Explain the variance between the two sets of labs. In your explanation, tell how the various enzymes are used to distinguish between MI, liver disease, pulmonary disease, etc
LDH: normally, serum contains more LDH2 than LDH1 . Damage to tissues rich in LDH1 causes the ratio to reverse. This reversal is an important diagnostic finding that occurs whether or not total LDH is elevated. In MI, the LDH1 to LDH2 ratio returns to normal within a week, even though total LDH may remain elevated.
The different fractions of LDH are found in different concentrations in various tissues. If those tissues are damaged to the point of cellular rupture, the enzymes are released into the blood and become elevated. By knowing which tissues are high in the various enzymes, tissue damage can be determined by analyzing the serum. For example: the heart and RBC are rich sources of LDH1 and LDH2; the brain is a source of LDH1, LDH2, and LDH3; the kidneys, LDH3 AND LDH4, etc. The fractions of CPK vary in the same manner with CPK2 being elevated with MI. ALT levels are only slightly elevated with MI but very sensitive to liver damage. AST may be elevated 5 x normal with MI.
You might also like to view...
A 22-year-old man has come to a Veterans Administration clinic following a tour of duty in Iraq. He complains of uncontrollable anger and states that he "hates himself and is depressed because of a recent arrest for a fight in a tavern."
The nurse suspects the man will be diagnosed with: A) Situational depression B) Posttraumatic stress disorder C) Schizophrenia D) Acute depression
Which of the ECG findings would be positive for an inferior wall MI?
a. ST segment depression in leads I, aVL, and V2 to V4 b. Q waves in leads V1 to V2 c. Q waves in leads II, III, and aVF d. T-wave inversion in leads V4 to V6, I, and aVL
The student nurse is preparing to perform a rapid assessment as the more experienced nurse observes. Which of the following statements by the student nurse indicate that further education is required?
1. "The rapid assessment should last approximately 10 minutes.". 2. "I should perform a rapid assessment for all of my assigned clients at the beginning of the shift to help me prioritize care.". 3. "The rapid assessment will help me establish baseline data about the client.". 4. "After I perform the rapid assessments on the clients I've been assigned, I can go back and get more information during my routine assessments.".
A nurse is conducting a teaching session to adolescents about Crohn's disease. Which statement, made by the nurse, is the most accurate?
a. Crohn's disease is responsive to dietary modifications. b. Crohn's disease can occur anywhere in the gastrointestinal tract. c. Edema usually accompanies this disease. d. Symptoms of Crohn's disease usually disappear by late adolescence.