Clinical Chemistry Exam 1 Lecture 4 – Flashcards
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| 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 |
