Clinical Chemistry Exam 1 Lecture 4 – Flashcards

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question
What is the reference range for the total protein in the plasma?
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6.5-8.5 g/dL
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There are more than ______ proteins identified so far
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500
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List the 9 Mechanisms that control protein levels in plasma:
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Nutrition
Liver function
Renal function
Metabolic errors
Disease
Blood Loss
Hemolysis
Burns
Dehydration
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Globulin
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All proteins except Albumin
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How do you calculate Globulin?
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Globulin = Total protein - Albumin
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Prealbumin
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Transports thyroid hormones T3 and T4, and Vit A
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What is the half life of Prealbumin?
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2-3 days
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Albumin
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Maintains osmotic pressure (80%)
Carrier for bilirubin, fatty acids, Ca, Mg, drugs, and other substances
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Which Plasma Protein is in the highest concentration?
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Albumin
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Antitrypsin (alpha 1)
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Neutralizes elastase enzymes released from neutrophils
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If unchecked what will Elastin cause?
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Structural damage to alveoli
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What will a deficiency in Antitrypsin lead to?
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Emphysema (as early as age 20) and cirrhosis
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Fetoprotein (alpha 1)
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Hepatocellular tumor marker
Low amounts and no purpose in adult serum
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What are High levels of Fetoprotein in amniotic fluid and maternal serum consistent with?
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NTDs
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Haptoglobin (alpha 2)
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Binds free hemoglobin after cell lysis to prevent loss into the urine.
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What organ recycles the iron and amino acids after RBCs have been lysed?
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Spleen
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Low levels of Haptoglobin is often associated with?
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Hemolytic anemia
Transfusion reactions
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Increased levels of Haptoglobin is often associated with?
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Inflammation (acute phase protein)
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"Acute phase reactants"
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Increase in response to tissue injury
General and non-specific
Act to destroy or inhibit microbes
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The following are all considered what type of reactants?
CRP, A1AT, Haptoglobin, Fibrinogen, C3, C4, others
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"Acute phase reactants"
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What is the reference range of Urinary proteins?
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100-250 mg/24 hours
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Microalbumin in the urine is an early indicator of what?
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diabetic neuropathy
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Bence Jones Protein (free light chains) may occur in what disease?
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Multiple Myeloma
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What protein produced in tubules is the basic matrix of urinary casts?
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Tamm-Horsfall protein
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What is the reference range or CSF Proteins?
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15-45 mg/dL (1/200 of plasma level)
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Cerebrospinal fluid proteins
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Indicates either increased permeability of the blood-brain barrier or increased production within the Central Nervous System
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CSF IgG Index
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Determines the source of an elevated CSF IgG protein
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Formula for the CSF IgG Index
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(CSF IgG x Serum albumin) / (Serum IgG x CSF albumin)
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In what type of diseases will you see a nonspecific elevation of CSF Proteins?
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Meningitis
Traumatic Tap
Multiple Sclerosis
Others
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What is the reference range of the CSF IgG index?
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0.3-0.8
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If the CSF IgG Index is >0.8 what does this indicate?
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Increased IgG production within the CSF
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If the CSF IgG Index is >0.8 what is this consistent with?
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Multiple Sclerosis
Some bacterial infections and inflammatory diseases
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Ceruloplasmin (alpha 2)
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Transports plasma copper
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What does decreased copper cause?
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Anemia
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Wilson's disease:
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Low ceruloplasmin causes accumulations of copper in skin, liver, brain, and cornea. Cirrhosis, neurologic damage, and Kayser-Fleischer rings
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Beta 2 Microglobulin
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Present on the surface of all white cells, especially lymphs.
At the time of diagnosis, levels reflect stage of disease and likely prognosis
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Overproduction of what causes increased levels of Beta 2 Microglobulin?
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WBCs
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High levels of what in HIV indicate the virus is killing lymphs?
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Beta 2 Mircoglobulin
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What do high levels of Beta 2 Microglobulin after kidney transplants indicate?
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Possible organ rejection
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Transferrin (Beta)
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Transports plasma iron to storage sites and bone marrow
Prevents loss of iron into urine
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When Transferrin is increased what is often associated with?
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Iron Deficiency Anemia
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Complement (Beta)
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A group of proteins that bind to ag-ab complexes to cause cell lysis
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What does a decrease in Complement cause?
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Increased susceptibility to infections
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What is Complement decreased in?
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SLE
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Firbinogen (Beta)
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Forms a fibrin clot when activated by thrombin
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Is Fibrinogen seen in serum?
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No, because it is used up in the clotting process
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When Fibrinogen is increased what is potentially happening?
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Inflammation
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C-Reactive Protein (Beta)
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Non specific
Inflammatory conditions: tissue necrosis, infections, AMI, rheumatoid arthritis
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HS-CRP
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Predictor for risk of heart attack and stroke.
Requires high-sensitivity testing methods
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Immunoglobins (delta)
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Synthesized in plasma cells in response to antigens
IgG, A, M, D, E
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Monoclonal increases in Immunoglobulins are consistent with which 2 diseases?
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Multiple Myeloma
Waldenstrom's
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Myoglobin and Troponin - cardiac markers
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Skeletal and cardiac muscle proteins
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True or False:
The degree of elevation of Myoglobin and/or Troponin may be indicative of the extent of cardiac damage
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True
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