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Lipid Profile
Lipid Profile :
1. 2. 3. 4. 5. 6. 7. LDL Cholesterol Cholesterol VLDL Cholesterol HDL Cholesterol Triglycerides Cholesterol/HDL ratio LDL /HDL ratio
Indications:
1. 2. 3. 4. 5. 6. 7. CAD Family history Obesity Hypertension Diabetes Renal diseases Liver diseases Thyroid related disorders
Lipase
Glycerol kinase
Peroxidase Indicator
TAG ---------> FA + Glycerol ----------------> G3P -----------------------> DHAP +H2O2 --------------> red color
Where LDLC= LDL cholesterol, HDLC = HDL Cholesterol, TC =total cholesterol and TG= triglycerides
Normal Values: HDL Male: >45 mg/dl or >0.75 mmol/l (SI units) Female: >55 mg/dl or >0.91 mmol/l (SI units)
Hypercholesterolemia Primary hyperlipoproteinemia Atherosclerosis Myocardial Infaraction Diabetes melitis Hypothyroidism Obstructive jaundice
Hypocholesterolemia Familial hypobeta l ipoproteinemia Hyperthyroidism Pernicious anemia Hemolytic jaundice Severe malnutrition
LDL/HDL ratio: Risk Level Low risk 3.3 4.4 Average risk 4.4 - 7.1 Moderate risk <6 High risk <7
LDL/HDL Ratio
Cholesterol concentration?
A patient's blood sample was processed for cholesterol estimation as per the above protocol. Following data were observed. Absorbance of the sample was 0.32, absorbance of the standard was 0.4, and the conc. of standard was 200 mg/dl. Determine the concentration of cholesterol in patients blood.
Cardiac Markers
1. Proteins that leak out of fatally injured myocytes i. Myoglobin ii. MB fraction of Creatine Kinase (CK-MB) iii. Troponins T and I iv. Lactate dehydrogenase (LDH) v. Aspartate Aminotransferase (AST) or SGOT 2. The rate of appearance of these markers depends on: i. Intracellular location and molecular weight ii. Blood flow and lymphatic drainage of area of infarct iii. Rate of elimination of marker from the blood
Quantitative estimation: CK-MB Based on rate of formation of ATP per unit time
Immunological Method:
Principle: Ck activity is measured in the presence of antibody (Ab) against CK-M monomer. This Ab completely inhibits the activity of CK-MM and half of CK-MB; while not affecting the B subunit activity in CK-BB or CK-MB. We use the ordinal CK method to quantitatively determine CK-B activity. The CK-MB activity is obtained by multiplying the CK-B activity by two
AST activity in Serum Quantitative determination Kinetic Method: change of rate of absorbance per unit time Principles:
The rate of NADH+ formation is indicated by increasing absorbance at 340nm and is directly proportional to serum LDH activity
Markers
Rises
Peaks
Duration
Specificity
Clinical significance
Myoglobin
1-2 hrs
6-8 hrs
1 day
NS
Very early D
CPK
4-6hs
12-24hrs
4-5days
NS
Early D
4-6hs 6hs
4-5days 5days
S NS
Early D Early D
cTnI
3-6 hs
24-48 hrs
3-5 days
Early D
cTnT
3-6 hs
24-48 hrs
10-14 days
Early D, FU
LDH
8-12hs
72-144 hs
14days
NS
FU
O- 4 hrs MI: Myoglobin is released 4- 48 hrs: CPK, CK-MB , cTnI, cTnT , AST > 48 hrs: LDH, cTnT