What do triglycerides consist of? How are triglycerides metabolised for storage in adipose tissue?
What do triglycerides consist of? How are triglycerides metabolised for storage in adipose tissue?
List the five major lipoproteins (based on density) that transport cholesterol and triglycerides in the blood. What are the major components of each lipoprotein? Write one sentence for each lipoprotein to summarise its function.
What is the relationship between cholesterol levels and coronary heart disease (discuss good and bad cholesterol)? What pattern of lipid profile is associated with good cardiovascular health?
Summarise the role of treating hyperlipidaemia in relationship to cardiovascular disease (see NICE guidelines https://www.nice.org.uk/guidance/cg181). Suggest maximum 400 words.
What is the definition of Acute Coronary Syndrome (ACS) and what are the diagnostic criteria?
List the treatment options for patients presenting with ACS (maximum 10 options) and a brief explanation of the role/benefit of the treatment.
What is Chronic Heart Failure and how is it diagnosed and classified? What are the treatment options for heart failure and what is the prognosis?
What are the modifiable and non-modifiable risk factors for cardiovascular disease?
7.8b Diagnosis of Cardiovascular Disease
What do GPs use to assess cardiovascular risk in a patient? What variables are required to complete these risk calculations?
What are the risks of increased triglyceride levels in relation to cardiovascular disease and what are the other potential complications of increased triglycerides?
What effects do the following factors have on lipid profile:
a)Sex
b)Age
c)Aerobic exercise
d)Obesity
e)Alcohol intake
f)Oestrogens e.g. oral contraceptive pill
What are the major causes of secondary hyperlipidaemia?
What are the features of familial hypercholesterolaemia? What is the underlying pathophysiology? What are the treatment options?
In our laboratory, what are the assay principles for the following analytes:
a)Cholesterol
b)Triglycerides
c)HDL cholesterol
What are the limitations of each of these assays?
List the sample requirements for each assay.
How do we calculate LDL cholesterol? What are the limitations of this method for estimating LDL? What methods are available for measuring LDL cholesterol e.g. in research laboratories?
List three other proposed markers for cardiovascular disease and describe the potential benefits and limitations of each marker.
7.8c Diagnosis of Acute Coronary Syndrome
Name two analytes that can be used in the diagnosis of Acute Coronary Syndrome (ACS). What factors have influenced the choice of marker used to diagnose ACS (e.g. discuss the role of serial measurements of these markers).
Write about the metabolic role of creatine kinase (suggest max five sentences describing the location of CK isoenzymes, functions of CK and possible reasons for elevated CK).
What is an isoenzyme?
Discuss the physiological role of the troponins and describe their structure (diagrams will help)
New algorithms for diagnostic use of troponin are being developed. Discuss the effect of high sensitivity troponin testing on these algorithms. What benefits can you think of for the patients/Emergency Department? (Hint: look up high sensitivity troponin and the Edinburgh Cardiovascular Centre)
What role does the laboratory play in the diagnosis, treatment and prognosis of a patient presenting with chest pain?
What are the analytical principles of our laboratorys cardiac troponin assay? What are the limitations of this assay?
What are the analytical principles of our laboratorys CK assay? What assays are available in other laboratories for measuring CK-MB?
What is copeptin? Write a few sentences about the physiology of copeptin and how it might be used in the assessment of ACS.
7.8d Diagnosis of Chronic Heart Failure
What are the causes of heart failure?
What are the symptoms and clinical signs of heart failure?
Describe the structure and physiological role of BNP.
What is the meaning of clinical sensitivity and clinical specificity?
What is the role of POCT BNP testing in patients with heart failure?
What are the sample requirements for BNP analysis? What are the analytical principles of the BNP assay? What are the limitations of the BNP assay?
Write a few sentences about NT-proBNP and what benefits it might offer compared with BNP analysis. What assays are available to measure NT-proBNP?