDL Apo markers

protein (50)

major component HDL

Lp(a)

-LDL-like

-elevated levels inc clotting

-heart disease risk

-inhibits TPA

cholesterol/HDL

cardiac risk equation

ABCG5/8

enzyme lost in familial hypercholesterolemia

NPC1L1

enzyme lost in inherited dislipidemia with low plasma cholesterol

hCG

-testicular cancer maker

-also elevated in pregnancy

calcitonin

elevated in thyroid carcinoma

pheochromocytoma, paraganglioma, neuroblastoma

-marker is catecholamine metabolites in urine

-adrenal medulla or head/neck adenomas

aldosterone

elevated in Conn’s syndrome with adrenal adenoma

ACTH

-paraneoplastic syndrome

-Cushing’s syndrome (hypercortisolism)

-small lung carcinoma

Ca

-paraneoplastic syndrome marker

-not due to hyperPTH if symptomatic

-Ig marker for MM (bone breakdown)

5-HIAA, PCA

elevated in carcinoid syndrome

-excess serotonin production → metabolite in urine

-GI tumors

-lung tumors

AFP

-oncofetal Ag (glycoprot)

marker for

-hepatocellular carcinoma

-testicular/ovarian cancer

CEA

-oncofetal Ag (glycoprot)

-nonspecific marker for colorectal cancer

PSA

isoenzyme marker for prostate cancer

neuron specific enolase (NSE)

isoenzyme marker for lung and neuroblastoma

CA15-3, 27.29

mucin carb Ag marker for breast cancer

CA19-9

mucin carb Ag marker for pancreatic cancer with Le Ag

CA125

mucin carb Ag marker for ovarian cancer

min toxic concen

point where drug will produce adverse response

min effective concen

point where drug will produce desired resp

1 hr

time post dose with peak drug concen

trough

lowest drug concen, meas just before next dose

5

number of half lives to determine steady state concentration

Digoxin (Digitalis)

cardiac glycoside for CHF

Quinidine, Procainimide (NAPA)

antiarrhythmics

Phenytoin (Dilantin), Phenobarbitol (Primidone), Carbamazepine (Tegretol), Ethosuccimide (Zarontin)

antiepileptics

theophylline (caffeine)

antiasthmatic

cyclosporin, tacrolimus, sirolimus

immunosuppressants

gentamycin, kanamycin, tobramycin, amikacin

aminoglycosides

-oto and nephro toxic

aminoglycosides

broad spectrum antibiotics for GNB

vancomycin

broad spectrum antibiotic for GPB

-red man syndrome

Li, tricyclic antidepressants

psychoactive drugs

methotrexate

antineoplastic

-Leucovorin rescue

6-mam

heroin metabolite

ben

cocaine metabolite

NAPQI

acetominophen metabolite

THC

marajuanna metabolite

oligoclonal bands

feature of electropheresis of multiple sclerosis CSF

IFE

done with monoclonal peak on protein electrophoresis

-Waldenstrom’s vs MM

IgM

Waldenstrom’s immunoglobulin

IgG, IgA

multiple myeloma immunoglobs

nitrogen

component of proteins measured with Kjedahl method

pep bonds (purple)

component of proteins measured with Biuret method (color)

coomasie blue

protein-binding dye

refractometry

method of protein measurement that uses light bending

serum

sample for protein electrophoresis

nephrotic syndrome

electrophoresis graph has significantly dec albumin peak and inc a2

cirrhosis

electrophoresis graph has dec albumin, a1, a2 and a beta/gamma bridge

acute

electrophoresis graph of inflammation has inc a2

chronic

electrophoresis graph of inflammation has dec albumin and beta, inc a1, a2, gamma

a1 antitrypsin deficiency

electrophoresis graph has no a1

-seen with neonatal emphysema

hypogammaglobulinemia

electrophoresis graph has decreased gamma peak

GI loss

electrophoresis graph has dec all fractions

M spike

feature of electrophoresis graph in gamma region indicative of waldenstrom’s or mm

-need to do IFE

light chains (kappa, lambda)

detected using urine electrophoresis

-what Bence Jones proteins are in mm and waldenstrom’s